中国学校卫生

Enhancing school-based sexuality education to promote the development of students' physical and mental health

LIU Wenli, LI Jiayang

2023, 44(11): 1601-1605. doi: 10.16835/j.cnki.1000-9817.2023.11.001

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School-based sexuality education continues to face problems and challenges, such as schools are unable to carry out their main role in regards to the provision of sexuality education, a shortage of teachers specialized in teaching this subject and the absence of a separate and dedicated curriculum that focuses on comprehensive sexuality education teaching content. In order to promote school-based sexuality education, it is necessary to promote a comprehensive curriculum that enhances content relevance, while continuously improving and optimizing national policies on sexuality education by focusing on more accurate policy-making, refining implementation methods, and strengthening the synergistic effect of school-based sexuality education policies.

Technical guideline for school sanitary and anti-epidemic measures after flood disasters

WU Shuangsheng, SU Jianting, DONG Yanhui, XU Wenjie, XIA Zhiwei, CHEN Dongni, LI Shugang, SONG Yi, GUO Xin, YANG Peng

2023, 44(11): 1606-1609. doi: 10.16835/j.cnki.1000-9817.2023.11.002

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Flood disasters are the common public health emergencies, mainly leading to environmental damage, water pollution, food pollution, vector breeding, infectious disease epidemic and other risk factors of sanitary and anti-epidemic work. The guideline has been formulated with reference to the technical documents such as Guideline for Environmental Sanitation Disposal and Preventive Disinfection in Flooded Areas and Technical Proposal for Sanitary and Anti-epidemic Measures after Flood Disasters, as well as the latest research progress at home and abroad. In order to guide the sanitary and anti-epidemic measures in flooded areas, protect the health and safety of students and teachers and ensure the normal educational and teaching order, the guideline introduces the key measures that should be taken by schools, teachers and students in flood-striken areas.

The edification of Japanese nutrition health educators' degree system on the promotion of nutrition and health education in schools in China

CHEN Jili, ZHU Liyan, YU Jie, ZHANG Guanchao, YANG Min

2023, 44(11): 1610-1613. doi: 10.16835/j.cnki.1000-9817.2023.11.003

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Objective Through in-depth investigation into Japanese nutrition health educators' post content, configuration, training mode, advanced education practice and the difficulties, the paper explores the effective ways of integrating nutrition health education into the school health education teacher and curriculum system as well as health promotion, so as to guide teachers and students to establish a correct concept of health, enhance health literacy and develop a healthy lifestyle. Additionally, the paper aims at providing suggestions for the construction of nutrition and health school as well as the future development of nutrition health education in China.

Exploration of the policy structure of China's school sexuality education based on text analysis

MA Cheng, MAO Ju

2023, 44(11): 1614-1617. doi: 10.16835/j.cnki.1000-9817.2023.11.004

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Objective To explore the structural status of school sexuality education policies in China, so as to provide a reference to optimize their effectiveness and development. Methods A total of 45 policy documents closely related to school sexuality education, released at the national level, as samples in order to construct an analytic framework of policy objectives/instruments by analyzing their textual content. Results In terms of policy objectives, school sexuality education policies focused on educational methods guidance (32.76%), and tend to underestimate the evaluation of educational effects (5.17%) and the protection of teachers' and students' rights and interests (5.17%), while failed to consider the creation of educational environments (0). In regards to policy tools, school sexuality education policies often used command line tools (59.45%) and capacity building tools (29.71%), while the use of system change tools (2.70%) and incentive tools was lacking (0). In respect to the adaptability of policy objectives/tools, school sexuality education policies focused on using command based tools to guide educational methods (68.42%), educational process management (54.55%), student literacy improvement (38.46%), and educational resource development (37.50%). However, system change tools and incentive tools were scarcely used to achieve policy goals in education effectiveness evaluation, to protect teacher-student rights and interests, and to improve student literacy and comprehensive social governance. Conclusions There is some deviations in the positioning of policy objectives, the selection of policy tools, and the interaction and adaptation between the two in school sex education policies, and further improvement is needed.

Experience and associated factors of sexuality education among kindergarten and primary and secondary school teachers

LI Jiayang, LIU Wenli, LI Yiyang

2023, 44(11): 1618-1621. doi: 10.16835/j.cnki.1000-9817.2023.11.005

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Objective To investigate the experience, attitude and practice of sexuality education for teachers, so as to provide evidence for promoting sexuality education training for teachers and teaching ability improvement. Methods From September to October 2021, 2 146 valid data of kindergarten and primary and secondary school teachers across the country were collected. Associateds factors of teachers' sexuality education behavior were explored by Logistic regression analysis. Results Family and school-based sexuality education experiences were insufficient among teachers (22.51%, 46.55%), and the proportions of female teachers who had received sexuality education (20.44%, 41.67%) were significantly higher than that of male teachers (2.05%, 4.90%). Currently, 47.53% of the kindergartens and primary and secondary schools from participating teachers didn't carry out sex education, which mainly focused in the field of reproductive health and physical development. Kindergartens and primary and secondary schools often integrated sex education into other disciplines (64.48%, 47.83%). Teachers' acceptance of family and school-based sexuality education, students' willingness to communicate on sexual topics with teachers, teachers' confidence in answering sexual questions were positively correlated with teachers' teaching activities of sexuality education (OR=1.59, 1.37, 1.67, 1.67, P < 0.01). Conclusions Teachers' teaching ability of sexuality education is insufficient, and school-based sexuality education couldn't meet students-developmental needs. Providing sexuality education training to teachers and enhancing their confidence in answering sexual questions are helpful to facilitate sexuality education teaching activities.

Effectiveness of body image education curriculum in primary schools among grade 4-6 students

XU Haiyan, SONG Zihao, LIU Weiming, GOU Ping

2023, 44(11): 1622-1625. doi: 10.16835/j.cnki.1000-9817.2023.11.006

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Objective To analyze the effectiveness of body image education curriculum on grade 4-6 students of early adolescence in primary schools, so as to provide teaching pructice research eridence for promoting positive body image during adolescence. Methods A primary school in Chengdu was selected as an experimental school, who offered 6 projects, each project 1 class hour, each chass hour 40 minutes, an average of 1.5 weeks body image education curriculum (body changes during adolescent, values, physical appearance, gender diverity expression and aesthetic diversity). The other school had the same school district conditions, school size and nature, teachers and teaching environment, and had no body image education courses. A pre-test and post-test survey was conducted in April and May 2023 on students in grades 4 to 6 in both schools through the Body Image State Scale adopting cluster sampling. Results The pre-test scores of body image in experimental school and control school were (34.99±8.72) and (35.74±8.57) respectively, with no significantly statistical difference (t=-1.29, P>0.05). The post-test scores of body image in experimental school and control school were (37.09±10.40) and (35.70±8.78) respectivily. There was a significant difference in body image between pre-test and post-test scores in experimental school (t=-5.70, P < 0.01), while no significant difference in control school (t=0.13, P>0.05). There were significant differences in body image between pre-test and post-test scores among students of different BMI groups in experimental and control schools (F=16.01, 7.19, 9.64, 5.30, P < 0.01). Conclusions Body image education curriculum in early adolescence is beneficial for improving students' body satisfaction. To help students develop a positive body image in early adolescence, it is necessary to implement relevant curriculum education in schools as early as possible.

Physical health status and influencing factors of preschool children in Tibet

CHEN Ting, LIANG Meng, WANG Jiajuan, ZHAO Xin, CHENG Hong, DU Wenjuan, SUN Ruizhe

2023, 44(11): 1626-1630. doi: 10.16835/j.cnki.1000-9817.2023.11.007

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Objective To explore physical health status and influencing factors of preschool children in Tibet, so as to provide a scientific reference and theoretical basis for the healthy development of physical fitness. Methods Data were collected from children (3-6 years old) of Xizang national physical fitness monitoring, and a total of 1 521 preschool children were recruited who received questionnaire survey and physical fitness test. Independent sample t-test and one-way ANOVA were used to compare the differences in physical fitness indexes of preschool children in different groups. Chi-square test and binary Logistic regression model were used to analyze the factors affecting physical health of preschool children. Results The total qualified rate of physical fitness was 79.75%, among which the excellent rate was 3.16%, the good rate was 15.12%, the qualified rate was 61.47% and the unqualified was 20.25%. From the perspective of BMI, the excellent physical fitness rate (3.74%) and good physical fitness rate (17.47%) were highest in healthy weight preschool children, and the qualified physical fitness rate of overweight preschool children (69.03%) was higher than that of obese (55.88%) and healthy weight preschool children (60.68%)(χ²=53.56, P < 0.01). From the perspective of ethnic, Tibetan children's physique proficiency (3.69%), good rate (17.13%) than with the elevation of the Han nationality (0.74%, 5.88%), fraction defective (16.97%), lower than that of Han nationality (35.29%) (χ²=53.71, P < 0.01); The results of chest circumference, skinfold thickness, body fat percentage, tennis throw distance, continuous jump of both feet, sitting forward bend and balance beam walking of Tibetan children were higher than those of Han children, and the results of quiet heart rate and standing long jump were lower than those of Han children (t=2.72, 10.95, 9.66, 3.68, 3.88, 8.04, 3.56, 8.70, -4.39, -4.40, P < 0.01). Binary Logistic regression analysis showed that Tibetans (OR=2.29), breastfeeding (OR=1.51), body dynamics outdoor daily exercise duration 30-90 min (30- < 60 min: OR=2.03; 60-90 min: OR=2.22) were positively correlated with physical health of preschool children (P < 0.05). Conclusions The total physical qualification rate of preschool children aged 3-6 years old in Tibet is lower than the national average. Ethnic group, feeding pattern during infancy, and physical activity are all factors that affected the physical fitness of preschool children in Tibet. It is of great significance to improve the physique of preschool children in Tibet to promote their sustainable and healthy development.

Milk consumption behavior and its impact on bone mineral density among 696 pupils in Hainan Province

ZHONG Chengwang, YANG Bin, FENG Qiqin, ZHAO Chanjuan, GUO Jingyue, ZHANG Tao, CHENG Qiuyun, ZHANG Fan

2023, 44(11): 1631-1635. doi: 10.16835/j.cnki.1000-9817.2023.11.008

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Objective To investigate the milk-drinking behavior and bone mineral density level of pupils in Hainan Province, and to explore the correlation between bone mineral density and milk-drinking behavior, in order to provide scientific basis for promoting the healthy development of bones in children and adolescents. Methods In November 2021, a cross-sectional survey including demographic characteristics, milk intake, unhealthy eating behavior, physical activity and sleep was conducted among 696 students from grades 3 to 5 in Sanya and Baisha, Hainan by stratified cluster random sampling, and bone mineral density at the distal 1/3 of the right forearm was measured by dual-energy X-ray absorptiometry. t-test was used to compare the differences in bone mineral density among different milk-drinking behaviors of pupils, and multiple linear regression was used to analyze the correlation between milk consumption and bone mineral density. Results About 25.3% students consumed milk daily and 13.9% consumed ≥300 g of milk daily. The mean bone mineral density at the distal 1/3 of the right forearm was (0.237±0.041)g/cm². The bone mineral density was greater in the group with daily milk intake than in the group without daily milk intake [(0.250±0.037)(0.204±0.034)g/cm², t=15.00, P < 0.01], and the bone mineral density was greater in the group with daily average milk intake ≥300 g than in the group with daily average milk intake < 300 g [(0.284±0.036)(0.229±0.037)g/cm², t=13.48, P < 0.01]. Multiple linear regression analysis showed that daily average milk intake was positively correlated with bone mineral density, with a correlation coefficient (β=0.020, t=21.46, P < 0.01). Conclusion Milk consumption among pupils is inadequate, and milk-drinking behavior has a positive impact on bone mineral density, so effective milk-drinking intervention should be carried out to promote children's bone development.

The impact of cumulative ecological risks on health risk behaviors among college students in Henan Province

HU Wanli, CHEN Zhiwei, QIN Hongzhan, LOU Wenhui, LOU Xiaomin, WU Cuiping

2023, 44(11): 1636-1640. doi: 10.16835/j.cnki.1000-9817.2023.11.009

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Objective To determine the current prevalence of health risk behaviors among college students in Henan Province, and to conduct an in-depth analysis of the impact of cumulative ecological risks on health risk behaviors, so as to provide scientific basis for promoting healthy development of adolescents. Methods Using a multi-stage stratified cluster sampling method, 9 743 college students from six universities in Henan Province were included as the research subjects from April to June 2023. A questionnaire survey was conducted using the College Student Cumulative Ecological Risk Scale and the China Urban Adolescent Health Related Behavior Survey Questionnaire (University Version). Data were analyzed by descriptive statistical analysis, Chi-square test and binary Logistic regression. Results The reporting rates of unhealthy eating behavior, unhealthy weight loss behaviors, lack of physical activity, daily risk behaviors, negative emotions, current smoking behavior current drinking behaviors, Internet addiction emotions and dangerous sexual behaviors among college students in Henan Province were 40.2%, 39.5%, 76.0%, 13.7%, 28.1%, 11.3%, 12.7%, 5.9% and 2.2%, respectively. The reporting rates of negative emotions, current smoking behaviors, current drinking behaviors, dangerous sexual behaviors and daily risk behaviors of college students were higher in boys than in girls (χ²=44.00, 995.20, 902.49, 121.95, 103.09, P < 0.05). In terms of reporting rates of unhealthy diet, unhealthy weight loss and lack of exercise behavior, girls were higher than boys (χ²=107.59, 13.01, 145.83, P < 0.05). Cumulative ecological risk was positively correlated with overall health risk behaviors. For every unit increase in the cumulative ecological risk index, the risk of health risk behaviors among college students increased by 48%. Conclusions The prevalence of health risk behaviors among college students is relatively common. It should adrocate for a healthy lifestyle, reduce the cumulative ecological risk and the occurrence of health risk behaviors to promote the healthy development of adolescents.

Establishment of an intervention model for adolescent obesity based on component isochronous substitution method

FENG Zhanpeng, TAN Sijie, LIU Yan, SONG Yunfeng, ZHANG Guojun, ZHANG Chen, ZHANG Xiaogang

2023, 44(11): 1641-1644. doi: 10.16835/j.cnki.1000-9817.2023.11.010

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Objective To explore the relationship between isochronous substitution and BMI, waist circumference (WC), and body fat rate (FAT) among physical activity (PA), sedentary (SB), and sleep (SLP), so as to provide effective measures for obesity control in adolescents. Methods A total of 193 adolescents aged 12-15 (90 males and 103 females) was randomly selected, and their height, weight, and BMI were measured using routine testing methods from May to August 2022. The PA, SB and SLP of the participants were measured using a 3D accelerometer (ActiGraph GT3X+). Results The arithmetic mean value overestimated SLP (40.8%) and SB (39.6%) to some extent, and underestimated LPA (16.1%) and MVPA (3.5%) to some extent. Based on the ISM at 15 min, MVPA was substituted for other activity, BMI-Z decreased by 0.17-0.22 units, WC-Z decreased by 0.16-0.20 units, and FAT-Z decreased by 0.17-0.22 units. The substitution between MVPA and for other activity exhibited significant asymmetry. The effects of MVPA substitutions for SB was the largest, followed by the effects of MVPA substitutions for SLP, and the effects of MVPA substitutions for LPA was the lowest. As MVPA substitutions for other behaviors, it reached its maximum (0.06-0.08 units) when the MVPA time increased by 5 minutes. Conclusions MVPA plays an irreplaceable role in the control of adolescent obesity. While reducing SB time, MVPA duration should be increased to ensure that the daily MVPA duration is not less than 55 minutes in order to effectively control obesity.

Cross-lagged analysis of adolescent social adaptability, physical exercise and mental health

QIN Guoyang, JIA Wei, QIN Yong

2023, 44(11): 1645-1649. doi: 10.16835/j.cnki.1000-9817.2023.11.012

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Objective To explore the relationships among social adaptation, physical exercise, and mental health of adolescents, so as to provide theoretical basis for social adaptation and mental health improvement. Methods Longitudinal follow-up survey data were collected from 1 163 adolescents in Jinan City, Shandong Province in September 2021 (T1), January 2022 (T2), and June 2022 (T3) by cluster random sampling method. The relationship between social adaptability, physical exercise, and mental health of adolescents was analyzed through cross lagged analysis. Results There were significant sex differences in physical exercise and mental health among adolescents on T1, T2, and T3 (Z=-3.83, -3.43, -4.59; -12.45, -8.93, -8.72, P < 0.01), with male students had more physical exercise [35(28, 42), 36(33, 42), 38(35, 43)] and better mental health [12(12, 17), 17(17, 21), 14(14, 26)] levels than female students [33(27, 40), 35(31, 40), 36(33, 41); 9(9, 12), 12(12, 23), 12(12, 23)]. No similar sex difference in social adaptability (T1, T2, T3) [male: 22 (14, 24), 22 (14, 24), 22 (16, 24); female: 21 (11, 23), 20 (14, 24), 22 (17, 24)] (Z=-0.79, -1.19, -1.34, P>0.05). Temporal and synchronous correlations were found in social adaptability, physical exercise and mental health (r=0.18-0.67, 0.12-0.68, P < 0.01). Teenager physical exercise and mental health could predict social adaptability across time (β_T1-T2=0.25, 0.13; β_T2-T3=0.25, 0.06, P < 0.05), with a mediating effect on the impact path of physical exercise on social adaptability in psychological health (β=0.14, P < 0.05). Conclusions There is a causal relationship between physical exercise, mental health, and social adaptability among adolescents. Encouraging adolescents to actively participate in physical exercise and promoting mental health can effectively enhance their social adaptability.

Association of mobile phone dependence, anxiety symptoms and uncertainty stress among medical undergraduates

SHEN Xinyu, XUE Yangrun, XU Chaoyu, XUE Kaiwen, LYU Hui, LI Xuefang, WANG Wei

2023, 44(11): 1650-1654. doi: 10.16835/j.cnki.1000-9817.2023.11.013

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Objective To explore medical students' mobile phone dependence and anxiety symptoms, as well as the association between their interaction and uncertainty stress, so as to provide a reference for uncertainty stress prevention and intervention in medical students intervention. Methods From November to December 2022, a total of 2 085 medical students from a medical university were selected by using stratified cluster random sampling. A questionnaire survey was conducted by using the Smartphone Addiction Scale-Short Version(SAS-SV), Generalized Anxiety Disorder-7 (GAD-7), and Uncertainty Stress Scale. Logistic regression was used to analyze the influence of mobile phone dependence and anxiety symptoms on uncertainty stress in medical students, and multiplicative and additive interaction models were employed to analyze their interaction. Results The detection rate of uncertainty stress was 26.2%. After adjusting for gender, age and other confounders, Logistic regression analysis showed that both mobile phone dependence and anxiety symptoms were related to uncertainty stress in medical students [OR (95%CI)=4.05(3.22-5.10), 9.80(6.84-14.03), P < 0.05]. Interaction analysis revealed no multiplicative interaction between mobile phone dependence and anxiety on uncertainty stress; however, additive interactions were observed [OR(95%CI)=39.59(24.60-62.74), RERI (95%CI)=26.68(8.07-45.28), AP(95%CI)=0.67(0.48-0.87), S(95%CI)=3.24(1.73-6.34), P < 0.05]. Conclusions Mobile phone dependence and anxiety symptoms in medical students are related to uncertainty stress, and they have a synergistic effect. Reducing medical students' dependence on mobile phones and alleviating their anxiety will help reduce the occurrence of uncertainty stress.

Associations between educational burden and depression and anxiety symptoms among middle school students in Taizhou City

ANG Ziyao, CHEN Xiaoxiao, LIN Haijiang, ZHANG Wei, YANG Yuting, WANG Tingting, WANG Jingyi, FU Chaowei

2023, 44(11): 1655-1659. doi: 10.16835/j.cnki.1000-9817.2023.11.014

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Objective To investigate the prevalence of depression and anxiety symptoms among middle school students in Taizhou, Zhejiang Province, and its associations with their educational burden, so as to provide a theoretical reference for making more targeted psychological interventional measures. Methods A cross-sectional study was conducted by multi-stage cluster sampling from September to November 2022 from 30 schools in five districts and counties of Taizhou, with a final sample of 8 128 junior and senior high school students completing the online surveys on the Questionnaire Star platform. The Educational Stress Scale for Adolescents (ESSA) was used to measure academic stress; the Child Depression Inventory (CDI) and the Generalized Anxiety Disorder Scale (GAD-7) were used to screen students' depression and anxiety, respectively. The relationships between educational burden and depression and anxiety symptoms were analyzed by Logistic regression models. Results The prevalence of depression and anxiety were 19.3% and 11.1%, respectively. The average score of middle school students' study pressure was (52.8±11.5). The number of extracurricular classes was < 1, the time length of extracurricular courses was < 1 hour per day, and students averagely spend 3.6 hours per day on homework assigned by school teachers. Nearly 30.0% students had ≤0.5 of discretionary time school days and 28.5% students had ≤2 on weekends. About 30.8% students though they do worse in their academic performance. According to the results of binary Logistic regression analysis, after controlling the demographic variables, the score in Study Pressure Scale, the number of extracurricular classes, the volume of homework and the time length of extracurricular courses were positively associated with depression and anxiety (OR=1.09, 1.07, 1.08, 1.05, 1.04, 1.08, 1.08, 1.08, 1.06, 1.09, 1.07, 1.47, 1.34, 2.84; 1.08, 1.06, 1.08, 1.04, 1.03, 1.05, 1.05, 1.05, 1.05, 1.07, 1.06, 1.48, 1.23, 1.75, P < 0.05). Students with overage grades had a higher risk of depression symptoms (OR=1.34, P < 0.05). Conclusions Academic burden has negative effects on depression and anxiety of students in Taizhou. It is advisable to alleviate academic stress, so as to improve the mental health of students.

Relationship between father's emotional symptoms and emotional and behavioral problems in preschool children

CHEN Rui, WANG Xiaoyan, YIN Gangzhu, SUN Yu, SHAO Ziyu

2023, 44(11): 1660-1664. doi: 10.16835/j.cnki.1000-9817.2023.11.015

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Objective To explore the relationship between father's emotional symptoms with offspring's emotional and behavioral problems, so as to provide reference for the prevention and intervention of emotional and behavioral problems in preschool children. Methods Using the method of multi-stage sampling, two kindergartens from each of the two counties, two districts and two development zones were selected from Hefei during February to April 2023. A total of 3 672 children aged 3 to 6 years old and their fathers were selected from 12 kindergartens. Fathers filled out the Depression Anxiety and Stress Scale (DASS-21) and mothers filled out the Strength and Difficulty Questionnaire (SDQ). Multivariate Logistic regression model was established to analyze the relationship between father's emotional symptoms and preschool children's emotional and behavioral problems. Results The detection rate of emotional and behavioral problems in preschool children was 18.65%, and the detection rates of stress, anxiety and depression in fathers were 4.82%, 10.05% and 6.64%, respectively. Multivariate Logistic regression model analysis showed when fathers had negative emotions of stress, anxiety and depression, the detection rate of emotional and behavioral problems in their offspring was higher than children with father without negative emotion group (OR=1.77-2.13, P < 0.01). Father's stress symptoms were associated with increased risk of emotional and behavioral problems in boys, while father's anxiety and depressive symptoms were associated with increased risk of emotional and behavioral problems in boys and girls (OR=1.45-2.69, P < 0.05). Father's stress symptoms were associated with increased risk of emotional and behavioral problems in the first child, while father's anxiety and depressive symptoms were associated with increased risk of emotional and behavioral problems in the first child, second child and above (OR=1.81-2.49, P < 0.05). Conclusions Father's negative emotional symptoms are important factors affecting preschool children's emotional and behavioral problems. Early detection and targeted intervention of father's negative emotional symptoms are beneficial to the prevention and control of preschool children's emotional and behavioral problems.

The role of mobile phone addiction and anxiety symptoms in the association between childhood psychological abuse and depressive symptoms among college students

PAN Zhiyin, TONG Jiani, XIONG Jiajie, HUA Long, FEI Suhai, YU Yue, CHU Yinghu, LI Ning, LIU Zhenfeng, XU Miao, CHANG Weiwei, CHEN Yan, ZHU Lijun, YAO Yingshui, JIN Yuelong

2023, 44(11): 1665-1669. doi: 10.16835/j.cnki.1000-9817.2023.11.016

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Objective To explore the role of mobile phone addiction and anxiety symptoms in the relationship between childhood psychological abuse and depressive symptoms among college students, in order to provide a basis for mental health promotion. Methods From February to May 2023, a stratified random sampling method was used to select 1 799 freshmen to juniors from a university in Wuhu City, Anhui Province. The questionnaire survey was conducted using the 2-item Patient Health Questionnaire (PHQ-2), Child Psychological Maltreatment Scale (CPMS), Mobile Phone Addiction Tendency Scale (MPATS), 2-item General Anxiety Disorder (GAD-2). Correlations among each variable were analyzed, and the chain mediating effect of mobile phone addiction and anxiety symptoms was explored. Results The detection rate of depressive symptoms among college students was 9.7%, and the positive detection rate of childhood psychological abuse was 28.6%. Depressive symptoms were positively correlated with childhood psychological abuse, mobile phone addiction and anxiety symptoms (r=0.28, 0.32, 0.27, P < 0.01). Childhood psychological abuse was positively correlated with mobile phone addiction and anxiety symptoms (r=0.29, 0.71, P < 0.01). Mobile phone addiction and anxiety symptoms were positively correlated (r=0.30, P < 0.01). Childhood psychological abuse could effectively predict depressiove symptoms, mobile phone addiction and anxiety symptoms (β=0.08, 0.06, 0.66, P < 0.01). Mobile phone addiction and anxiety symptoms had a chain mediating effect between childhood psychological abuse and depression symptoms, with a total indirect mediating effect (effect=25.27%, P < 0.05), accounting for 72.44% of the total effect. Conclusions Mobile phone addiction and anxiety symptoms play a chain mediating role between childhood psychological abuse and depressive symptoms. Focusing on childhood psychological abuse, mobile phone addiction and anxiety among college students are beneficial for depression symptoms prevention.

Social anxiety status and its relationship with sleep duration among Tibetan adolescents at high altitude

SUN Peng, MA Mingkun, ZHANG Yinling, TASHI Langcuo

2023, 44(11): 1670-1673. doi: 10.16835/j.cnki.1000-9817.2023.11.017

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Objective To understand social anxiety of Tibetan adolescents aged 10-15 years old in high altitude areas and its correlation with sleep duration, so as to provide a reference and support for social anxiety prevention and mental health interventions for Tibetan adolescents in high altitude areas. Methods A total of 2 426 Tibetan adolescents from the Lhasa, Chamdo, and Nagchu regions of Tibet were surveyed. From April to June 2022, basic demographics, social anxiety, and sleep status were obtained and analyzed using class-based, stratified whole group sampling, and the correlations detected between the two were analyzed by logistic regression analysis. Results The average social anxiety score of Tibetan adolescents aged 10-15 years in high-altitude areas was (6.51±4.32), and the detection rate of social anxiety was 5.23%. The mean sleep duration was (7.42±1.18) hours/day. The differences were statistically significant when compared across gender, overweight/obesity status, level of physically activity, and sleep duration (χ²=19.44, 14.39, 7.83, 7.21, P < 0.05). After adjusting for relevant variables, the Logistic regression analysis showed that sleep-deprivation among boys (OR=2.91, 95%CI=1.82-4.61), sleep-deprivation among girls (OR=3.51, 95%CI=2.01-6.04), and overall sleep-deprivation among Tibetan adolescents (OR=3.12, 95%CI=1.91-4.58) were positively associated with social anxiety(P < 0.01). Conclusions A positive association was found between social anxiety and sleep deprivation, indicating that social anxiety is an issue among Tibetan adolescents living in high altitude regions. Sufficient sleep duration plays a positive protective role in reducing social anxiety among Tibetan adolescents in high altitude areas, and the findings provide a reference for future mental health interventions.

Analysis of the correlation between sleep and mental health among primary and secondary school students in Shandong Province

PEI Yaxing, WANG Xuechun, KONG Lingmin, RAN Xiaoyu, WEI Mengke, GAO Jie

2023, 44(11): 1674-1678. doi: 10.16835/j.cnki.1000-9817.2023.11.018

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Objective To investigate the sleep and mental health status of adolescents in Shandong Province, to explore the correlation between sleep and mental health, so as to provide a basis for adolescent physical and mental health management. Methods From February to March 2023, a multistage stratified whole cluster sampling method was used to randomly select 3 cities in Shandong Province, one urban area and one township in each city, one junior high school and one senior high school in the urban area and the township, respectively, and then 4 classes were randomly selected from each grade level of each school, and all 3 667 students in the classes were surveyed by using the Pittsburgh Sleep Quality Index Scale (PSQI) short form and the Chinese Middle School Students' Mental Health Inventory (MMHI-60). Results The prevalence of sleep deprivation among adolescents in Shandong Province was 37.44%, and the detection rate of psychological problems was 46.41%. Adolescent psychology could be divided into four latent categories: psychological immune group (39.6%), psychological low-risk group (12.2%), psychological medium-risk group (13.2%) and psychological high-risk group (35.0%). Multifactorial Logistic regression analyses showed that gender, school year, sleep duration and sleep quality were influencing factors for the psychological latent categories (OR=1.39-9.55, P < 0.05), and that adolescents with sleep deprivation and poor sleep quality were more inclined to be classified as being in the psychological medium-and high-risk groups. Conclusions The sleep and mental health of adolescents in Shandong Province is not very good. Comprehensive prevention and control of psychological problems should not only focus on personality and psychological characteristics, but also need to be combined with the sleep condition of adolescents.

Evaluation of reliability and validity, and application on the Simplified Rating Questionnaire of Social Ecological Risks in Adolescents

WANG Jiaojiao, ZHANG Yi, XIE Yang, ZHANG Xinyu, ZHANG Xianglin, WAN Yuhui, TAO Fangbiao

2023, 44(11): 1679-1682. doi: 10.16835/j.cnki.1000-9817.2023.11.019

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Objective To develop a simplified Rating Questionnaire of Social Ecological Risks in Adolescents and to evaluate the reliability and predictive validity of the brief questionnaire, so as to provide data and evidence support for building the evaluation system of cumulative social-ecological risk exposure. Methods A large cross-sectional was conducted in eight areas, including Shenzhen, Zhengzhou, Xuzhou, Nanchang, Shenyang, Taiyuan, Kunming and Chongqing, from October to December 2021. A total of 22 868 adolescents were included in the analysis. Data on healthy behaviors from 10 838 adolescents from Shenyang, Taiyuan, Kunming, Chongqing were used for item selection, based on factor analysis, validity and reliability evaluation. The data from Shenzhen, Zhengzhou, Xuzhou, Nanchang, including 12 030 adolescents, were used to define the partition values of the brief questionnaire, and evaluate the predictive validity. Results The brief questionnaire containing 25-item were developed by analyzing and choosing all items of original questionnaire, and covered seven dimensions including individual, family, school, community, policy, time and culture. The cumulative contribution rate of variance was 54.95%, the Cronbach coefficient was 0.79, and the split-half coefficient was 0.70. Participants in the higher risk group had significantly higher risk of smoking (OR=4.05, 95%CI=2.78-5.92), drinking (OR=3.47, 95%CI=2.86-4.19), suicidal ideation (OR=8.85, 95%CI=7.68-10.21), suicidal plans (OR=8.85, 95%CI=7.27-10.78), suicidal attempt (OR=8.86, 95%CI=6.67-11.78) than individual in the lower risk group (P < 0.05). After stratified by gender, the above positive correlations still remained significant(P < 0.05). Conclusion The brief questionnaire, with good reliability and predictive validity, could be widely applicated in the further researches on social ecological risk factors.

Longitudinal mediating role of dispositional envy between upward social comparison and depression in college students' social networking

JIN Tonglin, WU Yuntena, GAO Jiaxin

2023, 44(11): 1683-1687. doi: 10.16835/j.cnki.1000-9817.2023.11.020

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Objective To explore the longitudinal mediating role of dispositional envy between upward social comparison to social networking and depression in college students, so as to provide a reference for depression prevention in college. Methods Using convenience cluster sampling, a total of 1 487 college students from 7 universities in Inner Mongolia Autonomous Region and other provinces of China were recruited to participate in a three-month-longitudinal study, which contained 3 waves of date collection in September 2019 (T1), October 2019 (T2) and November 2019 (T3). These college students were surveyed with Social Network Site Upward Comparison Questionnaire, Dispositional Envy Scale and Depression Scale. Correlations analysis, missing value and common method biases were performed with SPSS 25.0. Confirmatory factor analysis and longitudinal mediation analysis were performed by Mplus 8.3. Results The detection rates of depression of college students in the first to third (T1-T3) wave were 3.6%, 4.2%, and 2.8%. The upward social comparison to social networking (T1:2.81±0.94, T2:2.69±0.99, T3:2.47±1.06), dispositional envy (T1:1.97±0.75, T2:1.87±0.74, T3:1.76±0.75) and depression (T1:1.81±0.66, T2:1.74±0.65, T3:1.68±0.69) of college students showed a decreasing trend, and time main effects were statistically significant (F=71.97, η²=0.050; F=57.84, η²=0.040; F=39.64, η²=0.030, P < 0.01). T1 upward social comparison to social networking significantly predicted T2 dispositional envy (β=0.25); T1 upward social comparison to social networking significantly predicted T3 depression (β=0.10); T2 dispositional envy significantly predicted T3 depression (β=0.55), showing that the longitudinal mediating role of dispositional envy was statistically significant (P < 0.01), the indirect effect accounted for 58.3%. Conclusions College students' upward social comparison to social networking indirectly affects depression through the dispositional envy. Intervening dispositional envy could reduce college students' depression levels in the future.

Mediating role of stressful life events between sleep chronotype and depressive mood in adolescents

YU Xinlian, ZHAO Xicun, DAI Xinyue, ZHU Guijun, XU Ying

2023, 44(11): 1688-1691. doi: 10.16835/j.cnki.1000-9817.2023.11.021

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Objective A longitudinal mediating model was designed to explore the relationship between sleep chronotype and depressive mood with stressful life events as the mediating variable, so as to provide reference basis for preventing depression in adolescents. Methods From March (T1) to October (T2) 2022, the Munich Chronotype Questionnaire, and Adolescent Self-rating Life Events Checklist and Center for Epidemiologic Studies Depression Scale were administered in 1 251 middle school students in the first and second grades of a middle school in Meishan, Sichuan Province for a follow-up study. Two wave of date on sleep time type, stressful life events, and depressive moods were collected. Results At T1, the detection rate of depressive mood was 22.5% in adolescents but 27.0% at T2.At the same time point, there were significant positive correlations between chronotype, stressful life events and depressive mood (r=0.06-0.69, P < 0.05). Cross-lagged model results showed that early sleep chronotype could significantly predict later depressive mood (β=0.53, P < 0.05), and early depressive mood could significantly predict later sleep chronotype (β=0.01, P < 0.01). Longitudinal mediation model analysis showed that T1 sleep chronotype not only directly affected T2 depressive mood (direct effect value=1.421, 95%CI=0.985-1.858, P < 0.01), but also affect T2 depressive mood through the partial mediating effects of T2 stressful life events (indirect effect value=1.268, 95%CI=0.810-1.726, P < 0.05). Although T1 depressive mood was a direct predictor of T2 sleep chronotype (direct effect value=0.025, 95%CI=0.017-0.032), it was not a direct predictor of T2 sleep chronotype by partial intermediate action of T2 stressful life events (indirect effect value=-0.001, 95%CI=-0.006-0.004, P>0.05). Conclusions Sleep chronotype can not only directly predict depressive mood of adolescents, but also indirectly affect depressive mood of adolescents through the longitudinal mediating effect of stressful life events. To prevent depression and improve mental health in this population, adolescents should develop the habit of early sleep schedule, and improve their ability to cope with stressful life events.

Effect of aerobic pedal exercise on sleep quality and energy metabolism of female college students with mild sleep disorder

LIU Mengrui, WANG Hao, ZHANG Yifan, TANG Donghui

2023, 44(11): 1692-1696. doi: 10.16835/j.cnki.1000-9817.2023.11.022

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Objective To explore the intervention effect of aerobic step exercise on sleep quality of female college students, so as to provide a new perspective to improve the sleep quality of female college students. Methods In the 2020 fall semester, a total of 41 female college students with mild or more severe sleep disorders were selected from Beijing Normal University through a questionnaire and were randomly divided into experimental group (n=29) and control group (n=12).The experimental group received 55 minutes/time step aerobic exercise intervention for 8 weeks, three times a week, while the control group received no exercise intervention from October to December.The two groups maintained the original learning and living habits, without additional physical activity.The Pittsburgh Sleep Quality Index Scale and portable sleep monitor were used to assess the subjects'sleep quality from both subjective and objective aspects.Changes in energy metabolism were observed by triaxial accelerometer and standing body composition analyzer. Results After exercise intervention, subjective sleep quality factor (1.24±0.43, 0.86±0.58), sleep efficiency factor (0.66±0.67, 0.07±0.25), sleep disorder factor (1.24±0.51, 1.03±0.18), daytime dysfunction factor (1.90±0.86, 1.48±0.82) and PSQI score (7.21±1.85, 5.66±2.09) significantly improved (t=3.64, 4.63, 2.27, 2.36, 3.29, P < 0.05).The ratio of sleep to wakefulness decreased (25.54±7.86, 20.85±5.13), the ratio of deep sleep (31.79±12.20, 38.32±10.19) and sleep efficiency (73.99±7.91, 78.68±5.12) increased significantly (t=-2.12, -2.39, -2.21, P < 0.05).Lean body mass[(38.55±2.95, 39.07±2.94) g]and basal metabolic rate[(1 257.45±41.14, 1 262.66±42.22) kcal]of the experimental group significantly increased after the intervention of medium-high intensity aerobic pedal exercise (F=5.95, 3.49, P < 0.05).Total energy expenditure was positively correlated with subjective sleep quality and sleep efficiency (r=-0.26, -0.44, P < 0.05). Conclusions The 8-week aerobic step exercise intervention can increase the daytime energy consumption and basic metabolism of female college students.Improve the sleep depth and efficiency of female college students, reduce sleep disorders, and then effectively improve sleep quality.

Reliability and validity assessment of Daily Stressors Evaluation Questionnaire for Primary School Students

TONG Min, WANG Li, MAIHELIYAKEZI Tuersunniyazi, LU Yan, ZHANG Shumin, SHI Huijing

2023, 44(11): 1697-1701. doi: 10.16835/j.cnki.1000-9817.2023.11.023

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Objective To develop the Daily Stressor Evaluation Questionnaire for Primary School Students and to evaluate the reliability and validity of the questionnaire. Methods In November 2020, a convenience sampling method was used to conduct semi-structured interviews with 10 primary school students in Jiading District, Shanghai.Through literature review, semi-structured interviews, and expert consultation, 59 question items were developed, and 138 elementary school students in 2 districts in Shanghai were selected for a pre-survey in March 2021, and the formal questionnaire was formed after item screening and parallel analysis.Stratified cluster sampling was used to survey a total of 1 618 fourth-and fifth-grade students enrolled in five elementary schools in Jiading District, Shanghai from April to May, 2021, to further test the reliability of the questionnaire. Results The Daily Stressor Evaluation Questionnaire for Primary School Students contained 4 dimensions and 22 items in total.The internal consistency test showed that cronbach α coefficient of the questionnaire was 0.904 and Cronbach α coefficient of each dimension was between 0.689 to 0.803.The Guttman split-half reliability was 0.885 and ranged from 0.582 to 0.732 for each dimension.The results of the validation factor analysis showed that the χ²/df of the questionnaire was less than 4, the root mean square error of approximation was less than 0.08, and the Tueker-Lewis index and comparative fit index were above 0.80.The critical value of using the ROC curve to evaluate the questionnaire was 31 points.At this point, the area under the curve was determined to be 0.783, while the sensitivity and specificity were found to be 71.43% and 73.39%, respectively.Additionally, the positive predictive value and negative predictive value were calculated to be 23.26% and 95.79%, respectively. Conclusion The Daily Stressor Evaluation Questionnaire for Primary School Students developed in this study has good reliability and validity and can be used as an assessment tool for evaluating stressors in primary school students.

Effect of Wuqinxi on the psychological state and prefrontal oxygenated hemoglobin of female college students with subliminal depression

LI Ke, YANG Kunpeng, ZHANG Shanshan

2023, 44(11): 1702-1707. doi: 10.16835/j.cnki.1000-9817.2023.11.024

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Objective To observe the effect of dynamic and static combination of Wuqinxi on the psychological state and prefrontal oxygenated hemoglobin of female college students with subliminal depression (SD), so as to provide a high-quality reference for optimizing their interventional measures. Methods A total of 72 female college students with SD in their third year of two semesters in the 2021-2022 academic year of Chongqing Second Normal University were randomly divided into a control group, an observation group 1, and an observation group 2.The control group received routine psychological intervention once a week, 20 minutes/time, while the observation group 1 received Wuqinxi exercise twice a day for about 30 minutes on the basis of the control group.The observation group 2 received a combination of dynamic and static Wuqinxi exercise on the basis of the control group, Wuqinxi dynamic exercise combined with Wuqinxi exercise guided imagination training about 20 minutes/time.All three groups received 12 weeks of intervention.Observe the Chinese version of the Hamilton Depression Scale (HAMD-24), Subthreshold Depression Scale (STDS), and Symptom Checklist-90(SCL-90) before and after intervention, and collect serum γ-aminobutyric acid (GABA) and plasma adrenocor ticotropic hormone (ACTH), and the concentration of oxyhemoglobin (Oxy Hb) in the prefrontal lobe were detected by functional near-infrared spectroscopy (fNIRS). Results The results showed that the HAMD-24 and STDS scores of the two groups (11.33±1.29, 53.08±2.31) were lower than those of the control group and observation group 1(18.27±2.02, 73.60±4.05;15.19±1.92, 64.58±2.69), with statistically significant differences (F=8.64, 11.85, P < 0.05).Observing that the six dimensions of somatization, interpersonal, depression, anxiety, hostility psychoticism in the SCL-90 scale were lower in the two groups than in the other two groups (F=3.68, 9.83, 10.37, 5.85, 3.05, 7.46, P < 0.05).The plasma ACTH levels in the observation group were lower than those in the other two groups, while the peak concentration of Oxy Hb was higher than those in the other two groups (F=3.27, 6.08, P < 0.05).The serum GABA levels were higher than those in the control group, and there was no difference compared to the observation group 1(P>0.05). Conclusion The combination of dynamic and static Wuqinxi training can improve the psychological state of female college students with subthreshold depression, alleviate the depressive symptoms, possibly through increase of prefrontal oxygenated hemoglobin.

Relationship between anthropometric parameters and 20-meter shuttle run test among children and adolescents

WANG Xi, WANG Jiaojiao, ZHANG Qiang, XU Shaojun, SUN Jian, WU Xiaoyan, QIU Yan, ZHENG Shijie, ZHANG Xindong

2023, 44(11): 1708-1712. doi: 10.16835/j.cnki.1000-9817.2023.11.025

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Objective To determine the association between anthropometric parameters and 20-meter shuttle run test (20 m SRT) score among children and adolescents. Methods The convenient sampling method was conducted to select 3 192 primary and secondary school students in Baoan District, Shenzhen, based on the street-school types-school from April to May 2019.Height, weight, 20 m SRT score and general demographic indicators were assessed and collected.Individuals were divided into two groups based on the dose-response correlation between different anthropometric parameters (the Z-score of height, weight and BMI) and 20 m SRT score analyzed with the restricted cubic spline.The association between the Z-score of height and 20 m SRT score was further analyzed using the Spearman correlation analysis.Logistic regression analysis was used to analyze separately the relationship different anthropometric parameters and 20 m SRT score. Results The Z-value of weight and 20 m SRT score showed a non-linear dose-response association (P < 0.01), the significant but weak linear correlation between the Z-value of height and 20 m SRT score (r=0.06, P < 0.05).The prevalence rate on the low-level of the Z-value of 20 m SRT score in 3 192 children and adolescents was 44.7%, and the gender (χ²=14.02, P < 0.01) and grade difference (χ²=93.28, P < 0.01) were both statistically significant.There was no significant relationship between the Z-value of height and 20 m SRT score grade among total population, different genders and different grades (P>0.05).Compared with the reference group on the Z-value of weight ≤-0.23, individuals with the Z-value of weight >-0.23 had the low-level of 20 m SRT score (OR=0.61, P < 0.05).Compared with the reference group on the Z-value of BMI ≤0.25, individuals with the Z-value of weight >0.25 had the low-level of 20 m SRT score (OR=0.45, P < 0.05).Stratified for gender and grade, the above significant relationship on the Z-value of weight, Z-value of BMI and 20 m SRT score were still observed (P < 0.01). Conclusions The higher height Z-value shows on correlations with 20 m SRT score, but the positive association is found between weight and BMI Z-value and the 20 m SRT score.The cardiopulmonary fitness improvement may be more effective among children and adolescents when tuking weight and BMI Z scores into consideration.

Comprehensive evaluation of the epidemic warning and monitoring system for infectious disease aggregation in schools or daycare institutions with multi-source data

LIANG Jieya, QIN Chuoheng, ZHOU Mengxi

2023, 44(11): 1713-1715. doi: 10.16835/j.cnki.1000-9817.2023.11.026

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Objective To comprehensively evaluate the early warning monitoring system (WMS) for infectious disease aggregation in schools or daycare institutions with multi-source data, to identify the advantages and disadvantages of the system, and to provide a basis for optimizing its warning function and exploring further integration of other data sources. Methods The infectious disease warning data from the Chinese infectious disease Automated-alert and Response System (ARS), the Student Health Monitoring System (SHMS) in Foshan City, Guangdong Province, and WMS were collected from January 2021 to July 2023.The indicators such as sensitivity, specificity, Youden index, positive predictive value, early warning and median timeliness were used to comprehensively evaluate the early warning monitoring system. Results The ARS was not sensitive to common infectious disease warnings in schools or daycare institutions.The median timeliness of the SHMS and the WMS was 1 day.The sensitivity of SHMS and the WMS for early warning of hand-foot-mouth disease, infectious diarrhea, influenza-like cases, chickenpox and other infectious diseases were more than 70%, while the sensitivity for novel coronavirus infection were only 10.42% and 64.58%.The Youden index and positive predictors of the WMS were both the highest. Conclusion The WMS can timely and effectively warn schools or daycare institutions of clustered epidemics, improve the positive predictive value, but the data sources are still insufficient, and it is necessary to continuously increase the data sources in future exploration to improve the warning ability.

Field investigation of a mumps outbreak and evaluation of vaccine effectiveness in a remote village school

XU Yuxiang, KONG Deliang, LYU Yuling, LIAO Meiting, LI Yuhua, SHEN Wenhao, HUANG Guohua

2023, 44(11): 1716-1719. doi: 10.16835/j.cnki.1000-9817.2023.11.027

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Objective To investigate the outbreak of mumps in a remote village school of Zhaoqing City, to evaluate and vaccine effectiveness (VE) of mumps-containing vaccine (MuCV), so as to provide reference for the formulation of epidemic prevention and control strategies. Methods Through on-site case investigations and interviews, case data and epidemic related epidemiological information were obtained.Descriptive and retrospective cohort studies were used to analyze the epidemic characteristics, explore risk factors, and evaluate the protective effect of vaccines. Results Totally 166 cases of mumps were found, and all of them were students.The total attack rate was 7.79% and the outbreak lasted for 60 days.The first case occurred on October 11th and the last case occurred on December 9th in 2018.Most of the cases aged from 10 to 13 years old, accounting for 66.27%.There were 96 male patients and 70 female patients, with no statistically significant sex difference in the incidence rate (χ²=2.40, P>0.05).Involving 28 classes, 11 of which had an incidence rate more than 10%, mainly distributed in grades 2, 4 and 6.There were statistically significant differences in incidence rates among different grades (χ²=96.89, P < 0.01) and different floors (χ²=67.35, P < 0.01), with the third floor higher than the other floors.Twelve out of 58 boarding pupils were cases, and boarding pupils were 1.89 times higher in risk of contracting mumps than day students (RR=1.89, 95%CI=1.10-3.23).Pupils without being given the shot of MuCV were higher in the infection rate than those having the shot (χ²=5.70, P < 0.05), and the VE% was 35%(95%CI=7%-55%).The VE% of one dose was 34%(4%-54%), while the effectiveness of protection was declined with time (χ_trend²=6.53, P < 0.05).The effectiveness of vaccine almost diasappeared six years after the shot (χ²=1.12, P>0.05). Conclusion Delayed case report and isolation, low rate of receiving MuCV, and decreasing effectiveness of one shot MuCV are closely assocaited with the outbreak and ongoing spread of the epidemic.

Effectiveness of online and offline health education myopia intervention on primary school students

ZHANG Xiyan, XU Jimin, MIAO Shenghao, ZHANG Juan, CAI Jianping, WANG Wei, LI Ping, WANG Yan, YANG Wenyi, XIANG Yao, WANG Xin, XIN Yiliang, YANG Jie

2023, 44(11): 1720-1723. doi: 10.16835/j.cnki.1000-9817.2023.11.028

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Objective To assess the effectiveness of online and offline myopia prevention and control health education interventions using wearable behavior monitoring tools for non-myopic elementary school students, so as to provide evidence-based medical support for public health practices. Methods From May to June in 2021, two schools were selected within the same county in Jiangsu Province.School 1 conducted online and offline parental health education (n=111), while school 2 exclusively conducted offline health education activities, representing the traditional intervention group (n=122).Students from both schools underwent monitoring through wearable behavior-tracking tools, with feedback reports provided (eye distance, eye duration, ambient light, and outdoor exposure time).Both schools relied on activities to carry out health education interventions, and organized the distribution of promotional materials and display boards.The intervention group also established WeChat groups to conduct online"Healthy Parents Action"(answering and providing feedback on health knowledge related to myopia prevention and control, myopia prevention and control, science popularization, etc.raised by parents).Evaluation criteria included myopia rates, post-dilation refractive error, and axial length, with a tracking period of two years (from 2021 to 2023).Additionally, the study collected refractive parameters from non-myopic students who did not participate in wearable tool monitoring in the 12 classes across the two schools. Results The baseline results indicated that there were no significant differences between the two groups in terms of refractive parameters and wearable tool monitoring results (including screen time, viewing distance, outdoor exposure time, and homework light exposure)(t/Z/χ²=1.94, 1.17, 0.58, 0.40, 0.80, 0.69, 0.32, P>0.05).After a two-year follow-up, in the first and second year, the myopia rate of the online Healthy Parents Action group (11.4%, 29.7%) were lower than that of the traditional group (26.2%, 50.9%), and the degree of refractive change in the intervention group[0.63(0.38, 1.19) D]was lower than that of the traditional group[0.91(0.40, 1.50) D], and all the differences were statistically significant (χ²/Z=4.93, 10.37, 2.29, P < 0.05).However, there were no significant differences (P>0.05) in axial length changes between the two groups over the two-year intervention period.Nevertheless, in the second year, the axial length change in the traditional group[0.35(0.20, 0.65) mm]was lower than that in the natural observation group[0.55(0.30, 0.75) mm], and this difference was statistically significant (Z=1.92, P < 0.05). Conclusions Online and offline myopia prevention and control health education can effectively reduce myopia rates.The intervention mode combining wearable behavior monitoring tools with online health education may have better effects, but further large-sample and multi-center studies are needed to provide additional evidence and confirmation.

Delay on detection, and diagnosis of pulmonary tuberculosis and the influencing factors in Inner Mongolia students during 2011-2022

XU Lijuan, JIA Lili, WANG Wenrui

2023, 44(11): 1724-1728. doi: 10.16835/j.cnki.1000-9817.2023.11.029

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Objective To analyze the delay on detection, care-seeking, diagnosis and treatment of tuberculosis among students in Inner Mongolia Autonomous Region (Inner Mongolia) from 2011 to 2022 and its influencing factors, so as to provide support for the prevention and treatment of tuberculosis among students. Methods The general demographic indicators of students with tuberculosis in Inner Mongolia from January 1, 2011 to December 31, 2022 were collected from the infectious disease monitoring (new) module of the China Disease Prevention and Control Information System.General characteristics and trend of four types of delayed pulmonary tuberculosis patients in students were analyzed.The influencing factors were analyzed using univariate and multivariate Logistic regressions. Results From 2011 to 2022, there were 6 032 cases of pulmonary tuberculosis among students in Inner Mongolia.The rates of delayed detection, delayed care-seeking, delayed diagnosis, and delayed treatment were 51.71%, 64.01%, 7.82%, and 2.30%, respectively.The results of multivariate Logistic regression analysis showed that tracking (OR=1.51) in the patient source, league-level diagnosis (OR=3.16) in the diagnostic institution level, and county-level diagnosis (OR=2.41) were positively associated with delayed discovery (P < 0.05).At the level of diagnostic unit, league city-level diagnosis (OR=2.69), and county-level diagnosis (OR=3.67) associated with more delayed care-seeking (P < 0.05).Referral (OR=1.58) and follow-up (OR=2.55), floating population (OR=2.05), further consultation with a doctor (OR=2.11), and no results in imaging manifestations (OR=2.19) were positively associated with delayed diagnosis (P < 0.05).The factors contributing to delayed treatment were referral (OR=1.84), follow-up (OR=4.91), active screening (OR=5.46), and floating population (OR=1.95)(P < 0.05). Conclusions From 2011 to 2022, the delay on detection and care-seeking for tuberculosis patients among students in Inner Mongolia is at a relatively high level, while the delay in diagnosis and treatment is at a relatively low level but shows an increasing trend.It is necessary to focus on the factors associated with delays in identification, diagnosis and treatment in tuberculosis outbreak in the context of school to prevent or reduce school tuberculosis outbreak.

Effect of parental weight and early life factors on overweight and obesity in children and adolescents

YU Qiong, LI Ruifeng, YUN Ruifen, CAO Puli, LIU Dong, MENG Jiaoyang, LI Jianying

2023, 44(11): 1729-1732. doi: 10.16835/j.cnki.1000-9817.2023.11.030

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Objective To investigate the association of the risk of overweight/obesity in children and adolescents with their early life factors and parental weight. Methods From June 1 to June 30 of 2022, the stratified randomized cluster sampling method was used to collect information using questionnaires from 5 370 primary and secondary school students in Hohhot City, Inner Mongolia Autonomous Region, and multivariate analysis were performed using multiple Logistic regression model estimation in a generalized linear model for parental BMI and early life factors in children and adolescents. Results The prevalence of overweight/obesity was 32.2%, and the prevalence of overweight/obesity among male students was 37.8%, which was higher than that of female students 26.1% (χ²=84.59, P <0.01). The results of the multirariate Logistic regression anaysis showed that the prevalence of overweight/obesity was higher in only paternal overweight (OR=1.52, 95%CI=1.30-1.77), only maternal overweight (OR=1.61, 95%CI=1.31-1.97), and parentl overweight (OR=2.42, 95%CI=2.03-2.87)(P <0.05). The risk of overweight/obesity was higher in children with high birth weight (OR=1.29, 95%CI=1.08-1.55), children born by caesarean section (OR=1.32, 95%CI=1.17-1.48), and children whose mothers gained excessive weight during pregnancy (OR=1.24, 95%CI=1.06-1.46), and the results were statistically significant (P <0.05). Conclusions Overweight parents, excessive maternal weight gain during pregnancy, cesarean delivery, and high birth weight are associated with increased risk of overweight/obesity in children and adolescents. Attention should be paid to these aspects in obesity prevention and control.

Prevalence and influencing factors of elevated blood pressure among primary and middle school students in Anhui Province

ZHANG Yukun, WANG Zhiqiang, CHEN Guoping, WU Jing, YANG Yang, LI Weidong

2023, 44(11): 1733-1737. doi: 10.16835/j.cnki.1000-9817.2023.11.031

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Objective To analyze the prevalence of elevated blood pressure among primary and middle school students in Anhui Province in 2022, as well as its influencing factors, so as to provide scientific evidence for the development of effective measures to prevent and control elevated blood pressure among children and adolescents. Methods Using data from the 2022 "Monitoring of Common Diseases and health Influencing Factors of Students" in Anhui Province, a total of 210 360 primary and middle school students aged 7 to 17 with complete information. Statistical analysis, including independent sample t-tests, analysis of variance, and Chi-square tests, were conducted to compare blood pressure differences and prevalence rates among students with different characteristics. Generalized linear mixed models were established to analyze the influencing factors of elevated blood pressure in children and adolescents. Results The overall prevalence of elevated blood pressure among primary and middle school students in Anhui Province was 22.3%, higher among high school students (25.6%) and junior high school students (23.7%) than elementary school students (20.4%) (χ²=528.49, P<0.01); higher among obese(33.3%) and overweight students (24.9%) than that of normal students (18.6%) (χ²=3 704.52, P<0.01), higher among rural students (23.1%) than urban students (21.4%) (χ²=83.39, P<0.01), and higher in the northern part of Anhui Province (26.9%) than in the central part (21.9%) and southern part (17.6%) (χ²=1 777.51, P<0.01). The generalized linear mixed models revealed that girls, high school stage, overweight, obese, living in the northern part of Anhui Province, and living in rural were all positively correlated with elevated blood pressure(OR=1.11, 1.25, 1.47, 1.45, 2.24, 1.21, 1.67, P<0.01). Conclusions The prevalence of elevated blood pressure among children and adolescents in Anhui Province is the highest in the country. It is recommended that relevant departments promptly formulate corresponding measures to curb the increasing trend of elevated blood pressure and protect the physical and mental health of children and adolescents.

Current status of health standards and health management system in childcare institutions

LIANG Zhenglin

2023, 44(11): 1738-1742. doi: 10.16835/j.cnki.1000-9817.2023.11.032

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Children in childcare institutions are involved with a high degree of contact, poor personal hygiene habits, low resistance, high incidence of disease, infections diseases are easily spread without proper public health management. Compared with child care centers, the construction of national standards, industry standards and management systems for primary and secondary school health is relatively complete, while the applicability of the current hygiene standards and management systems for childcare centers is worth exploring. By reviewing the previous literature, the study sorted out the current status of hygiene standards and hygiene management system in childcare institutions, and assesse their applicability in childcare institutions, so as to provide references for the establishment of hygiene standards and hygiene management system in childcare institutions.

Retrospective analysis of childcare center disinfection in some regions of Anhui Province during 2019-2022

CHEN Fang, XU Peiru, CHENG Wenjun, YANG Kang, LIN Haofei, WU Lei, HUANG Fayuan, XU Qinghua

2023, 44(11): 1743-1746. doi: 10.16835/j.cnki.1000-9817.2023.11.033

Abstract(128) HTML (66) PDF(21)

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Objective To understand the status of childcare center disinfection around the COVID-19 pandemic, the needs of professional technical support, so as to give advice for improvement measures. Methods Using multi-stage stratified sampling method, one was selected from each area of northern and southern Anhui Province, with 3 counties/districts selected from each city. A total of 54, 58, 60 childcare institutions were selected. A questionnaire survey, as well as on-site visits and data check were administered in these childcare centers in Anhui Province were implemented. Information regarding the three-stage disinfection work from 2019 to 2022 and technical support needs were collected. Results A total of 54, 58, 60 childcare centers were investigated in 2019, 2020 and 2021-2022. Most of the childcare centers recorded disinfection work (96.3%, 96.6%, 98.3%), while few of them (26.4%, 26.3%, 58.3%) monitored disinfection factor intensity. The implementing rate of disinfection effect evaluation was 68.3% at the stage of normal prevention and control, the highest demand rate for professional technical support was guidance and training (95.0%), and the highest demand rate for training content was disinfectant preparation method (81.7%). There were significant differences in the rate of disinfection tableware room allocation (A: 93.3%, B: 70.0%), and the rate of disinfection effect evaluation among different cities (A: 53.3%, B: 83.3%)(χ²=6.24, 5.46, P < 0.05). Conclusions From 2019 to 2022, childcare center disinfection has significantly improved, however, disinfection factor intensity monitoring and disinfection effect evaluation are neglected during the stage of normal prevention and control. The demand for professional technical institutions to provide disinfectant preparation method guidance and training is high. It is suggested to strengthen the monitoring and evaluation of disinfection and related technical guidance.

A review of the impact of school-based interventions on cardiovascular metabolic risk in children

SHEN Fangjing, ZHANG Pingping, WANG Hui, ZHOU Ye, LI Li

2023, 44(11): 1747-1751. doi: 10.16835/j.cnki.1000-9817.2023.11.034

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School-based lifestyle interventions have many advantages, which can effectively reduce the prevalence of overweight and obesity, improve children and their families' knowledge of overweight and obesity, and enhance their cognition of behaviors related to energy balance. Moreover, it can improve the level of cardiometabolic risk (CMR). By searching PubMed, CNKI and Wanfang databases, the article review the effects of school-based physical activity and dietary interventions on children's blood pressure, blood lipids, blood glucose, and other CMR indicators, and analyze the differences among different groups of people, such as gender, age, and race, in order to provide the evidence for future school-based intervention studies on overweight and obesity in children.

Recent advances in intestinal flora characteristics and sexual dimorphism during puberty

ZHU Qili, LIU Yang

2023, 44(11): 1752-1755. doi: 10.16835/j.cnki.1000-9817.2023.11.035

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Gut flora undergoes a dynamic colonization and development process at different stages of human life. Sex-specific gut flora development begins during puberty, which is influenced by sex hormone levels. The potential relationship between sex hormone levels, which suggests that there may be a two-way interaction between intestinal flora and sex hormones. In addition, evidence is emerging for bidirectional effects of the microbiome in human health. Therefore, the review presents the dimorphism of intestinal flora, the characteristics of intestinal flora during puberty and the latest research progress, explores the close relationship between intestinal flora and precocious puberty and reproductive system diseases, and further explains the influence mechanism and treatment measures of considering gender factors in intestinal microflora, precocious puberty and reproductive system related diseases.

Research progress on HPV vaccination willingness, vaccination rate and influencing factors of female college students in China

CHEN Yaxin, SU Dan

2023, 44(11): 1756-1760. doi: 10.16835/j.cnki.1000-9817.2023.11.011

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HPV vaccination is one of the most important measures to prevent cervical cancer. Chinese female college students are in the recommended age for HPV vaccination, but the vaccination rate is still at a low level, which directly affects the effect iveness of cervical cancer prevention and control. The research on HPV vaccination inclination, coverage status and its influencing factors of female college students in China showed that they are more likely to vaccinate, but there are multiple sources of bawiers, including HPV vaccine access, the long inclubation period, lack of awareness, lack of marent support, which greatly influenced HPV vaccine coverage among female college students, Therefore, the national government, regulatory departments, medical institutions, universities and other parties should jointly take corresponding measures to actively eliminate these adverse effects, in order to improve the vaccination coverage of HPV vaccine in female college students.

2023 Vol. 44, No. 11