中国学校卫生

Implementation of school mental health social service system in accordance with the contemporary characteristics of children and adolescents' mental health problems

ZHANG Xujun

2023, 44(12): 1761-1764. doi: 10.16835/j.cnki.1000-9817.2023.12.001

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In recent years, mental health problems of children and adolescents are increasingly recognised as one of the most significant public health concerns. The article briefly describes the contemporary characteristics of mental health problems in children and adolescents, and proposes the implementation of school mental health social service system, including the establishment of comprehensive school mental health social service policies, the improvement of the school mental health social service model, the construction of regional school mental health service centers, and the strengthening of school mental health service practices in order to address youth mental health needs.

The experience and enlightenment of American home-school-community partnership to promote physical activity of school-age children for overweight and obesity prevention

DAI Yuxi, DONG Mengyuan, HE Yuxiu, LIU Chunyan

2023, 44(12): 1765-1769. doi: 10.16835/j.cnki.1000-9817.2023.12.002

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The study elaborates on the historical development of the home-school-community partnership in the United States, as well as physical activity strategies to prevent overweight and obesity in school-age children. Feasible suggestions are proposed for implementing the home-school-community collaboration in China. The finding suggests that in addition to cooperation with schools, families and communities need to take initiatives to actively support children's participation in various physical activities and provide facilities and guarantees. Schools should also do a top-level design that links with families and communities, and incorporate their participation into long-term physical education planning, making them an integral part of a closely interconnected collaborative network to further prevent overweight and obesity in school-age children.

Association of anxiety, insomnia, and family cohesion with Internet addiction and non-suicidal self-injury behavior in junior and senior school students

LIU Fangdu, YANG Yaming, XIAO Yue, JIANG Xuanli, WANG Xiaoyu, SHENG Jiating, LI Minhui, SU Liyan, MA Jun, ZHANG Xujun

2023, 44(12): 1770-1774. doi: 10.16835/j.cnki.1000-9817.2023.12.003

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Objective To explore the mediating effect of anxiety, insomnia, and family cohesion between Internet addiction and non-suicidal self-injury (NSSI) behavior among junior and senior school students, so as to develop interventions to promote adolescent mental health. Methods A total of 3 026 junior and senior school students from Yixing, Jiangsu Province, China, were selected by stratified cluster sampling from December 2022 to February 2023, and were administered the Ottawa Self-injury Inventory (OSI), Depression, Anxiety and Stress Scale-21 (DASS-21), Family Environment Scale-Chinese Version (FES-CV), Insomnia Severity Index (ISI), and Chinese Internet Addiction Scale Revised (CIAS-R). A mediating effect model was constructed to analyze the mediating effect of anxiety, insomnia, and family cohesion on Internet addiction and NSSI. Results Internet addiction (r=0.24), insomnia (r=0.28), and anxiety (r=0.27) were positively correlated with NSSI, while the latter was negatively correlated with family cohesion (r=-0.23) (P < 0.01). The mediating effect model was well fitted (CFI=0.999, TLI=0.978, RMSEA=0.030). Anxiety (mediation effect value: 0.12, 95%CI=0.08-0.18) and family cohesion (mediation effect value: 0.08, 95%CI=0.03-0.13) had a separate mediating effect. A chain meditating effect was found in the case of anxiety and insomnia (mediation effect value: 0.14, 95%CI=0.10-0.20), family cohesion and anxiety (mediation effect value: 0.05, 95%CI=0.03-0.07), family cohesion and insomnia (mediation effect value: 0.05, 95%CI=0.03-0.07), and family cohesion, anxiety, and insomnia (mediation effect value: 0.06, 95%CI=0.04-0.08). The mediating effect accounted for 14.9%, 10.1%, 17.5%, 6.0%, 5.6%, and 7.1%, respectively. Conclusions Anxiety, insomnia, and family cohesion partially mediate Internet addiction and NSSI. Schools and families should pay attention to Internet addiction among junior and senior school students and develop appropriate interventions to promote adolescent mental health, so as to reduce the prevalence of NSSI.

Relationship between depression, anxiety, stress and food addiction in primary and secondary school students

XU Huajing, SU Liyan, ZHANG Xujun, WANG Li, YANG Yaming

2023, 44(12): 1775-1779. doi: 10.16835/j.cnki.1000-9817.2023.12.004

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Objective To explore the relationship between depression, anxiety, stress and food addiction among primary and secondary school students in Yixing City, so as to provide reference and suggestions for maintaining healthy eating behavior and psychological health intervention and promotion among primary and secondary school students in Yixing City. Methods From December 2022 to February 2023, a stratified cluster random sampling method was used to select 4 180 primary and secondary school students from four primary and secondary schools in Yixing City, Jiangsu Province. A questionnaire survey was conducted using the Depression Anxiety Stress Scale-21 (DASS-21) and related behavior questionnaires. The data was analyzed using χ² test, Wilcoxon, Kruskal Wallis H rank sum test, and binary Logistic regression. Results The prevalence of food addiction among primary and secondary school students in Yixing City was 0.98% (41 students), and there was no statistically significant difference in the comparison of food addiction, depression, anxiety, and stress scores among students of different genders and age groups (Z/H=-1.34-5.74, P>0.05). There was a positive correlation between food addiction and binge eating behavior, depression, anxiety, and stress symptoms (r=0.14-0.23, P < 0.01). The results of binary Logistic regression showed that anxiety (OR=5.68, 95%CI=1.74-18.55) and stress (OR=5.41, 95%CI=2.20-13.32) were positively correlated with the occurrence of food addiction in primary and secondary school students (P < 0.01). Conclusions The risk of food addiction among primary and secondary school students with anxiety and stress symptoms is higher than that of the general population. Guidance and intervention on student mental health should cover the entire compulsory education and high school period, in order to improve the mental health level of students and reduce the occurrence of food addiction behavior.

Association between negative emotion, family intimacy and Internet addiction among junior and senior school students

SHENG Jiating, YANG Yaming, XIAO Yue, JIANG Xuanli, WANG Xiaoyu, LIU Fangdu, LI Minhui, SU Liyan, MA Jun, ZHANG Xujun

2023, 44(12): 1780-1783. doi: 10.16835/j.cnki.1000-9817.2023.12.005

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Objective To explore the association between negative emotion (depression, anxiety and stress), family intimacy and Internet addiction, so as to provide a basis for the intervention of Internet addiction among junior and senior high school students. Methods Students were selected by stratified random cluster sampling method from junior high schools and senior high schools from December 2022 to February 2023 in Yixing City, Jiangsu Provicne. A total of 3 026 students completed the questionnaire survey, including the demographic characteristics, Depression, Anxiety and Stress Scale-21 (DASS-21), Family Environment Scale-Chinese Version (FES-CV), and Chinese Internet Addiction Scale Revised (CIAS-R). Bivariate correlation was used to analyzed the association of family intimacy, depression, anxiety, stress, and Internet addiction. Mediating effect model was used to analyzed the mediating effect of negative emotion between family intimacy and Internet addiction. Results The average score of Internet addiction among junior and senior high school students was (46.26±15.58), and there were statistical differences in the average scores of Internet addiction across different grades (F=87.15, P < 0.01). Depression (r=0.57), anxiety (r=0.56), stress (r=0.57) were positively correlated with Internet addiction, and family intimacy (r=-0.34) was negatively correlated with Internet diction (P < 0.01). In the mediating effect model, family intimacy negatively predicted negative emotion (β=-0.48) and Internet addiction (β=-0.10), and negative emotion positively predicted Internet addiction (β=0.45) (P < 0.01). Negative emotion played a partial mediating role between family intimacy and Internet addiction (the mediation value: -1.71, 95%CI=-1.96-1.49, mediation ratio: 67.9%, P < 0.05). Conclusions There are associations between negative emotion, family intimacy and Internet addiction among junior and senior school students. Family intimacy indirectly affects Internet addiction mainly through negative emotion. It suggests that family education is in need of attention to reduce the prevalence rate of Internet addiction among junior and senior high school students, especially family intimacy.

Effects of dialectical behavior therapy on cognitive emotion regulation in adolescents with non-suicidal self-injury behaivor

ZHANG Junlei, ZHAO Yujie, PENG Shali, GUO Feifei, ZHANG Yan

2023, 44(12): 1784-1787. doi: 10.16835/j.cnki.1000-9817.2023.12.006

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Objective To explore the effect of dialectical behavior therapy (DBT) on cognitive emotion regulation in adolescents with non-suicidal self-injury (NSSI), so as to provide reference for improving the cognitive and emotional well-being of NSSI adolescents. Methods A total of 166 adolescents with non-suicidal self-injury who were hospitalized in the Department of Child and Adolescent Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University from March 2021 to March 2023, were selected by the convenient sampling method. According to the random number table method, participants were divided into the experimental group and the control group, with 83 cases in each group. The control group was given routine nursing, while the experimental group was given dialectical behavior therapy on the basis of routine nursing. The 8-week-intervention was conducted once a week, with 45-60 minutes each time. The control group and the experimental group were evaluated with Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Cognitive Emotion Regulation Questionnaire (CERQ) before and after the intervention. Statistical analysis was conducted using t-test and χ² test. Results Before the intervention, there was no significant difference in the scores of each scale include HAMA, HAMD and CERQ between the experimental group and control group (P>0.05). The scores of HAMD (13.58±3.24, 33.02±7.59), HAMA (12.41±2.51, 24.25±7.14), adaptive adjustment strategy score (69.20±11.97, 60.51±7.29) and non-adaptive adjustment strategy scores (37.43±7.87, 47.87±5.20) of CERQ, significantly changed after 8 weeks of intervention (t=-21.46, -14.25, 5.57, -10.08, P < 0.01). Conclusions Dialectical behavior therapy can improve the anxiety, depression and cognitive emotion regulation of adolescents with NSST. Active intervention should be taken to regulate the emotions of adolescent with NSSI and reduce the occurrence of NSSI.

Analysis of factors influencing campus bullying among junior and senior school students and construction of a nomogram model from Jiangsu Province

YANG Wenyi, WANG Yan, ZHANG Xiyan, XIANG Yao, WANG Xin, YANG Jie

2023, 44(12): 1788-1792. doi: 10.16835/j.cnki.1000-9817.2023.12.007

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Objective To explore the influencing factors of exposure to campus bullying among junior and senior school students, and to establish a column-line diagram model for risk prediction, while providing a theoretical basis for campus bullying prevention and control in secondary schools. Methods A total of 22 034 junior and senior school students were selected via direct sampling technique from September to November 2021 in 13 cities in Jiangsu Province, China, and questionnaires were administered using the Student Health Behavior Questionnaire. The Chi-squared test and multifactor Logistic regression analysis were used to derive the influencing factors of exposure to campus bullying, and a column-line graph prediction model was drawn. Results A total of 540 students reported that they had experienced campus bullying, with a prevalence rate of 2.45%. Being in a non-conventional family (OR=1.30, 95%CI=1.02-1.65), overweight/obesity (OR=1.35, 95%CI=1.09-1.67), scolding by parents in the past 30 days (OR=2.27, 95%CI=1.82-2.84), cigarette smoking in the past 30 days (OR=1.54, 95%CI=1.11-2.15), Internet addiction (OR=2.03, 95%CI=1.34-3.08), and depressive symptoms(OR=5.24, 95%CI=4.16-6.61), all of which were positively correlated with exposure to campus bullying among junior and senior school students (P < 0.05). Furthermore, the following factors were negatively associated with junior and senior school students' protection from campus bullying in female students (OR=0.58, 95%CI=0.46-0.72), senior school students (OR=0.68, 95%CI=0.54-0.83), eating breakfast sometimes (OR=0.37, 95%CI=0.22-0.62), and eating breakfast everyday (OR=0.28, 95%CI=0.17-0.49) (P < 0.05). The column line graph established based on the above influencing factors had an area under the curve of 0.792 (95%CI=0.769-0.815), and the calibration curve showed that the predicted value was basically the same as the measured value. Conclusions Non-conventional families, overweight/obesity, male students, junior school students, scolding by parents, cigarette smoking, Internet addiction, and depressive symptoms are correlated with school bullying among middle school students. The predictive model constructed in the study can provide an effective basis to predict the risk of school bullying and facilitate the implementation of proactive interventions for junior and senior school students.

Analysis of subtypes and risk characteristics of depression and anxiety among primary and secondary school students

LI Minhui, YANG Yaming, XIAO Yue, YANG Xinwei, JIANG Xuanli, WANG Xiaoyu, SHENG Jiating, LIU Fangdu, SU Liyan, MA Jun, ZHANG Xujun

2023, 44(12): 1793-1798. doi: 10.16835/j.cnki.1000-9817.2023.12.008

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Objective To understand different types of depression and anxiety among primary and secondary school students, as well as their influencing factors, so as to provide a basis for the development of future intervention programs for adolescent mental health. Methods From December 2022 to February 2023, a self-administered questionnaire survey was administered among grades 4 to 6 students and junior school, senior school students in Yixing City using Depression Anxiety and Stress Scale-21(DASS-21), Insomnia Severity Index (ISI), Family Environment Scale (FES), and modified Yale Food Addiction Scale 2.0(mYFAS 2.0), Ottawa Self-injury Inventory (OSI).A total of 4 180 students were included in the analysis.Different types of depression and anxiety in students and their influencing factors were analyzed by the Chi-square-test and multivariate Logistic regression. Results The overall prevalence of depression and anxiety among primary and secondary school students were 16.6% and 22.4%, respectively, with 14.0% of depression and anxiety comorbidities.The Logistic regression results showed that, compared to students with low-depression-low-anxiety, students of depression and anxiety who had parents in conflicts (OR=3.06), smoked (OR=3.16), exhibited moderate food addiction (OR=3.56), and had non-suicidal self-injury (NSSI)(OR=2.26) were more likely to be classified as a depression-predominant-depression-anxiety type.Students of depression and anxiety who consumed alcohol (OR=2.00), had serious food addiction (OR=5.44), moderate-to-severe insomnia (OR=3.25), and mild insomnia (OR=1.88) were more likely to be classified as anxiety-predominant-depression-anxiety type.Students of depression and anxiety with low mood (OR=10.87), mild food addiction (OR=2.00), moderate food addiction (OR=4.32), and severe food addiction (OR=7.35), mild (OR=2.96) or moderate to severe (OR=16.52) insomnia, and NSSI (OR=4.24) were more likely to be classified as the severe-depression-anxiety type (P < 0.05). Conclusions There are significant differences between different depression-anxiety types among primary and secondary school students with respect to food addiction, insomnia, NSSI, smoking, and alcohol use.Relevant departments should engage with schools and families to adopt targeted interventions for students to reduce the occurrence of mental health problems.

Cyberbullying and its effect on health risk behaviors among secondary vocational school students

WANG Jinyang, SHAN Guiying, ZHANG Hailian, WANG Yu, LIU Hongyang

2023, 44(12): 1799-1803. doi: 10.16835/j.cnki.1000-9817.2023.12.009

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Objective To investigate the current situation of cyberbullying and health risk behaviors among secondary vocational school students, to explore the effects of cyberbullying on health risk behaviors, so as to provide a reference for formulating intervention strategies to promote adolescent health-related behaviors. Methods From March to April 2023, a field survey was conducted on 1 184 students from one secondary vocational school each in Jilin City and Yanji City by random cluster sampling method.The data was analyzed using Chi-square tests and generalized linear models. Results Among secondary vocational school students, 839 individuals (70.9%) experienced the cyberbullying, and 1 036 individuals (87.5%) had one and more health risk behavior group.There was a positive correlation between cyberbullying and health risk behaviors (r=0.60, P < 0.01).The generalized linear model analysis showed that female and no Internet addiction were negatively correlated with the health risk behaviors of secondary vocational students (β=-2.75, -8.90), and the single-parent families and peer pressure was positively correlated with the health behaviors of secondary vocational students (β=2.56, 4.82)(P < 0.05).Secondary vocational students experienced cyberbullying who from single-parent families, peer pressure and social-oriented internet usage were more likely to engage in health risk behaviors (β=3.41, 4.88, 2.20, P < 0.05). Conclusions The incidence of cyberbullying and health risk behaviors among secondary vocational school students is relatively high, and cyberbullying can influence the occurrence of health risk behaviors.It is important to focus on and implement guidance for internet use and health behavior education for secondary vocational students from multiple perspectives, including the family, school, and society.Corresponding intervention strategies should be taken to promote the healthy development of adolescents.

An empirical study on the effect of tennis sports on visual health of primary school students

HAN Jinming, FAN Zemin, WANG Huihui, QIU Cheng, RAO Zilong, LIU Yang, HAN Qixun

2023, 44(12): 1804-1808. doi: 10.16835/j.cnki.1000-9817.2023.12.010

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Objective To explore the impact of tennis on the visual health of primary school students, so as to provide a basis for myopia prevention. Methods In September 2021, a total of 202 third grade students from Fengtai Affiliated School of Renmin University of China in Beijing were recruited, with 75 students in the intervention group and 127 students in the control group.In addition to attending the same cultural and physical education courses, the intervention group added a tennis course twice a week and tested their vision before the intervention (September 2021), middle (January 2022) and later (June 2022).Data collected at different time points in the two groups were analyzed by using independent sample t-test for comparison between blocks, and single-factor repeated measurement ANOVA for analysis of time point factors. Results After intervention, among male subjects, the average visual acuity of the left and right eyes in the intervention group were higher than that in the control group at the third visual acuity test (left eye: 5.00±0.13, 4.88±0.29, right eye: 5.00±0.12, 4.88±0.30, t=2.33, 2.36, P < 0.05).Among female subjects, the second visual acuity test (left eye: 5.03±0.17, 4.86±0.21, right eye: 5.03±0.15, 4.85±0.23) and the third visual acuity test (left eye: 4.97±0.13, 4.81±0.23, right eye: 4.97±0.14, 4.82±0.24) showed that the average visual acuity of the left and right eyes in the intervention group were higher than that in the control group among females (second: t=3.84, 3.87, third: t=3.70, 3.46, P < 0.01).After intervention, the detection rate of visual impairment in both males and females control groups increased at three tests, with statistically significant differences (χ²=17.86, 34.77, P < 0.01).In the first visual acuity test, there was no statistically significant difference in the detection rate of visual impairment between the control group and the intervention group for both males and females (χ²=0.01, 0.10, P>0.05).The third visual impairment detection rate of males in the intervention group was lower than that of the control group (20.00% vs 45.45%), while the second and third visual impairment detection rates of female students in the intervention group were lower than those of the control group (22.86% vs 54.00%;28.57% vs 70.00%)(χ²=7.34, 8.24, 14.18, P < 0.01). Conclusions Tennis can alleviate and prevent the occurrence of myopia in primary school students to a certain extent.Sports such as tennis should be actively promoted to protect the visual health of primary school students.

Associated factors on smoking behavior among adolescents in Chongqing based on a multi-level model

JIN Jiamin, DAI Jianan, YI Jing

2023, 44(12): 1809-1813. doi: 10.16835/j.cnki.1000-9817.2023.12.011

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Objective To investigate the current status of smoking behavior among adolescents in Chongqing and associated factors at both individual and school levels, so as to provide scientific evidence for the development of smoking control strategies for adolescents. Methods From September to October 2021, adolescents'tobacco epidemic monitoring was carried out in Chongqing.A total of 9 588 students from 10 monitoring districts and counties in Chongqing were selected to complete the Chinese adolescent tobacco epidemic survey questionnaire by multi-stage stratified cluster probability sampling method.Multi-level Logistic regression model was used to analyze smoking behavior among adolescents and associated factors. Results The attempted smoking rate among young people was 17.1%, and the current smoking rate was 3.9% in Chongqing.There was a clustering of smoking behavior among participants the school level.Multi-level Logistic regression models showed that general high school, vocational high school, male students, smoking at home, seeing someone smoking in indoor public places, seeing someone smoking at school, smoking among good friends (some smoking, most smoking, all smoking), feeling more comfortable of smoking in social occasions, using electronic cigarette, which were positively correlated with smoking attempts (OR=1.45, 1.40, 1.91, 1.50, 1.42, 1.43, 2.05, 5.38, 6.53, 1.36, 5.04, P < 0.05).Smoking making people look less attractive and feeling more uncomfortable of smoking in social occasions were negatively correlated with smoking attempts (OR=0.76, 0.48, P < 0.05).Vocational high school, male students, smoking at home, seeing someone smoking in indoor public places, smoking among good friends and using electronic cigarette, which were positively correlated with smoking now (OR=1.62, 1.67, 1.69, 1.83, 5.84, 23.02, 35.84, 6.28, P < 0.05).Feeling more uncomfortable of smoking in social occasions was negatively correlated with current smoking (OR=0.29, P < 0.01). Conclusions There is a cluster of attempted smoking and current smoking behaviors at the school level among adolescents in Chongqing, and the influencing factors include school type, gender, family environment, social factors, etc.It should strengthen the implementation and broaden the scope of smoking control regulations in public places, and promote the healthy growth of young people through social school family cooperation.

Analysis of a cohort study on myopia among primary and secondary school students in Henan Province, 2019-2020

XU Lisha, HUANG Ye, WU Wencan, BAN Xiaolei, LOU Xiaomin, WANG Chongjian, WANG Xian

2023, 44(12): 1814-1818. doi: 10.16835/j.cnki.1000-9817.2023.12.012

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Objective To track and investigate the changes in visual acuity of primary and secondary school students in Henan Province during the COVID-19 pandemic home confinement, so as to provide theoretical basis for the prevention and control of myopia. Methods A cohort study design was employed for this research.In September 2019, visual acuity tests were conducted among 2 222 primary and secondary school students by Multi-stage random cluster sampling method from four cities in Henan Province, including Zhengzhou, Xinxiang, Zhoukou, and Pingdingshan.A follow-up study was conducted in June 2020, with on-site visual acuity tests and questionnaire surveys.Wilcoxon rank sum test, Kruskal-Wallis rank sum test, Chi-square test, one-way analysis of variance, and multiple linear regression model were used to analyze the changes in visual acuity of primary and secondary school students and the influencing factors from 2019 to 2020. Results Compared with 2019, the overall myopia rate of students increased in 2020, and the difference was statistically significant (55.7%, 64.9%, χ²=1 035.91, P < 0.01), and the difference between mild, moderate and severe myopia rates occurred at 2 years (2019:32.4%, 18.8%, 4.4%, 2020:36.7%, 22.5%, 5.7%, χ²=8.43, 9.23, 3.94, P < 0.05).The myopia incidence rate of primary and secondary school students in 2020 was 28.3%.As presented in multiple linear regression analysis, middle school, grade 4th-6th and grade 1st-3rd of primary school, low economic level, using television for online classes, the study desk being not bright on sunny days, without looking far away during breaks, the brightness of the study desk and desktop which was average on sunny days, and using roof lamp only when studying at night were associated with myopia progression among students (B=-0.16, -0.18, -0.20, -0.06, -0.21, -0.13, -0.11, -0.40, P < 0.05). Conclusions During 2019-2020, primary and secondary school students in Henan Province experience a progression towards myopia, which is comprehensively influenced by education stage, economic level, the habit of using eyes, and visual environment.Myopia prevention and control should be actively intervened and strengthened to improve the eye environment for primary and secondary school students, in order to slow down the development of myopia.Myopia; Prevalence; Cohort studies; Regression analysis; Students

Current status and related factors of the ecological environment and health literacy among medical students in Shiyan City

TAN Yonghai, RAN Chenlu, ZHANG Miao, LU Yu

2023, 44(12): 1819-1823. doi: 10.16835/j.cnki.1000-9817.2023.12.013

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Objective To investigate the current situation and related factors of the ecological environment and health literacy level of medical college students in Shiyan City, so as to propose relevant countermeasures and suggestions for improvement in these domains. Methods From May to June 2023, 1 312 medical students from Hubei University of Medicine in Shiyan City were selected by accidental sampling to investigate the level and influencing factors of the ecological environment and health literacy among this population.The Chi-square test and binary multivariate Logistic regression analysis were performed to analyze the different characteristics and main influencing factors of the ecological environment and health literacy levels in this population. Results The level of the ecological environment and health literacy level among medical students in Shiyan City was 24.3%.Different levels of ecological environmental and health literacy were observed among medical students by gender, grade, major and ethnicity (χ²=5.13, 54.87, 64.71, 5.99, P < 0.05).Higher rates were also observed among public health major students than among students of other majors.The first three classification literacy levels consisting of basic literacy, basic knowledge, and basic skills were 4.6%, 49.5% and 50.4%, respectively.The possession rates of six secondary classification indicators were as follows: basic cognition (53.2%), basic attitudes (34.5%), scientific knowledge (3.0%), behavioral knowledge (22.5%), cognitive skills (59.5%) and operational skills (48.6%).The results of multivariate Logistic regression showed that ethnic minorities and biomedical majors were negatively correlated with medical students' ecological environment and health literacy (OR=0.61, 0.52), while female students, public health majors, sophomores and seniors were positively correlated with medical students' ecological environment and health literacy (OR=1.44, 1.95, 2.16, 2.24, P < 0.05). Conclusions The overall level of ecological environment and health literacy among medical students in Shiyan City is low.Schools should popularize environmental health knowledge from different perspectives in order to improve the overall literacy level of environmental health literacy among medical students.Environment; Health education; Regression analysis; Students

Effects of grandparent involvement in parenting on health-related behaviors among urban preschoolers

LU Yitong, ZOU Chaoyi, YAO Fang, TU Wenjuan, JIANG Kaihua, GAO Yuexia, LU Qingyun

2023, 44(12): 1824-1827. doi: 10.16835/j.cnki.1000-9817.2023.12.014

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Objective To explore the effects of grandparent involvement in parenting on health-related behaviors among urban preschool children, so as to provide a basis for the development of interventions for unhealthy behaviors among preschool children with different parenting pattern. Methods A total of 5 431 preschool children aged 3-6 years old in Xinbei District, Changzhou City, were selected by census method during January to October, 2022.General household characteristics and health-related behaviors of children were investigated by questionnaires, and the differences in health-related behaviors with different parenting pattern involving grandparents were explored by the χ² test.A multifactorial Logistic regression model was used to analyze the effects of grandparenting on preschool children's health behaviors. Results About 51.2% of preschoolers were raised by both parents, 46.1% were co-parented by grandparents, and 2.7% were raised by grandparents.After multifactorial Logistic regression analysis controlling for age, gender, annual household income, and family structure, children co-parented by grandparents had a reduced risk of screen exposure time>1 h/d (OR=0.79, P < 0.05), with increased risks of outdoor activity time < 2 h/d (OR=1.30, P < 0.05), sleep duration < 10 h/d (OR=1.31, P < 0.05), sleep difficulties (OR=1.39, P < 0.05) and adverse eating behaviors (OR=1.20, P < 0.05), compared with children parented by both parents.Children raised by grandparents were at increased risk for outdoor activity time < 2 h/d (OR=2.19) and unhealthy eating behaviors (OR=1.39)(P < 0.05). Conclusions Compared with children raised by both parents, the incidence of unhealthy behaviors is increased in children raised by parents and grandparents and in children raised by full grandparents.Active intervention should be focused on unhealthy behaviors of preschool children with pareting involving grandparents to promote the physical and mental health of preschool children.

Analysis of exercise density and exercise load in different physical classes for second-year junior high school students from Beijing City

WU Zhigui, CHANG Guangjie, JI Yongqi, DING Tiancui, HOU Lijuan

2023, 44(12): 1828-1832. doi: 10.16835/j.cnki.1000-9817.2023.12.015

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Objective To explore the exercise intensity and effective exercise load of different physical fitness classes for second-year junior high school students in Beijing, so as to provide a reference for optimizing the teaching content of physical fitness classes, reasonably regulating exercise load and the scientific development of physical fitness. Methods From October to November 2022, 30 second-year junior high school students from a middle school in Xicheng District, Beijing were selected to have their heart rate monitored during physical fitness classes using Polar heart rate monitors. Heart rate intervals and training impulse (TRIMP) were used to quantify exercise intensity and load. Independent sample t-test was used to statistically analyze differences in heart rate across different dimensions. Results The average heart rate of students in physical fitness classes was (140.62±9.41) counts/min, with effective exercise load (heart rates ≥120 counts/min) time accounting for 77.2%, and heart rate load of moderate to vigorous physical activity (MVPA) time accounting for 51.9%. The average heart rates for speed, speed endurance, and endurance physical fitness classes were (137.89±8.82) (137.67±11.27) and (145.35±8.98) counts/min, respectively. The average heart rates of male and female students in physical education class were (144.22±24.95) and (136.31±28.78) counts/min, and the difference was not statistically significant (t=4.04, P>0.05). The cumulative durations of effective exercise load among male and female students were (34.08±7.52) and (28.43±5.39) min, respectively. The average TRIMP value for physical fitness classes were (100.46±16.56), with a exercise density of 72.06%. Conclusions The exercise intensity of physical fitness classes for second-year junior high school students in Beijing is appropriate, mainly with moderate to vigorous intensity, and the accumulated time of MVPA is sufficient. The average heart rate and exercise density of students meet the requirements. Scientific setting of physical fitness class exercise load should be based on individual differences in students' physical fitness, in order to improve the physical health level of middle school students.

Association of screen time with psychological and behavioral development problems in children aged 3-6 years

HUANG Jinjiao, YE Peiqi, WEI Qian, LYU Pingping, SHI Yuyang, SHI Huijing

2023, 44(12): 1833-1838. doi: 10.16835/j.cnki.1000-9817.2023.12.016

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Objective To investigate the distribution of various types of screen time and examine the association of screen time with psychological and behavioral development problems in children aged 3-6 years, so as to provide scientific basis for children's screen use and mental health promotion. Methods A total of 3 875 mother-child dyads who completed the follow-up in Shanghai Maternal-Child Pairs Cohort were included. The daily usage time of children's tablet, mobile phone, TV, projectors, and other types of screens were obtained in questionnaire survey. Children's psychological and behavioral development problems were evaluated by Age-Stage Questionnaire, Third Edition (ASQ-3) and Strengths and Difficulties Questionnaire (Parent version) (SDQ). The Chi-square test, Mann-Whitney U and Kruskal-Wallis rank sum test were used to compare the detection rate of psychological and behavioral development problems and screen time in children with different characteristics. Multivariate binary Logistic regression was used to analyze the association of screen time with psychological and behavioral development problems. Results There were 49.91% of children having screen time more than 1 h/d. Children's TV, tablet and mobile phone screen time were 0.39(0.25, 0.96), 0.25(0, 0.61) and 0.18(0, 0.25) h/d. The detection rates of suspected developmental delay in fine motor, problem-solving and personal-social domains and pro-social behavior deficiency and externalizing behaviors in boys (8.54%, 6.77%, 5.46%, 30.07%, 27.39%) were higher than that in girls (4.64%, 4.85%, 2.48%, 22.10%, 22.36%) (χ²=23.76, 6.49, 22.37, 31.81, 13.06, P < 0.05). There were statistically significant differences in the detection rates of suspected developmental delay in communication, fine motor and problem-solving, as well as internalizing behavior and externalizing behavior of children with different parents' educational levels (χ²=14.37, 15.18, 21.10, 11.66, 9.27; 16.34, 26.75, 32.89, 16.97, 6.37, P < 0.05). There were significant differences in the detection rates of suspected developmental delay in problem-solving, prosocial behavior deficiency, internalizing behavior and externalizing behavior of children whose mothers had anxiety/depression symptoms during pregnancy (χ²=5.61, 9.05, 21.90, 7.17; 8.75, 6.06, 12.76, 5.55, P < 0.05). The average total screen time of boys was longer than that of girls (1.07, 1.00 h/d, Z=-2.08, P=0.04). Compared with children with other educational levels of their parents, the total screen time, mobile phone and TV screen time of children whose parents had college education or above were short (father: H=42.01, 44.49, 21.24, mother: H=42.31, 39.21, 26.47, P < 0.01). Among all types of screen time, mobile phone screen time had the most impact on psychological and behavioral development. More mobile phone screen time increased the risk of suspected developmental delay and abnormal emotional behavior (P < 0.05). Screen time of tablet, mobile phone and TV were positively correlated with externalizing behavior (OR=1.36, 1.57, 1.27, P < 0.05). Conclusions Screen time is related to children's psychological and behavioral development problems and mobile phones affect the most. Parents should limit their children's screen time to avoid excessive screen time affecting their psychological and behavioral development.

Analysis of heart rate variability in college students with depression and suicidal ideation

LI Mengtian, SI Feng, YIN Fei, JIN Xi, HUO Shuhui, CAO Jianqin

2023, 44(12): 1839-1842. doi: 10.16835/j.cnki.1000-9817.2023.12.017

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Objective To compare the differences in heart rate variability (HRV) indicators between depressive college students with and without suicidal ideation, so as to provide a reliable objective physiological basis for suicide screening and prevention among college students. Methods From March to April 2023, a total of 60 college students with depression aged 17-25 years old were recruited from three universities in Daqing City, Heilongjiang Province through online and campus recruitment. They were divided into the depression with suicidal ideation group (30 cases) and the depression without suicidal ideation group (30 cases) based on the presence of suicidal ideation. A screening survey was conducted on college students using a self-designed general information questionnaire, Hamilton Depression Scale (HAMD), and Scale for Suicide Ideation (SSI). In May 2023, 5-minute resting HRV data was collected from the two groups of participants, and statistical analysis was conducted using t-tests or Mann-Whitney U tests. Results The SSI and HAMD scores of college students in the depression group with suicidal ideation [7.00(4.25, 16.00), 40.73±12.88] were higher than those in the depression group without suicidal ideation [4.50(1.75, 6.00), 29.17±8.15] (Z/t=-6.64, 4.16, P < 0.01). The standard deviation of the NN (SDNN), standard deviation of the average NN intervals (SDANN) and standard deviation of the NN interval every 5 minutes (SDNN Index) in the HRV time-domain indicators of college students with depression and suicidal ideation [42.75(35.03, 60.75)ms, 32.75(26.65, 46.88)ms, (298.82±61.61)ms] were lower than those in the depression without suicidal ideation group [50.80(46.15, 59.68)ms, 38.80(34.50, 45.80)ms, (329.20±50.80)ms] (Z/t=-2.43, -2.20, -2.08, P < 0.05). The very low frequency (VLF) in frequency domain indicators of college students with depression and suicidal ideation [0.02(0.02, 0.02)Hz] was higher than that in the depression group without suicidal ideation [0.02(0.01, 0.02)Hz] (Z=-2.19, P < 0.05). Conclusions College students with suicidal ideation have higher levels of depression and imbalanced autonomic nervous system function, and HRV may become an objective physiological indicator for identifying suicidal ideation.

Association of pre-school children physical activities and sedentary behaviors on calcanues bone density

WEN Lei, ZHANG Shuna, SUN Shunli, SU Liqiang, HUANG Ting, ZOU Weina, FU Jinmei, ZHAO Miaolin

2023, 44(12): 1843-1847. doi: 10.16835/j.cnki.1000-9817.2023.12.018

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Objective To investigate the effects of physical activity (PA) intensity and sedentary behavior (SB) on calcanues bone mineral density (BMD) in preschool children, so as to provide a basis for rationalizing the daily physical activity of preschool children to promote bone health. Methods A total of 673 pre-school children aged 3-6 years from nine kindergartens in Pingxiang City, Ganzhou City and Yingtan City of Jiangxi Province, were selected from September to December 2021 by using the whole stratified cluster random sampling method. The PA levels and SB were measured by using a three-axis acceleration sensor, and left calcanues BMD was measured by an ultrasound bone densitometer. Multiple linear regression was used to explore the effects of changes in PA on calcanues BMD in pre-school children of all ages. Results Of the 673 preschoolers surveyed, 498 (74.0%) achieved an average of ≥60 min of moderate to vigorous physical activity (MVPA) per day, there were 265 boys (71.2%), and 233 girls (77.4%). The difference between genders was not statistically significant (χ²=2.77, P>0.05). There was no statistically significant difference in the BMD test of the calcaneus bones of preschoolers by gender (Z=0.42, P>0.05). The difference in BMD results of pre-school children with 3, 4, 5 to 6 years was statistically significant (H=2.65, P < 0.05). Correlation analysis revealed a negative correlation between SB duration and calcaneus BMD (r=-0.13), and a positive correlation between low-intensity physical activity (LPA) duration, MVPA duration, and calcaneus BMD (r=0.14, 0.25) (P < 0.05). Multivariate linear regression analysis showed that SB duration negatively correlated with calcaneus BMD, whereas LPA and MVPA duration positively correlated with calcaneus BMD (P < 0.05). Conclusions MVPA duration is positively correlated with the growth of BMD in the heel bone and negatively correlated with SB. The kindergartens can adjust their curricula according to the physical and mental developmental characteristics, gender and age differences of pre-school children, increase the time of outdoor activities, and reduce the sedentary time to promote the bone health of young children.

Association between different types of obesity and puberty timing in primary and secondary school students in Suzhou City

LYU Huiling, WANG Xi, HU Jiale, HAN Di, HU Jia, SHEN Hui

2023, 44(12): 1848-1852. doi: 10.16835/j.cnki.1000-9817.2023.12.019

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Objective To explore the association between obesity types and puberty timing, in order to provide clues for healthy development in children and adolescents. Methods From October to November 2022, a stratified cluster random sampling method was used to select a total of 2 009 students from 4 primary schools and 4 middle schools in Suzhou City. The basic information, diet, exercise behaviors, outdoor activities, sleep, view screen and pubertal development of students were collected through standardized questionnaires. Height, weight and waist circumference were measured. The association between different types of obesity and pubertal development was analyzed using Logistic regression model. Results The median age of menarche for girls in primary and middle schools in Suzhou was 11.64 years old, the median age of first spermatorrhea in boys was 14.43 years old. After adjusting the covariates, the Logistic regression analysis results showed that overweight and simple obesity, central obesity, and mixed obesity groups were positively correlated with puberty onset among girls [OR(95%CI)=3.20(1.63-6.29), 4.15(2.18-7.91), 2.70(1.52-4.79), 2.42(1.23-4.76)], as well as early puberty onset [OR(95%CI)=2.41(1.54-3.75), 2.46(1.55-3.90), 1.59(1.05-2.40), 1.72(1.06-2.81)] (P < 0.05). The overweight, simple obesity and central obesity group were negatively correlated with delayed onset of puberty [OR(95%CI)=0.45(0.24-0.85), 0.48(0.25-0.92), 0.44(0.24-0.80), respectively] (P < 0.05). There was no statistically significant association between overweight and obesity among boys and the onset and phase of puberty (P>0.05). Conclusions There are gender differences in the association between different types of obesity and the onset and timing of puberty among children and adolescents. Intervention measures should be taken to control obesity in children and adolescents, especially in girls, in order to improve their adolescent development.

Correlation between 24-hour time allocation patterns and physical fitness of Mongolian junior school students

JIN Liming, WUYUN Gerile, DELI Geer

2023, 44(12): 1853-1857. doi: 10.16835/j.cnki.1000-9817.2023.12.020

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Objective To identify the 24-hour time allocation patterns of Mongolian junior school students, and to clarify the nature and degree of the influence of the time allocation patterns on the physical fitness of junior school students, so as to provide reference for optimizing and improving the scientific allocation of activity time of young students. Methods In October 2022, 1 389 Mongolian junior school students aged 13-15 from four schools in Xing'an League of Inner Mongolia Autonomous Region were selected with stratified cluster sampling method. The 24-hour time utilization of students were collected by using the questionnaire of "China Time Utilization Survey (CTUS) Time Log in 2017" from October 21 to 22, 2022, and physical fitness was evaluated by using the test data of the National Student Physical Health Standard from September to November 2022. Students' time allocation patterns were determined by Latent Profile Analysis with Mplus software, and the correlation between the time allocation patterns and the physical fitness was analyzed by multiple linear regression. Results The time allocation patterns of Mongolian junior school students could be classified into four types: learning type, screen type, diversity type, and sports type, and the population distribution were 24.7%, 18.3%, 9.9% and 47.1%, respectively. Among all gender and age groups, the sports type received highest total score physical fitness, followed by diversified type, learning type, and screen type (F=72.25-154.94, P < 0.01). The results of multiple regression analysis showed that gender, age, and time allocation patterns were significantly related to the total score of physical fitness (P < 0.05). The total score of physical fitness in learning type, diversity type and sports type groups were all higher than that of screen type (β=5.63, 12.86, 18.03, P < 0.05). Moreover, the sports type showed highest effects on the total score of physical fitness, followed by the diversity type and learning type (B=0.72, 0.31, 0.19, P < 0.05). Conclusions There is a significant correlation between time allocation patterns and physical fitness of Mongolian junior school students, and those in sports type and diversity type of time allocation achieve better physical fitness, while those in learning type and screen type of time allocation shows relatively poorer physical fitness.In order to promote students' physical fitness and healthy development, it is suggested to scientifically arrange students' time allocation, increase physical activity time, and reduce sedentary activities that are detrimental to health.

Correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia

LI Lehui, ZHANG Xingguang, FANG Xin, CAO Ning, SU Zhigang, YAN Tao, ZHANG Nan

2023, 44(12): 1858-1862. doi: 10.16835/j.cnki.1000-9817.2023.12.021

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Objective To explore the correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia, so as to providing a scientific basis for guiding rational vitamin D supplementation among primary and middle school students in Inner Mongolia Region. Methods A total of 2 206 students of primary and middle school students from 8 counties (districts) in Inner Mongolia were enrolled for a questionnaire survey, physical examination, and laboratory test by a multi-stage stratified random sampling approach.The levels of fasting blood glucose, blood lipid and other related indexes with different vitamin D levels were analyzed, and their correlation was further discussed. Results The deficiency and insufficiency rates of vitamin D among primary and middle school students were 33.2% and 42.8%, respectively, and the suitable rate was 24.0%. The body mass index (BMI) and waist-height ratio (WHtR) of the vitamin D deficiency group [(22.87±7.41)kg/m², 0.46±0.08)]were higher than the insufficiency [(20.59±8.00)kg/m², 0.44±0.09)] and suitable group [(18.01±7.38)kg/m², 0.43±0.08)] (P < 0.05). Compared with the vitamin D suitable group [(3.87±0.85) mmol/L], the total cholesterol (TC) level in the deficiency group [(3.73±0.67)mmol/L] decreased, with a statistically significant difference (P < 0.05). The levels of high density lipoproteins (HDL) in the vitamin D insufficiency[(1.40±0.33)mmol/L] and deficiency groups [(1.34±0.31)mmol/L] were lower than the suitable group [(1.48±0.34)mmol/L], with a statistically significant difference (P < 0.05). The detection rate of hyperuricemia (HUA) in the vitamin D deficiency group (22.95%) was higher than the suitable group (17.20%), with a statistically significant difference (P < 0.016 7). Pearson correlation analysis showed that vitamin D was negatively correlated with BMI and WHtR (r=-0.23, -0.11), and positively correlated with TC and HDL level (r=0.06, 0.16) (P < 0.05). Conclusions The deficiency and insufficiency rates of serum vitamin D among primary and middle school students in Inner Mongolia are high which are associated with several indicators of blood lipids. Therefore, it is recommended to supplement vitamin D preparations in moderation in daily life.

Effect of high-intensity interval training exercise prescription on the physical health of obese primary school students

CAO Meng, YU Fengyuan, GAO Rongman, LI Jiaxin, YANG Hejin, WANG Xiaodong

2023, 44(12): 1863-1866. doi: 10.16835/j.cnki.1000-9817.2023.12.022

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Objective To examine the effects of high-intensity interval training (HIIT) on body composition and cardiorespiratory fitness of obese primary school students, so as to provide a theoretical basis and practical reference for HIIT exercise prescription in schools. Methods From August to December 2022, 25 obese children [age: (11.0±0.4)years, BMI: (23.3±0.8)kg/m²] from a primary school in Shenzhen were recruited and divided into an exercise group (n=13) and a control group (n=12). After 12 weeks of exercise intervention [The durations of load period and intermittent period were 15 s, load exercise intensity was 100% maximal aerobic speed (MAS), and intermittent exercise intensity was 50% MAS, each time there were 2 groups× 8 rounds, and the rest between groups was 2 minutes, totaling 10 minutes, and 20 meter shuttle run test (20 m-SRT) was performed once every 4 weeks to adjust and update MAS], the changes in body composition and cardio-respiratory fitness indexes of obese subjects before and after the intervention were compared. Results After the intervention, body weight, BMI, body fat, body fat percentage, and visceral adipose tissue area of obese subjects in the exercise group decreased from (55.6±6.2)kg, (22.7±0.6)kg/m², (41.8±6.9)kg, (23.4±5.5)% and (102.4±39.0)cm² to (52.3±5.8)kg, (21.1±0.8)kg/m², (38.6±6.3)kg, (20.2±4.5)% and (84.2±26.9)cm², respectively(t=8.73, 10.96, 7.02, 4.92, 4.95, P < 0.05). SBP decreased from (115.4±9.7)mmHg to (112.3±8.7)mmHg (t=2.96, P < 0.05). The content of skeletal muscle, 20 m-SRT and VO₂max increased from (21.3±5.3)kg, (21.6±4.9) times and (39.4±2.0)mL/(kg ·min) to (21.8±5.2)kg, (31.4±6.3)times and (43.6±2.6)mL/(kg ·min), respectively (t=-3.33, -8.37, -10.56, P < 0.05). Conclusions HIIT is an effective way to improve the body composition and cardiorespiratory fitness of obese primary school students. It is recommended that schools with the necessary conditions use this method as an intervention measure to help reduce weight and improve cardiovascular health among obese students.

Analysis of traffic injury and associated risk behaviors among secondary school students in Shanghai City

ZHOU Xinyi, ZHOU Yuefang, SUN Lijing, YUAN Linlin, ZHANG Zhe, ZHAI Yani, LUO Chunyan

2023, 44(12): 1867-1872. doi: 10.16835/j.cnki.1000-9817.2023.12.023

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Objective To investigate incidence of traffic injury and its associated factors among secondary school students in Shanghai, so as to provide scientific basis for intervention. Methods Using the method of multi-stage stratified random cluster sampling, an on-the-spot anonymous questionnaire survey was conducted among 19 629 adolescents from 16 districts in Shanghai from May to June 2021. The multivariate Logistic regression was used to analyze possible associated factors. Results The rate of road traffic injuries among secondary school students in Shanghai was 0.74%, the highest reporting rate among secondary vocational school students (1.35%), followed by junior high school students (0.72%), and the lowest reporting rate of road traffic injuries among senior high school students (0.55%), with statistically significant differences (χ²=13.39, P < 0.01). The results of multivariate Logistic regression analysis showed that the junior high school (OR=0.56, 95%CI=0.35-0.89) or senior high school (OR=0.40, 95%CI=0.24-0.68) and residential school (OR=0.39, 95%CI=0.18-0.88) were protective factors of road traffic injuries(P < 0.05). Male (OR=1.65, 95%CI=1.14-2.37), unaware of seat belt (OR=6.38, 95%CI=2.81-14.50), had a cycling chase/fight (OR=2.33, 95%CI=1.39-3.90), music or phone calls on a bicycle (OR=2.54, 95%CI=1.72-3.75) were positively correlated with road traffic injury(P < 0.05). Conclusions The road traffic injury among secondary school students in Shanghai is related to many factors, and traffic hazards are common among students in all school sections. Targeted measures should be taken to strengthen traffic safety knowledge education and intervention in healthy behaviors among adolescents, in order to reduce the incidence of road traffic injury.

Epidemiological characteristics of chronic diseases mortality among children aged 0-14 in China during 2012-2021

TANG Xin, ZHU Yan, ZHANG Yueling, NIE Ying, FANG Xue

2023, 44(12): 1873-1877. doi: 10.16835/j.cnki.1000-9817.2023.12.024

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Objective To analyze the epidemiological characteristics and trends of chronic disease mortality among children aged 0-14 in China during 2012-2021, so as to provide scientific basis for the formulation of prevention strategies for chronic diseases in children. Methods The descriptive epidemiological analysis was conducted for chronic disease mortality among children aged 0-14 during 2012 to 2021 from China Cause of Death Surveillance Data Set, and the Joinpoint regression models were used to analyze the average annual percentage change (AAPC) of child chronic disease mortality. Results From 2012 to 2021, the mortality rates of chronic diseases among children aged 0-14 years in China (23.33/100 000, 19.54/100 000, 19.27/100 000, 17.69/100 000, 16.87/100 000, 16.44/100 000, 14.49/100 000, 13.79/100 000, 11.61/100 000, 9.43/100 000)showed a decreasing trend (AAPC=-7.94%, P < 0.01). The overall mortality rates for boys and girls and for chronic diseases were decreasing in both urban and rural areas (AAPC=-8.44%, -7.05%, -8.42%, -6.77%, P < 0.05). The average annual mortality rate of chronic diseases was higher in boys (16.81/100 000) than in girls (13.96/100 000) (χ²=526.44, P < 0.01). The average annual mortality rate from chronic diseases among children was higher in urban (15.98/100 000) than in rural areas (13.46/100 000) in the central region, and higher in rural (19.75/100 000) than in urban areas (15.96/100 000) in the western region (χ²=117.63, 190.25, P < 0.01). Except for malignant tumors, the trend of overall mortality rates of congenital abnormalities, neurological and mental disorders, cardiovascular diseases, and digestive system diseases were all decreasing (AAPC=-11.48%, -2.92%, -7.82%, -12.51%, P < 0.05). Conclusions The overall mortality rate of chronic diseases in children in China shows a downward trend during 2012-2021, but the situation of chronic disease prevention and control is still severe. Targeted prevention strategies should be adopted, focusing on the prevention and health care of males, children under 5 years old.

A multilevel model analysis of the association between reading and writing posture with myopia in primary and secondary school students

XU Huiyu, QIN Ran, ZHANG Jingshu, WANG Lu, WANG Yan, LUO Huijuan, GUO Xin

2023, 44(12): 1878-1882. doi: 10.16835/j.cnki.1000-9817.2023.12.025

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Objective To explore the association between reading and writing posture with the occurrence of myopia in Chinese children and adolescents, so as to provide a reference for reducing its prevalence among primary and secondary school students. Methods Using data from the 2020 survey on the current status of hyperopia reserve in primary and secondary school students from six provinces/cities, namely Beijing, Zhejiang, Chongqing, Shaanxi, Liaoning, and Henan selected by multi-stage stratified cluster probability sampling method during November 2020 to June 2022. A total 16 782 students who completed the optometry examination of cycloplegia according to the Children and Adolescents Myopia Screening Standard and questionnaire survey were included for analyzing analyze the association between reading and writing posture with myopia. Results The overall detection rate of myopia among primary and secondary school students was 45.7%, of which 35.0% were primary school students, 84.1% junior high school students, and 90.4% senior high school students. Poor reading and writing posture was found in 73.6% of primary and secondary school students. Adjusting for confounding factors such as gender, school period, region, outdoor time every day, and whether parents were myopic, the results of the multilevel Logistic regression showed that the following factors were positively correlated with myopia: poor reading and writing posture (OR=1.17, 95%CI=1.07-1.28), never/occasionally reading and writing with a reading distance which was more than one foot away between the eyes and book (OR=1.28, 95%CI=1.08-1.53, OR=1.23, 95%CI=1.08-1.40), teachers occasionally reminding the child of their reading and writing posture (OR=1.13, 95%CI=1.01-1.25), and often/always reading and writing while lying down or with the face on the arm (OR=1.15, 95%CI=1.01-1.32, OR=1.46, 95%CI=1.17-1.82), always reading and writing with the head in the hand (OR=1.56, 95%CI=1.20-2.01). Further, a negative correlation was detected between myopia and parents occasionally reminding their children of their reading and writing posture (OR=0.85, 95%CI=0.76-0.96) (P < 0.05). Conclusion Poor reading and writing posture is a risk factor for the development of myopia in primary and secondary school students, and interventions for reading and writing posture need to be strengthened to reduce the occurrence of myopia among primary and secondary school students.

miR-142-3p alleviates house dust mite-induced airway inflammation among children

WU Feng, SONG Tingting, ZANG Xiao, HONG Shanchao, WANG Wei

2023, 44(12): 1883-1888. doi: 10.16835/j.cnki.1000-9817.2023.12.026

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Objective To investigate the role of miR-142-3p in alleviation of house dust mite-induced allergic airway inflammation among children, so as to provide insights into unraveling the pathogenesis of allergic airway inflammation. Methods Serum samples were collected from 15 patients with house dust mite-induced allergic asthma and 15 healthy children in Jiangnan University Medical Center from September to November 2022, and serum miR-142-3p expression was quantified using a fluorescent quantitative real-time PCR (qPCR) assay. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured in the cell culture supernatant using enzyme-linked immunosorbent assay (ELISA), and the expression of high mobility group box 1 (HMGB1) was detected at transcriptional and translational lvels using qPCR and Western blotting assays. The negative regulation of the HMGB1 gene by miR-142-3p was identified using a dual luciferase gene reporter assay, and the expression of downstream regulatory proteins was determined in human normal lung epithelial cells (BEAS-2B) cells transfected with miR-142-3p using Western blotting. In addition, female C57BL/6 mice at ages of 6-8 weeks were randomly assigned to the phosphate buffer saline (PBS) group, house dust mite-sensitized airway inflammation group and house dust mite-sensitized airway inflammation + miR-142-3p intervention group. Mouse airway inflammation was evaluated using hematoxylin-eosin staining, and the expression of inflammatory cells and inflammatory cytokines were detected in mouse bronchoalveolar lavage fluid (BALF) using Giemsa staining and ELISA. Results Lower serum miR-142-3p expression was quantified among children with house dust mite-induced allergic asthma than among healthy controls (1.33±0.21 vs. 4.74±0.62, t=5.22, P < 0.05). Stimulation with dermatophagoides farinae extract (DFE) resulted in a reduction in miR-142-3p expression in BEAS-2B cells (0.82±0.25), while transfection with miR-142-3p mimics resulted in a rise in miR-142-3p expression in BEAS-2B cells (0.55±0.14)(t=3.31, 3.94, P < 0.05). Pre-treatment with miR-142-3p reduced the expression of IL-6(2.25±0.46)and TNF-α(6.58±1.95) (t=4.86, 3.38, P < 0.05) in BEAS-2B cells stimulated with DFE, and treatment with miR-142-3p mimics resulted in a reduction in TLR4 and NF-κB expression in BEAS-2B cells via negative regulation of the HMGB1 expression. In addition, treatment with miR-142-3p was found to alleviate inflammatory cell infiltration in lung tissues of house dust mite-sensitized mice, and results in a reduction in interleukin-4 (IL-4)[(107.60±10.43)pg/mL], interleukin-5 (IL-5)[(95.78±13.14)pg/mL] and HMGB1[(2.52±0.87)pg/mL] expression in BALF (t=10.32, 7.29, 2.90, P < 0.05). Conclusion miR-142-3p alleviates house dust mite-induced allergic airway inflammation among children via negative regulation of the HMGB1/TLR4/NF-κB pathway.

Spatial-temporal feature of tuberculosis among high school students in Gansu Province from 2018 to 2022

WANG Bo, HE Aiwei, ZHAO Jianxi, BAI Yu'e, GUO Qiang, MA Yubao, YANG Shumin

2023, 44(12): 1889-1893. doi: 10.16835/j.cnki.1000-9817.2023.12.027

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Objective To analyze the spatial-temporal distribution characteristics of tuberculosis among high school students at county levels in Gansu Province from 2018 to 2022, so as to provide a scientific basis for tuberculosis prevention and control in schools. Methods Tuberculosis data from high school students in counties (districts) reported in Gansu Province from 2018 to 2022 was collected from the Tuberculosis Information Management System and Infectious Disease Information Reporting System of the Chinese Disease Prevention and Control Information Management System. Demographic data of high school students in counties (districts) came from the General Management System of the Chinese Disease Prevention and Control Information Management System, and the spatial clustering of the reported incidence rate of pulmonary tuberculosis among high school students in Gansu Province in the past five years was analyzed using the methods of global spatial autocorrelation (Moran's I) and local indicators of spatial audocorrelation(LISA). Results A total of 41 885 pulmonary tuberculosis cases were reported in various counties of Gansu Province From 2018 to 2022, with an average reported incidence rate of 32.81/100 000. During the same period, 1 170 high school students cases were reported, with an average reported incidence rate of 13.72/100 000. With the exception of 2020, the reported incidence rate of pulmonary tuberculosis among high school students was non random distribution in other 4 years, showed a moderate intensity of spatial clustering. From 2018 to 2022, most counties in Gansu Province reported that the incidence rate of pulmonary tuberculosis among high school students was 10.00/100 000 or below, the counties with reported incidence rate >40.00/100 000 were mainly distributed in Luqu County, Maqu County, Diebu County, Hezuo City, Xiahe County of Gannan Prefecture, Gangu County and Wushan County of Tianshui Prefecture, Wenxian County and Kangxian County of Longnan Prefecture, Huachi County of Pingliang Prefecture, Huanxian County of Qingyang Prefecture. The number of counties where the reported incidence rate of tuberculosis among high school students more than 30.00/100 000 gradually decreased from 2018 to 2022. In the past five years, the reported incidence rate of tuberculosis among high school students in all counties of Gannan Prefecture remained above 40.00/100 000. The LISA analysis results showed that the high incidence areas were mainly concentrated in Gannan Prefecture. Conclusions The epidemic situation of pulmonary tuberculosis among high-school students in Gansu province from 2018 to 2022 is still a serious condition, showing the characteristics of unbalanced regional distribution. The reported incidence rate shows a strong spatial clustering, and the hot spots are concentrated in the counties (districts) of Gannan prefecture in Gansu Province.

The prevalence and associated factors of functional constipation among primary and middle school students in Shaanxi Province

YANG Xing, WANG Lu, QIN Bin, ZHAO Xiaojing, DONG Lei

2023, 44(12): 1894-1897. doi: 10.16835/j.cnki.1000-9817.2023.12.028

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Abstract:
Objective To understand the prevalence and associated factors of functional constipation(FC) among primary and middle school students in Shaanxi Province, in order to provide a basis for preventing FC in students. Methods A stratified cluster random sampling method was used to conduct a questionnaire survey on 9 133 primary and middle school students aged 10-18 in eight primary and secondary schools in Shaanxi Province from March to September, 2017. Chi-square test and multivariate Logistic regression were used to analyze the associated factors of FC among primary and middle school students in Shaanxi Province. Results There were a total of 364 students meeting the FC Rome Ⅳ diagnostic criteria, with a prevalence rate of 3.99%. Among them, there were 155 male students with a prevalence rate of 3.43%, and 209 female students with a prevalence rate of 4.53%. Univariate analysis showed that gender, breastfeeding, separation from parents, long-term school meals, types of staple foods, breakfast frequency, cold foods eating frequency, spicy foods eating frequency, fried food eating frequency, pickled food eating frequency, desserts eating frequency, vegetables eating frequency were related to FC, and the differences were statistically significant (χ²=7.30, 18.75, 20.89, 35.54, 22.43, 16.05, 21.31, 13.97, 10.33, 23.96, 16.25, 17.74, P < 0.05). Multivariate Logistic regression analysis showed that female, non breastfeeding, separation from parents, long-term school meals, low consumption of staple food/staple food dominated by rice, and never eating vegetables were positively correlated with FC(OR=1.37, 1.96, 1.52, 2.07, 1.76, 1.58, 2.31, P < 0.05). Conclusions The prevalence of functional constipation is higher in primary and middle school students. Attention should be paid to factors related to students' dietary habits and food classification to prevent the occurrence of FC in primary and middle school students.

Epidemiological and etiological characteristics of hand-foot-mouth disease in Tongren City from 2018 to 2022

WU Dingguo, YU Yang, ZHANG Junli, GAO Qianrong

2023, 44(12): 1898-1901. doi: 10.16835/j.cnki.1000-9817.2023.12.029

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Objective To analyze the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in Tongren City during 2018 to 2022, so as to provide the reference for HFMD effective prevention and control. Methods Monitoring data on HFMD in Tongren City from 2018 to 2022 was collected from National Infectious Disease Reporting Information Management System. Descriptive epidemiological method was conducted on the data analysis. Results A total of 14 376 cases of HFMD were reported in Tongren City during 2018 to 2022, the average annual incidence rate of HFMD was 89.43/100 000. Totally 47 severe cases were reported, accounting for 0.33% of the total cases. The incidence rates of HFMD were generally declining trend during 2018 to 2022 (124.68/100 000, 95.37/100 000, 78.50/100 000, 61.63/100 000, 87.80/100 000) (χ_trend²=393.05, P < 0.01), mainly occurred during April to July (48.13%), among children under 5 years old (95.72%). During 2018 to 2022, a total of 967 laboratory diagnosed cases reported in different years, regions, age groups showed significant differences in pathogen composition ratio (χ²=169.62, 456.65, 167.96, P < 0.05). From 2018 to 2022, the dominant pathogen of HFMD was constantly changing. Other enteroviruses were the dominant epidemic strains in 2018 and 2022 (33.04%, 37.62%), CoxA 6 was the dominant epidemic strain in 2019 to 2020 (68.75%, 50.78%), and CoxA16 was the dominant epidemic strain in 2021(43.30%).In 2018, one case was infected with CoxA16 and EV71.The difference of pathogen composition ratio varied in different years (χ²=169.62, P < 0.01). Conclusions The prevalence of HFMD in Tongren City has showed a declining trend during 2018 to 2022, and the dominant strain of HFMD has changed in recent years. The pathogen monitoring of HFMD should be strengthened to timely grasp the distribution and changes of pathogens, so as to provide a basis for the precise prevention and control of HFMD.

Knowledge of disinfection and its influencing factors among caregivers in childcare centers in Huangpu District, Shanghai City

FAN Junhua, TANG Yi, JI Xiaofan, QIAN Ziyu, TIAN Liang, ZHU Renyi

2023, 44(12): 1902-1906. doi: 10.16835/j.cnki.1000-9817.2023.12.030

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Objective To understand the knowledge of disinfection and its influencing factors among caregivers in childcare centers in Huangpu District, Shanghai, in order to provide a basis for the future development of targeted training programs and the work plan to enhance the professional level of disinfection practitioners in childcare centers. Methods A total of 423 caregivers from 62 childcare centers (including nursery schools) in Huangpu District were selected for a questionnaire about disinfection knowledge, influencing factors, and training needs in March 2023. Differences in disinfection knowledge among subjects with different characteristics were compared using χ² tests, and influencing factors were analyzed using a multi-factor binary Logistic regression model. Results The overall knowledge rate of disinfection among caregivers was 50.12%, and those in public kindergartens, private ones, and nursery schools were 51.35%, 46.18%, and 42.57%, respectively, with statistically significant differences (χ²=14.25, P < 0.05). The caregivers in the highest level kindergartens (OR=4.50, 95%CI=1.97-10.29), in first level ones (OR=4.29, 95%CI=1.98-9.33), in the institutions had clusters of outbreaks (OR=1.87, 95%CI=1.14-3.07), in which the number of children to caregivers ratio being less than 10∶1 (OR=21.81, 95%CI=2.55-186.59), with 6-14 years of working experience (OR=3.51, 95%CI=1.59-7.75) had better knowledge of disinfection(P < 0.05). Conclusions Knowledge of disinfection among caregivers of childcare institutions is low in Huangpu District, Shanghai. Training of caregivers' disinfection knowledge should be strengthened for caregivers with fewer years of experience, in childcare institutions, to improve caregivers' disinfection expertise and skills.

Research progress of nutrition literacy assessment for children and adolescents

CHEN Danlu, DU Miao, JIANG Ying

2023, 44(12): 1907-1911. doi: 10.16835/j.cnki.1000-9817.2023.12.031

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Children and adolescents are at an important stage in the development of eating habits and food skills. Nutrition literacy is inseparable from healthy eating behaviors and higher nutritional quality, and improving nutrition literacy is an important pathway to better nutrition. The paper summarizes domestic and international research on nutrition literacy from the perspectives of definition and assessment tools in children and adolescents. It is found that there is no universal definition of nutritional literacy. Adult nutrition literacy or with appropriate adjustments are widely used in children and adolescents, without taking into account the unique developmental characteristics and nutritional needs of children and adolescents; the measurement tools of nutritional literacy are diverse, and there is no unified assessment tools, so it is difficult to compare and analyze research findings and draw reliable conclusions. In the future, authoritative definitions, and standardized evaluation tools are in great need.

Research progress on social withdrawal in children

ZOU Jiali, LI Zehui, FANG Guangping, LING Chengrong, ZHAO Dongmei, WU Yunlian

2023, 44(12): 1912-1915,1920. doi: 10.16835/j.cnki.1000-9817.2023.12.032

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Social withdrawal is a kind of behavioral inhibition in social situations, which may increase the risk for maladjustment, internalizing and externalizing problems, interfering with psychological development and healthy growth. With the deepening understanding in sociology of development, child social withdrawal has gradually received extensive attention from scholars across the world. Understanding the phenomenon of child social withdrawal is important for in-depth follow-up research. Based on the literature review, the paper aims to summarize the types, mechanisms and influencing factors of social withdrawal in children, in order to provide scientific basis for formulating prevention strategies and early intervention programs in the future.

Research progress on the effects of social media use on adolescents' mental health

CHEN Yihan, XIE Bin

2023, 44(12): 1916-1920. doi: 10.16835/j.cnki.1000-9817.2023.12.033

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Social media use and mental health problems in adolescents have long been a concern, but there is controversy in the conclusions on the direction of the relationship and the size of the effect. In order to clarify the relationship between social media and mental health, the paper mainly summarizes the concepts, mediating and moderating factors, as well as protective and risk factors, it also summarizes the limitations of past studies, so as to provide theoretical basis for future research directions.

2023 Vol. 44, No. 12