中国学校卫生

Focus on dietary behaviors and health school-aged children in western China

MA Fuchang, MA Guansheng

2023, 44(6): 801-804. doi: 10.16835/j.cnki.1000-9817.2023.06.001

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Abstract:
Children's school-aged time is the key period for the formation of dietary behaviors and the dietary behaviors is affected by economic, social, cultural, family, and personal factors. Due to economic, geographical, and food culture reasons, there exists several nutritional problems in western China, such as lack of nutrition health education and poor food environment. These problems may lead to suboptimal dietary behaviors of school-aged children, including but not limited to having single breakfast food and unhealthy snacks and drinks. The unhealthy dietary behaviors may further hinder the growth of children in western China. Experiences and lessons should be drawn from various effective interventions developed in other regions in China. It is necessary to develop a local-adapted comprehensive intervention program which incorporates the aspects of policies and laws, nutritious meals, school nutrition health education, and social nutrition health atmosphere.

Implementing the special action plan to comprehensively strengthen and improve students' mental health work

FAN Zemin, ZHU Hongsong, GAO Chunbai

2023, 44(6): 805-808. doi: 10.16835/j.cnki.1000-9817.2023.06.002

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In recent years, mental health issues have gradually expanded from adults and professional groups to the primary and secondary school students, and are showing a trend of younger age. The article analyzes the "Special Action Plan for Comprehensively Strengthening and Improving the Mental Health Work of Students in the New Era (2023-2025)" jointly issued by 17 departments including the Ministry of Education. It explores the current situation, overall concept, key tasks, and other aspects to further improve the "four in one" student mental health work system of health education, monitoring and warning, consulting services, intervention disposal, and improve students' mental health literacy.

Fast food consumption behaviors among senior primary school students in agricultural and pastoral areas of Qinghai Province

WANG Xing, ZHANG Man, YANG Sufang, ZHANG Na, CHI Ruixin, SHEN Guiyuan, LI Ziye, MA Fuchang, MA Guansheng

2023, 44(6): 809-813. doi: 10.16835/j.cnki.1000-9817.2023.06.003

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Objective To investigate fast food consumption behaviors among 4th and 5th grade primary school students in agricultural and pastoral areas in Qinghai Province, and to provide scientific basis for nutrition education and intervention measures for school-age children in agricultural and pastoral areas. Methods Using multi-stage stratified cluster random sampling method, a total of 969 fourth and fifth grade students were selected from 10 primary schools in 4 counties and districts in 3 cities of Haidong City, Hainan Prefecture and Haixi Prefecture from Qinghai Province. Self-administered questionnaires were used to investigate the fast food consumption behaviors of participants. Results The proportions of senior primary school students in agricultural and pastoral areas of Qinghai Province who had consumed western fast food and traditioal fast food in the past week were 45.8% and 75.6%, respectively, with statistically significant differences (χ²=290.24, P < 0.05). The times of traditional fast food consumption in the past week among boarding students were higher than that of non-boarding students(Z=6.44, 5.84, P < 0.05). The main reasons for senior primary school students in agricultural and pastoral areas of Qinghai Province to choose to consume western fast food were that it was delicious (84.7%), nutritious (62.6%), clean and hygienic (57.4%), and a better environment (57.0%). The top 4 reasons for chousing Chinese fast food were yummy(83.8%), nutritious(82.8%), clean and healthy(67.4%), and good environment(53.5%). Among the surveyed primary school students, 64.7% believed that diet structure of Chinese fast food was reasonable, 43.0% believed that the nutritional value of Chinese fast food was high, and 39.4% believed that the energy content of western fast food was high. Conclusion Fast food consumption is a common dietary behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province. Relevant departments should strengthen the nutrition education related to fast food, promote the dissemination of health knowledge, enable students to develop a good lifestyle and reduce fast food consumption.

Beverage behaviors of senior primary school students in agricultrual and pastoral areas of Qinghai Province

YANG Sufang, LI Ziye, ZHANG Man, SHEN Guiyuan, WANG Xing, CHI Ruixin, ZHANG Na, MA Fuchang, MA Guansheng

2023, 44(6): 814-818. doi: 10.16835/j.cnki.1000-9817.2023.06.004

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Objective To study the consumption of beverages among senior primary school students in rural and pastoral areas of Qinghai Province, China, in order to provide evidence for the development of nutrition and intervention strategies. Methods A multi-stage stratified cluster random sampling method was employed to select 969 primary school students in grades 4 and 5 from 10 schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All participants completed a questionnaire survey on daily beverage consumption. The Chi-square test was performed to compare differences in reported rates of beverage consumption among students in different groups. Results The proportion of students who consumed beverages at home, school and elsewhere were 96.9%, 64.5% and 84.9%, respectively. The most popular beverages consumed at home were milk and yogurt (63.1%), tea water (53.0%), and tea drinks (52.4%). The most popular beverages consumed at school were tea(29.8%), milk and yogurt (27.8%) and tea drinks (18.4%), while the most popular beverages consumed in other places were tea drinks (42.0%), carbonated drinks (38.1%) and milk and yogurt (35.0%). The top five reasons for choosing a given beverage were taste delicious (81.2%), nutritious (57.6%), healthy and clean(52.6%), many students like to drink(39.6%), family members often drink(37.7%). Conclusion The consumption of beverages was popular among students, and sugared beverages represented a large proportion of the beverages consumed. Therefore, there is an urgent need to improve the food environment and provide effective nutrition education for students, so as to encourage the consumption of healthy beverages and cultivate healthy eating behaviors.

Status of snack behavior of senior primary school students in agricultural and pastoral areas of Qinghai Province

ZHANG Man, WANG Xing, YANG Sufang, ZHANG Na, CHI Ruixin, SHEN Guiyuan, LI Ziye, MA Fuchang, MA Guansheng

2023, 44(6): 819-823. doi: 10.16835/j.cnki.1000-9817.2023.06.005

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Objective To understand the current situation regarding snack food consumption among grade 4 and grade 5 primary school students in agricultural and pastoral areas of Qinghai Province, China, and to provide a scientific basis for nutrition education and intervention strategies. Methods Multistage stratified cluster random sampling was employed. The research included 969 fourth-and fifth-grade students were selected from 10 primary schools in four counties and districts of three cities in Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. The self-report questionnaire method was used to investigate the current status regarding snack food consumption in this population. Results The proportion of students who consumed snack food at home, school and elsewhere were 98.2%, 88.5% and 75.4%, respectively. Male students reported a lower rate of snack consumption at school than female students (χ²=9.66). The fifth grade students reported a higher rate of snack consumption at home and other places than the fourth grade students (χ²=10.31, 6.77). The reported rate of snack consumption of students in the rural was higher than that in the county(χ²=6.03, 100.53, 24.77). The reported rate of snack consumption of boarding students at home was lower than that of non-boarding students (χ²=7.22), while the reported rate of snack consumption at school was higher than that of non-boarding students (χ²=9.04)(P < 0.01). The most popular snacks consumed at home included fruits and vegetables, cereals and nuts (76.9%, 67.2%, 63.7%), while the most popular snacks consumed at school were fruits and vegetables, cereals and candies (45.1%, 36.9%, 24.4%). The most popular snacks consumed in other settings included ice-cream, candies and beverages(54.7%, 51.6%, 42.9%). The top three reasons for snacking were that snacks were regarded as delicious, healthy/nutritious and clean (76.9%, 65.5% and 59.0%, respectively). Conclusion Snacking is popular among students, although many snacks are unhealthy. Therefore, there is a need to improve food environments and nutrition education, so as to help students to choose healthy beverages and adopt healthy eating behaviors.

Breakfast consumption behaviors of senior primary school students from agricultrual and pastoral areas of Qinghai Province

ZHANG Man, WANG Xing, YANG Sufang, ZHANG Na, CHI Ruixin, SHEN Guiyuan, LI Ziye, MA Fuchang, MA Guansheng

2023, 44(6): 824-827. doi: 10.16835/j.cnki.1000-9817.2023.06.006

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Objective To examine breakfast consumption among primary school students in grades 4 and 5 in Qinghai Province, China, and to provide evidence for nutrition education and intervention strategies. Methods We used a multistage stratified cluster random sampling method to select the participants. A total of 969 students were selected from 10 primary schools in four counties and districts of three cities, namely Haidong City, Hainan Prefecture and Haixi Prefecture in Qinghai Province. A self-rated questionnaire was administered to investigate breakfast consumption. Results The proportion of students who consumed breakfast 5 to 7 times per week, 3 or 4 times per week, and 1 or 2 times per week were 82.0%, 9.7%, and 6.7%, respectively, while 1.5% never ate breakfast. In descending order, the breakfast food types consumed were cereals and tubers; milk, legumes and nuts; vegetables and fruits; fish and poultry; and meat and eggs (84.1%, 69.8%, 66.8%, and 37.7%, respectively). The proportion of vegetables and fruits in the breakfast of grade 5 students was higher than that of grade 4 students(χ²=4.81, P=0.03), the proportion of fish, poultry, meat and eggs in county urban areas was higher than that of students in rural(χ²=6.94, P=0.03), while the proportion of vegetables and fruits in urban areas was lower than that of students in suburban areas(χ²=53.33, P < 0.01). The proportion of breakfast food containing fish, poultry, meat and eggs of boarding students was higher than that of non-boarding students(χ²=41.26, P < 0.01), while the proportion of breakfast food containing vegetables and fruits, milk & legumens & nuts was lower than that of non-boarding students(χ²=21.11, 4.41, P < 0.01). A total of 44.8% of students had a poor quality breakfast, and only 16.3% had a good quality breakfast. Moreover, 47.5% of breakfasts were prepared by mothers, followed by the school canteen which prepared 29.9%. Except for students in different grades, there were statistically significant differences in the distribution of breakfast preparers in other groups(P < 0.05). Conclusion In Qinghai Province, breakfast skipping is observed in some senior primary school students, and the quality of breakfast is poor. Diet and nutrition education should be provided for students, parents, and school canteen staff to improve the frequency and nutritional quality of children's breakfasts.

Food intake frequency of senior primary school students in agrecultural and pastoral areas of Qinghai Province

YANG Sufang, LI Ziye, ZHANG Man, SHEN Guiyuan, WANG Xing, CHI Ruixin, ZHANG Na, MA Fuchang, MA Guansheng

2023, 44(6): 828-831. doi: 10.16835/j.cnki.1000-9817.2023.06.007

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Objective To understand the current situation of food intake frequency among school-age children in agricultural and pastoral areas of Qinghai Province, and to provide a scientific basis for local education departments and schools to formulate scientific nutrition improvement plans and measures. Methods A multi-stage stratified cluster random sampling method was used to select 969 fourth and fifth grade primary school students from 10 primary schools in Hainan Autonomous Prefecture, Haixi Autonomous Prefecture and Haidong City. All the participants were investigated with a questionnaire survey of dietary behaviors. Results For the fourth and fifth grade primary school students, the highest proportion of "eaten almost every day" were cereal and tuber (84.3%) and fruits (44.6%), and the highest proportion of "barely eaten" was aquatic product (68.1%) and nutritious supplementary (45.9%). The intake of livestock meat and poultry, fishery products, beverages and nutritional supplements of boys was higher than that of girls(Z=-2.46, -2.46, -2.43, -2.37, P < 0.05). The intake of livestock meat and poultry and snacks of fifth grade students was higher than that of fourth grade students, while the intake of fishery products was lower than that of fourth grade students(Z=-2.66, -4.33, -2.65, P < 0.05). Conclusion The frequency of food intake varies among students of differences genders, grades, areas, boarding situation and urbanities. Relevant departments should improve nutrition improvement plans for school-age children with different characteristics. Schools and families should carry out nutrition education works to cultivate healthy eating behaviors of students.

Awereness and beliefs on sedentary behavior among university students in Hangzhou City

ZHANG Li, HU Jinfeng, WANG Dahui

2023, 44(6): 832-835. doi: 10.16835/j.cnki.1000-9817.2023.06.008

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Objective To analyze the awereness and beliefs on sedentary behavior among college students and associated factors, so as to provide a reference for improving sedentary behavior. Methods A total of 1 261 students from six universities in Hangzhou City, were selected using a convenience sampling method. Sedentary behavior and its influencing factors were analyzed using the Chi-square test and binary Logistic regression, respectively. Results The pass rate of the knowledge and belief scores were 33.2% and 55.5%, respectively. The average duration of sedentary behavior on weekdays and weedends were (6.73±3.03) and (6.22±3.41)h/d, respectively. The results of the binary Logistic regression analysis showed that the influencing factors of health-related sedentary behavior included gender, grade, subject major, sports performance and belief score (P < 0.01). Female students were 2.18 times more likely to exhibit unhealthy sedentary behaviors than male students (95%CI=1.58-3.01); senior college students were less likely to exhibit unhealthy static behaviors than freshmen (OR=0.38, 95%CI=0.23-0.61); and sports majors were less likely to exhibit unhealthy sedentary behaviors than medical majors (OR=0.10, 95%CI=0.03-0.34). Students with high sports performance were less likely to exhibit unhealthy sedentary behavior (OR=0.63, 95%CI=0.48-0.83). In terms of belief scores, students who obtained a pass rate were less likely to exhibit unhealthy static behavior (OR=0.67, 95%CI=0.52-0.87). Conclusion Sedentary behavior is common among college students, and is influenced by several factors influencing factors. Colleges and universities should pay attention to improving the knowledge and belief level of students' sedentary behavior, promote healthy exercise habits, reduce the duration of static behavior, and maintain the health level of college students.

Effect of screen time on sleep in preschool children in Haikou City

LIU Ying, ZHOU Jie, CHEN Bairong, HUANG Lihong

2023, 44(6): 836-839. doi: 10.16835/j.cnki.1000-9817.2023.06.009

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Objective To understand the impact of screen time on duration and quality of sleep, so as to provide scientific basis for the development of interventions. Methods A total of 3 584 preschool children in Haikou City were selected by stratified sampling method from March to June in 2022, and the Children's Sleep Habits Questionnaire (CSHQ) and self-designed questionnaire were used. Results The average sleep duration of preschool children was (10.41±0.98)h/d, the rate of sleep deprivation was 28.71%, and the report rate of sleep problems was 50.47%. The average sleep duration in general as well as on weekdays and weekends decreased by age (F=21.00, 29.53, 3.26, P < 0.05), and insufficient sleep duration rate significantly varied by age groups (χ²=29.85, P < 0.01). The average screen time was (1.15±0.37)h/d, and the screen exposure rate was 55.39%. The total sleep problems (52.14%), poor bedtime habits (43.02%), daytime sleepiness (67.10%), irregular sleep duration (53.05%), and abnormal sleep latency (24.99%) were all higher than those in the non-exposed group (48.41%, 39.59%, 63.29%, 48.91%, 19.57%) (χ²=4.94, 4.31, 5.69, 6.08, 14.85, P < 0.05). Multiple linear regression analysis showed that age and weekend average screen time were negatively associated with sleep duration (β=-0.01, -0.06), weekday and weekend average outdoor activity duration were positively correlated with sleep duration (β=0.08, 0.08) (P < 0.05). Conclusion Screen exposure to preschool children's sleep time, sleep quality was closely related. Parents should cultivate good sleep habits of preschool children, and limit children's screen time to maximize outdoor activities, so as to ensure healthy development of children.

Association between sexual orientation and high-risk sexual behaviors among college students in Hubei Province

WANG Yan, WANG Haijun, PENG Chang, CHENG Junhan, RONG Fajuan, YU Yizhen

2023, 44(6): 840-844. doi: 10.16835/j.cnki.1000-9817.2023.06.010

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Objective To examine the association between sexual orientation and high-risk sexual behaviors and its sex differences among college students, so as to provide a theoretical basis for intervention and controlling of high-risk sexual behaviors of the college students. Methods From November 2020 to May 2021, 1 920 college students among four universities in Hubei Province were recruited by multi-stage stratified random cluster sampling, and their sexual orientation and the frequency of high-risk sexual behaviors were investigated by a self-designed questionnaire. And then analyzed the association between sexual orientation and high-risk sexual behaviors and its sex differences by using Chi-square test and Logistic regression analysis method. Results The prevalence of sexual behaviors was 18.2%, the prevalence of high-risk sexual behaviors was 7.2%, and the prevalence of high-risk sexual behaviors was higher among non-heterosexuals(13.5%) than among heterosexuals (6.7%), the prevalence of high-risk sexual behaviors was higher among males (9.2%) than among females(5.3%), and the differences were statistically significant(χ²=9.40, 10.77, P < 0.01). Logistic regression analysis showed that the association between sexual orientation and high-risk sexual behaviors was not statistically significant(OR=1.52, 95%CI=0.83-2.80, P>0.05). However, stratified analysis by sex revealed that among male students, the risk of high-risk sexual behaviors was 3.57 times higher among non-heterosexuals than among heterosexuals(OR=3.57, 95%CI=1.52-8.41, P < 0.01), while among female students, the association between sexual orientation and high-risk sexual behaviors was not statistically significant(OR=0.48, 95%CI=0.15-1.57, P>0.05). Conclusion There are sex differences in the relationship between sexual orientation and high-risk sexual behaviors among college students. Male non-heterosexuals are at higher risk for high-risk sexual behaviors than male heterosexuals. Therefore, prevention and interventions for high-risk sexual behaviors among college students should focus on gay and bisexual men so as to reduce the occurance rate of their high-risk sexual behaviors.

Trend of diet-related behaviors among secondary school students in Shanghai, 2008-2019

YUE Guizhen, SUN Lijing, YANG Dongling, YAN Qiong, YANG Yanting, LUO Chunyan

2023, 44(6): 845-849. doi: 10.16835/j.cnki.1000-9817.2023.06.011

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Objective To understand the prevalence and trend of diet-related behaviors among secondary school students in Shanghai, and to provide a scientific basis for developing appropriate health education strategies. Methods Anonymous questionnaire surveys were conducted among 71 291 students selected by multi-stage stratified cluster sampling method from junior high schools, senior high schools and vocational schools in Shanghai in the year of 2008, 2012, 2015, 2017, 2019. The questionnaire adopted was "Shanghai adolescent health-related behavior questionnaire". Test for trend test were applied for the analysis of the prevalence of their dietary behaviors. Results The proportion of middle school students' nutritional status within the normal range in each survey year were 73.40%, 72.60%, 68.06%, 68.73%, 67.53%, respectively, while the rate of overweight and obesity increased from 13.17% in 2008 to 23.73% in 2019. The proportion of "eating fried food" decreased significantly by year, from 12.05% to 4.23% (male, APC=-7.94%, t=-4.33, female, APC= -9.29%, t=-7.71, P < 0.05) respectively. And the proportion of "eating dessert" also decreased significantly by year, from 31.66% to 11.14% (male, APC=-8.41%, t=-6.37, female, APC=-8.67%, t=-6.96, P < 0.05). In the five surveys, the percentages of healthy diet-related behaviors of secondary school students were 12.81%-21.82%, no significant upward trend was observed in the whole(P>0.05). The proportion of diet-related behaviors of nutrition unbalance and easily leading to obesity decreased significantly from 35.47% to 17.00%(APC=-6.71%, t=-5.00, P < 0.05). The proportion of diet-related behavior of nutrition unbalance and not easily leading to obesity increased significantly from 39.15% to 60.16%(APC=3.46%, t=6.18, P < 0.05). Conclusion Overweight and obesity among secondary school students in Shanghai are increasing during the past decade, and the proportion of healthy dietary behaviors is low. The knowledge of rational diet should be publicized among these students in order to develop healthy dietary behaviors.

Status quo and influencing factors of computer vision syndrome among college freshmen in Tianjin

LI Bingqin, ZHANG Hongmei, WANG Zhiyang, WEI Ruihua

2023, 44(6): 850-853, 858. doi: 10.16835/j.cnki.1000-9817.2023.06.012

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Objective To investigate the current situation and associated factors of computer vision syndrome (CVS) among college freshmen in Tianjin during the COVID-19 epidemic, and to provide a reference for visual comfort of college students. Methods A total of 868 college freshmen from one university in Tianjin were administered with CVS qualitative analysis questionnaire, eye health status questionnaire and eye health examination during Oct to Dec 2021. Chi-square test and multivariate Logistic regression were used for data analysis. Results The detection rate of CVS among the included students was 68.5% (n=595) and was higher in females (72.2%) than in males (61.7%). The CVS detection rate in girls, students without myopia, >30 min sleep onset, >1 h mobile phone usage, and ≤8 h sleep duration (72.2%, 70.4%, 81.1%, 72.7%, 71.2%) were significantly higher than boys, students with low-grade myopia, sleep onset required ≤30 min, use mobile phone for ≤1 h, and sleep duration >8 h(61.7%, 63.3%, 67.4%, 65.9%, 61.1%) (χ²=10.08, 3.94, 5.89, 4.40, 7.94, P < 0.05). Differences in CVS detection rates varied significantly by daily electronic device usage and academic stress students (χ²=22.03, 21.24, P < 0.05). Multivariate Logistic regression analysis showed that daily use of electronic devices 4-6, 7-9, ≥10 h, sleep onset required >30 min, moderate to higher academic pressure were positively associated with CVS (OR=1.95, 2.94, 2.30, 2.39, 3.51, 4.41, P < 0.05), boys, low-grade myopia, night sleep time >8 h were negatively associated with CVS (OR=0.65, 0.70, 0.65, P < 0.05). Conclusion The detection rate of CVS among freshmen in a university in Tianjing is high. Attention should be paid to the CVS situation of students with e-learning, and general public should also be educated to reduce the time of unnecessary electronic product use and ensure night sleep to reduce the prevalence of CVS.

Surveillance on pinworm infection among rural children in Anhui Province from 2017 to 2021

JIN Wei, LIU Daohua, LI Qiyang, WANG Min, ZHU Lei, GUO Jianduo, WANG Qizhi, HU Mingchuang, CAO Zhiguo

2023, 44(6): 854-858. doi: 10.16835/j.cnki.1000-9817.2023.06.013

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Objective To understand the status of pinworm infection in rural children aged 3-9 years in Anhui Province, and to provide scientific basis for the prevention and control strategy of pinworm disease. Methods According to the National Surveillance Program of Liver Fluke Disease and Soil Transmitted Nematodiasis(Trial), no less than 10% counties(cities and districts) in Anhui Province were selected as mobile surveillance sites every year. Each surveillance site was divided into 5 areas on the basis of geographical location(east, west, south, north and middle), from each of the areas, one administrative village was selected from one township(town, community) for conducting surveillance. Children at age 3-9 years from each site were examined for pinworm infection with the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method. Chi-square test was used to compare the infection rate. Results From 2017 to 2021, the 5-year average infection rate of pinworm in rural Anhui was 1.34%(128/9 557), and there was no significant difference in the infection rate over the years(P>0.05). The detection rates of the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method were 0.28% and 1.23%, respectively, the difference was statistically significant(χ²=72.97, P < 0.01). In different regions, the 5-year average infection rate of Fuyang City was the highest(4.27%), and the rate of each city was positively correlated with the number of local resident population(r=0.54, P < 0.05). There was no significant sex difference in the 5-year average infection rates(P>0.05). The 5-year average infection rate of children aged 3 to 9 years in rural areas were 0.62%, 1.10%, 1.44%, 1.57%, 0.94%, 2.09% and 1.57%, respectively, showed an increasing trend with the increase of age(χ²=14.41, χ_trend²=6.70, P < 0.05). There was no significant difference in the average infection rate between scattered children and collectively living children(P>0.05). Conclusion From 2017 to 2021, the infection rate of pinworm among children in rural Anhui province remains at a low level. In the future, health education and monitoring should be strengthened.

Knowledge, attitude and practice about myopia prevention and control among young children's parents in Guangzhou City

SUN Yi, LIN Rong, QU Yabin, XIONG Lihua, CHEN Siyu, LIU Weijia

2023, 44(6): 859-863. doi: 10.16835/j.cnki.1000-9817.2023.06.014

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Objective To understand the status and associated factors of knowledge, attitude and practice (KAP) about myopia prevention and control among young children's parents in Guangzhou, so as to provide reference for family health education on myopia prevention and control. Methods During January to February 2023, 4 584 parents of children from kindergarten and primary school (grade 1-3) were recruited. Two to three kindergartens and 2 primary schools were selected from each of the 3 urban districts and 2 suburb districts of Guangzhou by stratified cluster random sampling method. Parents of children were administered with online questionnaire survey on KAP about myopia prevention and control. Descriptive analyses and multivariate Logistic regression models were used. Results The proportion of parents reaching standard of KAP about myopia prevention and control was 61.54%, the knowledge awareness rate was 57.30%, the positive attitude holding rate was 76.98% and the health practice formation rate was 63.31%. Internet (70.35%) and lectures on school health education/health education materials (66.14%) were the most common ways for obtaining knowledge for parents. Multivariate Logistic regression analysis showed that urban area, higher education (college/undergraduate or above), annual household income 50 000-90 000, 100 000-290 000, 300 000-490 000, 500 000-590 000, and ≥600 000 Yuan, being aware of vision status (normal/poor) of their children, one or both parents with myopia, both parents with non-myopia, acquiring knowledge by multi-ways(2, 3, ≥4) were associated with higher KAP about myopia prev-ention and control (OR=1.23, 1.34, 1.36, 1.25, 1.49, 1.93, 2.34, 1.64, 1.66, 1.89, 3.48, 3.09, 2.42, 1.65, 2.29, 3.22, P < 0.05). Conclusion Knowledge and practice about myopia prevention and control among young children's parents in Guangzhou are insufficient, yet the attitude was satisfactory. It is necessary to carry out targeted education for parents, especially those living in suburb area, with low education and income level.

Analysis of 73 emergency visits in a university hospital in Beijing

LIU Xiaoyan, JIJIANG Fengping, CHEN Hongyan

2023, 44(6): 864-866. doi: 10.16835/j.cnki.1000-9817.2023.06.015

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Objective To understand the current situation regarding emergency visits to a university hospital in Beijing, and to provide a basis for the standardized construction and formulation of emergency visit measures to university hospitals. Methods This study carried out a retrospective investigation and analysis of 73 emergency visits from September 2020 to December 2022 at a university hospital in Beijing. Results A total of 17 cases(23.3%) exhibited the most common of symptoms associated with convulsions during emergency visits to university hospital, while nine cases of abdominal pain(12.3%) and eight cases of dizziness(11.0%) were recorded. The proportion of males and females who presented to the emergency department was 60.3% and 39.7%, respectively. The top three diseases among emergency department outpatients included nervous system diseases(40 cases), gynecological diseases(seven cases), depression and alcoholism(six cases). The peak number of emergency visits occurred in April, May, September and November. The most frequent emergency visits presented from 13:00 to 18:00(32.9%), followed by 7:00 to 12:00(30.1%). Following emergency care, 12 cases improved, 54 cases were transferred to higher-level hospitals for treatment, 2 depressive patients were taken home, 5 cases refused referral. Conclusion University hospitals should develop emergency plans for diseases related to emergency visits, provide targeted training for doctors and health education for teachers and students, and improve the emergency treatment capabilities.

Relationship between adverse childhood experiences and depression and anxiety among students in middle school

LIU Yulin, OUYANG Jingwen, ZHANG Hua, ZHOU Chunyan

2023, 44(6): 867-870. doi: 10.16835/j.cnki.1000-9817.2023.06.016

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Objective To investigate the relationship between adverse childhood experiences with depression and anxiety prevention and intervention among middle school students, so as to provide evidence for preventing and intervening in depression and anxiety among adolescents. Methods From October to November 2020, a total of 4 861 middle school students from 12 schools in a province in central China, including junior high schools, senior high schools, secondary vocational schools, and vocational high school selected by using convenient sampling method. Demographic information, adverse childhood experiences, depression and anxiety symptoms were collected. The Chi-square test and multivariate Logistic regression analysis were used to analyze the data. Results The detection rates of depression and anxiety of students in middle school were 39.0% and 52.3%, respectively. Univariate analysis showed that the total scores of adverse childhood experiences and dimensions of childhood maltreatment and neglect, family dysfunction, parent absence, and violence outside the home were significantly associated with depressive and anxiety symptoms (χ²=105.36, 147.12, 43.69, 46.61, 196.48; 100.06, 132.28, 26.53, 24.32, 169.94, P < 0.01). After controlling variables such as age, only child, sex and economic status of family, Logistic regression showed that childhood maltreatment and neglect, family dysfunction, family absence and violence outside the home were positively associated with depressive symptoms (OR=1.61, 1.62, 1.06, 2.08, P < 0.01) and anxiety symptoms (OR=1.66, 1.50, 1.98, P < 0.05). Conclusion Depressive and anxiety symptoms among middle school students are associated with adverse childhood experiences, and those who experienced childhood maltreatment and neglect and violence outside the home are at higher risk.

Independent food purchasing behavior and associated factors among primary and secondary school students in Haidian District, Beijing

ZHU Shuping, CAO Qingjiu

2023, 44(6): 871-874. doi: 10.16835/j.cnki.1000-9817.2023.06.017

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Objective To examine independent food purchasing behavior and influence factors among primary and secondary school students, and to provide evidence for formulating and implementing corresponding intervention measures. Methods Using a two-stage stratified random cluster sampling principle, 976 primary and secondary school students in Haidian District of Beijing were selected to participate in a questionnaire survey from March to May 2021, and students' independent food purchases and associated factors were considered. Results The proportion of middle school students who often purchased food independently (22.79%) was higher than that of primary school students(16.77%)(χ²=5.58, P < 0.05). The proportion of middle school students and primary school students who sometimes purchased food independently was 66.32% and 60.33%, respectively(χ²=3.78, P>0.05). The proportion of middle school students who never purchased food independently (10.88%) was lower than that of primary school students(22.90%)(χ²=25.10, P < 0.05). The proportion of middle school students and primary school students who often purchased food with their parents was 30.80% and 32.52%, respectively(χ²=0.33, P>0.05). The factors that primary and secondary school students often considered when purchasing food included personal factors (e.g., physical and psychological factors), family factors, social factors, and the food itself. The top five factors that middle school students often considered when purchasing food were taste, hygiene, production date, student's mood, and advertisement. The top five factors that primary school students often considered when purchasing food were hygiene, taste, production date, advertising, and quality. The proportion of students with consideration of nutritional value, calorie level and collocation type, as well as other nutritional factors, when purchasing food was low, no significant differences were observed between primary and middle school students(χ²=3.25, 2.93, 3.06, P>0.05). Conclusion Independent food purchasing behavior is prevalent among primary and secondary school students. Nutritional awareness among middle and primary school students is low. Effective and comprehensive nutrition interventions should be actively carried out for primary and secondary school students, while considering multiple dimensions such as schools, families and society, so as to encourage students to adopt a healthy diet.

Reliability and validity assessment of Daily Stressors Evaluation Scale for Urban Secondary School Students

WANG Li, ZHANG Shumin, WANG Yujie, LU Yan, SHI Huijing

2023, 44(6): 875-879. doi: 10.16835/j.cnki.1000-9817.2023.006.018

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Objective To formulate an evaluation scale on daily stressors with good reliability and validity for urban secondary school students, and to provide a tool for psychological stress assessment. Methods Based on steps of instrument development, a pool of items regarding the daily stressors of junior/senior high school students was constructed by combining existing scales of adolescent life events or stressors, and a preliminary survey was conducted for items analysis and dimension evaluation among 393 middle and high school students in 2 districts of Shanghai. Then confirmatory factor analysis of the scale was conducted among 2 949 students collected by stratified cluster sampling from 11 districts in Shanghai. Results The final 28-item daily stressors evaluation scale for urban secondary school students, with an overall Cronbach's alpha coefficient of 0.94, consists of 8, 7, 7, and 6 items for the four dimensions of academic stress, physical and psychological stress, interpersonal stress and family stress, respectively. The Guttman's split-half reliability was 0.88, and the test-retest reliability was 0.68. Total scores of the 28 items reflect general psychological stress level of participants, with higher scores representing higher stress intensity. The confirmatory factor analysis showed that the root mean squared error of approximation (RMSEA) and the standardized root mean square residual (SRMR) were both less than 0.08, while all fit indexes were above 0.8. Conclusion The Daily Stressors Evaluation Scale for Urban Secondary School Students, with good reliability, validity and model goodness of fit, can be applicable for urban secondary school students.

Correlation analysis of traditional Chinese medicine constitution classification and psychological pressure among college students

WANG Yaxin, XIE Jiadong, SHI Xiuwen, KAN Menghan, GUO Genghua, ZHANG Rui, ZHANG Haowen

2023, 44(6): 880-883. doi: 10.16835/j.cnki.1000-9817.2023.06.019

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Objective Analyzing the correlation between TCM (traditional Chinese medicine) constitution classification and psychological pressure among college students, to provide a reference for its incorporation into an early warning and intervention program. Methods From September to December 2022, this study assessed the use of TCM and psychological pressure among 1 157 college students from six universities in Nanjing, China, who were selected using the convenience sampling method and online surveys. Factors associated with psychological stress among college students was ranked by the random forest model. The Chi-square test, pearson correlation analysis and binary Logistic regression were performed to analyze the factors associated with psychological pressure among college students. Results The results of the random forest showed that the top three TCM constitutions of psychological stress among this population included qi stagnation, blood stasis and balanced constitutions. The Pearson correlation analysis showed that the scores of qi stagnation (r=0.75), blood stasis (r=0.66) and qi deficiency (r=0.62) constitutions were positively correlated with psychological pressure, while the scores of balanced constitution (r=-0.65) were negatively correlated with psychological pressure (P < 0.01). Multivariate Logistic regression analyses showed that qi stagnation and blood-stasis constitutions were positively correlated with psychological pressure. Conclusion Qi stagnation, blood stasis and qi-deficiency constitutions can be used as early warning constitutions and indicators for interventions aimed at addressing psychological pressure among college students, and in this respect, a balanced constitution can be regarded as a protective factor. Greater attention should be paid to the mental health of college students with a biased constitution.

Evaluation of effect of horticultural therapy on improving mental health in university students

QIU Chuanjing, LU Jiamei, ZHAO Jing, WANG Fan, SHI Linyao, LI Xiaowen, YAN Shengguang

2023, 44(6): 884-887. doi: 10.16835/j.cnki.1000-9817.2023.06.020

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Objective To investigate the effectiveness of horticultural therapy on improving university students' mental health problems and to provide evidence to support the application of horticultural therapy in the prevention and treatment of university students' mental health. Methods From March to May 2022, a before-and after-paired design was used with a blank control group, mental health screening abnormalities were recruited from a comprehensive university in Hebei Province, including 57 in the intervention group and 21 in the control group, and the Symptom Checklist-90(SCL-90) score and hair cortisol were included as outcome indicators, which was measured by enzyme-linked immunoassay Elisa double antibody sandwich method. Results The total SCL-90 scores of the intervention group decreased (t=4.28, P < 0.01) and were significantly lower compared with the control group(t=-2.66, P < 0.01), while no significant difference was observed in the control group(t=0.29, P>0.05), and the difference between the pre and post measures on each dimension of the SCL-90 was significantly lower in the intervention group (all P < 0.01); the difference between the pre and post measures of hair cortisol contentration in the intervention group was statistically significant(Z=-2.75, P < 0.05), and the hair cortiso contentration in pre-measure group was lower than that of control group(Z=-3.48, P < 0.01). In contrast, the difference between pre and post measurements of hair cortisol in the control group was not significant(Z=-0.75, P>0.05). Conclusion Horticultural therapy can improve the psychological symptoms of university students is suitable for psychological interventions in the university population and is beneficial to the health and well-being of university students.

Associations between physical activity intensity and body compositions in adolescents

HOU Xiao, LI Hongjuan, LIU Jingmin

2023, 44(6): 888-892. doi: 10.16835/j.cnki.1000-9817.2023.06.021

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Objective To study the specific correlation between physical activity intensities and body compositions of adolescents and to provide guidance for the improvement of various body compositions of Chinese adolescents. Methods From September to December 2019, body composition measurement based on bioelectrical impedance analyzer and the physical activity measurement based on accelerometers were performed among 971 adolescents from 8 high schools, such as Tsinghua Middle School in Beijing, by random number coding sampling. Statistical analysis was conducted by using independent sample t-test, Pearson correlation coefficient method and multiple linear regression method. Results Sedentary behavior(SB) of the junior and senior high school boys was significantly lower than that of girls, while the VPA(vigorous physical activity) and moderate-vigorous physical activity(MVPA) were significantly higher than those of boys (t=-1.98, -8.09; 5.20, 4.52; 3.53, 4.03, P < 0.05). light physical activity(LPA) and moderate physical activity(MPA) of boys were significantly higher than those of girls in the senior high schools (t=3.67, 5.63, P < 0.01). Lean mass(LM) of the junior school boys was correlated to their MVPA(β=0.302), bone mineral content(BMC) was quantitively related to SB(β=-0.001), MVPA(β=0.002), and fat mass(FM) was related to SB(β=0.050), and MVPA(β=-0.323) (P < 0.05). LM of junior school girls was quantitively correlated to LPA (β=0.080) and MVPA(β=0.613). And there was also correlation among BMC, SB(β=-0.004) and MVPA(β=0.008) between FM and MVPA(β=-0.237) (P < 0.05). There was a correlation between total body LM and MVPA (β=0.393), total body BMC and SB (β=-0.001), MVPA (β=0.002), and total body FM and MVPA (β=-0.393) in senior high school boys(P < 0.05). There was a correlation between senior high school girls' total body LM and LPA (β=0.063), MVPA (β=0.601), total body FM and SB (β=0.029), and MVPA (B=-0.529)(P < 0.05). Conclusion There are gender differences and correlations between adolescent physical activity intensity and body composition. It is recommended that relevant departments provide personalized physical activity dose guidance for adolescents to improve their physical fitness.

Risk factors associated with pre-myopia among preschool children

DENG Yibin, WANG Xiaoyin, WANG Huimin, MEN Dawei, WANG Ding, YE Lian

2023, 44(6): 893-896. doi: 10.16835/j.cnki.1000-9817.2023.06.022

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Objective To understand the prevalence rate of pre-myopia among preschoolers and its associated factors, so as to provide a basis for the formulation of myopia prevention and control policies. Methods In May 2022, a tatol of 1 070 preschoolers in the Science City Area of Mianyang City were selected by using a cluster sampling method. The visual acuity of preschool children was obtained through refractive examination, and a questionnaire survey was conducted to investigate associated factors of myopia in the preclinical stage by Chi-square test and multivariate Logistic regression analysis. Results The prevalence rate of pre-myopia in preschoolers was 67.01%, including 66.30% for boys and 67.76% for girls. There was no significant difference by sex(χ²=0.26, P>0.05). Multivariate Logistic regression analysis showed that at least one parent with myopia, too much near work activities, time spent on outdoor activity < 2 h per day, lack of sleep, and screen time ≥1 h per day were positively correlated with the occurrence of pre-myopia(OR=1.62, 1.46, 1.46, 1.38, 1.53, P < 0.01). Conclusion The prevalence of pre-myopia among preschool children in Science City Area is high. It is suggested that parents, kindergartens and relevant departments should pay attention to the visual status of preschoolers, increase outdoor activities, ensure adequate sleep and train preschoolers to develop scientific eye hygiene habits.

Analysis of epidemic characteristics of tuberculosis in schools in Shijiazhuang during 2011-2020

LI Tongxin, ZHOU Jikun, ZHU Jianliang, GUO Fuai

2023, 44(6): 897-899. doi: 10.16835/j.cnki.1000-9817.2023.06.023

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Objective To analyze the trend and characteristics of school tuberculosis epidemic in Shijiazhuang from 2011 to 2020, and to provide reference for school tuberculosis prevention and control. Methods Descriptive methods were used to analyze the epidemiological characteristics of tuberculosis among students and the epidemic situation of tuberculosis in schools in Shijiazhuang from 2011 to 2020. The χ² test and χ² trend test were used to analyze the characteristics and trend of school tuberculosis. Results A total of 4 896 cases of tuberculosis were registered among students in Shijiazhuang from 2011 to 2020. The average annual registered incidence rate of students was 24.69/100 000, and the difference in incidence rate was statistically significant (χ²=318.50, P < 0.01) the overall registered incidence rate of tuberculosis among students in the past 10 years was on the rise (χ_trend²=87.79, P < 0.01). Among the student cases, male accounted for 53.89%, female accounted for 46.11%. The age group of students aged >18 and above accounted for the largest proportion(50.35%), followed by the age group aged 16-18(35.80%). Most students cases occurred in April and September-November, with September the highest(12.03%). A total of 22 clustered outbreaks (174 cases) and the aggregate epidemic accounted for 3.55% of the total number of students with tuberculosis. Conclusion The prevention and control of tuberculosis epidemic in schools in Shijiazhuang should not be underestimated, and strengthen the supervision, management, publicity and education of students in key age groups to avoid clusters of outbreaks.

Research hotspots and trend analysis of puberty development among children and adolescents from 2013 to 2022

LI Jiaxin, SHI Di, LIU Yunfei, DANG Jiajia, ZHONG Panliang, CAI Shan, CHEN Ziyue, ZHANG Yihang, SONG Yi

2023, 44(6): 900-905. doi: 10.16835/j.cnki.1000-9817.2023.06.024

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Objective To analyze the hotspots, frontiers, and future research trends related to puberty development among children and adolescents from 2013 to 2022, and to provide a reference for subsequent research related to puberty development. Methods Data related to puberty development from 2013 to 2022 were retrieved from the Web of Science core collection with the search formula "puberty timing (title) OR puberty development (title) OR pubertal timing (title) OR pubertal development (title) OR puberty timing (abstract) OR puberty development (abstract) OR pubertal timing (abstract) OR pubertal development (abstract)". The CiteSpace was used for visual analysis. Results A total of 6 684 publications were obtained and an upward trend could be seen in the number of publications in the field of puberty development in the last 10 years. Researchers with a high number of publications were Juul Anders, Brix Nis, and Ernst Andreas, in addition, the United States had the highest number of publications (2 125) and the highest betweenness centrality (0.23) in this field. In the last decade, research hotspots had focused on the timing of pubertal initiation, biological mechanisms of pubertal development, and sex differences in pubertal development. Research on environmental endocrine disruptors and the mechanisms of pubertal development were at the forefront of research and future research trends. Conclusion Scholars can refer to the research hotspots and research trends in this field and focus on the issues related to environmental endocrine disruptors and pubertal development mechanisms.

Developmental status of iron deficiency anemia and factors among preschool children in Dongguan

YU Jingyun, XIE Yang, LIU Yuwei, LIANG Yu, YUAN Qian

2023, 44(6): 906-909. doi: 10.16835/j.cnki.1000-9817.2023.06.025

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Objective To analyze the influencing factors and physical and mental development of preschool children with iron deficiency anemia in Dongguan, so as to provide a reference for the prevention of iron deficiency anemia among preschool children. Methods A total of 118 preschool children with iron deficiency anemia who were examined in Dongguan Maternal and Child Health Center from January 2022 to December 2022 were enrolled in the anemia group, and 118 preschool healthy children who were examined in the hospital at the same time were enrolled in the control group. The physical and mental development of the children were evalucded in both groups. Demographic information and household per capita income were collected. The relationship between risk factors and iron deficiency anemia was analyzed by univariate analysis and multiple Logistic regression. Results The scores of fine motor skills, gross motor skills, adaptability, social communication, language ability and developmental quotient of children in anemia group were significantly lower than those in control group (t=4.14, 5.46, 5.60, 5.50, 4.90, 5.83, P < 0.01). The difference in scores of adaptability, fine motor skills, gross motor skills language ability, social communication and developmental quotient between the two groups increased with age (F=390.56, 414.63, 437.35, 409.68, 407.20, 404.54, P < 0.05). Multivariate Logistic regression analysis showed that household income, history of past digestive disease, gestational age, maternal anemia during pregnancy, maternal education, consumption of meat, eggs and milk, and intake of nuts were all associated with iron deficiency anemia among preschool children in Dongguan (OR=2.23, 2.99, 3.99, 3.56, 3.11, 1.68, 1.61, P < 0.05). Conclusion The physical and mental development of preschool children with iron deficiency anemia in Dongguan is slower than that of non-anemia children of the same age, and the development delay becomes more obvious with increasing age. Attention should be paid to the prevention of iron deficiency anemia among preschool children. It is important to provide reasonable dietary guidance for children with high-risk factors such as digestive disease history and prematurity.

Prevalence and risk factors of permanent tooth caries among junior high school students in Haikou

WU Wenzhi, FENG Daxing, CHEN Chuizhuang, ZHOU Lijuan

2023, 44(6): 910-913. doi: 10.16835/j.cnki.1000-9817.2023.06.026

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Objective To describe the prevalence of permanent tooth caries and associated factors among junior high school students in Haikou, and to provide reliable evidence for prevention and control of caries. Methods A total of 3 573 students from 8 junior high school in Haikou City and towns were selected by the methods of clustered sampling survey. Questionnaire survey and oral health examinations were conducted to analyze the caries rate, mean decayed-missing-filled tooth (DMFT), filling rate, pit and fissure sealant rate. Logistic regression was used to analyze the influencing factors of caries in permanent tooth. Results Among the surveyed junior high school students, the caries rate was 47.32%(n=1 691), the mean DMFT was 1.51. The caries rate and mean DMFT were higher in female students (49.59%) than in male students (44.95%), and higher in towns (50.77%) than in urban areas (44.04%), the difference were statistically significant (χ²=16.25, 7.72, P < 0.05). The filling rate and pit and fissure sealant rate among junior high school students in Haikou were 17.13%, 6.27% respectively. The filling rate and pit and fissure sealant rate were higher in urban areas (18.97%, 7.17%) than towns (15.76%, 5.33%), the difference were statistically significant (χ²=9.57, 5.13, P < 0.05). The multivariate Logistic analysis showed that female student, town residence, daily consumption of sweets or sugary drinks (≥1 time), bedtime snack were risk factors for junior high school students suffering from permanent dental caries(OR=1.41, 1.45, 2.63, 2.09, 1.53), while using fluoride toothpaste daily, oral education in school were protective factors(OR=0.44, 0.34)(P < 0.05). Conclusion The caries rate of permanent teeth among junior high school students in Haikou is at high level, but the filling rate of caries and pit and fissure sealant rate are lower. The prevention and treatment of dental caries should be carried out in high risk students, and oral health education in school is also needed to improve the oral health level of junior high school students.

Changing trend of sickness absenteeism among students during 2010-2017 academic years and its correlation with the incidence of acute infectious diseases in Jiading District, Shanghai

WANG Zhengzhong, YU Hongjie, JIANG Honglin, XIONG Ying, TONG Yixin, YIN Jiangfan, PENG Hui, ZHONG Peisong, JI Ying, ZHOU Yibiao

2023, 44(6): 914-918. doi: 10.16835/j.cnki.1000-9817.2023.06.027

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Objective To describe the sickness absenteeism among primary and secondary school students in Jiading District and to analyze its correlation with the incidence of infectious diseases and associated lead or lag times, so as, to provide a scientific basis for the health and education departments to take measures. Methods The regularity and symptom composition of school sickness absenteeism among primary and secondary school students in Jiading District from the 2010-2017 were described. The Joinpoint model was applied to analyze the changing trend of absenteeism. And the rate of school sickness absenteeism and incidences of 7 acute infectious diseases were compared through visual analysis. The time-lagged correlation coefficients and Granger causality tests were applied to quantitatively analyze the correlation and lead/lag patterns. Results The average rate of school sickness absenteeism among primary and secondary school students in Jiading District, Shanghai was 0.27%. Since the 2012 academic year, the overall rate of sickness absenteeism has been on the rise. Fever was the most common symptom of absenteeism (47.49%). The trend of sickness absenteeism rate was mainly consistent with the incidence of influenza, and showed a one-way Granger causality. The maximum time-lagged correlation coefficient was obtained in the second semester of the 2017 academic year with a value of 0.43 (95%CI=0.25-0.58). The maximum time-lagged correlation coefficient between the rate of sickness absenteeism with fever and other respiratory symptoms and the incidence of influenza was also obtained in the second semester of the 2017 academic year and the maximum correlation coefficient was 0.50(95%CI=0.33-0.65). Conclusion The sickness absenteeism rate in primary and secondary school students is correlated to influenza incidence, and it has potential application value in supplementing early warning of influenza activities in the community.

Effects of aquatic exercise on lipid metabolism, body composition and peripheral blood Irisin level in obese middle school boys

SHANG Wenjin

2023, 44(6): 919-924. doi: 10.16835/j.cnki.1000-9817.2023.06.028

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Objective To explore effects of aquatic exercise on lipid metabolism, body composition and peripheral blood Irisin level in obese middle school students, so as to provide reference for exercise and weight loss practice of obese children and adolescents. Methods Twenty-six male students, recruited to participate in the summer youth swimming(weight loss) camp in Rudong County Jiangsu Province, were divided into non-obese(n=12) and obese (n=14) group. And t-test method was applied for a statistical analysis of their ipid metabolism, body composition and peripheral blood irisin level before and after 8-week aquatic exercise. Results The high density lipoprotein cholesferol(HDL-C) in the obese group was significantly lower than non-obese group, which were (1.34±0.12) mmol/L and (1.51±0.21) ng/mL, respectively, and the differences were of statistical significance(t=2.81, 6.39, 8.96, 12.69, -2.72, P < 0.05). After intervention, body weight, body mass index (BMI), fat mass(FM), body fat percentage(BF%) of obese male middle school students decreased from (77.31±8.26)kg, (28.02±1.67)kg/m², (25.16±3.59)kg and (32.65±3.90)% to (72.37±7.19)kg, (26.15±1.21)kg/m², (21.71±2.66)kg and (30.14±3.61)%, muscle mass(MM) increased from (25.09±3.41)kg to (26.76±3.55)kg. TC, TG, LDL-C contents decreased from (4.69±0.48, 1.31±0.26, 2.74±0.42)mmol/L to (4.28±0.42, 1.14±0.14, 2.36±0.36)mmol/L, HDL-C increased from (1.34±0.12)mmol/L to (1.47±0.11)mmol/L, and serum Irisin concentrations lowered from (192.17±23.27) ng/mL to (164.15±21.69)ng/mL of obese male middle school students. Serum Irisin concentrations of the obese positively related to BMI(r=0.68), FM(r=0.87) and BF(r=0.64), as well as TC(r=0.61), TG(r=0.86), LDL-C(r=0.85), but negatively associated with HDL-C(r=-0.63). A positive relations existed between different value of serum Irisin concentrations and BMI, FM before and after intervention of obese students(r=0.58, 0.53)(P < 0.05). Conclusion Obese middle school students may be resistant to Irisin. 8 weeks of aquatic exercise can improve fat metabolism, body composition and serum Irisin levels of obese junior middle school students effectively. The qualified obese children and adolescents can use aquatic exercise as an intervention measure to control body weight reasonably and improve lipid metabolism.

Prevalence and factors influencing adolescent idiopathic scoliosis in Zhongshan City

HUANG Sizhe, LI Fenghua, YANG Junlin, TANG Weiming, HUANG Zifang, GAO Yihao, CHENG Mengyuan

2023, 44(6): 925-929. doi: 10.16835/j.cnki.1000-9817.2023.06.029

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Objective To investigate factors influencing adolescent idiopathic scoliosis (AIS), and to provide a scientific basis for effective prevention and treatment programs. Methods A questionnaire survey was conducted among 6 757 students who participated in the scoliosis screening program for primary and middle school students in Zhongshan City, China from April 2019 to March 2020. Visual examination and Adams flexion test were used to measure the rotation angle of trunk. For each student, individual and family demographics, family history of scoliosis, daily postural habits, school-bag carrying habits, vision, health, school environment, and physical activity were collected by questionnaire. Factors influencing AIS were analyzed using Chi-square test and multivariate Logistic regression. Results The positive screening rate for AIS was 2.0%(135 cases). Multivariate Logistic regression analysis revealed that female gender, no family history of AIS, standing with lumbar spine tilted forward, habit of leaning to the left when seated, and a monthly family income of >10 000 yuan were related to the occurrence of AIS in adolescents (OR=3.01, 0.38, 2.29, 1.74, 0.44, P < 0.05). Conclusion Female students aged 10-16 years with a family history of scoliosis in Zhongshan are identified as a high-risk group for scoliosis screening. Developing proper standing and sitting habits helps to reduce the risk of AIS in adolescents.

Association of famine exposure in early childhood with cardiovascular diseases in adulthood

SHEN Lijuan, MA Sheng, WANG Huan, ZOU Zhiyong

2023, 44(6): 930-934. doi: 10.16835/j.cnki.1000-9817.2023.06.030

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Objective To explore the association between exposure to famine in early childhood and cardiovascular diseases in later life, and to provide empirical evidence for studying the influencing factors of early life health. Methods From July to October 2022, 1 294 college students were recruited from several universities in Beijing and Shaanxi provinces to investigate the famine-exposed experience before the age of 10 and the current health status of their 2 169 paternal grandparents and complete the online questionnaire. Multiple Logistic regression was used to estimate the association between famine exposure and adult cardiovascular diseases. Results A total of 981(45.2%) paternal grandparents reporting cardiovascular diseases diagnosed by a doctor. After adjusting for potential confounding variables including age, income, smoking, drinking, body mass index, physical activity, diet quality score, and famine severity, the associations between exposure to famine during fetal, infancy, preschool and school age group and cardiovascular diseases were statistically significant, compared to non-exposed group[OR(95%CI)=1.89(1.10-3.26), 1.63(1.01-2.64), 1.71(1.06-2.77), 1.69(1.04-2.72), P < 0.05]. After adjusting for age-balanced control group, famine exposure during infancy and preschool age were statistically significantly associated with coronary heart disease [OR(95%CI)=1.99(1.25-3.17), 1.49(1.01-2.19)] and stroke [OR(95%CI)=2.08(1.13-3.82), 1.95(1.25-3.04)](P < 0.05). Participants who were lacking physical activity in all famine-exposed groups were associated with an increased risk of cardiovascular diseases in adulthood (P < 0.05). Conclusion Exposure to famine during not only the fetal and infant stage but also the preschool age was associated with an increased risk of coronary heart disease and stroke in adulthood, especially for individuals with unhealthy lifestyle. Therefore, emphasizing nutrition during the important developmental stages of early life and advocating for a healthy lifestyle can help prevent cardiovascular disease.

Analysis of influenza vaccination status of primary and secondary school students in Shijingshan District of Beijing from 2019 to 2023

SUN Likun, LI Yanhui, SHI Manli

2023, 44(6): 935-937. doi: 10.16835/j.cnki.1000-9817.2023.06.031

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Objective To provide scientific support for the prevention and control of influenza epidemic and the vaccination of influenza vaccine for primary and secondary school students by analyzing the influenza vaccination situation in Shijingshan District, Beijing from 2019 to 2023. Methods To make a data analysis collected from Beijing Immunization Planning Information Management System by descriptive epidemiological methods and Chi-square test method. Results There were totally 71 230 primary and secondary school students taking influenza vaccine in Shijingshan District from 2019 to 2023, within which the vaccination rate ranged from 62.24% to 77.64%, with an average annual vaccination rate of 69.36%. There was a statistically significant difference (χ²=926.39, P < 0.05) between the vaccination rates in each year. The vaccination ratio didn't vary by sex(69.16%, 69.59%)(χ²=0.40, P>0.05). The average vaccination rate of students in primary, middle and high school were respectively 80.86%, 47.09%, 43.88% with a statistically significant difference(χ²=610.36, 2 113.30, 6 720.88, 12 886.79, P < 0.05). The average vaccination rate of students in west area, middle area and east area, showing an increasing trend, were respectively 81.88%, 70.01%, 56.63% with a statistically significant difference(χ²=3 679.19, P < 0.05). In sum, there were significant differences in vaccination rate for both different years and areas(χ²=570.25, 987.18, 99.60, 1 111.99, P < 0.05). Conclusion The annual vaccination rate of influenza vaccine in primary and secondary schools in Shijingshan District from 2019 to 2023 has met the requirements for effective vaccination rates, but it should be recognized that not all schools and their students form the immune barrier. It is necessary to further strengthen publicity and education to guide students and parents to form a correct understanding, so as to reduce the occurrence of influenza epidemic.

Association between Norovirus epidemics and school toilets design and management in Chengdu City

DAI Yingxue, XU Kai, FENG Songqi, SU Liyuan, WANG Yao, WANG Liang

2023, 44(6): 938-941. doi: 10.16835/j.cnki.1000-9817.2023.06.032

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Abstract:
Objective To analyze the relationship between the toilet design and sanitary condition of primary and secondary schools in Chengdu and the epidemic situation of Norovirus infection, so as to provide scientific references for school toilet design and Norovirus prevention and control. Methods A total of 78 cases of norovirus epidemics from 2019 to 2020 were included in this study. These epidemics happened in 78 schools and the causes were indicated as human-to-human transmission. The Chi-square and Mann-Whitney U-test were used to compare categorical and continuous data respectively. Unconditional binary Logistic regression was used to examine the multivariate associations. Results Most epidemics happened from October in 2019 to March in 2020(79.49%, 62 cases), in primary schools (71.79%, 56 cases) and in the center area (52.56%, 41 cases). The median of the case number in each epidemic was 10. Overall, 56 schools (71.79%) were equipped with toilets which were flushed independently, and 22 schools (28.21%) were equipped with toilets which were flushed uniformly. There were 27 schools (34.62%) that did not have enough water taps. Logistic regression analysis found that those with toilets flushed uniformly had a stronger epidemic, compared to the schools with toilets flushed independently(OR=5.53, 95%CI=1.63-18.76, P < 0.05). Conclusion In order to prevent intestinal infectious diseases, it is suggested that schools should design or reconstruct independent flushing toilets with adequate faucets.

Research progress on the association between screen exposure and autism spectrum disorder in preschool children

HUANG Lei, WU Xiaoyan, NAN Nan, SU Yue, ZHENG Huiqin, GUO Jinxian

2023, 44(6): 942-945. doi: 10.16835/j.cnki.1000-9817.2023.06.033

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Abstract:
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder. Early-life social experience assessment before symptoms of ASD might be helpful for determining the causal link between social experiences and early childhood ASD. Younger children are exposed to excessive screen time in recent years. This paper summarizes the association between screen exposure with ASD in preschool children, and proposes future research directions and provides evidence-based guidance to optimize and support children's early media experiences.

Advantes in diagnosis, prevention and treatment of flexible flatfoot in children

ZHANG Jin, JIANG Shuyun, LI Yang, YU Yan, LU Xiaoying, LI Yiying

2023, 44(6): 946-950. doi: 10.16835/j.cnki.1000-9817.2023.06.034

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Abstract:
Flexibleis an important classification of flat foot. Flatfoot occurs due to a variety of reasons and causes the medial longitudinal arch to collapse or disappear. However, many children still do not develop a normal foot arch as the grow, and a failure to intervene in a timely manner will greatly harm a child's normal mobility development. Timely detection and intervention are the key to improve the prognosis. There is a lack of uniform quantitative criteria for the diagnosis of flexible flatfoot. Currently, the commonly used diagnostic methods include physical examination, foot printing, plantar pressure test and imaging examination. This article reviews the risk factors, diagnosis, prevention and treatment of Flexible Flatfoot.

Advances in evaluation methods of pubertal timing in children

WANG Shanshan, SUN Ying, TAO Fangbiao

2023, 44(6): 951-955. doi: 10.16835/j.cnki.1000-9817.2023.06.035

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Abstract:
Over the past 40 years, there has been a long-term trend of early pubertal onset in children in China. Early pubertal timing is closely associated with mental health and behavioral problems in children, and can even lead to cardiovascular and metabolic diseases, cancers of the endocrine system and abnormalities of the bone and joint system in adulthood. Prompt detection of early pubertal timing in children is important. There are many methods for evaluating pubertal timing, the appropriateness of which is worth exploring. This paper reviews previous literature publications, examines current research progress in evaluation methods of pubertal timing, evaluates their applicability in the study of children and adolescents, and provides a reference for the selection of an evaluation method to assess pubertal timing in children in China.

Advances in cognitive behavioral art therapy in the treatment of anxiety disorders in children and adolescents

LIAO Minghui, LIU Zhen, LIU Wenjing, ZHANG Fang, MA Changminghao, CHENG Wenhong

2023, 44(6): 956-960. doi: 10.16835/j.cnki.1000-9817.2023.06.036

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Abstract:
Cognitive behavior therapy (CBT) is one of the main psychotherapeutic methods used to treat anxiety disorders in children and adolescents. Art therapy, based on psychotherapy theory and methods, is rising in popularity abroad. At present, foreign scholars have started to apply cognitive behavioral art therapy (CBAT) for patients with anxiety disorders. Based on the current findings, children and adolescents with developing cognitive functions may also benefit from this therapy. This article summarizes the application status of CBAT in the treatment of anxiety disorder in patients at home and abroad, and innovatively explores its therapeutic potential for anxiety disorders in children and adolescents in China, thus providing a novel perspective that can address the shortcomings of CBT.

2023 Vol. 44, No. 6