中国学校卫生

Promoting digital technology to enable new opportunities for universal mental health services in schools

SUN Ying, TAO Fangbiao

2023, 44(7): 961-963. doi: 10.16835/j.cnki.1000-9817.2023.07.001

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In rescent years, schools are confronting continued mental health needs of children and adolescents. The person-centered school mental health service model is impossible to meet current and future increasingly public health problems. Under the framework of the "whole School, whole Community, whole Child" (WSCC) theory and the concept of health promoting schools proposed by the World Health Organization, the editorial proposes to integrate universal mental health services into essential public health services in school, as well as to build a digital school mental health service platform to enable new opportunities for universal mental health services in schools.

Development of speed indexes in student physical fitness tests

YANG Yuhang, WU Jin, SUN Youping

2023, 44(7): 964-968. doi: 10.16835/j.cnki.1000-9817.2023.07.002

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Speed is an important component of physical fitness testing for students around the world. On the whole, the different testing systems usually set up various indexes based on the moving speed, action speed and reaction speed; the indexes are diverse but uniform in number; there are differences in the age of application of the indexes and no gender differences. As far as the classification of indexes is concerned, there are two types of movement: sprinting and shuttle-run, for the moving speed test indexes; there are differences in the need for action speed and reaction speed tests. Based on this, from the perspective of energy metabolism and health benefits, the properties and testing methods for measuring moving speed and the need for action speed and reaction speed testing are analyzed. The study shows that acceleration capability should be a measured attribute of moving speed, the 30 m running can be used as a general index of moving speed for all students; the shuttle-run is not suitable as an index of moving speed; action speed is less correlated with physical health, so it should not be included in the testing system for the time being; and reaction speed which closely relates to physical health, should be included in the testing system.

Universal mental intervention for children in school based on mental resilience-forced enhancement: a randomized controlled trial study protocol

HUANG Wenjuan, WU Peipei, SUN Ying

2023, 44(7): 969-973. doi: 10.16835/j.cnki.1000-9817.2023.07.003

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Mental disorders represent 45% of the global disease burden among children and adolescents aged 10-24 years old. It is crucial to develop effective interventions that can be integrated into daily school activities in order to provide convenient and accessible mental health services for students and faculty members. The study conducts a randomized controlled trial to examine universal mental health promotion among children. The current protocol aims to develop a universal resilience-focused program, which focuses on emotional regulation, coping, and problem-solving. A total of 20 classes from two primary schools in grades 4-5 in Anhui, Tianchang were randomly assigned to either the intervention or waitlist group. This training consisted of 14 weekly 40-minute sessions of manualized interventions that were compatible with regular curricular activities. It is expected that this current intervention will enhance the psychological resilience of children and evaluate the effectiveness of promoting mental health among children followed up on indicators of depressive and anxiety symptoms, psychological resilience, oppositional defiant and conduct problems by questionnaires at baseline and after the intervention.

The exposure to television advertising of unhealthy food among children and adolescents and its impact in Beijing

XIANG Lin, TANG Yuxiang, LEI Nan, YE Lihong, CUI Jia, LIANG Kaipeng, ZHANG Juan

2023, 44(7): 974-978. doi: 10.16835/j.cnki.1000-9817.2023.07.004

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Objective To examine the exposure to television advertising of unhealthy food among children and adolescents in Beijing, in order to provide a basis for the formulation of marketing management policies with unhealthy food. Methods Four weekdays and four weekend days were randomly selected during October 19, 2020 to January 17, 2021, excluding holidays and school holidays. The top five popular channels of children and adolescents aged 3 to 18 years old were selected. A total of 720 hours was included for coding and analysis. World Health Organization Nutrient Profile Model for the Western Pacific Region was used to classify food and assess the health level. Results A total of 13 864 advertisings (ads) was monitored, 38.8% (5 376) of which were food ads. Furthermore, 49.9% (2 680) of food ads were unhealthy food ads, with a frequency of 2.00 per hour per channel. The top five most frequent food ads were infant formula for 12-36 months (26.7%), cheese (16.7%), savory snacks (12.2%), milk drinks (10.5%) and chocolate and candy (6.0%). The most frequently used marketing strategies for unhealthy food ads were brand benefit claims (96.8%) and promotional characters (67.9%). Conclusion Children and adolescents in Beijing are highly exposed to TV marketing of unhealthy foods. Marketing strategies such as brand benefit claims and promotional characters are employed to boost the impact of unhealthy food ads. There is an urgent need to introduce relevant policies to regulate TV marketing of unhealthy foods.

Development of Questionnaire for Parental Acceptability of School-based Depression Symptom Screening

WU Peipei, HUANG Wenjuan, ZHOU Yi, DING Wenqin, SUN Ying

2023, 44(7): 979-984. doi: 10.16835/j.cnki.1000-9817.2023.07.005

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Objective The study aimed to develop Questionnaire for Parental Acceptability of School-based Depression Symptom Screening by Delphi method, so as to provide a reference and suggestions for promoting screening adolescents' depression. Methods The study was conducted through the literature review and two rounds of the Delphi expert consultation. The initial construction of scale dimension and item was conducted through the literature search. A survey of 12 experts from 6 different provinces, cities and regions in China was conducted, and the Delphi technique was used to collect and analyze expert opinions data about the importance and feasibility of questionnaire content. The dimensions and specific items of the questionnaire were finally determinded. Results The response rates were 100% in both rounds of Delphi consultation. Kendall coordination degree W=0.22 (χ²=63.72, P < 0.01), which showed the agreement of expert opinions. The initial scale consisted of 4 dimensions and 17 items, including parental cognition of school-based depression screening, parental cognition of school depression screening results feedback and management, parental attitude of school-based depression screening, parental utilization of mental health services. After two rounds of expert consulattion, the final scale consisted of 3 first-grade dimensions including parental cognition of depression symptom, parental attitude of school-based depression symptom screening and parental mental health promotion behaviour, and also cinsisted of 4 second-grade dimensions including parental knowledge of depression symptom, parental attitude of school-based depression symptom screening, parental choice preference of school-based depression symptom screening, parental utilization of mental health services, which had a total of 25 items. Conclusion The questionnaire is developed for assessing parental acceptability of school-based depression screening and associated factors. The finding will facilitate mental health services providers in the screening implementation, but further empirical research is still needed.

Diet quality of primary and secondary school students in Yunnan Province

RAN Fei, ZI Fenhu, LU Xiyang, MAO Yongjun, MU Deyu, ZHANG Shunjun, YUE Xinwei, CAI Hejia, YANG Wenfen, WANG Hangping

2023, 44(7): 985-990. doi: 10.16835/j.cnki.1000-9817.2023.07.006

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Objective To evaluate diet quality and related problems among children and adolescents in Yunnan Province, in order to provide a theoretical basis for the formulation of targeted dietary interventions for children and adolescents in this region. Methods Using a stratified random sampling method, 1 078 primary and secondary school students from six prefecture-level cities in Yunnan Province were selected from August to November 2022. Dietary quality was evaluated by applying the China Children's Dietary Index (CCDI-2016) on the basis of a 3 d 24 h dietary survey. Results The total dietary index score of children and adolescents in Yunnan Province was 62.63(54.57, 71.19). The overall recommended intakes were largely achieved by consumption of cereals, eggs and sugary drinks, with dietary index scores of 9.91(8.24, 10.00), 5.58(0, 8.58) and 9.20(7.38, 10.00), respectively; there were inadequate intakes of vegetables, legumes, water, vitamin A and dietary fiber, with scores of 5.63(4.09, 7.59), 3.48(0, 9.70), 4.23(2.67, 5.50), 2.33(1.56, 3.53), 3.19(1.63, 5.67), respectively; intake of fruits, dairy and aquatic products were severely deficient, with scores of 0(0, 1.74), 0(0, 2.37), 0(0, 9.85), respectively; excessive intake of meat was found, with a dietary index score of 0(0, 2.46). The stratified analysis showed that children and adolescents aged 11-13 years had the highest total dietary scores[65.35(54.29, 72.03)], followed by those aged 7-10 years[63.46(56.19, 72.63)], while the 14-17 year-old age-group had the lowest scores[59.07(51.15, 68.30), H=32.23, P < 0.01]. Girls had higher total dietary scores than that of boys[64.20(56.12, 72.56), 59.32(52.60, 69.72), Z=-5.16, P < 0.01], while urban children and adolescents had higher total dietary scores than rural children and adolescents[65.30(54.84, 73.62), 62.17(54.31, 70.70), Z=-2.11, P < 0.05]. Furthermore, higher total dietary index scores were observed among children and adolescents whose parents had a higher educational level(H=27.68, 22.58, P < 0.01). The comparison of ethnic groups revealed that the Wa children and adolescents had the highest total dietary index scores, while the Hani children had the lowest(H=27.51, P < 0.01). Conclusion The overall dietary quality of children and adolescents in Yunnan Province is not high, the imbalance of dietary nutrition is prominent, and the dietary structure needs to be adjusted and optimized. Intervention programs should focus on the problem of insufficient intake of fruits and vegetables, milk and legumes, aquatic products and excessive intake of poultry meat among children and adolescents.

Correlation between academic stress and extracurricular physical exercise among college students

ZHU Guanren, CAO Wenwen, MAO Shengli, BAI Shengchao

2023, 44(7): 991-994. doi: 10.16835/j.cnki.1000-9817.2023.07.007

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Objective The study aimed to investigate the relationship between academic stress and extracurricular physical exercise among college students, with the goal of providing evidence and reference for effectively alleviating academic stress. Methods A stratified cluster random sampling method was employed, along with the Chinese College Student Psychological Health Screening Scale and a self-designed questionnaire. In January 2023, an online survey was conducted among 1 108 college students from eight colleges and universities in Jiangsu Province. Statistical analyses included independent samples t-test, one-way analysis of variance (ANOVA) and the optimal scale regression model. Results It revealed that 50.8% of students worried about falling behind their peers in their studies, 51.7% expressed concerns about exams, 21.7% exerted significant effort but still struggled to keep up with the pace of learning, and 24.9% felt difficulties in their studies. The overall index of academic stress was higher among undergraduate institutions, first-year students, female students, and urban residents (t/F=3.66, 10.96, -5.46, 3.52, P < 0.01). The average time of weekly extracurricular physical exercise for students was (2.35±2.18)h, and there were significant differences by gender, only-child status, and grade groups(t/F=2.35, 4.66, 7.09, P < 0.05). The optimal scale regression model analysis (R²=0.17, F=32.03, P < 0.01) revealed that the regression coefficient and partial correlation coefficient between academic stress and extracurricular physical exercise time were both -0.33(P < 0.01). The importance of extracurricular physical exercise in the model was 0.66, with a tolerance value of 0.97. The regression coefficients and partial correlation coefficients for academic stress and extracurricular physical exercise time were -0.35, -0.35 for undergraduate students, and -0.31, -0.32 for junior college students (P < 0.01). Conclusion A significant number of college students experience varying degrees of academic stress, and their engagement in extracurricular physical exercise is insufficient. There is a negative association between academic stress and extracurricular physical activity time among college students. Universities should encourage students to increase extracurricular physical activity time to reduce academic stress and promote college students' mental health.

School lunch leftovers of primary and middle school students and its influencing factors in Ningbo

XU Dian, GAO Hua, JIANG Danjie, ZHANG Yan

2023, 44(7): 995-999. doi: 10.16835/j.cnki.1000-9817.2023.07.008

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Objective To analyze the situation and associated factors of school lunch leftovers of primary and middle school students in Ningbo, so as to provide a basis for formulating policies to improve the quality of nutritious meals and reduce the leftover meal rates. Methods During March to May of 2022, 20 primary and middle schools were selected from 10 districts in Ningbo, and 4 443 students were selected from grade 4 to 6 of primary school and grade 1 to 3 of middle school. A questionnaire was conducted among them for the students' general situation and remaining meal situation. Results The total leftover rate was 62.4%, 7.9% of the students left rice every day, and 18.3% of the students left vegetables every day. The frequency of primary school students' leftover food was lower than that of junior high school students (χ²=-2.18, P < 0.05). Most of the students (68.3%) had only a little leftover food, half of the students (49.4%) had less than half leftovers, and the proportion of primary school students with large leftover food and leftovers was smaller than that of junior high school students (χ²=-2.05, -2.36, P < 0.05). The main reason for students' leftover food was "too much to eat" (accounting for 30.6%), and there was a statistical difference between primary school students and junior high school students in the composition of leftover food and leftovers (χ²=16.94, 14.28, P < 0.05). The leftover rate of vegetables was the highest (54.5%) and the leftover rate of milk was the lowest (2.5%). Multivariate Logistic regression model showed that nutrition and food-related courses during recent year, being aware the Chinese residents dietary guidelines, statisfaction with canteen food (general, more satisfied, very satisfied), reckoning school canteen food better than home food (almost, better than home) were less possibility to have leftover meals (OR=0.79, 0.73, 0.57, 0.41, 0.26, 0.69, 0.82, P < 0.05). Students chosed the meal after the teacher served the meal, the teacher divided meals and students who ate more frequently (4-6 times/week, 1 time/d, 2 times/d, ≥3 times/d) were more likely to have leftover meals (OR=1.64, 2.23, 1.27, 1.21, 1.52, 1.44, P < 0.05). Conclusion More than half of the students have leftovers. It should optimize the configuration of nutrition lunch, strengthen the education of nutrition knowledge and reduce the leftovers rate.

The effect of rs12145833 polymorphism of SDCCAG8 gene on intervention of childhood obesity

WU Yahui, XIAO Wucai, CHEN Jing, SONG Jieyun, SHAN Rui, ZHANG Han, LIU Zheng

2023, 44(7): 1000-1002. doi: 10.16835/j.cnki.1000-9817.2023.07.009

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Objective To study the role of rs12145833 polymorphism of SDCCAG8 gene in the intervention of childhood obesity, so as to provide scientific basis for formulating personalized intervention measures based on genetic background in children with obesity. Methods From September 2018 to June 2019, a total of 393 children aged 8-10 years in Beijing were enrolled in a cluster randomized controlled trial. Eight schools were randomly allocated into intervention group and control group at a ratio of 1∶1. Saliva DNA samples were collected to detect rs12145833 polymorphism of SDCCAG8 gene. The intervention group received a comprehensive intervention, while the control group received usual practice. Intervention measures included diet improvement, sports, school amd family sport. The obesity related indicators were measured at baseline and after the end of intervention 1 academic year. Multiple linear regression and Logistic regression were used to analyze the interaction between genes and intervention on obesity indicators. Results In the intervention group, children with TT genotype of rs12145833 of the SDCCAG8 gene had less increase in systolic(β=4.56, 95%CI=1.84-7.28, P < 0.01) and diastolic blood pressure(β=2.59, 95%CI=0.45-4.73, P < 0.05) than those with GT and GG genotypes. In the control group, the systolic blood pressure of children with TT genotype increased more than those with GT and GG genotype(β=-2.86, 95%CI=-5.63--0.83, P < 0.05). There was an interaction between rs12145833 polymorphism of SDCCAG8 gene and intervention on systolic blood pressure, diastolic blood pressure and body fat percentage in children(P < 0.05). Conclusion Children with TT genotype of rs12145833 in the SDCCAG8 gene are more sensitive to obesity intervention than those with GG and GT genotypes, especially in the improvement of systolic blood pressure, diastolic blood pressure and body fat percentage. Further trials to study the role of rs12145833 polymorphism of SDCCAG8 gene in the intervention of childhood obesity among different ethnic populations are needed.

The impact of health-related quality of life for children and adolescents aged 8-15 years in Nanjing

LIANG Junyan, YOU Hua, ZHAO Shiqi, LIU Li

2023, 44(7): 1003-1007. doi: 10.16835/j.cnki.1000-9817.2023.07.010

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Objective To investigate the impact of COVID-19 infection and health-related behaviors on the health-related quality of life of children and adolescents aged 8-15 years in Nanjing, so as to provide a theoretical basis for improving HRQoL in children and adolescents. Methods From December 2022 to January 2023, a total of 2 398 students aged 8-15 years from the third grade of primary school to junior middle school in Nanjing were selected by multistage random cluster sampling. The 3-level EuroQol 5-dimension Questionnaire Youth Vension (EQ-5D-Y-3L) was completed by the respondents on their own, and the parents assisted in completing the rest of the questionnaire. Results The EuroQol-index(EQ-index) and Visual Analogue Scale (VAS) scores of being infected individuals were lower than those of uninfected and previously infected (P < 0.05). The proportion of being infected individuals reporting difficulty on "Pain/Discomfort" was higher than that of uninfected and previously infected individuals, and the proportion of reporting difficulty on "Mobility" was also higher than that of uninfected individuals (P < 0.05). Lack of parental companionship(OR=10.19, 95%CI=3.12-33.22), irregular breakfast consumption (OR=10.63, 95%CI=3.20-35.25), and excessive screen time (OR=8.24, 95%CI=3.02-22.51) increased the risk of difficulty on "Mobility" in being infected individuals (P < 0.05). Irregular breakfast consumption (OR=1.93, 95%CI=1.31-2.84) and consumption of sweetened beverages and snacks (OR=1.56, 95%CI=1.17-2.10) increased the risk of having lower EQ-index in previously infected individuals compared to uninfected individuals. Furthermore, consumption of sweetened beverages and snacks (OR=1.57, 95%CI=1.21-2.05) and excessive screen time (OR=1.49, 95%CI=1.12-1.98) also increased the risk of VAS scores being lower in previously infected individuals compared to uninfected individuals (P < 0.05). Conclusion The COVID-19 infection impairs HRQoL, and unhealthy behaviors deteriorate its negative impact. Healthy behaviors and lifestyles should be advocated to reduce the impact of COVID-19 infection on HRQoL.

Current status and influencing factors of oral health-related quality of life among senior primary school students in Bengbu

YANG Congyan, ZHOU Ying, ZHOU Xiaomei, ZHANG Xiawan, LIU Wen, LI Jiancheng, LI Xiuchuan

2023, 44(7): 1008-1011. doi: 10.16835/j.cnki.1000-9817.2023.07.011

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Objective To investigate oral health-related life quality and associated factors of senior primary school students in Bengbu City, so as to provide scientific basis for targeted oral health education for children. Methods A stratified cluster random sampling method was adopted to select 1 760 senior students (grade 5 to 6) from 12 primary schools in 4 districts of Bengbu City from September to November 2022. A cross-sectional survey was conducted on the oral health of students through questionnaires related to oral health. The effect of oral problems on quality of life was assessed by the Child Daily Life Oral Influence Scale (Child-OIDP). Chi-square test, non-parametric test and binary Logistic regression model were used to analyze the influencing factors of oral health-related quality of life in senior primary school students. Results The prevalence of oral problems affecting the quality of daily life was 70.00%, and the severe impact rate was 15.06%. Oral feeding was the most affected (57.95%). The Child-OIDP score was (7.49±8.57). Binary Logistic regression analysis showed that mother's education level, self-rated teeth and oral conditions, bruised tooth, toothache in the past year, and gingival bleeding in the past 2 weeks were significantly associated with the incidence of Child-OIDP (OR=1.86-5.00, P < 0.05). Conclusion It is common that oral problems affect the quality of daily life of senior primary school students in Bengbu. Families and schools should strengthen oral health knowledge education and behavior guidance, so as to reduce the impact of oral problems on daily life among senior primary school students.

Cardiopulmonary resuscitation knowledge, attitude and practice among college students and its related factors in Guizhou Province

LONG Jianmei, ZHANG Tianxi, LIU Xiaohui, LI Li, PAN Xiaoying, TONG Qingqing, GAO Huiming, HU Rujun

2023, 44(7): 1012-1016. doi: 10.16835/j.cnki.1000-9817.2023.07.012

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Objective To investigate current situation and influencing factors of cardiopulmonary resuscitation (CPR) knowledge, attitude, and practices among college students in Guizhou Province, and to provide evidence for improving CPR knowledge, attitude, and practice among college students. Methods From February to June 2022, snowball sampling and purposive sampling methods were used to select college teachers and students in Guizhou Province. A self-designed questionnaire was used to conduct an online survey on 1 199 college students. Results The average awareness rate of CPR knowledge among college students was 62.2%; the average qualification rates for CPR attitude and practice were 97.0% and 94.1% respectively. Positive correlations were found between knowledge and attitudes, knowledge and practices, as well as attitudes and practices (r=0.44, 0.37, 0.71, P < 0.05). Multiple linear regression analysis revealed that medical-related majors, and higher education levels (bachelor's, master's and above) were positively correlated with CPR knowledge among college students (B=7.83, 5.73, 8.09). Students from rural areas demonstrated a negative correlation with CPR attitudes (B=-0.90). The use of automated external defibrillators (AED), previous CPR experience on others were positively correlated with CPR knowledge (B=3.48, 3.64), and practices (B=0.45, 0.46) among college students. Participation in CPR training and academic performance (good, excellent) were positively correlated with CPR knowledge (B=13.78, 1.11, 3.96), attitudes (B=2.08, 0.66, 2.11), and practices (B=0.62, 0.33, 1.13) among college students (P < 0.05). Conclusion College students in Guizhou Province have positive attitude and practice towards CPR, but are lack of sufficient CPR knowledge. CPR training and high academic performance are positively correlated with CPR knowledge, attitude, and practice among college students.

Consistency and influencing factors in parents' knowledge, attitude and practice about early childhood sex education in rural areas

YAN Run, LI Hui, LIU Ya, ZHANG Rong, YE Yunli

2023, 44(7): 1017-1020. doi: 10.16835/j.cnki.1000-9817.2023.07.013

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Objective To understand the consistency and factors influencing rural parents' knowledge, attitude and practice about early childhood sex education, so as to put forward effective suggestions and countermeasures for improving childhood sex education in rural areas. Methods A multi-stage stratified sampling method was used to investigate the knowledge, attitude and practice of early childhood sex education among 1 015 parents in 16 kindergartens in rural areas of Sichuan from March to May 2019. Chi-square text and multivariate Logistic regression analysis were used to analyze factors affecting the consistency of parents' knowledge, attitude and practice of childhood sex education. Results Nearly 64.9%, 85.9% and 44.7% of parents with sufficient knowledge, support, and implement of early children's sex education, respectively, and the consistency rate of knowledge, attitude and practice were 30.2%. The results of the multivariate Logistic regression analysis showed that parents aged < 31 years (OR=5.35, 95%CI=2.93-9.77), 31-40 years (OR=4.82, 95%CI=2.65-8.76) and 41-50 years (OR=2.37, 95%CI=1.10-5.11), and the mother's education level being middle school (OR=3.67, 95%CI=1.75-7.69), secondary/high school (OR=2.83, 95%CI=1.32-6.05) and college/bachelor's degree and above (OR=5.44, 95%CI=2.23-12.98), sex-related questions asked by child (OR=2.00, 95%CI=1.44-2.78), having sex education in the family (OR=5.38, 95% CI=3.82-7.59), believing that parents should be responsible for sex education for young children (OR=2.58, 95%CI=1.40-4.74) had a higher consistency rate of knowledge, attitude and practice in early childhood sex education (P < 0.05). Conclusion In rural areas of Sichuan, although parents highly support early childhood sex education, the eligible rate of knowledge and the implementing rate are quite low, as well as the consistent rate of knowledge, attitude and practice. Relevant departments should pay attention to strengthen publicity and education, especially among older parents, low-educated parents and those opposed to or not yet implementing child sex education.

Analysis of psychological crisis vulnerability among rural college students and its related factors

HU Fan, TANG Chunping, ZHANG Ke

2023, 44(7): 1021-1025. doi: 10.16835/j.cnki.1000-9817.2023.07.014

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Objective To understand vulnerability to psychological crisis among rural college students and its related factors, so as to provide reference for the prevention or intervention of psychological crisis among rural college students. Methods A total of 3 560 rural college students from grade one to grade three from five universities were selected using convenient cluster sampling method from January to September 2022 in Nanyang City. General information, vulnerability to psychological crisis, parenting style and Scale of Perceived Social Self-efficacy (PSSE) were collected and analyzed through questionnaire. Results Among the investigated rule college students, the score of psychological crisis vulnerability and spoiling dimension of parenting style were (10.76±3.46) points and (2.68±0.55) points, while the score of trust encouragement dimension of parenting style and PSSE were (2.52±0.62) points and (3.29±0.61) points. Pearson correlation analysis showed that vulnerability to psychological crisis of rural students was positively correlated with spoiling and neglect (r=0.32, 0.49), and was negatively correlated with trust encouragement, emotional warmth and PSSE (r=-0.38, -0.53, -0.51)(P < 0.05). Multiple linear regression analysis revealed that single-parent family or other families, poor students, left-behind experience, high score of spoiling and high score of neglect revealed high psychological crisis vulnerability (P < 0.05). High score of trust encouragement, high score of emotional warmth and PSSE were associated with low vulnerability to psychological crisis (P < 0.05). Conclusion Vulnerability to psychological crisis among rural college students is higher, which is related to the family structure, students whether they are poor, leftover experience, parenting style and PSSE. Mental health among rural college students should be promoted by strengthening communication with students' parents and cultivating students' social self-efficacy.

Reliability and validity of the Chinese version of the Questionnaire of Executive Functioning among elementary school students

GAO Xiang, HUANG Rongzhi, TIAN Junlong, CHEN Juan, CUI Xuyan, LUO Zhi

2023, 44(7): 1026-1029. doi: 10.16835/j.cnki.1000-9817.2023.07.015

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Objective To evaluate the reliability and validity of the Chinese version of the Questionnaire of Executive Functioning (QEF) among elementary school students aged 7-12 years. Methods A total of 841 elementary school students from four primary schools in the Pearl River Delta (Guangzhou), eastern Guangdong area (Jieyang), northern Guangdong area (Shaoguan), and western Guangdong area (Maoming) were selected for item analysis by using a stratified whole-group sampling method in September 2022. A total of 377 elementary school students from the four elementary schools were selected for testing the structural validity and reliability, and 87 subjects from an elementary school in Guangzhou were selected at 15-day intervals for assessing test-retest reliability test. Results The questionnaire had good discrimination, and the correlation between the items and the total score ranged from 0.22 to 0.46 (P < 0.01). Exploratory factor analysis showed a cumulative variance contribution rate of 56.68%, with item loadings ranging from 0.41 to 0.74. Confirmatory factor analysis showed a good model fit (χ²/df=3.048, CFI=0.988, TLI=0.980, RMSEA=0.058, SRMR=0.009). The overall Cronbach's α, split-half reliability and test-retest reliability of the questionnaire were 0.72, 0.76, 0.79, respectively. Conclusion The Chinese version of the Questionnaire of Executive Functioning has good reliability and validity, and it is suitable for application to the self-assessment of executive function among elementary school students.

Association of vitamin D deficiency with anxiety and depressive symptoms among middle school students in Shenzhen

ZHAO Mengya, XU Shaojun, LI Xiaoheng, XU Huiqiong, CHEN Dingyan, ZHU Yi, TAO Fangbiao

2023, 44(7): 1030-1033. doi: 10.16835/j.cnki.1000-9817.2023.07.016

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Objective To explore the association of vitamin D deficiency with anxiety and depressive symptoms as well as their comorbidity, so as to provide references for improving the mental health of children and adolescents. Methods From October to December 2021, a total of 1 323 students from four middle schools in Shenzhen were selected by using convenience sampling method for a questionnaire survey and physical examination. Fasting blood samples were collected to detect vitamin D levels. The Chi-square test and multiple Logistic regression model were used to analyze the association of vitamin D deficiency with anxiety and depressive symptoms and their comorbidity among middle school students. Results The detection rates of anxiety, depressive, and thier comorbidities in middle school students were 33.0%, 21.5% and 16.3%, respectively. After adjusting for confounding factors, vitamin D deficiency was positively associated with the risk of anxiety symptoms (OR=1.59, 95%CI=1.02-2.46), depressive symptoms (OR=1.94, 95%CI=1.22-3.09) and anxiety-depressive co-morbid symptoms (OR=1.75, 95%CI=1.06-2.90) in secondary school students (P < 0.05). Conclusion Vitamin D deficiency is associated with an increased risk of anxiety, depressive and their co-morbidity symptoms in middle school students, and the directionality of the association should be further studied.

Relationship between chronotype and mental health problems among middle school students in Taiyuan

YONG Zhongtian, WANG Kai, LIU Jin, CHE Guoyu, WU Meiqiong, HAN Jiangtao, CHEN Jin, WANG Li

2023, 44(7): 1034-1037. doi: 10.16835/j.cnki.1000-9817.2023.07.017

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Objective To examine mental health problems among adolescents in Taiyuan City and its relationship to chronotype, so as to give a scientific basis for supporting mental health of middle school students. Methods From October to November 2021, a total of 2 621 pupils were enrolled from three junior high schools and two senior high schools in Taiyuan by using a multi-stage stratified cluster random sampling method to investigate demographic characteristics, mental health status, and chronotype. Chi-squared test, Spearman correlation analysis and Logistic regression were used to analyze the relationship between sleep patterns and mental health problems in middle school students. Results The proportion of morning, intermediate and evening types of middle school students sleep were 17.9%, 65.6%, and 16.4%, respectively. The overall detection rate of mental health problems was 13.8%, which was statistically significant among middle school students in different grades, self-perceived family economic status, the number of friends and sleep patterns (χ²=42.69, 29.15, 46.02, 93.99, P < 0.05). After adjusting for grade, self-perceived family economic status and the number of friends, Logistic regression analysis revealed that mental health problems were positively associated with evening type (OR=2.84) and negatively associated with morning type (OR=0.61)(P < 0.05). Conclusion Chronotype is associated with mental health problems among middle school students, with a higher risk for evening type and a lower risk for morning type. Mental health of middle school students can be enhanced by changing their chronotype.

Association between depression and anxiety symptoms with physical activity among rural returning adolescents

XIE Qin, GE Meiqin, LI Hua, XU Jiali, SONG Yongjing, SU Fan, GONG Ling

2023, 44(7): 1038-1043. doi: 10.16835/j.cnki.1000-9817.2023.07.018

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Objective To understand the symptoms of depression and anxiety among rural returning adolescents and to analyze their association with physical activity-related factors, so as to provide reference for interventions targeting depression and anxiety symtoms in the population. Methods From April to June 2020, 3 495 middle school students were selected from 6 counties and districts of Shangrao City by random cluster stratified sampling sampling. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to evaluate the depressive and anxiety symptoms among middle school students. The International Physical Activity Questionnaire was used to assess their physical activity levels during the past week. Chi-square test and Logistic regression analysis were used to determine the strength of the association between depression and anxiety symptoms and physical activity-related factors in returning and non-returning adolescents as well as the overall population. Results Univariate analysis showed significant differences in the prevalence of depressive and anxiety symptoms between rural returning and non-returning adolescents and the overall population in terms of "type of school" "family economic situation" "parental occupation" "number of sports classes per week" and "level of physical activity per week" (χ²=78.21, 16.56, 135.44, 107.75, 7.10, 8.62; 97.94, 24.26, 124.07, 90.36, 9.60, 8.34, P < 0.05). Multivariate regression analysis showed a correlation between the occurrence of depression and the number of sports classes per week for rural returning and non-returning adolescents and the overall population (number of sports classes per week for non-returning was 2 times, OR=1.22, 95%CI=1.01-1.49; returning adolescents for 1 time, OR=1.85, 95%CI=1.06-3.23; the overall population for 1 time, OR=1.34, 95%CI=1.01-1.77 and 2 times, OR=1.20, 95%CI=1.01-1.43, P < 0.05). There was a correlation between anxiety symptoms and the number of sports classes per week for returning adolescents (number of sports classes per week for returning adolescents was 1 time, OR=2.10, 95%CI=1.21-3.63, P < 0.05). Conclusion A low frequency of weekly sports classes may be a risk factor for depressive or anxiety symptoms in rural and returning adolescents. Rural primary and secondary schools should appropriately increase the number of physical education courses or arrange sports extended classes to promote the development of adolescent mental health.

Association between non-school sedentary time and myopia among primary and secondary school students with different levels of physical activity

ZHU Yi, XU Shaojun, ZHANG Xinyu, ZHAO Mengya, WAN Yuhui, TAO Fangbiao

2023, 44(7): 1044-1048. doi: 10.16835/j.cnki.1000-9817.2023.07.019

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Objective To analyze the association between non-school sedentary time and myopia among primary and secondary school students with different levels of physical activity, so as to provide data for precise measures to prevent and control myopia. Methods From September to December 2019, stratified cluster sampling was used to select 7 872 primary and secondary students in grades 4 to 12, middle and high school students from Hefei, Suzhou, Chizhou and Wuhu Cities in Anhui Province.Face-to-face questionnaires and vision examinations were conducted to collect demographic information, physical activity time, sedentary study time and visual health status.Potential categories were analyzed for different types of physical activity time, and Logistic regression was used to assess the relationship between non-school sedentary time and myopia at different levels of physical activity. Results A total of 2 976 primary and secondary school students were found with high physical activity levels and 4 896 primary and secondary school students with low physical activity levels.The proportion of low physical activity was higher in girls than in boys (68.7%vs.55.6%), and the differences were statistically significant (χ²=143.97, P < 0.01).The overall screening myopia rate was 48.2%, with statistically significant differences among female students (53.0%) compared with male students (43.3%), urban students (51.8%) compared with rural students (44.5%), and longer non-school sedentary time students (60.6%) compared with average (45.1%) and shorter (42.1%) non-school sedentary time students, and the differences were statistically significant (χ²=73.15, 41.96, 161.74, P < 0.01).Adjusting for confounders such as residence, grade, gender, age, father's education, mother's education, and body mass index (BMI), multivariate Logistic regression analysis revealed that prolonged after-school sedentary study was positivety correlated with myopia among primary and secondary school students of low physical activity levels (OR=1.52, 95%CI=1.27-1.83, P < 0.01), and there was no statistical association between after-school sedentary time and myopia in primary and secondary school students with high physical activity levels (P>0.05). Conclusion Attention should be paid to non-school sedentary time for primary and secondary school students with low physical activity levels.And students who spend a lot of time sitting outside of school should be encouraged to maintain high physical activity levels to reduce the risk of myopia.

A longitudinal study on association between puberty development and thyroid function of school-aged girls in Minhang District, Shanghai

HE Dandan, LI Jinhong, XU Huilin, WANG Yingying, WEN Xiaosa, FU Ye, TANG Hongmei, SU Hualin, XU Dongli, WANG Na

2023, 44(7): 1049-1053. doi: 10.16835/j.cnki.1000-9817.2023.07.020

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Objective To observe the association between puberty development and thyroid function among school-aged girls in Minhang District of Shanghai, in order to explore the effect of puberty development on thyroid function. Methods The study was based on a cohort of adolescent girls recruited in iodine-suitable areas of Minhang District, and the baseline and follow-up survey have been carried out from January to March 2019.The method of phased cluster sampling was used to select one junior high school in the east, south, north and middle of Minhang District, Shanghai, respectively.Finally, 464 new junior high school girls were included in the Cohort study for physical examination, and girls were followed up from January to March 2021.The Puberty Development Scale (PDS) was used to assess the stage of puberty.Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were determined for each participant.Thyroid homeostasis structure parameters (THSPs) was calculated.Changes of Thyroid hormones at baseline and follow-up were compared by Wilcoxon signed rank sum test.Multiple linear regression analyses were used to evaluate the associations of thyroid hormones (THs) and THSPs changes with pubertal develepment. Results Serum TSH levels of female studentds decreased significantly, while their FT3 and FT4 levels increased significantly during the study period (Z=-10.53, -4.71, -12.46, P < 0.01).In multiple linear regression analysis after adjustment for co-variables (including baseline age, change of BMI and waist circumference), FT4 and thyroid feedback quantile-based index (TFQI) in the higher puberty category scores changes (△PCS) group were further reduced compared with those in the low △PCS group (β=-0.66, -0.55).Compared to the late puberty at baseline and follow-up (BLFL) group, FT4 and TFQI showed higher decline in the pre-puberty at baseline and late puberty at follow-up (BPFL) group with the pre-puberty at baseline and end of puberty at follow-up (BPFT) group (β=-0.55, -0.44)(P < 0.05).There were no association of △TSH, △FT3, △FT4/FT3 and TSH index changes (△TSHI) with △PCS or the puberty pattern. Conclusion Serum TSH decreases while serum FT3 and FT4 increase among girls during puberty.Both the initial stage and the velocity of pubertal development are related to thyroid hormone fluctuations.

Prevalence of myopia of primary and middle school students in Beijing from 2018 to 2021

LI Ting, ZHANG Jingshu, YANG Han, QIN Ran, GUO Xin

2023, 44(7): 1054-1057. doi: 10.16835/j.cnki.1000-9817.2023.07.021

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Objective To understand the vision status of primary and secondary school students in Beijing, in order to provide scientific reference for myopia prevention and control. Methods From 2018 to 2021, a stratified cluster sampling method was used to monitor myopia among 191 293 primary and secondary school students selected from 6 urban areas and 10 suburban areas in Beijing.Myopic screening was in accordance with the"standards for children and adolescents myopic screening", and was measured by an automatic desktop computer optometer under non-cycloplegic conditions.Statistical analysis was used by Chi-square test. Results The total myopia rate of primary and middle school students in Beijing from 2018 to 2021 were 60.7%, 57.6%, 59.2% and 59.7%, respectively.In 2018, the myopia rates of primary school students, middle school students, regular high school students and vocational high school students were 38.3%, 77.3%, 88.3% and 73.2% respectively.In 2019, they were 34.7%, 76.4%, 87.7% and 72.0%, respectively; in 2020, they were 37.5%, 76.8%, 86.8%, 74.9%;in 2021, they were 38.7%, 77.4%, 86.5% and 74.9% respectively.Significant differences in educational stage were observed (χ²=7 386.07, 11 104.28, 9 850.08, 9 714.59, P < 0.01).From 2018 to 2021, the overall myopia rate of girls (62.1%) was higher than that of boys (56.5%)(χ²=613.75, P < 0.01).The myopia rate of girls were higher than that of boys in each year, and significant differences in educational stage were observed, respectively (χ²=120.47, 163.47, 168.01, 162.24, P < 0.01).The overall myopia rate of urban students (63.0%) was higher than that of suburban students (56.0%)(χ²=978.82, P < 0.01).The myopia rate of urban students were higher than that of suburban students every year, and significant differences in educational stage were observed, respectively (χ²=86.71, 240.96, 302.56, 409.30, P < 0.01). Conclusion The detection rate of myopia rate of primary and middle school students in Beijing is still high.It is necessary to strengthen the publicity and intervention of poor visual acuity in primary and middle school students, especially among urban area students, with the aim of effectively control and reduction in the myopia rate, and the improvement of student visual health.

Effects of sports environment design on children's fundamental movement skills

YE Yue, NING Ke, SHANGGUAN Chunzi, DU Anlong, LI Zhangtao

2023, 44(7): 1058-1062. doi: 10.16835/j.cnki.1000-9817.2023.07.022

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Objective Based on Newell's Model of Constraints, the present study aims to explore the effects of sports environment design on children's fundamental movement skills, and to provide certain theoretical and practical guidance for promoting children's movement development and carrying out sports activities. Methods From March to June 2022, using the method of cluster sampling, 153 typical developmental children from a private kindergarten in Xi'an were selected, and were randomly assigned to the regular activity group, sports division A group, and sports division B group for a period of 12 weeks (twice a week, 1 hour each time) experimental intervention.Among them, the regular activity group engaged in regular physical activities according to the kindergarten plan; the sports division A group participated in daily physical activities after the sports division; and the sports division B group engaged in structured and autonomous physical activities after the sports division.Motorische Basiskompetenzen in Kindergarten (MOBAK-KG) scale was used to assess the level of fundamental movement skills.Chi-square test, one-way analysis of variance and repeated measures analysis of variance were used to test the effects of sports environment design on children's fundamental movement skills. Results After the experiment, children's manipulative skills, mobility skills, and fundamental movement skills improved significantly (P < 0.01);group and test time had a significant interaction on children's fundamental movement skills[F_{(2, 150)}=113.07, P < 0.01, η²=0.60], the posttest score of fundamental movement skills of children in group B of sports division (12.08±1.82) was significantly higher than that of group A of sports division (10.71±2.56), regular activity group (8.57±4.16). Conclusion The sports environment design under the constraint model perspective can effectively promote the development of children's fundamental movement skills.Kindergartens, families and communities should coordinate to promote the development of children's fundamental movement skills.

Trends and prediction of the burden of depression among adolescents aged 10 to 24 years in China from 1990 to 2019

YANG Li

2023, 44(7): 1063-1067. doi: 10.16835/j.cnki.1000-9817.2023.07.023

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Objective To analyze the trend of the burden of depression among adolescents aged 10-24 years from 1990 to 2019 and predict its future trend, so as to provide a theoretical basis for prevention and treatment. Methods The prevalence and disability-adjusted life years (DALYs) were determined using the 2019 Global Burden of Disease Database.The joinpoint regression model was employed to analyze the changing trend of the burden of depression among adolescents aged 10-24 years in China from 1990 to 2019.The ARIMA time series model was established using R software to predict the development trend of depression among adolescents aged 10-24 years in China from 2020 to 2029. Results From 1990 to 2019, the prevalence and DALYs rate were higher among adolescents aged 10-24 years in comparison to the general population and males.Furthermore, the prevalence and DALYs rate were higher among adolescents aged 20-24 years than among those aged 15-19 and 10-14 years, with statistical significance (P < 0.05).The joinpoint regression analysis revealed that the prevalence of depression among adolescents aged 10-24 years showed an overall decreasing trend with an average annual rate of 1.61%(t=-10.53, P < 0.05), while the prevalence of depression among male and female adolescents in the same age group also showed a decreasing trend, with an average annual decreasing rate of 1.18%(t=-5.79) and 1.79%(t=-11.84)(P < 0.05), and the overall decline rate was greater among women than men.There was no significant change in the prevalence of depression among adolescents aged 10-14 years from 1990 to 2019(AAPC=-0.28, P>0.05), while the prevalence of depression among adolescents aged 15-19 years and 20-24 years also showed a decreasing trend with an average annual rate of 1.43%(t=-12.05) and 1.90%(t=-24.92)(P < 0.05).The ARIMA model predicted that the prevalence of depression and the rate of DALYs among adolescents aged 10-24 years would continue to decline from 2020 to 2029. Conclusion The prevention and treatment of depression among adolescents aged 10-24 years in China should focus on females and those aged 20-24 years old.We should start from the environment and micro-environment of adolescent growth and take active and effective measures to prevent the occurrence of adolescent depression.

Current situation and influencing factors of varicella vaccination among left-behind children aged 4-8 years old in Quzhou

ZHENG Canjie, XU Wenjie, GONG Xiaoying, FANG Quanjun, YIN Zhiying

2023, 44(7): 1068-1071. doi: 10.16835/j.cnki.1000-9817.2023.07.024

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Objective To understand vaccination coverage and the influencing factors of varicella vaccine (VarV) among left-behind children in Quzhou, which based on protective motivation theory (PMT), so as to provide reference to consolidate VarV vaccination in the next step. Methods From September to December in 2022, simple random sampling was used to select 628 left-behind children in six counties of Quzhou City.A questionnaire survey on their caregivers was conducted to collect data relating to sociological characteristics and PMT factors, and the influencing factors of VarV were tested by Logistic regression. Results A total of 628 left-behind children participated in the study.The VarV rate was 69.59%, and 74.83% had received a second dose of VarV.The unvaccinated rate was 30.41%, and caregivers willingness to vaccinate children with VarV was only 10.99%.Logistic regression analysis showed that family relationships, annual household income, number of children in the family, extrinsic rewards and self-efficacy were the influencing factors of VarV among left-behind children (OR=0.43-3.40, P < 0.05).The external reward factor was positively correlated with the vaccination probability (OR=1.14), and the self-efficacy factor was negatively correlated with the vaccination probability (OR=0.95). Conclusion In the context of health education and school promotion, attention should be paid to factors relating to extrinsic rewards and self-efficacy as a means of increasing motivation to seek vaccine protection and improve the use of VarV.

Relationship between eczema and indoor environmental factors among preschool children in Haikou

WANG Shuomin, ZHA Yi, ZHANG Jing

2023, 44(7): 1072-1075. doi: 10.16835/j.cnki.1000-9817.2023.07.025

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Objective To investigate the influencing factors of home environment on eczema in preschool children, so as to provide theoretical basis for taking effective regional prevention for preschool children. Methods From December 2020 to January 2021, a cross-sectional survey of 3 049 preschool children was randomly carried out by stratified cluster sampling in Haikou kindergartens, and the impact of indoor environmental factors on preschool children's eczema was analyzed.Chi-squared test and binary Logistic regressive were used to analyze the related factors. Results The prevalence of eczema in preschool children was 13.6%.Multivariate Logistic regression showed that the positive correlation factors of eczema included the new decoration in the mother's residence one year before pregnancy (OR=1.71, 95%CI=1.09-2.68), the addition of new furniture in the child's residence when the child was 0-1 years old (OR=1.53, 95%CI=1.03-2.27), cockroaches in the house (OR=1.35, 95%CI=1.02-1.81) and cleaning of less than once per week (OR=1.30, 95%CI=1.01-1.66).The starting age of children's collective life since 3 years old (OR=0.76, 95%CI=0.60-0.96) had a negative correlation with eczema (P < 0.05). Conclusion There are multiple indoor environmental factors related to eczema among preschool children in Haikou city.Parents should take measures to prevent eczema in preschool children by paying attention to home environment and the starting age of children's collective life.

Prevalence of myopia among children and adolescents in Inner Mongolia Autonomous Region from 2019 to 2021

LI Guofeng, ZHANG Xiuhong, WEI Nana, YANG Tian, ZHAO Jufang, ZHAO Jing, YU Dong

2023, 44(7): 1076-1079. doi: 10.16835/j.cnki.1000-9817.2023.07.026

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Objective To analyze the prevalence and trend of myopia among children and adolescents in Inner Mongolia from 2019 to 2021, so as to provide a reference for making scientific and effective prevention and controlling measures of myopia. Methods By using the stratified random cluster sampling method, 555 093 children and adolescents were selected from 12 professional institutions in league cities of the whole region for remote vision examination and refractive examination.The refraction test was carried out under the condition of non-Ciliary muscle paralysis using a desktop automatic computer optometer.Chi-squared test and multivariate Logistic regression were used to analyze the myopia status of children and adolescents and its influencing factors. Results From 2019 to 2021, the myopia rate of children and adolescents was 53.30%, 58.65% and 54.82%, respectively, the difference was statistically significant (χ²=991.70, P < 0.01).The overall female myopia rate (58.82%) was higher than that of male (51.52%), and the differece was statistical significant (χ²=3 295.66, P < 0.05).The myopia rates of boys and girls by year were 49.44% and 57.30%, 54.76% and 62.60%, 51.23% and 57.62%, respectively, and the differences were statistically significant (χ²=1 197.02, 922.31, 1 172.09, P < 0.01).The overall myopia rate of urban students (59.42%) was higher than that of suburban counties (53.61%), and the difference was statistically significant (χ²=1 565.03, P < 0.05).The myopia rates of children and adolescentss in urban and suburban counties were 59.20% and 50.79%, 60.26% and 57.88%, 58.95% and 53.36%, and the differences were statistically significant (χ²=1 150.80, 74.10, 529.25, P < 0.01).The children and adolescents of learning stages were of statistical significance (χ²=92 402.39, P < 0.05), and the overall myopia rate of senior school students was the highest, accounting for 83.57%.The difference of overall myopia rates of different age groups was of statistical significance (χ²=121 881.67, P < 0.05), and the students in age group of 17 ranked the first (83.32%), those in age group of 5 ranked the last (15.52%). Conclusion From 2019 to 2021, the myopia rate of children and adolescents in the Inner Mongolia Autonomous Region increase first and then decrease, and the myopia rate in 2020 and 2021 is higher than that in 2019.The high incidence and low age of myopia are intensifying.The prevention and controlling of myopia among children and adolescents should be strengthened, so as to reduce the occurance of myopia.

Correlations between depression, sleep quality and dental caries among college students in Chongqing

LIU Feng, ZHU Lanlan, WANG Xu

2023, 44(7): 1080-1083. doi: 10.16835/j.cnki.1000-9817.2023.07.027

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Objective To understand the correlation between depression, sleep quality and dental caries among college students in Chongqing, so as so provide reference basis for targeted health education. Methods From January to June 2022, a multi-stage sampling method was used to select 627 students from six colleges in Chongqing. According to the Fourth National Epidemiological Survey of Oral Health and World Health Organization standards, dental caries were examined and diagnosed. The Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) Questionnaire and general situation questionnaire were adopted to investigate depressive symptoms and sleep quality of college students. Correlation analysis was performed to study the correlation between depression, sleep quality and dental caries. Results The prevalence of dental caries among college students was 42.1%, and there was a statistically significant difference in dental caries prevalence among college students depending on their gender, major, body shape, parental education level, and family sources (χ²=14.49, 16.81, 7.82, 15.14, 7.34, P < 0.05). The prevalence of depressive symptoms was 13.9%, and there was a statistically significant difference in SDS scores and depression prevalence among students of different body types (χ²=10.99, P < 0.05). The PSQI score was (4.36±0.94) points, and the rate of poor sleep quality was 26.16%. Furthermore, there was a statistically significant difference in the PSQI score and rate of poor sleep quality among college students of different genders and body types (χ²=25.41, 17.59, P < 0.05). There was a certain correlation between the occurrence of dental caries and poor sleep quality and depressive symptoms among college students, with contingency coefficients of 0.15 and 0.13, respectively (P < 0.05). Conclusion The prevalence of dental caries is high among college students in Chongqing. The occurrence of dental caries may be related to depression and sleep quality.

A qualitative study of the difficulties faced by adolescents with depression in the treatment and rehabilitation

YUN Wenjie, LIU Mengqi, CHEN Xu, CHU Hongling, WANG Haibo

2023, 44(7): 1084-1087. doi: 10.16835/j.cnki.1000-9817.2023.07.028

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Objective Based on a qualitative research method, the present study aims to explore the negative experiences and real dilemmas of adolescent with depression in the treatment and rehabilitation process, so as to provide references to promote the improvement of the treatment system for adolescent depression in China. Methods From August 2022 to November 2022, 30 adolescents with depression were selected for in-depth interviews in the inpatient department of child and adolescent psychiatry at Beijing An Ding Hospital affiliated with Capital Medical University by using the purposive sampling method, and the interview data were analyzed by using the Colaizzi method to summarize the themes. Results The real dilemmas faced by depressed adolescent during treatment and recovery included three aspects: inappropriate family coping (caregivers' lacking of correct disease cognition; caregivers' lacking of effective coping methods), difficulties in disease diagnosis and treatment (low rate of identification and adverse effect of treatment; medical service failing to satisfy the demands), and barriers to continued schooling (barriers to academic progress and interpersonal communication). Conclusion Adolescents with depression face real dilemmas in the process of disease treatment and rehabilitation at home, school and medical care. Caregivers' disease literacy and caregiving skills should be improved. A collaborative disease management system among family, school, community and medical institutions should be established to promote adolescent depression treatment and social function recovery.

Epidemiological investigation of an outbreak of pertussis in a primary school in Rizhao

LI Guohua, BU Jieqiong

2023, 44(7): 1088-1091. doi: 10.16835/j.cnki.1000-9817.2023.07.029

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Objective To investigate the epidemiological characteristics of a pertussis outbreak in a primary school in Rizhao City, so as to provide reference for the prevention and control strategy of pertussis. Methods The method of field epidemiological investigation was used to determine case definition for case search and case investigation, and the characteristics of the outbreak were comprehensively analyzed through descriptive epidemiological method. Results The outbreak lasted for 29 days from April 19 to May 17, 2022, with a total of 14 cases detected. All the cases were students aged 6-7 years from Class 2, Grade 1 in this primary school, including 6 boys and 8 girls. The attack rates of boys and girls were 30.00% and 34.78%, respectively. The time interval from onset to diagnosis of 14 cases ranged from 2 to 22 days, with a median of 10 days. All of them had received 4 doses of Diphtheria and Tetanus and acellular Pertussis(DTaP) combined vaccine, and the interval between the last vaccination and the onset of disease was 5-6 years. After isolated treatment, all the 14 sick students recovered, without severe or death cases. Conclusion The outbreak of pertussis in a primary school may be related to the decline in the effectiveness of pertussis vaccine protection over time, the lax implementation of a school registration and reporting system for sick absenteeism, and the poor sensitivity of existing pertussis surveillance systems.

Food safety and risk assessment for prepared beverage around the campus in Wuxi

CHEN Jiaqi, REN Liang, QIAN Hongdan

2023, 44(7): 1092-1094. doi: 10.16835/j.cnki.1000-9817.2023.07.030

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Objective To investigate the use of additives and microbiologic contamination in prepared beverages around campus in Wuxi City, so as to provide reference for ensuring the physical health of primary and secondary school students. Methods From August to September 2022, 108 prepared beverage were randomly collected from beverage stores around campus in four districts of Wuxi City. The food additives and microbiologic contamination were detected by the national standard method and evaluated according to the National Food Safety Standards for the Use of Food Additives and Local Food Safety Standards for Ready-made Beverages. Chi-squared test was used for statistical analysis. Results The use of 13 additives in prepared beverages didn't exceed the limits specified in relevant standards. The detection rate of preservatives in fruit juice (52.78%) was higher than that in tea (16.67%), and milk tea (27.78%), while the detection rate of pigments in milk tea (16.67%) was lower than that in tea (52.78%) and fruit juice (47.22%)(χ²=11.24, 11.46, P < 0.05). The overlapping use of the same functional additive did not exceed the specified limit. The exceeding rate of total bacterial count was 9.26%, and Escherichia coli was 14.81%. Conclusion There are certain food safety risks in prepared beverages around the campus in Wuxi City. Relevant enterprises and shops should strengthen supervision and management to ensure food safety for students.

Application of virtual reality technology in promoting mental health of college students

WU Yueyue, FENG Rong

2023, 44(7): 1095-1098. doi: 10.16835/j.cnki.1000-9817.2023.07.031

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College students are a vulnerable population for psychological problems, who are facing challenges from environmental adaptation, career planning, peer competition and interpersonal relationships. In recent years, the state attaches great importance to psychological health education of college students. Virtual reality technology (VR) has been widely used in clinical psychology with the development of techology. In order to enrich channels of psychological health education of college students, the paper summarizes the methods, advantages and future direction of its application in promoting mental health of college students, providing reference for expanding the intervention ways of college students' psychological health education and promotion.

Effectiveness of comprehensive intervention on primary dental caries in 3-year-old children in Bengbu

PAN Shukuang, SUN Yutong, HU Mengtian, DING Feng, XU Hui, SUN Tianli

2023, 44(7): 1099-1102. doi: 10.16835/j.cnki.1000-9817.2023.07.032

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Objective To explore the effectiveness of the comprehensive intervention on prevention of deciduous primary caries in 3-year-old children, so as so provide reference for the prevention, health care and treatment of oral caries. Methods Three-year-old children selected by drawing lots from 10 public kindergartens in 5 districts of Bengbu were examined in 2021, and were randomly divided into intervention group (n=300) and control group (n=300). During the initial examination, caries loss (dmf) including dental caries, missing teeth, filling teeth were assessed in the two groups. At the initial examination, the intervention group received caries intervention while no intervention was administered in the non-intervention group until half a year later. Intervention measures included education, diet, self-cleaning and fluoride application intervention. The number of cases and the mean of caries loss in the two groups were compared by χ² test. Results Before the intervention, 43 children in the control group suffered from caries, with 88 dmf, including 44 dmf for boys and 44 dmf for girls. There were 45 children in the intervention group, with 101 dmf, including 49 dmf for boys and 52 dmf for girls. There was no significant difference in the number of dmf between the intervention group and the control group (χ²=0.91, P>0.05), and there was no significant difference in the prevalence rate (15.0%, 14.3%, χ²=0.05, P>0.05). After the intervention, there were 26 new dental caries and 43 dmf in intervention group, including 25 dmf for boys and 18 dmf for girls. In the control group, there were 83 new dental caries and 168 dmf, including 72 dmf for boys and 96 dmf for girls. Compared with the control group, the new dmf in the intervention group was significantly different (χ²=75.38, P < 0.05). The number of new dental caries patients in the intervention group was significantly different from that in the control group (χ²=36.42, P < 0.05). Conclusion Comprehensive interventions to prevent dental caries can significantly reduce the incidence of primary teeth caries in children. It is suggested to intervene dental caries as early as possible to reduce the incidence of dental caries and other oral diseases.

Progress and prospect on the relationship between campus greening and health of students

LI Qian, YANG Wenhan

2023, 44(7): 1103-1106. doi: 10.16835/j.cnki.1000-9817.2023.07.033

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Abstract:
Childhood and adolescence are critical periods for physical and mental development, and much of their time is spent in school. Green campus not only has a direct impact on students, but also plays a necessary role in the formation of the whole social environment. Based on relevant previous literature, the review summarizes the latest research in the relationship between the campus greening and students' health, the potential mechanism and discusses the existing problems for the construction of a green campus infrastructure in China, so as to provide a scientific basis for health promotion among children and adolescents, and to provide directions for future research.

Disease burden and prediction of attention deficit hyperactivity disorder in Chinese children and adolescents from 1990 to 2019

YANG Xiaolei, LI Hongjie, DUO Yongsheng, GE Jie, ZHANG Yan, SUN Huixin

2023, 44(7): 1107-1111. doi: 10.16835/j.cnki.1000-9817.2023.07.034

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Abstract:
Objective To analyze the disease burden and trend of attention deficit hyperactivity disorder (ADHD) in China from 1990 to 2019, so as to provide the basic theoretical basis for the health administrative departments to formulate policies. Methods Using the 2019 Global Burden of Disease Database, the incidence, prevalence and disability adjusted life year (DALY) rates of ADHD were analyzed for both sex and different age groups, and the trends of ADHD were predicted. Results In 2019, the incidence, prevalence and DALY rate of ADHD in China were 70.41/100 000, 1 546.15/100 000 and 18.87/100 000 respectively. Compared with 1990, the rates decreased by 27.30%, 25.35% and 55.80% respectively, and these rates of females were lower than those of males. In 2019, the incidence rate of ADHD was the highest in the age group 5-9 years old (837.76/100 000), while the highest prevalence and DALY rates were found in ages groups of 10-14 years old (5 740.47/100 000 and 70.49/100 000). The results of the Joinpoint regression model showed that the incidence, prevalence and DALY rate had a downward trend from 1990 to 2019. The AAPC was -1.35%, -1.16% and -1.16%, respectively, with a statistically significant difference (P < 0.05). The prediction results of grey prediction model GM (1, 1) indicated that the incidence and prevalence rate of ADHD in China would decline from 2020 to 2030. Conclusion The burden of ADHD in China showed a decreasing trend from 1990 to 2019, indicating that the prevention and treatment effect of ADHD in children and adolescents of China was effective. China should take active preventive measures to reduce the burden of ADHD in children and adolescents.

Research progress in global digital mental health services for adolescents

XIONG Zhou, HUANG Beibei, CHEN Siyan, SUN Ying

2023, 44(7): 1112-1115. doi: 10.16835/j.cnki.1000-9817.2023.07.035

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Abstract:
The increasing fragile and vulnerable adolescents' mental health determines the increasing demand for psychological health services among teenagers, which indicates the inadequacy of traditional mental health service models. This article summarizes the necessity of digital mental health services for adolescents, and then lists the application examples of digital mental health services across the world, aiming to provide reference for digital mental health services among Chinese adolescents.

Research progress on risk factors and identification tools for child abuse

LI Yongzhen, XIE Li, WANG Wenchao, LIU Jing, CHEN Yang, SONG Jun, HU Fei, GONG Hairong

2023, 44(7): 1116-1120. doi: 10.16835/j.cnki.1000-9817.2023.07.036

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Abstract:
Child abuse is a global public health problem, which has emerged as a neglected yet pressing issue in global development. Early and accurate identification of abuse at a lower-age group is of great significance for treatment, which might reduce the risk of re-maltreatment and promote children's physical and mental health development. Therefore, by reviewing the clinical characteristics, risk factors and existing abuse identification and screening tools of child abuse, the study aims at providing basic evidence for the development of child abuse risk identification tools and the establishment of child maltreatment system in China, so as to take timely intervention measures to prevent adverse outcomes or reduce their severity.

2023 Vol. 44, No. 7