中国学校卫生

Establishment and exploration of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of major health problems of children and adolescents

SONG Yi, ZHANG Xiuhong, MA Jun

2023, 44(9): 1281-1285. doi: 10.16835/j.cnki.1000-9817.2023.09.001

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In recent years, child and adolescent health problems such as myopia, obesity, and mental health have attracted the attention of society as a whole and have become important public health issues. Considering high prevalence in each of the major health problems among children and adolescents in China, current high prevalence of co-morbidities of these health problems needs further attention. Shared behavioral and environmental risk and protective factors make it possible to improve the co-morbidities among children and adolescents through the same interventions. It is urgent to explore the Co-morbidity, Shared Etiology, and Shared Prevention mechanism of common diseases of children and adolescents in China, and to explore standardized programs and processes for the implementation of comorbidity intervention for children and adolescents across varied scenarios including families, schools, communities and medical institutions, so as to improve the health level of children and adolescents.

The content and implementation path of child safety education in Australia

YANG Yuedi

2023, 44(9): 1286-1288. doi: 10.16835/j.cnki.1000-9817.2023.09.002

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The safety of children is an important area of concern for Australian education policy. To ensure children's safety, Australia has developed child safety education around topics, such as, road traffic, forest fire and water safety. In the process of implementation, Australia has emphasized the issue of safety education for special groups of children, mobilized resources from family, kindergarten and society, developed reasonable risk assessment tools, and formed a complete child safety education process from learning target and content, educational personnel and assessment. Australia's experience in child safety education can provide a theoretical and practical reference for China to build an appropriate safety education approach, promote balanced and high-quality development of safety education, and improve the quality assurance system of safety education.

Prevalence trend and related factors of scoliosis and myopia co-morbidities among primary and middle school students in Inner Mongolia Autonomous Region from 2019 to 2022

MA Xinyue, ZHANG Xiuhong, SONG Yi, DONG Yanhui, YANG Tian, MA Caixia, GAO Sheng

2023, 44(9): 1289-1293. doi: 10.16835/j.cnki.1000-9817.2023.09.003

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Objective To analyze the prevalence trend of scoliosis among myopic students in Inner Mongolia Autonomous Region during 2019-2022, to explore the common etiology of myopia and scoliosis co-morbidities, so as to provide a reference for the development of relevant measures. Methods The method of stratified random cluster sampling was used to select 181 533, 141 552, 200 987, 190 918 primary and secondary school students from 12 leagues(103 banners) in Inner Mongolia Atuonomous Region in September each year from 2019 to 2022. And scoliosis screening, vision examination and questionnaire survey were conducted among students in the included studies. The χ² test was used to analyze the data, and the binary multivariate Logistic regression model was used to screen the influencing factors of scoliosis and myopia co-morbidities. Results From 2019 to 2022, the myopia rate of primary and secondary school students in Inner Mongolia Autonomous Region was 55.55%-59.72%, scoliosis rate was 1.56%-2.81% and the rates of scoliosis and myopia co-morbidities were 1.14%-1.95%, and the difference between different years was statistically significant (χ²=595.01, 775.56, 461.84, P < 0.05). In 2022, the co-morbidity rate was higher in girls than in boys(1.32% vs 0.97%), the rate of urban areas was higher than that of rural areas(2.57% vs 0.62%), the rate of students in vocational high school and high school was higher than that in junior high school and primary school (3.82%, 2.47% vs 1.70%, 0.42%), the rate of over-developed areas was higher than that of poor areas (1.21% vs 0.99%)(χ²=52.19, 1 269.82, 1 361.52, 17.29, P < 0.05). Logistic regression analysis showed that at least 1 h of moderate and high-intensity exercise every day on weekends, the number of physical education classes per week was more than 3 sessions, the height of desks and chairs was adjusted according to height, resting outdoors, limiting screen time, and strictly requiring standing and sitting posture were the negative correlated with scoliosis and myopia, and the OR value was 0.65-0.90, reading books or electronic screens while participating in cram classes, walking or riding in the car were positively correlated with comorbid scoliosis and myopia, and the OR values were 1.27 and 1.13 (P < 0.05), respectively. Conclusion Behavioral habits severely affect scoliosis and myopic of students. Prevention and control of scoliosis and myopia co-morbidity should start with students' behavioral habits, early screening and early intervention.

Co-occurrence trend and association study of Internet addiction and depressive symptoms among students in Inner Mongolia Autonomous Region

YUAN Wen, JIANG Jianuo, QIN Yang, WANG Ruolin, ZHANG Yi, ZHANG Yihang, CHEN Li, LIU Jieyu, GUO Tongjun, YANG Tian, ZHANG Xiuhong, SONG Yi, MA Jun, DONG Yanhui

2023, 44(9): 1294-1298. doi: 10.16835/j.cnki.1000-9817.2023.09.004

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Objective To investigate the prevalence of Internet addiction and depression of students, and to analyze the co-occurrence and trend, so as to provide a theoretical basis for prevention and controlling measures of Internet addiction and depression. Methods A total of 6 317, 7 152, 81 808, 71 180 and 89 932 students aged 10 to 24 years from 12 leagues (103 banners) in Inner Mongolia Autonomous Region were selected by stratified random cluster sampling in September each year from 2017 to 2021. The Internet Addiction Scale and the Central for Epidemiologic Studies Depression Scale(CES-D) was used to measure Internet addiction and depression. And the annual inspection rate, group difference and annual change trend in students were calculated. Multivariate linear regression and restricted cubic spline analysis were used to estimate the linear and non-linear associations between Internet addiction and depression in students. Results The Internet addiction proportion in students gradually decreased from 4.1% in 2017 to 2.1% in 2020, but increased to 3.9% in 2021. And the depressive symptoms proportion increased from 20.9% in 2017 to 28.0% in 2020 and 27.0% in 2021. The detection rate of Internet addiction and depression co-morbidities remained at 1.8% to 2.5%. The Internet addiction proportion in boys was higher than that in girls(χ²=42.82, P < 0.05). The depressive symptoms prevalence in girls was higher than that in boys(χ²=553.90, P < 0.05). Taking reversal in prevalence of Internet addiction in urban and rural areas was observed in 2019. The detection rates of depressive symptoms and comorbidity were higher in urban areas than these in suburban counties on the whole, and the difference showed a trend of decreasing or even equalizing year by year. Internet addiction was positively correlated with depressive symptoms score (B=1.67, 95%CI=1.64-1.71), the proportion of depressive symptoms (OR=1.39, 95%CI=1.38-1.41) and the proportion of major depressive symptoms (OR=1.35, 95%CI=1.33-1.36) among students in 2021 (P < 0.05). An N-shaped curve was found in the significant nonlinear associations between internet addiction and depression across sex, region and school stage. Conclusion Internet addiction and depression in students show significant linear and non-linear associations, which are consistent in different sexes, regions and school stages. Therefore, relevant measures should be made and implemented in each region, especially in suburb areas, so as to prevent the increasingly development of adolescents and children's Internet addiction and depression.

Co-morbidity of myopia and obesity and the moderating role of lifestyle among primary and secondary school students in Inner Mongolia Autonomous Region in 2021

ZHANG Yihang, YUAN Wen, DANG Jiajia, LIU Yunfei, CAI Shan, SHI Di, CHEN Ziyue, YANG Tian, MA Xinyue, MA Caixia, JIANG Jianuo, DONG Yanhui, ZHANG Xiuhong, MA Jun, SONG Yi

2023, 44(9): 1299-1303. doi: 10.16835/j.cnki.1000-9817.2023.09.005

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Objective To describe the current status of the prevalence of co-morbid myopia and obesity among 7-18 years students in the Inner Mongolia Autonomous Region in 2021 and to analyze the moderating effect of lifestyle in this association, so as to provide scientific basis for the establishment of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of common diseases in children and adolescents. Methods A total of 139 630 primary and secondary school students aged 7-18 years from Inner Mongolia Autonomous Region were selected by stratified random cluster sampling method in September, 2021. Myopia was determined using distance visual acuity examination and refractive error examination, and obesity was determined according to the BMI classification criteria for overweight, obesity screening of Chinese school-age children and adolescents. Used a questionnaire, healthy lifestyles were determined according to the American Heart Association's Healthy Lifestyle Score by totaling the six scores for smoking, alcohol consumption, diet, exercise, screen time, and sleep duration. The χ² test was used to compare the association between group differences in the co-morbidity rate of myopia and obesity. The multivariable Logistic regression model was used to explore the influencing factors of the co-morbidity of myopia and obesity, and the stratified analysis was used to analyze the moderating effect of lifestyles on the prevalence of the co-morbidity. Results The prevalence of myopia and obesity co-morbidity among students aged 7-18 years old in the Inner Mongolia Autonmous Region in 2021 was 13.7%, higher among boys than girls (15.5% vs. 11.8%), higher among those aged 10-12 years old than 7-9, 13-15, and 16-18 years old (14.7%, 13.7%, 13.3%, 12.0%), higher among other ethnic minorities than Han Chinese and Mongolians (15.3%, 14.0%, 12.5%), higher in urban areas than that in suburban areas(15.3%, 13.0%), and middle economic level tracts were higher than poor and good tracts (14.8%, 12.9%, 12.6%) (χ²=392.37, 115.73, 62.80, 119.02, 121.60, P < 0.05). Multivariable Logistic regression modeling showed that unhealthy lifestyles (OR=1.24, 95%CI=1.19-1.29) and middle level of lifestyle score (OR=1.15, 95%CI=1.10-1.19) students had higher prevalence of co-morbidity, and the results were statistically significant among both boys and girls, the age groups of 10-12, 13-15, and 16-18 years old, as well as the Han and Mongolian ethnic groups (all P < 0.05). Conclusion In 2021, the current situation of myopia and obesity co-morbidity and unhealthy lifestyles among primary and secondary school students in the Inner Mongolia Autonomous Region are not optimistic.

Co-occurrence trend of school bullying and depression and its correlation with dietary patterns among middle school students from Inner Mongolia Autonomous Region in 2021

ZHANG Xiuhong, SONG Yi, DONG Yanhui, YUAN Wen, YANG Tian, ZHAO Jing, ZHAO Jufang

2023, 44(9): 1304-1307. doi: 10.16835/j.cnki.1000-9817.2023.09.006

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Objective To investigate the correlation between school bullying and depressive symptoms comorbidity and dietary patterns among middle school students in Inner Mongolia Autonomous Region from 2021, so as to provide reference for the prevention of school bullying and depressive symptoms. Methods In September 2021, stratified random cluster sampling was used to select 87 414 middle school students in 12 leagues in Inner Mongolia Autonomous Region. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression, and the bullying was determined according to the items related to bullying in the program of Chinese National Surveillance on Students' Common Diseases and Risk Factors. Results In 2021, the detection rate of depressive symptoms among middle school students in Inner Mongolia Autonomous Region was 15.24%, school bullying was 3.02%, and the co-occurrence of school bullying and depression was 1.64%. Binary Logistic regression analysis showed that junior high school students (OR=1.52) and girls (OR=1.10) were more likely to suffer from comorbidity of school bullying and depression (P < 0.05). Eating fried food less than one and more than once a day, smoking and drinking were positively correlated with school bullying and depression comorbidity (OR=2.15, 2.11, 2.14, 1.70, P < 0.05). Conclusion The combination of bullying and depression among middle school students in Inner Mongolia Autonomous Region is affected by various dietary methods. In terms of diet, reducing the intake of fried food, no smoking, no drinking can effectively reduce the incidence of co-occurrence school bullying and depression.

Co-morbidity of overweight, obesity and depression and its influencing factors among students in Inner Mongolia Autonomous Region

MA Caixia, MA Jun, SONG Yi, DONG Yanhui, YUAN Wen, ZHANG Xiuhong, GAO Sheng, YANG Tian

2023, 44(9): 1308-1312. doi: 10.16835/j.cnki.1000-9817.2023.09.007

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Objective To analyze the prevalence of overweight, obesity and depression among students in the Inner Mongolia Autonomous Region in 2019-2022 and explore the relevant factors affecting the co-morbidity of overweight, obesity and depression among students, so as to provide scientific basis for the prevention of co-morbidity. Methods From September 2019 to 2022, used stratified random cluster sampling, 90 519, 71 560, 90 079, 91 089 students were selected from all 12 leagues in Inner Mongolia Autonomous Region for questionnaire survey and physical examination. The χ² test was used for demographic characteristics and univariate analysis, and a binary Logistic regression model was used to explore the association between lifestyle behaviors and co-morbidity. Results The detection rate of overweight, obesity among students from 2019-2022 was 29.21%, 34.38%, 35.20%, 34.61%, the detection rate of depression was 18.35%, 17.53%, 16.43%, 16.00%, and the co-morbidity detection rate of the two was 5.52%, 5.93%, 5.76%, 5.46%. The number of overweight, obesity and depression co-morbidity students in 2022 was 4 978 students, and the co-morbidity detection rates of the students were significantly different in terms of the school segments and the family structures (χ²=103.51, 99.90, P < 0.01). Multivariate Logistic regression analysis showed that consuming sugar-sweetened beverages or fried food ≥1 time/d, sometimes or never eat breakfast, watching computer or TV ≥2 h/d, and less than 1 h of moderate-to-vigorous physical activity on weekends were positively correlated with the occurrence of the co-morbidity of overweight, obesity and depression, with the value of OR ranging from 1.17 to 1.59 (P < 0.05). Eated fresh fruits or drinking milk and soy milk ≥1 time/d, outdoor activities ≥1 h/d, sleep ≥8 h/d, not smoking and not drinking alcohol were negatively correlated with the occurrence of comorbid overweight, obesity and depression, with the value of OR ranging from 0.47 to 0.92 (P < 0.05). Conclusion The occurrence of overweight, obesity and depressive symptoms co-morbidity in students is associated with dietary, exercise and lifestyle behavior. Targeted measures should be taken to maintain students' healthy weight and prevent the occurrence of depression from the aspects of diet, exercise and life habits.

Co-occurrence trend of overweight, obesity and elevated blood pressure and its association with lifestyle factors among students in Inner Mongolia Autonomous Region

JIANG Jianuo, YANG Tian, YUAN Wen, QIN Yang, SONG Xinli, ZHANG Yi, CHEN Li, WANG Ruolin, ZHANG Xiuhong, SONG Yi, MA Jun, DONG Yanhui

2023, 44(9): 1313-1318. doi: 10.16835/j.cnki.1000-9817.2023.09.008

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Objective To explore the epidemiological trend of overweight and obesity, elevated blood pressure and their comorbidities in children and adolescents from Inner Mongolia Autonomous Region during 2016-2021, and to analyze its association with lifestyle, so as to provide reference for formulating prevention and control strategies of regional common comorbidities in schools. Methods A total of 8 908, 8 222, 9 448, 127 068, 100 778, and 138 540 students aged 10-18 years in Inner Mongolia were selected by stratified random cluster sampling in September each year from 2016 to 2021. Physical examination and questionnaire survey were conducted on the included students. The prevalence trends of overweight, obesity, elevated blood pressure and their co-occurrence were analyzed. Logistic regression was used to compare the prevalence of elevated blood pressure in different body mass index (BMI) groups. After excluding individuals without lifestyle information in 2021, Logistic regression analysis was used on 136 374 subjects to analyze the association between overweight, obesity, elevated blood pressure and their co-occurrence and lifestyle factors. Results During 2016 to 2021, the prevalence of comorbidity of overweight, obesity with elevated blood pressure among students in Inner Mongolia Autonomous Region were 5.04%, 5.14%, 4.99%, 7.51%, 7.60% and 9.45%, respectively. The prevalence of overweight and obesity was 26.94%, 28.07%, 29.62%, 34.19%, 36.71% and 37.53%, respectively. The prevalence of elevated blood pressure were 16.05%, 11.54%, 13.12%, 14.85%, 14.12% and 18.40%, respectively. Except for 2016, the risk of elevated blood pressure in overweight and obese people was higher than that in normal BMI group in other years, and there was a positive correlation between overweight and obesity and elevated blood pressure after gender and urban and rural areas (P < 0.05). In 2021, the detection rate of comorbidity of overweight and obesity with elevated blood pressure among children and adolescents in urban areas was higher than that in suburban counties, and the reporting rate of healthy lifestyle was lower than that in suburban counties (P < 0.05).Skipping breakfast (OR=1.11, 95%CI=1.07-1.16) and non-daily moderate and high-intensity physical activity(OR=1.27, 95%CI=1.20-1.34) were positively correlated with the co-occurrence of overweight, obesity and elevated blood pressure among children and adolescents in Inner Mongolia Autonomous Region. Non-daily moderate and high-intensity physical activity ≥60 min was positively correlated with elevated blood pressure (OR=1.11, 95%CI=1.07-1.16), and insufficient sleep was positively correlated with overweight, obesity (OR=1.04, 95%CI=1.01-1.06)(P < 0.05). Conclusion The prevalence of overweight, obesity, elevated blood pressure and their co-occurrence among children and adolescents in Inner Mongolia Autonomous Region is relatively high. Overweight/obesity is an important risk factor for elevated blood pressure, and unhealthy lifestyles are risk factors for co-occurrence of overweight, obesity and elevated blood pressure. Region-specific lifestyle interventions are indispensable for the prevention and control of regional common comorbidities. Urban areas may be a key focus for lifestyle interventions.

Snack consumption of children and adolescents in China and its correlation with overweight and obesity

HUANG Feifei, ZHANG Jiguo, LI Yuan, GUO Chunlei, WANG Huijun

2023, 44(9): 1319-1323. doi: 10.16835/j.cnki.1000-9817.2023.09.009

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Objective To understand the current situation of snack consumption among children and adolescents in China and its relationship with overweight and obesity, so as to provide a basis for formulating strategies of preventing and controlling overweight and obesity in children and adolescents in China. Methods A total of 1 882 children and adolescents aged 6-17 years old, choosed from 15 provinces, autonomous regions and municipalities according to China Health and Nutrition Survey in 2018, were selected. Snack consumption was investigated by the 24-hour dietary retrospective method for three consecutive days. The pattern of snack consumption was explored by cluster analysis, and the relationship between snack consumption and overweight and obesity was analyzed by Logistic regression. Results The snack consumption rate was 60.6%, and the percentage of daily energy intake from snacks was 2.4%. Snack consumption characteristics could be divided into four modes. Mode 1 was characterized by daily intake of medium amount of fruit, Mode 2 was characterized by daily intake of small amount of fruit and baked goods, Mode 3 was characterized by daily intake of small amount of fruit, and Mode 4 was characterized by daily intake of medium amount of milk and small amount of fruit. After adjusting the relevant covariates such as energy intake, compared with those who did not eat snacks, the OR(95%CI) values of the risk of overweight and obesity in different snack consumption patterns were 1.56(0.93-2.58), 0.81(0.51-1.24), 1.24(0.94-1.63) and 1.00(0.60-1.63), respectively; the OR(95%CI) values of percentage of daily energy intake from snacks from low to high quartiles were 1.17(0.81-1.68), 1.32(0.92-1.89), 1.12(0.77-1.61) and 1.00(0.69-1.45), respectively. There was no statistically significant difference(P>0.05). Conclusion The proportion of Chinese children and adolescents consuming snacks is relatively high, mainly including fruit and its products, milk and its products and baked goods. No association between snack consumption and overweight and obesity has been found.

Status of anemic among kindergarten children within Suzhou urban area from 2018 to 2022

ZHOU Bi, HOU Yuanyuan, YANG Xiao, SHI Zongyu, LI Ying, ZHU Feng

2023, 44(9): 1324-1327. doi: 10.16835/j.cnki.1000-9817.2023.09.010

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Objective To understand the current situation and trends of anemia among kindergarten children in urban area of Suzhou from 2018 to 2022, so as to provide a theoretical basis for prevention and intervention in anemia among kindergarten children. Methods From March 2023, a total of 24 178 person-times of children from 59 kindergartens selected by random number table method were enrolled, and their physical examination data from 2018 to 2022 were collected, including hemoglobin (Hb), height, gender, weight. The period of 2018-2019 was defined as before the COVID-19 epidemic, and period of 2020-2022 was defined as the COVID-19 epidemic. Data were analyzed using the Mann-Whitney U test, χ² test and Spearman's correlation analysis. Results From 2018 to 2019, the M(P₂₅, P₇₅) of Hb levels of children in nursery, middle, and senior class were 118 (112, 129), 120 (112, 132) and 122 (113, 134)g/L, respectively, which were higher than that of during 2020-2022 [116(110, 123), 117(111, 124), 119(112, 126)g/L, Z=-10.7, -12.7, -12.9, P < 0.05]. A total of 4 584 person-times of children were anemic, with a detection rate of 19.0%. The overall anemia detection rate of kindergarten children during 2018-2019 was lower than that in 2020-2022 (15.3% vs 20.7%, χ²=100.8, P < 0.05). The anemia detection rate of kindergarten children in 2022 (24.5%) was higher than that in 2020 (20.6%) and in 2021 (17.0%) (χ²=93.9, P < 0.05). The anemia prevalence of children in the nursery, middle, and senior class were 13.9%, 14.7% and 17.1% during 2018-2019, 19.3%, 15.9% and 26.6% during 2020-2022, and 17.6%, 15.5% and 23.6% during 2018-2022, respectively (χ²=10.7, 204.6, 186.8, P < 0.01). There was no statistically significant correlation between Hb values and body mass index (BMI) in boys and girls with anemia, and all children in kindergarten (r=0.03, 0.03, 0.09, P > 0.05). Conclusion The prevalence of anemia among kindergarten children in the urban area of Suzhou is relatively high. The COVID-19 pandemic may have increased the risk of anemia among children.

The norm of the Physical Activity afterschool Questionnaire for Preschooler (P-PAQ) in urban areas of China

WANG Xiaojuan, ZHANG Mengnan, XU Mengxue, HE Yanlu, KUANG Xiaoni, ZHANG Xuejiao, WANG Nianrong, LUO Yan, YANG Lin, DONG Wenhong, WU Jianxin, ZHANG Ting, ZHU Zonghan, WANG Jian, TONG Meiling, GUAN Hongyan

2023, 44(9): 1328-1332. doi: 10.16835/j.cnki.1000-9817.2023.09.011

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Objective To establish the norm of the Physical Activity afterschool Questionnaire for Preschooler(P-PAQ) in urban areas of China, so as to provide a basis for graded guidance from the family perspective and to improve children's physical activity levels. Methods From October 2020 to January 2021, 6 267 children aged 3-6 years old were recruited from 40 kindergartens in eight cities across six major administrative regions by stratified cluster sampling, and the P-PAQ initially developed by the researchers of this study were completed by the primary caregivers. The questionnaire was administered to collect data relating to the amount of physical activity undertaken by the preschoolers, and the norm was determined by quartiles. Data relating to parental concepts of sports and parental behavior were assessed by calculating mean scores in order to establish the norm. Results Among preschoolers in urban areas, the M(P₂₅, P₇₅) of total physical activity time (min/day), moderate-to-vigorous physical activity time (min/day), outdoor time (min/day) and screen time (min/day) on school days outside kindergarten and on weekends were 84 (54, 120), 22 (8, 40), 12 (0, 24) and 18 (6, 30), and 170 (115, 240), 60 (30, 95), 90 (35, 120) and 30 (20, 60), respectively. When the score of parents' sports concept and behavior (total score of 40) were≥34, 29- < 34, 24- < 29, < 24, it was defined as four levels about above medium, medium, lower medium and lower, respectively. And for two dimensions, when the score of parental sports concept were ≥19, 17- < 19, 15- < 17, < 15, and the score of parental behaviors were ≥16, 12- < 16, 8- < 12, < 8, it was defined as four levels about upper medium, medium, lower medium and lower, respectively. Conclusion The norm of extracurricular activities among preschool children in Chinese cities has good representativeness and appropriate threshold values, which could provide a valuable reference for early assessment, as well as guidance in relation to out-of-school physical activity behaviors among children aged 3-6 years old.

Development of an Assessment Questionnaire for Screen-based Behaviors among Primary and Secondary School Students

HU Jingwen, LYU Pingping, SHI Jiaojiao, WANG Yujie, SHI Huijing

2023, 44(9): 1333-1337. doi: 10.16835/j.cnki.1000-9817.2023.09.012

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Objective To develop an assessment questionnaire for screen-based behaviors among primary and secondary school students, so as to provide a basis for comprehensive assessment among the population. Methods Nineteen experts were invited to take part in this study from August to September 2022. The initial framework and item pool of the assessment questionnaire were developed based on literature review and a series of guidelines and standards issued by the national education and health authorities, as well as relevant domestic and foreign guidelines, and were combined with existing assessment tools that were used to evaluate screen-based behavior among these age groups. Experts in related fields were selected for two rounds of Delphi consultation to determine the dimensions, items and corresponding weights of the assessment questionnaire. Results The response rates from two rounds of consultation were 95.0% and 100.0% respectively, the opinion submission rates were 89.5% and 63.2% respectively, and the authority coefficient (Cr) was 0.87. An assessment questionnaire was finally designed, consisting in 44 items and four dimensions, namely screen use type and time, screen use related health behaviors, safety and civilization in screen use, and reasonable arrangement of screen and non-screen activities. The coefficient of variation(CV) of each item ranged from 0.00 to 0.19, and the Kendall's W increased from 0.22 to 0.34(P < 0.01). Expert opinions were in agreement and credible. Conclusion The designed assessment questionnaire can be used to comprehensively evaluate screen-based behavior among primary and middle school students, and provides a basis for subsequent intervention measures to improve screen-based behavior among this population.

Factors influencing unprotected sexual behavior among college students with different cognitive styles

XI Kaiguo, TANG Liang, YUAN Lili

2023, 44(9): 1338-1341. doi: 10.16835/j.cnki.1000-9817.2023.09.013

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Objective To determine the factors influencing unprotected sexual behavior among college students, so as to provide the reference and basis for better sex safety education in college. Methods From March to August, 2022, 3 188 college students from three universities, namely "double-first-class" universities, ordinary public undergraduate universities and ordinary private universities, were selected by stratified random cluster sampling method. Cognitive Style Graphic Test, Adolescent Health-related Risk Behavior Questionnaire and deographic information questionnaire were used to investigate. Results Cognitive style and unprotected sexual behavior were positively correlated (r=0.13, P < 0.05). A total of 18.23% (n=314) of participants reported engaging in unprotected sexual behavior. Binary Logistic regression analysis of participants grouped by cognitive style indicated major factors affecting unprotected sexual behavior among college students. In the field-independence group, male students, senior students, and those with frequent romantic encounters (1, 2, and ≥3 times) had more unprotected sexual behavior (OR=1.28, 1.79, 1.35, 1.68, 1.84, P < 0.05). Four major factors were associated with unprotected sexual behavior in the field-independence group: junior and senior college students, those that study liberal arts, urban student source, and those with frequent romantic encounters (1, 2 and ≥3 times) (OR=1.91, 2.01, 1.26, 1.40, 1.46, 1.78, 1.99, P < 0.05). Conclusion College students' unprotected sexual behavior is associated with multiple factors. Cognitive style is an important reference variable. The factors influencing this behavior have differing effects according to the different cognitive styles among college students.

Development and evaluation of the reliability and validity of the Assessment of Smartphone Multitasking for Adolescents

LI Renjie, TAO Shuman, WAN Yuhui, WU Xiaoyan, XU Shaojun, TAO Fangbiao

2023, 44(9): 1342-1345. doi: 10.16835/j.cnki.1000-9817.2023.09.014

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Objective To develop the Assessment of Smartphone Multitasking for Adolescents (ASMA) and evaluate its reliability and construct validity, so that to provide an evaluation tool for relevant epidemiological studies. Methods Based on literature review, expert-based judgement, and group discussion, the self-administered ASMA identified 3 dimensions named smartphone activities and non-media activities multitasking, smartphone activities and other media activities multitasking, and smartphone functional use multitasking, which initially included 27 items. From October to December 2021, 5 566 college students were selected from 7 regions, including Liaoning, Shanxi, Henan, Shanghai, Chongqing, Shenzhen, and Yunnan by multi-stage cluster sampling method, and item analysis, factor analysis, and reliability evaluation were used to screen items and evaluate reliability and validity. Results The final version of AMSA contained 3 dimensions covering 26 items. The variance cumulative contribution rate was 59.63%. The internal consistency test showed that Cronbach's alpha coefficient for the questionnaire was 0.944, and ranged from 0.838 to 0.928 for each dimension. The split-half coefficient of the questionnaire was 0.849 and ranging from 0.781 to 0.874 for each dimension. The results of confirmatory factor analysis showed that the root mean square error of approximation (RMSEA), comparative fit index (CFI), and Tucker-Lewis index (TLI) of the questionnaire were 0.068, 0.901, and 0.891, respectively, which had which had a good fitting degree. The results of Pearson correlation analysis showed that the criterion validity of the questionnaire was good (r=0.206-0.351, P < 0.01). Conclusion The ASMA is consistent with the evaluation standard of psychometrics and can be used as an assessment tool to evaluate smartphone multitasking behaviors in adolescents.

An experimental study of physical intelligence teaching on sensory integration function of 4-5-year-old children

LI Li, CHEN Yujuan, JIA Fuchi, JIA Jingyi, WANG Lijun, MENG Xiangzhen, HU Wenwen

2023, 44(9): 1346-1350. doi: 10.16835/j.cnki.1000-9817.2023.09.015

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Objective To examine the impact of physical intelligence teaching on the function of children's sensory integration, so as to provide reference for promoting the development of sensory integration system. Methods From February to May 2023, the intervention was implemented for 12 weeks among 136 children aged 4-5 (68 in the intervention group and 68 in the control group). The intervention group received situational and game based physical intelligence teaching, the control group received sports game teaching according to the original curriculum objectives of the kindergarten. Intervention was administered 3 times a week for 40 minutes each time. The sensory integration ability of the intervention group and the control group were evaluated before and after the intervention with Chi-square test and t-test. Results The vestibular sensation, proprioception and tactile sensation of between boys and girls in the intervention group were significantly improved compared with before intervention (boys: 44.14±11.52 vs. 53.34±9.49, 44.57±12.76 vs. 50.54±11.86, 49.31±12.18 vs. 55.00±10.24, girls: 46.00±11.01 vs. 54.58±10.06, 48.79±13.17 vs. 53.64±11.97, 52.67±11.67 vs. 56.91±10.42, t=-3.24, -2.49, -2.09, -5.24, -12.94, -2.56, P < 0.05). There was no significant difference in vestibular sensation between boys and girls in the control group (boys: 45.91±11.66 vs. 46.31±11.20, girls: 48.27±13.56 vs. 48.45±13.54, t=-0.87, -0.07, P>0.05), but there was a significant improvement in proprioception and tactile sensation in both boys and girls (boys: 46.63±11.76 vs. 48.06±11.69, 51.63±11.98 vs. 52.40±12.18, girls: 50.45±12.16 vs. 51.67±12.03, 53.36±12.48 vs. 54.39±12.57, t=-3.36, -2.08, -4.66, -2.86, P < 0.05). After the intervention, compared with the control group, the vestibular sensation of both boys and girls significantly improved (t=2.83, 2.08, P < 0.05), with exception of proprioception and tactile sensation (t=0.88, 0.67, 0.97, 0.88, P>0.05). In the experimental group, the number of normal boys increased from 12 to 24, while the number of dysfunctional boys decreased from 23 to 11, with a statistically significant difference (χ²=11.53, P < 0.01). There was no statistically significant difference in sensory integration in boys of the control group before and after the experiment (χ²=1.10, P>0.05). After intervention, the number of normal girls in the experimental group increased from 15 to 27, while the number of dysfunctional girls decreased from 18 to 6, with a statistically significant difference (χ²=10.39, P < 0.05). There was no statistically significant difference in sensory integration in girls from the control group before and after the experiment (χ²=2.08, P>0.05). Conclusion Physical intelligence teaching can effectively improve children's sensory integration ability, especially for vestibular function.

The characteristics of daily exercise load of students of different grades in a primary school in Beijing

ZHAO Pengrui, SUN Yinghua, CHI Wenying, WU Zhigui, XUE Jiao, HOU Lijuan

2023, 44(9): 1351-1354. doi: 10.16835/j.cnki.1000-9817.2023.09.016

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Objective To analyze the characteristics of the daily exercise load and the One Hour of Moderate to Vigorous Physical Activity (MVPA) per day among primary school students, so as to provide a reference for improving the quality of the physical activity of primary school students in school. Methods A total of 223 students from an elementary school in Beijing from May to June of 2023, were selected by stratified random cluster sampling method. The Polar Verity Sense heart rate arm band was used to monitor and evaluate the daily exercise load heart rate according to different grades, gender and physical quality. Results The average heart rate of primary school students in outdoor class, zero point sports, recess and indoor class was (130.01±13.11, 119.89±16.02, 109.96±8.11, 96.81±7.89) times/min, respectively, and only 4.04% students met the standard of 1-hour MVPA daily. From the perspective of different grades, the MVPA time ratio of lower grade students in outdoor class, zero point sports and big break was 28.41%, 42.47% and 8.24%, that of middle grade students was 18.33%, 6.41% and 5.90%, and that of senior students was 45.91%, 3.88% and 11.43%. The number of students who achieved 1-hour daily MVPA was 5.41%, 0 and 6.67%. Time ratio of MVPA in outdoor classes, zero hour sports and big breaks accounted for 30.09%, 16.34% and 9.23% for boys, 31.70%, 16.24% and 6.13% for girls, and the interval distribution of boys and girls who achieved MVPA for one hour per day was 5.88% and 2.86%.Time ratio of MVPA for students with excellent physical fitness were 33.19%, 21.76% and 8.25% in outdoor class, zero point sports and big break, while those with good physical fitness were 29.76%, 12.93% and 8.19%.A total of 21.78%, 5.99% and 4.80% of the students passed the physical fitness test, and the number of students with excellent, good and passed the physical fitness test who achieved the daily 1-hour MVPA was 5.88%, 3.77% and 0. Conclusion In the present study, elementary and middle school students' time for in-school physical activity was adequate, but there are problems of low loading intensity and insufficient time for MVPA. It is necessary to arrange targeted physical activity programs for students of different grades, genders and physical fitness levels to increase the daily exercise load of students in school.

Association between school bullying and the early age at menarche among girls

ZHOU Kejing, XIONG Huali, TANG Dayi

2023, 44(9): 1355-1359. doi: 10.16835/j.cnki.1000-9817.2023.09.017

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Objective To analyze the correlation between school bullying and the age at menarche (AAM) in girls, so as to provide references for promoting the healthy growth of girls in puberty. Methods In April 2022, a total of 987 middle school girls with onset of menarche in Rongchang District of Chongqing were selected by using a stratified random cluster sampling method to carry out a questionnaire survey and physical examination. The t-tests, variance analysis and Dunnett-t tests were conducted to analyze the differences between individuals who experienced different types of school bullying and AAM. Multivariate Logistic regression analysis was conducted to analyze the association between school bullying and the early age at menarche. Results The average AAM of 987 girls was (12.13±1.03) years, and 22.90% of them had early AAM. The AAM of those who did not experience bullying events (12.18±0.96) varied significantly with those who experienced bullying events (11.86±1.44) (t=3.71, P<0.01). The average AAM of individuals who experienced 1, 2, 3 or more school bullying events was (12.08±1.38, 11.74±1.07, 11.61±1.63) years old, respectively. There was a statistically significant difference in AAM between girls who did not experience school bullying and those who experienced 1, 2, 3 or more types of school bullying (F=6.99, P<0.01). Multivariate Logistic regression analysis found that after adjusting confounding factors, experiencing school bullying (OR=2.71, 95%CI=2.04-4.27), being deliberately excluded from collective activities or being isolated (OR=2.58, 95%CI=1.69-4.67), being kicked, pushed or locked in the house (OR=2.85, 95%CI=1.39-4.92), being teased due to physical defects or appearance (OR=2.74, 95%CI=1.77-5.02), experiencing one school bullying event (OR=2.33, 95%CI=1.52-4.23), and experiencing two school bullying events (OR=3.36, 95%CI=1.82-7.36), and experiencing three or more school bullying events (OR=2.89, 95%CI=1.74-5.71) were associated with the early age at menarche (P<0.05). Conclusion School bullying is related to the earlier AAM among girls. Strengthening school anti-bullying education might be helpful for promoting girls' healthy growth and development in adolescence.

Association of peer bullying, life satisfaction with self-harm among junior high school students

YE Juan, WANG Shaojie, WANG Gengfu

2023, 44(9): 1360-1364. doi: 10.16835/j.cnki.1000-9817.2023.09.018

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Objective To explore the association between adolescent peer bullying, life satisfaction and self-harm, so as to provide intervention support for the prevention of adolescent self-harm behaviors. Methods In October 2022, 5 724 junior high school students from Xuancheng, Hefei, Huaibei in Anhui Province were selected by multistage stratified random cluster sampling, and a self-administered adolescent mental health behavior questionnaire was used to conduct the survey. Results The detection rate of peer bullying among adolescents was 30.0%, and the detection rates of the five self-harm behaviors including highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harm with latency damage, and psychological self-harm were 10.2%, 25.8%, 35.5%, 20.8% and 28.2%, respectively. Logistic regression model results showed a positive association between exposure to peer bullying and the five self-harmful behaviors (OR=2.52-3.21, P < 0.01), and a negative association between life satisfaction and the five self-harmful behaviors (OR=0.19-0.33, P < 0.01). Adolescent life satisfaction had a moderating effect between exposure to peer bullying and highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, and self-harm with latency damage (OR=1.53, 1.42, 1.30, 1.39, P < 0.05), and no moderating effect between exposure to peer bullying and psychological self-harm (P>0.05). Conclusion Peer bullying among adolescents may increase the risk of self-harm behavior. Improvement of life satisfaction can effectively mitigate the negative effects of peer bullying on adolescent self-harm.

The current situation and influencing factors of online psychological help-seeking behavior among college students in Guangxi

KUANG Hongda, LI Jian, GU Zhengjie, YUE Feng

2023, 44(9): 1365-1369. doi: 10.16835/j.cnki.1000-9817.2023.09.019

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Objective To understand the current situation and influencing factors of online psychological help-seeking behavior among college students in Guangxi, China, so as to provide a scientific basis for improving the mental health of college students. Methods From March to June 2022, a convenient sampling method was employed to select 2 239 university students from eight universities in Guangxi. The survey included the College Student Online Psychological Help Behavior Questionnaire, General Help-Seeking Questionnaire (GHSQ), Attitudes Toward Seeking Professional Psychological Help Scale-short Form (ATSPPH-SF), and the 10-item Kessler Psychological Distress Scale (Kessler10) to statistically analyze online psychological help-seeking behavior and associated influencing factors. Results The score of online psychological help-seeking behavior among college students was (13.96±5.20), and the scores of the three dimensions were as follows: online psychological self-help behavior (7.13±2.95), online non-professional psychological help-seeking behavior (4.28±2.19), online professional psychological help-seeking behavior (2.54±1.29). The factors influencing online psychological help-seeking behavior were ranked as follows: mental health (β=0.32), CHSQ (β=0.21), gender (β=-0.09), ATSPPH-SF (β=0.09) and registered residence (β=0.08) (P < 0.05). Conclusion The online psychological help-seeking behavior of college students in Guangxi is influenced by factors such as mental health. Seeking psychological help online has become a new form of support aimed at meeting the psychological health needs of college students, and constitutes an important supplement to offline psychological assistance. While there are similarities and differences between both modes, universities should pay attention to them.

The effect of maternal anxiety during pregnancy on the social-emotional development among toddlers

XU Zhanbin, NI Yufei, XU Xiaojing, GU Qiuyan, JIANG Chengcheng, WANG Feiying, HE Li

2023, 44(9): 1370-1372. doi: 10.16835/j.cnki.1000-9817.2023.09.020

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Objective To explore the impact of maternal anxiety during pregnancy on social-emotional development of toddlers aged 1-3 year old, so as to provide references for scientific early parenting and early intervention for toddlers with social-emotional difficulties. Methods From September 2022 to March 2023, a total of 815 toddlers aged 1-3 who underwent physical examinations and their mothers at Nantong Maternal and Child Health Hospital were enrolled. The Chinese Infant Toddler Social and Emotional Assessment (CITSEA) was used to evaluate the social-emotional ability among toddlers. Maternal anxiety evaluated using the Self-rating Anxiety Scale (SAS) during prenatal visit was collected. Results The average scores on the externalizing, internalizing, dysregulation and competence domains of the CITSEA were (49.40±9.48, 47.42±9.60, 48.67±10.15, 50.07±10.20), respectively. Among boys, the score of externalizing domain (50.89±9.45) was higher than that of girls (48.76±9.50), while the score of competence domain (49.22±10.30) was lower than that of girls (51.17±9.84), and the differences were statistically significant(t=2.10, -3.03, P < 0.05). The detection rates of abnormalities in the externalizing, internalizing, dysregulation, and competence domains were 7.36%, 7.12%, 7.61%, and 7.24%, respectively. Among them, boys (8.43%, 6.32%, 7.96%, 7.49%) and girls (6.19%, 7.99%, 7.22%, 6.96%) showed no statistical differences (χ²=1.50, 0.85, 0.16, 0.09, P>0.05). There were significant differences in externalizing domain scores(47.77±9.52, 49.56±8.95, 52.51±9.77) and competence domain scores(51.70±10.38, 49.65±10.05, 46.68±10.03) among toddlers of different maternal anxiety(normal, mild, moderate to severe) (F=7.05, 7.10, P < 0.01). There were significant differences in the abnormal detection rate of externalizing domain (4.81%, 7.54%, 11.17%) and competence domain(4.81%, 6.96%, 11.73%)(χ²=6.60, 7.98, P < 0.05). Conclusion Maternal anxiety during pregnancy has a negative impact on the social-emotional development among toddlers. In order to improve social-emotional development of toddlers, multidimensional social support and education during pregnancy should be carried out.

Changes in physical health among primary and secondary school students in Jinan City during 2019 to 2022

QIN Guoyang, JIA Wei, QIN Yong

2023, 44(9): 1373-1376. doi: 10.16835/j.cnki.1000-9817.2023.09.021

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Objective To analyze the changes in physical health among primary and secondary school students in Jinan during 2019 to 2022, so as to provide reference for primary and secondary school students physical health promotion. Methods From 2019 to 2022, 16 496 primary and junior middle school students will be selected from Jinan by cluster random sampling method, the comprehensive scores of physical health for each year were calculated according to the National Student Physical Health Standards (revised in 2014), and changes in physical health were analyzed using t-tests, univariate analysis, analysis of covariance and χ² tests. Results The students' physical health scores ranged from high to low in 2022(80.78±12.63), 2021(79.12±12.72), 2019 (75.17±2.03)and 2020(73.82±12.63). During 2019 to 2022, the overall physical health score of female students were higher than that of male students (F=105.39, 288.29, 197.90, 159.36, P < 0.01). The differences in the comprehensive physical and health scores of male and female students in different grades from 2019 to 2022 were statistically significant (F=34.22, 34.96, 20.33, 45.08, 13.56, 18.29, 24.86, 30.01, P < 0.01). The individual indicators showed varying degrees of decline in 2020. Except for body mass index (BMI), the fluctuations in lung's capacity, run 50 meters, sit forward, standing long jump, 1-minute sit-ups, pull-up, endurance running, 1-minute skipping rope during 2019 to 2022 were statistically significant (primary school: F=127.58, 44.80, 223.64, 76.66, 10.69, 296.79, secondary school: F=189.31, 52.10, 63.12, 61.49, 7.34, 8.10, 50.94, P < 0.01). The detection rates of overweight and obesity in primary and secondary school students from 2019 to 2022 were 30.09%, 31.45%, 30.14%, and 30.60%, respectively (χ²=2.26, P > 0.05). From 2019 to 2022, the rates of overweight and obesity in primary and middle school boys were 34.56%, 34.66%, 32.14%, 33.73%, 37.41%, 43.53%, 41.36%, 39.16%, respectively, and the rates of overweight and obesity in primary and middle school girls were 24.66%, 24.39%, 24.61%, 24.65%, 23.82%, 28.74%, 26.99%, 27.95%, respectively, none of which were statistically significant (χ²=2.93, 4.29, 0.04, 3.12, P > 0.05). Conclusion During 2019 to 2022, there are no significant changes in physical health indicators among primary and secondary school students in Jinan, and the overall level of physical health recovered rapidly after a slight decline due to the COVID-19 epidemic.

Dilemma and optimization strategies of school psychological crisis intervention from multiple perspectives

XIE Siyuan, HU Xiaolan, SHAO Hai, NIE Heng

2023, 44(9): 1377-1381. doi: 10.16835/j.cnki.1000-9817.2023.09.022

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Objective To understand the dilemma of different participants in school psychological crisis intervention, so as to provide guidance for the implementation of comprehensive psychological crisis intervention from multiple perspectives. Methods From March 2022 to January 2023, a total of 10 psychological consultants, 10 counselors, 10 peer students, 10 parents and 10 clients were selected from a certain university using convenient sampling method was interviewed with semi-structured interviews, and the transcribed data were analyzed according to grounded theory. Results The predicaments of psychological crisis intervention mainly involved three core themes: early warning, ethical dilemma and negative emotion. Early warning approaches mainly included three core themes: school, social media and other institutions, and 50 participants reported mainly on peer students in schools(18 cases) and online media in social media(18 cases). Ethical dilemmas mainly focued on the conflict between confidentiality breaches and privacy protection. The negative emotions mainly include three core themes of anxiety, fear and powerlessness, which were characterized by dispersion. The optimization expectation of psychological crisis intervention mainly consisted of two core themes: professional expectation and collaborative expectation, both of which were the common expectation of the people involved. Conclusion School psychological crisis intervention should pay attention to the establishment of crisis early warning system and dialectic between confidentiality breaches and privacy protection. Schools should prevent the dispersion of negative emotions of participants, deepen professional construction and the coordination between home and school, and implement psychological crisis intervention from a comprehensive perspective.

The isochronous substitution effect of 24-hour activity behavior on physical health of college students

SONG Yunfeng, TAN Sijie, QI Yugang, FENG Zhanpeng, ZHANG Guojun, CAO Liquan

2023, 44(9): 1382-1386. doi: 10.16835/j.cnki.1000-9817.2023.09.023

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Objective An isochronous substitution model was established to explore the association and substitution effect between college students' 24-hour activity behavior and physical health, so as to provide specific activity behavior suggestions for college students to improve their physical health. Methods A stratified random cluster sampling method was used to conduct physical fitness tests and 24-hour activity behavior surveys among 2 794 college students in 12 colleges and universities in Tianjin.Time spent on sedentary behavior(SB), light-intensity physical activity(LPA), moderate to vigorous physical activity(MVPA) and sleep(SLP) time. The isochronous method of components was used to explore the relationship between 24 h activity behavior and physical health. Results Except for 50 m running, MVPA was negatively correlated with BMI-Z (β=-0.62, P < 0.05), but positively correlated with other physical fitness indexes (β=0.34~274.23, P < 0.05). LPA was not associated with lung capacity, sitting forward flexion and 50 m running, and negatively correlated with other physical fitness indexes (β=-14.30- -0.19, P < 0.05). SB was negatively correlated with most physical fitness indexes (β=-11.57- -0.33, P < 0.05), but positively correlated with BMI-Z (β=0.45, P < 0.05). In addition to lung capacity, SLP was positively correlated with BMI-Z, total physical fitness score, 1-minute sit-ups, pull-ups, 800/1 000 m running, sitting forward flexion, and 50 m running (β=0.27-11.21, P < 0.05), but negatively correlated with long jump (β=-0.10, P < 0.05). Isochronous substitution showed that the adverse effects of 30 min/d SB and LPA substitution of MVPA were much greater than the beneficial effects of MVPA substitution for corresponding behaviors (total physical score: SB, -0.58 vs 0.47 points; LPA, -0.50 vs 0.38 points). Conclusion MVPA and SLP have been found to have a positive effect on physical fitness among college students. Therefore, in the process of improving the physical health of college students, ensuring adequate sleep, improving MVPA and reducing SB as much as possible may be one of the effective methods.

Discriminante analysis of risk factors Nomograms of myopia in children and adolescents in Yunnan Province

ZHANG Jinjiao, CHANG Litao, XIAO Jie, LI Peiqian, XIE Xueni, MA Zixue, LI Xixi, LUO Xiao, CHEN Maosen, HUANG Ying

2023, 44(9): 1387-1391. doi: 10.16835/j.cnki.1000-9817.2023.09.024

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Objective To explore the related factors of myopia among children and adolescents in Yunnan Province, and to predict and evaluate the influencing factors, so as to provide a scientific theoretical basis for the prevention and control of myopia. Methods From March 9 to 14, 2023, 848 students from 6 primary and secondary schools in Dali and Lijiang of Yunnan Province were selected by multi-stage stratified random cluster sampling method for visual acuity detection and questionnaire survey on myopia-related factors. Multivariate Logistic regression analysis was used to establish a Nomogram prediction model for the selected influencing factors. Results The overall myopia rate of the respondents was 68.3%, the myopia rate of boys (63.4%) was lower than that of girls (72.9%), and the myopia rate of primary school students (46.7%) was lower than that of junior high school students (81.1%), and the difference was statistically significant(χ²=8.71, 108.07, P < 0.05). Daily eye exercises, activities outside the teaching building during recess, having daily sleep time of 7-9 and >9 h, having both parents without myopia were negatively correlated with the occurrence of myopia in children and adolescents in Yunnan Province (OR=0.64, 0.63, 0.56, 0.28, 0.48, P < 0.05). The reading and writing time after school ≥3 h per day and parents' unrestricted time to play video games were positively correlated with myopia (OR=1.94, 1.78, P < 0.05). Based on the influencing factors, a Nomogram prediction model was established to quantitatively evaluate the risk of myopia. The results showed that greater risk for myopia was associated with sleep duration, parental history of myopia, and the time spent reading and writing after school every day. Conclusion Both genetic factors and environmental factors are related to myopia in children and adolescents. The prediction model of nomogram is beneficial for screening high risk factors of myopia and taking corresponding prevention and treatment measures.

The association between rotavirus diarrhea in children and atmospheric pressure in Guangzhou City from 2012 to 2020

LI Lijuan, YUAN Hao, HE Yiling, GUO Qiaozhi, ZHAO Danyang, CHEN Qin

2023, 44(9): 1392-1395. doi: 10.16835/j.cnki.1000-9817.2023.09.025

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Objective To explore the relative risks of rotavirus diarrhea after exposure to different levels of atmospheric pressure in children in Guangzhou City, so as to provide reference for improving public awareness of high atmospheric pressure exposure. Methods The study used the China Notifiable Communicable Diseases Network System and China Meteorological Science Data Sharing Service Network to collect meteorological data and data relating to daily cases of rotavirus diarrhea in children at Guangzhou Women and Children's Medical Center from 2012 to 2020. The association between rotavirus diarrhea and atmospheric pressure was analyzed using distributed lag non-linear models (DLNM). The relative risks of different sex and age sub-groups exposed to different atmospheric pressures were also evaluated. Results A total of 18 587 cases of rotavirus diarrhea were reported from 2012 to 2020, among which 11 662 cases (62.7%) were boys, and 12 582 cases (67.7%) were children aged 6 to 24 months old, which represented the highest proportion. The results of the DLNM showed that the relative risk of rotavirus diarrhea was the highest on the day of exposure to extreme high atmospheric pressure (RR=1.50, 95%CI=1.24-1.82, P < 0.05) and the effect could last for 28 days. Risk of rotavirus diarrhea was low for exposure to low pressure within 2 weeks (P < 0.05). During extremely high atmospheric pressure weather, RR was higher in girls (RR=3.31, 95%CI=1.46-7.49, P < 0.05) than that in boys (RR=1.98, 95%CI=0.96-4.07, P>0.05). Among different age sub-groups, RR was the highest in children aged 24 to 60 months after exposure to the highest level of atmospheric pressure exposure (RR=3.36, 95%CI=1.27-8.89, P < 0.05). Conclusion In Guangzhou, exposure to high pressure increases the risk of rotavirus diarrhea in children. In the future, public awareness should be raised regarding the risk after exposure to high atmospheric pressure.

The associated factors of earphone usage on hearing impairment among students aged 14 to 28

WAN Tingyue, CHEN Junjiang, WU Zhili, WU Yazhou, SONG Qiuyue

2023, 44(9): 1396-1398. doi: 10.16835/j.cnki.1000-9817.2023.09.026

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Objective To investigate the relationship between the use of earphone and hearing impairment and its influencing factors among students aged 14-28, so as to provide a reference for appropriate earphone usage and hearing impairment prevention. Methods A cross-sectional survey was conducted through the questionnaire star platform, and 983 students aged 14 to 28 were recruited across China by snowball-sampling during April 3 to May 1, 2022. The χ² test was used to identify indicators affecting hearing, the Logistic regression model was used to further selection. Results There were 366 students with hearing impairment, accounting for 37.23%. Univariate analysis showed significant differences in hearing impairment by gender, earphone usage duration and volume, wearing during sleep, and replacement frequency (χ²=6.03, 6.86, 14.87, 12.22, 11.15, P < 0.05). The Logistic regression model analysis showed that girls (OR=1.43, 95%CI=1.10-1.88), maximum earphone volume (OR=3.08, 95%CI=1.56-6.08), earphone usage for >1.5-3 h each time (OR=1.44, 95%CI=1.04-1.99), sleep with headphone (OR=1.53, 95%CI=1.11-2.11) were positively associated with hearing impairment (P < 0.05), earphone replacement every 4- < 6 months (OR=0.38, 95%CI=0.17-0.86) and earphone replacement every six months or longer (OR=0.39, 95%CI=0.18-0.85) were negatively associated with hearing impairment (P < 0.05). Conclusion Students aged 14 to 28 earphone usage shows adverse impact on hearing. When using earphone, it is recommended to limit time spent on earphone usage, low the volume of earphone, avoid sleeping with earphone and replace earphone frequently.

Status of scoliosis and the related factors among 12-year-old school students from Inner Mongolia Autonomous Region in 2021

ZHAO Jing, ZHANG Yifan, GAO Sheng, YANG Tian, ZHAO Jufang, LI Guofeng, BA Teer, ZHANG Xiuhong

2023, 44(9): 1399-1402. doi: 10.16835/j.cnki.1000-9817.2023.09.027

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Objective To understand the current situation and influencing factors of scoliosis in 12-year-old students from Inner Mongolia Autonomous Region, so as to provide scientific basis for accurate prevention and control of abnormal spinal curvature. Methods From October to November 2021, a total of 18 399 students aged 12 were selected by region and school level by stratified random cluster sampling method, and spinal curvature screening and questionnaire survey of common diseases and health influencing factors among students were carried out. Chi-squared test was used for single factor analysis, and binary Logistic regression model was used for multi factor analysis. Results A total of 397 students (2.2%) were detected with abnormal curvature of the spine, including 368 students (2.0%) with scoliosis. Among them, 205 cases were in the lumbar thoracic segment with a detection rate of 1.1%, 173 cases were in the thoracic segment with a detection rate of 0.9%, and 141 cases were in lumbar thoracic segment with a detection rate of 0.8%. Binary Logistic regression analysis showed that urban area, economic area(moderate), attending tutorial classes before primary school and class seats never changed regularly were positively correlated with the occurrence of scoliosis among 12 year old students (OR=1.95, 1.67, 1.76, 1.71, P < 0.05). Obesity, attending an average of 3 or 4 physical education classes per week, attending physical fitness and beauty classes before primary school were negatively correlated with the occurrence of scoliosis among 12 year old students (OR=0.69, 0.31, 0.36, 0.71, P < 0.05). Conclusion The prevalence of scoliosis among 12-year-old students in Inner Mongolia Autonomous Region is not optimistic. It should pay attention to the prevention and control of scoliosis in students before the age of 12, actively prevent the occurrence and progress of scoliosis.

Overweight and obesity among children and adolescents in Jinan City in 2021 and comparison with Chinese and international standards

JIANG Nana, LIU Jiahui, TIAN Yalan, ZHAO Yue, XU Huaru.

2023, 44(9): 1403-1408. doi: 10.16835/j.cnki.1000-9817.2023.09.028

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Objective To describe the prevalence of overweight and obesity among children and adolescents in Jinan City according the national and international criteria, as well as to compare the Chinese and international standards, so as to provide basic data for relevant intervention strategies. Methods From September to December 2021, using the height and weight data obtained from the health checkup reports of 746 985 primary and secondary school students in Jinan City in 2021, body mass index(BMI) was calculated to evaluate the current status of the prevalence of overweight and obesity among this sample of children and adolescents aged 6-18 years old. The consistency of the Chinese standard, U.S. Centers for Disease Control and Prevention (CDC) standard, International Obesity Task Force (IOTF) standard, and World Health Organization (WHO) standard was compared by calculating the weighted Kappa value. Results Based on the Chinese, U.S. CDC, IOTF and WHO standards, the overweight rates of children and adolescents aged 6-18 years in Jinan were 17.3%, 16.5%, 21.1% and 13.6%, respectively, and the obesity rates were 23.1%, 19.5%, 13.5% and 6.6%, respectively. The overweight and obesity rates of boys were higher than those of girls under the four criteria (China: χ²=1 418.48, 9 868.51, U.S. CDC: χ²=145.78, 23 211.41, IOTF: χ²=1 326.94, 13 615.62, WHO: χ²=873.13, 46.41, P < 0.01).The overweight rate of adolescents in the 13-18 year-old age group was higher than that of children aged 6-12 years (China: χ²=29.13, U.S. CDC: χ²=6.43, IOTF: χ²=15.87, WHO: χ²=19.48, P < 0.01) and the obesity rate of the group aged 6-10 years was significantly higher than that of the group aged 11-18 years (China: χ²=217.02, U.S. CDC: χ²=227.54, IOTF: χ²=171.91, WHO: χ²=165.91, P < 0.01). The rates of overweight and obesity in urban children and adolescents were slightly higher than those in rural children and adolescents (China: χ²=25.06, 245.12, U.S. CDC: χ²=56.13, 205.93, IOTF: χ²=182.34, 22.04, WHO: χ²=200.88, 21.61, P < 0.01). The Chinese standard showed good agreement with the IOTF standard and U.S. CDC standard, with weighted Kappa values of 0.72 and 0.83, but poor agreement with the WHO standard, with a weighted Kappa value of 0.33. Conclusion The current prevalence of overweight and obesity among children and adolescents in Jinan is serious. The Chinese standard has good consistency with IOTF standard and American CDC standard, and poor consistency with WHO standard.

Relationship between polycyclic aromatic hydrocarbons internal exposure and lung function change among healthy college students

CHEN Junjie, LIU Siqiao, LI Miao, HAO Kelu, ZHANG Yanli, LI Weihong, XU Houjun, HAO Yulan, WANG Manman, WANG Xuesheng, WANG Qian.

2023, 44(9): 1409-1413. doi: 10.16835/j.cnki.1000-9817.2023.09.029

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Abstract:
Objective To investigate the relationship between urinary monohydroxylated metabolites of hydroxyl polycyclic aromatic hydrocarbons (OH-PAHs) and lung function, as well as the role of oxidative stress in these associations, so as to provide a scientific basis for air pollution control and policy formulation. Methods A panel study was carried out among 45 young healthy adults. Four follow-up surveys and health examinations were conducted from November 2017 to October 2018 to measure lung function parameters [forced vital capacity (FVC), second forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), FEV1/FVC, and forced expiratory flow between 25% and 75% vital capacity (FEF_25%~75%)], markers of exposure to 7OH-PAHs [∑₇OH-PAHs], and markers of oxidative stress[8-hydroxy-2'-deoxyguanosine (8-OHdG) and 8-isoprostaglandin-F_2α (8-iso-PGF_2α)]. The relationship between urinary PAH metabolites and lung function was quantified by linear mixed effects models. Mediation analysis was performed to assess the role of oxidative stress in the relationship between OH-PAHs and lung function. Results The median values of FVC, FEV1, FEVI/FVC, PEF, and FEF_25%-75% were 4.37 L, 3.58 L, 83.00%, 4.38 L/s, and 3.32 L/s, respectively. The results showed that each 1-unit increase in log-transformed value of 2-Hydroxyfluorene (2-OHFlu) was associated with a 5.05% decrease (β%=-5.05%, 95%CI=-8.85%--1.09%) in FVC, 4.15% decrease (β%=-4.15%, 95%CI=-7.94%--0.22%) in FEV1 and 5.87% decrease (β%=-5.87%, 95%CI=-11.35%--0.05%) in FEF_25%-75%, respectively. Each 1-unit increase in log-transformed values of 2-OHFlu and 9-Phenanthrol (9-OHPhe) was associated with a 7.03% decrease (β%=-7.03%, 95%CI=-12.60%--1.11%) and a 7.08% decrease (β%=-7.08%, 95%CI=-13.50%--0.17%) in PEF, respectively. Additionally, urinary ∑₇OH-PAHs had a positive correlation with the levels of urinary 8-OHdG and 8-iso-PGF_2α (r=0.64, 0.69, P < 0.01). Meanwhile, the levels of 8-OHdG mediated 17.06% and 15.71% of the association between 2-OHFlu with FVC and FEV1. Conclusion The finding reveales a negative relationship between urinary OH-PAHs and lung function among young healthy adults. The 8-OHdG plays a mediated role in the correlation of 2-OHFlu with FVC and FEV1. Active relevant policies are needed to control air pollution and maintain the healthy living conditions of young people.

Comparative application of three methods for testing distance visual acuity among children

GAO Zongshi, XU Shaojun, ZHU Yi, SUN Zhihong, SU Yu, TAO Fangbiao

2023, 44(9): 1414-1417. doi: 10.16835/j.cnki.1000-9817.2023.09.030

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Objective To understand the differences in the application of three distant vision examination methods in children, so as to provide a reference for developing a unified distant vision examination for this population. Methods The study involved 98 children aged 4 to 16 years who visited the ophthalmology department of a children's hospital in Anhui Province between August 15 and 25, 2022. Vision was measured using the distant vision test method specified in the 2014 National Student Physical Fitness and Health Survey (V1), the 2019 National Student Physical Fitness and Health Survey (V2), and Specification for Screening of Refractive Error in Primary and Secondary School Students (WS/T 663-2020) (V3). The paired-samples McNemar's test and Wilcoxon test were performed to compare the detection rate of poor vision and the difference between the visual acuity test results of the three methods. Results The results of the 98 children examined according to V1, V2, and V3 showed that the M(P₂₅, P₇₅) of the right eye were 4.8(4.6, 5.0), 4.8(4.7, 5.0), and 4.8(4.7, 5.0)while the left eye visual acuity M(P₂₅, P₇₅) were 4.8(4.6, 5.0), 4.9(4.7, 5.0), and 4.9(4.7, 5.0), respectively. The rates of poor visual acuity detection for the right eye were 63.3%, 58.2% and 58.2% for V1, V2, and V3, respectively, while for the left eye, they were 58.2%, 54.1% and 53.1%, respectively. McNemar test results showed that there were no statistically significant differences in the rates of poor visual acuity detection between the right and left eyes for V1 vs. V2, V1 vs. V3, and V2 vs. V3 (left eyes: χ²=2.25, 2.29, 0.00, right eyes: χ²=3.20, 3.20, 0.00, P>0.05).Wilcoxon test results indicated that there were statistically significant differences between the right and left eye visual acuity groups for V1 vs. V2 and V1 vs. V3 (left eyes: Z=-4.15, -4.60, right eyes: Z= -4.70, -4.99, P < 0.01). Conclusion Irrespective of whether the starting visual standard starts at row 4.0 or 5.0, different standards of visual standard passage have an impact on the visual acuity results. It is recommended that existing methods of screening for distance vision are standardized.

Construction of an evaluation index system for the response capacity of universities to public health emergencies

LI Zhijie, DU Guoping, LI Xiaoshan, LIU Yangyang, LI Rui, WANG Yaqing, CHEN Xiaoyan, WEI Pingmin

2023, 44(9): 1418-1422. doi: 10.16835/j.cnki.1000-9817.2023.09.031

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Objective To construct an evaluation index system to assess the response capacity of universities to public health emergencies, so as to provide a basis for improvements the response capacity. Methods In November 2019, in order to develop an evaluation system based on literature review and expert discussions, 15 experts were invited to conduct a subjective evaluation used hierarchical analysis. The objective evaluation was conducted in 120 universities in Jiangsu Province used the inverse entropy weighting method, and the final evaluation employed the joint subjective and objective weighting method. Results The indicator system consisted of four primary indicators, nine secondary indicators, 32 tertiary indicators and 67 quaternary indicators. The analysis of the combined weighting method showed that the primary indicators, in descending order, included incident handling capability (0.666), incident detection capability (0.203), prior preparation capability (0.101) and post-event recovery capability (0.031). The top three secondary indicator weights were emergency response (0.480), monitoring and reporting (0.203) and command and coordination (0.151). The results of the evaluation of the consistency indicators showed that the expert authority coefficient was 0.909 and the Kendall's W coordination coefficient was 0.836 (P < 0.01), with all consistency scale values < 0.1. Conclusion The evaluation system is highly scientific and credible, and provides basis for evaluating the response capability of universities to public health emergencies.

Research progress on burden and etiological mechanism of mental health as the core comorbidity in children and adolescents

YUAN Wen, YANG Tian, SONG Yi, MA Jun, DONG Yanhui

2023, 44(9): 1423-1427. doi: 10.16835/j.cnki.1000-9817.2023.09.032

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The prevalence of mental health problems in children and adolescents has been gradually increasing, which has become an important public health problem related to the future of the country and the nation. However, mental disorder rarely exists independently, and comorbidity often occurs, which brings great harm and burden to individuals, families and society. This study introduces the prevalence, burden, characteristics and manifestations of different types of comorbidity with mental disorders as the core. Then it explaines the main causes and mechanisms of comorbidity, and proposes future research directions.

Research progress on the correlation between adolescent digital lifestyles and digital eye strain

SUN Lei, REN Jinyu, ZHANG Xiaodan

2023, 44(9): 1428-1431. doi: 10.16835/j.cnki.1000-9817.2023.09.033

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To explore the association between a digital lifestyle and digital eye strain among adolescents, the present study analyses that a digital lifestyle has direct, mediating and moderating effects on digital eye strain of adolescents, and explores that visual load, attention and cognitive load are identified as the associated mechanisms of digital eye strain. In terms of management, the article highlights the need to raise awareness and promote healthy behavior in respect to the use of digital devices, as well as the importance of diversifying lifestyles, ensuring family and school support, and engaging in multidisciplinary co-operation to promote visual health and digital literacy among adolescents.

Research progress on the impact of social network on eating behavior of adolescents and the effectiveness of related intervention

HUA Yuxuan, PAN Dan, HUA Ming, XU Xinyu, ZHU Jingfen

2023, 44(9): 1432-1435. doi: 10.16835/j.cnki.1000-9817.2023.09.034

Abstract(282) HTML (164) PDF(49)

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Social network of adolescents is one of the important factors affecting the initiation and development of their unhealthy eating behaviors, and different types of social networks shows varied influences on adolescents' eating behaviors through divergent mechanisms. In the context of the new media era, social networks of adolescents establish via social media appear more complex and extensive. Based on relevant previous literature, the paper explores the impact and possible mechanisms of social network on eating behavior of adolescents, as well as its development and application in the new media era to provide references for better intervention strategies and healthier eating behaviors among adolescents from the perspective of social network.

Research progress on the relationship between home food environment and overweight and obesity in children and adolescents

WANG Zhifang, ZHANG Qian, YANG Titi, XU Peipei, XU Juan

2023, 44(9): 1436-1440. doi: 10.16835/j.cnki.1000-9817.2023.09.035

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The rate of overweight and obesity in Chinese children and adolescents is gradually increasing, and it has multiple hazards for their health. Overweight and obesity are affected by many factors such as genetics and environment. The home food environment is very important among the many factors affecting children's overweight and obesity. This paper analyzes the relationship between parents' feeding behaviors, including pressure eating, restricted eating and food as reward, accessibility and usability of family food, with overweight and obesity of children and adolescents, aiming to provide a scientific reference for controlling children overweight and obesity by focusing on home food environment.

2023 Vol. 44, No. 9