中国学校卫生

Comprehensive prevention and management of childhood obesity to reduce potential adverse health outcome

XI Bo

2024, 45(10): 1369-1371. doi: 10.16835/j.cnki.1000-9817.2024308

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In recent years, with the rapid development of social economy, unhealthy lifestyle is becoming more prevalent, and the prevalence of childhood overweight and obesity increases rapidly. Childhood obesity can cause various target organ damages, including heart, blood vessels, liver and kidney. It is urgent to reduce adverse health outcome of childhood obesity. Relevant national ministries and commissions have successively issued technical guidelines for the prevention and control of childhood obesity in China, aiming to achieve effective prevention and control of childhood obesity from the perspective of tertiary prevention. Future directions for childhood obesity prevention and closed-loop management should focus on joint collaboration among families, schools, medical and health institutions, as well as governments.

Expert interpretation on the Technical Guidelines for the Joint Prevention of Common Disease Multimorbidity among Students

TAO Shuman, WU Xiaoyan, TAO Fangbiao

2024, 45(10): 1372-1377. doi: 10.16835/j.cnki.1000-9817.2024305

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Common diseases among students such as myopia, overweight and obesity, scoliosis, and mental health problems are prevalent, which usually exist concurrently under similar public health influencing factors. Therefore, there is a need to carry out the joint prevention of multimorbidity. The National Disease Control and Prevention Administration of China have organize the development of the Technical Guidelines for the Joint Prevention of Common Disease Multimorbidity among Students (hereafter referred to as the Guidelines). For the first time, the Guidelines clarifies the concept of multimorbidity joint prevention, specifies that the departments of centers for disease control and prevention should strengthen environmental and behavioral surveillance, proposes integrated public health interventions for multimorbidity joint prevention based on a three tiered prevention strategy, and recommends the appropriate technology of a healthy lifestyle featuring six key principles. It also advocates exploring the establishment of a six-in-one model (government-professional institution-community-school-family-students collaboration) for multimorbidity joint prevention, which has achieved a leap in theory and practice in the prevention and control of common diseases among students. The article focuses on the background, theoretical basis and core content of the Guidelines, in order to improve the understanding of the Guidelines by professionals in public health institutions and people concerned about students' health, and to promote the application and dissemination of the Guidelines.

Interaction between vitamin D deficiency and dyslipidemia with overweight and obesity in children and adolescents

LI Tingting, LUO Xiaoyan, TIAN Meina, LIU Changqing

2024, 45(10): 1378-1382. doi: 10.16835/j.cnki.1000-9817.2024311

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Objective To explore the association of the interaction between vitamin D deficiency and dyslipidemia with the comorbidity risk of overweight and obesity in children and adolescents, so as to provide the theoretical basis for prevention and control of overweight and obesity in children and adolescents. Methods The data for the study was obtained from the population aged 6-17 in Hebei Province during the 2022-2023 monitoring of nutrition and health status of Chinese residents. A stratified cluster random sampling method was used to conduct questionnaire surveys, physical measurements, and laboratory tests on 2 118 children and adolescents. Logistic regression was used to analyze the association of vitamin D deficiency and dyslipidemia with overweight and obesity, and multiplication and addition models were used to analyze the interaction of vitamin D deficiency and dyslipidemia with overweight and obesit. Results The prevalence of vitamin D deficiency in the surveyed children and adolescents was 67.80%, the incidence of dyslipidemia was 24.46%, and the prevalence of overweight and obesity was 41.97%. After adjusting for confounding factors, the results of multivariate Logistic regression analysis showed that there was no multiplicative interaction of vitamin D deficiency and dyslipidemia with overweight and obesit (OR=0.90, 95%CI=0.57-1.43, P>0.05). However, the risk of overweight and obesity among children and adolescents with vitamin D deficiency and dyslipidemia was 3.99 times higher than that of those with sufficient vitamin D and normal blood lipids (OR=3.99, 95%CI=2.93-5.45, P < 0.01). There was a positive additive interaction between vitamin D deficiency and dyslipidemia, with relative excess risk of interaction, attributable proportion of interaction and synergy index of 14.40, 81.50% and 7.35, respectively. Conclusions For children and adolescents, there is a synergistic effect between vitamin D deficiency and dyslipidemia, and the coexistence of both increases the risk of overweight and obesity. Comprehensive prevention and control measures should be taken to timely supplement vitamin D and maintain normal blood lipid levels, to reduce the occurrence of overweight and obesity in children and adolescents.

Joint effects between body fat mass and insulin resistance with dyslipidemia in children

WANG Jiani, YANG Hui, ZHAO Min, XI Bo

2024, 45(10): 1383-1387. doi: 10.16835/j.cnki.1000-9817.2024312

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Objective To explore joint effects between body fat mass and insulin resistance with dyslipidemia in children, in order to provide scientific evidence for the prevention and treatment of dyslipidemia in children. Methods Data was derived from the second follow-up survey (2021) of the Huantai Childhood Cardiovascular Health Cohort. The complete information of a total of 1 322 children was included in the study. Multivariate Logistic regression model was used to analyze the association among fat mass percentage (FMP), fat mass index (FMI), subcutaneous fat mass (SFM) and visceral fat mass (VFM) and dyslipidemia. Restrictive cubic spline model was used to analyze dose-response relationship between levels of each of the four body fat mass indicators and dyslipidemia. Multivariate Logistic regression model was used to analyze the association of interaction of body fat mass indicators and insulin resistance (IR) with dyslipidemia. Results Boys had higher VFM and fasting plasma glucose (FPG) levels, while FMP, FMI, SFM, total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) levels were all lower than those of girls (t/Z=3.22, 2.58, -15.85, -7.35, -6.49, -2.40, -4.05, -2.40, P < 0.05). After adjusting for all covariates, compared with children with normal FMP, those with higher FMP had an increased likelihood of elevated triglyceride levels (OR=4.26, 95%CI=2.58-7.09) and low HDL-C levels (OR=4.10, 95%CI=2.51-6.76). FMI, SFM, and VFM observed similar results to FMP (P < 0.05). Additionally, the additive interaction analyses showed that all four indicators of elevated body fat mass interacted with IR, increasing the likelihood of dyslipidemia in children (P < 0.05). There were linear or nonlinear dose-response association between each of four body fat mass indicators and dyslipidemia. Conclusions Elevated body fat mass increases the likelihood of dyslipidemia in children, and the likelihood of dyslipidemia further would increase if children have concomitant IR. Therefore, it is necessary to pay more attention to children with elevated body fat mass and IR to prevent the occurrence of dyslipidemia.

Association between alanine aminotransferase levels and cardiac structure in childhood

SONG Yangxiao, YANG Lili, ZHAO Min, XI Bo

2024, 45(10): 1388-1392. doi: 10.16835/j.cnki.1000-9817.2024310

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Objective To explore the association between alanine aminotransferase (ALT) levels and cardiac structure in childhood, so as to provide scientific evidence to promote childhood cardiac health. Methods Data were obtained from the baseline survey of the "Huantai Childhood Cardiovascular Health Cohort Study" conducted from November 2017 to January 2018. A total of 1 340 children with complete data were included in the study. Demographic information and lifestyle factors were collected through questionnaires. Physical examinations and blood biochemical tests were performed to obtain children's body mass index (BMI), blood pressure, fasting plasma glucose (FPG), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and ALT levels. Further, cardiac structural indicators such as left ventricular end-diastolic diameter (LVDD), left ventricular end-systolic diameter (LVSD), left ventricular posterior wall thickness (LVPWT), and interventricular septal thickness (IVST) were measured by ultrasound. Relative wall thickness (RWT), left ventricular mass (LVM), and left ventricular mass index (LVMI) were calculated. Multivariate linear regression models were used to analyze the relationship between ALT levels and cardiac structural indicators. Restricted cubic spline (RCS) models were used to explore the dose-response relationship between ALT levels and cardiac structural indicators. Results There were significant differences in LVDD, LVSD, IVST, LVPWT, LVM, LVMI and RWT in different ALT level groups (F=78.69, 60.08, 72.86, 74.89, 83.14, 36.70, 20.46, P < 0.05). Multivariate linear regression analysis showed that ALT levels were positively associated with LVDD, LVSD, IVST, LVPWT, LVM, and LVMI (β=0.10, 0.20, 0.16, 0.16, 0.23, 0.18, P < 0.05) after adjusting for potential covariates. The RCS showed a linear dose-response relationship between ALT levels and LVDD, LVSD, IVST, and LVMI after adjusting for potential covariates (P_non-linear>0.05). In contrast, a non-linear dose-response relationship was found between ALT levels and LVPWT and LVM (P_non-linear < 0.05). Conclusions ALT levels in childhood are positively associated with the majority of cardiac structural indicators, presenting a linear or non-linear dose-response relationship.

Association between high body fat mass and elevated blood pressure in children

YAN Yujiao, YANG Hui, CHENG Anlan, ZHAO Min, XI Bo

2024, 45(10): 1393-1398. doi: 10.16835/j.cnki.1000-9817.2024309

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Objective To examine the association between high body fat mass and elevated blood pressure in children, so as to provide scientific evidence for the prevention and treatment of childhood hypertension. Methods Participants were recruited from the second follow-up survey of the Huantai Childhood Cardiovascular Health Cohort Study conducted in 2021 in Huantai County, Zibo City, Shandong Province, China. A total of 1 266 children aged 10-15 years old were included. The study categorized fat mass (FM), fat mass percentage (FMP), fat mass index (FMI), subcutaneous fat mass (SFM), and visceral fat mass (VFM), respectively, into normal and elevated groups based on age- and gender-specific median values (P₅₀) in the study population. The multivariate Logistic regression model was used to analyze the association between the status of body mass and elevated blood pressure. A restrictive cubic spline (RCS) model was used to examine the dose-response relationship between the levels of body mass and elevated blood pressure. Results The detection rates of elevated blood pressure in children with elevated FM, elevated FMP, elevated FMI, elevated SFM, and elevated VFM were all significantly higher than those in the normal group (P < 0.05). After adjusting for all potential covariates, compared to the normal group, elevated FM (OR=4.51, 95%CI=3.28-6.28), elevated FMP (OR=4.51, 95%CI=3.28-6.27), elevated FMI (OR=4.40, 95%CI=3.20-6.12), elevated SFM (OR=4.52, 95%CI=3.29-6.30), and elevated VFM (OR=4.48, 95%CI=3.28-6.18) were all positively associated with elevated blood pressure (P < 0.05). The RCS analysis demonstrated that the high levels of FM, FMP, FMI, and SFM showed linear dose-response relationships with elevated blood pressure (P_non-linear>0.05), and elevated VFM was associated with elevated blood pressure in a nonlinear dose-response relationship (P_non-linear < 0.05). Conclusions Children with elevated body fat have a higher risk of elevated blood pressure. There was a dose-response relationship between high body mass content and elevated blood pressure in children. It is essential to take appropriate measures to reduce the elevated body fat in children, in order to prevent the occurrence of high elevated blood pressure in children.

Analysis of vitamin D nutritional status and associated factors among primary and middle school students in Shandong Province

JIANG Ying, SUN Qing, LIANG Zhengyan, SONG Jian, ZHANG Yingxiu

2024, 45(10): 1399-1402. doi: 10.16835/j.cnki.1000-9817.2024291

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Objective To determine the nutritional status and associated factors of vitamin D in primary and middle school students in Shandong Province, so as to provide reference for developing targeted vitamin deficiency interventions. Methods From January to September 2021, using multi-stage stratified random sampling, physical examinations and laboratory tests were carried out among 3 539 primary and middle school students in Shandong Province. Associated factors of vitamin D were analyzed by Logsitc regression analysis. Results The average vitamin D level among primary and middle school students was (17.56±6.65) ng/mL, while the deficiency and severe deficiency rate was 67.4%. Multivariate Logistic regression analysis showed that girls (OR=1.95), students in junior high school (OR=2.14) and senior high school (OR=2.36) were at higher risk of vitamin D deficiency and severe deficiency (P < 0.05). Students from coastal areas (OR=0.54), physical examination in summer and autumn (OR=0.74), and 35 g of egg intake per day (OR=0.53), and with outdoor activity time greater than 60-120 min and >120 min (OR=0.63, 0.48) had lower risk of vitamin D deficiency (P < 0.05). Conclusions The nutritional status of vitamin D among elementary and secondary school students in Shandong Province warrants further attention. Intervention measures such as nutritional education, healthy diet and prolonging outdoor activities should be promoted in primary and middle school students.

Meta-analysis of the relationship of milk and dairy products intake with overweight and obesity in children and adolescents

YOU Wenshuo, XU Peipei, ZHANG Qian, XU Juan

2024, 45(10): 1403-1408. doi: 10.16835/j.cnki.1000-9817.2024300

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Objective To systematically analyze the association between dairy products intake and overweight and obesity in children and adolescents, so as to provide evidence for the control of overweight and obesity in children and adolescents. Methods Retrieve between January 2013 and October 2023, the relevant research literature about milk and its products of the relationship between intake of child and adolescent overweight and obesity were collected, from China National Knowledge Infrastructure(CNKI), Wanfang, PubMed, Web of Science, Embase, and the Cochrane Library databases. Taking OR and 95%CI as effect indicators, quality evaluation and data extraction were conducted by using the inclusion and exclusion criteria, Revmam 5.4 software was used for test for heterogeneity and publication bias analysis. Results A total of 19 articles were included, including 11 cross-sectional studies, 4 cohort studies, 3 randomized controlled studies, and 1 case-control study. A total of 109 661 participants were included. The results of Meta-analysis of cross-sectional studies showed that the total intake of milk and dairy products was not significantly associated with obesity in children and adolescents (OR=0.91, 95%CI=0.76-1.09, P>0.05). However, liquid milk intake was negatively associated with overweight and obesity in children and adolescents (OR=0.82, 95%CI=0.74-0.91, P < 0.01). The Meta-analysis of cohort studies showed that milk and dairy products intake were negatively associated with obesity in children and adolescents (OR=0.59, 95%CI=0.45-0.79, P < 0.01). Randomized controlled studies supported the effects of milk and dairy products intake on children and adolescents with overweight and obesity, while case-control studies showed an inverse association (P < 0.05). Conclusions The intake of milk and dairy products is associated with overweight and obesity in children and adolescents. Measures should be taken to guide children and adolescents' milk intake behaviors to prevent childhood overweight and obesity.

Policy implementation on daily study time standard among secondary school students in Shandong Province

SHI Yihan, XU Xin, LIU Kaiqi, LIU Zhaolu, TU Ying, LIANG Qian, WANG Fei, LEI Suwen, LI Jing

2024, 45(10): 1409-1413. doi: 10.16835/j.cnki.1000-9817.2024299

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Objective To understand the implementation of daily study time standard among secondary school students in Shandong Province, so as to provide scientific basis for the formulation and implementation of relevant policies. Methods From January to May 2023, a multi-stage random sampling method was used to select 8 725 middle school students in Shandong Province. A survey questionnaire was designed based on the Requirements for Daily Study Time of Primary and Secondary School Students(GB/T 17223-2012), to investigate indicators such as students' daily learning schedule, sleep and physical activity time, break time and scheduling requirements. Results The compliance rates for daily study time in junior and senior high school students in Shandong Province were 29.2% and 23.6%, respectively, with a statistically significant difference (χ²=33.63, P < 0.01). Compliance rates for sleep duration, physical activity and recess time, morning and afternoon class hours, and class duration were 19.3%, 26.2%, 30.5%, 73.2% and 16.2%. Class duration compliance was relatively high, with rates of 96.7% in junior high and 94.4% in senior high school students. There was a statistically significant difference in compliance rates for extended class breaks between different educational stages (χ²=81.78, P < 0.01), with rates of 84.6% in junior high and 83.4% in senior high school students. As students progressed through their educational stages, compliance rates for physical activities, class breaks, consecutive classes, and total weekly class hours showed a decreasing trend, with rates of 31.8% and 18.3%, 35.7% and 23.1%, 60.5% and 29.6%, 55.2% and 35.1% in junior and senior high school students, respectively. Conclusions The revised standard of Requirements for Daily Study Time of Primary and Secondary School Students(GB/T 17223-2012) optimizes the daily study and life schedule of middle school students to a certain extent. However, daily study time for middle school students in Shandong Province exceeds standard. Relevant departments need to enhance their ability to implement standards and strengthen the supervision of policy standards implementation.

Correlation between health literacy and sports injuries among high school students with athletic specialization

LIU Cong, YUAN Yan, XIONG Jianping, ZHU Juncheng, LIU Wei, GUO Zhifang, JIANG Jing, LU Jinkui

2024, 45(10): 1414-1419. doi: 10.16835/j.cnki.1000-9817.2024295

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Objective To investigate the relationship between health literacy and sports injuries among high school students with athletic specialization, so as to provide theoretical basis for the intervention of sports injury occurrence of sports special students. Methods A total of 443 high school students with athletic specialization aged 16-18 years old from 21 urban and rural areas in Shangrao City, Ganzhou City and Nanchang City of Jiangxi Province were selected by convenient sampling method from March to April 2023, and the health literacy and sports injury incidence were investigated. The assessment of sports injury was based on the Monitoring Method of Child and Adolescent Injury, and the assessment of health literacy level was conducted using the Interactive Health Literacy Questionnaire of Chinese Adolescents. χ² test was used to compare the reported rate of sports injuries among the demographic and sports training groups and the correlation between health literacy and sports injuries. Binary Logistic regression analysis was used to infer the correlation between the health literacy level of high school students with athletic specialization and the occurrence of sports injuries. Results The prevalence of sports injury was 49.4% in high school students with athletic specialization. Binary Logistic regression analysis showed that the risk of sports injury of high school students with athletic specialization with medium and low level of health literacy was significantly increased compared with high level (medium level: OR=1.98, 95%CI=1.12-3.51; low level: OR=2.08, 95%CI=1.18-3.68), high school students with athletic specialization in low level of health awareness of sports injury risk was higher than other dimensions of health literacy level (middle level: OR=2.77, 95%CI=1.48-5.19; low level: OR=2.01, 95%CI=1.04-3.88)(P < 0.05). The results of stratified analysis showed that among male students with athletic specialization and students with track and field, students with moderate/low overall health literacy had a higher risk of sports injuries compared to high level students (male students: low level, OR=2.46, 95%CI=1.15-5.28; track and field: intermediate level, OR=2.17, 95%CI=1.06-4.43, low level, OR=2.09, 95%CI=1.02-4.30; P < 0.05). Conclusions There is a correlation between the health literacy level of high school students with athletic specialization and the occurrence of sports injuries. Students' health awareness should be improved to reduce the risk of sports injuries.

Physical activity patterns and influencing factors of preschooler in and outside of kindergarten during weekdays

WEI Lai, YE Peiqi, LÜ Pingping, LIU Su, HUANG Jinjiao, SHI Huijing

2024, 45(10): 1420-1425. doi: 10.16835/j.cnki.1000-9817.2024323

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Objective To evaluate the characteristics and related factors of physical activities both inside and outside the kindergarten among preschool children, so as to provide a reference for promoting targeted physical activities among different types of children in the future. Methods From April 2016 to December 2022, 706 preschool children aged 3 to 6 years from the Shanghai parent-child cohort followed up. Accelerometers were used to measure their physical activities during kindergarten hours, and a parent questionnaire was employed to assess their physical activities and screen time outside the kindergarten. Restrictive cubic spline analysis was used to examine the relationship between moderate to vigorous physical activities (MVPA) inside and outside the kindergarten. Cluster analysis was performed to identify physical activity patterns among children, and multinomial Logistic regression analysis was conducted to explore the influencing factors of these physical activity patterns. Results On weekdays, preschooler accumulated an average of (40.83±15.71) minutes of MVPA inside the kindergarten and 30(15, 53) minutes outside daily. Restricted cubic spline analysis revealed an inverted U-shaped relationship between MVPA inside and outside the kindergarten. Cluster analysis identified four groups: low daily MVPA but active inside (196, 27.8%), moderate daily MVPA but high screen time outside (97, 13.7%), adequate daily MVPA and relatively active outside (96, 13.6%), and low daily MVPA and relatively inactive both inside and outside (317, 44.9%). Compared to the reference group of adequate daily MVPA and relatively active outside, children with screen time exceeding 60 minutes at 2 years old were more likely to belong to the group with adequate daily MVPA but more screen time outside (OR=3.84, 95%CI=1.16-12.74, P < 0.05). Boys had a lower likelihood of being in the group with low daily MVPA and relatively inactive both inside and outside (OR=0.33, 95%CI=0.16-0.70, P < 0.05). Children from neighborhoods with insufficient sport facilities were more likely to be in the low daily MVPA and relatively inactive group (OR=2.20, 95%CI=1.05-4.63, P < 0.05). Conclusions Behavior patterns of physical activity and screen time for both inside and outside the kindergarten vary greatly among different children. Screen time at the age of 2 and the sports facilities around the commuinty are key factors influencing the physical activity pattern. It is recommended to implement personalized intervention plans in collaboration with schools and families for different types of children.

Relationship between residential neighborhood green space and mental health of middle school students

ZHANG Shunjun, RAN Fei, WU Wenqiao, ZENG Qingwen, YUE Xinwei

2024, 45(10): 1426-1430. doi: 10.16835/j.cnki.1000-9817.2024294

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Objective To understand the relationship between residential neighborhood green space and mental health of middle school students, so as to provide a theoretical basis for mental health promotion among of middle school students at the level of residential environment. Methods From October to December 2023, 1 258 students from three junior high schools and two general high schools in Panlong, Wuhua, Chenggong, and Guandu districts of Kunming City were selected by stratified cluster random sampling method. Conducting on-site questionnaire survey using the Mental Health Inventroy of Middle-School students, residential neighborhood green space were evaluated using normalized difference vegetation index (NDVI). Analysis of variance, Pearson correlation analysis and linear regression analysis were used to analyze the relationship between as green space in residential neighborhoods and the mental health of middle school students. Results The average mental health score of middle school students in Kunming was (2.02±0.69), of which 447 (37.92%) had mild mental health problems, 107 (8.51%) had moderate mental health problems, and 12 (0.95%) had more severe mental health problems. Mental health scores of middle school students varied significantly by gender, grade, and family income (t/F=6.99, 7.15, 3.70, P < 0.05). Correlation analysis showed that NDVI_250 m, NDVI_500 m, and NDVI_1 000 m were all negatively correlated with the total mental health scores of middle school students (r=-0.07, -0.09, -0.10, P < 0.05). Multiple linear regression analysis showed that gender, grade, NDVI_250 m, NDVI_500 m, and NDVI_1 000 m were infuencing factors on the mental health of middle school students(B=0.25, 0.05, -0.47, -0.67, -0.78, P < 0.05). Conclusions Mental health of middle school students in Kunming is related to green space in different buffer zones around residences. The mental health education of middle school students should be strengthened, especially for girls and senior students, optimizing resources to reduce pressure, and improving the quality of green space in residential communities to improve the mental health of adolescents.

Demand for online training on early childhood sexuality education of parents in urban of Changshou District, Chongqing

WANG Zhennan, LI Bowen, ZHAO Jun, YE Yunli, JIANG Qinling, JIANG Guangqun

2024, 45(10): 1431-1435. doi: 10.16835/j.cnki.1000-9817.2024313

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Objective To understand the needs of parents of kindergarten children in urban areas for online training on sexuality education, so as to provide a basis for the development of parent training courses. Methods In May 2023, a multistage cluster random sampling method was used to select 3 516 parents of young children from 12 kindergartens in urban areas of Changshou District, Chongqing. A self-designed questionnaire on Knowledge, Attitude and Practice of Early Childhood Sexuality Education (Parents) was used for the survey, and χ² test and multi-factor Logistic regression model were used for data analysis. Results The online training demand rate of urban parents for early childhood sexuality education was 57.05%. The results of the multi-factor Logistic regression analysis showed that age, education level, occupation, whether or not they were the main caregivers, total score level of the scale, awareness of their own responsibility, communication with family and friends about early childhood sexuality education and young children's participation in kindergarten sexuality education activities were the influencing factors of parents' online training demand on sexuality education (OR=1.18, 1.44, 1.42, 0.83, 1.19, 0.51, 0.75, 0.75, P < 0.05). Conclusion Urban parents have a high demand for online training on early childhood sexuality education, and training courses should be developed according to the specific needs and characteristics of parents of young children.

Relationship between consumption status of milk tea and psychological distress among college students in four provinces of China

GU Zhengyun, XIONG Jianping, GUO Zhifang, MA Nan, SONG Yongjing, LIN Yanmin, HUANG Bo, JIANG Jing

2024, 45(10): 1436-1440. doi: 10.16835/j.cnki.1000-9817.2024302

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Objective To investigate the current status of milk tea consumption and its association with psychological distress among college students, so as to provide theoretial support for promoting the mental health of college students. Methods From September to November 2023, a convenience sampling method was used to select 15 440 college students aged 17-24 from seven universities in Shanghai, Jiangxi, Hubei, and Shanxi. A self-designed questionnaire and the Kessler Psychological Distress Scale were used to assess milk tea consumption and psychological distress, respectively. The Mantel-Haenszel test was employed to analyze the trend of psychological distress at different levels of milk tea consumption. Binary Logistic regression analysis was used to determine the association between milk tea consumption and psychological distress, and the restricted cubic spline method was applied to explore the nonlinear relationship between milk tea consumption and symptoms of psychological distress. Results The detection rate of psychological distress among college students was 59.6%. Univariate analysis indicated a significant trend association between milk tea consumption frequency (χ_trend²=42.33) and milk tea intake level (χ_trend²=5.17) with psychological distress (P < 0.05). Binary Logistic regression models showed a positive association between different levels of milk tea consumption frequency and psychological distress [1-3 times (mild to moderate distress, OR=1.20, 1.41), 4-5 times (mild to severe distress, OR=2.80, 5.44, 4.12), and ≥6 times (severe distress, OR=8.04); and milk tea intake level: 1-1 500 mL (severe distress, OR=1.35), >1 500- < 3 000 mL (mild to moderate distress, OR=1.21, 1.35), ≥3 000 mL (mild to severe distress, OR=1.33, 1.71, 1.29)] (P < 0.05). The restricted cubic spline model showed a nonlinear association between milk tea intake and the risk of psychological distress (F=107.34, P_non-linear < 0.01, P_overall < 0.01). Conclusions High-frequency and high-volume milk tea consumption are associated with an increased risk of psychological distress among college students. Reducing the consumption behavior of college students' milk tea is helpful to improve mental health.

Life satisfaction and associated factors among adolescents relocated for poverty alleviation in Shanxi Province

LI Zhenhao, YANG Le, YAO Dianrui, YANG Yang, GUO Dan, YU Qi

2024, 45(10): 1441-1445. doi: 10.16835/j.cnki.1000-9817.2024297

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Objective To investigate factors associated with life satisfaction among adolescents who have been relocated for poverty alleviation, so as to provide scientific evidence to support adolescent physical and mental well-being. Methods A multi-stage stratified random sampling was conducted from June to August 2023 across 24 relocation sites in 8 counties of 4 cities in Shanxi Province. A total of 631 adolescents aged 10-19 were surveyed regarding personal characteristics, family environment, health behaviors, mental health, and social capital. Univariate analysis of variance and binary Logistic regression were used to explore the influencing factors. Results The life satisfaction rate of the relocated adolescents was 63.9%(403/631), and the average score of life satisfaction was (23.21±6.28). The Logistic regression analysis showed that, significant factors affecting life satisfaction of the relocated adolescents included age (17-19 years old: AOR=0.54, 95%CI=0.33-0.88), subjective family economic status (moderate: AOR=1.70, 95%CI=1.04-2.76; good: AOR=6.95, 95%CI=1.85-26.16), sleep quality (good: AOR=1.61, 95%CI=1.09-2.38), depression (AOR=0.94, 95%CI=0.90-0.99), and social capital (AOR=1.17, 95%CI=1.10-1.23)(P < 0.05). Conclusions The satisfaction of 17-19-year-old adolescents who have relocated for poverty alleviation is relatively low, while those with better family economic status, high sleep quality, low depression level and rich social capital showed high life satisfaction. Targeted interventions by families, communities, schools, and social institutions are recommended to improve adolescents' quality of life.

Intervention effects of bedtime screen use content on nighttime sleep quality among college students with high sedentary behavior

YOU Chuanqi, CUI Yupeng

2024, 45(10): 1446-1450. doi: 10.16835/j.cnki.1000-9817.2024324

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Objective To explore the effects of different screen content on the nighttime sleep quality of college students based on screen time 1 h before bedtime, so as to provide a basis for healthy sleep habits. Methods From March 1 to 15, 2024, 40 college students were recruited from Capital Institute of Physical Education through student social media groups or recruitment posters, and were randomly assigned to TV/movie streaming group (n=10), video game group (n=10), online surfing/social networking group (n=10), sleep aid video group (n=10) by single-blind randomized experimental design. The International Physical Activity Questionnaire Short Form (IPAQ-SF), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) were used to measure the physical activity and emotional state levels of college students before the experiment. In the 5-day experiment, participants watched different screen content 1 h before sleep, then Pittsburgh Sleep Quality Index (PSQI), sleep duration, sleep latency and wake-up time were collected before and after the intervention. A paired sample t-test was used to compare the differences within groups before and after the intervention, and one-way analysis of variance was used for horizontal comparison between groups. Results In the longitudinal within-group comparisons before and after the intervention, there was an increase in PSQI scores in the TV/movie strearming (5.40±0.70, 6.30±0.67) and online surfing/social networking (5.50±0.97, 6.20±0.63) groups (t=-3.86, -2.33, P < 0.05) and the sleep aid video group (5.80±0.92, 4.90±0.74) with a decrease in PSQI scores (t=3.25, P < 0.05), and the difference in PSQI scores in the video game group (5.60±0.84, 5.80±0.79) was not statistically significant (t=-0.69, P>0.05). In the post-intervention cross-sectional comparison between groups, the sleep aid video group had better PSQI scores (4.90±0.74; 6.30±0.67, 5.80±0.79, 6.20±0.63), sleep latency (0:25±0.24 h, 1:31±0.36 h, 00:56±0.56 h, 01:22±0.54 h) and sleep efficiency[(81.83±5.40)%; (72.60±5.00)%, (75.50±4.43)%, (74.80±5.20)%] than the other 3 groups (F=8.00, 6.61, 19.00) and better sleep duration than the TV/movie strearming group and the online surfing/social networking group [(7.30±0.68) (6.20±0.26) (6.36±0.64)h] (F=6.61) (P < 0.01). Conclusions Bedtime screen use with different screen contents affects sleep quality differently. The screen content of TV/movie streaming and online surfing/socialising reduced sleep quality, whereas watching sleep aiding videos may improve sleep quality, while playing video games shows no effects on sleep quality.

Longitudinal study on association between sugar-sweetened beverages consumption and insomnia among college students in Yunnan Province

SU Yingzhen, YANG Jieru, ZHANG Gaohong, TAO Jian, LU Qiuan, HU Dongyue, LIU Zihan, SU Yunpeng, XU Honglü

2024, 45(10): 1451-1454. doi: 10.16835/j.cnki.1000-9817.2024318

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Objective To study the relationship between sugar-sweetened beverages consumption characteristics and insomnia of college students in Yunnan Province, so as to provide evidence for sleep quality improvement of college students. Methods A cluster random sampling method was used to select 2 515 college students from two universities (Kunming University and Dali Nursing Vocational College) in Kunming and Dali in Yunnan Province for a longitudinal study, including baseline survey (T1, November 2021) and three follow-up surveys (T2: June 2022, T3: November 2022, T4: June 2023). Sugar-sweetened beverages consumption of college students was collected by Semi-quantitative Food Frequency Questionnaire and insomnia was assessed by Insomnia Severity Index Scale. Sugar-sweetened beverages consumption was analyzed by Kruskal-Wallis test. The Mann-Whiter U test and Kruskal-Wallis test were used to compare the detection rate of insomnia in college students with different population characteristics, and the generalized estimating equations model was established to analyze the association between sugar-sweetened beverages consumption and insomnia. Results The reported rate of insomnia among college students from T1 to T4 was 21.2%, 23.6%, 30.5% and 36.0%, respectively. The median of sugar-sweetened beverages consumption per week was 5 (1, 9) bottles per person, and there were significant differences in sugar-sweetened beverages (carbonated beverages, fruit beverages, tea beverages, milk beverages, energy beverages) consumption among college students with different insomnia status (χ²=42.91, 23.67, 29.98, 61.70, 30.82, P < 0.01). The analysis of the generalized estimating equation model revealed that the consumption of carbonated beverages (β=0.04, 95%CI=0.00-0.08) and the consumption of milk beverages among college students (β=0.04, 95%CI=0.00-0.09) were correlated with insomnia (P < 0.05). The stratified analysis indicated that consumption of carbonated beverages by female college students was associated with insomnia [β(95%CI)=0.06(0.01-0.11)]; consumption of milk beverages among college students from middle-income family was associated with insomnia [β(95%CI)=0.05(0.00-0.10)], and consumption of carbonated beverages and fruit beverages from college students with high household economic status were both associated with insomnia [β(95%CI)=0.35(0.23-0.46), 0.12(0.00-0.24)] (P < 0.05). Conclusion Sugar-sweetened beverages, especially carbonated beverages, are associated with insomnia among college students in Yunnan Province.

Internet addiction and associated factors of junior high school students in Inner Mongolia

YANG Qin, ZHANG Xiuhong, YANG Tian, FAN Yaochun, MA Caixia

2024, 45(10): 1455-1459. doi: 10.16835/j.cnki.1000-9817.2024293

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Objective To explore the current situation of Internet addiction among junior high school students in Inner Mongolia and its associated factors, so as to provide a theoretical basis for the prevention and control of Internet addiction among junior high school students. Methods In September 2023, 53 755 junior high school students were selected by stratified cluster random sampling method from all the flag counties in Inner Mongolia, and questionnaires were administered according to the "Monitoring and Intervention Program of Common Diseases and Health Influencing Factors of Students, by using the Internet Addiction Inventory and Generalized Anxiety Disorder Scale-7 Item. The Chi-test and multiple Logistic regression analysis were used to explore related factors and draw nomograms. Results The reported rate of Internet addiction among junior high school students in Inner Mongolia was 2.15%. The results of multivariate Logistic regression analyses showed that students were more likely to be in higher grades (grade eight: OR=1.54; grade nine: OR=1.64), being scolded by their parents (OR=1.06), living in the school (OR=2.28), being bullied in the school (OR=1.91), anxiety symptoms (OR=3.15), and substance abuse (smoking: OR=2.56; drinking alcohol: OR=2.29; inhaling soluble solvents for pleasure: OR=2.17; using cough suppressant except for coughing: OR=1.50; using sedatives without doctor's permission: OR=1.34) were positively correlated with Internet addiction among junior high school students in Inner Mongolia (P < 0.05). The area under the curve was 0.819, and the calibration curve showed that the predicted values were basically consistent with the measured values. Conclusions Internet addiction among junior high school students in Inner Mongolia is related to students' living environment and substance abuse behavior. Attention should be paid to the living environment of junior high school students and strengthen the preventive education of substance abuse in order to reduce the occurrence of Internet addiction among junior high school students.

Functional near-infrared spectroscopy of the impact of childhood traumatic experiences on risky decisions in early adulthood

JI Shanling, WANG Yan, CHEN Yuzhou, DU Yuxin, JIA Siqi, LIN Xinyu, LIU Bingqian, SU Maoxuan, WANG Rui, WANG Yue, YU Hao

2024, 45(10): 1460-1464. doi: 10.16835/j.cnki.1000-9817.2024319

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Objective To investigate the impact of childhood traumatic experiences on individual risk-taking decisions in early adulthood using functional near-infrared spectroscopy (fNIRS), so as to provide the reference for clarifying the brain mechanisms underlying the impact of childhood trauma on individual risky decision. Methods From December 2023 to March 2024, 28 children with childhood trauma experiences (trauma group) and 32 healthy college students (control group) were selected from Jining Medical University by a combination of stratified descent and convenient sampling methods. All subjects participated in the Iowa Game task fNIRS scanning. The brain activation, functional connectivity, graph theory properties (degree centrality, betweenness centrality, and local efficiency), and Receiver Operating Characteristic (ROC) analysis were performed by using pre-processing fNIRS data. Results Compared with control group, trauma group showed significantly fewer choice times in the inferior deck (Z=-0.88), and showed significantly decreased activation levels in the right frontalpolar (Z=-2.59), as well as showed significant decreased functional connectivity between left dorsolateral prefrontal and in right dorsolateral prefrontal (Z=-3.78), and between left dorsolateral prefrontal cortex and the right frontal pole (Z=-3.68)(P < 0.05). The central index of right inferior frontal gyrus in the trauma group was higher than that in the control group, while the central index of left and right dorsolateral frontal lobes was lower than that in the control group (Z=2.13, -2.53, -2.12, P < 0.05). The centrality index of the right inferior frontal gyrus in the trauma group was higher than that in the control group (Z=2.47, P < 0.05). The local efficiency indicators of the right inferior frontal gyrus, left and right frontal pole in the trauma group were higher than those in the control group (Z=2.51, 2.17, 2.53, P < 0.05). The results of the ROC curve analysis showed that the local efficiency achieved the highest area under the curve (AUC=0.68). Conclusions Young adults with childhood trauma experience tend to choose lower loss, and the frontal pole shows a lack of activation in the whole process of risk decision performance. The abnormalities in the brain connectivity and network properties might be the neural basis of excessive defense mechanisms that childhood trauma leads to risky decisions.

Association between sleep and depressive symptoms among primary and secondary school students

YUAN Yayun

2024, 45(10): 1465-1470. doi: 10.16835/j.cnki.1000-9817.2024301

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Objective To understand the sleep status of primary and secondary school students in China and its relationship with depressive symptoms, so as to provide scientific evidence for improving their sleep status and reducing the incidence of depressive symptoms. Methods Data of 4 232 primary and secondary school students come from China Family Panel Studies (CFPS) data of 2018 and 2020. Sleep status was measured by using self-reported questionnaire, and depressive symptoms was measured by using the Center for Epidemiologic Studies Depression Scale-8 Items (CES-D8). Variance analysis, χ² test, multiple linear regression analysis (MLR) and restricted cubic spline models (RCS) were conducted to analysis the association of sleep status and depressive symptoms among primary and secondary school students. Results From 2018 to 2020, the average sleep duration on weekdays and on weekends among primary and secondary school students was (7.96±1.38) and (9.30±1.51)h, respectively. The prevalence of insufficient sleep was 42.75%, 11.41%. A total of 1 921 students (45.39%) had a nap, 567 (13.40%) students napped >1.0 h/d. A total of 2 997 students (70.82%) caught up sleep on weekends, 595 (14.06%) caught up sleep >2.0 h/d. MLR showed that insufficient sleep on weekdays, insufficient sleep on weekends, catching up >2.0 h/d on weekends were risk factors for depressive symptoms of primary and secondary school students (β=0.40, 0.39, 0.41, P < 0.05). RCS showed that sleep duration at night, and napping duration had nonlinear dose-response relationships with depressive symptoms (P_trend < 0.05, P_non-linear < 0.05), with optimal durations of 9.0 h, 10.0 h, and 40 min. Conclusions Insufficient sleep at night, inappropriate napping duration and inappropriate weekend catch-up sleep duration are risk factors for depressive symptoms of primary and secondary school students. It is necessary to actively change bad sleep behaviors to reduce the risk of depressive symptoms.

Analysis of pediatric flexible flatfoot screening and associated factors among children aged 7-8 in Changzhou City

DAI Xiaoyu, FENG Keshu, XU Chenyang, ZHANG Yige, DING Kai, ZHAO Yiwen, WANG Yirong, LI Xuefei, DING Wenge

2024, 45(10): 1471-1475. doi: 10.16835/j.cnki.1000-9817.2024285

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Objective To analyze the prevalence and related factors of pediatric flexible flatfoot (PFF) among 7-8-year-old children in Changzhou, so as to provide a feasible basis for the prevention and treatment of PFF. Methods From December 2023 to February 2024, a total of 1 685 children aged 7-8 from 10 primary schools in Changzhou were selected by stratified cluster random sampling method, and screened for PFF by using a foot optical assessment recording device. Information including sex, body mass index (BMI), diet, exercise and shoe-wearing habits were collected. The valgus angle of the hindfoot was measured on the body surface by using an orthopedic measuring ruler in the standing position. Pain levels were evaluated by using visual analogue score (VAS) for children with flatfoot syndrome. Multivariate Logistic analysis was used to analyze related factors of PFF. Results The overall detection rate of PFF was 27.4%, and there was a significant difference in the detection rate of PFF between boys and girls, with 30.3% and 24.1% respectively (χ²=7.96, P < 0.01). Most cases of PFF were mild flatfoot (60.8%) and bilateral (60.4%). Approximately 13.2% of children with PFF had flatfoot syndrome, with a mean VAS of (2.86±0.73). About 56.1% of children with PFF had a normal valgus angle of the hindfoot. Sex, high BMI and preference for shoe last with front upturned shoe shape were positively correlated with the detection of PFF (OR=1.74, 1.54, 1.13, P < 0.05). After stratified by sex, regular exercise in boys and age in girls were negatively correlated with the detection of PFF (OR=0.40, 0.64, P < 0.05). Conclusions The detection rate of PFF in 7-8-year-old children is high. Additionally, PFF combined with flatfoot syndrome or valgus hindfoot is relatively rare and is likely to be underestimated, which emphasizes the importance of early detection and intervention for PFF.

Epidemic characteristics and spatial distribution of vomiting and diarrhea outbreaks in schools and kindergartens in Shanghai from 2015 to 2019

GONG Xiaohuan, XIAO Wenjia, ZHENG Yaxu, LIN Sheng, YU Xiao, WU Huanyu, CHEN Jian, PAN Hao

2024, 45(10): 1476-1480. doi: 10.16835/j.cnki.1000-9817.2024292

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Objective To retrospectively analyze the epidemic characteristics and spatial distribution of vomiting and diarrhea outbreaks in schools and kindergartens in Shanghai from 2015 to 2019, so as to provide the scientific evidence for optimizing prevention and control of vomiting and diarrhea outbreaks in schools and kindergartens. Methods Data collection and analysis were carried out on the vomiting and diarrhea outbreaks reported to Shanghai Municipal Center for Disease Control and Prevention from 2015 to 2019. Epidemiological characteristics were analyzed and compared. The proportion and incidence of outbreaks in schools and kindergartens were calculated, and the influencing factors of outbreaks were analyzed by multivariate Logistic regression. The index of Moran's I was used for the global and local spatial auto-correlation analysis. Results Among the 344 vomiting and diarrhea outbreaks, 98.26% occurred in kindergartens, primary schools, middle schools and other educational institutions. The median number of cases per outbreak was 15. The number of suspected outbreaks and the percentage of cases involved peaked in 2015 (60.00%, 84.35%) and then decreased year by year to 16.00% and 38.80% in 2019. About 86.98% of the outbreaks were transmitted by human-to-human contact. Among the 329 outbreaks with samples collected from cases and/or environments, the main pathogen detected was norovirus (n=280), and sapovirus was detected in outbreak for the first time in 2016. The outbreaks showed obvious seasonality, with two peaks (November, March) and one trough (July), and the majority of outbreaks occurred in primary schools (44.38%) and kindergartens (32.84%). Compared with kindergartens, the probabilities of suspected epidemic outbreaks in primary schools, combined schools, middle schools and other educational institutions were higher (adjusted OR=6.40, 9.16, 12.64, 5.58, P < 0.01). The proportion and incidence of outbreaks in educational institutions in different districts showed no high-high aggregation areas. Conclusions Primary schools and kindergartens are key places for the prevention and control of vomiting and diarrhea outbreaks. Targeted prevention and control measures should be strengthened at the beginning of each semester and before the peak of the epidemic each year. Timely reporting of symptoms, suspension of school admissions after symptoms appear and standardized disposal of vomit are effective measures to reduce interpersonal transmission and control the scale of an outbreak.

Network analysis of the association between adverse childhood experiences and mental health status in college students

LIU Ailou, ZHAI Ruyue, ZHANG Libin

2024, 45(10): 1481-1485. doi: 10.16835/j.cnki.1000-9817.2024303

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Objective To investigate the relationship between adverse childhood experiences (ACEs) and mental health status through network analysis in college students, so as to provide empirical evidence for the development of targeted intervention programs. Methods From October to November 2023, a survey was conducted on 1 974 college students from three universities in Hubei Province by using ACEs Questionnaire and Symptom Checklist-90 (SCL-90). The network analysis method was used to construct a network structure to analyze the association between ACEs and SCL-90 symptom factors among college students. Results The network structure of SCL-90 symptom factors and ACEs was stable, each forming a relatively tight cluster; there were 89 non-zero edges between ACEs and SCL-90 symptom factors. Emotional neglect-depression played a significant pathway role in connecting the ACEs and SCL-90 symptom factors network. Depression, anxiety, and interpersonal sensitivity of SCL-90 symptom factors had the highest centrality in the ACEs and SCL-90 symptom factors network. Emotional neglect and physical neglect in ACEs and depression and psychoticism in SCL-90 symptom factors had a high node bridge expected influence, acting as Touchpoints to activate the whole network. Conclusion Early identification and intervention of emotional and physical neglect, with a focus on depression, anxiety, and interpersonal sensitivity symptoms of childhood neglected individuals, which is beneficial for improving the overall mental health level of college students.

Association between strength quality with comorbid depressive and anxiety and its subtypes among junior high school students in Jiangxi Province

YU Liang, ZHAI Zhankui, JIANG Jing, SHA Mian, CHEN Zhongli

2024, 45(10): 1486-1491. doi: 10.16835/j.cnki.1000-9817.2024307

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Objective To analyze the association of strength quality of junior high school students with comorbid depressive and anxiety (CDA) and its subtypes, so as to provide reference for mental health improvement among junior high students. Methods A convenient sampling method was used to select 10 007 junior high students aged 13-16 from four cities (Nanchang, Ganzhou, Jiujiang, Shangrao) in Jiangxi Province during September to November 2023. A questionnaire survey and physical fitness tests were employed to collect basic information and assess students' depressive and anxiety status, as well as strength quality. The χ² test was used to compare the distribution differences of CDA and its subtypes among different demographic characteristics, sleep, physical activity, and overweight/obesity conditions. Logistic regression models were applied to infer the association strength between strength quality and CDA and its subtypes. Results The overall detection rate of CDA among junior high students was 11.04%. Among the CDA subtypes, the detection rates for mild depression-mild anxiety type, anxiety-dominant type, depression-dominant type, and severe depression-severe anxiety type were 3.67%, 3.35%, 0.39% and 3.64%, respectively. Compared to the grip strength and standing long jump scores in the >P₇₅ group, the risk of CDA occurrence increased in other groups (grip strength: P₂₅-P₇₅, OR=1.20; < P₂₅, OR=1.28; standing long jump: P₂₅-P₇₅, OR=1.31; < P₂₅, OR=1.51; P < 0.05). In stratified analysis of different CDA subtypes, compared to the grip strength >P₇₅ group, the risks for mild depression-mild anxiety type increased in the P₂₅-P₇₅ and < P₂₅ groups (OR=1.32, 1.44, P < 0.05). Compared to the standing long jump >P₇₅ group, the risks for anxiety-dominant type and severe depression-severe anxiety type increased in other groups (anxiety-dominant type: P₂₅-P₇₅, OR=1.32; severe depression-severe anxiety type: < P₂₅, OR=1.87; P < 0.05). Conclusions Lower levels of grip strength and standing long jump performance among junior high students are positively correlated with CDA and its subtypes. Lower levels of lower limb strength may be an important predictor of CDA in severe depression and anxiety.

Relationship between classroom environment in primary and secondary schools and screening myopia in Shaanxi Province

LI Minmin, ZHAO Jingjun, WANG Yanxin, MI Baibing, HE Wenxiang, SHI Wei

2024, 45(10): 1492-1496. doi: 10.16835/j.cnki.1000-9817.2024298

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Objective To understand the correlation between classroom environment in primary and secondary schools in Shaanxi Province with students' myopia, so as to provide the reference for the development of effective strategies for myopia prevention and control in children and adolescents. Methods From November 2022 to March 2023, primary and secondary schools were selected from all districts and counties in 10 cities in Shaanxi Province by a stratified cluster random sampling method. A total of 386 classrooms received environmental hygiene evaluation, and 3 760 students underwent visual examinations using logarithmic visual acuity chart and non dilated computer optometry, as well as questionnaire surveys. The association between classroom environment in primary and secondary schools and screening myopia in students were analyzed by the Logistic regression model. Results A total of 2 299 primary and secondary school students were screened for myopia, with a detection rate of 61.14%. After adjusting factors such as gender, academic stage, sleep time, outdoor activity time, electronic mobile device usage time and homework time after school, the results of multiple Logistic regression analysis showed that the risk of screening myopia among students with unqualified average illuminance on blackboard and uniformity ratio of illuminance of blackboard was 1.24 times (OR=1.24, 95%CI=1.08-1.43) and 1.31 times (OR=1.31, 95%CI=1.06-1.60) higher than that of qualified classrooms respectively (P < 0.05). Subgroup analysis showed that the risk of screening myopia detected by boys in classrooms with unqualified blackboard illumination was 1.26 times (OR=1.26, 95%CI=1.04-1.54) than that of qualified classrooms, the risk of screening myopia detected by girls in classrooms with unqualified blackboard size was 1.55 times (OR=1.55, 95%CI=1.19-2.02) and unqualified blackboard illumination uniformity was 1.38 times (OR=1.38, 95%CI=1.01-1.89) higher than that of qualified classrooms (P < 0.05). Conclusions Teaching environment health of primary and secondary schools in Shaanxi Province need to be improved. The risk increasing of screening myopia among students is related to the size of the blackboard, average illuminance on the blackboard surface and uneven illuminance.

Detection of group A streptococcus in scarlet fever cluster outbreaks in schools in Tianjin City

DONG Xiaochun, LI Lin, ZHANG Ying

2024, 45(10): 1497-1499. doi: 10.16835/j.cnki.1000-9817.2024286

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Objective To investigate the infection status of group A streptococcus (GAS) among scarlet fever cases within the same class in schools experiencing clustering outbreaks and to analyze the factors associated with GAS detection, so as to provide a reference for the prevention and control of scarlet fever. Methods All the classes with scarlet fever cases in schools reporting the clustering outbreaks of scarlet fever in Tianjin in 2023 were selected, and a total of 528 pharyngeal swab samples were collected from other students in the class for GAS isolation and identification except for the 97 patients. Conditional Logistic regression was used to analyze the influencing factors of GAS detection. Results The overall positive rate of GAS among students in 15 classes from 12 clustering outbreaks with scarlet fever was 21.02%. There was a positive correlation between the positive rate of GAS detection in the class and the number of scarlet fever cases in the class (r=0.82, P < 0.01). The results of conditional Logistic regression analysis showed that pharyngeal pain (OR=2.53, 95%CI=1.61-3.99) and tonsillar enlargement (OR=1.90, 95%CI=1.15-3.14) of the sampled students were more likely to detect GAS positivity (P < 0.05). Conclusions In the clustered outbreak of scarlet fever in schools, students with sore throat and swollen tonsils who are in the same class as the case are more likely to be detected with GAS. During a school scarlet fever cluster outbreak, students with sore throat and swollen tonsils should be closely monitored and managed similarly to confirmed cases. At the same time, identifying close contacts in the affected class should not be restricted to those seated directly around the case.

Core competence of school health teachers with medicine-education integrated background

HOU Xiaojing, FENG Shiying

2024, 45(10): 1500-1504. doi: 10.16835/j.cnki.1000-9817.2024317

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Objective To understand towards core competence of integrated medicine-education health teachers of graduates with undergraduate major of health education in China, so as to provide evidence for improving the quality of teaching workforce. Methods From January to May 2023, a questionnaire survey was conducted on 92 primary and secondary school health teachers who graduated from Sanda University. All the participants reported the achievement of core competence after graduation, the performance of core competence at present and the importance of competencies. Group comparisons were conducted by using t-test or analysis of variance, while open-ended questions were analyzed by using word cloud analysis. Results In the nine dimensions of core competency, the top three dimensions among scores of achievement and performance were general quality as a teacher, emergency response to accidents(4.52±0.59, 4.38±0.61, 4.32±0.70), and prevention and control of public health events in schools (4.58±0.55, 4.49±0.62, 4.50±0.61). Compared with the achievement after graduation, the mean score of the current performance of core competence has increased in all dimensions except for basic health education literacy (t=2.28-4.69, P < 0.05). Among them, the rank of Basic Literacy of Health Education decreased significantly compared to graduation time (ranking down from 5th to 8th), and School Health Management and Improvement increased significantly (ranking up from 8th to 5th). There were no statistically significant differences in the achievement and the current performance scores of the core competence among graduates with different graduation years (F=0.56-1.45, 0.73-1.23, P>0.05). According to the respondents, the most important competencies were associated with emergency response to accidents, prevention and control of infectious diseases, identification and management of common disease symptoms, and teachers' moral cultivation. Conclusions The development of core competencies for healthcare teachers in integrated medical and educational schools is not yet balanced, the core competency performance of graduates with major of health education varied significantly by graduation time. Medical related abilities and professional ethics are considered the most important core competencies for graduates.

Association of health risk behaviors with obesity and depressive symptoms in middle school students

SUN Zhiying, ZHANG Xianwei, YUAN Wen, DONG Yanhui, XU Ke, ZHAO Saisai, CHEN Lu, LIU Zhonghui

2024, 45(10): 1505-1510. doi: 10.16835/j.cnki.1000-9817.2024304

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Objective To investigate the tendency of obesity and depressive symptoms in middle school students in Tianjin, so as to provide a reference for exploring the clustering patterns of health risk behaviors and their effects on obesity and depressive symptoms. Methods A stratified cluster sampling method was used to investigate the obesity, depressive symptoms and health risk behaviors of middle school students from 16 counties of Tianjin from 2019 to 2023. The latent classes analysis was used to classify health risk behaviors. The χ² test and Logistic regression were used to analyze the effects of different categories on obesity and depression symptoms. Results The obesity detection rate of middle school students in Tianjin from 2019 to 2023 first increased (20.90% in 2019, 23.35% in 2020) and then decreased and gradually stabilized (2021-2023:22.20%-22.69%), and the detection rate of depressive symptoms showed a decreasing trend (from 21.65% to 14.92%). The detection rate of comorbidity of obesity and depressive symptoms first increased (4.62% in 2019, 4.66% in 2020) and then gradually decreased to 3.43% in 2023, and the rate was higher in boys than in girls and higher in urban areas than in suburban areas. Latent category analysis classified health risk behaviors into four categories: lack of exercise group, poor behaviors such as sleep group, poor diet group and healthy group. After adjusting for demographic characteristics, the results of Logistic regression analysis showed that the co-occurrence risk of obesity and depression symptoms among the top three groups of middle school students were 1.35(OR=1.35, 95%CI=1.15-1.58), 4.20(OR=4.20, 95%CI=3.50-5.04), and 1.84(OR=1.84, 95%CI=1.40-2.38)times, compared to the healthy group (P < 0.05). Conclusions From 2019 to 2023, the comorbidity rate of obesity and depression among middle school students in Tianjin increased first and then decreased gradually. Interventions should be made in the aspects of exercise, diet, sleep and other behaviors.

Research progress on the impact of complex systems in sport on mental health among primary and secondary school students

XIA Shuhua, YIN Shizhen, PENG Yulin

2024, 45(10): 1511-1515. doi: 10.16835/j.cnki.1000-9817.2024306

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Mental health education of adolescents has received lots attention, while complex systems in sport are of great significance for promoting mental health of primary and middle school students. By comprehensively analyzing relevant findings, the paper discusses the effects of complex systems in sport on mental health problems of primary and middle school students, especially depression, anxiety, sleep, cognition, and social ability, and explores possible strategies associated with complex systems in sport to promote mental health of primary and middle school students, aiming provide data for effective sports health education among school teachers.

Evaluation methods and applications of cardiovascular health in children and adolescents

HU Jiale, WANG Xi, LÜ Huiling, HU Jia, SHEN Hui

2024, 45(10): 1516-1520. doi: 10.16835/j.cnki.1000-9817.2024315

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Cardiovascular disease is the leading cause of death and disease burden in China and worldwide. The state of cardiovascular health in childhood and adolescence has been shown to be a strong predictor of cardiovascular health in adulthood. The study summarizes current state of cardiovascular health evaluation methods in children and adolescents, including Life's Simple 7, Life's Essential 8, and the aggregation of cardiovascular risk factors; and relevant indicators include diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood pressure, blood glucose, and the application of evaluation methods, so as to provide insights for the development of cardiovascular health evaluation methods applicable to children and adolescents in China.

2024 Vol. 45, No. 10