中国学校卫生

Constructing a high-level school health system to facilitate joint prevention practice of common diseases among students

DONG Yanhui, CHEN Lu, MA Jun, SONG Yi

2024, 45(5): 609-614. doi: 10.16835/j.cnki.1000-9817.2024160

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Currently the school health system in China is transitioning from basic safeguarding to comprehensive health management and has been elevated to a national strategic level. However the diversification of students' health issues and the imbalance in resource allocation remain major challenges. To address issues such as adolescent myopia obesity spinal curvature mental health and infectious diseases there is an urgently need to build a high-level school health system that encompasses multiple aspects such as resource allocation optimization professional skill enhancement and health education improvement. Simultaneously it is need to deepen the research and implementation of common disease prevention strategies for students. It will play a vital role in promoting the construction of Healthy China the modernization of education and the establishment of a high-quality disease control system.

Building an integrated mental health education system in schools

LI Xiongying, BAIERNA·Alifu, TAN Chenxi

2024, 45(5): 615-619. doi: 10.16835/j.cnki.1000-9817.2024151

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The psychological development of students is characterized by continuity and discontinuity. At the same time, the psychological development of students in different academic stages is interrelated and gradual. To promote mental health of children and adolescents, considering the widespread, high prevalence and frequent occurrence of students' psychological problems and lack of integrated connection of mental health education in different school stages, it is urgent to build a "five integration" mental health education system intergrating kindergarten, primary school, secondary school and university, which includes cognition integration, system integration, information integration, research integration, and management integration, aiming to unify our notion, goal, content and action, provide students with timely, professional and effective mental health services, prevent the occurrence of mental illnesses, as well as create positive psychological qualities.

Current status of regional school health work in Tianjin during 2019-2023

JIANG Jianuo, LIU Zhonghui, ZHANG Xianwei, SONG Xinli, ZHANG Yihang, DONG Ziqi, YUAN Wen, DONG Yanhui, CHEN Lu, SONG Yi, MA Jun

2024, 45(5): 620-625. doi: 10.16835/j.cnki.1000-9817.2024163

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Objective To explore the current status and progress of regional school health work to provide policy reference for school health improvement. Methods Survey data on school health work in Tianjin from 2019, 2021 and 2023 was used. School health staff allocation and expenditure of the health administrative department, CDC and education department, as well as the annual implementation of health education, prevention and control of common diseases and infectious diseases, sports activities and food nutrition in primary and secondary schools were analyzed. Statistical analysis was conducted using Kruskal-Wallis test, Chi-square test, and Fisher's exact test. Results The number of school health staff in the health commissions and education departments from 2019, 2021 and 2023 was relatively stable. Part-time staffs were often employed by health commissions while full-time staffs were mainly employed by education departments. The number of school health staff at CDCs increased gradually (H=12.65, P < 0.01). School health expenditure of administrative departments and schools in 2021 and 2023 increased significantly compared with that in 2019 (H=22.28, 23.75, P < 0.05). More than 95% of schools set up clinics or health care rooms, and about 97% of schools had school health technicians or health teachers. More than 90% of schools had health education courses over 4 hours per semester. The rate of mental health education increased by year (86.87%, 89.91%, 96.30%, Z=2.40, P < 0.05). Lack of courses regarded safety emergency and risk avoidance, growth and development, and adolescent health education. The provision rate of psychological counseling services (89.00%, 97.25%, 100.00%) and psychological problem prevention and control (56.12%, 71.56%, 81.48%) also increased by year (Z=3.83, 3.96, P < 0.01). The implementation rates of prevention and control of poor vision, dental caries, overweight and obesity were all higher than 80%, and the prevention and control rate of abnormal spinal curvature showed an increasing trend (38.78%, 77.06%, 72.22%, Z=4.87, P < 0.01). More than 90% of schools met the standard for physical education class hours, and the proportion of schools conducting at least 30 minutes of recess physical activities every day increased year by year (65.00%, 80.73%, 85.98%, Z=3.59, P < 0.01). All schools did not have shops. Conclusions School health work in Tianjin is effective and constantly developing. It is necessary to continue to increase the investment of human resources and expenditure in school health, explore the approaches of co-occurrence and prevention of common diseases, and improve the school sports and nutrition environment.

Comorbidity of myopia and scoliosis in primary and secondary school students and analysis of risk factors in school environment in Tianjin

ZHANG Xianwei, CHEN Lu, LIU Zhonghui, DONG Yanhui, SONG Yi, SUN Zhiying, XU Ke, ZHAO Saisai

2024, 45(5): 626-629. doi: 10.16835/j.cnki.1000-9817.2024162

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Objective To investigate the comorbidity of myopia and scoliosis among primary and secondary school students in Tianjin, and to analyze the school environment risk factors contributing to these health issues, so as to provide a scientific basis for development effective prevention measures. Methods A total of 41 654 primary and secondary school students from 16 districts of Tianjin were selected by stratified random cluster sampling from September to October 2023 to screen for myopia and scoliosis. Univariate analysis was performed to examine the data, followed by a bivariate multivariate Logistic regression model and cumulative effect analysis to explore the influencing factors of their comorbidity. Results In 2023, the prevalence of comorbidity of screening positive myopia and scoliosis among primary and secondary school students in Tianjin was 2.65%. The prevalence was higher in suburban areas (3.26%) compared to urban areas (2.02%), higher among females (3.81%) compared to males (1.59%), and highest in high school students (6.17%) compared to middle school (4.19%) and primary school students (0.44%) (χ²=62.23, 198.69, 953.19, P < 0.01). Logistic regression analysis showed that the number of physical education classes ≥3 per week, the number of eye health exercises at school ≥2 per day, outdoor activities between classes, teachers' reminding to pay attention to reading and writing posture and strict eye standing posture were negatively correlated with the comorbidity of screening positive myopia and scoliosis (OR=0.66, 0.77, 0.71, 0.78, 0.74, P < 0.05). Reading or electronic screen while lying or lying on the stomach was positively associated with the comorbidity of screening positive myopia and scoliosis (OR=1.77, P < 0.05). Cumulative effect analysis showed that the cumulative score (4-7, 7-9, ≥10) was negatively correlated with the comorbidity of screening positive of myopia and scoliosis (OR=0.65, 0.55, 0.52, P < 0.05). Conclusions The school environment support and students' personal behavior habits in school are related to the comorbidity of comorbidity of screening positive myopia and scoliosis. Prevention and control of myopia and scoliosis should improve the environmental factors related to students' health in school.

Relationship between lifestyle and the comorbidity of myopia and depressive symptoms among primary and secondary school students in Nanjing

LI Juntong, LIU Hui, YE Sheng, YANG Yue, LU Xuelei, LIU Li

2024, 45(5): 630-634. doi: 10.16835/j.cnki.1000-9817.2024146

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Objective To explore the relationship between lifestyle and myopia and depressive symptoms comorbidity among primary and secondary school students in Nanjing, so as to provide a scientific basis for developing effective prevention measures. Methods In October 2022, a stratified cluster random sampling method was used to select primary and secondary school students aged 9-19 years in 4 urban and 4 suburban districts in Nanjing as the research subjects. A total of 10 498 students were included for physical examination and questionnaire survey by using the student health condition and influencing factors questionnaire. Chi-square test was used for univariate analysis, and multi-factor Logistic regression analysis was used to analyze the relationship between students' lifestyle and the co-occurrence of myopia and depressive symptoms. Results The prevalence of comorbidity of screening positive myopia and depression among primary and secondary school students in Nanjing was 18.11%. The prevalence of comorbidity was higher in girls (20.97%) than in boys (15.47%), higher in boarding students (31.31%) than in non-boarding students (16.51%), and higher in high school students than in middle and primary school students (28.63%, 19.10%, 7.76%), with statistically significant differences (χ²=53.49, 149.31, 522.55, P < 0.01). Multivariate Logistic regression results showed that smoking (OR=1.51), drinking (OR=2.36), looking at electronic screens in dim conditions (OR=2.40), screen time ≥2 h/d(OR=1.50), after-school homework time ≥2 h/d(OR=1.48) were positively correlated with the prevalence of comorbidity of screening positive myopia and depressive symptoms, healthy diet (OR=0.67), outdoor activities during breaks (OR=0.80), sufficient sleep (OR=0.64), meeting physical activity standards (OR=0.74) and outdoor activity time ≥2 h/d(OR=0.84) were negatively correlated with the prevalence of comorbidity of screening positive of myopia and depressive symptoms (P < 0.05). Conclusions The lifestyle of primary and secondary school students in Nanjing is related to the comorbidity of myopia and depressive symptoms. Schools and families should carry out relevant education and intervention measures to promote students to develop good living habits and jointly prevent the occurrence of myopia and depressive symptoms.

Comorbidity of common illnesses and associated factors among primary and middle school students in Shanghai in 2021

HUANG Shenglei, ZHANG Fengyun, QU Shuangxiao, QI Wenjuan, HUANG Yuting, YANG Yanting, YANG Dongling, LUO Chunyan

2024, 45(5): 635-639. doi: 10.16835/j.cnki.1000-9817.2024135

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Objective To understand the current status and associated factors of comorbidity of common illnesses among primary and middle school students in Shanghai, so as to provide a reference for improving the pathogenic environment and preventing the occurrence of comorbidity of common illnesses. Methods From September to November 2021, a stratified cluster sampling method was used to select 30 331 middle school students from 112 schools in 16 districts of Shanghai, each with 2 primary schools, 2 junior high schools, 2 high schools and 1 vocational high school. Elementary school students, their health status and influencing factor questionnaires were analyzed. Results The detection rate of two or more common diseases such as myopia, overweight and obesity, high blood pressure, and abnormal spinal curvature among primary and secondary school students in Shanghai was 38.91%, of which 29.64% of primary and secondary school students had two diseases at the same time, and 9.19% had three diseases, 0.09% had 4 diseases. The detection rate of comorbidity was higher in boys (44.12%) than in girls (33.40%), and higher in junior high school students (40.40%) than in high school students (38.58%) and primary school students (38.01%). The differences were statistically significant (χ²=366.44, 50.33, P < 0.01). Multi-factor Logistic regression analysis showed that girls sometimes supervise themselves and often remind themselves that their sitting and standing postures were negatively correlated with the common comorbidities of primary and secondary school students (OR=0.64, 0.93, 0.90); junior middle school students and watching TV/d ≥1 h, using computers for ≥1 h/d, and using mobile electronic devices for >1 h/d were positively correlated with the comorbidity of common diseases among primary and secondary school students (OR=1.07, 1.10, 1.06, 1.10) (P < 0.05). Conclusions The prevalence of comorbidity of common illnesses among primary and middle school students in Shanghai is not optimistic, which might be associated with combined effects of various external environmental factors. Targeted intervention should be implemented to effectively prevent the occurrence of comorbidities among students.

Associations of sleep quality trajectory and social jetlag with comorbid symptoms of anxiety and depression among college students

XIANG Bo, NIU Yaqian, LI Tingting, XIE Yang, TAO Shuman, YANG Yajuan, ZOU Liwei, TAO Fangbiao, WU Xiaoyan

2024, 45(5): 640-643. doi: 10.16835/j.cnki.1000-9817.2024161

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Objective To describe the prevalence and the association of sleep quality trajectory, social jetlag and comorbid symptoms of anxiety and depression among college students, in order to provide a theoretical basis for improving the comorbid symptoms of anxiety and depression in college students. Methods A questionnaire survey was conducted among 1 135 college students from two universities in Shangrao, Jiangxi Province and Hefei, Anhui Province from April to May 2019, and were followed up once every one year for a total of three times, with a valid sample size of 1 034 individuals after matching with the baseline survey. A self-assessment questionnaire was used to investigate the social jetlag of college students, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire 9 (PHQ-9) were used to evaluate anxiety and depression symptoms, respectively, while the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. College students with GAD-7 score ≥5 and PHQ-9 score ≥5 were defined as having comorbid anxiety and depression symptoms. Latent class growth model (LCGM) was employed to analyze the sleep quality trajectory of college students, and binary Logistic regression was used to analyze the relationship between social jetlag, sleep quality trajectory and comorbid symptoms of anxiety and depression. Results The detection rate of comorbid symptoms of anxiety and depression among college students was 16.9%, and the detection rate of social jetlag ≥2 h was 13.8%. The sleep quality showed an overall improvement trend, and the two trajectories were good sleep quality (81.6%) and poor sleep quality (18.4%). Binary Logistic regression model showed that poor sleep quality and social jetlag ≥2 h were positively correlated with comorbid symptoms of anxiety and depression (OR=5.94, 1.84, P < 0.05). Conclusions Poor sleep quality and social jetlag ≥2 h in college students increase the risk of comorbid symptoms of anxiety and depression. Early screening and intervention of sleep quality and reduction of social jetlag are crucial for enhancing the mental health of college students.

Associations between physical fitness and comorbidity of problematic mobile phone use and depression among first-year students of a medical college in Jiangsu

YANG Weiwei, PENG Xianzhen, WANG Danhua, XU Jida, REN Jiacui

2024, 45(5): 644-648. doi: 10.16835/j.cnki.1000-9817.2024143

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Objective To exploring the associations of the physical fitness index with depression, problematic mobile phone use, and comorbidity, so as to provide references for exploring the comorbidity co-cause and co-prevention of mobile phone dependence and depression symptoms among adolescents. Methods A stratified cluster random sampling method was used to select 1 984 first-year students at two medical colleges in Jiangsu Province from October to November in 2021. The Patient Health Questionnaire-9 (PHQ-9) and Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) were used to evaluate the risk of depression and symptoms of problematic mobile phone use. Tests included grip strength, standing long jump, 50 m running, modified sitting forward flexion, 20 s repeated traverse, 1 min sit-ups, 20 m round-trip running (20 m SRT), and 800/1 000 m run. Binary Logistic regression analysis was used to explore the associations of the physical fitness index with depression and problematic mobile phone use, and mediating effects were analyzed. Results The overall detection rates were 28.63% for depression symptoms, 24.95% for problematic mobile phone use, and 13.65% for comorbidity. Compared with students without depressive symptoms, students without mobile phone dependence, and students without comorbidity[0.08(-1.84, 2.06), 0.14(-1.84, 2.06), 0.15(-1.82, 2.12)], students with depressive symptoms[mild: -0.03(-1.91, 1.41), moderate: -0.22(-3.17, 2.37), severe: -1.62(-3.33, -0.16)], mobile phone dependence[-0.45(-2.17, 1.06)], and their comorbid symptoms [no depression and mobile phone dependence: 0.06(-1.98, 1.54), depression without mobile phone dependence: -0.37(-2.21, 1.17), both: -0.52(-2.17, 0.97)] had lower physical fitness index (Z/H=4.40, 20.84, 20.80, P < 0.01). The risk of depression and problematic mobile phone use, and the co-morbidity detection rate in the higher physical fitness index group were lower than those in the lower physical fitness index group [OR(95%CI)=0.61(0.47-0.80), 0.62(0.48-0.79), 0.65(0.47-0.91), P < 0.05]. Analysis of mediating effects indicated that problematic mobile phone use had an indirect effect (indirect effect=0.014) on the physical fitness index and depression, and accounted for 36.84% of the total effect. Conclusions The physical fitness index is associated with depression, problematic mobile phone use, and comorbidity. Physical exercise and physical fitness efforts should be strengthened to prevent the occurrence of mobile phone dependence, depression, and comorbidity.

Nutritional literacy of school-age children in grades 4-9 and its relationship with physical health in Guizhou Province

XIE Jingcheng, WANG Huiqun, YU Huixian, LIU Tao, HE Lin, LIU Yiya, LIU Jing

2024, 45(5): 649-653. doi: 10.16835/j.cnki.1000-9817.2024145

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Objective To understand the level of nutritional literacy and its influencing factors among school-age children in grades 4-9 in Guizhou Province, and to explore the relationship between nutritional literacy and physical health, so as to provide reference for improving nutritional literacy and physical health of school-age children. Methods Using multi-stage stratified cluster sampling method, 1 155 school-age children in grades 4-6 in elementary school and grades 7-9 in secondary schools in three prefectural and municipal cities of Guizhou Province (Zunyi, Tongren, and Bijie) were sampled from February to July 2023, and were surveyed for nutritional literacy by using the "Food and Nutritional Literacy Questionnaire for Chinese School-age Children", and their physical health data (data on body measurement indicators, such as height, weight, lung capacity, and vertical jump) were obtained from the physical health surveillance platform. Pearson correlation analysis and binary Logistic regression modeling were used to explore the association between nutritional literacy and physical health. Results The nutritional literacy score of the study population was (63.50±8.63), and the scores of each level of nutritional literacy in descending order were interactivity (66.09±13.99), functionality (63.84±8.80), and criticism (61.15±14.65); and the scores of cognitive domain of nutritional literacy, and skill domain were (64.71±10.77) (62.97±9.21); food selection, food preparation, and food intake dimension scores were (64.68±13.52) (56.39±12.17) (63.63±10.04), respectively. Differences in the total nutritional literacy scores of school-aged children who were only children or not, by gender, ethnicity, grade level, primary caregiver, primary caregiver's education, and family economic situation were statistically significant (t/F=2.88, -3.28, 5.02, 18.32, 4.67, 32.47, 32.53, P < 0.05); the physical health pass rate was 85.8%, and the mean scores of the total physical health score, physical form, physical function, and physical fitness dimensions were (71.86±10.52) (93.29±12.06) (72.12±14.42) (67.26±13.13), respectively; after controlling for confounders, the nutritional literacy scores were positively correlated with physical health (OR=1.03, 95%CI=1.01-1.05, P < 0.05). Conclusion Nutritional literacy scores of school-age children in grades 4-9 in Guizhou Province are low, and there is a positive correlation between nutritional literacy and physical health in this school age children.

Status of exposure to television advertising of sugar sweetened beverages among children and adolescents in Beijing

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

2024, 45(5): 654-658. doi: 10.16835/j.cnki.1000-9817.2024134

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Objective To investigate the exposure to television advertising of sugar sweetened beverages and the use of persuasive marketing techniques among children and adolescents in Beijing, so as to provide evidence for reduing children's intake of sugar sweetened beverages. Methods From October 19, 2020 to November 16, 2021, 32 days were randomly selected. The top four popular channels of children and adolescents aged 3-18 years were defined. Each channel was monitored from 6:00:00 to 23:59:59 for each date. A total of 2 304 h was recorded. Advertisements involving sugar sweetened beverages broadcast before, during or after the program were included. The frequency and the use of persuasive marketing techniques were analyzed. Results A total of 1 237 advertisements for sugar sweetened beverages were included, of which 50.93% were dairy beverages, 28.38% were tea-based beverages, and 19.48% were vegetable protein beverages. The average frequency of sugar sweetened beverages advertisements on every channel was (0.62±1.29)piece/h. The frequency of sugar sweetened beverages advertisements on every local channel [(1.04±1.35)piece/h] and children's channel [(1.11±1.61)piece/h] was separately higher than every national channel [(0.48±1.24)piece/h] and general channel [(0.12±0.48)piece/h] (t=-14.05, 31.64, P < 0.01). There were seasonal differences in television advertising of sugar sweetened beverages, and were more frequent during lunch and dinner times. The most frequently used persuasive marketing techniques were "images of children" (74.54%), "nutritional message" (61.76%), "product composition details" (58.61%), "nutrition claim" (57.24%), and "nutrition function claim or other function claim" (53.11%). Conclusions Children and adolescents are often exposed to television advertisement of sugar sweetened beverages on children's channels and during meal times. There is an urgent need to formulate relevant policies to regulate the marketing of sugar sweetened beverages advertisement and reduce children and adolescent's intake.

Sexual knowledge, sexuality education and related factors among secondary vocational school students

JIA Xin, FANG Yuhang, JIN Yan, ZUO Xiayun, YU Chunyan, LIAN Qiguo, LI Lihe, HONG Ping, TU Xiaowen

2024, 45(5): 659-664. doi: 10.16835/j.cnki.1000-9817.2024131

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Objective To understand sexual and reproductive health knowledge, access to sexuality education and associated factors among secondary vocational school students in Shanghai Municipality and Shaanxi Province, so as to provide a scientific basis for conducting sexuality educaiton in vocational schools. Methods A cross-sectional survey was conducted among 3 180 students in grades 1-3 selected by cluster sampling during April to June 2021 in six secondary vocational schools from three cities of Shanghai and Shaanxi (Shangluo, Ankang, Baoji). Participants were investigated through online questionnaire survey, inlcuding demographic characteristics, household information, sexual health at home and school, knowledge on sexual and reproductive health. Both t test and Chi-square test were used for group comparisons, and multivariate ordial Logistic regression was used to explore possible risk factors for sexual and reproductive health score in quartiles. Results Respondent's average score was (51.36±21.61), with the highest score on sexual harassment/sexual abuse (66.45±42.27) and the lowest score on reproduction and physiology (47.67±31.94) and contraception (43.85±26.81). Although significant differences were observed between two study sites, the primary source of knowledge in both sites was schools/teachers, followed by the Internet or friends; the main theme of school sexuality education was puberty development and health care (more than 80%); the most frequently reported topic between respondents and their parents in both sites was interpersonal relationships (more than 55%), and there were significant differences in the reporting rates of secondary vocational school students between the two regions(χ²=28.56, 32.02, P < 0.05). The results of multivariable Logistic regression analysis showed that residential area, gender, grade, registered residence, number of sexual related topics communicated with parents, number of subjects received from school sexuality education, and reported information sources from classmates/friends, books/magazines/newspapers, internet and communities were related to knowledge level of respondents (OR=1.62, 0.72, 1.20, 1.58, 2.09, 1.17, 1.18, 1.66, 1.62, 1.69, 1.22, P < 0.05). Conclusions Vocational students of Shanghai and Shaanxi have poor sexual and reproductive health knowledge and limited access to school and family sexuality education. It is necessary to strengthen sexuality education for secondary vocational school students.

Family food environment and related factors of primary and secondary school students in Tongzhou District, Beijing

JIANG Nan, LEI Yuchen, WU Yanfang, SUN Wentao

2024, 45(5): 665-668. doi: 10.16835/j.cnki.1000-9817.2024147

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Objective To understand family food environment and its associated factors of primary and secondary school students in Tongzhou District, so as to provide reference for the improvement of family food environment of primary and secondary school students in Tongzhou District. Methods From 2021 to 2023, a stratified cluster sampling method was used to conduct a questionnaire survey on 1 485 families of students from 11 schools in Tongzhou District. Single Factor Analysis of Variance (ANOVA) was used to compare the differences in family food environment across different demographic background, and the associated factors were analyzed by the multiple binary Logistic regression model. Results The average score of family food environment of primary and secondary school students in Tongzhou District was 64.32(12.28) points, and the total compliance rate (≥60 points) was 67.41%. The score of family feeding pattern [58.33 (11.11) points] and the compliance rate (42.76%) ranked the bottom among the five dimensions of family food environment. Rural families (OR=1.78, 95%CI=1.41-2.25), junior high schools (OR=1.42, 95%CI=1.07-1.87), senior high schools (OR=2.28, 95%CI=1.73-3.00), single-parent families (OR=1.89, 95%CI=1.15-3.10) and obese parents (OR=1.81, 95%CI=1.23-2.65) had a higher risk of substandard family food environment (P < 0.05). Conclusions Family food environment of primary and secondary school students in Tongzhou District is not optimistic, family feeding mode needs to be improved. Attention should be paid to the family food environment, so as to effectively promote healthy growth of children and adolescents.

Meta-analysis of the effects of sports participation on adolescent aggressive behavior

LIU Dongfei, LI Baoguo, CHEN Jinlan, LU Xuanjun, JIANG Yucheng, ZHAO Zhimin

2024, 45(5): 669-673. doi: 10.16835/j.cnki.1000-9817.2024152

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Objective To explore the relationship between adolescent sports participation and aggression, so as to provide a reference basis for sports interventions aimed at reducing adolescent aggression. Methods The search databases used in the study included China National Knowledge Infrastructure, Vipo, Wanfang, Web of Science, Ebsco, Pro Quest, and PubMed, and the search period was from the construction of the database to October 22, 2023. The search terms for sports participation were "sport" "exercise" "exercise" "physical activity" "physical activity"; the search terms for aggressive behavior were "assault" "aggressive behavior" "aggression"; the search terms for aggressive behavior were "assault" "aggressive behavior" "aggression" "bullying", and "violence", and the above keywords were jointly searched. Foreign language data were searched using Web of Science, Ebsco, Pro Quest, PubMed and supplemented by Google Scholar. The search terms for sports participation were sport, athletics, exercise, train, fitness, physical exercise, physical activity, physical education; and the search terms for aggressive behavior were aggression, bullying, violence, atrocity, fighting, aggressive behavior, physical assault; the above keywords were jointly searched. Statistical analysis was performed using CMA 3.0 software. Results A total of 20 studies with 80 effect sizes and 9 308 subjects were included. The Meta-analysis showed that adolescent sports participation was moderately negatively correlated with indicators of aggression (r=-0.11), physical aggression (r=-0.14), verbal aggression (r=-0.14), and hostility (r=-0.16), and weakly negatively correlated with indicators of anger (r=-0.08) (P < 0.05). Aggressive behavior was influenced by gender, school stage, mode of exercise, and the sports participants' region (P < 0.05). Conclusions Exercise participation has a positive impact on reducing aggressive behavior in adolescents, and mode of exercise, age, gender, and region are moderating variables in the relationship. Schools can reduce adolescent aggression by developing exercise and physical education interventions.

Core self-evaluations and redundant thinking among physical education college students: the longitudinal effects of perceived discrimination on anxiety

TIAN Benben, SUN Yan

2024, 45(5): 674-678. doi: 10.16835/j.cnki.1000-9817.2024149

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Objective To investigate the effects of perceived discrimination on anxiety among college students in physical education (PE) majors, and to determine the longitudinal mediating role of core self-evaluations and redundant thinking, so as to provide reference for preventing and treating anxiety in the population. Methods A total of 2 335 college students in PE majors were selected from six colleges and universities in Jiangxi Province, China, for four surveys by using type sampling. The baseline period was March 2022 (T1), and three follow-up surveys were conducted at 6-month intervals (T2, T3, T4). Students were surveyed at each time period using the Discrimination Perception Scale for College Students in Physical Education, the Core Self-esteem Scale, the Redundancy Reflections Scale, and the Anxiety Self-rating Scale. Cross-lagged models were constructed to analyze the data. Results Statistically significant correlations were found between T1 and T4 discrimination perceptions, core self-evaluations, redundant thinking and anxiety (r=-0.55-0.77, P < 0.01). Perceived discrimination in T2 significantly and positively affected anxiety in T4 (β=0.15, P < 0.01). Perceived discrimination in T1 indirectly affected anxiety in T3 through the mediating effect of core self-evaluations in T2 (mediation effect value of 0.001, mediation effect size of 12.48%), while perceived discrimination in T2 indirectly affected anxiety in T4 through the mediating effect of core self-evaluations in T3 (mediation effect value of 0.001, mediation effect size of 12.48%). Mood (mediation effect value of 0.011, mediation effect size of 13.31%) and perceived discrimination in T1 indirectly affected anxiety in T3 through the mediating effect of redundant thinking in T2 (mediation effect value of 0.015, mediation effect size of 18.12%). Conclusions Core self-evaluations and redundant thinking are identified as mediating variables in the relationship between perceived discrimination and anxiety among college students in PE majors. Focusing on perceived discrimination, core self-evaluations, and redundant thinking among sport majors may help to reduce anxiety.

Latent class of medical freshmen's school adjustment and the relationship among its transition, social support and mental resilience

DING Minjiang, LIAO Youguo

2024, 45(5): 679-683. doi: 10.16835/j.cnki.1000-9817.2024158

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Objective To explore the possible latent classes and transition characteristics of medical freshmen and their relationship with social support and mental resilience, so as to provide a scientific reference for preventive education. Methods A total of 1 155 medical freshmen were cluster random sampled from 3 medical universities in Fujian Province and received 2 rounds of surveys(T1, October 2022; T2, December 2022) by applying Student Adaptation to College Questionnaire, Child and Adolescent Social Support Scale and Connor-Davidson Resilience Scale. And the relevant data was analyzed by using latent profile analysis, latent transition analysis and multiple Logistic regression. Results There were three different subgroups of school adjustment at two time points for T1 and T2, including high school adjustment group (34.0%, 19.8%), mild school adjustment group (60.5%, 53.8%) and low school adjustment group (5.5%, 26.4%). The low school adjustment group, relatively stable, had the greatest probability of remaining in the same group(94.0%). The high school adjustment group tended to change to mild school adjustment group(25.0%), and the mild school adjustment group tended to change to low school adjustment group (22.0%). Affected by social support, high school adjustment group was less likely to transfer to be mild school adjustment group (OR=0.40) and low school adjustment group (OR=0.26). The mild school adjustment group was prone to transfer to be high school adjustment group (OR=1.47), and less likely to be low school adjustment group (OR=0.58). Influenced by mental resilence, high school adjustment group was less likely to transfer to be mild school adjustment group (OR=0.20) and low school adjustment group (OR=0.13). The mild school adjustment group was prone to transfer to be high school adjustment group (OR=9.17), and less likely to be low school adjustment group (OR=0.42). The low school adjustment group was more likely to transfer to be high school adjustment group(OR=5.43)(P < 0.05). Conclusions There are three subgroups of school adjustment in medical freshmen, and class transition in school adjustment are at higher risk and are influenced by social support and mental resilience. The social support and resilience of medical freshmen should be enhanced to promote the school adjustment.

Associations of physical activity, sleep quality with anxiety and depressive symptoms among college students

CHEN Baoxiang, ZHOU Yulan, HUANG Zan

2024, 45(5): 684-688. doi: 10.16835/j.cnki.1000-9817.2024139

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Objective To explore the associations of physical activity and sleep quality with anxiety and depressive symptoms in college students, in order to provide empirical support and theoretical guidance for mental health intervention among college students. Methods From March to April 2023, 2 099 college students from universities in 6 different provinces were selected by a convenient sampling method. Physical activity, sleep quality, anxiety and depressive symptoms were evaluated by the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Anxiety Self-Rating Scale (SAS), respectively. Descriptive statistics and Logistic regression models were used to analyze the data. Results The reporting rates of low-intensity, moderate-intensity, and high-intensity physical activity among college students were 30.3%, 45.3%, and 24.4%, respectively. Moreover, among the participants, anxiety was detected in 21.6% and depressive symptoms in 39.9%, while 62.3% experienced poor sleep quality. Compared with males, females exhibited a lower proportion of high-intensity physical activity (22.3% vs 42.8%), while reported higher proportions of moderate-intensity (48.1% vs 40.8%) and low-intensity physical activity (29.5% vs 16.4%). Additionally, the proportion of females reporting poor sleep quality (65.0%) was higher than that of males (58.0%) (χ²=110.15, 10.70, P < 0.05). The proportion of girls (43.8%) with depressive sypmtoms was higher than that of boys (33.9%) (χ²=20.48, P < 0.05). Logistic regression analysis showed that high physical activity was negatively correlated with anxiety and depression (OR=0.45, 0.33), poor sleep quality was positively correlated with anxiety and depressive symptoms (OR=3.89, 3.94) (P < 0.01).The interaction effect between high physical activity and good sleep quality was associated with the reduction of anxiety and depression among college students (OR=0.14, 0.08, P < 0.01). Conclusions Physical activity and sleep quality are associated with anxiety and depressive symptoms among college students. The interventions for mental health problems such as depression and anxiety among college students should aim to improve physical activity and sleep quality.

Relationship among psychological resilience, parental control, and behavioral problems in junior high school students in Guizhou Province

YE Dexin, ZHANG Jiangping, LUO Peng, WANG Junhua, LONG Rong, LU Chunyuan, MAO Yongjia, XIE Hongya, LI Xiuling

2024, 45(5): 689-692. doi: 10.16835/j.cnki.1000-9817.2024154

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Objective To investigate the relationships among psychological resilience, parental control, and behavioral problems in middle school students, aiming to provide evidence-based recommendations for the prevention and intervention of behavioral issues in middle school students, as well as for the development of related policies. Methods A stratified cluster sampling method was used to select 2 745 participants from three cities in Guizhou Province with different levels of economic development from August to December 2021. The Child Behavior Checklist (CBCL), Parental Control Questionnaire, and Psychological Resilience Questionnaire were administered to junior high school students and their parents. A network analysis method was employed to construct a network analysis model of factors influencing behavioral problems. Results The detection rate of behavioral problems among junior high school students in Guizhou Province was 22.62%. The scores for psychological resilience (goal focus, emotional control, positive cognition, family support, and interpersonal assistance) and proactive inquiry in behavior control were higher in the group without behavioral problems than in the group with behavioral problems. Scores for psychological control (inducing guilt, with drawing affection, and asserting authority) were higher in the group with behavioral problems than in the group without behavioral problems, with statistically significant differences (t=9.80, 17.76, 6.21, 12.20, 13.18, 6.28, 11.58, 11.10, 10.74, P < 0.05). The network model showed that among the same variable factors, the strongest connection weight was between inducing guilt and withdrawing affection, with a weight of 0.79. Between different variables, there were negative correlation between behavioral problems and psychological resilience (goal focus, emotional control, positive cognition, family support, interpersonal assistance) and behavior control (proactive inquiry, behavioral restraint) with correlation coefficients (r=-0.25, -0.42, -0.16, -0.31, -0.33, -0.17, -0.03, P < 0.05), respectively. There were positive correlation between psychological control factors (inducing guilt, withdrawing affection, and asserting authority) and behavioral problems (r=0.29, 0.27, 0.27), and a negative correlation between these psychological control factors and psychological resilience factors (goal focus, emotional control, positive cognition, family support, interpersonal assistance)(r=-0.53--0.13)(P < 0.05). The strongest connection weight was between withdrawing affection and family support, with a connection weight of -0.53. Family support was an important bridge symptom connecting the entire behavioral problem network model, with a high centrality. Conclusions The detection rate of behavioral problems among junior high school students in Guizhou Province is relatively high. Assisting adolescents in establishing a supportive family environment facilitates the cultivation of their psychological resilience, thereby mitigating the occurrence of behavioral problems.

Analysis of the characteristics and related factors of executive function in adolescents

LI Wan, YIN Xiaojian, MA Yuanyuan, WANG Jinxian, WU Huipan, SHI Lijuan, ZHANG Yingkun, LI Yong

2024, 45(5): 693-699. doi: 10.16835/j.cnki.1000-9817.2024159

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Objective To explore the characteristics and related factors of adolescent executive function, so as to provide theoretical basis for promoting the development of adolescent executive function. Methods A total of 5 018 adolescents aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi were selected by convenient cluster random sampling method from September to December 2022, and their basic information, family status, lifestyle behavior, physical fitness and executive function were investigated by questionnaire survey. Considering the heterogeneity between schools, a multilevel Logistic model was established to analyze the related factors of adolescent executive function. Results The inhibitory function of high school students was better than that of middle school students (Z=-2.69). In terms of refreshment function, high school students were superior than middle school students (1-back: Z=-11.32; 2-back: Z=-11.36), and male students were superior than female students (2-back: Z=-2.18); in terms of shifting function, high school students were superior than middle school students (Z=-2.63), and boys were superior than girls (Z=-7.10)(P < 0.05). The results of multilevel model analysis showed that the executive function of adolescents was clustered at the school level. At the individual level, junior high school refreshment function (1-back: β=56.94; 2-back: β=127.00), and shifting function (β=35.64) were worse than that of high school students; the refreshment function 2-back (β=-21.24) and shifting function (β=-28.42) of male students were better than those of female students; the refreshment function 2-back of non-only child was better than that of only child (β=-19.36); refreshment function of low fitness was worse than that of high fitness (β=37.35); the shifting function of the video screen time not up to standard was better than that of the standard (β=-14.30)(P < 0.05). Conclusions The executive function of high school students is better than that of middle school students, the refreshment function and shifting function of boys are better than that of girls. Family environment, lifestyle and physical health are significant factors related to executive function of Chinese adolescents. By raising awareness of the major supporting and impeding factors for executive functioning in adolescents, it can help to develop effective intervention programs for adolescents.

Impact of the sense of security on interpersonal relationships among impoverished college students

XIE Ying, HONG Lin

2024, 45(5): 700-703. doi: 10.16835/j.cnki.1000-9817.2024157

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Objective To explore the impact of the sense of security on interpersonal relationships among impoverished college students, so as to provide empirical evidence for effective interpersonal communication cirsis prevention among impoverished college students. Methods In March 2023, a stratified random sampling method was used to select one university from Shanghai, Jiangsu, Henan, Anhui, Inner Mongolia, Gansu, Guangxi respatively. A total of 1 687 impoverished college students from 7 universities were surveyed using the Sense of Security Scale, Interpersonal Relationship Comprehensive Diagnosis Scale, Stress Perception Scale (SPS), and Mindfulness Attention Awareness Scale (MAAS). Moderated mediation effect analysis was performed using Model 7 in the SPSS macro program PROCESS. Results There was significant gender differences in the sense of security among impoverished college students (t=-2.31, P < 0.05), and significant difference in interpersonal relationships by grade was observed (F=3.60, P < 0.05). A sense of security was negatively associated with difficulties in interpersonal relationships among impoverished college students (β=-0.17, t=-9.27, P < 0.01). Psychological stress partially mediates the relationship between the two, accounting for 19.54% of the total effect. Mindfulness regulates the first half of the path (β=0.10, t=5.32, P < 0.01). Conclusions The sense of security shows impacts on interpersonal relationships among impoverished college students through psychological pressure. And it strengthens with the improvement of mindfulness level. Attention should be paid to cultivating a sense of security among impoverished college students, improving their level of mindfulness, and preventing interpersonal crisis due to excessive psychological pressure.

Epidemiological characteristics and genotype of norovirus outbreaks in schools in Xicheng District of Beijing from 2017 to 2022

LIU Xiaoxiao, HUANG Yanhong, CHU Yanhui, SUN Jingyi, YANG Xiong, KONG Qingzheng, JI Yanli, GAO Zhiyong

2024, 45(5): 704-707. doi: 10.16835/j.cnki.1000-9817.2024155

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Objective To analyze the epidemiological and molecular characteristics of norovirus outbreaks in schools in Xicheng District of Beijing from 2017 to 2022, so as to provide evidence for the prevention and control of norovirus outbreaks in schools. Methods Data of norovirus outbreaks in schools in Xicheng District, Beijing during 2017 to 2022 were collected and analyzed by descriptive epidemiological methods. Real-time PCR was used to detect the nucleic acid of group GⅠ and GⅡ norovirus, the positive norovirus nucleic acid samples were sent to Beijing Center for Disease Control and Prevention for molecular typing. Results From 2017 to 2022, 185 norovirus outbreaks were reported in schools in Xicheng District, including 166 cluster outbreaks and 19 outbreaks. A total of 2 044 cases were reported, with a total attack rate of 13.92%. There were two peaks in the outbreak time, which were from March to June after the spring semester and from October to December after autumn semester. Primary schools were the most common place of occurrence (101 cases), followed by nursery institutions (68 cases) and secondary schools (16 cases). There were statistically significant differences in the incidence rates among different sites(12.37%, 22.78%, 8.47%, χ²=263.34, P < 0.01). There were significant differences in the incidence of vomiting, diarrhea, nausea and stomachache among different students (χ²=263.33, 90.58, 20.42, 30.29, P < 0.01). Vomiting was the main symptom in primary school and nursery school children (96.41%, 98.28%), and the diarrhea rate was higher in middle school students (68.22%). The outbreaks were mainly caused by type GⅡ norovirus. The genotype from 2017 to 2021 showed the characteristics of diversity, mainly GⅡ.2[P16], but there was no significant advantage for the GⅡ.2 [P16] during 2019 to 2021. Conclusions The norovirus outbreak in schools in Xicheng district of Beijing from 2017 to 2022 are mainly caused by GⅡ type genome. The main genotype is GⅡ.2[P16]. Norovirus infection mainly occurred in primary schools and kindergartens. For the vulnerable populations, it is necessary to improve the capacity to early identification, student infectious disease management, active infection control and prevention measures, and pathogen surveillance and sporadic case monitoring.

Combined effect of health literacy and non-suicidal self-injurious behaviors on suicide-related behaviors of junior middle school students

LUO Yu, WEI Ke, ZHANG Ronghuinan, LIU Aini, YANG Siwei, WANG Hong

2024, 45(5): 708-713. doi: 10.16835/j.cnki.1000-9817.2024141

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Objective To explore the combined effect of health literacy and non-suicidal self-injury on suicide-related behaviors in junior middle school students, so as to provide reference for suicide prevention. Methods During May to June 2023, a self-filling questionnaire survey was conducted among 7 367 junior middle school students selected by the methods of multi-stage stratified cluster sampling combined with conventient sampling in Chongqing. And a binary Logistic regression model was established to analyze the association of health literacy and NSSI with suicide-related behaviors. Results The detection rates of suicidal ideation, suicide planning, and suicide attempt among junior middle school students were 27.99%, 9.84%, and 4.64%, and the detection rate of NSSI was 38.03%, the rates of possessing total health literacy, functional health literacy, interactive health literacy, and critical health literacy were 62.68%, 66.51%, 54.24%, and 72.65%, respectively. Binary Logistic regression analyses showed that the absence of total health literacy and the three dimensions of health literacy and NSSI were positively correlated with suicidal ideation, suicide planning, and suicide attempt in junior middle school students (OR=1.42-10.30), and there were combined effects (OR=7.43-18.71) (P < 0.05). Conclusions Lack of health literacy or the presence of NSSI and their co-existence increase the risk of suicide-related behaviors, and health literacy level should be improved in junior middle school students to reduce NSSI and thereby prevent suicide-related behaviors.

Association between age of life adversity and insulin resistance in girls with precocious puberty

WANG Ya, LI Jing, LI Ting, ZHOU Yan, ZHU Ruoping, SUN Ying

2024, 45(5): 714-718. doi: 10.16835/j.cnki.1000-9817.2024150

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Objective To investigate the association between early life adversity(ELA) and the triglyceride-glucose (TyG) index for an indicator of insulin resistance among girls with precocious puberty, so as to provide scientific basis for effective prevention and intervention measures. Methods From July 2020 to September 2021, girls with precocious puberty were recruited from the children's health clinic of Anhui Provincial Children's Hospital. Among them, 150 girls with complete blood indicators and questionnaire information were included. Both parental reports and child self-reports were combined to assess ELA exposure. Fasting blood samples were collected to evaluate thetyg index. According to the ELA score classification, girls were classified into 3 groups for 0, 1 and >2, multiple linear regression analysis were conducted to examine the association between ELA exposure and TyG index in girls with precocious puberty. Results Precocious pubertal girls subjectively reported high rates of ELA exposure, with an average ELA score of (1.07±1.17) and an average TyG level of (7.99±0.49). A single adverse association was found that the exposure of girls with precocious puberty to a lack of warm nurturing was significantly positively correlated with the TyG index (β=0.26, 95%CI=0.03-0.50, P<0.05). Multiple linear regression analysis showed that girls in the ELA≥2 group had a 0.24 increase in TyG levels compared to girls who did not experience ELA (β=0.24, 95%CI=0.04-0.43). After controlling for covariates such as child age, mother's age, father's age, physical activity, screen time, birth weight, birth method (including natural and cesarean sections), perceived stress, BMI standardized Z-score, and parental assessment SDQ score, The association remained significant after controlling for covariates and was independent of BMI (β=0.25, 95%CI=0.04-0.46)(P<0.05). Conclusions Cumulative early life adversity in girls with precocious puberty is significantly positively correlated with the TyG index. It should early identify the girls exposed to high ELA for precocious puberty and timely intervent to improve their glucose metabolism function.

Correlation between age of menarche/first spermatozoa and obesity in urban and rural primary and secondary school students in Inner Mongolia

YANG Tian, SONG Yi, DONG Yanhui, YUAN Wen, ZHANG Xiuhong, FAN Yaochun, LI Huan, YUE Xuanzhi

2024, 45(5): 719-722. doi: 10.16835/j.cnki.1000-9817.2024137

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Objective To understand the pubertal development of primary and secondary school students in urban and rural areas of the Inner Mongolia Autonomous Region in 2021, so as to provide clues for further clarification of the health hazards of early pubertal initiation. Methods From October to November 2021, primary and secondary school students in 12 provinces and cities of Inner Mongolia were selected by stratified cluster random sampling, including 21 662 girls who had reached menarche and 10 600 boys who had their first seminal emission, as well as 46 183 girls who had not reached menarche and 78 995 boys who had not experienced their first seminal emission. The height and weight of the primary and secondary school students were measured, and the time of first seminal emission or menarche was recorded. The study used the Mann-Whitney U test to analyze the differences between urban and rural students, Spearman's rank correlation to analyze the correlation between overweight and obesity and the age of pubertal initiation, and the Logistic regression model to analyze the correlation between pubertal initiation and age of pubertal initiation. Results The age of menarche for urban girls [(12.31±1.29) years old] was earlier than that of suburban girls [(12.43±1.24) years old], and the age of first spermatozoa for urban boys [(13.85±1.20) years old] was statistically significant compared with that of suburban boys [(13.79±1.36) years old] (t=12.76, 10.58, P<0.05). There was a negative correlation between the age of menarche and overweight/obesity among girls aged 10-14 years (r=-0.169, P<0.05), and there was no statistically significant correlation between the age of spermarche and overweight/obesity in boys aged 5-9, 10-14, and 15-20 years (r=0.122, -0.022, -0.004, P > 0.05). The occurrence of menarche in overweight girls was 1.06(95%CI=1.01-1.11) times higher than that in the normal group, and 1.13(95%CI=1.06-1.20) times higher among obese girls than normal-weight girls. Compared to urban areas, primary and secondary school students in suburban counties observed the onset of puberty later [OR=0.88(95%CI=0.85-0.91) for menarche, OR=0.94(95%CI=0.89-0.99) for first spermatozoa] (P<0.05). Conclusions Obesity during childhood and adolescence is associated with earlier onset of puberty among female students in Inner Mongolia, and later onset of puberty among primary and secondary school students in suburban counties compared with those in urban areas.

Detection characteristics of the virus during school influenza outbreaks in Linyi City

WANG Chuanbao, JIANG Chunyun, LIU Xiangliang, LI Chengwei, LIU Jiancheng, YIN Deqing, JI Shengxiang, WU Fangfang, LIU Xiufang

2024, 45(5): 723-726. doi: 10.16835/j.cnki.1000-9817.2024156

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Objective To analyze the characteristics of influenza virus detection in an influenza outbreak in schools, so as to provide a strategic basis for the treatment of influenza outbreaks in schools. Methods A total of 1 702 samples were collected from 52 school influenza outbreaks reported in Linyi City in 2021-2022. The samples were divided into 3 types according to different symptoms during the management of the epidemic [group A: influenza-like illness (ILI) group; group B: mild illness group; group C: close contacts group]. Rt-PCR was used to detect influenza virus nucleic acid in the collected samples. The detection rate of influenza virus in the outbreaks was analyzed by χ² test. Results In total, 1 071 samples (62.93%) tested positive for influenza virus nucleic acid. Among them, 610 out of 726 samples (84.02%) were detected in group A, while 331 out of 634 samples (52.21%) were detected in group B. In group C, 130 out of 342 samples (38.01%) tested positive. The differences were statistically significant (χ²=260.71, P<0.01). In group A, males had a detection rate of 80.83% for influenza virus nucleic acid, compared to 91.36% for females. For group B, the rates were 53.31% for males and 50.87% for females. In group C, males had a rate of 30.72%, while females had a rate of 43.92%. Statistical significance for gender differences was observed only in groups A and C (χ²=12.67, 6.25, P<0.05). According to the days of onset, the detection rates of influenza virus nucleic acid among patients with onset 0-6 days were 56.30%, 74.49%, 89.35%, 86.23%, 69.67%, 62.75%, 34.33%, respectively, and the difference was statistically significant (χ²=128.27, P<0.01). Conclusions Mild cases and close contacts are likely key factors contributing to the prolonged emergence of new cases within classrooms during school influenza outbreaks. The progression of influenza symptoms is related to the risk of transmission.

Assiciation of myopia progression and sleep characteristics among lower grade primary school students in Shanghai

PENG Hui, SHI Huijing, ZHU Hongfei, YANG Feifei, BAI Huiying, XUE Junlei, ZHANG Yanfei, MA Feifei, PENG Qian, WANG Ying

2024, 45(5): 727-731. doi: 10.16835/j.cnki.1000-9817.2024148

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Objective To study the impact of sleep characteristics on myopia, among lower primary school students in Shanghai, so as to provide foundation for the prevention of the onset and development of myopia. Methods A total of 636 students from the first and second grades of two primary schools in Jiading District, Shanghai, were selected through cluster random sampling for questionnaire surveys and ophthalmological examinations in October 2022. The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep quality at baseline. Ophthalmological examinations were conducted in October 2023(479), during which the students' study time, screen time and outdoor activity time were monitored for two-week, repeated twice. Generalized multivariable Logistic regression models and linear regression models were employed to examine the association between sleep-related factors and myopia, as well as the strength of this association. Results The baseline survey indicated a myopia prevalence of 18.58%, with 17.18% at follow-up. The average CSHQ total score was (51.58±4.44), and the average daily sleep duration was (9.43±4.84)h/d, with only 11.6% of participants meeting the recommended sleep sufficiency. Multivariable regression models indicated that insufficient sleep showed positive association with myopia (OR=1.64, 95%CI=1.05-2.56), while bedtime duration was significantly negative associated with myopia (OR=0.74, 95%CI=0.63-0.91, P<0.05), adjusting for confounding factors. Inconsistency in bed rest time was a risk factor for myopia (OR=1.07, P<0.05), and the consistency of bed rest time, and wake-up time showed statistically significant correlations with SE (P<0.05). There was also statistically significant correlations between consistency in sleep time, bed rest time, and wake-up time with AL (P<0.05). Conclusions Insufficient sleep and bedtime duration are correlated with the onset and progression of myopia. It is critical to ensure sufficient sleep duration and regular sleep habits for children to reduce the occurrence of myopia in the primary school students.

Analysis of recessive infection of hand, foot and mouth disease and associated risk factors among healthy children and guardians in Qingdao

XIN Xueling, ZHANG Hongmei, JI Qianpeng, JIA Jing, WANG Chunhui

2024, 45(5): 732-736. doi: 10.16835/j.cnki.1000-9817.2024140

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Objective To investigate the recessive infection rate of healthy children and guardians in different epidemic periods of hand, foot and mouth disease (HFMD) in Qingdao, analyze the risk factors affecting recessive infection, so as to provide the basis for HFMD prevention and control. Methods In the non-epidemic period of 2022, the random cluster sampling method was used to selected 546 children and guardians from 4 childcare institutions in Laoshan District and Pingdu City. In the epidemic period of 2023, 690 children and guardians were selected from 6 childcare institutions in Shibei District, Laoshan District and Pingdu District. A questionnair survey was conducted in the epidemic period. Logistic regression analysis was used to analyze the factors affecting the recessive infection. Dominance analysis was used to explore the relative importance of the risk factors affecting recessive infection. Results The results showed that the recessive infection rates of healthy children and guardians in the epidemic period were 18.84% and 13.62%, respectively; the recessive infection rates were 9.09% and 4.44% in the non-epidemic period, respectively. The results of multivariate Logistic analysis showed that rural areas (OR=4.71, 95%CI=2.57-8.61) and recessive infection of guardians (OR=18.62, 95%CI=7.45-46.56) were positively correlated with recessive infection of HFMD in healthy children (P<0.05). Washing hands (OR=0.09, 95%CI=0.04-0.20), using towels alone (OR=0.17, 95%CI=0.07-0.40), and EV71 vaccination (OR=0.42, 95%CI=0.20-0.87) were negatively correlated with recessive infection of HFMD in healthy children (P<0.05). Public toilets (OR=3.02, 95%CI=1.50-6.09) and drying bedding once per quarter (OR=3.89, 95%CI=1.75-8.68) were positively correlated with recessive infection of HFMD in healthy guardians. Housing with good lighting (OR=0.31, 95%CI=0.12-0.79), and tableware disinfection (OR=0.31, 95%CI=0.15-0.65) were negatively correlated with recessive infection of HFMD in healthy guardians (P<0.05). The results showed that recessive infection of guardians was relatively the most important for healthy children (41.51%), and tableware disinfection was relatively the most important for recessive infection of guardians (28.87%). Conclusions The recessive infections of HFMD are common among healthy populations in Qingdao, and the recessive infection rate among children during the epidemic period is relatively higher. Guardians play an important role in the recessive infection of healthy children. Therefore, healthy education should be strengthened for key populations, especially to enhance parents' awareness of prevention and control to reduce the occurrence of recessive infections of hand, foot and mouth disease in children and guardians.

Prevalence and associated factors of screening positive myopia among elementary and middle school students in Guangdong

XU Chan, LI Meng, SHEN Shaojun, CHEN Qiuxia, YU Huijuan, YANG Wenhan, QU Yabin

2024, 45(5): 737-741. doi: 10.16835/j.cnki.1000-9817.2024132

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Objective The study aims to analyze the prevalence and associated factors of myopia among 4 to 9 grade students in Guangdong Province in 2022, so as to provide a scientific basis for targeted intervention measures for myopia in children and adolescents. Methods From September to October 2022, stratified cluster random sampling was used to select 29 095 of 4 to 9 grade students from Guangzhou, Jiangmen, and Meizhou in Guangdong Province for myopia screening and questionnaire surveys. The Chi-square test was applied to compare the differences between groups, and multivariable Logistic stepwise regression analysis was used to analyze factors associated with myopia. Results The myopia detection rate of 4 to 9 grade students was 61.7%, with detection rates of 51.5% for 4 to 6 grade primary school students and 71.95% for 7 to 9 grade junior high school students. Multivariable Logistic regression analysis showed that higher myopia rates were detected among girls (OR=1.39, 95%CI=1.30-1.49), students with one (OR=1.82, 95%CI=1.69-1.96) or both parents having myopia (OR=2.86, 95%CI=2.56-3.18), and indoor sedentary time >6 h(OR=1.28, 95%CI=1.17-1.39) in the 4 to 6 grade. Lower myopia rates were detected in the county (OR=0.92, 95%CI=0.86-0.99) and outdoors at recess activities (OR=0.88, 95%CI=0.81-0.95). Meanwhile, higher myopia rates were detected among girls (OR=1.84, 95%CI=1.69-1.99), students with one (OR=1.87, 95%CI=1.71-2.04) or both parents having myopia (OR=3.03, 95%CI=2.63-3.50), and indoor sedentary time >6 h/d (OR=1.11, 95%CI=1.01-1.23) in the 7 to 9 grade. Lower myopia rates were detected in the county (OR=0.74, 95%CI=0.68-0.80), outdoors at recess activities (OR=0.83, 95%CI=0.76-0.91), and outdoor activity time ≥2 h/d(OR=0.87, 95%CI=0.80-0.95)(P<0.05). Conclusions The detection rate of myopia among 4 to 9 grade students in Guangdong Province is relatively high. Place of recess activities, daily outdoor activity and indoor sedentary duration are associated with myopia. Therefore, targeted intervention measures should be adopted, such as appropriately increasing outdoor activity to reduce the occurrence of myopia among primary and middle school students.

Prevalence of non-alcoholic fatty liver disease and associated factors in overweight and obese children in Hohhot

YU Qiong, LI Jianying, CAO Puli, LIU Dong, ZHANG Jian, LI Ruifeng

2024, 45(5): 742-745. doi: 10.16835/j.cnki.1000-9817.2024142

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Abstract:
Objective To explore prevalence and associated factors of non-alcoholic fatty liver disease (NAFLD) in overweight and obese children in Hohhot City, so as to provide the oretical basis for developing health education plans and implementing prevention and treatment of NAFLD in children. Methods A total of 156 overweight and obese children was enrolled from 4 primary schools in Hohhot City using cluster sampling method during 28th Aug. 2022 to 5th Mar. 2023. Height and weight were measured and body mass index was calculated, and fasting blood was taken in the early morning for fasting blood glucose, alanine aminotransferase, aspartate aminotransferase. Single factor analysis was conducted using t-test, χ² test and Fisher's exact probability method, while multivariate analysis was conducted using Logistic regression analysis and subject characteristic curves. Results The differences in age, waist circumference, hip circumference, fasting glucose, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, uric acid, and triglyceride were statistically significant between the non-NAFLD and the NAFLD group (U/t=1 070.0-2 164.0, P < 0.05). Significant differences were observed in aspartate aminotransferase (AST) and uric acid levels (AST OR=1.16, 95%CI=1.04-1.28; uric OR=1.01, 95%CI=1.00-1.01, P < 0.05). The area under a receiver operating characteristic were 0.737 for aspartate aminotransferase and 0.665 for uric acid, respectively. Conclusions The prevalence of NAFLD is high in overweight/obese children in Hohhot, and both elevated aspartate aminotransferase and hyperuricemia could increase the risk of NAFLD in overweight/obese children. Special attention should be paid to the NAFLD in overweight and obese children. It is recommended to reduce both BMI and uric level in the prevention and treatment of NAFLD to achieve better treatment outcomes.

A scoping review on compliance in orthokeratology among children and adolescents

ZHANG Chunhua, LIN Shudan, CHEN Yanyan

2024, 45(5): 746-750. doi: 10.16835/j.cnki.1000-9817.2024153

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Abstract:
Objective To describe and analyze the current research status of compliance in orthokeratology among children and adolescents in and beyond China, so as to guide future research in this field. Methods By combining subject words with free words, the paper systematically searched the research related to the compliance of children and adolescents wearing orthokeratology lenses in PubMed, Web of Science, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP and China Biomedical Literature Database. The retrieval time limit was until September 1, 2023.Two researchers independently screened and extracted data. Results A total of 35 articles were included, and four themes were identified: the current level of compliance, evaluation indicators, influencing factors, and intervention programs. The evaluation indicators of orthokeratology lens-wearing compliance were diverse, and the influencing factors involved general demographic characteristics, personal internal factors, external factors, and specific clinical situations related to orthokeratology. Conclusions Multiple factors are associated with compliance in orthokeratology. Eyecare practitioners should choose suitable evaluation tools based on specific conditions and implement diverse and practical intervention strategies guided by theory to enhance the safety and effectiveness of orthokeratology lens-wearing among children and adolescents.

Research progress on the current status and associated factors of airborne microbial pollution in college campuses

DENG Xunuo, LIU Yuheng, GAO Chunyan, XU Zihua, MA Xuezheng, REN Liping, CHEN Xiaoqin

2024, 45(5): 751-756. doi: 10.16835/j.cnki.1000-9817.2024133

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Abstract:
Airborne microorganisms, especially pathogenic microorganisms, are easily transmitted through dust and droplets, leading to various infectious diseases. The study summarizes the status of airborne microbial pollution, potential exposure levels, particle size, and species distribution of microorganisms, discusses the impact of airborne microorganisms on human health, and analyzes specific factors affecting campus air microorganisms from four aspects: climate, anthropogenic factors, time, and space, to provide a scientific basis for formulating effective improvement measures, improving air quality and safeguarding the health of teachers and students.

Effects of high-frequency visual information on myopia among children and adolescents

LIU Xiaoling, XIE Yang, TAO Fangbiao

2024, 45(5): 757-760. doi: 10.16835/j.cnki.1000-9817.2024138

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Abstract:
Prevention and control of myopia is the key to delaying its occurrence and progression. Understanding the causes of myopia and its related mechanisms is conducive to better prevention and control. The acceleration of urbanization and increased time in indoor environments have become significant factors for the lack of high-frequency visual information, which constitutes new etiological considerations. Therefore, the study focuses on the research progress on the association between high-frequency visual information and myopia in different scene environments, and further explores the etiology of insufficient high-frequency visual information in myopia from the perspectives of contrast sensitivity, ON-OFF visual pathways, and gene expression, so as to provide reference for carrying out targeted myopia prevention and control measures in different scenarios.

2024 Vol. 45, No. 5