中国学校卫生

Co-exposure to the social and natural environment promotes risk factors for psychological and behavioral problems in children and adolescents

WAN Yuhui, TAO Fangbiao

2024, 45(8): 1065-1069. doi: 10.16835/j.cnki.1000-9817.2024229

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The roles of social and environmental factors in psychological and behavioral problems among children and adolescents have been repeatedly demonstrated, and the relationship between the natural environment and mental health has received increasing attention. On the basis of research on the relationships of social and natural environmental factors and psychological with behavioral problems in children and adolescents, the article attempts to unravel the compound health effects of these factors on psychological and behavioral problems, and proposes research directions to promote research and interventions regarding risk factors for psychological and behavioral problems arising from co-exposure to social and natural environmental factors among children and adolescents.

Development process of school health education since China's reform and opening up

GAO Disi, MA Yinghua, ZHEN Cheng

2024, 45(8): 1070-1074. doi: 10.16835/j.cnki.1000-9817.2024230

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School health education and health promotion have been the focus of China's school health work since the reform and opening up, and have been emphasized at different stages. By reviewing the problems at three different stages, namely, transformation stage of school education into the school health education stage, the institutionalization stage of school health education, and the new concept stage of school health education, the paper traces the development process of school health education in China since the reform and opening up, and summarizes the experience and reflections, so as to provide implications and suggestions for the development of school health education in China.

Correlation of adverse and positive childhood experiences and depression and anxiety symptoms among middle school students

GAO Yue, XIAO Wan, WEI Ruihong, WANG Ruoxi, JIANG Linlin, WAN Yuhui, SONG Lü

2024, 45(8): 1075-1079. doi: 10.16835/j.cnki.1000-9817.2024238

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Objective To analyze the correlation and gender differences between adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) and depression and anxiety symptoms among middle school students, so as to provide a reference for promoting the mental health of middle school students. Methods With a stratified random cluster sampling method, a total of 6 656 middle school students in 4 cities, including Nanchang, Shenyang, Taiyuan, and Zhengzhou, were selected as research subjects from October 2021 to October 2022. The Adverse Childhood Experiences International Questionnaire (ACEs-IQ), Benevolent Childhood Experiences Scale (BCEs), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7) scale were used to conduct questionnaire surveys.The Chi-square test was used to compare the reporting rates of depression and anxiety symptoms among middle school students in different groups, and a Logistic regression model was established to analyze the effects of ACEs and PCEs on depression and anxiety symptoms among middle school students and their gender differences. Results The reporting rate of depressive symptoms among middle school students was 20.1%, and the reporting rate of anxiety symptoms was 13.9%. ACEs were positively correlated with depression and anxiety symptoms among middle school students (depression symptoms: OR=1.20, 95%CI=1.18-1.22, anxiety symptoms: OR=1.18, 95%CI=1.16-1.20), while PCEs were negatively correlated with depression and anxiety symptoms among middle school students(depression symptoms: OR=0.84, 95%CI=0.83-0.86, anxiety symptoms: OR=0.85, 95%CI=0.83-0.87) (P < 0.05). In the general population (depression symptoms : OR=0.99, 95%CI=0.98-0.99, anxiety symptoms: OR=0.99, 95%CI=0.99-1.00) and among girls (depression symptoms: OR=0.98, 95%CI=0.97-0.99, anxiety symptoms : OR=0.99, 95%CI=0.98-1.00), the interaction term between ACEs and PCEs were negatively correlated with depression and anxiety symptoms (P < 0.05). Conclusions ACEs significantly affect the depression and anxiety symptoms of middle school students, while PCEs can help reduce the impact of ACEs on the depression and anxiety symptoms of middle school students, girls are more susceptible to the impact of early experiences than boys. It should focus on gender differences, formulate comprehensive mental health protection strategies, to promote the mental health development of middle school students.

Building a predictive model for adolescent Internet gaming disorder based on machine learning

KONG Weisen, WANG Kailun, TUO Anxie, LI Bing, ZHENG Qubo, JIANG Huaibin

2024, 45(8): 1080-1085. doi: 10.16835/j.cnki.1000-9817.2024239

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Objective To explore the effectiveness of machine learning in predicting adolescent Internet gaming disorder, so as to provide guidance for formulating effective intervention measures. Methods From June to September, 2023, a total of 2 100 students from 3 middle schools and 3 high schools in Bijie City, Qianxi City and Jinsha County, Guizhou Province were selected by stratified random cluster sampling as research subjects. Data was collected by using several instruments, including the Nine-item Internet Gaming Disorder Scale-Short From (IGDS9-SF), Parental Psychological Control and Autonomy Support Questionnaire(PPCASQ), Motivation Structure Questionnaire, Relative Deprivation Questionnaire, Deviant Peer Association Questionnaire, and Dual Systems of Self-control Scale. Descriptive statistical analysis was conducted to characterize the sample features, and the distribution differences of categorical variables were analyzed by using Chi-square test and Mann-Whitney U test. Demographic variables and various influencing factors were served as independent variables, and whether adolescents were addicted to Internet gaming was the dependent variable. Various machine learning algorithms, including random forest, Logistic regression, support vector machine, gradient boosting trees, decision trees, and adaptive boosting were employed to construct predictive models. Results The detection rate of Internet gaming disorder among adolescents was 4.57% (96 cases). Males and middle school students had higher Internet gaming disorder detection rates (5.52%, 6.29%) than females and high school students (3.32%, 3.62%), and the differences were statistically significant (χ²=5.71, 7.86, P < 0.01).The scores of relative deprivation, deviant peer affiliation, paternal psychological control, maternal psychological control, control motivation, impulsive system and its dimensions (impulsivity, distractibility, low delay of gratification) in Internet gaming disorder group were higher than in non-Internet gaming disorder, while the score of parental autonomy support was lower than that in the non-Internet gaming disorder group (Z=-2.88, -9.32, -4.13, -4.48, -6.58, -7.50, -7.18, -7.56, -7.43, -2.27, P < 0.05). The adaptive boosting algorithm performed the best (accuracy=99%, recall=95%, F1 score=97%, AUC=0.96). Random forest and gradient boosting trees also performed excellently (accuracy=98%, recall=95%, F1 score=97%, 96%, AUC=0.96). Conclusions Compared to other models, the adaptive boosting algorithm shows a good predictive effectiveness for adolescent Internet gaming disorder. Appropriate models should be selected to identify individuals with Internet gaming disorder as early as possible, to develop effective intervention strategies and reduce the risk of Internet gaming disorder.

Association of greenness surrounding school with aggression among primary school students

ZHANG Yi, LI Yanqi, XIE Xinyi, LIN Xiaoyi, HUANG Mengxin, FU Huihang, TANG Jie

2024, 45(8): 1086-1090. doi: 10.16835/j.cnki.1000-9817.2024256

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Objective To explore the association between greenness surrounding school and aggression among primary school students, and to explore the potential mediating roles of social support, loneliness, particulate matter (PM_2.5) and Nitrogen Dioxide (NO₂) in this association, in order to provide a scientific reference for preventing and ameliorating aggressive behaviors of primary school students. Methods The data was used from a survey of children and adolescents conducted in 2015. The Chinese version of the Buss-Warren Aggression Questionnaire was used to assess total and sub-types of aggression, and the mean values of normalized difference vegetation index (NDVI) of 100 m, 500 m, 1 000 m circular buffers surrounding school were used to indicate the participants' greenness exposure. PM_2.5 and NO₂ datas were obtained from the China High Air Pollutants Dataset.Generalized Linear Mixed Models were used to assess the associations of greenness surrounding school with total and sub-types of aggression. Results Per IQR increment of NDVI-500 m [OR(95%CI)=1.09(1.03-1.15)] and NDVI-1 000 m[OR(95%CI)=1.07(1.02-1.13)] were positively correlated with physical aggression among primary school children, and per IQR increment of NDVI-100 m [OR(95%CI)=0.94(0.90-0.99)], NDVI-500 m [OR(95%CI)=0.93(0.89-0.98)] and NDVI-1 000 m [OR(95%CI)=0.95(0.91-1.00)] were negatively associated with verbal aggression (P < 0.05). Mediation analyses revealed that social support partially mediated the association between the NDVI-500 m and physical aggression (mediation ratio: 18.0%) and verbal aggression (mediation ratio: -8.3%) among primary school students, and loneliness partially mediated the association between the NDVI-500 m and physical aggression and verbal aggression among elementary school students effects, with proportion mediated ratios of -10.0% and 21.0%, respectively (P < 0.05). Conclusions Exposure to school surrounding greenness is likely to associated with physical aggression and verbal aggression in primary school students, and social support and loneliness may partially mediate these associations.

Cross-lagged model analysis of the relationship between physical exercise, academic performance, and aggressive behavior in junior high school students

XU Jiuyang, ZHU Yao, ZHU Hao, CHEN Weiguo, LIU Yi, ZHU Fengshu

2024, 45(8): 1091-1095. doi: 10.16835/j.cnki.1000-9817.2024244

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Objective To investigate the causal relationship between junior high school students aggressive behavior, physical exercise and academic performance, so as to provide a reference basis for the development of scientific exercise programs. Methods A longitudinal follow-up study was conducted on 502 junior high school students over a 12-month period from June 2021 to June 2022 using the Buss-Perry Aggressive Questionnaire (BPAQ), Physical Activity Questionnaire for Adolescents (PAQ-A), and test scores as the measurement tools (T1:June 2021, T2:December 2021, T3:June 2022), and a cross-lagged model was constructed to measure the relationship between aggression, physical activity and academic performance. Results At T1, physical exercise had a positive effect on academic performance at T2 (β=0.22) and a negative effect on aggressive behavior at T2 (β=-0.13), aggressive behavior negatively affected academic performance at T2 (β=-0.23), and academic performance had a negative effect on aggressive behavior at T2 (β=-0.09). Physical exercise at T2 had a negative effect on aggressive behavior at T3 (β=-0.05) and a positive effect on academic performance at T3 (β=0.19). Aggressive behavior at T2 negatively influenced academic performance at T3 (β=-0.08). Academic performance at T2 negatively influenced aggressive behavior at T3 (β=-0.06) (P < 0.05). The results of cross-lagged modeling of junior high school students aggressive behavior, physical exercise and academic performance showed that the model was well fitted (χ²/df=8.80, CFI=0.96, NFI=0.95, RFI=0.87, IFI=0.96, TLI=0.88, RMSEA=0.12). The results of multi-group structural equation modeling showed that the differences between the models and the baseline model (CFI=0.95, TLI=0.86, RMSEA=0.10, 90%CI=0.08-0.11, P < 0.01) were not statistically significant in terms of gender (△CFI < 0.05, P>0.05). Conclusions Physical exercise negatively predictes aggressive behavior and positively predictes academic performance, and academic performance and aggressive behavior negatively affect each other. A scientific exercise program should be developed to reduce aggression and effectively improve adolescents' academic performance.

Adolescent depressive symptoms in single-parent families in Jianyang City and construction and verification of the early warning model

REN Xiaobing, XU Hongxia, ZHONG Ruoshi, DUAN Xin, YU Jing

2024, 45(8): 1096-1100. doi: 10.16835/j.cnki.1000-9817.2024231

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Objective To analyze the current situation of adolescent depressive symptoms in single-parent families in Jianyang City, and to construct and verify the early warning model, so as to provide a scientific basis for the government to formulate a plan of promoting the development of adolescent mental health. Methods A stratified cluster random sampling method was used to select 12 125 middle and high school students from 25 middle schools in Jianyang City from March 2022 to October 2023 for an anonymous self-filling questionnaire survey, and a total of 1 142 adolescents from valid single-parent families were obtained as the survey objects. They were randomly divided into the training set (914 participants) and the verification set (228 participants) according to the ratio of 8∶2. The Chinese version of Beck depression Inventory (BDI) was used to evaluate depressive symptoms among adolescents from single-parent families in Jianyang City. The factors related of depressive symptoms in adolescents from single-parent families were analyzed, and a prediction model was established to verify the model and evaluate its effectiveness. Results There were 158 adolescents (17.29%) in the training set and 43 adolescents (18.86%) in the verification set with depressive symptoms. Multivariate Logistic regression analysis showed that learning stress (OR=4.31, 95%CI=1.67-11.13), Connor-Davidson Resilience Scale (CDRISC) score (OR=0.29, 95%CI=0.12-0.71) and Family Adaptability and Cohesion Scale (FACESⅡ) scores (OR=0.19, 95%CI=0.06-0.63) were all related factors the occurrence of depressive symptoms in adolescents from single-parent families (P < 0.05). The results showed that the C-index was 0.80 (95%CI=0.75-0.80), and the correction curve for predicting the occurrence of depressive symptoms in single-parent families was close to the ideal curve (χ²=0.26, P>0.05). Receiver operating characteristic (ROC) curve results of the training set showed that the sensitivity and specificity of the nomogram model in predicting depressive symptoms in adolescents from single-parent families were 80.38% and 80.03% respectively, ROC area under the curve (AUC) was 0.84 (95%CI=0.76-0.92). The ROC curve results of the verification set showed that the sensitivity, specificity and AUC of histogram model to predict depressive symptoms in adolescents from single-parent families were 79.07%, 82.16% and 0.83 (95%CI=0.76-0.91). Conclusions Learning stress, mental resilience and family function are all factors that affect the occurrence of depressive symptoms in adolescents from single parent families in Jianyang City. Based on this, the early warning model can predict depressive symptoms in Jianyang City.

Qualitative research on cognitive appraisal of middle school students with mental illness after experiencing childhood trauma

SONG Liping, CHEN Jie, XIONG Chang'e, ZENG Jing

2024, 45(8): 1101-1105. doi: 10.16835/j.cnki.1000-9817.2024245

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Objective To gain an in-depth understanding of the cognitive appraisal of middle school students with mental illness after experiencing childhood trauma, so as to provide a reference for the development of effective interventions. Methods From March to September in 2023, 21 middle school students with childhood trauma experiences and mental illnesses were selected from outpatient and inpatient departments through purposive sampling in a tertiary grade A psychiatric hospital in Wuhan. Semi-structured interviews were conducted and the seven steps of Colaizzi phenomenology were used to analyze the data and extract themes. Results A total of 3 themes and 11 sub-themes were extracted: insufficient awareness of childhood trauma (lack of self-awareness, lack of awareness of primary caregivers), multiple hurtful experiences after experiencing childhood trauma (complex negative affective experiences, multiple physical discomfort, pessimistic attitudes toward life, social impairment, and academic impairment), and influences on childhood trauma experiences (personality traits, inappropriate personal coping styles, poor upbringing environment, and difficulty in obtaining social support). Conclusions Middle school students with mental illnesses and their caregivers generally lack knowledge about childhood trauma, which brings widespread harm and are affected by multiple factors. It should jointly strengthen the popularization of scientific knowledge, intervene in a timely manner, and thereby reduce the adverse consequences of childhood trauma experiences.

Occurrence of hyperactivity behavior and its relationship with neuropsychological development in children aged 3-6 in Yunnan Province

ZHANG Xiaoyu, GUO Guangping, AN Yanting, CHE Xueji, WANG Daijiao, YANG Yan, LIU Yunfen, TANG Siyi, HU Hongwei

2024, 45(8): 1106-1110. doi: 10.16835/j.cnki.1000-9817.2024254

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Objective To investigate the prevalence of hyperactivity behavior in children aged 3-6 in Yunnan Province, to explore its relationship with neuropsychological development, so as to provide clues for early prevention and intervention of attention deficit hyperactivity disorder (ADHD) in children. Methods A total of 1 321 children aged 3 to 6 from 10 kindergartens in 5 prefectures (cities) of Yunnan Province were selected by stratified random sampling method from October 2022 to May 2023. Teacher Rating Scale (TRS) was used to investigate children's hyperactive behavior and co-existent behavior. A qualified evaluator applied the Developmental Scale for Children Aged 0-6 Years to assess the development of 5 ability areas of gross motor movement, fine movement, adaptive ability, language and social behavior. Statistical analysis was performed using Wilcoxon rank sum test and χ² test. Binary Logistic regression was applied to analyze the score of their hyperactivity behavior and its relationship with other behavior problems and neuropsychological development. Results The detection rate of hyperactivity behavior was 8.6% in children aged 3 to 6 years, 12.8% in boys and 4.1% in girls (χ²=31.53, P < 0.01). The detection rate of hyperactivity in 3-year-old children was 13.9%, which was higher than that in 4-year-old (9.2%) and 5-year-old children (7.0%) (χ²=8.73, P < 0.05). The detection rate of inattention-passivity of rural children (14.6%) was higher than that of urban children (5.9%) (χ²=22.23, P < 0.01). Binary Logistic regression analysis showed that the higher the level of adaptive development, the lower the risk of hyperactivity (OR=0.58, 95%CI=0.39-0.86), the higher the risk of hyperactivity (OR=0.57, 95%CI=0.35-0.91), the higher the risk of conduct problems (OR=0.57, 95%CI=0.37-0.87), inattention-passivity (OR=0.49, 95%CI=0.33-0.74) were also at lower risk (P < 0.05). Children with higher levels of fine motor development had a lower risk of inattention-passivity (OR=0.59, 95%CI=0.37-0.93, P < 0.05). Conclusions Hyperactivity in boys and inattention-passivity in rural children requires more attention. It is necessary to strengthen children's early adaptive ability and fine motor training to prevent hyperactive behavior and inattention.

Associations among body mass index, screen exposure, and executive function in preschool children

ZHOU Yang, LI Ruoyu, ZHA Jinhong, WU Jun, WAN Yuhui, HUANG Yongling

2024, 45(8): 1111-1114. doi: 10.16835/j.cnki.1000-9817.2024232

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Objective To analyze the associations among body mass index (BMI), learning screen/gaming screen exposure and executive function in preschool children in Anhui Province, so as to provide a basis for promoting the development of executive function in preschool children. Methods In June 2022, a stratified cluster sampling and convenience sampling methods were used to survey 3 534 mothers of preschool children in Wuhu City, Lu'an City, and Fuyang City, Anhui Province. The Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) was used to assess the preschool children's executive function abnormalities. Binary Logistic regression was conducted to examine the relationships among BMI, learning screen/gaming screen exposure, and their combined effects on executive function abnormalities. Results The detection rate of abnormal executive function in preschool children was 9.65%. Logistic regression analysis showed that after adjusting for the confounding factors such as pregnancy-induced hypertension, primary caregivers, family per capita monthly income and family structure, the risk of abnormal executive function of children in overweight/obesity group and high learning screen/gaming screen exposure group increased significantly (overweight/obesity: OR=1.78, 95%CI=1.31-2.42, learning screen exposure: OR=1.48, 95%CI=1.18-1.86, gaming screen exposure: OR=1.50, 95%CI=1.18-1.91, P < 0.05). Compared with children with normal BMI and low learning screen/gaming screen screen exposure, those with both overweight/obesity and high learning screen/gaming screen exposure had a significantly greater risk of executive function abnormalities (OR=2.07, 95%CI=1.29-3.31; OR=2.42, 95%CI=1.59-3.68, P < 0.05). Conclusions Overweight/obesity and high learning screen/gaming screen exposure are important risk factors for executive function abnormalities in preschool children. Therefore, actively guiding preschool children to develop healthy life habits to promote the normal development of their executive functions is essential.

Association of school bullying with the comorbidity of anxiety and depressive symptoms among middle school students in Anhui Province

CHEN Guoping, WANG Zhiqiang, SUN Ying, ZHANG Yukun, WU Jing, YANG Yang, WANG Yuting, YAO Yuan, SONG Weiwei, LI Weidong

2024, 45(8): 1115-1119. doi: 10.16835/j.cnki.1000-9817.2024250

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Objective To understand the prevalence of school bullying and the comorbidity of anxiety and depressive symptoms among middle school students and their association, so as to provide a basis for developing related intervention strategies. Methods From September to December 2023, a multi-stage random cluster sampling was employed to select 107 851 middle school students across 104 counties in Anhui Province. The Center for Epidemiological Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7) Scale were used to assess depressive and anxiety symptoms. Logistic regression analysis was utilized to examine the correlations between experiences of school bullying and the comorbidity of anxiety and depressive symptoms. Results The findings revealed that 2.80% of middle school students had experienced school bullying in the past 30 days. Additionally, 27.03% exhibited potential symptoms of depression, 8.94% showed signs of anxiety symptom, and the comorbidity rate of anxiety and depressive symptoms was 8.04%. Logistic regression analysis showed that statistically significant correlations were identified between experiences of school bullying and increased risks of depressive symptoms (OR=6.42, 95%CI=5.93-6.94, P < 0.01), anxiety symptoms (OR=5.94, 95%CI=5.47-6.44, P < 0.01), and their comorbidity (OR=6.38, 95%CI=5.88-6.93, P < 0.01). Compared with those who did not suffer from school bullying, junior high school students, ordinary senior high school students, vocational senior high school students, boys and girls who suffered from school bullying all had increased risks of comorbidity of anxiety and depressive symptoms (OR=7.25, 5.55, 4.80, 6.42, 6.27, P < 0.01). Conclusions The study underscores the significant impact of school bullying on increasing the risk of comorbidity of anxiety and depressive symptoms among middle school students. It is important to pay attention to the psychological health of bullied students and implement timely psychological intervention measures.

Trends and associated factors in tuberculosis knowledge and behavior among freshmen from Jiangsu Province, 2019-2022

DU Guoping, CHEN Xiaoyan, LÜ Yumei, LI Xiaoshan, TAN Bingxin, LI Yanhui, YE Yuxiu, WEI Yixuan, ZHANG Yuncheng

2024, 45(8): 1120-1125. doi: 10.16835/j.cnki.1000-9817.2024257

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Objective To understand the trends and associated factors of tuberculosis knowledge and behavior among freshmen from Jiangsu Province, 2019 to 2022, so as to provide theoretical support for the popularization of tuberculosis knowledge and the prevention and control of tuberculosis in universities. Methods From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were selected by stratified random sampling, and tuberculosis knowledge and behavior were surveyed online using a self-designed questionnaire. One-way variance trend test and multiple linear regression analysis were used to analyze the trend of knowledge and behavior levels, and a multiple linear regression model was used to analyze the influencing factors. Results The overall awareness rate of tuberculosis among freshmen from Jiangsu Province was 90.6%, and the overall awareness rates from 2019 to 2022 were 88.4%, 90.4%, 91.7%, and 91.8%, respectively. The overall behavioral accuracy rate was 92.3%, with the annual rates from 2019 to 2022 being 91.8%, 92.3%, 92.7%, and 92.4%, respectively. Both the awareness rate and accuracy behavior rate increased annually (F=216.67, 11.75, P < 0.01). The multiple linear regression analysis showed that school type, ethnicity, father's educational level, mother's educational level, mother's occupation, family per capita monthly income, and living arrangement in high school affected both personal knowledge awareness rate and personal behavioral accuracy rate (β=-0.047-0.035, P < 0.01), while region, gender, family residence, and being an only child only affected behavioral accuracy rate (β=-0.003-0.032, P < 0.05). Conclusions The tuberculosis knowledge and behavior levels of freshmen from Jiangsu Province have been increasing by year. Targeted health education should be carried out based on the relevant influencing factors to further enhance the tuberculosis prevention and control literacy.

Tobacco epidemic and related factors among junior high school students in Beijing in 2019 and 2023

QIN Ran, WANG Yifan, ZHAO Jinhui, LI Ting, ZHANG Jingshu, GUO Xin

2024, 45(8): 1126-1130. doi: 10.16835/j.cnki.1000-9817.2024233

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Objective To understand the prevalence and related factors of tobacco use among junior high school students in Beijing, so as to provide evidence to effectively conduct tobacco control intervention strategy. Methods From April to June in 2019 and 2023, 6 489 and 6 898 junior high school students were selected by the probability proportion to size(PPS) method, and a total of 13 387 questionnaires were completed. Questionnaire on tobacco monitoring among junior high school students in Beijing was completed by self-filling. The monitoring content included demographic information, second-hand smoke exposure, tobacco product use, tobacco awareness, etc. Chi-square test was used to compare the difference of various indicators in different groups, and multivariate Logistic regression analysis was adopted to analysis the influencing factors related to the current smoking among junior high school students. Results In 2019, the current traditional cigarettes and e-cigarette smoking rates among junior high school students in Beijing were 1.34%, 1.88%, respectively, and decreased to 0.81%, 1.06% in 2023 (χ²=8.36, 15.17, P < 0.01). The attempted traditional cigarettes and e-cigarette smoking rates among junior high school students in Beijing decreased from 6.67%, 6.47% in 2019 to 3.93%, 4.16% in 2023 (χ²=49.99, 35.26, P < 0.01). In 2019, the second-hand smoke exposure rates of junior high school students at homes, indoor public places, and outdoor public places were 31.04%, 44.94%, and 49.88% respectively which decreased to 22.59%, 30.23%, and 36.14% in 2023 (χ²=121.63, 308.60, 257.41, P < 0.01). In 2023, male students (OR=2.88), senior students (grade 2 and 3) (OR=4.37, 4.92), disposable pocket money>20 yuan/week (OR=2.01), second-hand smoke exposure at home (OR=2.74), indoor public places (OR=2.64), perception that smoking makes young people more attractive (OR=6.29), and perception that e-cigarettes help quit smoking (OR=4.31) were associated with higher tobacco use (P < 0.05). Conclusions Tobacco use and second-hand smoke among junior high school students in Beijing decrease significantly. Tobacco control interventions should be provided for junior high school students continuously with a focus on e-cigarettes use to promote physical and mental health development among students.

Use of mobile fitness APP in college students and its relationship with healthy lifestyle

MA Guangbin, SHI Yongli, JU Hongxin, CHEN Jiyu, ZHAO Zixuan, CHEN Zhongming

2024, 45(8): 1131-1135. doi: 10.16835/j.cnki.1000-9817.2024253

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Objective To investigate the use of mobile fitness application (APP) and healthy lifestyles of college students, so as to provide a theoretical basis for improving the health quality of college students and promoting the national scientific fitness. Methods From August to October 2023, 591 college students from three universities in Jinan and Weifang Cities, Shandong Province were selected by stratified cluster random sampling method, and the online questionnaire was conducted on the mobile fitness APP use behavior and healthy lifestyle. The t-test and analysis of variance were used to assess the differences in healthy lifestyle of college students, and stratified linear regression was used to analyze the effect of mobile fitness APP use on healthy lifestyle. Results The utilization rate of mobile fitness APP among college students was 82.57% (n=488), and the average score of healthy lifestyles was (3.49±0.66). The differences in students' healthy lifestyle scores between different residences, grades, majors, monthly living expenses, annual personal visits, and family medical expenses were statistically significant (t/F=23.82, 4.87, 6.07, 10.17, 3.79, 16.92, P < 0.05). The results of stratified regression analysis showed that the overall evaluation of mobile fitness APP, and the recommendation intention of mobile fitness phone APP were the main related factors of healthy lifestyles among college students (β=0.47, 0.06, P < 0.05). Conclusions College students have a high degree of use of the mobile fitness APP, and the mobile fitness APP is positively associated with a healthy lifestyle.It should increase the publicity and promotion of mobile fitness APP to promote college students to develop a healthy lifestyle.

Present situation of health education on school myopia prevention and control in primary and middle schools in Beijing

WANG Yao, QIN Tingting, GU Mingyu, YANG Yutong, GUO Junjun, LI Xingming

2024, 45(8): 1136-1139. doi: 10.16835/j.cnki.1000-9817.2024246

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Objective To investigate the present situation of health education on school myopia prevention and control in primary and middle schools in Beijing, so as to provide scientific basis and suggestions for effective implementation of health education on school myopia prevention and control. Methods From November 6-17, 2023, a total of 551 school doctors and health care teachers from public primary and secondary schools in seven districts of Beijing were investigated by using stratified random cluster sampling method. The contents included basic information, the basic situation of school health work, and the status of myopia prevention and control in schools. The data was described by frequency and proportion. Chi-square test was used to analyze the influencing factors. Results A total of 89.8% of the respondents were found in the school of offering health education courses about myopia prevention and control. Among these respondents, 54.5% were equipped with health education course material of professional myopia prevention and control, and the teachers were primarily class teachers (57.6%), health care teachers (45.5%), and physical education teachers (45.1%), and most of the classes were conducted once a month (33.7%) and once a semester (28.1%). A total of 95.6% of the subjects had health education activities about myopia prevention and control at their schools. The frequency of activities was once a month (38.5%) and once a semester (27.9%). There were statistically significant differences of the report rate in setting up health education courses on myopia prevention and control, and the frequency of activities in different areas and different types of schools (χ²=19.53, 13.15, 34.30, 20.32, P < 0.05). Conclusions Health education on school myopia prevention and control in primary and middle schools in Beijing is supportive. But health education courses taught by professional teachers should pay attention to the norms of the course material to complete a certain amount of class time, and development of health education activities should be diversified, so as to effectively implement health education of myopia prevention and control at school.

Association between dietary habits and sleep duration among middle school students in Shanghai

YIN Xiaoya, ZHAI Yani, YUAN Linlin, YAN Qiong, ZHOU Xinyi, LUO Chunyan, SUN Lijing

2024, 45(8): 1140-1143. doi: 10.16835/j.cnki.1000-9817.2024202

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Objective To explore the association between dietary behaviors and sleep duration among middle school students in Shanghai, so as to provide reference for interventions targeting insufficient sleep. Methods From May to June 2021, a stratified cluster random sampling method was employed to select a sample of 10-17-year-old middle school students for monitoring their health-risk behaviors. A total of 5 538 valid questionnaires were collected. The survey included items such as daily sleep duration, weekly consumption of sugary beverages, freshly squeezed fruit juice, fresh fruits, fresh vegetables, fried foods, milk and yogurt, breakfast habits, and frequency of eating outside. Statistical analysis was conducted using Chi-square test, Wilcoxon rank-sum test, and multivariable Logistic regression model. Results About 73.7% of middle school students reported insufficient sleep in Shanghai. There was a positive correlation between the average daily consumption of fresh fruits and breakfast consumption with sleep duration. In other words, a higher frequency of consuming fresh fruits (OR=1.29) and eating breakfast (OR=1.07) were associated with a higher likelihood of sufficient sleep. Conversely, there was a negative correlation between the frequency of consuming desserts (OR=0.78) and fried foods (OR=0.88) and sleep duration (P < 0.05). Conclusions Increasing the consumption of fresh fruits and maintaining regular breakfast habits while reducing the intake of fried foods can contribute to achieving sufficient sleep among middle school students. When implementing interventions to improve sleep among middle school students, promoting healthy and balanced diets can be considered as one of the intervention strategies.

Association between family screen environment and screen content for preschool children in Shanghai

SUN Yi, YU Tao, PENG Yajun, CHEN Hao, LUO Sha, JIA Yingnan

2024, 45(8): 1144-1147. doi: 10.16835/j.cnki.1000-9817.2024255

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Objective To investigate the current status of screen exposure among preschool children in Shanghai and its association with family screen environment, so as to provide a scientific basis for family screen management. Methods Using a convenient sampling method, a total of 349 preschool children aged 4-6 years were selected from 36 kindergarten classes in Xuhui District and Pudong New Area in Shanghai during April to June in 2023. Demographic characteristics and family screen environment were surveyed through an online questionnaire. Screen exposure of children was assessed using a diary method, with parents recording the activities over a 7-day period. Multiple Logistic regression analysis was employed to identify factors influencing children's screen content. Results The average daily screen exposure time for children was (61.2±40.2) minutes, with an average of (12.4±17.6) minutes spent on educational screen content, 80.8% predominantly watched non-educational screen content. The percentages of time spent on educational screen content for 4-year-old boys, 4-year-old girls, 5-year-old boys, 5-year-old girls, 6-year-old boys, and 6-year-old girls were 20.1%, 14.7%, 21.3%, 21.9%, 20.6%, and 26.9%, respectively. Multivariate Logistic regression showed that children aged 5-year-old (OR=0.49, 95%CI=0.25-0.96) and 6-year-old (OR=0.45, 95%CI=0.21-0.95) were negatively associated with more non-educational screen content (P < 0.05). However, occasional (OR=2.02, 95%CI=1.09-3.75) and sometimes (OR=4.50, 95%CI=1.70-11.90) using electronic devices to calm young child when crying, as well as children using electronic devices without adult supervision (OR=1.81, 95%CI=1.01-3.24) were positively associated with more non-educational screen content (P < 0.05). Conclusions Preschool children in Shanghai exhibit high exposure to non-educational screen content, and family screen environment and parent-child interaction are associated with non-educational screen exposure. Strategies for family screen management should be developed to regulate children's screen exposure behaviors, allowing electronic devices to play a positive role in their developmental process.

Awareness and service utilization of HIV pre- and post-exposure prophylaxis among the young students aged 15-24 years in Hefei

DAI Seying, ZHANG Jin, ZHANG Dandan, LIU Aiwen, YAO Hui, WU Jiabing

2024, 45(8): 1148-1151. doi: 10.16835/j.cnki.1000-9817.2024251

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Objective To understand the awareness and service utilization of HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) among the young students aged 15-24 in Hefei, so as to provide reference for the prevention and treatment of AIDS among young students in the future. Methods From May to June 2022, a stratified random cluster sampling method was used to select two different types of universities(undergraduate and vocational colleges) in Hefei, and a cross-sectional survey was conducted among the 916 young students at the selected schools. The Chi-square test was used for statistical analysis. Results Among the surveyed young students, 88.4% had heterosexual orientation, and 12.4% had sexual behavior including 8.8% of homosexual sexual behavior and 91.2% of heterosexual sexual behavior. The rate of condom use was 70.0% in the last homosexual intercourse, and the rate of condom use was 83.7% in the last heterosexual intercourse. About 41.9% of young students heard of PrEP, and the proportions of young students who knew about PrEP, consulted PrEP and used PrEP were 43.0%, 15.9% and 9.4% respectively. About 38.3% of young students had heard of PEP, and the proportions of young students who knew about PEP, consulted PEP and used PEP were 18.2%, 15.4% and 6.0%. Conclusions The awareness rate and utilization rate of PrEP and PEP among young students in Hefei are relatively low. PrEP and PEP publicity should be combined with education of HIV knowledge, and enhance the awareness rate of the young students, in order to reduce the risk of AIDS infection among young students with high-risk behaviors.

Correlation between physical exercise and parenting styles, and psychological resilience of college students

ZHAO Renda, YU Jihao, GUO Jiarui, WANG Xiangying

2024, 45(8): 1152-1156. doi: 10.16835/j.cnki.1000-9817.2024240

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Objective To explore the relationship between physical exercise and parenting styles, and psychological resilience among college students, in order to provide guidance for improving college students' physical exercise status. Methods From September 10, 2022 to January 6, 2023, 1 227 students from three comprehensive universities in Jinan were selected for investigation using a stratified random sampling and convenient sampling method. Physical exercise was assessed using the Physical Activity Rating Scale, parenting style was evaluated with the short-Egna Minnen av Barndoms Uppfostran for Chinese (s-EMBU-C), and psychological resilience was measured by the Resilience Scale for Chinese Adolescents (RSCA). The influence of parenting style and psychological resilience on physical exercise was explored by Pearson correlation analysis, linear and Logistic regression analysis. Results A total of 815 (66.42%) engaged in low-intensity exercise, 308 (25.10%) in moderate-intensity exercise, and 104 (8.48%) in high-intensity exercise. The total score on the Physical Activity Rating Scale was (22.15±0.72). Logistic regression analysis showed that gender (OR=1.58, 95%CI=1.07-2.33) and whether the student was a sports specialist (OR=1.61, 95%CI=1.17-2.22) were the related factors for college students' physical exercise classification(P < 0.05). Linear regression analysis showed that emotional warmth dimensions of the s-EMBU-C (mother version and father version), the total score of s-EMBU-C(mother version), positive cognition, emotional control and the total score of RSCA all affected the physical activity level of college students (β=0.29, 0.20, 0.26, 0.32, 0.15, 0.20, P < 0.05). Conclusions College students' physical exercise behavior is closely related to gender, sports specialization, parenting styles, and psychological resilience. Colleges and universities can promote changes in physical exercise behavior among college students through joint parental supervision and psychological counseling.

Analysis of sub-clinical eating disorders and associated factors in college students

ZHANG Ye, HAN Ting, YAO Hongwen, SUN Liping, ZHAO Minxin, ZHU Lujiao, ZHANG Jingjing, LIAO Yuexia

2024, 45(8): 1157-1161. doi: 10.16835/j.cnki.1000-9817.2024247

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Objective To investigate the sub-clinical eating disorders among college students and to analyze associated factors, so as to provide a basis for the prevention and treatment of eating disorders among adolescents. Methods From November to December 2023, a total of 5 201 college students were selected by stratified random cluster sampling from one undergraduate college and one specialized college in Yangzhou City, Jiangsu Province. Data on general information, sub-clinical eating disorders, body image perception, depressive symptoms, anxiety symptoms, and mental health literacy were collected using questionnaires. The Chi-square test was used to compare the detection rates of sub-clinical eating disorders between groups, and binary Logistic regression was employed to analyze associated factors. Results The detection rate of sub-clinical eating disorders among college students was 16.0%. Binary Logistic regression analysis showed that the prevalence of sub-clinical eating disorders among college students was higher in the following categories: being in a relationship (OR=1.22, 95%CI=1.04-1.44), being overweight and obese (OR=2.75, 3.82, 95%CI=2.24-3.38, 2.89-5.06), overestimation of body shape (OR=2.04, 95%CI=1.68-2.49), being in a depressive state (OR=2.53, 95%CI=1.99-3.21), experiencing anxiety (OR=2.63, 95%CI=2.16-3.20), and having substandard mental health literacy (OR=1.37, 95%CI=1.11-1.70). Conversely, low body weight (OR=0.15, 95%CI=0.10-0.22) and underestimation of body shape (OR=0.37, 95%CI=0.27-0.51) were associated with a lower risk (P < 0.05). Conclusions The detection rate of sub-clinical eating disorders among college students is high, and it is associated with relationship status, body mass index classification, body shape perception, depressive and anxiety symptoms, and mental health literacy. Comprehensive interventions should be implemented to improve the sub-clinical eating disorders and promote the physical and mental health of college students.

Changes in physical fitness of freshmen in one university from 2014 to 2022

ZHAO Yang, SUN Tong, LIANG Dan, CHEN Huadong

2024, 45(8): 1162-1165. doi: 10.16835/j.cnki.1000-9817.2024228

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Objective To analyze the trend of physical fitness of freshmen of Fujian Medical University from 2014 to 2022, so as to provide theoretical basis and reference for deepening the reform of physical education in medical colleges. Methods Based on the physical examination and health monitoring data of 23 874 freshmen from Fujian Medical University during 2014 to 2022, Pearson correlation analysis and linear regression analysis were used to analyze the development trend of physical health of freshmen over the past 9 years. Results From 2014 to 2022, there was an upward trend in height, weight, body mass index (BMI), and lung capacity among first-year male students, first-year girls showed an upward trend in height, weight, BMI, lung capacity, standing long jump, sitting forward bending, sit ups, and 800 meter run performance. From the perspective of effect size d and explanatory rate r², male lung capacity (d=0.60) showed a moderate effect, while the lung capacity (d=0.81) and sit ups (d=1.01) of female students showed a moderate effect, and sitting forward flexion (d=0.57) showed a large effect (P < 0.01). Conclusions Physical form level of freshmen have steadily improved during 2014 to 2022. Female students show a more clear increasing trend in standing long jump, sitting forward bending, sit ups, and 800 meter run.

Development and application of Beverage Addiction Scale for College Students

XU Honglü, TAO Shuman, YANG Jieru, SU Yunpeng, TU Xiaohong, TAO Fangbiao

2024, 45(8): 1166-1170. doi: 10.16835/j.cnki.1000-9817.2024227

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Objective The aim of the present study was to develop the beverage addiction scale for college students, so as to provide an effective tool for assessing college students beverage addiction. Methods In November 2022, a cluster sample of 8 792 college students from three colleges in Yunnan and Jiangxi were surveyed by Beverage Addication Scale for College Students. After a through literature review, 12 items were proposed, including withdrawal symptoms, health effects and addiction symptoms, with 4 items each. The t-test and correlation analysis were used to filter the items, and exploratory factor analysis and confirmatory factor analysis were used to evaluate the structural validity of the questionnaire. In May 2023, 5 279 college students from the above three universities were surveyed again to evaluate the reliability and validity of the scale and the positive demarcation value of symptoms. Results The scale fitted into a tool for measuring symptoms of beverage dependence in a college student population. The scale was composed of 11 items in accordance with withdrawal symptoms, health effects and addiction symptoms, with a cumulative contribution rate of variance was 74.51%. Cronbach α coefficients for the overall scale and three dimensions were 0.94, 0.88, 0.90 and 0.92, respectively. The correlation coefficient between each item and the total score ranged from 0.56 to 0.79, and the correlation coefficient with the dimension ranged from 0.71 to 0.92. The confirmatory factor analysis model was well fitted, and the RMSEA, CFI, TLI and SRMR value were 0.06, 0.95, 0.93 and 0.04, respectively. The application of the scale showed that scores on the scale and each dimension ≥P₈₅ were positive for symptoms. Conclusion The reliability and validity of Beverage Addiction Scale for College Students is good, which can be used to evaluate the beverage addiction symptom of college students.

Prevalence of comorbidity of spinal curvature abnormality and malnutrition among primary and middle school students in Tianjin in 2023

ZHANG Yihang, LI Jiaxin, HUANG Tianyu, CAI Shan, CHEN Ziyue, DANG Jiajia, LIU Yunfei, SHI Di, JIANG Jianuo, LIU Zhonghui, CHEN Lu, ZHANG Xianwei, DONG Yanhui, SONG Yi

2024, 45(8): 1171-1175. doi: 10.16835/j.cnki.1000-9817.2024235

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Objective To analyze the prevalence of comorbidity of spinal curvature abnormality and malnutrition among primary and secondary school students aged 10-18 years in Tianjin in 2023, so as to provide scientific basis for the combined prevention of common diseases and multiple diseases among students and the construction of school health system. Methods In September to October 2023, 31 884 primary and secondary school students aged 10 to 18 years in Tianjin were selected using stratified cluster random sampling. Abnormal spinal curvature in children and adolescents was assessed by Sereening of Spinal Curvature Abnormality of Children and Adolescents, while stunting, wasting, overweight, and obesity were determined according to the Screening for Malnutrition among School-age Children and Adolescents and Screening for Overweight and Obesity among School-age Children and Adolescents. The χ² test was used to compare between-group differences in co-prevalence, and multiple Logistic regression models were used to analyze the risk of different comorbidity types in different clusters. Results The co-prevalence of spinal curvature abnormality and malnutrition among primary and secondary school students in Tianjin was 1.6%, which was higher for girls than boys (1.8%, 1.4%), higher (2.5%) for senior high schools than for junior high schools and elementary schools (2.0%, 0.5%), and higher in rural than in urban areas (2.1%, 1.1%) (χ²=9.45, 141.92, 46.94, P < 0.05). Multiple Logistic regression models showed that junior high school girls had a higher risk of incorrect posture comorbid with stunting and wasting (OR=4.52, 95%CI=1.84-11.06) and incorrect posture comorbid with overweight and obesity (OR=2.67, 95%CI=1.74-4.10) than boys, and that scoliosis/sagittal spinal abnormality comorbid with stunting and wasting (OR=0.10, 95%CI=0.02-0.44) risk was lower than that of boys, senior high school girls had a lower risk of scoliosis/sagittal spinal abnormality comorbid with overweight and obesity (OR=0.27, 95%CI=0.11-0.66) (P < 0.05). Conclusions The co-prevalence of spinal curvature abnormality and malnutrition is specific among primary and secondary school students in Tianjin, and the comorbidity type varies by gender and education stage. There is a need to increase prevention and control of spinal curvature abnormalities in school health working, intensive screening of key populations, and timely intervention.

Trends and factors associated with overweight and obesity among primary and secondary school students in Tianjin from 2019 to 2023

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

2024, 45(8): 1176-1180. doi: 10.16835/j.cnki.1000-9817.2024234

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Objective To understand trends and related factors influencing overweight and obesity among primary and secondary school students in Tianjin, so as to provide a basis for formulating overweight and obesity prevention and control strategies. Methods In September of each year from 2019 to 2023, a survey was conducted among 197 707 primary and secondary school students in 16 districts of Tianjin through a stratified random cluster sampling method. Physical examination was carried out in accordance with the Technical Standard for Physical examination for Student, and overweight and obesity survey was carried out. Basic information, smoking, drinking, diet, physical exercise, and sleep status were collected through questionnaire surveys. Results The detection rates of overweight and obesity among primary and secondary school students in Tianjin from 2019 to 2023 were 39.07%, 43.33%, 41.54%, 43.92%, and 40.24%, respectively, showing an increasing trend(χ_trend²=7.96, P < 0.01). The detection rates of overweight increased in both vocational high schools and suburban counties (χ_trends²=9.08, 47.18, P < 0.01). The detection rates of obesity increased among both male and female students, in primary and vocational high schools and suburban counties (χ_trends²=108.34, 15.99, 7.32, 10.95, 14.75, P < 0.01). Multivariate Logistic regression analysis showed that smoking, drinking, unhealthful diet, and lack of proper physical exercise had a higher risk of obesity among primary and secondary school students (OR=1.26, 1.13, 1.08, 1.21, P < 0.05). Stratified analysis showed that the risk of obesity was higher among boys with unhealthful and moderate lifestyle habits, as well as primary school students with unhealthful lifestyle habits (OR=1.15, 1.11, 1.27, P < 0.05). Boys, girls and primary school students with unhealthful lifestyle habits, girls and ordinary high school students with moderate lifestyle habits had higher risk of being overweight (OR=1.14, 1.32, 1.21, 1.18, 1.40, P < 0.05). Conclusions The detection rates of overweight and obesity among primary and secondary school students in Tianjin shows an increasing trend. Comprehensive lifestyle should be implemented to better prevent and control the risk of overweight and obesity.

Dose-response relationship between elevated blood pressure and body mass index in primary and secondary school students in Shibei District, Qingdao

WANG Chunhui, HU Baocui, REN Zhisheng, CHEN Jian, HE Qianqian

2024, 45(8): 1181-1185. doi: 10.16835/j.cnki.1000-9817.2024249

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Objective To investigate the dose-response relationship between the risk of elevated blood pressure and body mass index (BMI) in primary and secondary school students in Shibei District, Qingdao, so as to provide a reference for precise interventions of elevated blood pressure. Methods Statistical analysis was conducted on the health examination data of 92 091 primary and secondary school students in Shibei District, Qingdao, in 2022. Overweight and obesity were assessed using the standards from the Screening for Overweight and Obesity among School-aged Children and Adolescents, and blood pressure levels were evaluated using the Reference of Screening for Elevated Blood Pressure among Children and Adolescents Aged 7-18 Years. The relationship between BMI and elevated blood pressure was examined using analysis of variance, Chi-square test, multifactorial Logistic regression, and a combination of restricted cubic spline after data cleaning. Results Based on the standardized scores under different age and gender, BMI was classified into 5 categories. Compared with the group of BMI-Z scores 0- < 1, the risk of developing high blood pressure gradually decreased with BMI-Z scores (OR=0.55, 0.53, P < 0.05). Conversely, the risk of developing high blood pressure increased with increasing BMI-Z scores (OR=1.90, 3.71, P < 0.05). Stratified analyses showed that BMI was positively associated with elevated blood pressure by gender (male, female), age (aged 7-8, 9-11, 12-14, 15-16), and waist-to-hip ratio (≤0.83, >0.83) (OR=1.18, 1.19, 1.15, 1.22, 1.19, 1.18, 1.19, 1.18, P < 0.01). There were multiplicative interactions between BMI and gender, between BMI and age, between BMI and waist-to-hip ratio (OR=1.53, 1.08, 2.31, P < 0.01). Restricted cubic spline analysis showed that as BMI levels increased, the risk of developing elevated blood pressure showed a non-linear increasing trend in both the 7-year-old and the 10 to 16-year-old (χ²=27.56, 10.69, 6.10, 27.26, 18.32, 25.71, 10.53, 6.14, P < 0.05). Conclusions The risk of elevated blood pressure in primary and secondary school students increases with BMI, showing a non-linear dose-response relationship. The blood pressure should be monitored regularly, and comprehensive and effective measures should be implemented to control elevated blood pressure in children and adolescents.

Current status and trend prediction of the disease burden of eating disorders among Chinese adolescents aged 10-24 years

LU Di, ZENG Zhi, ZHU Di, HE Yijuan, CHEN Sinian

2024, 45(8): 1186-1190. doi: 10.16835/j.cnki.1000-9817.2024252

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Objective To analyze the burden indicators and trend predictions of eating disorders in Chinese adolescents aged 10-24 years from 1990 to 2019, so as to provide a reference for the prevention and control of eating disorders among adolescents. Methods According to the latest data of the Global Burden of Disease Study(GBD) 2019 database classified by gender, age group and other indicators, the Joinpoint regression model and bayesian age period cohort model(BAPC) were used to analyze and predict the incidence rate, prevalence and disability-adjusted life year (DALY) rate of eating disorders among Chinese adolescents aged 10 to 24 years old, and explore the trend of the disease burden of eating disorders in this population in the past three decades. Results From 1990 to 2019, the overall crude incidence rate of eating disorders among adolescents in China increased from 278.93/10⁵ to 422.27/10⁵, and the crude incidence rate increased from 122.63/10⁵ to 198.80/10⁵, and the crude DALY rate increased from 26.67/10⁵ to 43.50/10⁵. In terms of gender, the standardized incidence rate, standardized prevalence rate and standardized DALY rate of eating disorders of boys and girls all showed an upward trend(boys: AAPC=1.52%, 1.84%, 1.86%, girls: AAPC=1.28%, 1.74%, 1.77%, P < 0.05). The standardized incidence rate, standardized prevalence rate and standardized DALY rate of boys with eating disorders (54.97%, 68.88%, 69.75%) were higher than those of girls (44.26%, 64.48%, 65.56%), and the differences were statistically significant (χ²=201.45, 35.02, 34.55, P < 0.05). In terms of age groups, the incidence rate of the 15-19-year-old age group (524.10/10⁵) was higher than that of other age groups (10-14-year-old age: 251.17/10⁵, 20-24-year-old age: 476.49/10⁵) (χ²=156.87, P < 0.05), the prevalence rate of the 20-24-year-old age group (278.67/10⁵) and the DALY rate (60.83/10⁵) were higher than those of other age groups (10-14-year-old age: 81.79/10⁵, 18.02/10⁵, 15-19-year-old age: 221.81/10⁵, 48.59/10⁵) (χ²=204.50, 197.14, P < 0.05). BAPC prediction model showed that in the future, the incidence rate of eating disorders among adolescents in China would still show an upward trend, but the prevalence rate and DALY rate would show a steady downward trend, which might reach 516.43/10⁵, 188.41/10⁵ and 41.23/10⁵ respectively in 2030. Conclusions The burden of eating disorders among adolescents in China continues to increase, with boys and those aged 15-19 years being the key populations for prevention and treatment. All sectors of society should actively take relevant measures and pay attention to the prevention and treatment of adolescent eating disorders.

Investigation of a kindergarten norovirus outbreak and detoxification time of infected children in Wuhan

PEI Hongbing, YAN Zhiwen, WU Xiaomin, QI Li, WU Changhan

2024, 45(8): 1191-1194. doi: 10.16835/j.cnki.1000-9817.2024236

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Objective To analyze the characteristics of a norovirus outbreak in a kindergarten, and factors affecting the detoxification time, so as to provide a scientific basis for targeted control measures. Methods On February 24, 2023, the basic personal information, clinical manifestations, morbidity and treatment of 16 kindergarten cases with a norovirus outbreak in Wuhan were collected. Anal swabs were collected every 7 d after the outbreak to detect norovirus. Chi-square test was used for comparison of intergroup rates. The comparison of detoxification time between different groups was conducted by Log-rank test, and the influencing factors of detoxification time in cases were analyzed by Cox multiple regression analysis. Results From February 19-28, 2023, a total of 18 cases were reported and 16 of them participated in the detoxication time monitoring. In the first, second, third and fourth sampling after the outbreak, the positive rates were 60.00%, 100.00%, 75.00% and 0, respectively. The reverse transcriptionpolymerase chain reaction cycle threshold (Ct values) were (25.83±5.74, 28.83±5.55, 36.13±4.30), and undetected, respectively. The median time of detoxification was 19.42 d with 95%CI=(18.21-20.64)d. The results of Cox regression showed that the detoxication time was shorter in the treatment group than in the non-treatment group[HR(95%CI)=5.09(1.39-18.58), P < 0.05]. Conclusion Children infected with norovirus has a long duration of detoxification, and case management, which could be shortened by drugs, and disinfection should be strengthened after the case returned to school.

Co-morbidity of screening myopia and scoliosis among primary and secondary school students in Beijing and associated factors

GAO Ruoyi, SUN Bingjie, LUO Huijuan, E Boran, KUANG Huining, GUO Xin

2024, 45(8): 1195-1198. doi: 10.16835/j.cnki.1000-9817.2024248

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Objective To investigate the co-morbidity of screening myopia and scoliosis among primary and secondary school students in Beijing from 2019 to 2022 and its influencing factors, in order to provide new ideas for comprehensive prevention and control of myopia and scoliosis in children and adolescents. Methods From 2019 to 2022, 34 923, 34 321, 36 008 and 35 598 primary and secondary school students in Beijing were selected by stratified cluster random sampling method, and visual acuity examination, scoliosis examination and questionnaire survey were conducted on them. Chi-square test was used to analyze the inter-group differences between screening myopia and scoliosis among primary and secondary school students, and the correlation factors between screening myopia and scoliosis were analyzed by multivariate Logistic regression. Results From 2019 to 2022, the prevalence of screening myopia increased by year, while scoliosis decreased by year, and the comorbidity rate in 2022 (0.69%) decreased by 1.62% compared with 2019 (2.31%). In 2022, screening myopia with scoliosis rates (0.98%) than urban suburbs (0.50%), high school students (1.65%) >professional high school students (1.21%) >junior middle school students (0.76%) >primary school students (0.22%) (χ²=28.97, 153.55, P < 0.01). The results of multivariate Logistic analysis found that insufficient sleep time and parents did not limit the use of electronic screen time were the risk factors for screening myopia and scoliosis [OR(95%CI)=1.59(1.20-2.12), 1.34(1.02-1.76), P < 0.05]. Teachers often or always remind that reading and writing posture and one hour or more of moderate-intensity physical activity every day were protective factors for screening myopia and scoliosis [OR(95%CI)=0.70(0.52-0.96), 0.56(0.34-0.92), P < 0.05]. Conclusions The co-morbidity of acadmic screening myopia and scdiosis is not optimistic in Beijing. Attention should be paid to the reading and writing posture and related behavioral habits of children and adolescents, and ensure that children in each school section have sufficient sleep time, so as to prevent the occurrence and development of screening myopia and scoliosis.

Qualitative study on HIV/AIDS-related behavioral characteristics in young cases of male students from a district of Chengdu

LENG Bing, ZHOU Jianhui, XU Jingpei, WANG Dewei

2024, 45(8): 1199-1202. doi: 10.16835/j.cnki.1000-9817.2024241

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Objective To investigate the sexual behaviors and acquired immunodeficiency syndrome (AIDS) knowledge acquisition of male students with human immunodeficiency virus(HIV)/AIDS before diagnosis, so as to provide reference for formulating policies and measures for AIDS prevention and control among young students. Methods Qualitative interviews were conducted among 25 newly reported HIV/AIDS male students recruited from January 2021 to December 2023 in the district of Chengdu. The contents of the interviews included high-risk behaviors related to HIV infection, access to knowledge and psychological status after infection. Results All interviewees had sex with men, and the mean age of first homosexual behavior was (17.48±1.64) years old. The time from first sexual behavior to confirmation ranged 0-8 years, with an average of (2.72±1.41) years. The proportion of condom use among interviewees was low, only 2 students reported using every time, and 12 students had never been tested for HIV infection before diagnosis. All interviewees were aware of knowledge about AIDS, but their awareness of risk was low. Among them, 16 thought that they would not be infected, 8 were aware of risks but held a luck mindset, and one did not know the role of such knowledge. Schools and Internet were the main ways to obtain knowledge. Among them, 3 got knowledge through Weibo, Douyin, Zhihu, etc., 9 got knowledge through school lectures, theme class meetings, etc., and 13 got knowledge through schools and the Internet. None of the interviewees had acquired AIDS related knowledge from family education. After knowing being infected, 21 students reported depression, frustration, pessimism, despair and other negative emotions(7 students expressed anxiety and depression, 9 students had fear and terror, 5 students felt regret) and only 4 students had a relatively calm attitude. Conclusions The primary reasons for the infection of young students are early age of first sexual behavior, multiple sexual partners, popularity of online dating and separation of AIDS knowledge and practice among HIV/AIDS male students. Targeted prevention and control measures should be developed to suppress AIDS transmission among young students.

Research progress of adverse exposure in early life and abnormal visual acuity in offspring

LIU Shiyin, YOU Xue, LIN Xiaoyan, MAI Kaitong, LIU Xingtong, CAO Mengting, DU Jiangbo

2024, 45(8): 1203-1207. doi: 10.16835/j.cnki.1000-9817.2024242

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In recent years, the prevention and treatment of eye diseases in children has become one of the worldwide recognized public health issues. Both genetic and environmental factors can influence the development of offspring visual systems, leading to abnormal vision acuity such as refractive errors, strabismus, and nystagmus. With the aim of elucidating the influencing factors and mechanisms of early life adverse exposures on offspring vision outcomes, the article summarizes the research on exposure in early life and visual acuity in offspring from different perspectives, including tobacco exposure during pregnancy, exposure to microelements, gestational diabetes, gestational hypertension, and drug abuse during pregnancy, so as to provide scientific evidence for the development of more effective strategies to prevent and control eye diseases in children and adolescents.

Research progress in the relationships between natural environmental factors and psychological problems among children and adolescents

WEI Runyu, LI Shuqin, WAN Yuhui

2024, 45(8): 1208-1211. doi: 10.16835/j.cnki.1000-9817.2024237

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Abstract:
Increasing attention has been paid to the relationships between the natural environment and psychological problems among children and adolescents. The article reviews research, conducted in China and other countries, examining the relationships between natural environmental factors-such as green space, air pollution, climate change, noise, and psychological problems among children and adolescents, to enhance understanding of these relationships and their possible underlying biological mechanisms. The findings may provide a reference for promoting mental health in children and adolescents.

A narrative review on digital self-harm in adolescents

QIU Yafei

2024, 45(8): 1212-1216. doi: 10.16835/j.cnki.1000-9817.2024243

Abstract(167) HTML (54) PDF(50)

Abstract:
There is a higher incidence of digital self-harm among adolescents and it is more common among adolescents with peer rejection or injury. The motivation for digital self-harm is diverse but more likely to be a means of emotional regulation. The present review clarifies the definition, prevalence and high-risk population of digital self-harm, and explores the motivations, warns of the crisis and risks of adolescent digital self-harm, aims to provide necessary theoretical support and assistance for the prevention of digital self-harm among adolescents.

2024 Vol. 45, No. 8