中国学校卫生

Optimizing the construction of school doctor team and improve the capacity of school health services

CHEN Yajun, YANG Xiuzhi

2024, 45(12): 1673-1676. doi: 10.16835/j.cnki.1000-9817.2024365

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The capacity of school health services is an important guarantee for ensuring physical and mental health of students and faculty, and is an important component of healthy schools. With the development of society, health status of children and adolescents presents new characteristics, which puts forward higher requirements for school health service capabilities. The allocation of health personnel, whether in universities or primary and secondary schools, still faces a common problem of being extremely mismatched with educational needs. To comprehensively build a high-quality school health system that meets the current goal of building a strong education country, optimizing the construction of school doctors has become a key part of it. The article summarizes the main problems and challenges in the construction of school medical teams in China, proposes potential development paths and suggestions, in order to provide the reference for improving and developing high-quality school health work systems, enhancing overall school health service capabilities, and promoting the comprehensive healthy development of children and adolescents.

Fundamental and symptomatic causes of myopia in children and adolescents: optimization and improvement of a comprehensive system

WANG Zhiyong, XU Jun, JIANG Junshu, GUO Lipeng, ZHANG Lijun, ZHANG Mei, MENG Jun, HE Zuoli, ZHANG Fuyong, SUN Ke, LI Rui, LIU Yang, ZHOU Dezhuang

2024, 45(12): 1677-1680. doi: 10.16835/j.cnki.1000-9817.2024353

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Prevention and control of myopia requires comprehensive measures. Based on the system established earlier, the system is revised and upgraded. The original system emphasizes comprehensive measures and proposes to focus on both the symptoms and root causes. These measures are summarized into six aspects, three address the root cause measures including health education, glasses optics and visual environment, and three address symptoms measures including eye exercises, physical therapy and drugs. The paper is comprehensively supplemented and analyzes the primary and the secondary, and promotes physical therapy from treating the symptoms to treat both the symptoms and the root causes. These improvement measures will help promote the prevention and control of myopia in children and adolescents.

Establishment and management of health room in primary and secondary schools in Jilin Province

WANG Qiao, YANG Shujuan, ZHANG Yiquan, ZHANG Peibin, YU Miao, LIU Yunjuan, CUI Ting

2024, 45(12): 1681-1685. doi: 10.16835/j.cnki.1000-9817.2024379

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Objective To understand the current situation of health rooms in primary and secondary schools in Jilin Province, so as to provide the data support for scientific decision-making. Methods From April to July 2023, 512 primary and secondary schools and 1 432 school doctors and health care teachers were selected through convenience sampling method in Jilin Province to conduct an electronic questionnaire survey, including the basic information of the school, the situation of health rooms, personnel setting, and the development of school health work. Results Among the 512 schools, only 6.4% of the 299 schools that should have clinics had medical institution practice licenses. The compliance rate of clinic area was 16.6%, and the compliance rate of health room area was 75.0%. About 92.1% of the middle schools and 90.6% of the primary schools identified the reporters of infectious diseases, and 90.9% of the primary schools and 85.5% of the secondary schools filed files for students. Totally 73.5% of the staff in the health room were teachers, and only 17.9% were health professionals. Nearly 70.1% of school doctors or health care teachers were engaged in part-time jobs, and 60.9% engaged in school health for ≤5 years. In terms of the content in urgent need of training and improvement, the top five were knowledge about first aid (79.7%), infectious disease prevention and treatment(73.3%), health education (64.0%), common disease diagnosis (60.1%) and psychological counseling (53.6%). Conclusions Health care institutions, equipment and facilities in primary and secondary schools in Jilin Province are inadequate, and the construction of school doctors and health care teachers is in need of improvement. It should pay more attention to school health and work together to optimize the team of school doctors and health care teachers.

Current situation of mental health education in primary and secondary schools in Beijing

HOU Xinyu, YANG Jia, LI Ying, LIU Peng, GAO Liwang, GU Mei, ZHAO Jingxuan

2024, 45(12): 1686-1690. doi: 10.16835/j.cnki.1000-9817.2024385

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Objective To understand the current situation of mental health education in primary and secondary schools in Beijing, so as to provide the data support and policy suggestions for mental health work in Beijing. Methods From April to May 2024, a multi-stage random sampling method was used to select 399 primary and secondary schools in Beijing to conduct a questionnaire survey. Chi-square test was used to compare the differences resource allocation of mental health education, current status of mental health education by regions and educational stages. Results There were significant differences in reporting rates for the allocation of professional and part-time psychological teachers in different regions and educational stages (professional: χ²=17.86, 20.74, part-time: χ²=13.56, 25.63, P < 0.05). There was significant differences the implementation of mental health education courses for students in different educational stages (χ²=12.83, P < 0.05). There was significant differences the implementation of mental health education training for staff in different regions (χ²=17.79, P < 0.05). Professional psychology teachers were well equipped in urban schools (84.13%) and 9-year or 12-year schools (85.33%), and part-time psychology teachers were well equipped in suburban schools (68.49%) and primary schools (71.35%). Schools in the outer suburbs (96.88%) had the best implementation of mental health education training for staff, and the 9-year or 12-year schools (100.00%) had the best implementation of mental health education courses for students. Totally 93.98% of schools carried out mental health education activities, 90.23% of schools established mental health consultation rooms, and 88.97% of schools integrated mental health education into other courses. Conclusions The development of mental health education in primary and secondary schools in Beijing is good. It is suggested that the quality of mental health education in primary and secondary schools in Beijing should be improved by implementing the requirements of psychological teacher allocation, the coordination among family, school and community, and paying attention to teachers' mental health level.

Current status of standardized construction of health system in colleges and universities of Guangdong Province

YANG Xiuzhi, CHEN Yajun

2024, 45(12): 1691-1694. doi: 10.16835/j.cnki.1000-9817.2024371

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Objective To understand the current status of the standardized construction of the health system in colleges and universities in Guangdong Province, so as to provide recommendations for promoting its standardized construction. Methods From October to November 2023, a random digital table method combined with a questionnaire survey and one-site investigation were used to investigate the basic information of school medical institutions, the construction situation of school medical institutions, the service provision of school medical institutions, the work of infectious disease prevention and control, and health education in 281 branches of 169 colleges and universities across 21 cities in Guangdong Province. Results Among the 281 branches of colleges in Guangdong Province, 264 (94.0%) had school medical institutions. Among those, 88 (33.3%) had a preventive health care department, and 35 (13.5%) had one office for health education research. There were a total of 2 950 health professionals in school medical institutions, with 988 being regular staff members, 372 (12.6%) of whom hold senior titles. A total of 190 (73.4%) branches conducted annual infectious disease prevention and control health education for faculty, 219 (84.6%) branches conducted annual health education for students with at least 1 hour of instruction, 109 (42.1%) branches offered health education courses, and 106 (40.9%) branches established health education resources. Conclusion The construction of health system in colleges and universities in Guangdong Province is becoming more complete, but there are still issues such as unclear functional positioning of school health-related departments and personnel, a weak team of school health professionals, and insufficient investment in health education.

Allocation of school health staff and clinics in primary and secondary schools in Guangdong Province

JIN Zhengge, CHEN Yican, ZHAO Yu, ZHANG Shuxin, KAKAER Aerziguli, TAN Kaiyun, ZHANG Jingshu, CHEN Yajun

2024, 45(12): 1695-1698. doi: 10.16835/j.cnki.1000-9817.2024372

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Objective To understand the allocation of health staff and clinics in primary and secondary schools in Guangdong Province, so as to provide a reference for school health construction. Methods In December 2020, a total of 17 205 primary and secondary schools in 21 cities in Guangdong Province were investigated by combining document verification and on-site surveys. The allocation of health staff and clinics in different cities and types of schools was analyzed using SPSS 25.0 software. Results The proportion of schools in Guangdong Province that met the national standard for school health staff ratio was 37.7%. Among different types of schools, the lowest ratio was found in nine-year schools (33.1%), while the highest was in twelve-year schools (61.3%). Among the 17 205 schools in the province, 12.6% had clinics with an area of >40 m², and 6.9% with occupational licenses for medical institutions. The proportion of full-time health staff was 39.1%. Among all school health staffs, the proportions of permanent staff, temporary staff, and appointed staff were 47.5%, 29.0% and 23.6%, respectively. The rate of school health staff with professional qualifications was 44.9%, while 48.3% had graduated from medical-related majors, and 20.9% held a bachelor's degree or higher as their first degree. There were differences among various types of schools, with primary schools having the lowest health staff configuration and professional level (24.0% and 35.7%, respectively). Conclusions There are still issues of insufficient staff and low professional level in health staff and establishment of clinics in primary and secondary schools in Guangdong Province, and the allocation is uneven across different types of schools. The allocation of clinics in the province is still in urgent need of improvement.

Current situation of primary and secondary school students' health services in community health service organizations in Shenzhen

LU Wenlong, LIN Bingliang, XUAN Peng, LI Yan, WEN Erya, LAN Lina, XIONG Jingfan

2024, 45(12): 1699-1703. doi: 10.16835/j.cnki.1000-9817.2024357

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Objective To understand and assess the current situation of primary and secondary school students' health services in community health service organizations in Shenzhen, so as to provide a basis for upgrading the capacity of health services. Methods A total of 684 community health service organizations and 587 part-time health vice-principals in the Shenzhen City were selected for the study in June 2022, and the special questionnaire surveys regarding primary and secondary school students' health service capacity and the community health service organizations and part-time health vice-principals performance ability were administered in Shenzhen. SPSS 26.0 software was used for a descriptive analysis. Results The staffing rate of general practitioners or clinical physicians in Shenzhen's community health service organizations was 99.9%, 67.1% of community health service organizations established counterpart collaborative relationships with schools, 50.8% of community health service organizations provided diagnostic and treatment services for students, 24.8% of community health service organizations provided health check-up services for students, 85.2% of community health service organizations provided health guidance to schools, and 94.3% of community health service organizations had a part-time vice-principal of health with a score of (7.63±1.59) in the self-assessment of their ability to carry out their duties, and space constraints and shortage of nursing were the main problems in promoting student medical check-ups in the community health service organizations. Conclusions The community health service organizations in Shenzhen suffer from inadequate medical service resources and inadequate training for professional staff, resulting in low service capacity for providing physical examinations and health management for primary and secondary school students. There is a need to further promote the integrated development of education and health, and continuously enhance service capabilities, to promote the orderly development of student health work.

Association between parental education level and time spent outdoors among children

WANG Tianxiao, WANG Jingjing, DU Linlin, YANG Jinliuxing, CHEN Hui, DONG Kaige, ZHANG Bo, HE Xiangui, CHEN Jun

2024, 45(12): 1704-1707. doi: 10.16835/j.cnki.1000-9817.2024367

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Objective To explore the association between parental education level and time spent outdoors among children, so as to provide the scientific evidence for formulating policies of myopia prevention and control among children. Methods The study was based on secondary analysis of data from outdoor intervention studies in Shanghai. The follow-up period was from March to December 2018. It included control group children (n=1 117) with complete questionnaire surveys, ocular examinations, and time spent outdoors. Generalized linear regression models and trend tests were used to analyze the effect of parental education level on time spent outdoors among children. Results The median time spent outdoors was 76.4(59.7, 94.6) minutes. After adjusting for covariates including children's sex and age, generalized linear regression model suggested that there was no statistical significance between father's education level and outdoor activity time (P>0.05). Compared with children whose mothers had a junior high school education or below, children whose mothers had high school/vocational high school education, college or above had shorter time spent outdoors (β=-6.64, -8.84, P < 0.05). Trend tests revealed that time spent outdoors among children decreased with the increase of parental education level (P_trend < 0.01). Conclusions The higher the education level of fathers or mothers, the shorter time spent outdoors of children. In addition to highlight outdoor activities at school, myopia prevention and control efforts should be focused on the role of parents in increasing children's outdoor activities.

Effect of accelerometer assessment methods on the evaluation results of sedentary behaviour and physical activity in school-aged children

XIANG Cheng, GAO Ying, LI Qingyang, ZHAO Hanhua

2024, 45(12): 1708-1712. doi: 10.16835/j.cnki.1000-9817.2024383

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Objective To explore the effects of different positions, epoch lengths and cut points of accelerometers on the measurement of sedentary behaviour (SB), light physical activity (LPA) and moderate-vigorous physical activity (MVPA) in school-aged children, so as to provide a reference for optimizing the criteria of accelerometers to measure SB and physical activity in school-aged children. Methods From May 2021 to September 2022, 110 school-aged children aged 8-12 years old were convenient selected from a primary school in Hangzhou, and the accelerometers were worn on the waist, back, thigh, and wrist during the school time, and the collected data were transformed into six datasets with different epoch lengths (1, 5, 10, 15, 30, and 60 s) and compared using 4 common cut-points developed by Puyau, Freedson, Evenson, and Pulsford (a total of 96 combinations) for classifying the percentages of time spent in SB, LPA, and MVPA. The effects of different positions, epoch lengths and cut points and their interactions on the assessment results were analyzed using a three-way repeated measures ANOVA, and the variability of multiple comparisons between groups was analyzed using a Bonferroni post-hoc test. Results Except for the interaction of cut point × position × epoch on the percentage of time spent in SB and the main effect of epoch on he percentage of time spent in MVPA were not statistically significant (F=0.66, 1.18, P>0.05), the remaining main effects and interactions of the three factors on the assessment results were all statistically significant (F=6.28-11 662.28, P < 0.01). The differences between the results of different positions were statistically significant (F=90.98-308.79, P < 0.01). The percentages of time spent in SB and MVPA decreased with the increase of epoch lengths, while the percentage of time spent in LPA increased with the increase of epoch lengths (F=16.54-676.35, P < 0.01). The difference between the results using different cut points measurements was statistically significant (F=98.14-976.40, P < 0.01). Conclusions Accelerometer methodological factors including positions, epoch lengths and cut points will affect the estimates of SB and physical activity in school-aged children. Therefore, it is recommended that future studies need to optimize the applicability of accelerometer analysis methods in school-aged children, and the comparisons of results between studies need to be treated with caution.

Association between 24 h activity behaviors and physical health among primary school students in Tianjin

TANG Yi, LU Donglei, TONG Li, TENG Jianqiang, ZHAO Yanan, CAO Liquan

2024, 45(12): 1713-1717. doi: 10.16835/j.cnki.1000-9817.2024370

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Objective To analyze the association of 24 h activity behaviors and physical health of primary school students, so as to provide a reference for promoting the physical health of children and adolescents. Methods From May to June, 2023, by stratified random sampling method, 583 primary school students aged 7-12 were selected from Tianjin for physical health examination. ActiGraph GT3X+ was used to measure their 24 h activity behaviors for 7 d, and their mental health and 24 h activity behaviors were analyzed by gender and grade. LASSO regression was applied for assessing the impact of 24 h activity on their health. Results The compliance rate of seated forward bending (93.12%) were higher in boys than girls (91.86%), and the differences were statistically significant (χ²=4.53, P < 0.05). Sleep time (β=0.06), light-intensity physical activity (LPA) time (β=0.11), and moderate to vigorous physical activity (MVPA) time (β=0.14) were positively correlated with physical fitness, whereas sedentary behavior (SB) time (β=-0.08) were negatively correlated with physical fitness, and MVPA time had a positive effect on physical health of children and adolescents, followed by LPA time; while sleep time also had a positive effect, and SB time had a negative effect (P < 0.05). Conclusions Primary school students are generally faced with low physical activity level and high SB time, and MVPA and LPA have a significant impact on physical health. Therefore, it is crucial to develop personalized and differentiated physical activity promotion policies and interventions for primary school students with different classmates and gender.

Prevalence and related factors of HIV testing among young students who ever had sexual experiences in Guangdong Province

LIU Youzhao, LI Yan, LI Jianrong, YAO Zhilu, XIE Shilan, PAN Siyuan, LIN Peng, XU Huifang, LI Jie, YANG Fang

2024, 45(12): 1718-1721. doi: 10.16835/j.cnki.1000-9817.2024382

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Objective To understand the prevalence of HIV testing and related factors among young students who had sex in Guangdong Province, in order to provide evidence for relevant education programs and HIV testing promotion in young students. Methods From September to December 2022, a convenient sampling method was used to select 48 749 young students from 16 universities and mechanic colleges in 6 cities including Guangzhou, Shantou, Maoming, Huizhou, Dongguan, and Zhongshan in Guangdong Province for online questionnaire survey. A total of 2 971 students who ever had sexual experiences were screened out, and the HIV testing situation and related factors were investigated by using the questionnaire designed by AIDS Prevention and Education Project for College Students of China STD and AIDS Prevention Association.The influencing factors of HIV testing were analyzed using Chi-square test and multiple Logistic regression model. Results Among students who had sexual experiences, 11.92% (354/2 971) were tested for HIV. The results of multivariate Logistic regression analysis showed that among young sexual students, using psychoactive substances during sexual activity in the last 1 year (OR=7.70), having first sex with the same sex (OR=3.87), having commercial sex (OR=2.37), having heard of PEP (OR=2.20), having a high level of self-assessed understanding of HIV testing (OR=1.73), inconsistent use of condoms (OR=1.56), being aware of HIV infection (OR=1.53), being aware of HIV knowledge (OR=1.51) were more likely to test for HIV, and females (OR=0.39) were less likely to test for HIV (P < 0.05). Conclusions The proportion of HIV testing is low among sexually active young students in Guangdong Province. Targeted interventions should be tailored to promote HIV testing coverage.

Association between physical activity and anxiety/depression symptoms among college students in Jiangxi Province

ZHOU Jianfeng, MA Sheng, XIONG Jianping, SONG Yongjing, ZOU Zhiyong

2024, 45(12): 1722-1726. doi: 10.16835/j.cnki.1000-9817.2024364

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Objective To investigate the association between physical activity frequency and anxiety/depression symptoms among college students in Jiangxi Province, so as to provide a basis for the physical and mental health development of adolescents. Methods From July to October 2023, 5 761 college students from 11 colleges and universities in Jiangxi Province were selected by convenience sampling to conduct an online questionnaire survey regarding physical activity and mental health. Anxiety symptoms and depressive symptoms were assessed by General Anxiety Disorder Scale-7 and Patient Health Questionnaires-9, respectively. Contingency table was used to analyze the distribution of different anxiety and depression symptoms by physical activity frequency, and ordered Logistic regression was used to analyze the association between physical activity frequency with anxiety and depressive symptoms, and stratified analysis was performed based on gender. Results The detection rate of anxiety symptoms of college students was 43.6% (n=2 513), and the detection rate of depression symptoms was 63.9% (n=3 682). There were significant differences in the detection rate of anxiety and depression symptoms among different gender and physical activity frequency groups (χ²=15.98, 106.32; 30.65, 150.88, P<0.05). The detection rates of severe anxiety and depression symptoms of male and female who never exercise were higher (severe anxiety: 6.1% for male and 5.2% for female, severe depression: 8.7% for male and 7.4% for female).The results of ordered Logistic regression analysis showed that compared with college students who never exercised, male college students who were physically active almost every day were negatively correlated with mild anxiety and moderate depression symptoms (OR=0.53, 0.33, P<0.05). In addition, male college students who do physical activity 3-4 times a week were negatively correlated with moderate depressive symptoms (OR=0.43), while male college students who do physical activity 1-2 times a week were negatively correlated with severe depressive symptoms (OR=0.21) (P<0.05). Physical activity was negatively correlated with different degress of anxiety and depression symptoms in female college students (anxiety: OR=0.27-0.74, depression: OR=0.18-0.75, P<0.05). Conclusions The frequency of physical activity in college students (especially female college students) is negatively correlated with anxiety and depressive symptoms. It is suggested to improve the frequency of physical activity to promote physical and mental health.

Association between physical activity patterns and negative emotional symptoms among college students

LEI Zhenzhou, XIONG Jianping, WANG Huixia, LIU Xiangdong, MAO Chaoliang, XU Jiali, JIANG Jing

2024, 45(12): 1727-1732. doi: 10.16835/j.cnki.1000-9817.2024377

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Objective To explore the association between physical activity patterns and negative emotional symptoms among college students, so as to provide a reference for improving college students' mental health. Methods A convenience sampling method was employed between October and November 2023 to select 14 767 college students from seven institutions across Shanghai, Jiangxi, Hubei, and Shanxi Provinces (municipalities) as participants. Data were collected using the Chinese Short Form of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety and Stress Scale-21 (DASS-21), a self-designed questionnaire, and the Insomnia Severity Index (ISI) to assess general demographic characteristics, physical activity levels, negative emotional symptoms, consumption of carbonated beverages and fast food, and sleep status. The Mann-Whitney U test and Kruskal-Wallis H test were used to examine associations between physical activity related factors and negative emotional symptoms. Logistic regression analysis was applied to evaluate the strength of the association between physical activity patterns and the severity of depression, anxiety, and stress symptoms. Results Statistically significant differences were observed in the distribution of male and female students across physical activity levels, moderate-to-vigorous physical activity (MVPA) habits over the past week, adherence to recommended MVPA levels, and physical activity patterns (χ²=297.07, 259.27, 351.40, 353.32, P<0.01). The prevalence rates of depression, anxiety, and stress symptoms among college students were 26.6%, 34.9%, 13.3%, respectively. Differences in the rate of depression, anxiety, and stress symptoms were significant across groups defined by physical activity levels, MVPA habits over the past week, adherence to recommended MVPA levels, and physical activity patterns (Z/H=82.21, 30.03, 20.65; -8.83, -5.29, -5.01; -5.36, -5.43, -4.95; 31.37, 30.21, 24.55, P<0.01). Logistic regression analysis stratified showed a positive association between physical activity patterns and varying levels of negative emotional symptoms. Compared to students with regular physical activity patterns, those with insufficient physical activity patterns exhibited increased risks of mild and severe depression, severe anxiety, and moderate to severe stress symptoms (OR=1.26-1.41, P<0.05). Conclusions Physical activity patterns among college students are closely associated with negative emotional symptoms. Optimizing students' physical activity patterns may help prevent and manage negative emotional issues.

Longitudinal associations between sleep chronotype with suicide-related psychological behaviors among middle school students

WANG Yali, CHE Wanyu, WANG Meng, TAO Shuman, TAO Fangbiao, WU Xiaoyan

2024, 45(12): 1733-1737. doi: 10.16835/j.cnki.1000-9817.2024355

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Objective To analyze the association between sleep chronotype and suicidal psychological behaviors among middle school students, so as to provide a scientific basis for the prevention and control of middle school students suicide. Methods In October 2021 and November 2022, a multi-stage cluster sampling method was used to conduct baseline and follow-up surveys in Shenyang, Zhengzhou, Nanchang, and Taiyuan cities in China, and a total of 6 656 middle and high school students were included as the research subjects. The Chi-square test was used to analyze the groups differences, and generalized estimating equation was used to analyze the associations between middle school students' sleep chronotype and suicide ideation, suicide plan and suicide attempt, and the grade stratification was carried out. Results Baseline detection of suicide ideation, suicide plan, and suicide attempt were 26.3%, 12.6%, and 5.3%, respectively, with follow-up rates of 21.0%, 10.0%, and 4.8% for each, and varied significantly by gender, academic stress, smoking or alcohol use, and anxiety or depressive symptoms among middle school students (χ²=11.93-880.20, P<0.05). After adjusting for gender, academic stress, physical activity, smoking, alcohol use, anxiety and depressive symptoms, generalized estimating equations showed that compared with the morning sleep chronotype, the OR(95%CI) for suicide ideation, suicide plan and suicide attempt were 1.61(1.36-1.89), 1.66(1.35-2.05) and 1.41(1.06-1.88) among evening chronotype students, and were higher among junior 1.78(1.39-2.27), 2.00(1.48-2.69) and senior middle school students 1.84(1.44-2.35), 1.67(1.20-2.33) (P<0.05). Conclusion There is a positive association between evening sleep chronotype and middle school students suicidal psychological behavior, and improving sleep chronotype may be one of the effective measures to prevent middle school students suicide.

Social adaptation in the association between attitude towards parents with academic anxiety among middle school students

LI Zhanghong, ZHOU Yaning, YANG Tianye, ZHU Beibei, FENG Zhengzhi

2024, 45(12): 1738-1742. doi: 10.16835/j.cnki.1000-9817.2024384

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Objective To understand the social adaptation in the association between attitude towards parents with academic anxiety among middle school students in Chongqing, so as to provide a basis and thinking method for theoretical framework of family education and youth development. Methods Convenient and clustering sampling method was used to select 34 097 middle school students aged 13-18 years during September to November 2023. All the participants were investigated with self-designed questionnaire, Social Adaptability Scale and Mental Health Test. The mediating effect of social adaptability in the relationship between students' attitudes towards their parents academic anxiety was evaluated by using Logistic regression analysis and structural equation model. Results The proportion of high school students in Chongqing with academic anxiety was 48.80%. Academic anxiety differed significantly by sex, academic grade, attitude towards parents, and social adaptability (χ²=948.45, 173.92, 537.51, 4 770.04, P<0.01). The results of Logistic regression analysis showed that positive attitudes towards parents were positively correlated with moderate academic anxiety (OR=1.13, 95%CI=1.08-1.18) and high academic anxiety (OR=1.14, 95%CI=1.09-1.19) (P<0.05). The results of the mediation effect analysis showed that positive attitude of middle school students towards their parents negatively predicted academic anxiety (β=-0.12, P<0.01), but when social adaptation ability was used as a control variable, the original negative relationship between the positive attitude towards parents and academic anxiety of middle school students changed (β=0.02, P<0.01), and social adaptation ability played a masking effect in the relationship. The social adaptation ability of middle school students played a mediating role in the relationship between their positive attitudes towards their parents and academic anxiety, with a mediating effect of -0.63. Conclusions The attitude of middle school students towards their parents will directly affect academic anxiety, and also have an indirect impact on academic anxiety through social adaptability, but there is a cover effect. Pay more attention to family education and actively focus on students' social adaptability can contribute to improve the mental health level of adolescents.

Sleep chronotype of middle school students in Shenzhen and its association with mental health

CHEN Dingyan, ZHOU Li, HUANG Yuanyuan, WU Yu, WANG Yun, WAN Yuhui, LI Xiaoheng

2024, 45(12): 1743-1746. doi: 10.16835/j.cnki.1000-9817.2024374

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Objective To investigate the sleep chronotype of middle school students in Shenzhen and its correlation with mental health status, so as to provide a reference for early prevention of psychological problems among middle school students. Methods In October 2021, a stratified cluster sampling and convenience sampling method was used to select 4 029 students from 3 junior high schools and 3 high schools in Shenzhen as the study subjects. Sleep chronotypes and mental health status were investigated by Morningness/Eveningness Questionnaire 5 (MEQ-5) and Brief Instrument on Psychological Health of Youths, and the correlation between the two was examined using Spearman correlation and partial correlation. Results Among the middle school students, the majority 66.79% (2 811 students) had an intermediate sleep chronotype. The proportions of moderate morning types, moderate evening types, definite evening types, and definite morning types were 14.97% (630 students), 14.49% (610 students), 2.40% (101 students), and 1.35% (57 students), respectively. The detection rates of mental health issues among students with definite evening, moderate evening, intermediate, moderate morning, and definite morning sleep chronotypes were 43.56%, 28.36%, 12.63%, 7.14%, and 22.81%, respectively, with statistically significant differences (χ²=196.00, P<0.01). The results of partial correlation analysis indicated a negative correlation between students' sleep chronotype scores and the number of mental health symptoms (r=-0.21, P<0.01). Conclusions The majority of middle school students in Shenzhen report intermediate sleep chronotype, but those with evening chronotypes have the highest proportion of mental health issues. It is suggested that intervention measures of improving students' sleep chronotypes may help reduce the risk of mental health problems.

Association between parenting behaviors and sleep problems in preschool children

DING Peng, GENG Menglong, WU Xiaoyan, TAO Shuman, TAO Fangbiao

2024, 45(12): 1747-1751. doi: 10.16835/j.cnki.1000-9817.2024361

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Objective To analyze the relationship between parenting behaviors and sleep problems of preschool children, so as to provide a strategic decision support for child growth and parenting behavior improvement. Methods Using the questionnaire data of 27 200 preschool children parents selected from 11 cities in Hubei, Anhui and Jiangsu provinces in October 2017, parents' parenting behavior was assessed by Parent Behavior Inventory (PBI), and children's sleep problems were assessed by Children's Sleep Habits Questionnaire (CSHQ). Data were analyzed using descriptive statistics and Logistic regression models. Results The reporting rate of sleep problems among preschool children was 15.3%. After adjusting for confounding factors, maternal hostile/coercive parenting behavior scores (medium level: OR=1.38; high level: OR=1.86) and paternal hostile/coercive parenting behavior scores (medium level: OR=1.17; high level: OR=1.59) were positively correlated with sleep problems (P < 0.05). Hostile/coercive parenting behaviors by their parents (maternal high level: the OR values were 1.75, 2.97, 1.86, and 2.75 respectively; paternal high level: OR values were 1.79, 1.91, 1.69, and 1.79 respectively) were positively associated with sleep problems in preschool children aged 3, 4, 5, and 6. Scores of parental support/engaged (fathers of 4-year-old children medium level: OR=0.84; fathers of 5-year-old children medium and high level: OR=0.84, 0.82) were negatively correlated with children aged 4 and 5 (P < 0.05). High level maternal supportive/engaged and paternal hostile/coercive scores were positively associated with child sleep problems (OR=1.93); high level maternal hostile/coercive and paternal supportive/engaged scores were positively associated with child sleep problems (OR=1.93); high scores of parental hostile/coercive were positively correlated with child sleep problems (OR=2.60) (P < 0.05). Conclusion Sleep problems among children are related to parenting behaviors, especially hostile/coercive parenting behaviors that increases the risk of sleep problems among children.

Association between the consumption of milk tea beverage and insomnia symptoms among college students

GU Zhengyun, ZHANG Yuhan, ZHU Juncheng, GUO Zhifang, SONG Jiancai, HUANG Bo

2024, 45(12): 1752-1756. doi: 10.16835/j.cnki.1000-9817.2024354

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Objective To investigate the association between consumption of milk tea beverages and other sugary beverages with insomnia symptoms among college students, so as to the provide reference for promoting sleep quality among college students. Methods From September to November 2023, a convenience sampling method was used to select 15 440 college students from seven universities in Shanghai, Jiangxi Province, Hubei Province, and Shanxi Province. A self-developed questionnaire and the Insomnia Severity Index were used to assess milk tea beverage consumption, other sugary beverages and insomnia symptoms. Univariate analysis of insomnia symptoms among college students was performed using Chi-square tests and Cochran-Armitage trend χ² tests. Multivariate Logistic regression analysis was conducted for the association between milk tea and other sugary beverage consumption with insomnia symptoms. Results The detection rates of insomnia symptoms among college students was 40.83%. The frequency of consumption of different milk tea and various sugary drinks (juice, tea, milk, sodas, yogurt, functional drinks, coffee) per week was related to the detection trend rate of insomnia symptoms of college students (χ_trend²=38.38, 47.66, 74.16, 32.44, 65.78, 38.71, 35.94, 91.59, P<0.01). Multivariate analysis indicated that compared to individuals with no milk tea consumption, college students engaging in milk tea consumption had a significantly increased risk of insomnia symptoms (OR=1.24, P<0.05). Students consuming milk tea at low to moderate frequencies (1-3, 4-5 times per week) showed a higher risk of insomnia symptoms compared to those with no consumption (OR=1.20, 1.54, P<0.05). Furthermore, higher levels of milk tea consumption were significantly associated with insomnia symptoms (1 501-2 999 mL, OR=1.22; ≥3 000 mL, OR=1.36), and the consumption of other sugary beverages were also associated with insomnia symptoms of college students (OR=1.10-1.55) (P<0.05). Conclusions There is a relationship between consumption of milk tea beverage other sugary beverages with insomnia symptoms among college students. Colleges should regularly conduct dietary health education seminars to improve sleep quality among college students.

Correlation between stress and Internet addiction among middle school students in Shanghai

YUAN Linlin, ZHANG Zhe, ZHOU Xinyi, ZHAI Yani, YIN Xiaoya, LI Shuman, SUN Lijing

2024, 45(12): 1757-1760. doi: 10.16835/j.cnki.1000-9817.2024369

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Objective To understand the relationship between stress and Internet addiction among middle school students in Shanghai, so as to provide a scientific basis for promoting students' mental health and preventing Internet addiction. Methods From May to June 2021, a stratified random cluster sampling method was used to select 6 123 middle and high school students in Shanghai for health risk behavior monitoring. Daily Stressors Evaluation Scale for Urban Secondary School Students was used to evaluate students' stress, and the Internet Addiction Test compiled by Young was used to evaluate students' Internet addiction. The correlation between student stress and Internet addiction was analyzed by Kruskal-Wallis H test, Chi-square test and multiple Logistic regression. Results Total stress score of middle school students in Shanghai was 24 (12, 39), academic stress score was 8 (5, 13), physical and psychological stress score was 6 (2, 10), interpersonal stress score was 5 (1, 9), and family stress score was 4 (1, 8). The detection rate of Internet addiction was 4.7%. Multivariate Logistic regression analysis showed that the risk of Internet addiction among middle school students with high levels of stress was 8.05 times(95%CI=4.59-14.12) that of students with low levels of stress(P < 0.05). The risk of Internet addiction among middle school students with high levels of academic stress, physical and psychological stress, interpersonal stress and family stress was 5.98(95%CI=3.69-9.70), 6.92(95%CI=4.03-11.88), 4.85(95%CI=3.11-7.55), and 4.18(95%CI=2.73-6.40) times that of students with low levels of stress, respectively(P < 0.05). Conclusion The academic stress, physical and psychological stress, interpersonal stress, and family stress among middle school students can all lead to an increased risk of Internet addiction.

Association of dieting and binge eating with non-suicidal self-injury among secondary vocational school students

HAN Yang, WANG Lianhua, LI Qiushuo, KONG Weisen, LI Zhong, LENG Peihong, ZHUANG Lirun, LI Bing, TUO Anxie

2024, 45(12): 1761-1765. doi: 10.16835/j.cnki.1000-9817.2024380

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Objective To explore the relationship between dieting and binge eating with non-suicidal self-injury (NSSI) among secondary vocational school students, so as to provide a scientific basis for the development of effective interventions to prevent NSSI. Methods From October to December 2023, 2 364 students were selected by stratified cluster random sampling method from nine secondary vocational schools in Guizhou Province to conduct a self-administered questionnaire survey. Unconditional binary Logisitic regression was used to analyze the relationship between dieting, binge-eating behaviours, and the co-occurrence of the two and NSSI among secondary vocational school students, and were stratified by sex. Results The detection rate of NSSI among secondary vocational school students in Guizhou Province was 27.5%, 6.8% of secondary vocational school students reported dieting, 10.5% reported binge-eating behaviour, and 2.9% showed both dieting and binge-eating behaviours. The adjusted model of unconditional binary Logistic regression showed that the presence of dieting (OR=2.37), binge-eating behaviour (OR=2.31), and the co-occurrence of both (OR=2.60) were associated with higher risk of NSSI among secondary vocational school students; stratified analysis by gender showed that both males and females with dieting, binge eating and coexistence of dieting and binge eating behaviours were at increased risk of NSSI (females: OR=2.27, 2.26, 2.78; males: OR=2.15, 2.08, 2.02) (P<0.01). Conclusions Dieting and binge eating behavior of secondary vocational school students will increase the risk of NSSI. When preventing and intervening NSSI problems of secondary vocational school students, it should pay more attention to eating habits.

Trend of overweight and obesity among children and adolescents in Hainan Province from 2005 to 2019

LIANG Qiqing, TIAN Ye, ZUO Xin, QING Fenmei, LIU Yumei

2024, 45(12): 1766-1769. doi: 10.16835/j.cnki.1000-9817.2024375

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Objective To analyze the trends of overweight and obesity in children and adolescents aged 7-18 in Hainan Province from 2005 to 2019, in order to provide a scientific basis for prevention strategies. Methods Data were sourced from a total of 42 811 students in Hainan Province in 2005, 2010, 2014 and 2019 for physical fitness and health investigation, according to the criteria of Screening for Overweight and Obesity among School-aged Children and Adolescents. The linear trend of overweight and obesity was compared by using the χ² test and χ² trend test, and with 2005 as the base period, the dynamic analysis was conducted to compare the growth and development rates of overweight and obesity. Results The detection rates of overweight in children and adolescents aged 7-18 in Hainan Province were 4.7%, 5.1%, 6.7% and 10.8% in 2005, 2010, 2014 and 2019, respectively, while the detection rates of obesity were 2.7%, 2.4%, 2.5% and 6.8%, which showed an overall upward trend by year (χ_trend²=370.57, 313.55, P < 0.01). All differences in overweight and obesity detection rates across gender, ethnicity, and age groups were statistically significant for each year (χ²=9.56-290.95, P < 0.01). And the detection rates of overweight and obesity increased linearly over year in different characteristic groups (χ_trend²=29.92-280.11, P < 0.01). The annual growth rate of overweight detection rate was higher for girls (6.4%) than for boys (6.1%), higher for ethnic minorities (7.1%) than for Han (5.7%), and higher for the 16-18 age group (8.4%) than for the 7-9 (3.6%), 10-12 (6.2%), and 13-15 age groups (7.7%). And the annual growth rate of obesity detection rate was higher for boys (8.1%) than for girls (5.7%), higher for ethnic minorities (7.1%) than for Han (6.8%), and higher for the 16-18 age group (77.2%) than for the 7-9 (2.8%), 10-12 (8.2%), and 13-15 (18.7%) age groups. Conclusions The overall prevalence of overweight and obesity among children and adolescents aged 7-18 in Hainan Province continues to increase from 2005 to 2019, with differences in genders, ethnic and ages. Interventions should be implemented to reduce the incidence of overweight obesity in children and adolescents.

Trend of blood pressure among children and adolescents and its correlation with pubertal development and nutritional status

HAO Zhihong, WEI Feixue, LI Qiaofeng, HAN Weifang, WANG Li

2024, 45(12): 1770-1774. doi: 10.16835/j.cnki.1000-9817.2024363

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Objective To explore the trend of blood pressure among children and adolescents and its correlation with pubertal development and nutritional status, so as to provide a scientific basis for developing prevention strategies targeting early stage hypertension. Methods In September 2023, a multi-stage random cluster sampling was used to select 20 241 primary and secondary school students aged 7-18 years from 57 schools in Jinzhong, whose height, weight, and blood pressure were measured. The Chi-square test for trend was used to analyze the change trend in the detection rate of elevated blood pressure and hypertension in children and adolescents with the development of adolescence puberty, and the Logistic regression was used to analyze the correlation between elevated blood pressure and hypertension and nutritional status. Results The prevalence of elevated blood pressure was 17.3% among children and adolescents. The middle and late pubertal groups had the highest prevalence (23.2% and 24.3%), followed by the early pubertal group (19.5%) and the prepuberty group (10.8%) (χ_trend²=372.86, P < 0.01). The prevalence of hypertension was 14.8%, with the highest prevalence reported in the late pubertal group (22.4%), followed by the middle pubertal group (18.9%), and the early pubertal (13.0%)/prepuberty (12.2%) groups (χ_trend²=175.43, P < 0.01). The prevalence of elevated blood pressure and hypertension increased with pubertal development, regardless of gender, region, or nutritional status (χ_trend²=9.21-771.90, P < 0.01). Overweight and obesity were influencing factors of elevated blood pressure and hypertension among children and adolescents during all stages of pubertal development (OR=1.2-2.8, P < 0.01). Conclusion The prevalence of elevated blood pressure and hypertension among children and adolescents during pubertal development is high, showing an increasing trend with pubertal development.

An empirical study on the effect of influenza vaccination on the prevention of school absence among primary and secondary school students

LI Wu, LIU Lanlan, TAN Huiling, JIANG Yawen, CHEN Wanyi, ZHUANG Chunyan, XIE Yuanna, XIE Xu, LI Gang

2024, 45(12): 1775-1779. doi: 10.16835/j.cnki.1000-9817.2024376

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Objective To evaluate the preventive effect of implementing the free influenza vaccination policy on school absence among primary and secondary school students, so as to provide a reference for formulating and adjusting vaccination strategies. Methods Among primary and secondary school students aged 6 to 18 in Longgang District, Shenzhen, they were divided into a vaccinated group (265 996 students) and an unvaccinated group (122 513 students) according to their influenza vaccination history during November 2023. Propensity score matching was used to conduct a 1∶1 match between the two groups to balance covariates. The number of absences per month was set as the dependent variable to construct a difference-in-differences model, and Poisson regression was employed to analyze the overall and multi-time-point effects. Results Vaccination against influenza was associated with low rate of absenteeism among primary and secondary school students, with an overall preventive effect of 26.52% (95%CI=23.47%-29.45%). The preventive effects in November (the month of vaccination) and December 2023, January and March 2024 were 42.12%, 40.12%, 30.33% and 20.91%, respectively. The preventive effect of the influenza vaccine on absenteeism among primary school students (26.39%) was not significantly different from that among secondary school students (27.97%) (P>0.05). The regression coefficient for class vaccination rates ranged from 0.998 to 0.999 (P < 0.01), indicating that for every 10% increase in influenza vaccination rates, absenteeism could be reduced by 1.5% to 2.2%. Conclusion Implementing free influenza vaccination for primary and secondary school students might help to reduce the risk of absenteeism, yielding significant socioeconomic benefits.

Effects of cardiorespiratory fitness on physical activity and cardiometabolic health among obese adolescents

LIANG Manna, ZHU Lin, ZHENG Li, XIE Weijun

2024, 45(12): 1780-1784. doi: 10.16835/j.cnki.1000-9817.2024368

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Objective To explore the effect of cardiorespiratory fitness (CRF) on cardiometabolic health and physical activity among obese adolescents, in order to provide a scientific basis for health promotion of obese adolescents. Methods From July to August 2021 and 2022, 140 obese adolescents aged 10-17 were recruited in a residential weight-loss camp. Sedentary behavior (SB), low intensity physical activity (LPA), total physical activity (TPA) and moderate-to-vigorous physical activity (MVPA) were measured by ActiGraph GT3X+ triaxial motion accelerometer, and CRF levels were measured by 20-meter shuttle run test. Cardiometabolic risk Z score (CMR-Z) was constructed by measuring the cardiometabolic health indicators of obese adolescents, including waist circumference (WC), sagittal abdominal diameter (SAD), systolic blood pressure (SBP), diastolic blood pressure (DBP), average blood pressure (ABP), fasting insulin (FINs), fasting plasma glucose (FPG), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C). The mediating effect analysis was conducted by using the SPSS Process plug-in compiled. Results Cardiovascular health indicators WC, SAD, SBP, DBP, ABP, FINs, FPG, TC, HDL-C and CMR-Z were (93.21±11.51)cm, (21.77±2.71)cm, (111.24±11.86)mmHg, (66.08±9.03)mmHg and (88.66±8.97)mmHg, (8.98±6.42)μU/mL, (4.42±0.62)mmol/L, (4.43±0.97)mmol/L, (1.29±0.28)mmol/L, -0.43(-1.83, 1.78)min, respectively. In the daily activity behavior indicators, the duration of SB, LPA, MVPA and TPA were (345.16±78.47, 267.35±62.65, 64.77±39.52, 677.30±57.63)min, respectively. SB, LPA and MVPA accounted for 50.96%, 39.47% and 9.56%, respectively. The indicator VO_2max of CRF was (37.95±4.96)mL/(kg · min). Mediation analysis showed that CRF played a fully mediating role between LPA and waist-to-height ratio (WHtR), accounting for 44.2%. It exhibited a suppressing effect between LPA and ABP accounting for 31.5%, with a suppressing effect between MVPA and SAD accounting for 43.2% and a suppressing effect between MVPA and CMR-Z accounting for 96.0%. Conclusions CRF may be an important factor in the relationship between physical activity and cardiometabolic health of obese adolescents. Improving CRF level may be conducive to promoting cardiometabolic health of obese adolescents.

Analysis of TLR9 and TLR7 gene polymorphisms among children with hand-foot-mouth disease in a medical institution of Jinan

ZHOU Na, WU Tao, CHEN Shan, QIAN Jiao, WANG Hongbo

2024, 45(12): 1785-1788. doi: 10.16835/j.cnki.1000-9817.2024366

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Objective To analyze the relationship between Toll-like receptor (TLR) 9 and TLR7 gene polymorphisms among children with hand-foot-mouth disease in a medical institution of Jinan City from 2020 to 2023, so as to provide reference for prevention of hand-foot-mouth disease. Methods Data of 284 preschool children aged 3-6 with hand-foot-mouth disease, including the season pattern, clinical manifestations, pathogen distribution, were collected in department of pediatric infectious diseases of the Second Children & Women's Healthcare of Jinan from 2020 to 2023. The distribution conditions of TLR9 and TLR7 genotypes of enterovirus 71 (EV71) subtype and coxsackievirus A16 (CA16) subtype were compared by Chi-square test. Hardy Weinberg equilibrium test was used to characteristic sample population distribution, and Logistic regression analysis in the additive genetic model was adopted to evaluate the relationship between TLR9 and TLR7 gene polymorphisms with hand-foot-mouth disease subtype. Results The time to admission after symptom onset with hand-foot-mouth disease among 284 children was mostly >2-4 d (45.42%), followed by ≤2 d (44.72%). The season pattern was mostly in summer (58.10%). The severity was mostly mild (69.72%), and the main clinical manifestations were skin rash (100.00%) and fever (65.49%). The majority pathogen was EV71 (60.56%). Hardy Weinberg equilibrium test showed good population representation (P>0.05). Logistic regression analysis was applied to analyze the relationship between TLR9 rs187084 locus and hand-foot-mouth disease subtypes under the additive genetic model after adjusting for age and gender of the study population, and it was found that compared with those without C allele, each additional C allele increased the risk of CA16 subtype hand-foot-mouth disease by 109% (OR=2.09, 95%CI=1.13-3.27). Analysis of relationship between TLR7 rs3853839 locus and hand-foot-mouth disease subtype showed that compared with those without C allele, the risk of EV71 subtype hand-foot-mouth disease increased by 57% for each additional C allele (OR=1.57, 95%CI=1.10-2.11) (P < 0.05). Conclusions From 2020 to 2023, children with hand-foot-mouth disease in a medical institution of Jinan City is mostly mild and caused by EV71 infection. The polymorphism of rs3853839 locus of TLR7 may be related to EV71 infection in children with hand-foot-mouth disease, and the polymorphism of rs187084 locus of TLR9 may be related to CA16 infection.

Analysis of human metapneumovirus outbreaks in kindergartens and schools in Shenzhen, 2017-2023

WANG Xin, FANG Shisong, WU Weihua, LIU Hui, SUN Ying, ZOU Xuan, TANG Xiujuan

2024, 45(12): 1789-1791. doi: 10.16835/j.cnki.1000-9817.2024356

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Objective To analyze the monitoring results and characteristics of human metapneumovirus (HMPV) outbreaks in Shenzhen in kindergartens and schools during 2017-2023, so as to provide a evidence for prevention and control of respiratory diseases. Methods Based on the epidemiological data and laboratory test results of HMPV outbreaks in kindergartens and schools of Shenzhen during 2017 to 2023, collected from the influenza monitoring network platform, Mann Kendall test was applied for trend analysis pf HMPV. Results A total of 11 HMPV outbreaks were identified in kindergartens and schools from 2017 to 2023 for 128 cases with an average incidence rate of 26.61% in 2018. The most yearly HMPV outbreaks were reported in 2020 being 4 outbreaks, followed by 2 outbreaks in 2018. A total of 72.73% (8 outbreaks) of HMPV outbreaks were identified in kindergartens with 27.27% (3 outbreaks) occurring in primary schools. The monthly greatest count of outbreak was 3(27.27%) in March and December, followed by 2 outbreaks (18.18%) in April and June. A total of 98 swab samples were collected, and 80 samples were positive for respiratory viruses with a positive rate of 81.63%; among them, 67 samples were positive for HMPV alone, 10 samples were positive for other respiratory viruses alone, and 3 samples were positive both for HMPV and other respiratory virus. Among the 11 human metalung virus cases, 6 HMPV outbreaks were caused by human metapneumovirus alone, and 5 outbreaks were caused by HMPV and other respiratory viruses. Except for 2020, the percentage of HMPV outbreaks in influenza like illness outbreaks increased with year (Z=2.25, P=0.02). Conclusion HMPV outbreaks have been reported every year from 2017 to 2023 in kindergartens and schools in Shenzhen, most of HMPV in kindergartens, and the peak seasons of HMPV outbreaks are spring and winter.

Temporal trend of tuberculosis burden among children under 5 years old in China from 1990 to 2021

TAO Luqiu, ZHANG Ziyu, TAN Gao, ZOU Yanzheng, PAN Li, ZHU Hongru, QIAN Yili, LIU Xiaoli, WANG Wei

2024, 45(12): 1792-1797. doi: 10.16835/j.cnki.1000-9817.2024358

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Objective To analyze the trends in disease burden of tuberculosis among children under 5 years of age in China from 1990 to 2021, so as to provide insights for future tuberculosis control measures among children in China. Methods Based on the Global Burden of Disease (GBD) 2021 datasets, the incidence, prevalence, mortality and disability-adjusted life year(DALY) of tuberculosis of children under 5 years of age in China and globally were collected from 1990 to 2021. The incidence, prevalence, mortality and DALY rate of tuberculosis were compared by genders and types. In addition, the annual percent change(APC) and the average annual percent change(AAPC) of children's tuberculosis burden in China and globally from 1990 to 2021 were calculated by using the Joinpoint regression model, and the changing trends were analyzed. Results The numbers of incident, prevalent and dead tuberculosis cases were 9 700, 8 477 800 and 200 among children under 5 years of age in China in 2021, and the DALY due to tuberculosis were 27 100 person-years. There were significant reductions in incidence, prevalence, mortality and DALY rate of tuberculosis among children under 5 years of age in China (AAPC=-5.45%, -1.14%, -12.37%, -11.34%) and globally(AAPC=-2.38%, -1.41%, -4.66%, -4.56%), and the reductions in the incidence, mortality and DALY rate were more significant in China than globally (P < 0.05).In 1992 and later, the numbers of incident, prevalent and dead tuberculosis cases and the DALY of tuberculosis were higher among male than among female. In addition, the disease burden of drug-susceptible tuberculosis appeared a tendency of downward in China from 1990 to 2021, while the incidence and prevalence of extensively drug-resistant tuberculosis rose since 2015. Conclusions The disease burden of tuberculosis remarkably reduced among children under 5 years of age in China from 1990 to 2021. However, the burden of disease due to multidrug-resistant tuberculosis appeared an upward trend recently. Increased attention is required to be paid to the prevention and control of tuberculosis among children and improved diagnosis and treatment of drug-resistant tuberculosis are recommended.

Current status and related factors of antiviral treatment among HIV-infected men who have sex with men students

YUE Teng, CHENG Zhaoyu, XIAN Yidan, LIU Xuan, WEI Siyue, LIU Yuanyuan, LIU Fengli, YANG Jie, YU Maohe, LI Changping, CUI Zhuang

2024, 45(12): 1798-1801. doi: 10.16835/j.cnki.1000-9817.2024373

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Objective To investigate the current situation and related factors of antiretroviral therapy (ART) among HIV-infected male students engaging in men who have sex with men (MSM), so as to provide the reference data for HIV prevention and treatment. Methods In November 2021, 137 MSM students from 31 provincial administrative regions in China were recruited. An online survey was conducted to collect data on demographic characteristics, ART status, CD4 count, and HIV viral load before treatment. Logistic regression was used to analyze the factors related the effectiveness of ART in MSM. Results Among the included research subjects, 14.6% had late detection of HIV, 97.1% of participants were currently undergoing ART. Among those whose ART duration was less than 6 months, while 76.9% were undergoing ART. Logistic regression indicated that HIV-infected students who received ART for more than 24 months (OR=5.28, 95%CI=1.38-20.22) had a higher rate of successful HIV suppression. HIV-infected students who reported physical sensory side effects (OR=0.08, 95%CI=0.01-0.71) and cognitive side effects (OR=0.28, 95%CI=0.09-0.90) were more likely to experience failure of ARI inhibition (P < 0.05). Conclusions There is still room for improvement in the efficacy of ART among MSM students. Strategies to improve treatment adherence must consider individual variances among HIV-infected patients and the side effects of medications when designing treatment plans.

Willingness to preventive treatments and related factors among college freshmen with latent tuberculosis infection in Changzhou

FENG Bin, ZHOU Tingyu, WANG Zhou, TANG Siyi, ZHANG Li, CHEN Yanfei, JIANG Hong, WU Yinyan, ZHANG Xing

2024, 45(12): 1802-1806. doi: 10.16835/j.cnki.1000-9817.2024360

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Objective To investigate the willingness to accept preventive treatments and its related factors among college freshmen with latent tuberculosis infection (LTBI), so as to provide the evidence for preventive treatment intervention measures for students with LTBI. Methods Cluster sampling method was used to select 368 LTBI freshmen from 8 colleges and universities in Changzhou in September 2023, who conducted a questionnaire survey on the willingness to receive preventive treatment. General demographic data were collected and relevant data were collected using tuberculosis knowledge scale, General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Adaptation, Partnership, Growth, Affection and Resolve (APGAR), and a self-developed Stigma Scale. A binary Logistic regression model was constructed with the willingness to accept preventive treatment as the dependent variable to analyze the willingness to accept preventive treatment and the influencing factors. Results A total of 253 LTBI college freshmen were willing to take preventive treatment, the acceptance rate was 68.75%. The rate of willingness to accept preventive treatment for LTBI was higher among students whose fathers had an education level of high school, compared to those whose fathers had an education level of junior high school or below (OR=2.16, P < 0.05). LTBI students whose per capita family income was >5 000-10 000 yuan and >10 000 yuan were more willing to accept LTBI preventive treatment than those whose per capita family income was < 3 000 yuan (OR=2.72, 4.46, P < 0.05). LTBI students who engaged in physical exercise for more than 2 hours per week were more willing to accept than those who exercised less than 0.5 hours per week (OR=1.91, P < 0.05). LTBI students with high levels of tuberculosis knowledge and stigma were more likely to receive preventive treatment (OR=1.18, 1.11, P < 0.05). LTBI students with high PHQ-9 (OR=0.85) and GAD-7 (OR=0.92) scores were more likely to refuse preventive treatment (P < 0.05). Conclusion The present study revealed a moderate level of willingness of LTBI students to preventive treatment in Changzhou City, and the acceptance is affected by family factors, healthy lifestyles, tuberculosis knowledge and psychological status.

Prevalence and factors related to overweight, obesity and hypertension comorbidities among primary and secondary school students in Ningxia

WEI Rong, LI Yuan, MA Ning, WANG Xiaoli, JIN Yanan, MA Fang, YANG Yi, CHEN Yaogeng

2024, 45(12): 1807-1810. doi: 10.16835/j.cnki.1000-9817.2024359

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Objective To explore the prevalence and related factors of overweight, obesity and hypertension comorbidities among children and adolescents in Ningxia, so as to provide a scientific basis for effective early health intervention in children and adolescents. Methods From September 2021 to June 2022, a total of 4 577 students aged 9-16 were selected from Jinfeng District of Yinchuan City, Shapotou District of Zhongwei City, Yanchi County of Wuzhong City and Pingluo County of Shizuishan City in Ningxia by multi-stage cluster random sampling method for questionnaire survey and physical measurement. The influencing factors of overweight, obesity and hypertension comorbidities in children and adolescents were investigated by Chi-square test and multivariate unconditioned Logistic regression analysis with weighted complex sampling design. Results The prevalence of overweight and obesity among primary and secondary school students in Ningxia was 22.87%, the prevalence of hypertension was 1.30%, and the comorbity rate of overweight, obesity and hypertension was 1.07%. Multivariate Logistic regression analysis showed that students aged 13-16 (OR=15.66, 95%CI=3.84-63.96, P < 0.05) were more likely to suffer from overweight, obesity and hypertension than students aged 9-12. The students of insufficient sleep duration (OR=5.47, 95%CI=1.73-17.33, P < 0.05) had higher levels of overweight, obesity and hypertension comorbidities than those of adequate sleep duration. Students who had breakfast 1 to 7 times a week (OR=0.08, 95%CI=0.02-0.37) had lower incidence than those who had breakfast once a week (P < 0.05). Conclusions Age, sleep time and breakfast frequency are all related factors of overweight, obesity and hypertension co-morbidity among primary and secondary school students in Ningxia. Close attention should be paid to students aged 9-12 years with insufficient sleep time and fasting in the morning, and carry out scientific education and prevention and control interventions should be carried out.

Application of digital games for interventions to reduce risky sexual behavior among adolescents: a systematic review

FU Chen, MA Juanjuan, LIANG Xiaohui, ZHAO Shuairan, LUO Qiusha, ZHANG Hui

2024, 45(12): 1811-1814. doi: 10.16835/j.cnki.1000-9817.2024362

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Abstract:
Objective To analyze the application of digital games for interventions to reduce risky sexual behavior among adolescents, so as to provide a reference for reducing adolescent risky sexual behavior. Methods The study used PubMed, Web of Science, Cochrane Library, Scopus, Embase, China Biomedical Database, CNKI, Wanfang Database and VIP to carry out a literature search of the application of digital games for interventions aimed at reducing risky sexual behavior among adolescents covering the time period up until February 2024. Results A total of 10 English articles were included, involving a total of 3 063 adolescents aged 10-24 years old. The publication time spanned from 2013 to 2023. The development and design of the digital games were mostly based on cognitive behavior theory and authentic decision-making situations and dialogues. The game participants were divided into single-party and multi-party categories, mainly using virtual role-playing, interactive narrative, and adventure challenges, and there were some differences in content. Digital game intervention had good feasibility and acceptability, which could improve adolescents' sexual health knowledge, attitudes, self-efficacy, and risk perception, so as to reduce the occurrence of risky behavior. Conclusion As an intervention aimed at reducing risky sexual behavior in adolescents, digital show has significant advantages and can serve as a new prevention and control strategy.

Research updates in visual working memory deficits in children with autism spectrum disorders

AN Wenjun, ZHU Ziqiao, DING Zhongbing, YANG Fuyi

2024, 45(12): 1815-1819. doi: 10.16835/j.cnki.1000-9817.2024381

Abstract(28) HTML (21) PDF(3)

Abstract:
In order to enhance the visual working memory abilities of children with autism spectrum disorders (ASD) and to promote future exploration and practice in related fields, the study systematically sorts out and summarizes the relevant research at home and abroad, and points out that the performance of children with ASD in various visual working memory tasks is generally lower than that of normal children, especially in the function of refreshing, transforming and suppressing visual information, which reflect that children with ASD have difficulties in processing visual information. Neuroimaging and electrophysiological studies further reveal the abnormal activation of ASD children in related brain regions, especially the dysfunction in key areas such as prefrontal cortex and contralateral delayed activity. In addition, the abnormal oscillation of α, θ and β bands also shows that children with ASD are deficient in visual attention control and information processing, which affects the overall performance of their visual working memory.

Research progress of intergenerational effects of parental childhood trauma on adolescent depressive disorders

CHEN Jiajia, LI Jingya, YANG Ying

2024, 45(12): 1820-1824. doi: 10.16835/j.cnki.1000-9817.2024378

Abstract(32) HTML (17) PDF(9)

Abstract:
In order to understand the intergenerational impact of parental childhood trauma on development of adolescent depression disorder and its mechanism, the study comprehensively elaborates possible mechanisms underlying association between parental childhood trauma and adolescent depressive disorders from multiple levels based on the biopsychosocial integrative medicine model. Future research is needed to further clarify possible mechanisms in an integrated model. Preventive and intervention measures can be proposed and early block the malignant of intergenerational influence of childhood trauma.

Current Articles 2024, Volume 45, Issue 12

Current Articles
2024, Volume 45, Issue 12