中国学校卫生

Nutrition status and improvement strategies in Chinese school age children

ZHANG Qian

2021, 42(3): 321-324, 333. doi: 10.16835/j.cnki.1000-9817.2021.03.001

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School age is critical period for children growth and behavior development. With the improvement of nutrition and health status in Chinese school-age children, they also faced multiple challenges, such as the increase of overweight and obesity, the prevalence of undernutrition and micronutrients deficiency. This is related to the irrational diet, lack of physical activity and unhealthy lifestyle, and also affected by the change of social environment. China has issued a series of nutrition and health related policies to promote healthy development of school-age children, either on poor rural children nutrition improvement, or on children obesity prevention and control. International organizations suggest that governments adopt comprehensive strategies to promote children's health by management on the food environment. It is suggested that China should strengthen the construction of laws and regulations, implement nutrition education and dietary guidance, strengthen the responsibility of parents, and evaluate the efficiency of policies, so as to improve the child nutrition and health.

Curriculum standards and teaching materials in compulsory education in China from the perspective of comprehensive sexuality education

GUO Lingfeng, LIU Wenli

2021, 42(3): 325-328. doi: 10.16835/j.cnki.1000-9817.2021.03.002

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Comprehensive sexuality education (CSE) is a instruction method based on curriculum, which explores the cognitive, emotional, physical and social significance of sexuality. Based on the analysis model of teaching materials and Interpretative Structural Model (ISM), this paper analyzes and evaluates the curriculum standards and teaching materials of compulsory education in China from the perspective of CSE. It reveals that the contents of CSE mainly appear in the 19 curriculum standards as well as in the teaching objectives, contents, practice activities and compiling elements of teaching materials. Based on CSE, the reliability of teaching objectives and content, the comprehensiveness of teaching content, the feasibility and effectiveness of teaching practice of curriculum standards and textbooks need to be further strengthened and improved.

Snack consumption and the influencing factors of students participation in the Nutrition Improvement Program for Rural Compulsory Education in 2019

BI Xiaoyi, LI Li, YANG Titi, XU Peipei, CAO Wei, XU Juan, GAN Qian, PAN Hui, HU Xiaoqi, ZHANG Qian

2021, 42(3): 329-333. doi: 10.16835/j.cnki.1000-9817.2021.03.003

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Objective To evaluate snack consumption and the influencing factors associated with student participation in the Nutrition Improvement Program, and to provide a scientific basis for improving the program. Methods Among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns (i.e., school, company, and mix). This study randomly selected one or two classes from each grade, which ranged from grade 3 to grade 9. A questionnaire, which addressed snack consumption and choice, was distributed to 27 374 students. Results The findings revealed that 14.0% of students from poor rural areas in central and western regions consumed snacks two or more times per day, and 21.6% of students spent 3 yuan or more on snacks each day. The top three choices of snacks included fruit and vegetables (50.6%), biscuits and bread (50.1%), and puffed food (40.0%). Students who had mothers who worked outside the home, parents who worked outside the home, who consumed corporate meals, and who had access to a small shop on campus were more likely to consume snacks one or more times per day(OR=1.35, 1.19, 1.11, 1.51, P < 0.05). Conclusion The phenomenon of snack consumption among primary and middle school students from poor rural areas in central and western regions is common, and the selection of unhealthy snacks was identified as a problem. A health education system with comprehensive support and guidance from individuals, families, schools, and society should be established to guide students to opt for healthier snacks.

Evaluation of the effect of health education interventions on nutrition-related guidelines in rural schools in Chengdu

LI Li, FENG Min, BI Xiaoyi, LI Xiaohui, YANG Bo, ZHANG Qian

2021, 42(3): 334-336, 341. doi: 10.16835/j.cnki.1000-9817.2021.03.004

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Objective To explore the intervention effect of multiple nutritional health guidelines for school-aged children on the knowledge, attitudes and practices (KAP) of primary school students in Chengdu. Methods A primary school in Chengdu, which had a school canteen, was selected as the intervention school, and another similar primary school was selected as the control school. Students from the intervention school received nutritional education for six months, while the control school did not provide such intervention measures. A total of 589 students from grades 3 to 5 were selected to participate in the questionnaire survey(eligible 558, missing 31). Results Before the intervention, no significant difference was found in the rate of awareness regarding nutritional knowledge, including dietary attitudes and dietary behavior. After the intervention, the rate of awareness of nutritional knowledge and the overall awareness rate reached more than 80% in the intervention group, which was significantly higher than that observed in the control group(P < 0.05). The intervention group consumed less than one type of breakfast food(26.6%), which was less than the control group(49.4%). The frequency of weekly egg and milk consumption was higher in the experimental group than in the control group. The proportion of students who consumed three or more types of vegetables daily was higher in the intervention group than in the control group. The proportion of leftovers was lower in the intervention group (15.8%) than in the control group(57.9%). Conclusion The comprehensive nutritional education based on a variety of nutritional health guidelines for school-age children can enhance students' awareness of nutritional knowledge and healthier dietary behaviors.

Changing trends in school-meal catering services as part of the Nutrition Improvement Program for Rural Compulsory Education Students

XU Peipei, YANG Titi, XU Juan, CAO Wei, LI Li, GAN Qian, PAN Hui, ZHANG Qian

2021, 42(3): 337-341. doi: 10.16835/j.cnki.1000-9817.2021.03.005

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Objective To analyze the usage of catering software and the creation of recipes by schools, as part of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) 2013-2017. Methods In each county of the 699 trial counties across 22 provinces in central and western area of China under the NNIPRCES, no less than 10% of primary and junior middle schools were randomly selected according to their catering mode (i.e., school feeding, food packages, and family feeding). School questionnaires were used to collect information concerning the schools and the creation of recipes. Results From 2013 to 2017, the utilization rate of catering software was 11.7%, 8.0%, 17.8%, 16.9%, and 14.0%, respectively with significant differences(χ²=345.09, P < 0.01). The creators of school-meal recipes included schools, the Education Bureau, hospitals and colleges, the centers of disease prevention and control. Differences were observed in the proportion of recipe creators across school type, area, and catering mode, while annual trends also varied (P < 0.01), as indicated by the following proportions: 74.9%, 20.0%, 3.7%, 1.3%, respectively. Food safety was identified as the main factor that needs to be considered when creating school recipes, the proportions of which were 58.0%, 78.4%, 70.6%, and 87.4% from 2014 to 2017. Conclusion From 2013 to 2017, the utilization rate and the frequency of catering software were both relatively low, and recipe creation was in need of professional guidance. It is necessary to strengthen the popularization of catering software and improve the nutritional knowledge and skills of canteen workers to ensure the quality of school meals.

Temporal trend in energy and macronutrients for pilot schools involved in the Nutrition Improvement Program for Rural Compulsory Education Students in 2012-2017

GAN Qian, XU Peipei, LI Li, YANG Titi, CAO Wei, XU Juan, PAN Hui, HU Xiaoqi, ZHANG Qian

2021, 42(3): 342-345. doi: 10.16835/j.cnki.1000-9817.2021.03.006

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Objective To evaluate temporal trend in food supply among pilot schools involved in the National Nutrition Improvement Program for Rural Compulsory Education Students (NNIPRCES). Methods Ten percent of pilot schools were randomly selected and asked to report the information on food supplies. Daily intake of energy, carbohydrates and protein for each student were calculated and compared with the reference value in Nutrition Guidelines of School Meals (WS/T 554-2017). Results Energy and protein supply increased among those pilot schools. The supply of energy increased from 1 566.5 kcal in 2012 to 1 927.4 kcal in 2017, protein increased from 49.0 g to 61.0 g. The energy ratio of fat increased from 31.9% to 34.9%, while energy ratio of carbohydrate decreased significantly (F=83.38, 128.36, 20.27 and 17.28, all P < 0.05). The proportion of reasonable energy supply from carbohydrate and fat in 2017 were 17.5% and 26.8%, respectively. Conclusion The supply of energy and macronutrients in the pilot areas were unreasonable, more measures including dietary guide and monitoring need to be adopted to improve students' nutrition status among rural areas.

Prevalence of stunting among students under the Nutrition Improvement Program for Rural Compulsory Education Students during 2012-2017

CAO Wei, YANG Titi, XU Peipei, LI Li, GAN Qian, PAN Hui, XU Juan, HU Xiaoqi, ZHANG Qian

2021, 42(3): 346-349. doi: 10.16835/j.cnki.1000-9817.2021.03.007

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Objective To analyze the prevalence of stunting among students received subsidies of the National Nutrition Improvement Program for rural Compulsory Education Students (NNIPRCES) during 2012-2017. Methods By using the data from 2012-2017 NNIPRCES survey, students aged 6-15 with valid height records were included. Stunting was defined according to the Screening Criteria of Malnutrition for School Age Children and Adolescents (WS/T 456—2014). To explore the association of the risk of stunting between different regions, gender or age groups in rural students. Results The prevalence of stunting among students aged 6-15 who received subsidies of NNIPRCES during 2012-2017 were 8.0%, 7.9%, 6.9%, 6.5%, 6.0% and 5.3%, declined by 2.7, 1.8, 4.0 percentage points in average, as well as in central and western region, respectively. The prevalence of stunting declined with 2.7 percentage points for boys and, 2.9 percentage points for girls. The prevalence of stunting declined most at the age of 13, with 4.0 percentage points. Conclusion The prevalence of stunting of students has declined after the implementation of NNIPRCES from 2012 to 2017. However, the total prevalence of stunting was still high and the development was unbalanced between central and western region, which requires more target intervening strategies to improve the nutritional status of students.

Analysis school absenteeism in Nutrition Improvement Program for Rural Compulsory Education Students area from 2012-2017

XU Juan, XU Peipei, YANG Titi, LI Li, GAN Qian, CAO Wei, PAN Hui, HU Xiaoqi, ZHANG Qian

2021, 42(3): 350-353, 357. doi: 10.16835/j.cnki.1000-9817.2021.03.008

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Objective To investigate the changes of school absenteeism among students received Nutrition Improvement Program for Rural Compulsory Education Student (NIPCES), and to provide basic data for further nutritional health improvement for rural students. Methods Among 699 NIPCES monitored counties among 22 provinces across western and central China, 10%-30% of elementary and junior high schools were randomly selected as monitoring schools within each stratification according to the food supply pattern (school canteen, company and mix) in each county, school absenteeism information were collected and analyzed from 2012 to 2017. Results The total rate of student absenteeism was 26.0 per 10 000. From 2012 to 2016, it dropped from 30.8 per 10 000 to 23.4 per 10 000 year by year, but it increased again in 2017(28.2 per 10 000). The rate of school absenteeism in the western region (29.4 per 10 000) was higher than that in the central region (21.5 per 10 000); The sick leave rate (15.0 per 10 000) of primary school students was higher than that of junior high school students (13.4 per 10 000), and the rate of personal leave absences (16.9 per 10 000) of junior high school students was higher than that of elementary school students(9.9 per 10 000); the absentees rate in mixed-food supply schools (28.5 per 10 000) was higher than that in canteen food supply schools(26.4 per 10 000), the latter was higher than that of company food supply schools(25.0 per 10 000). The rate of sick leave absenteeism was highest in December(18.4 per 10 000), and the rate of personal leave absenteeism in June was highest(14.6 per 10 000). Conclusion The rate of school absenteeism among students in the NIPCES area showed an overall downward trend year by year. The absentee rate of students varies by regions, grade, food supply patterns and school locations.

Sleep duration, sleep quality and related factors among primary school students in Shanghai

SUN Lijing, ZHANG Zhe, ZHOU Yuefang, ZHOU Xinyi, LUO Chunyan

2021, 42(3): 354-357. doi: 10.16835/j.cnki.1000-9817.2021.03.009

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Objective To investigate the general situation of sleep duration, sleep quality and related risk factors among primary students in Shanghai and to provide evidence for the prevention and control of students' sleep health. Methods By using stratified cluster random sampling method, 3 410 students from 16 primary schools in four urban areas and four suburb areas of Shanghai were selected to conduct sleep health questionnaire survey and physical examination Chi-square test was used for group comparison while binary Logistic regression was used to assess possible factors related with sleep quality. Results The detection rate of sleep insufficiency (< 10 h) among students was 93.0%. The detection rate of poor sleep quality was 66.8% with 67.1% in girls and 66.6% in boys. The top three sleep problems were daytime sleepiness(80.9%), irregular sleep duration (74.1%) and sleep anxiety(59.5%). Multivariate Logistic regression analysis showed that everyday moderate-intensity physical activity (OR=1.51, 95%CI=1.04-2.21) and daily walking activity (more than 10 minutes)(OR=1.27, 95%CI=1.08-1.50) were risk factors of poor sleep quality(P < 0.05). Conclusion In Shanghai, the prevalence of sleep insufficiency and poor sleep quality among primary students are high. Sleep health was associated with moderate physical activity and walking activity. Increasing the duration of moderate physical activity and daily walking activity is the very important measures in prevention and control of the sleep problems.

Effects and correlation of gross motor intervention on movement and social skills of autistic children

LIU Rongsheng, ZHAN Xiaomei, LI Xiafang, DAI Lei, ZHANG Sijing, HONG Jiayu, CHEN Linyan

2021, 42(3): 358-362, 366. doi: 10.16835/j.cnki.1000-9817.2021.03.010

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Objective To explore the effects and correlation of gross motor intervention on social skills of autistic children. To provide new ideas for rehabilitation intervention of autistic children's social ability. Methods Recruiting 23 autistic children through WeChat in Nanchang, randomly divided into experimental groups (n=13) and control group (n=10). The experimental group underwent 6 weeks of large muscle exercise intervention, in the control group, Test of Gross Motor Development-3 (TGMD3), Social Responsiveness Scale(SRS) and the Autism Social Skills Scale (ASSS) examined changes in social skills, and analyze the relationship between sports and social ability. Results TGMD-3 score in the intervention group before intervention was (34.31±9.79) and increased significantly after intervention (59.77±13.92)(t=-15.28, P < 0.01). There was no statistical significance before and after experiment in the control group (P>0.05). The scores of SRS and ASSS in the experimental group were (96.77±15.79, 97.31±29.22) before the intervention, and (82.92±15.86, 117.62±24.93) after the intervention, and the differences were statistically significant(t=4.55, -5.61, P < 0.01). The difference between the SRS and ASSS scores of the control group before and after experiment was not statistically significant(P>0.05). Both the TGMD-3 score and the object manipulation score were related to the SRS total score (r=-0.49, -0.45) and ASSS total score(r=0.54, 0.51)(P < 0.05). Conclusion Gross motor intervention can improve the motor and social skills of children with autism, and there is a positive correlation between motor ability and social skills in children with autism.

Association of screen time with self-injury behavior among primary school students in five provinces in China

LIU Zhihao, LIU Zhiye, LYU Shuhong

2021, 42(3): 363-366. doi: 10.16835/j.cnki.1000-9817.2021.03.011

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Objective To explore the association of screen time with self-injury behavior in primary school students in China, to provide evidence for prevention on self-injury behavior. Methods From June to November in 2017, 1 090 primary school students were selected by stratified cluster sampling method from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou province in China, to analyze the association between screen time and incidence of self-injury. Results Totally 5.6% students reported screen time over 2 hours per day, boy, rural students, students with low health literacy, ever drinking had a higher rate of screen overuse(χ²=12.35, 6.94, 6.86, 16.86, P<0.05). The prevalence of screen overuse varied significantly by amount of pocket money(P<0.01). The prevalence of self-injury was 11.3%, students from western areas, boy, grade three, from rural area, adult relatives as guardians, low health literacy, smoking, drinking and screen time over 2 hours per day had a higher rate of self-injury behavior(χ²=27.31, 11.49, 23.91, 22.12, 15.11, 55.16, 19.03, 25.16, 19.35, P<0.05). Compared with the students with screen time less than 2 hours per day, multiple Logistic regression analyses showed that, the OR(95%CI) values of self-injury was 2.62(1.31-5.23) among students with screen time less than 2 hours per day. Conclusion The risk of self-injury behavior is related to screen time in primary school students,

Lifestyle pattern of middle school students in Guangzhou

LI Zhanglong, RAO Shufang, SONG Xinrui, QIU Yuanyuan, LIANG Jianping, TAN Weiqing, YANG Yi, GAO Yanhui, LIU Li, LI Lixia

2021, 42(3): 367-370. doi: 10.16835/j.cnki.1000-9817.2021.03.012

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Objective To identify the lifestyle pattern of adolescents in Guangzhou and to provide a scientific basis for targeted and individualized interventions for adolescents with different lifestyle pattern. Methods A survey was conducted by questionnaire among 12 540 students from 27 middle schools in the urban area of Guangzhou using a convenient sampling method. The latent class model (LCM) was used to identify lifestyle patterns of adolescents, and further analyses were conducted to compare differences in dietary habits and willingness to exercise among the different classes. Results Three lifestyle patterns were identified based on the latent class model: "high sweet snacks/excessive screen time, sleep and exercise deficiency group", 3 797 people, accounting for 30.3%; "low nutrition diet/severe sleep and exercise deficiency group", 2 745 people, accounting for 21.9%; "general diet/sleep and exercise deficiency group", 5 998 people, accounting for 47.8%. Adolescents of different classes had different perceptions of their eating habits and different degrees of willingness to participate in physical exercise, these differences were statistically significant(χ²=671.54, Z=153.16, P<0.05). Conclusion The results of the latent class model showed that the three classes of adolescents had their own unique characteristics. It is necessary to inform them of their needs, provide guidance and implement targeted interventions according to the unique characteristics of the different lifestyle patterns in empirical work.

Willingness and associated factors of novel coronavirus vaccination among parents of primary and middle school students in Tongzhou District of Beijing

ZHAO Chunyan, SHI Jing, ZHANG Guofeng, LIU Bo

2021, 42(3): 371-374,380. doi: 10.16835/j.cnki.1000-9817.2021.03.013

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Objective To understand the willingness and associated factors with novel coronavirus vaccination ('COVID-19 vaccination') among parents of primary and middle school students in Tongzhou District of Beijing, and to provide reference for studying the feasibility of COVID-19 vaccination among students. Methods Multistage stratified cluster random sampling method was conducted to select 3 026 parents of students in Tongzhou District. An online questionnaire survey was conducted to compare the willingness of COVID-19 vaccination by different characteristics. Multivariate Logistic regression model was conducted to analyze associated factors of COVID-19 vaccination. Results About 65.40% of parents were willing to vaccinate their children. Multivariate Logistic regression analysis showed that parets from rural areas, who had daughters, children in good health, who direct participated in the prevention and control, and those whose child had received vaccines at their own cost are more positive with COVID-19 vaccination of children(OR=1.17, 1.33, 0.64, 1.32, 1.47, P<0.05). Conclusion Parents of primary and secondary schools in Tongzhou District have a low willingness to vaccinate their children with COVID-19 vaccine. The propaganda of the government authorities and the official media should be strengthened, and the vaccination rate should be improved through the recommendation of medical personnel.

Dose-response relationship between emotional state and anxiety disorder among primary students

XUE Cheng, REN Jun, YIN Xiaoya, CHEN Bohao, WANG Shumei

2021, 42(3): 375-380. doi: 10.16835/j.cnki.1000-9817.2021.03.014

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Objective To explore the dose-response relationship between duration of emotional experience of primary school students and the intensity of anxiety disorders, and to understand the risk of anxiety disorders corresponding to different emotional state levels. Methods A total of 7 152 primary students from grade 3 to 5 were investigated with questionnaire survey from 16 public primary schools, by using the Screen for Child Anxiety Related Emotional Disorder (SCARED) and Positive Affect and Negative Affect Scale. Results The prevalence of anxiety disorders was 19.91%, among which the prevalence rates of anxiety disorders in boys and girls were 19.41% and 20.43%, respectively. After adjusting for gender, grade, household register, the only child, parental marital status, parental occupation, parental educational level, family financial level, serving as a class leader, receiving special training or counseling in sports and art, and being bullied, the risk of anxiety disorder in children with positive emotions lasting for 7-16 days, 17-24 days and >24 days was lower compared to those with positive emotions lasting for less than 6 days(P<0.05); the risk of anxiety disorder in children with negative emotions lasting for 0.27-0.93 day, 0.94-2 days and >2 days was higher compared to those with negative emotions lasting less than 0.26 day(P<0.05). Restricted cubic spline analysis showed that the duration of emotional state and anxiety disorder showed a significant non-linear dose-response relationship (non-linear test, P<0.01), that is, as the number of days of positive emotions increases, the risk of anxiety disorder continues to decrease, and as the number of days of negative emotions increases, the risk of anxiety disorder continues to increase. Conclusion There is a significant dose-response relationship between the duration of the emotional state of primary school students and the prevalence of anxiety disorders. Acquirement and maintain positive emotions m be an important entry point for mental health promotion among primary school students.

Effect of school health promotion intervention on overweight and obesity of middle school students

CHENG Qiaoyun, ZHENG Wenfeng, WU Hong, ZHAO Jianming, GUO Zhenping.

2021, 42(3): 381-384,388. doi: 10.16835/j.cnki.1000-9817.2021.03.015

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Objective To evaluate the effects of overweight and obesity intervention in the health-promoting school model and to provide reference for effective prevention and control of overweight and obesityin middle Schools. Methods Using stratified cluster random sampling, 10 middle schools in Sanmenxia City were randomly divided into intervention group and control group. In the intervention group and the control group, one middle school and one high school were randomly selected. The students from the two classes randomly selected in the first and second grades in the four schools that were selected, the questionnaire survey and medical examination was conducted before and after the intervention to evaluate the intervention effect. Results After intervention, the ratio of overweight and obesity of the intervention group decreased from 22.70% before intervention to 17.45%, statistical significance(χ²=4.11, P<0.05), and the ratio of overweight and obesity of the control group increased from 22.39% before intervention to 22.91%, no significant difference(P>0.05). After the intervention, the response rates of limiting red meat, fried food and sugarsweetened beverages were all higher than those before the intervention, the differences were statistically significant (χ²=125.73, 10.69, 208.55, 170.66, 50.01, P<0.01). Conclusion The comprehensive intervention measures of overweight and obesity in the model of health promotion school can encourage students to develop healthy behaviors and effectively prevent and control middle school students from overweight and obesity, and it is easy to form a long-term intervention mechanism.

Sleep quality and influencing factors of college students returning to school during COVID-19 epidemic

WANG Jing, ZHAO Ying, JIANG Minmin, WU Nan, DU Mengxue, FANG Zhengmei, ZHU Lijun, CHEN Yan, YAO Yingshui, JIN Yuelong

2021, 42(3): 385-388. doi: 10.16835/j.cnki.1000-9817.2021.03.016

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Objective To investigate the sleep quality and influencing factors of the first batch of college students returning to school during COVID-19 epidemic, so as to provide scientific basis for taking corresponding measures. Methods An anonymous self-administered questionnaire survey was conducted among the first batch of college students returning from a certain university by cluster sampling, which included general demographic characteristics, Trait Coping Style Questionnaire (TCSQ) and Pittsburgh Sleep Quality Index(PSQI). Results The detection rate of sleep disorders was 19.33%(522/2 701). The mother's education level was high school or technical secondary school or below(OR=2.24, 95%CI=1.47-3.41), never eat breakfast(OR=3.25, 95%CI=1.86-5.68), families were damaged during the outbreak (OR=1.48, 95%CI=1.17-1.87) and negative coping (OR=1.15, 95%CI=1.12-1.17) were risk factors for sleep disorders(P < 0.05). Compared to having a very poor relationship with parents, the relationship between parents was average(OR=0.23, 95%CI=0.06-0.89), better(OR=0.23, 95%CI=0.06-0.87), very good (OR=0.19, 95%CI=0.05-0.74) were protective factors for sleep disorders(P < 0.05). Exercise once or twice a week during the epidemic(OR=0.76, 95%CI=0.58-1.00), positive coping (OR=0.93, 95%CI=0.91-0.96) were protective factors for sleep disorders(P < 0.05). Conclusion In this COVID-19 epidemic, the sleep quality of returning college students was affected to different extent, and the relationship between parents, sports, mother's education, breakfast habits, and family damage during the COVID-19 were factors affecting their sleep quality. Targeted psychological intervention measures should be given to returning college students in the early stage.

Impact of parental conflict perception on adolescent anxiety and the therapeutic effect of family therapy

ZHU Li, CHENG Li, ZHANG Mian, XIE Jun, YANG Jingyue

2021, 42(3): 389-391. doi: 10.16835/j.cnki.1000-9817.2021.03.017

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Objective To investigate the impact of parental conflict perception on adolescent anxiety and the therapeutic effect of family therapy on adolescent anxiety. Methods A total of 120 adolescent anxiety patients who attend the psychological clinic of the fourth renming hospital in Hefei were selected and were divided into two groups, the treatment group and control group, impact clinical medication while the treatment group recevied both clinical medication and family therapy(for three months). Parents Conflict Consciousness Scale(CPIC), Hamilton Anxiety Scale (HAMA) was used to assess parents conflict consciousness of adolescent anxiety. Effects of family therapy on teenagers anxiety and CPIC, HAMA score were analyzed. Results CPIC conflict intensity, threats of cognitive conflict and content for adolescent anxiety were positively correlated with HAMA scores(r=0.26, 0.20, 0.18, P<0.05), At the end of the three-month treatment, the score on HAMA and CPIC of the treatment group (HAMA: 9.23±1.98, CPIC: 9.52±2.35) was significantly lower than that of the control group(HAMA: 14.52±2.66, CPIC: 11.98±2.55)(t=11.88, 5.48, P<0.01). HAMA and CPIC scores of patients in both groups significantly decreased compared to before treatment(control group t=13.88, 16.84; treatment group t=20.50, 21.89, P<0.01). Conclusion Parental conflict perception shows impact on adolescent anxiety, and family therapy can reduce parental conflict perception and relieve adolescent anxiety.

Association between childhood abuse and recent negative life events with suicidal psychological behavior of middle school students

GAO Xin, WAN Yuhui, XIE Yang, JIANG Zhicheng, LI Shuqin, ZHANG Yi, CAO Xiujing, TAO Fangbiao.

2021, 42(3): 392-395, 398. doi: 10.16835/j.cnki.1000-9817.2021.03.018

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Objective To investigate the relationship between childhood abuse and recent negative life events with suicidal ideation and attempt, and to provide reference for prevention and control of suicidal behaviors in middle school students. Methods Stratified cluster sampling method was used to select 7 986 middle school students from Shenzhen, Nanchang and Shenyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse, negative life events, suicidal ideation and suicide attempt, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and negative life events with suicidal ideation and suicide attempt. Results The prevalence of suicidal ideation and suicide attempt was 22.9% and 4.7%. After adjusted for confounding variables, with the increase of childhood abuse and negative life events, suicidal ideation and attempt in middle school students showed an increasing trend(P<0.05). Compared those with low level of childhood abuse and negative life events, students with high childhood abuse and high negative life events had a higher suicidal ideation and suicide attempt risk, the multiple adjusted odds ratio was 10.43 and 19.75(P<0.05). Conclusion Childhood abuse and negative life events are important risk factors affecting suicidal ideation and attempt in middle school students. Strategies to reduce childhood abuse and negative life events should be an integral component of targeted mental health interventions.

School-based sexual harassment among college students in Guangzhou, China

CHEN Xin, HUANG Bing, QIU Qianwen, CAI Min, ZHANG Jie, CHEN Xiongfei, DONG Xiaomei

2021, 42(3): 396-398. doi: 10.16835/j.cnki.1000-9817.2021.03.019

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Objective This study examined school-based sexual harassment experience among college students in Guangzhou, and to provide theoretical basis for preventing campus sexual harassment. Methods A cross-sectional survey was conducted among 1 062 college students from five universities in Guangzhou, China. A self-made questionnaire regarding awareness sexual harassment and experience of school-based sexual harassment was filled out by students voluntarily and anonymously. Results A total of 169 students reported they experienced school-based sexual harassment. The incidence of school-based sexual harassment among college students in Guangzhou was 15.91%, higher among female students (20.30%) than male students(10.2%)(χ²=19.91, P < 0.01). Verbal harassment (10.26%) was the most common type of sexual harassment, followed by physical harassment (7.16%), visual harassment (4.61%) and unwanted sexual advances (1.69%). Sexual harassment primarily took place in teaching building(58), dormitory(33) and office(17). Among the victims, 116(68.64%) were influenced by harassment. Females(n=94) being harassed were more likely to be negatively influenced compare to males(n=22). Conclusion School-based sexual harassment may result adverse psychological outcomes to students, more emphasis should be put on the prevention of sexual harassment.

Psychological flexibility training for career adaptability improvement among second-year middle-school students

LIU Zidi, BAI Xiaoyu, ZHANG Ye, WU Mengxue, LIU Yinhui, ZHU Zhuohong, LI Mei, LI Xinying

2021, 42(3): 399-403. doi: 10.16835/j.cnki.1000-9817.2021.03.020

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Objective To test the effectiveness of psychological flexibility training on career adaptability among middle school students who undertook psychological courses based on acceptance commitment therapy and the adolescent mental flexibility model(DNA-V), and to provide a reference plan to improve the mental health of middle school students. Methods This study recruited 110 junior high school students (60 boys and 50 girls) from a middle-school in Beijing. The students were randomly divided by class into a DNA-V face-to-face course group(offline group n=33), a DNA-V online course group(online group n=40), and a regular school psychology course group(control group n=37). Louise Hayes' DNA-V intervention program was condensed into a six-hour middle-school DNA-V psychology curriculum. Using the Avoidance and Fusion Questionnaire for Youth and the Career Adaptability Scale, changes in psychological flexibility and career adaptability were measured before(T1), one week after(T2), and two months after (T3) the intervention. Results Linear mixed models were used for the analysis, while controlling for demographic variables. Psychological flexibility and career adaptability in the offline group were higher at T2 and T3 than at T1(psychological flexibility t=4.22, 3.11; career adaptablity t=3.05, 4.16, P < 0.01), while the difference between T2 and T3 was not statistically significant. The psychological flexibility and career adaptability of the online group were not statistically significant at T1, T2, and T3. The psychological flexibility and career adaptability of the control group increased from T1 to T2(t=4.64, 2.47, P < 0.05), but T3 decreased back to a level close to T1. Conclusion In terms of both psychological flexibility and career adaptability, the DNA-V face-to-face psychology course resulted in a retention period of at least two months.

Prevalence and influencing factors of dental fear among 12-15-year-old children in Shenzhen

ZHANG Ziyang, XUAN Peng, HU Xiaowen, LI Juhong

2021, 42(3): 404-407. doi: 10.16835/j.cnki.1000-9817.2021.03.021

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Objective To understand the prevalence and influencing factors of Children's Dental Fear (CDF) among 12-15-year-old children in Shenzhen city, so as to provide a framework to alleviate CDF and promote oral health. Methods Multi-stage stratified random sampling was used to select 5 509 children, aged 12-15 years, to participate in this study, which was carried out from October to November, 2018. The Children's Fear Survey Scheduling-Dental Subscale (CFSS-DS) and oral health examinations were conducted in Shenzhen. Results The prevalence of dental fear in children aged 12, 13, 14, and 15 years in Shenzhen was 30.3%, 30.5%, 33.6%, and 26.9%, respectively(χ²=11.97, P=0.01). The CFSS-DS scores were(29.86±13.23)(29.72±13.59)(31.23±14.47)(29.79±13.24), respectively(F=3.60, P=0.01). The CFSS-DS scores of male and female participants were (27.92±13.69) and (32.62±13.12)(t=-12.97, P < 0.01), respectively, and the CDF prevalence rates were 23.8% and 38.8%, respectively(χ²=159.29, P < 0.01). Multivariate Logistic regression analysis showed that gender, brushing frequency, visiting experience, oral knowledge level, oral health attitude, oral health and general health status were correlated with CDF (P < 0.05). Conclusion Attention should be paid to the prevalence of dental phobia among children aged 12-15 years in Shenzhen, and comprehensive intervention measures should be taken to improve children's oral health.

Influence of school mental health education combined with family intervention on the mental health of middle school students

ZHAO Xianzi, WANG Jianbiao

2021, 42(3): 408-411. doi: 10.16835/j.cnki.1000-9817.2021.03.022

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Objective To explore the influence of school mental health education combined with family intervention on the mental and physical health of middle school students. Methods A total of 280 students in six classes of the experimental middle school attached to Hebei Normal University were convenient selected as participants, and two classes in each grade were included in the experimental group and the control group. The experimental group received school mental health education and family intervention, while the control group only received school mental health education. The changes in GHQ, SCL-90 and common mental health problems were compared before and after intervention. Results The total score of GHQ-12 was (5.06±1.33) in the experimental group after intervention and (15.62±3.84) before intervention. The total score of GHQ-12 in the experimental group after intervention was significantly lower than that before intervention, and significantly lower than that in the control group(t=13.65, 8.39, P < 0.05). The scores for somatization, anxiety, depression, paranoia, interpersonal sensitivity, obsessive-compulsive symptoms, hostility, paranoia and psychosis in the experimental group were significantly lower than those in the control group(t=-13.21--6.71, P < 0.05). After the intervention, the proportions of good interpersonal relationships, good parent-child relationships and after-school hobbies in the experimental group were 68.28%, 66.21% and 84.14%, respectively, which were significantly higher than those in the control group(35.56%, 40.74% and 51.85%, respectively), the proportions of people without intimate friends, early love and love after school were 9.66%, 9.66% and 4.14%, respectively, which were significantly lower than those in the control group(20.74%, 24.44%, 21.48%)(P < 0.05). Conclusion School mental health education and family intervention can effectively improve the mental health of middle school students, improve their interpersonal relationships and promote their mental and physical health.

Family relationship and psychological stress response of college students in Shanghai under the COVID-19 epidemic

GUO Peipei, YU Haiyan, GAO Jinmin

2021, 42(3): 412-416. doi: 10.16835/j.cnki.1000-9817.2021.03.023

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Objective To investigate the association between the family relationship of college students in Shanghai and the psychological stress response under the COVID-19 epidemic. Methods Totally 904 college students from universities in Shanghai were investigated with questionnaire of FACESII-CV and IES-R. Results The score of family relationship intimacy was(61.32±6.29), the score of family relationship adaptability was(43.30±5.83), the score of psychological stress was(30.77±7.33), the score of internal dimension, avoidance, high alertness were(11.63±2.53)(11.69±2.64)(7.45±2.33). About 77.5%(701) and 17.3%(156) of college students showed mild and moderate stress reactions. Three dimensional scores of psychological stress response and two dimensional scores of family relationship differed significantly by age, grade, family income and parental education(P < 0.01). Moreover, family relationship intimacy and adaptability scores showed negative associations with intrusive symptoms, avoidance symptoms, and high alert symptom dimension scores(P < 0.05). Conclusion College students showed mild psychological stress under the COVID-19 epidemic with intrusion and avoidance symptoms as the most common. The intimacy and adaptability of family relationships are negatively associated with psychological stress response of college students under the epidemic. High-quality family relationships can reduce the psychological impact and adverse effects of the new crown epidemic on college students.

Persistent effects of adverse childhood experiences on the course of pubertal development

YU Hejun, ZHANG Yanzhen, ZHOU Bo, WANG Meifen, WANG Dan, WU Lanyan, YAO Rongying

2021, 42(3): 417-421. doi: 10.16835/j.cnki.1000-9817.2021.03.024

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Objective To explore the influence of adverse childhood experiences (ACEs) on pubertal development of boys and girls and to provide a reference for the development of intervention measures. Methods A stratified cluster sampling method was used to select a total of 1 156 students in grades three and four in the boarding school system and public primary schools in Huangshan City and surrounding towns in September 2018, using the Childhood Trauma Questionnaire (CTQ) and the Pubertal Development Scale (PDS). For the baseline self-assessment survey, according to different dimensions, abuse children score no exposure groups. Children were divided into an exposure group and a high exposure level group, according to their childhood experiences. PDS self-report questionnaire was administered two years later, and an analysis of ACE type and severity of the continuous impact of youth development was conducted. Results In the baseline survey, there were 53 girls (11.32%) and 51 boys (7.41%) who developed earlier. The rate of early development in girls was higher than that of boys, and the difference was statistically significant(χ²=5.21, P < 0.05). Univariate analysis showed gender differences in the effects of type and severity of ACEs and abuse on adolescent development at both baseline and follow-up. There were gender differences in the rate of early development between boys and girls at baseline and at follow-up between the exposure groups. Regression analysis showed that the higher the degree of emotional abuse, emotional neglect, and sexual abuse in girls, the higher the PDS score(B=0.22, 0.15, 0.08, P < 0.05). In boys, the more severe the emotional abuse experienced, the higher the PDS score, and the more severe the physical abuse experienced, the lower the PDS score(B=0.20, 0.04, P < 0.05). Conclusion Attention should be paid to the influence of ACEs and gender differences during youth development among male and female students, and more long-term studies should also be carried out.

Influence of impulsivity on adolescents' pornography use

YU Chunyan, LIAN Qiguo, ZHONG Xiangyang, ZHANG Jiashuai, TU Xiaowen, LOU Chaohua, ZUO Xiayun

2021, 42(3): 422-425. doi: 10.16835/j.cnki.1000-9817.2021.03.025

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Objective To explore the influence of impulsive traits of adolescent on pornography use through the analysis of the Global Early Adolescent Study(GEAS) longitudinal survey data collected in Shanghai, and to provide evidence for adolescent sexual health promotion. Methods Totally 1 512 students from grades 6 to 8 in three middle schools in a district of Shanghai were selected for the present study by stratified cluster sampling method. Baseline and two-wave follow-up investigation were conducted between 2017 and 2020. Three waves of pornography use and social demographic information were collected using electronic questionnaire through tablets while impulsivity were tested only once during the follow-up in 2018 using the paper and pencil based Barratt Impulsivity Scale, version11 (BIS-11). General statistical description and panel data statistical description, as well as multilevel mixed effect linear model were used to do the analysis. Results About 32.7% (494) of the adolescents reported the experience of watching pornography in three-wave analysis. Boys were more impulsive than girls in the motor subscale (16.33±3.25, 15.66±2.93, t=4.13, P < 0.01) while girls were more impulsive than boys in the nonplanning subscale (23.65±5.11, 22.83±5.21, t=-3.03, P < 0.01). Mixed effect linear model result showed that impulsivity was correlated with pornography use(β=0.001, P < 0.01); higher impulsivity in motor and attention were correlated with more frequent pornography use(P < 0.01). Being female, perceived more parental awareness and perceived care from school adults would decrease the use of pornography while spent more than 3 hours on internet would increase the use of pornography (P < 0.01). Conclusion There are stable correlations between impulsivity and pornography use. It is urgent to equip young adolescents with the necessary ability to distinguish the good from the bad in the mass and internet media world.

Effect of pubertal timing on learning adaptation in junior high school students

LIU Yanyan

2021, 42(3): 426-429. doi: 10.16835/j.cnki.1000-9817.2021.03.026

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Objective To explore the influence of pubertal timing on learning adaptation in junior high school students, so as to provide reference for the prevention and intervention of junior high school students' learning adaptation. Methods From April to June 2019, 1 677 students were sampled by stratified cluster sampling from three middle schools in Zhoukou and Xiangcheng, Henan Province. The Chinese version of Youth Development Scale and Learning Adaptation Scale were used for questionnaire survey. Results The scores of learning task, learning attitude and learning achievement of female students were higher than those of male students, and the differences were statistically significant(t=-2.34, -2.14, -5.81, P < 0.05); The learning attitude, academic performance, interpersonal environment score of grade 7 were higher than that of grade 9, the total learning adaptation score of grade 7 was higher than that of grade 8, the differences were statistically significant(F=1.95, 1.87, 2.24, 1.37, P < 0.05). Partial correlation analysis showed that junior high school students' pubertal timing was negatively correlated with the total scores of learning tasks and learning adaptation(r=-0.15, -0.13, P < 0.05). The scores of learning task, total score of learning adaptation and academic performance of the earlier group were lower than those of the later group, and the scores of learning attitude of the earlier group were lower than those of the moderate group, the differences were statistically significant(F=4.76, 1.97, 3.23, 3.80, P < 0.01). Regression analysis showed that pubertal timing had a significant negative predictive effect on learning adaptation scores and learning tasks(β=-0.12, -0.13, P < 0.05). Conclusion The pubertal timing of junior high school students is closely related to learning adaptation, and pubertal timing will lead to the increased risk of learning adaptation of junior high school students. Schools should carry out corresponding health education and provide professional psychological counseling services, so as to improve the learning adaptation among early starters.

Analysis of thyroid hormone level and its influencing factors among pubertal girls in Minhang District of Shanghai

HE Dandan, WEN Xiaosa, FU Ye, XU Xiaoli, TAO Shiji, SU Hualin, XU Dongli, WANG Na

2021, 42(3): 430-435. doi: 10.16835/j.cnki.1000-9817.2021.03.027

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Objective To investigate thyroid hormone concentration and associated factors among pubertal girls in Minhang District of Shanghai. Methods From January to March 2019, a stratified sampling method was used to select junior high schools from the east, south, north, and middle areas in Minhang district. A total of 386 girls of grade 6 in selected schools were included in the study. Physical examination was conducted, and their urine and blood samples were collected to determine urinary iodine concentration (UIC) and thyroid function. Puberty Development Self-rating Scale (PDS) was used to define the pubertal stage. Logistic regression models were conducted to analyze the associations between pubertal stage and thyroid function. Results The median urinary iodine concentration was 163.57(106.57, 232.96) μg/L. The geometric mean values of TSH, TT3, FT3 and FT4 were 0.29 mU/L, 0.26 nmol/L, 0.68 pmol/L and 1.18 pmol/L.The mean value of TT4 was 91.64 nmol / L. The abnormal rates of TGAb and TPOAb were 6.22% and 4.15%. The rate of abnormal TGAb combined with abnormal TPOAb was 3.68%. Girls in puberty and post-puberty had the lower level of TT4 (OR=0.47, 0.43) as compared with girls in pre-puberty stage. Obese girls had higher level of TT3(OR=9.08, 95%CI=1.52-54.07). With the increase of exercise time(0.5-1, >1 h/d), FT4 level was increased (OR=2.45, 2.19). TSH levels were significantly higher in girls with higher TGAb and TPOAb. Girls had higher TT4 or FT4 levels if their TGAb levels were higher and TPOAb levels were normal. Conclusion There is an association between pubertal stage, obesity, exercise and thyroid function in school-aged girls during puberty in iodine sufficient areas. TSH, FT4 and TT4 levels are correlated with TGAb and TPOAb levels.

Analysis of serum uric acid levels and associated factors among primary and middle school students in Tongzhou District, Beijing

JIANG Nan, WANG Shuang, WU Chang

2021, 42(3): 436-439,453. doi: 10.16835/j.cnki.1000-9817.2021.03.028

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Objective To examine uric acid (UA) levels and their influencing factors among primary and middle school students in the Tongzhou District of Beijing, and to provide referential guidance for the prevention and control of hyperuricemia in teenagers. Methods A total of 1 483 students from four middle schools and four primary schools in three cities and three towns in Tongzhou District were selected for a questionnaire survey, physical examination, and blood examination using a multi-stage stratified cluster sampling method. The results of the serum uric acid (SUA) examinations were statistically analyzed and the influencing factors were evaluated. Results The UA level of the students was skewed, with a median value of 296.0 mol/L and an interquartile distance of 96.0 mol/L. The overall detection rate of hyperuricemia was 14.83% (220/1 483). Middle school students (342 μmol/L), students from villages and towns (307 μmol/L), males (309 μmol/L), family dining students (298 μmol/L), students with high levels of triglyceride (TG) (318 μmol/L), students with low levels of high-density lipoprotein cholesterol (HDL-C) (329 μmol/L), and obese students (303 μmol/L) all had statistically higher SUA levels(H/U value was 119 938, 229 525, 212 043, 156 347, 42 052, 63 375, 33.49, P < 0.05). The univariate analysis showed that the HUA detection rate was higher in older age groups, middle school students, township students, overweight or obese students, and low HDL-C students(χ²=614.55, 73.20, 6.16, 30.56, 14.50, P < 0.05). Multivariate Logistic regression showed that older age, being male, low HDL-C, high LDL-C, overweight, and obesity were risk factors for HUA(P < 0.05). Conclusion The SUA level and the detection rate of hyperuricemia among primary and middle school students in Tongzhou District were high, and the risk of disease and influencing factors had significant characteristics. Therefore, targeted prevention and control measures should be strengthened.

Characteristics of functional movement screening in junior middle school students

TAN Yan, LI Wei, ZHU Jianyong

2021, 42(3): 440-443. doi: 10.16835/j.cnki.1000-9817.2021.03.029

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Objective The influence of BMI and gender on Function Movement Screens (FMS) was analyzed to provide objective basis for improving physical quality and prevention of sports injuries among adolescents. Methods A total of 676 junior middle school students aged between 11 and 14 in grade 2 selected from a middle school in Beijing, were grouped by sex for FMS total score comparison. FMS scores of male and female students were compared according to body mass index (BMI). The 7 movements of FMS were compared and analyzed by male and female groups respectively. The influence of gender on FMS and the relationship between BMI and FMS were explored to seek the features of FMS in Chinese adolescents. Results FMS scores of male and female students in the BMI standard group were significantly higher than those of the super-recombination group(P < 0.01); there was no significant difference in FMS scores between the standard group and the low weight group. BMI score was negatively correlated with FMS score, and the r value of boys was -0.27; for girls, the r value was -0.18(P < 0.05). The total FMS score of male group was significantly lower than that of female group, which was (13.09±2.17) for male group and (13.91±1.79) for female group(t=-5.31, P < 0.01). In comparison between men and women on each FMS test, there were significant differences in all categories except for the stability of trunk rotation (P < 0.05). Conclusion Combined with BMI, FMS score can objectively reflect the overall athletic ability of adolescents. There were gender differences in FMS total score and individual score. FMS score can be used as a supplementary reference for physical fitness test of middle school students.

Abnormal spinal curvature and influencing factors in children and adolescents in Hongkou District, Shanghai

QI Deyun, LI Liping, JIANG Yanwei, ZHOU Yuan

2021, 42(3): 444-447, 453. doi: 10.16835/j.cnki.1000-9817.2021.03.030

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Objective To investigate the incidence of abnormal spinal curvature and related factors in primary and secondary school students in the Hongkou District of Shanghai, so as to provide evidence for abnormal spinal curvature prevention and treatment. Methods Using a stratified cluster random sampling method, 1 884 students of grade 4 to grade 12 from seven schools were investigated via questionnaires for abnormal spinal curvature in Hongkou District. Results The detectable rate of abnormal spinal curvature was 7.2%, The detectable rate of abnormal spinal curvature increased with increasing age(P < 0.01): senior high school (15.7%) > vocational high school (8.1%) > junior high school (3.4%) > primary school(1.8%)(χ²=91.24, P < 0.01). The detectable rate of spinal curvature among female students was 8.6%, which was higher than that among male students(5.9%), and the difference was significant(χ²=5.27, P < 0.05). Multivariate Logistic regression analysis showed that the factors influencing abnormal spinal curvature included phase of studying, nutritional status and time spent engaged in outdoor activities every day(P < 0.05). Conclusion Abnormal spinal curvature is one of the common conditions that endangers the health of children and adolescents. The collaboration of the school, students and parents is required to strengthen screening and prevention.

Interval training for cardiopulmonary fitness of college students: a network Meta-analysis

LI Zhen, XIAO Tao, WANG Chenyu, ZHEN Jie

2021, 42(3): 448-453. doi: 10.16835/j.cnki.1000-9817.2021.03.031

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Objective To compare the effects of different types of high-intensity interval training and moderate-intensity steady training on improving cardiorespiratory fitness of college students, and to provide evidence supporting intervention methods for health promotion of college students. Methods By using the method of Meta-analysis, Web of science, PubMed, Scopus and CNKI database was searched for randomized control trails regarding high-intensity intervention (HIIT), repeated-sprint training (RST) and sprint-interval training (SIT) among sedentary college students in April 1, 2020. Two independent researchers conducted literature filtering, data extraction, risk of bias assessment, as well as traditional Meta-analysis and network Meta-analysis by using Stata software version 16.0. Results A total of 21 articles and 728 participants were included. Meta-analysis showed that HIIT (SMD=0.35, 95%CI=0.10-0.60, P < 0.05) and SIT (SMD=0.38, 95%CI=0.05-0.70, P < 0.05) were significantly better than MICT, there was no statistical difference in RST (SMD=-0.08, 95%CI=-0.41-0.25, P>0.05) compared with MICT; HIIT (SMD=0.40, 95%CI=0.08-0.72, P < 0.05) and SIT (SMD=0.35, 95%CI=0.03-0.67, P < 0.05) were significantly better than RST, there was no significant difference between HIIT and SIT(SMD=0.05, 95%CI=-0.25-0.36, P>0.05). The ranking of the four training methods for improving the effect size of VO₂max index was HIIT>SIT>RST>MICT. Conclusion The overall effect of high intensity interval training on VO₂max is better than MICT, and HIIT training may be the best.

Eating behaviors and growth status in children with attention deficit and hyperactivity disorder

CHEN Shujin, WU Dandan, HUANG Rong, LI Rong, CHEN Mengying, HUANG Yiyang, LIN Shuang, LI Xiaonan

2021, 42(3): 454-458. doi: 10.16835/j.cnki.1000-9817.2021.03.032

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Objective To discuss the correlation between growth status and eating behaviors in children with attention deficit and hyperactivity disorder (ADHD), providing reference data for management and dietary behavior guidance among ADHD children. Methods A total of 703 children aged 4-13 years old were collected from the ADHD patients from Children's Health Department of Children's Hospital of Nanjing Medical University from June to September, 2019. The demographic characteristics and information regarding children's eating behaviors were collected by self-designed questionnaire and Chinese version of the parent-completed Children's Eating Behavior Questionnaire(CEBQ). The correlation physical growth with dietary behaviors among the ADHD children were analyzed. Results Food avoidant behaviors, including satiety responsiveness, slowness in eating and emotional undereating in ADHD children with thinness scored significantly higher than that of children with short stature, overweight and obesity(F=17.57, 29.32, 4.07, P < 0.01), while food approach behaviors, including food responsiveness, enjoyment of food, desire to drink and emotional overeating scored higher in obese children, compared to other three groups(F=24.54, 47.44, 2.96, 5.85, P < 0.05). Multiple linear regression analysis showed that, after adjusting for the confounders, satiety responsiveness, slowness in eating were still negatively associated with BMI-Z score of the ADHD children(B=-0.05, -0.07, P < 0.01). Food responsiveness, enjoyment of food and emotional overeating had a positive association with the BMI-Z score(B=0.04, 0.09, 0.05, P < 0.05). Conclusion Emotional eating and high food responsiveness in ADHD children are associated with the overweight and obesity, while long eating time and high satiety responsiveness is associated with underweight among ADHD children. For clinical doctors and parents, problematic eating behaviors among ADHD children should be concerned regarding its negative effects on growth and development, besides core symptoms of ADHD.

Health literacy and associated factors of freshmen from Jiangsu Province during 2017 and 2018

DU Guoping, ZHANG Suqin, JIN Dan, HE Yan, WANG Yaqing, XU Songping, LI Xiaoshan

2021, 42(3): 459-464, 470. doi: 10.16835/j.cnki.1000-9817.2021.03.033

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Objective To understand health literacy and associated factors of freshmen from Jiangsu Province, and to provide reference for youth health education. Methods From 2017 October to 2018 October, a total of 15 602 college freshman were randomly selected from 20 universities in Jiangsu Province via stratified cluster sampling method. Structural questionnaires were used to investigate the status of health literacy. The χ² test and multivariate Logistic regression model were used to analyze the influencing factors of health literacy. Results The health literacy level of college freshmen from Jiangsu Province was 20.2%, among which the literacy levels of knowledge, behavior and skills were 23.0%, 30.7% and 31.5% respectively. The literacy levels of the six public health issues, including safety and first aid, scientific health attitude, knowledge of prevention and treatment of infectious diseases, health information, basic health care, and prevention and treatment of chronic diseases, from high to low, were 72.8%, 58.7%, 28.5%, 28.2%, 20.3% and 15.9%, respectively. Multivariate Logistic regression analysis has showed that students from undergraduate colleges(OR=2.77, 95%CI=2.47-3.11), urban areas(OR=1.20, 95%CI=1.07-1.34), or southern Jiangsu regions(OR=1.10, 95%CI=1.00-1.22), being the only child(OR=1.13, 95%CI=1.03-1.25), higher maternal education level (OR=1.53, 95%CI=1.30-1.79), having both parents(OR=1.16, 95%CI=1.00-1.34), reported higher level of health literacy. Conclusion The three aspects and six dimensions of health literacy of college freshmen were unbalanced. Health literacy is a shared function of multiple factors including society, family, and individuals. It is essential to promote health education through more efforts on key issues, in order to effectively elevate the health literacy level of adolescent students.

Research progress on neural mechanism of orthographic processing in children with Chinese developmental dyslexia

LIU Fangfang, ZUO Pengxiang, TANG Shuting, GAO Xiaoyan, HE Hongyao

2021, 42(3): 465-470. doi: 10.16835/j.cnki.1000-9817.2021.03.034

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Objective The possible mechanisms of developmental dyslexia mainly include the hypothesis of language framework and the hypothesis of non-verbal framework. The language framework assumes that people with developmental dyslexia may exhibit defects in phonetic awareness, rapid naming, phonetic memory, and orthographic processing. Studies of developmental dyslexia in Chinese have found that deficiencies in orthography may be an important cause of dyslexia, but there are diverse views and opinions regarding orthography processing. This article sorts out the research progress in behavioral and neuroimaging aspects of orthography studies, and provides references for further development of processing test materials and methods in the research of processing mechanism of developmental dyslexia orthography.

Research updates of international strategies to control sugar-sweetened beverages consumption in children and adolescents

WANG Hongliang, GAN Qian, ZHANG Qian

2021, 42(3): 471-475. doi: 10.16835/j.cnki.1000-9817.2021.03.035

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Excessive intake of sugar-sweetened beverages among children and adolescents could increase the risks of adverse health outcomes, including dental caries and obesity. This study reviewed the consumption of sugar-sweetened beverages among children and adolescents in China and the international strategies to reduce the consumption of sugar-sweetened beverage. The aim of the study was to provide a reference for the introduction of relevant policies to control the intake of sugar-sweetened beverages in children and adolescents in China. In summary, measures including a tax on sugar-sweetened beverages, implementing front-of-pack labelling system, restricting marketing and publicity and education have been adopted to control the consumption of sugar-sweetened beverages in some countries, while public publicity and education have been adopted in China. It is suggested that comprehensive policies and measures should be adopted to control the intake of sugar-sweetened beverage among Chinese children.

Reseach update on determinants of child oral health based on Anderson extended model

LIU Lu, LI Li

2021, 42(3): 476-480. doi: 10.16835/j.cnki.1000-9817.2021.03.036

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Children's oral health is related to many factors. Research on potential risk factors of children's oral health helps improve children's oral health. Based on the Anderson extended model, this review reviews the domestic and foreign literature on the factors affecting children's oral health, and finally concludes that children's oral health is related to exogenous variables, primary determinants of oral health, oral health behavior and other factors. Children's oral health can be improved by developing good oral habits, strengthening the health beliefs of parents and children, improving the oral health service system and developing oral insurance system.

2021 Vol. 42, No. 3