2021 Vol. 42, No. 4

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Establishment of dietary quality assessment system for children is necessary for growth and development research
CHENG Guo, DING Gangqiang
2021, 42(4): 481-484. doi: 10.16835/j.cnki.1000-9817.2021.04.001
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Nutrition in childhood has an important effect on health in adulthood. To examine the diet-growth relationship, it is necessary to carry out a comprehensive and objective evaluation of diet quality in children and to develop effective nutrition intervention programs, so as to improve children's health. This paper summarizes the characteristics and application of current methods of collecting dietary intake information and evaluating dietary quality, and proposes several suggestions related to the development of the children's diet quality assessment system in China.
E-sports and depression, opportunities and challenges: rational thinking based on adolescent health and exercise intervention
JIN Shengjie, CHEN Xianghe, LIU Bo, LU Pengcheng, LI Wenxiu, TIAN Zhikai, ZENG Xinyu
2021, 42(4): 485-488. doi: 10.16835/j.cnki.1000-9817.2021.04.002
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Teen E-sports and their negative impact should not be underestimated. The effects of gaming, as an emerging sport, should be examined to determine whether it plays an active role in contributing to the onset of adolescent depression. Therefore, this study outlines the development status of E-sports, analyzes the influence of E-sports on adolescent depression, and highlights the hidden concerns that E-sports pose for the mental health development of adolescents. While taking into account the advantages of E-sports and exercise intervention programs, an emphasis should be placed on the prevention of depression, and feasible suggestions and countermeasures should be put forward to promote E-sports, while at the same time safeguarding the healthy and orderly development of adolescent mental health.
Cumulative influence of preadolescent lifestyles on the prevalence of elevated blood pressure among children
LI Yanhui, GAO Di, CHEN Manman, MA Ying, CHEN Li, DONG Yanhui, SONG Yi, MA Jun
2021, 42(4): 489-492,496. doi: 10.16835/j.cnki.1000-9817.2021.04.003
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  Objective  To analyze the cumulative effect of preadolescent lifestyles on the prevalence and incidence of elevated blood pressure (EBP) in children, and to provide evidence for early hypertensive intervention.  Methods  In 2017, a cohort study on pubertal development was conducted in Xiamen, Fujian Province. Participants underwent a physical examination and questionnaire survey. Between 2017 and 2019, this study carried out a 2-year follow-up of 1 316 students whose complete data were obtained. Preadolescent lifestyles were assessed by referring to baseline survey results obtained in 2017, and the prevalence and incidence of EBP were determined according to blood pressure levels that were determined in 2019. The logistic regression model was used to analyze the influence of healthy lifestyles on the prevalence and incidence of EBP after adjusted for confounding factors.  Results  The prevalence of EBP in 2017 and 2019 was 25.0% and 23.3%, respectively, and its incidence was 18.9% after the 2-year follow-up. Children with a healthy lifestyle had a lower prevalence and incidence of EBP. The regression analysis showed that children who have more healthy lifestyle factors were at a lower risk of EBP (P < 0.05). Compared with students with 0-2 healthy lifestyle factors, the OR value of EBP prevalence was 0.52 (95%CI=0.30-0.90) and the RR value of EBP incidence was 0.60(95%CI=0.29-1.22) in children with 4-5 healthy lifestyle factors. Among them, children who were overweight or obese were at a significantly lower risk of EBP prevalence (OR=0.29, 95%CI=0.10-0.81).  Conclusion  Preadolescent lifestyles seemed to have a cumulative effect on the occurrence of EBP. Maintaining a healthy lifestyle had a positive effect on reducing the risk of EBP, particularly in overweight and obese children, and this was due to their adoption of a comprehensive healthy lifestyle.
Prospective effects of protein and animal foods intake on age at menarche among Chinese girls
LI Jing, DUAN Ruonan, CHEN Mengxue, CHEN Yue, FENG Ping, WANG Xiaoyu, GAO Wanke, SHAN Shufang, XU Yujie, QIAO Tian, LIU Xueting, CHENG Guo
2021, 42(4): 493-496. doi: 10.16835/j.cnki.1000-9817.2021.04.004
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  Objective  To investigate the prospective effects of the consumption of protein and animal foods before menarche on the age at menarche among Chinese girls.  Methods  This paper was based on the data collected in the China Health and Nutrition Survey(CHNS) from 1997 to 2015. A total of 683 girls aged 6 and over who had completed information on age at menarche, height, weight, per capita annual household income, maternal education level and participated in at least one complete dietary survey within 1 to 4 years before menarche were included. Urban-rural stratified multivariable linear regression model was used to examine the effects of protein and animal foods intake before menarche on Chinese girls' age at menarche in urban and rural areas.  Results  After adjusted for total energy intake, body mass index standard deviation score and per capita annual household income, the consumption of meat before menarche was negatively associated with the age at menarche among rural Chinese girls(B=-0.003, P=0.00), but not among urban Chinese girls(B=0.002, P>0.05). Total protein, dairy, eggs and aquatic products intake before menarche were not associated with Chinese girls' age at menarche in urban and rural areas(B=0.002, -0.001, 0.003, 0.000; 0.001, 0.001, -0.001, -0.003, P>0.05).  Conclusion  Higher intake of meat before menarche might lead to earlier menarche onset in rural Chinese girls. The consumption of total protein, dairy, eggs, and aquatic products before menarche did not affect the age at menarche in Chinese girls.
Interaction effects between childhood emotional overeating and polygenic influences on pubertal timing and tempo
LIU Wanxu, JIANG Weikang, ZHAO Li, XIONG Jingyuan, SU Puyu, WAN Yuhui, FANG Jiao, CHENG Guo, SUN Ying
2021, 42(4): 497-500. doi: 10.16835/j.cnki.1000-9817.2021.04.005
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  Objective  To explore the interaction effects and possible sex differences in childhood emotional overeating and polygenic influences on adolescent pubertal timing and tempo.  Methods  In March 2016 (T0), all participants were recruited from grades 1 to 3 from two primary school of Bengbu, Anhui Province using cluster sampling, and follow-up surveys were conducted once per year (T1, T2, T3). Emotional overeating was assessed at T1 and pubertal development was assessed annually (breast Tanner stage in girls and testicular volume in boys). The nonlinear growth model was used to estimate pubertal timing and tempo. Polygenic risk scores were calculated based on 17 SNPs for early pubertal timing. Hierarchical linear regression was performed to examine the interaction effects between childhood emotional overeating and polygenic risk scores on pubertal timing and tempo.  Results  The complete data of 896 children were analyzed, including 373 boys (41.60%) and 523 girls (58.40%). A total of 203 (22.7%) children reported emotional overeating behavior at T1. After adjusting for several variables including early life adversity, delivery mode, and birthweight, only emotional overeating was associated with accelerated pubertal tempo among girls with a high genetic risk (B=0.19, 95%CI=0.07~0.32, P < 0.01), although there was no association with pubertal timing (B=0.14, 95%CI=-0.12~0.41, P=0.28). In girls with a low genetic risk and boys, no evidence was found to support interaction effects between childhood emotional overeating and polygenic influences on pubertal timing and tempo (P > 0.05).  Conclusion  Emotional overeating was associated with a faster pubertal tempo in girls who had a high genetic risk of early pubertal development.
Prospective association between peripubertal diet quality and puberty timing
DUAN Ruonan, QIAO Tian, XIONG Jingyuan, ZHAO Li, CHENG Guo
2021, 42(4): 501-505. doi: 10.16835/j.cnki.1000-9817.2021.04.006
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  Objective  To examine the prospective association between peripubertal diet quality and pubertal timing.  Methods  Multivariate regression analyses were performed using data obtained from 1 588 SCCNG (Southwest China Childhood Nutrition and Growth) study participants, which included dietary data, anthropometric parameters, and information about potential confounders during peri-puberty, two and four years before the onset of menarche or voice break. Dietary intake in peri-puberty was assessed using a validated food frequency questionnaire. Diet quality was determined using the Chinese Children Dietary Index (CCDI), which measures adherence to current dietary recommendations. Age at menarche or voice break (M/VB) were used as pubertal markers.  Results  The CCDI score ranged from 58.0 to 132.5 for girls and from 48.3 to 129.9 for boys. The pubertal markers consistently indicated that girls and boys with a higher peripubertal diet quality entered puberty later than their counterparts with lower CCDI scores (higher vs. lower CCDI tertiles: age at M was 13.1 years (11.2-13.3) and 12.5 years (12.0-13.9)(P < 0.01); VB was 13.8 years (12.1-14.8) and 13.4 years (12.5-15.1)(P=0.03), after adjusting for paternal education level, energy intake, and pre-pubertal body fat.  Conclusion  Children with a higher diet quality during peri-puberty entered puberty at a later age. Dietary guidance and intervention are needed for better dietary quality among children during pubertal transition.
A cohort study on the association between sugar-sweetened beverage intake and childhood obesity using a group-based trajectory model
XU Yuxiang, JIANG Weikang, ZHAO Li, XIONG Jingyuan, SU Puyu, WAN Yuhui, FANG Jiao, CHENG Guo, SUN Ying
2021, 42(4): 506-509. doi: 10.16835/j.cnki.1000-9817.2021.04.007
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  Objective  To evaluate the development trajectory of sugar-sweetened beverage (SSB) intake in childhood, and to explore the influence of different SSB intake patterns on childhood obesity.  Methods  In 2016, a follow-up cohort study was carried out in two primary schools in Bengbu, Anhui Province. Three annual follow-ups were conducted in 1 263 children at baseline, and 997 children were included in the final analysis. Parental and student questionnaires were used to obtain basic information related to the children's consumption of SSBs. A group-based trajectory model (GBTM) was applied to classify the development trajectory of SSB intake patterns in childhood. Multiple linear regression analyses were performed to assess the correlation between different SSB intake patterns and childhood obesity.  Results  GBTM identified four childhood SSB intake patterns, namely, the "persistently-low group (n=822), "decreasing-after-increasing" group (n=20), "gradually-decreasing" group (n=106), and "increasing" group (n=49). In the decreasing-after-increasing group and the gradually-decreasing group, baseline BMI levels and BMI levels obtained at the three follow-ups were significantly higher than those observed in the persistently-low group (F=6.26, 5.90, 5.99, 5.87, P < 0.01). There were sex differences in the association between SSB intake patterns and the children's BMI levels. Among girls, after adjusting for confounding factors, the gradually-decreasing group increased by 1.20 kg/m2(B=1.20, 95%CI=0.25-2.15, P=0.01) when compared with the persistently low group at the third follow-up. Among boys, no statistically significant association was found between SSB intake patterns and BMI levels (P>0.05).  Conclusion  Sex differences were observed with respect to the association between SSB intake patterns and obesity in children. Girls with a higher SSB intake had a significantly increased risk of obesity. Further studies are needed to explore the physiological mechanisms underlying sex differences, to provide the theoretical basis for developing intervention programs to prevent childhood obesity.
Sex differences in the growth and physical development of Beijing school-aged children and adolescents
ZHAO Ruilan, LI Ziang, XIAO Huidi, DUAN Junwei, LI Li, ZHAO Fangfang, SHU Wen, LI Menglong, Nubiya Amaerjiang, Jiawulan Zunong, HU Yifei
2021, 42(4): 510-514. doi: 10.16835/j.cnki.1000-9817.2021.04.008
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  Objective  The study aimed to explore sex differences in the growth and physical development of Beijing school-aged children and adolescents.  Methods  Data obtained from regular health examinations of 94 122 school-aged children and adolescents aged 6-18 years old were collected from primary and high schools in Shunyi District from 2009 to 2018, and a longitudinal dataset was compiled with complete anthropometric parameters including height, weight, and BMI levels after linkage of individual-level information. The age-specific growth rate was calculated and a linear mixed-effects model was used to identify sex differences according to chronological or relative age to peak height velocity (PHA).  Results  Height, weight, and BMI levels increased with age in both boys and girls. Girls were taller than boys in the 10-11-year-old age group, catch-up growth in height was observed in boys at age 12, whose height surpassed that of girls thereafter. Boys had a higher weight and BMI than girls in all age groups (P < 0.01). Sex differences were found in the growth rates of height, weight, and BMI levels(t=-67.56, -47.46, 3.22, P < 0.01), which was demonstrated by the interaction effect of sex and age in the linear mixed-effects model. The PHA in boys was 12 years old, which was two years later than the PHA in girls. Boys reached peak weight velocity at 12 years old, lagging one year behind girls who reached their peak at 11 years old. The curves of the BMI growth rate with age showed double peaks in boys and the first peak appeared at 10 years, which was one year earlier than girls. The change in weight was highly synchronized in time with the increase in height, after adjusting for the growth rate of weight by PHA. Weight velocity increased with age before the onset of puberty until PHA, and then it declined; boys presented with obvious fat accumulation before the onset of puberty.  Conclusion  Sex differences in the growth and physical development of school-aged children and adolescents were persistent and apparent, and the change in weight was highly synchronized in time with the increase in height.
Combined effect of height growth and overweight/obesity on blood pressure in children
GAO Di, LI Yanhui, DONG Yanhui, WANG Xijie, YANG Zhaogeng, SONG Yi, MA Jun
2021, 42(4): 515-518, 523. doi: 10.16835/j.cnki.1000-9817.2021.04.009
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  Objective  To investigate the association between the combined effect of height growth and overweight/obesity with elevated blood pressure in Chinese children.  Methods  Based on a cohort study of puberty development in Xiamen, a cluster sampling method was used to select 1 313 children whose complete height, weight and blood pressure levels at baseline were obtained in 2017 and during a follow-up in 2019. The incidence of elevated blood pressure was compared between four different subgroups, and multivariate Logistic regression was performed to analyze the combined effect in boys and girls.  Results  Among 1 313 children, the prevalence of elevated blood pressure at baseline was 25.2%. After 2 years of follow-up, the incidence of elevated blood pressure was 19.7% and 23.4% in boys, and 16.6% in girls. After adjusting for factors including age, sex, family history of hypertension, sleep time, intake of fruits, vegetables, sugar-sweetened beverages, and meat products, multivariate Logistic regression analyses showed that children in the high height growth and overweight/obesity group were more likely to exhibit a higher incidence of elevated blood pressure (overall: RR=2.41, 95%CI=1.44-4.04;boys: RR=2.69, 95%CI=1.45-5.02). Among girls, the risk of elevated blood pressure in the low height growth and overweight/obesity group also increased significantly (RR=4.47, 95%CI=1.45-13.75).  Conclusion  A large magnitude of height growth and being overweight/obesity were associated with elevated blood pressure in children, especially boys. Therefore, interventions that are targeted toward obesity prevention in children before pubertal growth spurts in height may be beneficial to reduce childhood high blood pressure.
Diet-related knowledge and behavior among students in Anhui Province
CHEN Zhifei, MENG Can, GUAN Hengyan, PENG Ailing, LU Fen, LIN Chao, WANG Xiaohu, WU Jing, LI Weidong
2021, 42(4): 519-523. doi: 10.16835/j.cnki.1000-9817.2021.04.010
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  Objective  To assess diet-related knowledge and behavior among primary and middle-school students in five cities of Anhui, and to provide evidence for nutrition education and intervention strategies.  Methods  A multi-stage stratified cluster random sampling method was used to select 2 045 students in five cities(Huaibei, Bengbu, Ma'anshan, Hefei and Wuhu) of Anhui for a questionnaire survey on nutrition knowledge, diet behavior, food preferences, and diet education.  Results  The overall rate of good nutritional awareness was 38.3%; students had the highest rate of awareness on plain water being the healthiest drink(91.6%). The overall rate of healthy food preferences was 51.5%, with milk and dairy products being the highest rated (66.4%). The overall rate of good diet behavior was 85.8%, with eating most meals on time and in appropriate quantities being the highest rated (87.7%). The overall rate of students with good diet education was 25.0%, while the rate of table cleaning was 73.0%. Middle-school students had more knowledge of nutrition(χ2=28.8), while primary school students had better healthy food preferences and diet behaviors(χ2=31.3, 77.6), and girls were more frequently involved in setting and clearing the table(χ2=12.2)(P < 0.05).  Conclusion  Insufficient nutrition knowledge, clear food preferences, unhealthy dietary behaviors, and a lack of diet education were observed in primary and middle-school students in Anhui. Specific nutritional education in school settings should be developed, home-school cooperation should be strengthened, and diet education activities should be increased to help primary and middle-school students form a healthy lifestyle.
Effectiveness evaluation of dietary intervention among migrant children in Hongshan District of Wuhan
HE Qiuping, LIU Han, SHAO Lijing, XIANG Bing, YANG Mei, ZENG Jing
2021, 42(4): 524-528,533. doi: 10.16835/j.cnki.1000-9817.2021.04.011
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  Objective  To understand nutrient intake and dietary structure among migrant children in primary schools in Hongshan District of Wuhan, so as to carry out dietary nutrition intervention and evaluate the effectiveness of the intervention.  Methods  Stratified random sampling was used-to select children in grade 3-6 who were randomly assigned to the intervention group (n=218) and the control group (n=222) from primary schools with a large number of migrant children in Hongshan District of Wuhan. After the baseline survey, the intervention group was given a two-month diet intervention with "nutrition class" and knowledge lecture, and the caregivers of the intervention group were also given an intervention.  Results  At baseline, both groups had inadequate nutrient intake, with adequate intake rate of calcium, selenium, vitamin B1 and vitamin B2 less than 5%; children were lack of dietary diversity with adequate intake of vegitable, milk and milk product less than 5%. After intervention, the intake of energy, three main macronutrients, calcium, vitamin A, and vitamin C in the intervention group were higher than that of before intervention, as well as than the control group, differences were statistically significant (Z=2.22-8.65, 2.62-8.46, P < 0.05). In terms of dietary structure, adequate intake rate of cereals and miscellaneous beans increased from 55.5% to 68.8%, livestock and poultry meat increased from 45.9% to 56.4%, which were higher than that of the control group (56.3% and 44.6%) (χ2=5.29-13.25, 4.39-14.13, P < 0.05).  Conclusion  Inadequate nutrient intake and unreasonable dietary structure of migrant children can be improved through short-term dietary intervention including nutrition education to both parents and children.
Correlation between nutritional status and dietary behavior of college students in a medical college in Guangzhou
ZHONG Xiaoting, WANG Tingxian, ZHOU Quan, CHEN Xiaoyi, WANG Xiaoyan
2021, 42(4): 529-533. doi: 10.16835/j.cnki.1000-9817.2021.04.012
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  Objective  To evaluate the nutritional status, food intake, eating behavior and physical activity level of college students in a medical college in Guangzhou, and to explore its association with dietary behavior.  Methods  A total of 263 students selected using stratified random sampling method from a medical college in Guangzhou were investigated by questionnaire from October to December in 2019. Chi-square test and Wilcoxon test were used to analyze group differences. Multivariate Logistic regression was used to analyze associated factors with thinness, overweight and obesity.  Results  The rate of thinness was 25.5%, and the rate of overweight and obesity was 11.8%. The intake of cereals, fruits, eggs, livestock, fried foods and carbonated drinks varied significantly by gender (U=3 278.00, 5 224.50, 5 981.00, 6 663.00, 5 460.00, 3 873.00, P < 0.05). There was significant difference in total physical activity level in different grades (U=4 239.50, P < 0.05). Multivariate analysis showed that egg intake was negatively correlated with emaciation (OR=0.20, P < 0.01). Picky eating and partial eating were positively correlated with emaciation (OR=2.96, P < 0.01). Eating fast was positively correlated with overweight and obesity (OR=5.35, P < 0.05).  Conclusion  The detection rate of malnutrition among college students in this college is relatively high, and dietary behavior is associated with thinness, overweight and obesity.
Evaluation of intervention effect of aerobic combined with resistance exercise on adolescents with moderate mental retardation
WANG Xin, HOU Xiaohui, MA Zheming, FU Xinbo, FENG Yanqing
2021, 42(4): 534-537. doi: 10.16835/j.cnki.1000-9817.2021.04.013
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  Objective  To explore the effect of aerobic plus resistance training on the intervention of adolescents with moderate mental retardation and to provide reference for healthy development among specific need population.  Methods  Totally 29 adolescents with moderate mental retardation, aged 12-17 years from one middle school in Shunde district of Foshan, were divided into intervention group and control group (16/13) with random number table. The intervention group was subjected to aerobic combined resistance exercise for 11 weeks. The control group maintained the original activities. The changes in body composition, muscle strength, cardiorespiratory endurance and balance ability of the two groups of subjects before and after intervention were compared.  Results  After the intervention, the intervention group's skeletal muscle (22.90±3.63)kg, muscle mass (39.75±5.57)kg, lean body mass (41.52±6.79)kg, sitting arm support (49.19±35.28)s, standing timing test (22.13±6.01)s, half crunches (20.12±6.48), grip strength, heart rate immediately after 2 min stepping exercise (91.43±13.44)frequency/min, Standing on one foot with eyes closed compared with before exercise, the body fat decreased(t=2.57, 2.72, 2.07, 2.10, 3.31, 2.92, 2.76, 3.44, 2.86, 2.04, 2.38, -2.92, P < 0.05); after the intervention, the sitting arm support and closed eyes standing(right) improved(P < 0.05).  Conclusion  Aerobic combined resistance exercise can improve muscle strength and endurance, aerobic endurance and balance ability in adolescents with moderate mental retardation and adaptability of teenagers with moderate mental retardation.
Awareness of early childhood sex education and influencing factors among rural kindergarten teachers in Sichuan
YANG Jianhan, ZHANG Chunlian, WANG Zhennan, LU Shiya, HUANG Na, LUO Sili, YE Yunli
2021, 42(4): 538-541. doi: 10.16835/j.cnki.1000-9817.2021.04.014
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  Objective  To investigate the awareness of sexuality education knowledge in kindergarten teachers in rural areas of Sichuan and its influencing factors, and to provide a scientific basis for sex education capacity improvement among rural teachers.  Methods  With multi-stage stratified cluster sampling method, 162 teachers selected from 16 rural kindergartens in rural areas of Sichuan Province to conduct questionnaires related to early childhood sex education.  Results  The awereness of early childhood sex education foreskin care in rural areas in Sichuan was 73.8%. Knowledge regarding foreskin care(58.8%)", "the function of the family includes rest and entertainment functions(65.6%)", "girls need to clean the reproductive truets from the front to back (68.8%)".Multivariate non-conditional Logistic regression analysis results showed that teaching experience>4 years(OR=4.16, 95%CI=1.74-9.98), notice of young children with sexual related behaviors(OR=2.97, 95%CI=1.19-7.40), the number of sources of sexual knowledge sources ≥5(OR=3.39, 95%CI=1.42-8.13) were associated with high awareness of preschool sex education knowledge.  Conclusion  The preschool sex education knowledge awareness among Sichuan rural kindergarten teachers needs to be improved. A variety of sex education channels should be constructed to encourage teachers, especially those who are newly employed, to acquire more relevant knowledge, pay attention to children's sex-related behaviors, and improve their ability in sex education.
Knowledge attitude and behavior towards COVID-19 prevention among middle school students in the phase of normalized prevention and control in Wuhan
SUN Zhen, TAO Zhiyang, WU Xiaodong, WANG Gaoming, LI Xinyue
2021, 42(4): 542-546. doi: 10.16835/j.cnki.1000-9817.2021.04.015
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  Objective  To understand knowledge, attitude and behavior toward Coronavirus disease 2019 (COVID-19) among middle school students in Wuhan, in the phase of normalized control and prevention of COVID-19, so as to provide evidence for further health education.  Methods  In January 2021, cluster random sampling method was used to select one middle school from Hongshan and Dongxihu District, as well as Donghu high tech zone, respectively. By using the "questionnaire star" platform, questionnaire QR code were sent to students through QQ or wechat by schools. A total of 4 531 middle school students were investigated.  Results  Preventive knowledge and behavior rate was 71.5% (3 238) and 56.0% (2 537), respectively. Preventive behaviors towards COVD-19 was reported in 56.0% (2 537) of participants. Students with parents as health care workers reported higher preventive behaviors(P < 0.05).Girls had a higher rate of possession of health knowledge for prevention and control than boys. Compared with "essentially no concern about the epidemic", "students with less concern about the epidemic" and "those with similar concern as 2020" were more likely to have higher awareness of health knowledge for prevention and control. Compared with the first-year junior middle school students, high school students were less likely to have the rates of knowledge for prevention and control health [OR(95%CI)=1.24(1.09-1.43), 2.56(1.54-4.25), 3.30(1.99-5.48), 0.49(0.39-0.62), 0.45(0.36-0.57), 0.63(0.46-0.88)].In terms of health behavior rate, middle school students whose mothers are undergraduates, whose incomes were more than 8 001-15 000 and 15 000 yuan, "whose attention to epidemic situation has declined", "whose attention is the same as that in 2020", "who did not plan to study medicine before", "who are determined to study medicine, and who plan to study medicine more firmly after epidemic situation " were more likely to have health behavior, [OR(95%CI)=1.29(1.04-1.60), 1.39(1.07-1.82), 1.74(1.32-2.29), 1.77(1.06-2.96), 3.47(2.08-5.81)], The grade-2 high middle school students had lower probability of preventing and controlling health behaviors [OR(95%CI)=0.74(0.60-0.90)](P < 0.05). Preventive knowledge and behaviors towards COVID-19 are mainly from school education, communication with parents and mobile learning.  Conclusion  Preventive knowledge and behaviors towards COVID-19 among Wuhan middle school students are needed to be improved and targeted health education should be implemented accordingly.
Status of sleep and exercise during remote learning period for primary school students in one city during the outbreak of COVID-19
LIN Xiaoman, LIU Rui, ZHANG Dongmei, HUANG Jingyi
2021, 42(4): 547-550, 555. doi: 10.16835/j.cnki.1000-9817.2021.04.016
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  Objective  To explore the relationship between sleep and exercise among grade 1-6 students in a certain city during the period of home-based online courses in the epidemic, and to provide reference basis for the government and relevant departments to make relevant policies on student health promotion.  Methods  From April 22 to May 14 in 2020, 24 452 primary school students were selected by stratified cluster random sampling method to network questionnaire survey, which included general situation, sleep time, and exercise.  Results  Totally 21.6% of primary school students participated in low-intensity exercise, 9.4% in moderate-intensity exercise and 5.8% in high-intensity exercise every day. Less than 10% of the students participated in all types of intense sports for more than 30 minutes each time. The report rate of sleep deprivation among students in grades 1 to 6 was 22.5%, 25.5%, 28.9%, 31.3%, 35.0%, 39.9%, respectively(χ2=350.75, P < 0.05). Multivariate Logistic regression analysis showed that after adjusting for gender, grade, oneness and other factors, high-intensity exercise was negatively correlated with sleep deprivation(OR=0.91, 95%CI=0.86-0.97).  Conclusion  Insufficient sleep is common among primary students, and appropriate amount of high intensity exercise is a favorable factor to ensure adequate sleep time in primary school students.
Health literacy, screen time and associated factors among middle school students in Yinchuan
ZHANG Peiyu, XU Jie, ZHANG Wanting, LIU Xuan, TIAN Xi, YANG Xueyan, NIU Xiaoli
2021, 42(4): 551-555. doi: 10.16835/j.cnki.1000-9817.2021.04.017
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  Objective  To investigate the status and influencing factors of health literacy of middle school students in Yinchuan City, to provide reference for health literacy improvement of middle school students in this region.  Methods  Using stratified cluster sampling method, 2 003 middle school students from three districts of Yinchuan were investigated to complete the questionnaire survey.The survey included basic characteristics, health literacy and screen time status.  Results  The total score of Chinese Adolescent Interactive Health Literacy Questionnaire was(101.3±17.5). The proportion of high, medium and low level of health literacy were 25.0%, 51.2% and 23.9% respectively; the proportion of long screen time exposure among middle school students was 52.5%. The health literacy level of junior middle school students, middle school students with father or mother education level of high school or above and appropriate screen time were higher than those of the corresponding group(χ2=49.90, 14.59, 16.53, 46.73, P < 0.01). Logistic regression analysis showed that education group, grade, father's or mother's education level and long screen time exposure were associated with middle school students' health literacy level(P < 0.05).  Conclusion  The health literacy level of middle school students in Yinchuan City needs to be further improved and targeted health education should be carried out from school, family and society.
Smartphone addiction intervention through sports combining with group psychological training among college students
ZHAO Yuxia, HAO Yanhong, JING Xiangzhi
2021, 42(4): 556-559, 564. doi: 10.16835/j.cnki.1000-9817.2021.04.018
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  Objective  To explore the intervention effect of sports combined with group psychological counseling on the psychological craving, addiction sererity, as well as comorbid depression with anxiety severity of college students with smartphone addiction.  Methods  Totally 148 smart-phone addicts were randomly divided into 3 groups(sports group 49 students, group psychological counseling group 50 students, sports group counseling group 49 students). Smartphone addiction was evaluated by using the University Student Smartphone Addiction Scale(SAS-C); the degree of mental hunger was assessed by the Visual Analog Scale(VAS); the Hamilton Depression Scale(HAMD) and the Hamilton Anxiety Scale(HAMA) were used to evaluate the degree of anxiety and depression. All scales were evaluated before intervention, after intervention and 3 months after the intervention.  Results  The SAS-C, VAS, HAMD, HAMA scores of the three groups decreased with time(F=36.05, 38.54, 37.27, 39.27, P < 0.01), and the scores were the lowest in the sports group counseling group, SAS-C, VAS, HAMD, HAMA followed by the group counseling group and the highest in the sports group(F=34.33, 32.36, 32.34, 34.96, P < 0.01). Howevey, all the 3 groups still had depression and anxiety symptoms after 3 months of intervention.  Conclusion  Sports, group psychological counseling, sports combined with group counseling can all differentially help decreasing the psychological cravings and addiction levels of smartphone addicts and severity of depression and anxiety with the latter shows the highest effectiveness, followed by the group counseling and sports intervention alone.
Oral health-related quality of life and associated factors of Chinese adolescents in Foshan City
SU Shuwen, ZHANG Jianming, DENG Ruibing, WANG Weiping, CUI Tianqiang, SU Yuwu, LI Xia
2021, 42(4): 560-564. doi: 10.16835/j.cnki.1000-9817.2021.04.019
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  Objective  To investigate oral health related quality of life and associated factors of adolescents between 12 and 15 years old, and to provide countermeasures and suggestions for oral health promotion of adolescents.  Methods  This cross-sectional study recruited 3 840 adolescents aged 12-15 through multi-stage stratified cluster sampling method. The oral clinical examination and oral health questionnaire were conducted. Descriptive analysis, non-parametric testing and logistic regression analysis were used to analyze the oral health-related quality of life and associated factors.  Results  Oral problems showed moderate to severe impact on quality of life, especially on eating (27.1%). Ordinal Logistic regression analysis showed that low sugar intake frequency, few teeth with gingival bleeding, no history of dental pain in the past 12 months, no history of tooth injuries, and administrative region of residence (Nanhai, Shunde) were associated with higher oral health-related quality of life, (OR=0.6-0.8, P < 0.05).  Conclusion  The oral health-related quality of life of adolescents in Foshan was slightly better than the average national level. It is recommended to accurately formulate and ensure the full implementation of oral public health measures based on the comprehensive analysis of the local area, and combine various efforts to strengthen education on reducing excessive intake of sugar, prevent gingival bleeding, relieve and treat toothache in time, pay attention to adolescents with histories of dental trauma, and update the concepts of receiving oral health examination for the adolescents themselves, parents and teachers, and help adolescents develop the habit of regular oral examinations.
Effects of auricular stimulation on functional constipation among female college students
CHEN Jing, LI Fei, HAN Wenyi, JU Xinmei
2021, 42(4): 565-568, 573. doi: 10.16835/j.cnki.1000-9817.2021.04.020
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  Objective  To explore the effects of auricular point stimulation on constipation among college students and to provide a reference for improving constipation among college students.  Methods  Between September 15 and September 30, 2019, the International Nursing College of Hainan Medical College Nursing School Survey, which included the constipation assessment scale (CAS), was conducted among 603 female college students. There were 90 cases of functional constipation, which were divided into a control group and an observation group of 45 cases each using the random number table method. The control group was given health education and behavioral guidance, such as a diet intervention, an exercise intervention, an emotional management intervention, and guidance on defecation habits, etc, via WeChat. The observation group received auricular stimulation intervention in addition to the control group measures. Before and two weeks after the intervention, the Wexner constipation and the Patient Assessment of Constipation Quality of Life (PAC-QOL) scales were used to assess the effect of auricular stimulation on students with constipation.  Results  Before intervention, there was no significant difference in the Wexner constipation scores between the two groups (P>0.05). After the intervention, the Wexner constipation scores in the observation group were lower than those in the control group, and the differences were statistically significant (t=8.38, 8.95, 11.96, 9.08, 6.45, 13.18, 11.93, 6.19, P < 0.05). Before intervention, there was no statistically significant difference in PAC-QOL score between the two groups (P>0.05). After intervention, the difference in the control group's PAC-QOL scores on all dimensions and total dimension score lower earlier, was statistically significant (t=5.29, 6.64, 10.28, 7.81, 9.60, P < 0.01). The observation group's PAC-QOL scores after the intervention were lower compared to before the intervention (t=7.98, 11.81, 11.44, 6.93, 8.81, P < 0.01), and the difference was statistically significant. All individual and total dimension scores of the observation group and the control group were significantly lower than those of the control group, and the difference was statistically significant(P < 0.05).  Conclusion  Auricular stimulation of TCM can significantly improve the constipation score of college students and improve their quality of life.
Effect of functional high-intensity interval training combined with inhalation dietary intervention on obese college students
LU Xin, XIE Bo
2021, 42(4): 569-573. doi: 10.16835/j.cnki.1000-9817.2021.04.021
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  Objective  To observe the effect of functional high-intensity intermittent training combined with breathing and diet intervention on body shape, blood lipid and liver function of obese college students, so as to verify and improve the relevant intervention methods.  Methods  Fifty-eight obese college students recruited by Chongqing Telecom Vocational College were selected as participants. According to gender and body mass index (BMI), functional high-intensity intermittent training, breathing training and diet control intervention were carried out for 6 weeks. BMI, body fat percentage, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-alcoholic fatty liver disease (NAFLD), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyltransferase (GGT) and other physical indicators were compared before and after intervention.  Results  Before and after the intervention, the changes of body indexes were as follows: BMI, body fat percentage of male and female were significantly decreased (t=7.57, 4.40;4.17, 5.61, P < 0.01); TC, TG and LDL-C of male and female were significantly decreased, while HDL-C increased significantly (t=7.56, 5.80;2.58, 4.76;12.26, 11.07;3.72, 3.37, P < 0.05); NAFLD, abnormal ALT, abnormal ast, abnormal GGT were significantly reduced(P < 0.05).  Conclusion  The comprehensive intervention method can significantly reduce body weight and regulate blood lipid metabolism and liver function in obese college students, and the intervention experience is better. It can be applied and promoted as an effective way to lose weight for obese college students.
Analysis of mental health and influencing factors of college students in the online learning period during the outbreak of COVID-19
JIN Yuelong, CHANG Weiwei, CHANG Xin, ZHU Lijun, FANG Zhengmei, CHEN Yan, YAO Yingshui
2021, 42(4): 574-578. doi: 10.16835/j.cnki.1000-9817.2021.04.022
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  Objective  To investigate the mental health and influencing factors of college students during online learning under the coronavirus disease 2019 (COVID-19) epidemic, and to provide a scientific basis for mental health education.  Methods  From June to July 2020, a cluster sampling method was used to select one medical and non-medical colleges and universities in southern Anhui Province. Among them, the Depression Anxiety and Stress Scale-21 (DASS-21) was used to conduct an online questionnaire survey among 3 781 medical and non-medical college students.  Results  The reporting rates of depression, anxiety and stress among medical college students (30.03%, 31.05% and 14.50%, respectively) were lower than those of non-medical college students(44.49%, 46.22%, 24.81%)(χ2=81.49, 88.26, 63.08, P < 0.05). During the online learning period of college students, the depression and anxiety were mainly moderate(18.43%, 20.68%), and the stress was mainly mild and moderate(9.41%, 5.29%). Multivariate Logistic regression analysis showed that non-medical students, poor parent relationships, poor relationships with fathers, teachers' inadequate preparation before class, and dissatisfaction with online teaching results were prone to depression(OR=1.84, 1.28, 1.63, 1.75, 1.24), anxiety (OR=1.79, 1.22, 1.65, 1.77, 1.19) and stress(OR=2.09, 1.41, 1.58, 1.29, 1.48)(P < 0.05). Girls were less prone to depression (OR=0.82) and anxiety(OR=0.74); College students who live in rural areas were more likely to have anxiety symptoms(OR=1.27); Senior students were more likely to feel stress(P < 0.05).  Conclusion  The detection rate of depression, anxiety and stress negative emotion in college students was higher during online study. Families and schools should pay attention to the mental health of college students during online learning, and provide targeted psychological counseling for different students.
Comparative study on the quality of life and mental health of teenagers in Zhengzhou and HongKong and Taiwan
CHANG Mingyu, ZHANG Ruixing, WANG Mengjia, CHENG Mengyin, Lee Regina, Su Ing-Ya
2021, 42(4): 579-582. doi: 10.16835/j.cnki.1000-9817.2021.04.023
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  Objective  To explore the quality of life and mental health status of adolescents in Zhengzhou, and to compare with HongKong and Taiwan.  Methods  A total of 6 401 students from 12 primary and secondary schools in Zhengzhou City. A total of 3 642 students from HongKong and 1 547 students from Taiwan were selected by cluster sampling. And Padiatric Quality of Life Inventory Version 4.0, Self-Esteem Scale, General Self-efficacy Scale, Depression Anxiety Stress Scale and self-made general situation questionnaire were used to conduct questionnaire survey.  Results  The total score of quality of life and the scores of each dimension in Zhengzhou were significantly higher than those in HongKong, while self-esteem and anxiety were lower than those of Taiwan adolescents(P < 0.05). In addition to self-esteem, anxiety and stress, the scores of quality of life and mental health of adolescents of different grades and genders in Zhengzhou were statistically different(t=13.53, 20.71, 10.92, 20.26, 14.68, -16.03, 21.26;6.16, 3.81, -2.22, -0.33, 8.76, 4.16, 2.71, P < 0.01). The quality of life of adolescents in HongKong and Taiwan in different grades and genders were basically the same as those in Zhengzhou, and the differences of depression and stress scores in grades were the same as those in Zhengzhou.  Conclusion  The overall quality of life and mental health of adolescents in Zhengzhou is better than that in Hong Kong and Taiwan. It is necessary to explore the relationship between the quality of life and mental health of adolescents in order to improve their quality of life.
Latent classes of health risk behaviors in medical students and depressive symptoms
YANG Yajuan, XU Honglyu, WANG Ying, XIE Yang, ZOU Liwei, LI Tingting, TAO Shuman, WU Xiaoyan
2021, 42(4): 583-586, 592. doi: 10.16835/j.cnki.1000-9817.2021.04.024
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  Objective  To identify the latent classes of various health risk behaviors among medical students and further analyze the correlation between different classes and depression.  Methods  Using the method of convenient sampling, 2 014 medical students were selected from Anhui Medical University in October 2018. Self-designed online questionnaire were used to collect demographic data, health risk behavior (including smoking, drinking, suicide, sleep disorders, mobile phone dependence and lack of exercise) and depressive symptoms. Latent Class Analysis was used to cluster individuals. Logistic regression was provided to further analyze the association between health risk behaviors and depressive symptoms for the groups.  Results  The health hazard behaviors of medical students could be divided into three separate classes: substance dependence group (8.4%), mobile phone dependence group (22.4%) and low-risk group (69.2%). The distribution of health risk behaviors of medical students with different gender, major, grade, only child, father's educational level, monthly living expenses, academic achievement and number of friends were statistically significant (χ2=99.37, 19.07, 12.05, 6.64, 14.28, 19.35, 20.61, 26.39, P < 0.05). The results of Logistic regression analysis showed that after adjusting for gender, major, grade, only child, father's educational level, monthly living expenses, academic achievement and number of friends, the mobile phone dependence group was positively correlated with depressive symptoms (β=1.75, P < 0.01).  Conclusion  Different ratent classes of health risk behaviors have different correlation with depressive symptoms in groups.It is suggested that school health workers should make individualized intervention plan for different types of health hazard behavior of medical students in the future educational activities, carry out stratified intervention, alleviate the symptoms of depression and promote the mental health of medical students.
Effect of curriculum teaching on freshmen's mental health literacy
SUN Bin, HOU Jinbo, LIU Chenling
2021, 42(4): 587-592. doi: 10.16835/j.cnki.1000-9817.2021.04.025
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  Objective  The purpose of this study is to investigate the status of freshmen's mental health literacy and its impact on mental health and to provide a reference for probing into the effectiveness and sustainality of curriculum education as the main channel of improvement of mental health literacy.  Methods  Mental health literacy questionnaire for Chinese adults and college students mental health screening scale were used to investigate 2 878 freshmen in a university in Wuhan. Mental health literacy was one of the indicators of course teaching evaluation. The curriculum intervention effect was investigated through pre-test, post-test and 10-month follow-up.  Results  The mental health literacy of freshmen (40.12±6.57) was higher than the national average level(35.81±8.06), but lower than the average level in terms of self-help mental health literacy(F=28.25, P < 0.01). There were gender differences and urban-rural differences in mental health literacy. The mental health literacy of freshmen without psychological problems was significantly higher than that of freshmen with psychological problems(F=374.80, P < 0.01). Structured course teaching significantly improved freshmen's mental health literacy, which were still significant after 10 months.  Conclusion  College freshmen's mental health literacy is generally great, and the mental health curriculum improved their mental health literacy.
Relationship between sleep quality with depression and anxiety symptoms in college students at Tibet Plateau areas
GAO Lei, LI Fangming, GAO Xiaolei
2021, 42(4): 593-596, 601. doi: 10.16835/j.cnki.1000-9817.2021.04.026
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  Objective  To explore the relationship between sleep quality with depression and anxiety symptoms among college students in Tibet plateau areas, and to provide scientific basis for sleep quality promotion, as well as depression and anxiety allevation in high-altitude areas.  Methods  The stratified cluster sampling method was used to investigate 1 288 second-and third-year college students in Tibet University from October to November 2019. The Chinese Version of Pittsburgh Sleep Quality Index(PSQI), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) were used in this survey, and the survey results were tested by t-test, variance analysis and Logistics regression analysis.  Results  The mean sleep quality index was(5.32±2.94), and 20.5% (n=264) of participants reported poor sleep quality. The detection rates of depression and anxiety symptoms were 46.0% (n=592) and 24.4%(n=314), respectively. And 20.4% (n=263) had the worst sleep quality with the coexistence of depression and anxiety symptoms. College students who are female, Tibetan, smoking, drinking and poor sleep quality have a higher risk of depression(OR=1.55, 1.80, 1.51, 1.67, 5.60), while Tibetan, drinking and poor sleep quality college students have a higher risk of anxiety(OR=1.52, 1.91, 10.22)(P < 0.05).  Conclusion  There is a close relationship between the sleep quality of college students in Tibet Plateau areas with depression and anxiety symptoms. Mental health education department in colleges should attach great importance to the sleep quality of students, especially for individuals with sleep disorders, so as to reduce the incidence of depression and anxiety symptoms among college students.
Analysis of differences between middle school and high school students' help-seeking behaviors and association with non-suicidal self-injury
AO Cheng, HU Wang, ZHOU Fan, HU Dazhen, LONG Xianxian, HUANG Peng
2021, 42(4): 597-601. doi: 10.16835/j.cnki.1000-9817.2021.04.027
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  Objective  To understand and compare the differences in help-seeking behavior among junior high school students and senior high school students and their association with non-suicidal self-injury to provide a basis for the prevention and control of non-suicidal self-injury among middle school students.  Methods  Three middle schools in Nanchang were selected, and the survey were conducted among 4 434 students through the General Situation Questionnaire, the Ottawa Self-injury Judgment Entry, and the Middle School Students' Help-Seeking Behavior Questionnaire, and SPSS 22.0 was used for statistical analysis.  Results  The NSSI detection rate among middle school students was 33.3%, and junior high school students' detection rate(36.0%) were higher than high school students(29.6%) (χ2=19.41, P < 0.01). Differences in willingness to ask for help, asking for help from family and teachers, and talking face-to-face for help were statistically significant (all P < 0.01) among NSSI participants and non-NSSI participants, for both junior high school and high school students. Females (OR=1.45), class cadres (OR=1.26), urban household registration (OR=1.45), frequent scolding by elders (OR=1.98) and a high academic burden (OR=1.39) all possible increased the risk of NSSI in junior high school students, while assistance to family members (OR=0.95) or teachers (OR=0.95) possible reduced the risk of NSSI in junior high school students. Females (OR=1.50), class cadres (OR=1.34), only children (OR=1.45), fathers with college education and above (compared to junior high school and below) (OR=1.56), frequent scolding by elders (OR=2.08), frequent corporal punishment from elders (OR=4.12) and high academic burden (OR=1.38) possibly increased the risk of NSSI among high school students, while willingness to ask for help (OR=0.82), asking for help from family (OR=0.95) and teachers (OR=0.96) possible reduced the risk of NSSI among high school students.  Conclusion  There are some differences in help-seeking behavior between junior and high school students, and school and parents should actively focus on middle school students' help-seeking behavior and encourage them to seek help.
Depression and anxiety and assciated factors among college students returned to campus during the outbreak of COVID-19
WU Nan, ZHANG Wanjun, DU Mengxue, JIANG Minmin, WANG Jing, FANG Zhengmei, ZHU Lijun, JIN Yuelong, CHEN Yan, YAO Yingshui
2021, 42(4): 602-605, 610. doi: 10.16835/j.cnki.1000-9817.2021.04.028
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  Objective  The purpose of this study was to investigate the state of depression and anxiety and assciated factors of back-to-school college students during the outbreak of COVID-19, so as to provide theoretical basis for emotional counseling and psychological crisis intervention after long-term school closure due to epidemic outbreak.  Methods  Cluster sampling was used to select the first batch of 2 697 back-to-school students in a high vocational college. The survey content includes basic information questionnaire, Depression Self-rating Scale (SDS) and Anxiety Self-rating Scale(SAS).  Results  The detection rate of depression and anxiety was 31.8% and 10.4% respectively. Multivariate Logistic regression analysis showed that the risk of depression in female college students was 1.28 times higher than that in male students. The risk of depression among college students with family loss experience caused by the outbreak of COVID-19 was 1.30 times that of those without family loss experience caused by the outbreak of COVID-19. Outgoing personality(OR=0.62), neutral (OR=0.55) and mild temper(OR=0.46), moderate frequency of physical exercise per week(1-2 times: OR=0.73, 3-4 times: OR=0.65) were protective effects for depression in college students.Low frequency of breakfast were the risk effects for depression in college. The risk of anxiety among college students who was the only child in the family was 1.61 times higher than that who was not the only child in the family. The risk of anxiety among college students with family loss experience caused by the outbreak of COVID-19 was 1.45 times higher than that college students without family loss experience caused by the outbreak of COVID-19. Neutral temper, mild temper and physical exercise 1-2 times a week were associated with lower level of anxiety in college students(OR=0.67, 0.56, 0.67). Breakfast skipping (OR=2.03) was associated with higher levvel of anxiety in college students.  Conclusions  During the outbreak of COVID-19, the first batch of back-to-school college students presented high level of depression. Colleges are suggested to promptly carry out effective emotional relief and psychological intervention for students, especially those whose family suffered in COVID-19, the only child in the family, with poor breakfast eating habits, as well as breakfast skipping and lack of physical exercise.
Levels of 24-hour movement and associations with childhood obesity in Chinese school students
WANG Yu, ZHU Rui, WANG Yang, LONG Jiaheng, ZHANG Youjie
2021, 42(4): 606-610. doi: 10.16835/j.cnki.1000-9817.2021.04.029
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  Objective  To analyze relationships between levels of 24-hour movement (physical activity, screen time and sleep) and childhood obesity in students aged 7-18 years.  Methods  This study used data from students aged 7-18 years in the 2015 China health and nutrition survey, and assessed levels of physical activity, screen time and sleep based on the Canadian 24 hour Movement Guidelines for Children and Youth. Associations between levels of 24-hour movement and childhood obesity were assessed using multivariable Logistic regression models.  Results  The overall rate of overweight and obesity was 21.56%. Proportions of students meeting the guidelines for physical activity, screen time, sleep and three behaviors combined were 24.84%, 38.69%, 57.08%, and 6.77%, respectively. After adjusting for age, sex, location of residence and nationality, students meeting the sleep guideline were less likely to be overweight and obese than those who did not(OR=0.73), students meeting both sleep and screen time guidelines had a lower risk in overweight and obesity than those met neither guidelines(OR=0.58)(P < 0.05). However, other behaviors and behavior combinations showed no significant associations with overweight and obesity.  Conclusion  Only a small proportion of students met all three 24-hour movement guidelines. Ensuring adequate sleep and limiting excessive screen time may be an important strategy for childhood obesity prevention and management.
Obesity and associated factors among students in Inner Mongolia in 2019
YANG Tian, ZHANG Kaiwen, GAO Sheng, ZHANG Xiuhong
2021, 42(4): 611-614. doi: 10.16835/j.cnki.1000-9817.2021.04.030
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  Objective  To understand the prevalence of obesity and its associations with diet, exercise and mental health among students in Inner Mongolia, so as to provide scientific basis for the formulation of obesity intervention measures for students in this area.  Methods  Stratified and cluster random sampling was used to select 186 649 students from all 12 cities and 103 banners and counties in Inner Mongolia Autonomous region. All the participants were divided into groups according to the BMI classification criteria for overweight/obesity screening of Chinese school-age children and adolescents (kg/m2). Univariate analysis was carried out by means of rectangular χ2 test, and multivariate unconditional Logistic regression model was used to screen the risk factors of obesity.  Results  The overall obesity rate was 18.54%, the obesity rate of boys was 22.04%, and the obesity rate of girls was 14.99%. The results of multivariate Logistic regression analysis showed that area(OR=0.79), sex (OR=0.61), times of eating fried food per day (OR=1.08), daily exercise for more than 60 minutes per week >2 days (OR=0.89), eat breakfast every day (OR=0.86), times of drinking drinks per day (OR=1.12), Smoking (OR=0.87), drinking (OR=1.07), eating fruit per day (OR=1.07), watching TV ≥2 hours a day (OR=1.06), sleeping time (OR=0.93) and school period may be related to obesity (P < 0.05).  Conclusion  The overall obesity rate of students in Inner Mongolia is relatively high, and the occurrence of obesity is related to diet, exercise behavior, living habits and psychological factors.
Factors influencing the delay of seeking medical treatment among students with tuberculosis in Shaanxi Province from 2015 to 2019
MA Yu, DU Xin, DENG Yali, ZHANG Tianhua, ZHANG Hongwei
2021, 42(4): 615-618, 622. doi: 10.16835/j.cnki.1000-9817.2021.04.031
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  Objective  To analyze the delay of seeking medical treatment and associated factors among students with tuberculosis in Shaanxi Province from 2015 to 2019, so as to provide scientific evidence for the early detection and control of tuberculosis epidemics in schools.  Methods  Data from 6 739 students with pulmonary tuberculosis registered in Shaanxi Province from 2015 to 2019 were collected from the TB Management Information System of China Information System for Disease Control and Prevention. Univariate and multivariate Logistic regression analyses were used to analyze the characteristics and influencing factors of pulmonary tuberculosis patients.  Results  Among 6 739 cases of students with pulmonary tuberculosis from 2015 to 2019 in Shaanxi Province, 3 040 patients delayed seeking medical treatment. The rate of delayed treatment was as high as 45.1%, and the median delayed treatment time was 38(24, 68) days. From 2015 to 2019, the overall delay rate of students showed a downward trend, with a significant difference(χ2=120.45, P < 0.05). Univariate analysis showed that there were statistically significant differences in delay rate between different patient sources, diagnosis results and regions(χ2=274.19, 26.75, 24.12, P < 0.05), among which for factors such as tracing, tuberculosis pleurisy, doctor delay in the northern part of Shaanxi, the rates were higher. The results of multivariate Logistic regression analysis showed that the regions of northern Shaanxi(OR=2.74), central Shaanxi(OR=2.09), and southern Shaanxi(OR=2.39), and clinical consultation(OR=1.84), recommendation(OR=2.81), tracing(OR=3.28), and tracing (OR=6.07) were risk factors for delay of consultation. A lack of etiology results(OR=0.47) was to protect delay of consultation.  Conclusion  From 2015 to 2019 in Shaanxi Province, a delay in seeking medical treatment was relatively common among students with tuberculosis. The region, source of patients and diagnosis results were factors that influenced the delay in finding tuberculosis patients in Shaanxi Province.
Analysis of plant and poisonous mushroom poisoning events among people aged 0-19 in Guizhou Province from 2015 to 2019
DING Ling, ZHOU Yajuan, ZHU Shu, SONG Shenchao, LEI Shiguang
2021, 42(4): 619-622. doi: 10.16835/j.cnki.1000-9817.2021.04.032
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  Objective  To analyze the epidemiological characteristics of plant and mushroom poisoning events among people aged 0-19 in Guizhou Province from 2015 to 2019, so as to provide the basis for prevention and control of food poisoning events among children and adolescents.  Methods  Data of people aged 0 to 19 involved in plant and mushroom poisoning incidents reported by the foodborne disease outbreak surveillance system in Guizhou Province from 2015 to 2019 were collected, verified, sorted and statistically analyzed.  Results  From 2015 to 2019, there were 590 cases of plant and mushroom poisoning among people aged 0 to 19 in Guizhou Province, 1 441 people were poisoned and 5 died. In May and September, family and collective dining halls were the places with the highest incidence of plant and poisonous mushroom poisoning incidents, accounting for 90.68% (535/590) of the total incidents. Poisonous mushrooms and masanberry accounted for 71.69% (423/590) of the food poisoning causes, and 5 people died of poisoning were caused by poisonous mushrooms.  Conclusion  In the cases of plant and mushroom poisoning among people aged 0-19 years in Guizhou Province, preschool primary and middle school students in rural areas are most vulnerable population of poisoning, so it is necessary to strengthen the publicity and education on the prevention and control of toxic plant and mushroom poisoning among children and teenagers in rural areas, so as to reduce the occurrence of relevant poisoning incidents.
Epidemiological characteristics of children's Hand, Foot and Mouth Disease and its association with temperature in Nanjing from 2011-2016
ZHAO Hui, HONG Lei, CHEN Jiaping, ZHOU Yimin, MIN Ji, XU Fei, SHAO Fang, LIU Sijun
2021, 42(4): 623-626, 630. doi: 10.16835/j.cnki.1000-9817.2021.04.033
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  Objective  This study aims to investigate the epidemiological distribution of HFMD and quantify the association of temperature with the incidence of children's HFMD in Nanjing, China.  Methods  Daily counts of HFMD in children under 5 years and daily meteorological variables during 2011-2016 were obtained. Descriptive statistics were used to describe the epidemiological characteristics and distributed lag non-linear model (DLNM) was used to assess the associations of temperature on HFMD cases.  Results  A total of 104 977 HFMD cases aged 0-5 years were reported in Nanjing during the study period and the male-to-female sex ratio was 1.49∶1. The average annual incidence was 213.5 per 100 000. A bimodal seasonal pattern was observed and the south and west were found to be the high-incidence areas in the city. Of these laboratory-confirmed enteroviruses positive cases, 32.5% cases were positive for EV-A71 infections, 29.1% cases were positive for CV-A16 infections and 38.4% cases were positive of other enteroviruses infections. The temperature-HFMD relationships were non-linear and showed obvious lag effects. The cumulative relative risk presented as an approximately inverted U-shape over 14 days and peaked at 25.7 ℃ with value of 2.71(95%CI=1.93-3.81). Subgroup analyses revealed that males and children aged < 1 year were more vulnerable to temperature variations.  Conclusion  Epidemiological characteristics of HFMD among children aged 0-5 years old in Nanjing presented temporal and regional distribution. The temperature has significant impact on children's HFMD occurrence.
Role of school-based symptom monitoring system in public health emergencies in Hangzhou
HUANG Chunping, WANG Bing, WANG Jing, SONG Shujuan, SUN Wei, DING Hua
2021, 42(4): 627-630. doi: 10.16835/j.cnki.1000-9817.2021.04.034
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Abstract:
  Objective  To analyze the role of school-based symptom monitoring system in public health emergencies in Hangzhou, to provide the basis for prevention and control strategies for public health emergencies in schools.  Methods  Data regarding school public health emergencies in Hangzhou in 2019 were collected from the Public Health Emergencies Report Management Information System, and data regarding public health early warning in schools were collected from the Hangzhou School Symptom Monitoring System. The usage of school symptom monitoring system was analyzed by SAS 9.0 software, and the positive warning events and public health emergencies were compared and analyzed, the rate and composition ratio were compared with the χ2 test, the number of cases was compared with the non-parameter rank and the Mann-Whitney test, and the trend test was conducted using Cochran-Armitage test.  Results  In 2019, the average use rate of the city's school symptom monitoring system was 54.65%, the average response rate of automatic early warning was 70.68%, and the use rate (χ2=860.79, P < 0.01) and automatic early warning response rate (χ2=1 615.91, P < 0.01) of school systems varied greatly by region. In 2019, 161 positive early warning incidents were detected through the school symptom monitoring system, 197 public health emergencies were reported through the emergency network, and fewer public health emergencies were reported in areas where more positive warning events were detected(Z=10.65, P < 0.01). The proportion of disease category in positive warning events was different from that in public health emergencies in(χ2=28.33, P < 0.01). The number of cases of positive early warning events of the same disease was much lower than the number of cases of public health emergencies without warning, and the time of positive warning signals was on average 4 days ahead of the time of receiving the report of public health emergencies.  Conclusion  Smartphone-based school symptom monitoring system in Hangzhou plays a sentinel role in public health emergencies prevention and control in schools.
Research progress in the children' dietary index
ZHAO Li, QIAO Tian, SUN Ying, CHENG Guo
2021, 42(4): 631-635, 640. doi: 10.16835/j.cnki.1000-9817.2021.04.035
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Abstract:
Given the improved understanding of the complexity of individual diets, the method of evaluating dietary characteristics by analyzing the overall dietary pattern has been widely explored. The Dietary Index is commonly used to assess dietary patterns. Some countries have established dietary indices that are suitable for the diet and growth characteristics of children in their domestic population. The study aimed to review widely used and representative dietary indices for children, and to analyze the characteristics of the established index system and the scoring methods that were used for each dietary index, so as to provide a basis for developing a more accurate assessment of overall diet quality in children.
Role formation of cyberbullying victims and effectiveness of coping strategy
GE Cao, XIAO Danhe, XU Hui
2021, 42(4): 636-640. doi: 10.16835/j.cnki.1000-9817.2021.04.036
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Abstract:
Objective Victims of cyberbullying are the most affected role group in cyberbullying. Cyberbullying not only brings emotional and psychological distress to the victims, but also results in irrational externalizing behaviors among those victims. Victims of cyberbullying need profound psychological counseling and behavior intervention to resolve the long-standing dilemma. How to deal with cyberbullying and how to avoid being victims of cyberbullying are of great importance. From the perspective of psychology, this paper analyzes and expounds the role formation of victims of cyberbullying and the effectiveness of coping strategies, so as to provide a theoretical basis for cyberbullying intervention.