中国学校卫生

Focus on autism spectrum disorder's sensory abnormalities and the integration of mechanism research and intervention treatment

WANG Jia, WU Lijie

2023, 44(3): 321-324. doi: 10.16835/j.cnki.1000-9817.2023.03.001

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Sensory abnormalities are common in patients with autism spectrum disorder (ASD), and its manifestations are complex and diverse, which may be an important factor that affects and aggravates core damages such as social barriers and rigid behaviors. However, at present, there is obviously insufficient emphasis on sensory abnormality in ASD, and a lack of questionnaires and evaluation tools for comprehensively evaluating the characteristics of sensory abnormality in China. The research on the peripheral and central nervous mechanisms behind abnormal behavior is still in its infancy, sensory evaluation tools and methods should be developed and enriched as soon as possible, for ultra-early identification and clinical accurate classification of ASD. Future researches on the neural mechanism related to sensory abnormality should be promoted for targeted intervention therapy, and individualized and diversified intervention in ASD and individualized and diversified.

Implementation of the healthy school construction plan to promote students' health and well-being

MA Yinghua, WANG Pei, LI Yuancheng

2023, 44(3): 325-329. doi: 10.16835/j.cnki.1000-9817.2023.03.002

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With the development of society, the health and well-being of children and adolescents are receiving increasing attention from the government and scholars. The implementation of the health (promoting) school construction plan has a significant effect on promoting students' health and well-being, which is especially important in the normalized stage of COVID-19 epidemic prevention and control. The study summarizes the importance of health (promoting) schools for students' health and well-being, reviews the development of health (promoting) school construction in China, and proposes countermeasures and recommendations to further promote health (promoting) school construction in China in the light of the new era.

Status and intervention strategy of adolescent health services

DENG Changfei, ZHANG Yaguo, HUANG Chun, XIONG Ping, NIU Yaxuan, QIAO Mutian, PU Jie

2023, 44(3): 330-334. doi: 10.16835/j.cnki.1000-9817.2023.03.003

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By reviewing the advocacy framework and implementation path of global adolescent health promotion, summarizing the main health problems of adolescents worldwide and current status of adolescent health care services in China, an ecological model of adolescent health care was concluded according to the demands of adolescents towards health care services. A comprehensive intervention strategy, ie. multi-sector cooperation, community participation and integration of hospital, school, community and family, etc, has been put forward to promote the health and sustainable development of adolescents.

Functional connectivity among insula, sensory and social brain regions in boys with autism spectrum disorder

LI Xiaoxue, ZHAI Jinhe, HAO Haiying, XU Zihan, CAO Xuan, XIA Wei, WANG Jia

2023, 44(3): 335-338. doi: 10.16835/j.cnki.1000-9817.2023.03.004

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Objective To identify the functional connectivity characteristics of insula, sensory and social related brain regions in boys with autism spectrum disorder(ASD), to explore the central nervous basis of sensory abnormality affecting core symptoms in boys with ASD. Methods Resting-state functional magnetic resonance imaging (rs-fMRI) data were collected from 34 boys with ASD and 29 typical development boys (TD group). Based on functional connectivity analysis, the sensory-related brain regions, insula, and social-related brain regions were taken as regions of interest to calculate the functional connectivity (FC) level between the regions of interest, the differences between the two groups were compared and the results were corrected by FDR. The Autism Diagnostic Observation Schedule (ADOS), Childhood Autism Rating Scale (CARS) and Autism Spectrum Quotient-Children's Version (AQ-Child) were used to assess the core phenotypes of boys with ASD. Results Compared with the TD group, the levels of FC between tactile brain regions and insula, olfactory brain regions and insula, auditory brain regions and insula in boys with ASD group were significantly increased. The level of FC between the insula and bilateral amygdala, insula and the medial prefrontal cortex(mPFC) were significantly increased(P < 0.05).Pearson correlation analysis showed that the level of FC between auditory brain region(BA42)and left insula in ASD group was negatively correlated with the scores of communication subscale of ADOS(r=-0.44), social interaction subscale of ADOS(r=-0.43), communication & social interaction subscale of ADOS(r=-0.49), attention to details subscale of AQ-Child(r=-0.41). The level of FC between the right insula and right amygdala was positively correlated with the attention switch subscale of AQ-Child(r=0.38), the level of FC between right insula and mPFC was positively correlated with the scores of repetitive behavior subscale of ADOS(r=0.48), the attention switch subscale of AQ-Child(r=0.49), total scale subscale of AQ-Child(r=0.41), total scale of CARS(r=0.41)(P < 0.05). Conclusion The levels of FC between insula and sensory-related, social-related brain regions are abnormal in children with ASD, which have significant correlations with clinical symptoms. In-depth studies can be conducted to explore underlying neutral mechanisms.

Autism spectrum disorder's sensory characteristics and its correlation with core phenotype

ZHAI Jinhe, LI Xiaoxue, XU Zihan, HAO Haiying, XIA Wei, FAN Lili, TENG Wanmeng, WANG Jia

2023, 44(3): 339-343. doi: 10.16835/j.cnki.1000-9817.2023.03.005

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Objective To explore the differences of sensory manifestations between ASD children and typical development children, and to clarify the characteristics of sensory abnormalities in ASD and their relationship with various clinical symptoms, so as to provide scientific basis for early identification and specific intervention. Methods A total of 265 ASD children who received rehabilitation training in autism rehabilitation institutions in Heilongjiang Province were collected as the case group, and 223 typical development children in ordinary kindergartens and schools in Harbin were taken as the control group. Short Sensory Profile (SSP) was used to evaluate the difference of children's sensory perception level between the two groups, and Social Response Scale (SRS) and Autism Behavior Checklist (ABC) were used to evaluate the severity of symptoms including social disorder of autistic children. The correlation between SSP scores in ASD group and clinical scales was analyzed. Results The comparison of SSP scores between the two groups found that the median scores of all sensory dimensions in ASD group (tactile=33, taste/smell=18, motion sensitivity=13, Low response/sensation seeking=28, auditory filtering=19, low strength=22, visual/auditory=20) were lower than those of the healthy control group(Z=-2.73, -4.36, -3.17, -5.09, -11.00, -10.45, -3.43, P < 0.05). The abnormal rate of multi-sensory score in children in ASD group was 55.1%, and that in control group was 21.2%, with significant difference(χ²=57.15, P < 0.05). Correlation analysis showed that SSP score in ASD group was negatively correlated with all dimensions of SRS, nonverbal communication, and social function of ADI-R scale, ADOS communication and social interaction, and total scores of ABC and CARS(P < 0.05). Conclusion Children with ASD have atypical sensory experiences, especially in auditory filtering dimension, and the level of atypical sensation is related to the severity of clinical symptoms of autism. In the future clinical diagnosis, treatment and research, it is necessary to strengthen the ability to recognize the sensory symptoms of children with ASD, so as to realize the early diagnosis and intervention.

Atypical developmental of the sensorimotor network optimal frequency in children with autism spectrum disorder

LU Chunying, ZHANG Qianyue, CHEN Xue, LI Bowen, HE Bifang, YE Shaobing, CHEN Heng

2023, 44(3): 344-347. doi: 10.16835/j.cnki.1000-9817.2023.03.006

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Objective On the basis of the dominant frequency index of functional connectivity, the "brain age" analysis method was used to explore abnormal development patterns of sensorimotor networks in boys with autism spectrum disorder(ASD). Methods The resting state functional magnetic resonance data (7-12 years old) for 105 boys with ASD and 102 matched boys with normal development from the ABIDE public database were screened. Functional connection networks in different frequency bands of sensorimotor related brain regions were constructed for each individual, and the frequency of the strongest connection were constructed as the optimal frequency of the connection. Brain age analysis was used to explore the difference between brain age and chronological age in boys with ASD. Results The brain sensorimotor network of boys with ASD showed an abnormal development pattern of overdevelopment followed by underdevelopment, and the transition between the two patterns occurred at approximately 7.8 years of age. Older boys with ASD (older than 10 years) whose underdevelopment trend was suppressed had lower ASD severity(r=-0.43, P < 0.05). Conclusion The brain sensorimotor network in boys with ASD has an abnormal development process, and the brain-chronological age difference in the sensorimotor network has potential as a neuroimaging marker to measure the development of ASD.

Evaluation of the effectiveness of healthy school canteen intervention on nutritional literacy and dietary behavior among primary school students

FENG Jingwen, DING Caicui, GONG Weiyan, WANG Liangyou, QIU Yujie, LIU Ailing

2023, 44(3): 348-352. doi: 10.16835/j.cnki.1000-9817.2023.03.007

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Objective To explore the effectiveness of healthy school canteen intervention on nutritional literacy, food consumption, as well as attitude towards school canteen. Methods A primary school in Taizhou City was selected as the intervention school, and another comparable primary school was selected as the control one. A total of 320 students (163 in the intervention group and 157 in the control group) received a comprehensive intervention based on the construction of a healthy school canteen in the school, incluling healthy dining environment, food impravement, chef training, nutrition and health education, while the control group did not receive any intervention. Questionnaires survey was administered to both groups before and after the intervention. Results Before the intervention, no significant differences were found in the total scores of skills and nutrition literacy, frequency of food intake, behaviors and attitudes related to canteen construction between the two groups(P>0.05). Daily intake of vegetables, dairy products, fish/poultry/eggs/lean meat increased by 19.63, 15.95 and 19.63 percentage point respectively (χ²=15.25, 9.14, 13.93, P < 0.01). The proportion of students reporting have read related intervention materials in the intervention group(95.71%) was higher than the control group(84.71%) (χ²=11.04, P < 0.01). The students in favor of low-salt, low-oil and low-sugar dishes in the intervention group (74.85%) was higher than in the control group(48.41%) (χ²=23.73, P < 0.01). Conclusion Based on the comprehensive intervention of nutrition and health canteens can improve students' nutrition literacy and dietary structure. It is recommended to adopt the form of "home-school linkage" to carry out the construction of large-sample, multi-regional and long-term nutrition and health canteens.

Monitoring of iodine nutrition level of children in Luohu District, Shenzhen from 2018 to 2022

FENG Fendong, YE Xiaoli, NI Yiping, YE Min

2023, 44(3): 353-355. doi: 10.16835/j.cnki.1000-9817.2023.03.008

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Objective To understand the iodine nutrition status of school children aged 8-10 years in Luohu District of Shenzhen City, so as to provide basis for scientific iodine supplement for special population in the district. Methods From 2018 to 2022, edible salt and random urine samples of non-boarding students aged 8-10 years Luohu District of Shenzhen were collected for iodine content detection and follow-up investigation. Meanwhile, thyroid volume was measured by ultrasonography. Results From 2018 to 2022, a total of 1 000 salt samples were tested, of which the median salt iodine content was 26.2 mg/kg, the edible rate of iodized salt was 90.3%, and the edible rate of qualified iodized salt was 84.0%. The median urinary iodine of children was 201 μg/L. The proportion of iodine undernutrition in children who consumed qualified iodized salt was 11.0%, and the proportion of iodine undernutrition in children who consumed unqualified iodized salt was 35.0%. The goiter rate ranged from 1.0% to 2.5% between 2018 and 2022. Conclusion The rate of qualified iodine coverage and goiter of children aged 8-10 in the district reached the national standard for iodine deficiency disorders elimination, the median urinary iodine reached the appropriate level of iodine, and the iodine nutritional status was good. The iodine nutritional status of children who eat qualified iodized salt is better than that of children who eat unqualified iodized salt.

Children parents' attitude and demand towards family-based child sexual abuse prevention education

LIAO Maoxu, SONG Xianqin, ZHANG Xiao, LU Lu, ZHOU Zhongxian, YU Ying, CAI Hao, YE Yunli

2023, 44(3): 356-360. doi: 10.16835/j.cnki.1000-9817.2023.03.009

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Objective To investigate the attitudes and demands of parents of children in Luzhou towards family-based child sexual abuse prevention education. Methods A self-administered anonymous questionnaire survey was conducted among parents of children in Luzhou City who were selected from stratified cluster sampling. Multiple linear regression model was used to analyze parents' attitudes. Results Parents' attitude towards prevention of sexual assault education was positive (average score 16.70±3.67). The results of multiple regression analysis showed that parents of only child (β=0.30), parents who participated in related activities (β=1.28), communicated with relatives and friends (β=0.81), and lived in urban areas (β=0.49) had more positive attitudes. In terms of parental factors, average annual family income higher than 100 000 yuan (β=0.39), mothers of young children (β=0.88), and parents with a high level of knowledge about sexual assault prevention education (β=0.98), the mother being a teacher or a medical staff (β=0.52), and educational background of the mother being high school/secondary school (β=1.03), college/undergraduate or above (β=1.42) were associated with more positive attitudes(P < 0.01). The results of demand analysis showed that parents had high demand for child's self-protection (96.86%). Conclusion Parents of young children in Luzhou City show generally positive attitude and high demand towards family-based sexual abuse prevention. Knowledge training and publicity regarding child sexual abuse should be improved for children who had siblings, from rural and township areas, and whose parents with low educational background.

Knowledge, attitudes and practices regarding tuberculosis prevention and control: analysis of influencing factors of prevention and control behavior among college students in Wuhan, China

ZHANG Zhengbin, YANG Yun, LI Li, WU Jun, LI Yuehua, LIU Jing, WANG Lina, LU Zhouqin, WANG Tiantian, WU Gang

2023, 44(3): 361-365. doi: 10.16835/j.cnki.1000-9817.2023.03.010

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Objective To determine the knowledge, attitudes and practices (KAP) regarding tuberculosis prevention and control among college students in Wuhan, China, while analyzing the factors affecting tuberculosis prevention behavior. Methods Referring to the National KAP Questionnaire for Tuberculosis Prevention and Control among College Students, which was designed by China Center for Disease Control and Prevention, 22 colleges and universities in Wuhan were selected using a judgment sampling method, and a questionnaire survey was carried out through the online questionnaire platform. The formation of tuberculosis prevention and control behavior among this population was analyzed by single factor and multi-factor Logistic regression. Results The total awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan was 79.69%; the awareness rate of core knowledge was 79.28%, and the passing rate was 92.46%. The correct attitude holding rate was 89.69%, while the passing rate was 90.56%. In respect to correct behavior, the formation rate was 72.11%, with a passing rate of 96.62%. The multivariate Logistic regression analysis showed that the following factors were more likely to promote tuberculosis prevention and control behaviors that met the target: female college students (OR=1.86); college students whose father had a primary school education level, junior high school and equivalent, high school and equivalent, and junior high school students (OR=2.94, 3.05, 3.17, 3.24); no history of tuberculosis (OR=3.32); the passing knowledge of core knowledge (OR=9.91), and the passing attitude holding score (OR=7.35)(P < 0.05). Conclusion The overall awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan is acceptable, the mainly influenced factors are gender, history of tuberculosis, awareness rate of core knowledge about prevention and control, attitudes and cognition, and parents' educational background.

Association between time spent on digital devices and body weight overestimation in children and adolescents

MA Qi, ZHANG Yi, CUI Mengjie, WANG Xinxin, LIU Jieyu, CHEN Manman, MA Tao, CHEN Li, DONG Yanhui, MA Jun, XING Yi

2023, 44(3): 366-369. doi: 10.16835/j.cnki.1000-9817.2023.03.011

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Objective To explore the association between digital devices usage and body weight overestimation in children and adolescents aged 7-18, in order to provide a scientific basis for body weight overestimation prevention in children and adolescents. Methods Based on the data of the Research Special Project for Public Welfare Industry of Health using stratified cluster sampling method in 2012, a tatal of 40 073 children and adolescents from 7 provinces with complete information were chosen. Ordinal multivariable Logistic regression model estimated the association between digital devices usage and body weight overestimation. Results A total of 4 276(11.8%) students with overestimation of body weight were detected, who spent >300 min/d time in digital devices(5.12%) than others (3.84%)(χ²=19.14, P < 0.01). Univariate analysis showed that students with time spent on digital devices >300 min/d had a higher risk in overestimation of body weight (OR=1.36, 95%CI=1.18-1.57, P < 0.01) compared with students who spent on digital devices≤120 min/d. There was still a significant association after confounder adjustment (OR=1.28, 95%CI=1.10-1.48, P < 0.05). Stratified analysis showed that the association between digital devices usage and overestimation of body weight were only observed in girls, 11-18 years old and non-single child(P < 0.05). Conclusion The time usage of digital devices is associated with overestimation of body weight in children and adolescents. It may helpful for children and adolescents to prevent overestimation of body weight by reducing time spent on digital devices.

Effect of experiential health education on diet control of college students with type 2 pre-diabetes mellitus

GUO Xiaoyan, TIAN Chen, ZHANG Feng, ZHANG Jing, LI Na, XIE Bing, LU Xiangling

2023, 44(3): 370-374. doi: 10.16835/j.cnki.1000-9817.2023.03.012

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Objective To understand the influence of experiential health education on diet control of college students with pre-diabetes mellitus, and to provide reference for healthy eating habits promotion among college students. Methods According to the method of random number table, 78 pre-diabetic college students screened from Changzhi Medical College from September 2020 to June 2021 were randomly assigned to observation group and control group (39 students in each group). The control group received routine health education for 10 months, once a week for 1 hour each time; On the basis of the above, the observation group received experiential health education once a week for 1 hour, including diet experience, exercise experience, blood sugar test experience and chronic complications experience. Blood glucose and lipids level, body mass index (BMI), dietary control as well as the stages of change for dietary control behavior were compared between the two groups. Results There was significant difference between the observation group and the control group in the stages of change for dietary control behavior 10 months after intervention (χ²=8.92, P < 0.05). The compliance score of the observation group was significantly higher than that of the control group in the same period 10 months after the intervention (t=3.74, P < 0.01), the score of the knowledge of diet control in the observation group 10 months after intervention was significantly higher than that in the control group (t=11.51, P < 0.05). The levels of BMI, TG and TC in the observation group were significantly lower than those in the control group at 5 and 10 months after intervention, and the differences were statistically significant (P < 0.05). Conclusion Experiential health education helps to promote awareness of diabete-related knowledge, enhance self-management behavior and good diet control habits, and is effective for blood glucose control.

Influence of health literacy of rural junior middle school students on knowledge, attitudes and practices of COVID-19 protection in Jiangxi Province

ZHANG Cheng, DENG Lifang, WANG Naibo, XU Lewei, WU Lei, WAN Dezhi, LIU Yong

2023, 44(3): 375-378. doi: 10.16835/j.cnki.1000-9817.2023.03.013

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Objective To understand the influence of junior middle school students' health literacy on knowledge, belief and behavior of COVID-19 in rural areas of Jiangxi Province, and to enhance junior middle school students' ability to deal with public health emergencies. Methods Stratified cluster random sampling was used to investigate the health literacy, knowledge level and behavior of COVID-19 protection of 4 311 grade 7 to grade 8 students in rural areas of Jiangxi Province; Chi-square test and Logistic regression analysis were used to analyze the correlation between junior high school students' health literacy and COVID-19 protection knowledge, belief and behavior. Results The rate of health literacy of junior middle school students in rural areas was 18.21%(n=785), the reported rate of intermediate level was high (n=2 454, 56.92%), and the reported rate of junior high school students at a low level of health literacy was 24.87%(n=1 072). The rate of junior middle school students in rural areas with good COVID-19 protection knowledge was 63.49%, the rate of positive protection attitude was 74.25%, and the rate of good protection behavior was 85.36%; Rate of COVID-19 protection knowledge (OR=4.85, 95%CI=3.80-6.18) and positive rate of protection attitude of high-level health literacy (OR=44.07, 95%CI=24.57-79.05), protective behavior possession rate (OR=25.99, 95%CI=19.67-34.35) were higher than those with low level of health literacy(P < 0.01). Conclusion Health literacy is associated with COVID-19 protection knowledge, belief and behavior in rural junior high school students of Jiangxi Province, the findings provide direction for junior middle school students to improve their ability to deal with public health emergencies.

Relationship between body image satisfaction and adverse childhood experiences in adolescents

ZUO Xiayun, ZHANG Ziwei, LIAN Qiguo, YU Chunyan, TU Xiaowen, FANG Yuhang, LOU Chaohua

2023, 44(3): 379-383. doi: 10.16835/j.cnki.1000-9817.2023.03.014

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Objective To explore the relationship between body image and adverse childhood experiences (ACEs) in adolescents. Methods A total of 1 701 adolescents in grade 6-8 in three middle schools in Shanghai were selected by stratified cluster sampling, and were investigated anonymously using computer assisted self-interview approach. Information including demographic characteristics, body image satisfaction, and ACEs were collected. The Chi-square test and multivariate Logistic regression were used to explore the relationship between adolescent body image satisfaction and types of ACEs. Results About 60.73% of the respondents were satisfied with their body image, with higher satisfaction among boys(66.16%) than among girls(55.13%)(χ²=21.70, P < 0.01). About 79.19% of the respondents had experienced at least one ACE, and respectively 61.61%, 65.14% and 21.58% of them had experienced abuse, neglect and family dysfunction. Multivariate Logistic regression analysis indicated that experiencing at least one ACE, abuse, neglect and family dysfunction were all related with low body image satisfaction among girls(OR=0.33-0.57, P < 0.01), while among boys neglect, having 3 or more than 4 ACEs were found to be associated with body image satisfaction (OR=0.54-0.64, P < 0.05). The cumulative effects of ACEs on adolescent body image were observed. Conclusion Different types of ACEs are associated with body image in adolescents, ACEs have cumulative effects on adolescent body image, which shows gender differences.Screen of ACEs and improvement of family nurturing environment should be highlighted among adolescents, especially among girls.

Correlation between waist circumference and psychological sub-health of middle school students in Xinjiang

XU Kaixuan, ZHAO Zhimin, HU Yanyan, LIU Yang

2023, 44(3): 384-388. doi: 10.16835/j.cnki.1000-9817.2023.03.015

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Objective To understand the association between waist circumference with psychological sub-health among middle school students in Xinjiang, and to provide evidence for the management of waist circumference and effective prevention of mental health problems. Methods By using the stratified cluster sampling, 6 191 middle school students aged 13-15 in Urumqi, Karamay, Yining, and Kashgar of Xinjiang were surveyed on demographic information, lifestyle, waist circumference, and psychological sub-health symptoms. Chi-square test, one-way ANOVA, and Logistic regression analysis were used to analyze the association between waist circumference and mental sub-health. Results The detection rate of psychological sub-health among secondary school students in Xinjiang was 21.4%. The detection rates of emotional problems, behavioral problems, and social adjustment difficulties were 28.4%, 28.1%, and 17.7%, respectively. Significant differences in the detection rate of emotional problems, social adjustment difficulties, and psychological sub-health scores were observed among students with different waist circumference levels (F=4.03, 10.90, 5.81, P < 0.05). Logistic regression analysis showed that secondary school students with high waist circumference had a higher risk of social adjustment difficulties (OR=1.45, 95%CI=1.20-1.75) and psychological sub-health problems (OR=1.46, 95%CI=1.22-1.74) compared to those with normal waist circumference (P < 0.01). Conclusion Psychological sub-health problems of middle school students in Xinjiang are prominent, and the waist circumference is positively related to the psychological sub-health problems. Schools should pay attention to the mental health education of middle school students, ensure reasonable diet, sleep and living habits, and promote their physical and mental health development.

Association of interaction effects of outdoor physical activity and insomnia with depressive symptoms in college students

ZHANG Yunjie, LIU Cong, TU Xiaohong, WANG Cuimei, DAI Yuxin, JIANG Jing, QIU Jianhua

2023, 44(3): 389-393. doi: 10.16835/j.cnki.1000-9817.2023.03.016

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Objective The aim of the study was to investigate the association of outdoor physical activity and insomnia symptoms with depressive symptoms in college students, so as to provide a theoretical basis for preventing and improving depression of the college students. Methods A sample survey of 9 349 college students from 4 colleges and universities in 3 provinces in Hubei, Jiangxi and Chongqing were conducted from November to December 2021. The Patient Health Questionnaire, Insomnia Severity Index and outdoor physical activity questionnaire were used to evaluate the depressive symptoms, insomnia symptoms and outdoor activities of college students, respectively. The χ² test was used to compare the difference of the positive rate of depressive symptoms in college students. Logistic regression analysis was used to analyze the association between outdoor physical activity, insomnia symptoms and depressive symptoms. Generalized linear model was used to analyze the association of interaction effect of outdoor activity and insomnia symptoms with depressive symptoms. Results The detection rate of depressive symptoms in college students was 37.4%. Significant differences in the detection rate of depressive symptoms were observed among college students with different majors, nationalities, educational backgrounds, family residence, family type, family economic conditions, study burden, number of friends, father's education level, mother's education level(P < 0.05). Logistic regression analysis showed that outdoor physical activity (OR=0.51-0.69, P < 0.01) and insomnia symptoms (OR=6.15-21.30, P < 0.01) were associated with depressive symptoms(P < 0.01). Generalized linear model showed that insomnia symptoms(B=0.57), outdoor physical activity (B=-0.15) and their interaction terms (B=-0.02) were associated with college students' depression(P < 0.05). Conclusion This study suggests that insufficient time for outdoor physical activity and insomnia symptoms may increase the risk of depressive symptoms in college students. College students with insufficient time for outdoor physical activity and insomnia have a higher risk of developing depressive symptoms.

Loneliness and associated factors among adolescents with mixed anxiety and depressive disorder

HE Yunling, WANG Dongxue, ZHAO Ling, LIAO Rong, REN Kai, ZHANG Hui

2023, 44(3): 394-397. doi: 10.16835/j.cnki.1000-9817.2023.03.017

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Objective To investigate loneliness and associated factors among adolescents with mixed anxiety and depressive disorder(MADD), and to provide reference for drawing up effective and targeted interventions. Methods Using convenience sampling method, 265 adolescents with MADD in Daqing Third Hospital were selected from September 2020 to June 2021. General information questionnaire, Pittsburgh sleep quality index(PSQI), Resilience Scale for Chinese Adolescents(RSCA), Child and Adolescent Peer Relationship Scale and UCLA Loneliness Scale were used to investigate the status and influencing factors of loneliness among adolescents with MADD. Results The average score of UCLA among 265 adolescents with MADD was (56.49±10.83). The results of univariate analysis showed that age, gender, burden of medical expenses, drinking behavior and parents' migrant work had statistically significant differences in the UCLA scores. The results of Pearson correlation analysis showed that loneliness in MADD adolescents was negatively correlated with psychological resilience(F/t=57.65, -60.62, 21.92, 8.52, 16.22, P < 0.01), and positively correlated with sleep quality and interpersonal distress(F/t=-0.69, 0.76, 0.50, P < 0.01). The results of multiple stepwise regression analysis showed that phase of study, sex, burden of medical expenses, interpersonal distress, sleep quality and resilience were the influencing factors of loneliness among adolescents with MADD(B=0.11, 0.13, 0.09, 0.46, 0.10, -0.24, P < 0.01). Conclusion Adolescents with MADD have moderate loneliness, which needs to be improved. Nursing staff should pay attention to the negative emotional experience such as loneliness among adolescents with MADD, and reduce their loneliness by improving sleep quality and resilience, reducing interpersonal distress.

Cyberbullying and associated factors among middle school students

JIANG Xuanli, WANG Xiaoyu, GU Jiachang, MENG Yanyuan, SHENG Jiating, LIU Fangdu, LI Minhui, FEI Gaoqiang, ZHANG Xujun, LIN Ping

2023, 44(3): 398-402. doi: 10.16835/j.cnki.1000-9817.2023.03.018

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Objective To explore cyberbullying and risk factors of middle school students, and to provide a reference for cyberbullying prevention in school settings. Methods A stratified cluster random sampling method was used to select 12 940 students from three junior high schools and four senior high schools in Yixing City of Jiangsu Province, China, to conduct a questionnaire survey from March 1 to May 31, 2019. The Chi-square test was performed to compare differences in the prevalence of cyberbullying among groups with different sociodemographic characteristics, and the multivariate Logistic regression model was employed to analyze the risk factors. A risk predictive nomogram model was constructed and then verified. Results Middle school students were found to be victims of cyberbullying at a rate of 12.3%. The Logistic regression results showed that alcohol use (OR=1.93), lack of emotional management (OR=1.30), feeling unsafe (OR=1.70), not trusting people (OR=1.66), increased daily online time (OR=1.39), higher frequency of using social software or websites (OR=2.24), poor relationships with family members (OR=1.46), parental neglect (OR=1.50), class leadership (OR=1.30) and poor relationships with classmates (OR=1.34) were risk factors for middle school students who were victims of cyberbullying (P < 0.05). Based on these 10 independent risk factors, the nomogram prediction model, had good discrimination (AUC=0.73). Conclusion Cyberbullying is common among middle school students. Internet use, parental neglect and class leadership all have an impact on cyberbullying.

Physical fitness evaluation results among students in Yunnan Province in 2019

HUANG Dafeng, CHANG Litao, HUANG Xin, DAI Limei, DENG Shuzhen, LI Wenwen, LI Yujie

2023, 44(3): 403-406. doi: 10.16835/j.cnki.1000-9817.2023.03.019

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Objective To analyze physical fitness of students aged 6-22 years old from seven ethnic groups in Yunnan Province, and to provide reference for physical fitness intervention measures. Methods The nationality, gender, grade, body shape, vital capacity, exercise quality of students were derived from the 2019 Yunnan Student Physical Health Survey Database. Comprehensive physical fitness score was calculated according to the National Student Physical Fitness Standards(revised in 2014). t-test, ANOVA, and χ² test were used to analyze physical fitness score and level among students with different ethnic groups, gender, and school stages. Results The average comprehensive score of physical fitness among students from 7 ethnic groups in Yunnan Province was (70.02±9.69), with the pass rate being 88.91%. The proportion of excellent was 0.93%, good was 17.90%, pass 70.09%, and failed was 11.09%. Physical fitness score was highest in BMI (94.99 points), followed by 50-meter running (74.13 points), sitting forward bend (72.63 points), endurance running (70.43 points), standing long jump (67.77 points), sit-ups (65.71 points), 1 minute skipping rope (65.25 points), vital capacity (62.97 points), pull-up (29.04 points). Physical fitness score and pass rate and evaluation level varied significantly by ethnicity and school stage(F=293.53, 452.85, χ²/χ_trend²=466.65, 412.57;1 553.22, 1 045.36, P < 0.01). Conclusion The excellent rate of physical fitness among students in Yunnan Province is relatively low. Physical fitness promotion requires specific guidance and training based on ethnicity and school stage.

Relationship between social support and psychological resilience and post-traumatic stress disorder in college students

REN Chunhua, CHEN Xiaofei, PAN Riyu

2023, 44(3): 407-410. doi: 10.16835/j.cnki.1000-9817.2023.03.020

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Objective To investigate the characteristics of post-traumatic stress disorder (PTSD) in college students during the outbreak of COVID-19, and to explore the mediating role of psychological resilience between social support and PTSD. Methods By using direct selection method, 572 college students in Anhui and Shanghai were selected and administered with General Characteristics Questionnaire, the PTSD Checklist-Civilian Version(PCL-C), Psychological Resilience Scale(PRS) and Social Support Rating Scale(SSRS). Results Among the participants, 25.0% had moderate PTSD symptoms, 11.7% had obvious PTSD symptoms, and the positive rate of PTSD was 36.7%. The prevalence of PTSD in college students was higher in males than in females (χ²=4.31, P < 0.05). The junior students were higher than other students (χ²=16.81, P < 0.01). The scores of social support, psychological resilience and PTSD were (33.79±4.83), (92.17±13.39) and (35.50±11.39), respectively. The correlations of all variables were statistically significant(r=-0.49-0.76, P < 0.05); The mediation test showed that social support could not only negatively predict PTSD directly(direct effect was -0.35), but also indirectly affect PTSD through psychological resilience(indirect effect was -0.32). Conclusion More than one third of college students have PTSD symptoms, and psychological resilience plays a partial mediating role in the relationship between social support and PTSD, social support can both directly and negatively predict PTSD and indirectly affect PTSD by increasing an individual's psychological resilience.

Association of maternal emotional symptoms and childhood adverse experiences with children's emotional and behavioral problems

YU Min, ZHU Min, HE Haiyan, DOU Lianjie, LI Ruoyu, WAN Yuhui

2023, 44(3): 411-414. doi: 10.16835/j.cnki.1000-9817.2023.03.021

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Objective To explore the mediating effect of maternal emotional symptoms on maternal adverse experiences and children's emotional behavior problems, so as to provide a scientific basis for family intervention of children with emotional behavior problems. Methods A multi-stage sampling method was used to select 12 kindergartens in 3 districts and counties of Wuhu City. The questionnaire star method was used to investigate the love of homosexuality in families and children, children's emotional behavior development questionnaire, mother's life experience questionnaire, mother's emotional symptoms questionnaire, etc. SPSS 23.0 software was used for general descriptive analysis and Spearman correlation analysis. GLS method was used to evaluate the mediating effect of maternal mental health level between maternal adverse experiences and children's emotional and behavioral problems. Results The difficulty factor score in the Strength and Difficulty Questionnaire (SDQ) of preschool children in Wuhu City was (10.08±4.05) points, the abnormal detection rate of the total difficulty score was 6.6%, and the abnormal detection rate of prosocial behavior was 16.5%, the total score of mother's adverse experience was positively correlated with the total score of mother's SDQ difficulties and the scores of mother's depression, anxiety and stress symptoms. The total score of children's SDQ difficulties was positively correlated with the scores of mother's depression, anxiety and stress emotions(r=0.17-0.71, P < 0.01). The results of mediating effect analysis showed that the intermediate effect coefficients of maternal depression, anxiety, stress and other emotions between the total score of maternal adverse experience and the total score of children's SDQ difficulties were statistically significant(P < 0.05), and the mediating effect accounted for 22.6%, 15.2% and 17.1% of the total effect, respectively. Conclusion The relationship between maternal adverse childhood experiences and children's emotional behavior problems was influenced by maternal emotional symptoms. Attention to mothers' early life experience and mental health is beneficial to the prevention and control of children's emotional and behavioral problems.

Effect of different immunization schedules on diphtheria antibody level among preschool children in Shenzhen

PENG Yuanzhou, HA Yongting, LI Wenhao, HUANG Fang, XIE Xu, CHENG Jinquan, WU Yu, ZHANG Yanwei

2023, 44(3): 415-418. doi: 10.16835/j.cnki.1000-9817.2023.03.022

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Objective To evaluate the immunity and influencing factors of diphtheria among preschool children in Shenzhen, to provide reference for effective monitoring of diphtheria IgG antibody level in preschool children. Methods Serum samples were collected from 296 preschool children aged 4-6 who were recruited in Shenzhen. The diphtheria antibody titer in serum was determined by enzyme-linked immunosorbent assay, and the effect of different immumuzation schedule including types of vaccine and vaccination timing, on the geometric mean concentration (GMC) of diphtheria IgG antibody and antibody positive rate were analyzed. Results The GMC of diphtheria IgG antibody was 0.71 IU/mL, and the positive conversion rate was 33.1%. There were significant differences in antibody GMC and antibody positive conversion rate of diphtheria in different age groups(F/χ²=11.77, 27.45, P < 0.01). The GMC and antibody positive conversion rate showed significant differences by diphtheria antibodies, vaccine types and end dose vaccination intervals(F=49.53, 12.95, 11.61, P < 0.01). There were statistically significant differences in the positive conversion rate of diphtheria antibodies in children with different types of diphtheria antibodies, vaccine types of diphtheria antibodies, and diphtheria antibodies at the time interval of final vaccination (Fisher exact probability method, P < 0.01). Conclusion The overall positive conversion rate of diphtheria antibody in preschool children in Shenzhen is high. Timely completion of full diphtheria vaccination can improve the antibody level and plays a better role in protecting preschool children.

Association between plasma Irisin concentrations and changes in blood pressure among children: a cohort study

TAN Minyi, HU Yan, SONG Yanyan, ZENG Xia, GUI Zhaohuan, WU Shengchi, CHEN Yajun, CAI Li

2023, 44(3): 419-422. doi: 10.16835/j.cnki.1000-9817.2023.03.023

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Objective To investigate the longitudinal association of plasma Irisin concentrations with changes in blood pressure (BP) levels among children, and to assess the moderating effect of physical activity (PA) or sedentary behavior (SB) on the relationship between Irisin levels and BP. Methods Based on a cohort study, a cluster sampling method was used to select 3 651 school-aged children from five schools in Guangzhou in 2017 at the baseline survey and follow-up in 2019. Both at baseline and during follow-up, PA and SB were assessed by validated questionnaires, and BP levels were measured by an electronic sphygmomanometer. A final sample of 521 children were enrolled based on the PA and SB at baseline. Plasma Irisin concentrations were measured by ELISA at baseline. Logistic regression analysis was recruited for exploring the associations of plasma Irisin concentrations with changes in BP. Moderating effects of PA and SB on the relationship between Irisin concentrations and BP were estimated using stratified analysis. Results Logistic regression analysis indicated that there was no significant association between Irisin concentrations and changes in BP levels among children (OR=0.98, P>0.05). After stratification for SB, Irisin levels in the low SB subgroup were inversely associated with changes in diastolic blood pressure (OR=0.87, 95%CI=0.77-0.98, P=0.02). In addition, SB level had a moderating effect on the relationship between Irisin levels and the DBP changes (P=0.01). Conclusion Increased Irisin concentration is associated with the decrease of DBP level among low SB children. Furthermore, SB level shows moderating role in the relationship between Irisin concentrations and changes in DBP levels.

Association between latent classes of health risk behaviors and depressive symptoms among junior middle school students in Tianjin

HOU Changchun, LIANG Mingyue, LIU Zhonghui, ZHANG Xin, SUN Zhiying

2023, 44(3): 423-427. doi: 10.16835/j.cnki.1000-9817.2023.03.024

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Objective To investigate the prevalence of depressive symptoms among junior middle school students in Tianjin, and to explore the association between latent classes of health risk behaviors and depressive symptoms, so as to provide clues for identifying high-risk groups of depressive symptoms and a scientific basis for comprehensive intervention measures. Methods By using a multistage stratified cluster sampling method, 8 175 students in 16 districts of Tianjin were investigated with demographic characteristics, depressive symptoms, and health risk behaviors. Latent class analysis was performed by Mplus 8.3. SPSS 23.0. Results The prevalence of depressive symptoms among junior high school students in Tianjin was 17.8%, the prevalence of depressive symptoms in urban(19.4%) areas was higher than that in rural areas(16.5%), and that of female students(20.2%) was higher than that of male students(15.5%)(χ²=11.62, 30.58, P < 0.01). Health risk behaviors were classified into three groups: healthy group (84.0%), poor diet group (3.8%) and multiple risk behaviors group (12.2%). After adjusting for region, grade, gender, and family type, multivariate Logistic regression analysis showed that the poor diet group (OR=2.82, 95%CI=2.17-3.66) and the multiple risk behaviors group (OR=4.31, 95%CI=3.67-5.05) had a higher risk of depressive symptoms compared with the healthy group (P < 0.01). Conclusion Depressive symptoms are prevalent among junior middle school students in Tianjin. Different latent classes of health risk behaviors have different correlations with depressive symptoms. It is important to ensure early detection and personalized intervention for different types of health risk behavior among junior middle school students to maximize cost-effectiveness.

Association of vertical jump performance with anthropological variables among adolescents aged 12-15

TIAN Junlong, GAO Xiang, LIU Yi, LI Lin

2023, 44(3): 428-431. doi: 10.16835/j.cnki.1000-9817.2023.03.025

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Objective To explore characteristics of vertical jump ability by age and gender and its correlation with anthropological variables among adolescents aged 12-15. Methods A total of 1 280 adolescents aged 12-15 years were recruited from 15 middle schools in 9 provinces and cities in China. The Smartjump contact mat, an assessing vertical jump system, was used to measure the squat jump height (SJ-H), countermovement jump height (CMJ-H), left-leg countermovement jump height (LCMJ-H) and right-leg countermovement jump height (RCMJ-H). The eccentric utilization ratio (EUR) was calculated as the ratio between CMJ-H and SJ-H. Data on height, weight, body mass index (BMI), calf circumference, and foot length of participants were collected. The differences in vertical jump ability by age and gender were compared by using a one-way ANOVA and the correlation between vertical jump ability and anthropological variables was analyzed by using a partial correlation analysis. Results The SJ-H (29.3-37.0 cm), CMJ-H (30.8-39.9 cm), LCMJ-H (15.1-19.2 cm) and RCMJ-H (14.8-18.9 cm) increased significantly with age among boys aged 12-15. But among girls, only the SJ-H and CMJ-H significantly increased in the 14-year-old group (SJ-H: 25.3 cm, CMJ-H: 27.0 cm) compared to the 13-year-old (24.5, 26.1 cm) (t=2.01, 2.19, P < 0.05). Additionally, boys performed better on the SJ-H, CMJ-H, LCMJ-H, and RCMJ-H, and this sex difference increased with age. There was no significant difference in EUR between boys and girls at different ages (1.06-1.09) (t=-0.11-0.94, P>0.05). The partial correlation analysis showed that SJ-H, CMJ-H, LCMJ-H, and RCMJ-H had low to moderate positive correlations with height (r=0.38-0.43), foot length (r=0.22-0.29) while low negative correlation with weight (r=-0.17-0.14)(P < 0.01). Conclusion The vertical jump performance increases with age among boys aged 12-15, while girls hardly increase until over the age of 14. The vertical jump performance is significantly associated with height, weight, and foot length and is restricted by greater weight among adolescents aged 12-15 years.

A follow-up study of body fat distribution and blood pressure among 6-9 years old children in Beijing

AMAERJIANG Nubiya, JIANG Xiaofeng, TANG Ruishu, LI Menglong, XIAO Huidi, ZUNONG Jiawulan, HU Yifei

2023, 44(3): 432-435. doi: 10.16835/j.cnki.1000-9817.2023.03.026

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Objective To explore the association of body fat mass and distribution indices including fat mass percentage (FMP), visceral fat area (VFA) and percentage of trunk fat mass (%TFM) with blood pressure in children to inform early management of blood pressure in children. Methods Based on the Beijing Child Growth and Health Cohort in Shunyi District, lifestyle questionnaire survey, baseline and follow-up physical examination were conducted among children from October to November 2018 and September 2020. Bioelectrical impedance analysis (BIA) was used to measure the body composition, and 1 098 participants with completed data were finally included. Results Both body fat indices and blood pressure increased with age in boys and girls. For FMP, VFA, and %TFM, no significant differences presented between sex at baseline, while FMP, VFA, and %TFM were significantly higher in boys than girls at follow-up (t=2.73, 3.76, 3.41, P < 0.01). Before and after adjusting for age, height and lifestyles or not, linear mixed-effect models showed longitudinal associations existing between body fat indices and blood pressure in both boys and girls (β=0.64-3.48, P < 0.05). The association coefficients of body fat indices with systolic blood pressure were ranked as %TFM>FMP>VFA in both boys and girls. The association coefficients of body fat indices with diastolic blood pressure were ranked sequentially as FMP>%TFM>VFA in boys, and VFA>FMP>%TFM in girls. Conclusion Longitudinal associations are observed between body fat indices and blood pressure in children. Primordial prevention of high pressure should pay attention on body fat distribution.

Trends and influencing factors of endurance performance of Han college students in Hunan Province during 1985—2019

ZENG Yuan, ZHOU Qionghua, YANG Yide, CHEN Mingxia, ZHANG Xiaotong, ZHENG Chanjuan, QUAN Hongjiao

2023, 44(3): 436-440. doi: 10.16835/j.cnki.1000-9817.2023.03.027

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Objective To analyze the trends and influencing factors of endurance performance of 19-22 years old college students in Hunan Province from 1985 to 2019, so as to provide objective and scientific basis for sports and health work in colleges and universities. Methods A retrospective analysis was conducted on the data of 14 490 college students aged 19-22 in Hunan Province from 8 consecutive National Student Physical Fitness and Health Surveys conducted from 1985 to 2019. The analysis indexes were 1 000 m running for boys and 800 m running for girls. Results From 1985 to 2019, the endurance running time of 19-22 years old Han college students in Hunan Province showed an obvious trend of decline. The 1 000 m running time of urban and rural male students increased by 41.9 and 45.4 s on average, and the 800 m running time of urban and rural female students increased by 29.5 and 30.6 s on average, respectively. Multiple linear regression analysis showed that age (β=0.17), urban students (rural students as reference; β=0.44), GDP (β=0.94) and urbanization level (β=0.44) were positively correlated with the average endurance running time of males. Urban students (β=0.92), GDP (β=1.38) and Engel coefficient (β=0.93) were positively correlated with the average endurance running time of females. BMI (β=-0.47) was negatively correlated with the females mean time of endurance running (P < 0.05). Conclusion The endurance performance of Han college students in Hunan Province showed a declining trend from 1985 to 2019, which is associated with age, urban and rural distribution, regional GDP, Engel's coefficient, urbanization level and BMI. Effective measures should be taken to improve the physical quality of college students.

Effect of exercise interventions on cardiovascular disease risk factors among school-age children: a Meta-analysis

DONG Yu, LUO Dongmei

2023, 44(3): 441-446. doi: 10.16835/j.cnki.1000-9817.2023.03.028

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Objective To understand the effect of exercise interventions on cardiovascular disease risk factors among school-age children, and to provide guidance for developing relevant interventions. Methods Relevant documents were sourced from Wanfang database, CNKI, VIP, PubMed, Web of Science and other databases, and the inclusion criteria were published literature related to randomized controlled intervention trials on cardiovascular risk factors among school-age children. The search was conducted using Chinese keywords including "physical activity or exercise or exercise intervention" and "school-age or children or 7-12" and "cardiovascular disease or blood pressure or blood lipid profile or insulin resistance or inflammatory factor or arterial stiffness or arterial thickness or cardiovascular comprehensive risk factor" and "intervention experiment or randomized controlled experiment", and English keywords including "physical activity or exercise intervention" and "school-age or children" and "cardiovascular disease or CVD or lipid profile or insulin resistance or information or arterial thickness or arterial stiffness or CVD combined score" and "randomized controlled trial." Results A total of 37 articles were included, with six outcome indicators. The results of the Meta-analysis showed that exercise interventions had a beneficial effect on high-density lipoproteins (SMD=0.31, 95%CI=0.03-0.59), low-density lipoproteins (SMD=-0.37, 95%CI=-0.59--0.15), triglycerides (SMD=-0.45, 95%CI=-0.72--0.18), HOMA-IR (SMD=-0.35, 95%CI=-0.58--0.12), systolic blood pressure (SMD=-0.25, 95%CI=-0.36--0.14), and diastolic blood pressure (SMD=-0.29, 95%CI=-0.40--0.18). Conclusion Exercise interventions show a positive effect on cardiovascular risk factors among school-age children, and can contribute to improvements in blood lipid status, blood pressure and insulin resistance.

Abnormal spinal curvature and its influencing factors among middle and high school students in Inner Mongolia Autonomous Region

YANG Tian, ZHANG Xiuhong, GAO Sheng, LI Guofeng, ZHAO Jing, ZHAO Jufang

2023, 44(3): 447-450. doi: 10.16835/j.cnki.1000-9817.2023.03.029

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Objective To investigate the incidence of abnormal spinal curvature and related factors among middle school students in the Inner Mongolia Autonomous Region, so as to provide evidence for abnormal spinal curvature prevention and treatment. Methods By using a random stratified cluster sampling method, 87 908 students of middle and high school students from all 12 counties(districts) were investigated via questionnaires for abnormal spinal curvature and health influencing factors in Inner Mongolia Autonomous Region. Chi-square test was used to perform demographic characteristics and univariate analysis, and binary multivariate Logistic regression model was used to screen the risk factors for spinal curvature abnormalities in middle school students. Results A total of 3 131(3.56%) students with spinal curvature abnormalities were detected, with boys (3.69%) higher than that of girls(3.44%), urban areas (6.15%) higher than that of the suburban counties (2.50%), and high school students (4.97%) higher than that of junior high school(2.73%) students(χ²=4.01, 702.19, 299.36, P < 0.05). The detectable rate of spinal curvature abnormalities increased with grade (χ_trend²=309.29, P < 0.05). Logistic regression analysis showed that factors influencing abnormal spinal curvature included myopia, overweight, obesity, the frequency of classroom seating arrangements, time spent on homework/reading after school every day, time spent in daytime outdoor activities, self-imposed requirements for posture of sitting and standing, phase of studying, gender, and area (OR=0.53-2.55, P < 0.05). Conclusion Abnormal spinal curvature is strongly correlated to nutritional status, myopia, sitting posture when reading and writing, sedentary time, and time spent in outdoor activities. The collaboration of multiple departments is required to establish anenvironment to protect the spine, early detection and early intervention.

Investigation of an acute gastroenteritis outbreak caused by Norovirus infection in a university

YIN Shuqin, LIU Guangtao

2023, 44(3): 451-453. doi: 10.16835/j.cnki.1000-9817.2023.03.030

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Objective To investigate an acute gastroenteritis outbreak caused by Norovirus, and to provide evidence for effective school infectious outbreak prevention and control. Methods In March 2019, basic information of Huzhou Normal University and related data of cases were collected. Epidemiological characteristics were analyzed. Anal swabs of the 10 cases were collected for laboratory detection. Case definitions, specific detection criteria and procedures were based on the Diagnostic Criteria for Infectious Diarrhea (WS 271-2007) and the Technical Guidelines for the Investigation, Prevention and Control of Outbreaks of Norovirus Infection (2015 edition). Results During March 15 to March 20, a total of 13 (12 girls and 1 boy) confirmed cases were reported, all of them were from the same class, with the incidence rate being 25.00% (1/4) and 37.50% (12/32) in boys and girls, respectively. No significant sex difference was found (χ²=2.05, P>0.05). Anal swab specimens of 10 students were collected from laboratory were positive for Norovirus GII and have an identity of 100%. Conclusion The gastroenteritis outbreak was deduced to be attributed to GII Norovirus infection, which are likely caused by fecal contamination through person-to-person contact. It is suggested that schools should strengthen knowledge education on the prevention and control of infectious diseases and improve the protection awareness and ability of teachers and students to protect them.

Public health emergency response capacity in primary and secondary schools

SHEN Huijie, JIAO Feng, MA Yinghua, HAN Fang, DENG Rui, ZHU Min, HUANG Hongyun, ZHAO Ruilan

2023, 44(3): 454-457. doi: 10.16835/j.cnki.1000-9817.2023.03.031

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Objective To understand the public health emergency response capacity in primary and secondary schools, and to explore the problems and challenges in the prevention and control of public health emergency in primary and secondary schools for specific strategies. Methods By using the stratified group sampling method, a questionnaire survey on general situation, knowledge, attitude and training, as well as public health emergencies response capacity among 2 988 teachers or leaders responsible for school emergency response in primary and secondary schools from Beijing, Chongqing and Yunnan. Results Participants varied on their positions, titles, educational background and knowledge accuracy. Higher knowledge accuracy was associated with higher educational background (χ²=50.73-203.36, P < 0.05). The implementation of regular public health emergency-related programs was poorly conducted in high schools (50.0%). Urban schools (42.0%) had higher proportion of qualified health care professionals than rural schools (18.2%), and private schools (48.5%) was higher than public schools (24.7%). The primary challenges included the shortage of guidance from professionals and the lack of related testing equipment (84.91%, 74.03%). Conclusion Although the ability of emergency handling of public health emergencies in schools in the three regions is advancing with the times, there are still many deficiencies, some omissions in the mastery of knowledge. It is suggested to inerease pre-service and special training of school health work CDC should strengthen technical guidance and work supervision of infectious disease management in schools.

Gender differences in myopia prevalence among Han students aged 7 to 18 years in China during 2005-2019

TONG Haojie, LI Yulan, ZHU Liling

2023, 44(3): 458-461. doi: 10.16835/j.cnki.1000-9817.2023.03.032

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Objective To investigate gender differences regarding changes of myopia rates among Han Chinese students aged 7-18 years in China, and to provide a scientific basis for precise myopia prevention and control. Methods The visual acuity data of 871 112 students aged 7-18 years from four national student physical fitness and health surveys in 2005, 2010, 2014 and 2019 were selected to analyze gender differences in myopia rates and myopia rates among male and female students in each age group. Results The overall myopia rate of students aged 7-18 years in China increased from 2005 to 2019(χ²=7 265.06, P < 0.01), and the myopia rate increased from 47.9%(2005) to 60.1% (2019). Gender differences in myopia rates among students trended to decrease(χ²=72.24, P < 0.01), and showed an inverted "U-shaped" distribution from south to north, decreasing first and then increasing. Conclusion The problem of myopia in children and adolescents cannot be ignored, and the difference in myopia rates between male and female students should be taken into account, precise prevention and control of myopia accurately according to gender.

Review on screen time among children and adolescents and impact on mental health

CAO Hui, LIAN Xinyao, CHEN Yuanyuan, SU Mintao, XU Qingsong, LIN Shujian, LIU Jufen

2023, 44(3): 462-465. doi: 10.16835/j.cnki.1000-9817.2023.03.033

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The popularization of the use of electronic has become a global trend, and children are exposed to devices at younger ages. A large proportion of children and adolescents spend on screen time more than 2 h which is recommended in most guidelines. The paper reviews possible effects of screen time on physical and mental health, as well as mental disorders in children and adolescents. It is found that excessive screen time showed negative impacts on mental health, including depression, anxiety, mood disorder, social adaptational problems, behavioral disorders, self-injurious behaviors, and health risk behaviors. Much attention has been paid on the association between excessive screen time and mental health of children and adolescents, while possible mechanisms and influencing factors are lacking. Effective intervention studies are needed to provide a basis for child and adolescent health promotion.

Research progress on the association between built environment and myopia in children and adolescents

WANG Meng, TAO Shuman, TAO Liming, TAO Fangbiao

2023, 44(3): 466-470. doi: 10.16835/j.cnki.1000-9817.2023.03.034

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Myopia is the most common visual impairment among children and adolescents. With the acceleration of urbanization, the relationship between myopia and factors of the built environment, such as building density, living space, green environment, etc, has attracted widespread attention in society. A growing number of studies have shown that the factors of the built environment play an important role in the onset and progression of myopia. This current review focuses on the effects of the built environment on myopia in children and adolescents, summarizes the association between the built environment and myopia in children and adolescents from the aspects of environmental density, living space and green space environment, and discusses the potential paths of the association, including affecting the light environment and restricting the outdoor activities of children and adolescents, which could provide environmental etiological clues for the prevention and control of myopia in children and adolescents and reduce the burden of public health caused by myopia.

Analysis of the influencing factors and intervention methods of sibling jealousy in children

LI Ranran, ZHAN Fang, QIAN Guoying

2023, 44(3): 471-475. doi: 10.16835/j.cnki.1000-9817.2023.03.035

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With the successive liberalization of the two-child and three-child policies in China, the issue of sibling relationships has been paid more and more attention by society. Severe sibling jealousy has a negative impact on the physical and mental health development of both young children and their siblings. The study reviewed the influencing factors of sibling jealousy, and analyzed the effect of applying six related intervention methods to the sibling jealousy intervention.The review aims to provide theoretical and empirical basis for children's sibling jealousy intervention, to reduce the level of sibling jealousy through the intervention, and to promote the physical and mental health of young children and their brothers and sisters.

The joint influence of subjective social status and life skill level on adolescent health risk behaviors

JIA Bibo, ZHU Fan, WANG Pei, LIU Sichen, LI Yuancheng, ZHU Guiyin, MA Yinghua

2023, 44(3): 476-480. doi: 10.16835/j.cnki.1000-9817.2023.03.036

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Subjective social status and life skill level are important influencing factors of adolescent health risk behaviors, and they interact with each other and jointly act on adolescent health risk behaviors, which make the mechanism of adolescent health risk behaviors become more diverse and complex. The current paper reviews the correlations among subjective social status, life skill level and adolescent health risk behaviors, in order to explore the joint influence of subjective social status and life skill level on adolescent health risk behaviors, then provides future directions for exploring possible mechanisms, and proposes recommendations for effective prevention strategies of adolescent health risk behaviors.

2023 Vol. 44, No. 3