中国学校卫生

Shift the focus to earlier prevention and control of adolescent depression

YIN Xiaojian, DING Ji

2023, 44(5): 641-644. doi: 10.16835/j.cnki.1000-9817.2023.05.001

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Depression severely affects the healthy development of adolescents and has become a major public health challenge in China. The outbreak and normalization of COVID-19 have posed a serious challenge to the prevention and treatment of depression in adolescents. Given the characteristics of adolescent physical and mental development and depression pathology, the prevention and control of depression in adolescents should be shifted to an earlier stage. "Screening and dynamic monitoring" should be an important way to shift the focus of prevention and control of depression in adolescents. "Population-based prevention" should be an important guarantee for achieving the shift toward early prevention and control of depression in adolescents, which builds a solid barrier for the mental health protection and promotion among Chinese adolescents.

Characteristics and enlightenment of Guidelines on Physical Activity, Sedentary Behavior and Sleep for Children under 5 Years of Age

WANG Detao, LYU Hewu, LI Tiancun

2023, 44(5): 645-648. doi: 10.16835/j.cnki.1000-9817.2023.05.002

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In recent years, the trend of getting chronic diseases at younger age has cast a shadow on the health of children around the world. In order to improve this situation, the paper analyzes the Guidelines on Physical Activity, Sedentary Behavior and Sleep for Children under 5 Years of Age, and explores its theoretical basis, behavioral norms and policy implementation. The present paper suggests to introduce the guidelines on health promotion for children under the age of 5 as soon as possible from the aspects of index system, publicity model and evaluation system, so as to provide impetus for the construction of "Healthy China".

Correlation between nutritional status and depressive symptoms in middle school students

SHEN Jinbo, GAN Minlei, YIN Xiaojian, WU Huipan, MA Yuanyuan, LI Jiawei, HOU Yuxin, DENG Ting, LI Feifan, LIU Yuan

2023, 44(5): 649-653. doi: 10.16835/j.cnki.1000-9817.2023.05.003

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Objective To explore the correlation between different nutritional status and depressive symptoms among adolescents, so as to provide a theoretical basis for targeted improvement of nutritional status and depressive symptoms in adolescents. Methods A total of 8 102 adolescents aged 12-17 years in Shanghai, Urumqi, Changsha and Kunming were selected by random cluster sampling. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale(CES-D). Height and weight were measured. Kruskal-Wallis H test, Chi-square test and ordinal Logistic regression were used to analyze the relationship between nutritional status and depressive symptoms in adolescents. Results The overall detection rate of depressive symptoms in adolescents was 25.6%, with girls (30.1%) higher than that of boys (21.1%) (χ²=87.60, P < 0.01). There were statistically significant differences in the scores of depressive symptoms among girls with different nutritional status (Z=8.34, P < 0.05). The detectable rate of depressive symptoms increased with BMI among girls(χ_trend²=6.04, P < 0.05). After controlling for confounding factors, ordinal Logistic regression showed that the obese girls had higher risks in depressive symptoms detection compared with normal weight girls (OR=1.45, 95%CI=1.10-1.91, P < 0.05). Conclusion The nutritional status of girls is better than boys, but the prevalence of depressive symptoms is higher than boys. The risk of depressive symptoms in girls increases with BMI.

Correlation between physical fitness condition and depressive symptoms in adolescents

ZHOU Jianfeng, LU Jinkui, GAN Minlei, YIN Xiaojian, WU Huipan, MA Yuanyuan, ZHANG Xiang, LI Yong, ZHANG Yingkun, LI Feifan, LIU Yuan

2023, 44(5): 654-658. doi: 10.16835/j.cnki.1000-9817.2023.05.004

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Objective To explore the relationship between adolescents' physical fitness and depressive symptoms, and to provide reference for the early prevention and intervention of depressive symptoms and improvement of physical fitness in Chinese adolescents. Methods From September to December 2021, a total of 8 102 adolescents were selected by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming. The Center for Epidemiologic Studies Depression Scale(CES-D) was used to investigate the depressive symptoms, and completed grip strength, standing long jump, 50 m running, modified sitting forward flexion, 20 s repeated traverse, 30 s sit-ups, 20 m round-trip running (20 m SRT) test. χ² test, Goodman-Kruskal Gamma and Logistic regression analysis were used to analyze the relationship between physical fitness index(PFI) and depressive symptoms. Results The overall detection rate of depressive symptoms in adolescents with high level PFI was 23.4%, and the detection rate of low level adolescents was 26.3%, with a statistically significant difference (χ²=6.73, P=0.01). There was a significant positive correlation between PFI and depressive symptoms in the high school group (G=0.09, P < 0.05) and the boy group (G=0.12, P < 0.05), and there was no significant association between PFI and depressive symptoms in the junior high school group and the girl group (P>0.05). After adjusting for gender and age in the Logistic regression model, compared with those with high PFI, the risk of depressive symptoms in those with low PFI was 1.18 times (95%CI=1.05-1.33). Conclusion There is a correlation between physical fitness and depressive symptoms in adolescents. Adolescents with low PFI are at higher risk of developing depressive symptoms than those with high PFI.

Correlation analysis between non-suicidal self-injury behavior and depressive symptoms in adolescents

YUAN Yong, GAN Minlei, YIN Xiaojian, WU Huipan, SHEN Jinbo, MA Yuanyuan, HOU Yuxin, LI Yong, ZHANG Dongru, LIU Yuan

2023, 44(5): 659-663. doi: 10.16835/j.cnki.1000-9817.2023.05.005

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Objective To explore the correlation between non-suicidal self-injury(NSSI) behaviors and depressive symptoms in adolescents and to provide a theoretical basis for improvement of adolescent physical and mental health. Methods A total of 8 102 adolescents aged 12-17 years were selected by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming, using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Adolescent Non-Suicidal Self-Injurious Behavior Assessment Questionnaire. Depressive symptoms and the occurrence of NSSI behaviors were assessed. The relationship between NSSI behaviors and depressive symptoms was analyzed using Chi-square test, one-way analysis and Logistic regression analysis. Results The overall detection rate of NSSI in adolescents, 24.6%, with a significantly lower detection rate in boys (23.1%) than in girls (26.2%) (χ²=10.97, P < 0.05), and 24.7%, 24.6% in the middle school and high school segments, respectively, but the difference was not statistically significant (χ²=0.01, P>0.05). The overall detection rate of adolescent depressive symptoms was 49.7% in the group with NSSI and 17.7% in the group without NSSI, with statistically significant differences (χ²=808.80, P < 0.01). The detection rates of adolescent depressive symptoms in the group with NSSI (male: 44.0%, female: 54.7%, middle school: 49.6%, high school: 49.8%) and the group without NSSI (male: 14.2%, female: 21.4%, middle school: 14.3%, high school: 21.0%) were statistically significant by sex and age groups (χ²=385.58, 412.44, 520.60, 313.78, P < 0.01). Logistic regression models, after adjusting for gender and age, the risk for depressive symptoms was 2.65 times (95%CI=2.27-3.09) and 7.28 times (95%CI=6.34-8.37) more frequently in adolescents with episodic self-injurious behavior and frequent self-injurious behavior, respectively, compared to those without self-injurious behavior. The association between NSSI status and depressive symptoms did not show sex differences (P > 0.05). Conclusion Adolescent NSSI behavior is positively associated with depressive symptoms, the attention should be paid to adolescent physical and mental health to reduce the occurrence of NSSI.

Associations of family functioning with sleep disturbance and depressive symptoms among primary and secondary school students

WEN Fuhua, ZHOU Huannan, TU Nanping, ZHANG Min, YUAN Junyi, FAN Fang

2023, 44(5): 664-667. doi: 10.16835/j.cnki.1000-9817.2023.05.006

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Objective The study aims to explore the associations of family functioning with sleep disturbance and depressive symptoms among primary and secondary school students, to provide scientific reference for preventing depression in primary and middle school students. Methods A convenience sampling method was used to recruit 124 357 primary and secondary school students in Baoan District, Shenzhen. A self-administered general information questionnaire, the Youth Self-Rating Insomnia Scale, and the Patient Heath Questionnaire-9 were used to assess the students' demographic characteristics, family functioning, sleep disturbance, and depressive symptoms. Results About 34.6% of students reported moderate family dysfunction, and 8.7% reported severe family dysfunction. The prevalence rates of sleep disturbance and depressive symptoms were 13.0% and 13.1% in elementary and secondary school students, respectively. The prevalence rates of sleep disturbance and depressive symptoms were statistically significantly higher in girls(14.6%, 16.8%) than boys(11.6%, 9.9%) (χ²=255.25, 1 269.50, P < 0.01). Depressive symptoms were positively correlated with sleep disturbance (r=0.61) and negatively correlated with family functioning (r=-0.31)(P < 0.01). Family functioning moderated the relationship between sleep disturbance and depressive symptoms, and the positive predictive effect of sleep disturbance on depressive symptoms decreases as the level of family functioning increases. Conclusion Family functioning buffers the effects of sleep disturbance on depressive symptoms among primary and secondary school students. Attention should be paid to sleep quality among primary and secondary school students, to improve their family functioning, and thus decrease and prevent the occurrence of depression in adolescents.

Network modeling analysis of depression, Internet addiction and campus bullying in adolescents

YANG Wenyi, YANG Jie, YU Xiaojin

2023, 44(5): 668-671. doi: 10.16835/j.cnki.1000-9817.2023.05.007

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Objective To explore network relationships among depression, Internet addiction and campus bullying among adolescents, so as to provide a theoretical basis for the comprehensive prevention and control of adolescents' psychological status and risky behaviors. Methods In September 2020, a stratified random cluster sampling method was adopted to select 5 000 middle-school students for investigation. A structural equation model was used to analyze depression, Internet addiction and bullying and their related influencing factors in order to clarify the pathway and magnitude of effects. Results Depression had a positive effect on Internet addiction with adolescents(β=0.35, P < 0.01), school bullying had a positive effect on depression and Internet addiction with adolescents(β=0.23, 0.05, P < 0.01). Adolescent depression was found to play a partial mediating role with respect to the influence of sleep duration on Internet addiction, and the indirect effect was -0.01, accounting for 63.6% of the total effect. Depression played a partial mediating role regarding the influence of the frequency of moderate and high intensity exercise on Internet addiction in adolescents; the indirect effect was -0.01, accounting for 21.8% of the total effect. Conclusion Considering the interaction among adolescent depression, Internet addiction, and school bullying, it's important to include associated factors when developing effective prevention and intervention strategies, which can thus promote the physical and mental health of students, and provide scientific and effective protection.

Correlation between physical activity and depressive symptoms in adolescents

WU Haitan, GAN Minlei, YIN Xiaojian, WU Huipan, SHEN Jinbo, MA Yuanyuan, LI Jiawei, LI Yong, WANG Jinxian, LIU Yuan

2023, 44(5): 672-676. doi: 10.16835/j.cnki.1000-9817.2023.05.008

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Objective To analyze the correlation between physical activity and depressive symptoms in adolescents, so as to provide a reference for the early prevention of depression among adolescents. Methods Using a random cluster sampling method, 8 102 adolescents from Shanghai, Urumqi, Changsha and Kunming were investigated via the Physical Activity Assessment Questionnaire of Chinese Children and Adolescents aged 7 to 18 and the Center for Epidemiologic Studies Depression Scale (CES-D) for physical activity and depressive symptoms. Multivariate Logistic regression analysis was used to analyze the correlation between physical activity and depressive symptoms in adolescents. Results The proportion of adolescents who met moderate to vigorous physical activity (MVPA) standard was 37.0%, and the detection rate of depressive symptoms was 25.6%. The detection rate of depressive symptomsin compliant with MVPA standard group was significantly lower than that in non-compliant group among different age and gender(χ²=7.62-34.54, P < 0.05). Adolescents with severe depressive symptoms had high light-intensity physical activity(LPA) duration and low vigorous-intensity physical activity(VPA) duration, while adolescents with mild depressive symptoms or asymptomatic adolescents had higher MVPA duration. There were differences in LPA and VPA among adolescents with different levels of depressive symptoms in the overall sample, and the differences were still significant among girls, middle school and statistically significant differences in LPA, moderate-intensity physical activity(MPA), MVPA were also found among the high school subgroup. However, differences only in LPA were observed among boys with different levels of depression(H=46.48, 10.31, 25.02, 29.54, 30.25, 19.80, 22.20, 9.54, 8.62, 18.06, P < 0.05). Multivariate Logistic regression model showed that gender and duration of MVPA were significantly related to risk of depressive symptoms(OR=1.56, 1.42, P < 0.05). Conclusion Physical activity among adolescents is significantly related to depressive symptoms. MVPA may be an effective measure to reduce the degree of depressive symptoms.To improve the physical health and prevent depression among adolescents, it is important to choose appropriate physical activity types and effectively increase the duration of MVPA.

Correlation between family environment and depressive symptoms among adolescents

DING Ji, WAN Qin, GAN Minlei, YIN Xiaojian, WU Huipan, MA Yuanyuan, HOU Yuxin, LI Jiawei, LI Yong, LIU Yuan

2023, 44(5): 677-681. doi: 10.16835/j.cnki.1000-9817.2023.05.009

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Objective To understand the relationship between family environment and depressive symptoms among adolescent, and to provide a reference for adolescent mental health promotion and intervention. Methods From September to December in 2021, a questionnaire survey on family environment and depressive symptoms was conducted among 8 102 middle school students by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming. The Chi-square test was used to compare the depression status of students in different family environments. Multivariate Logistic regression analysis was used to explore the relationship between family environment and depressive symptoms. Results The detection rates of possible depression, likely depression and severe depression in adolescents were 11.2%, 5.9% and 8.4%, respectively. There were significant differences in the detection rate of depression by gender, academic period, urban and rural areas, family forms and only-child statu(χ²=87.60, 27.19, 6.65, 45.59, 4.78, P < 0.05). Logistic regression analysis showed that adolescents in single parent families (OR=1.45) and reorganized families(OR=1.69) were positively correlated with the occurrence of depressive symptoms compared with those in nuclear families(P < 0.01). Conclusion Compared with nuclear families, the risks of adolescent depressive symptoms in single-parent families and reorganized families are higher. Attention should be paid to the mental health education of teenagers from single parents and reorganized families to ensure the development of their physical and mental health.

Relationship between adolescents' sense of life purpose and depression: the moderating role of grade

WU Ning, ZHOU Ting, HUANG Zheng

2023, 44(5): 682-685. doi: 10.16835/j.cnki.1000-9817.2023.05.010

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Objective Exploring the relationship between adolescents' sense of life purpose and depression as well as the moderating effect of grade, in order to provide evidence for the situation of sense of life purpose among Chinese adolescents. Methods A total of 1 627 adolescents from grade 4 to 9 in Hebei and Yunnan provinces were selected as the research subjects by using convenient cluster sampling method. The survey was conducted by using the Depression Self-Rating Scale for Children and the Revised Youth Purpose Survey, and stratified regression was used for moderating effect analysis with a simple slope test. Results There were statistically significant differences in the score of depression among adolescents of different genders, mother's education level, father's education level, family economy and academic performances(t/F=-2.70, 3.62, 2.82, 13.67, 13.81, P < 0.01). There were statistically significant differences in the score of sense of life purpose among adolescents of different mother's education level, father's education level, family economy and academic performances(F=3.24, 4.27, 7.50, 9.39, P < 0.01). Correlation analysis showed that adolescents' sense of life purpose was significantly negatively correlated with depression(r=-0.38, P < 0.01). Hierarchical regression model results showed that adolescents' sense of life purpose significantly negatively predicted depression(β=-0.19, t=-5.93, P < 0.01). Grade played a moderating role between adolescents' sense of life purpose and depression(β=-0.34, t=-7.54, P < 0.01). The simple slope test showed that depression decreased as the sense of life purpose increased in primary school students(grades 4-6) and in middle school students(grades 7-9), and the decrease of the middle school students was greater(β=-0.19, -0.53, t=-5.93, -16.15, P < 0.01). Conclusion The sense of life purpose negatively predicted depression of adolescents, and grade moderated the relationship between the sense of life purpose and depression. Compared with students in grades 4-6, the improvement of life purpose of middle school students have a more significant protective effect on depression.

The total fluids intake among college students from Hebei Province in spring and summer

LU Junbo, ZHANG Jianfen, ZHANG Na, WANG Xing, LIU Shufang, MA Guansheng

2023, 44(5): 686-690. doi: 10.16835/j.cnki.1000-9817.2023.05.011

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Objective To analyze the total fluids intake and sources of college students from Hebei in spring and summer, and to provide a scientific reference for appropriate fluids intake in different seasons. Methods Subjects were recruited in a university in Baoding, Hebei Province, and investigations were conducted in April and June 2021. The number of people who completed both spring and summer investigations was 80. Quantitative instruments and 7-day 24 h Fluid Intake Questionnaire were used to investigate the total drinking fluids, and it was recorded for 7 consecutive days in spring and summer respectively. The duplicate portion method was used to investigate the water from food. The total fluids intake and sources among subjects were analyzed in spring and summer. Results There was no statistical significance between the total drinking fluids and total fluids intake between spring and summer [1 141(715), 1 176(649)mL/d, (2 496±604)(2 458±554)mL/d] (F=1.86, 0.59, P>0.05). Spring showed significantly higher water from food compared with summer [(1 318±274)(1 217±302)mL/d](F=16.63, P < 0.05). The proportions of total drinking fluids and water from food in spring were 46% and 54%, respectively, and both were 50% in summer, the differences were statistically significant (F=12.97, 12.97, P < 0.05). There were differences in total fluids intake, total drinking fluids and water from food of different genders in earch season (t/Z=4.75, -3.63, 3.44; 4.80, -2.91, 4.01, P < 0.05). There were differences in total water intake, total drinking fluids, the proportions of total drinking fluids and water from food of different BMI groups in each season (F/H=8.08, 16.65, 3.03, 3.03; 7.11, 17.97, 4.52, 4.52, P < 0.05). In spring, only 13.8% of subjects achieved the recommended total drinking fluids of China, compared with 18.8% in summer. In spring and summer, the total fluids intake, total drinking fluids, the proportions of total drinking fluids in the group achieved the recommendation were all higher than those who did not reach the recommendation (t/Z=6.64, -5.19, 5.79; 8.12, -5.97, 5.70, P < 0.05). Conclusion Season is a factor that affects total fluids intake, and it should be taken into account when setting the recommendation on adequate water intake.

Sugar-sweetened beverages knowledge and associated factors among primary and middle school students in Shenzhen

ZHANG Shuangxia, LI Yanyan, XIONG Jingfan, LI Yan, YAO Ping

2023, 44(5): 691-695. doi: 10.16835/j.cnki.1000-9817.2023.05.012

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Objective To explore the status of sugar-sweetened beverages(SSBs) and its associated factors among primary and middle school students in Shenzhen, providing reference for nutrition and health education. Methods A random number table and convenience sampling method was used to select 40 135 primary and middle school students aged 6-18 years in Shenzhen. Data was collected to investigate their SSBs knowledge and associated factors. Results The proportion of SSBs knowledge score less than 60 points, between 60-79 points and 80-100 points were 5.6%, 41.9% and 52.4%. Multivariate analysis showed that age(4-6 grade, junior middle and high school), gender(female), parents education(high school or vocational schools, colleges and universities as bachelors, masters or doctors), students pay attention to the ingredient list (seldom, none), parental dissuasion or reward behavior (only forced dissuasion, giving no dissuasion, occasional reward, no reward), and the storing beverages at home (seldom, none) were associated with total SSBs knowledge score and milk-containing beverage knowledge score (β=-0.79, -1.19, -1.74, 0.58, 1.20, 1.81, 2.98, 3.13, 2.70, 4.85, 6.34, 6.41, -0.99, -0.78, -1.81, -2.40, 5.85, 6.26, 0.61, 1.92, P < 0.05). Age(4-6 grade, junior middle and high school), gender(female), father's education background(with colleges and universities as bachelor, masters or doctors), mother's education background(high schools or vocational schools, colleges and universities as bachelors, masters or doctors), parents dissuation behaviors(giving no dissuation), parents' rewarding behavior(seldom, none), storing beverages at home(seldom, none) were associated with the total SSBs knowledge score and milk-containing beverage knowledge score(β=-0.68, -0.92, -0.49, 0.26, 0.51, 1.05, 1.09, 0.90, 1.93, 2.62, 2.55, -0.68, 0.93, 1.13, 0.21, 0.92, P < 0.05). Conclusion Primary and middle school students have moderate to high level of SSBs knowledge. It is necessary for students and their parents to learn more SSBs related nutrition healthy knowledge, and to reduce home availability of SSBs.

Association between eye-use behaviors and self-reported myopia in middle and high school students

WANG Meng, TAO Shuman, WAN Yuhui, WU Xiaoyan, XU Shaojun, TAO Fangbiao

2023, 44(5): 696-700. doi: 10.16835/j.cnki.1000-9817.2023.05.013

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Objective To analyze the association between eye-use behavior and self-reported myopia in middle and high school students, and provide the scientific basis for the prevention and control of myopia. Methods A total of 14 872 middle and high school students was selected from four provinces and cities from December 2015 to March 2016, including Jiangxi(Nanchang, Yintan, Dexing), Liaoning(Shenyang), Guangdong(Shenzhen), Henan(Zhengzhou) provinces. A self-administrated questionnaire was used to collect the basic information, self-reported myopia and eye-use behaviors among middle and high school students. The Chi-square tests were applied to compare the differences in self-reported myopia among middle and high school students with different characteristics. Multivariate binary Logistic regression models were used to analyze the association between eye-use behavior and self-reported myopia in middle and high school students. Results The self-reported myopia rate of middle and high school students was 68.5%, with 59.7% and 78.6% for junior high school students and senior high school students, respectively. After adjusting for the potential confounders, the Logistic regression models showed that middle and high school students who read and write with their heads down (OR=1.94, 2.32), middle and high school students who lie down or lie on stomach when using their eyes (OR=1.27, 1.28) had a higher risk of self-reported myopia (P < 0.01). There was a negative correlation between eye-use distance (reading and writing distance, distance from eyes to TV, mobile phone, or tablet) and self-reported myopia (OR=0.73, 0.70, 0.81; 0.61, 0.66, 0.76) in middle and high school students (P < 0.01). In addition, the risk of self-reported myopia was lower in middle school students with longer eye-to-computer distance (OR=0.77, P < 0.01). Conclusion There is a significant association between eye-use postures, eye-use distance and self-reported myopia in middle and high school students. Health education for the risk and behavior factors of myopia should be actively promoted to ensure the visual health of children and adolescents.

Preliminary development of Health Literacy Evaluation Scale for Pupils

JIA Bibo, HUANG Xiaoling, QI Tiantian, ZHU Guiyin, ZHU Fan, WANG Pei, ZHAO Tianjie, GUO Shihao, HU Bin, MA Yinghua

2023, 44(5): 701-705. doi: 10.16835/j.cnki.1000-9817.2023.05.014

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Objective To preliminarily develop Health Literacy Scale for pupils, providing a tool for dynamic monitoring and related health literacy research among pupils. Methods Through policy and literature review, the health literacy evaluation index system of pupils was established. Through two rounds of expert consultation, the evaluation index system and scale item pool of three levels in primary school were formed, and "Evaluation Scale 1.0" was developed. Through two panel discussions, health education experts, teachers and students were invited to provide advices on the content, expression and structure of scale 1.0, turning it into "Evaluation Scale 2.0", and completing the preliminary development of the scale. Results The health literacy assessment index system of primary school students includes three levels, including level-1 was Grade 1-2, level-2 was Grade 3-4, level-3 was Grade 5-6, covering two level indexes. The scale for primary school students contained five horizontal dimensions and four vertical dimensions. In the Delphi consultation, the response rate was 100%, and the authority coefficient was 0.85. After item selection and modification, the final version of level-1, level-2 and level-3 scales contained 36, 44 and 50 items respectively. Conclusion The development of Health Literacy Evaluation Scale for pupils has high applicability and practical value.

Establishment of a concise health index synthetic evaluation method for adolescents

XU Huiqiong, ZHANG Xinyu, LI Xiaoheng, CHEN Dingyan, ZHANG Xindong, WANG Xi, WAN Yuhui, TAO Fangbiao

2023, 44(5): 706-710. doi: 10.16835/j.cnki.1000-9817.2023.05.015

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Objective The aim of this study was to establish a comprehensive concise health index (CHI) for evaluating adolescents, so as to provide a basis for determining the overall health status of adolescents in China. Methods On the basis of a literature review and consensus among core researchers, adolescent CHI indicators in the following five dimensions were assessed: physical growth, physical fitness, common diseases, mental health and behavioral health. A total of 24 experts used an analysis hierarcgy process (AHP) to calculate the indicators' subjective weights. In addition, from October to December of 2021, two regions, A and B were selected to conduct empirical research, and the CRITIC method was used to calculate the objective weights of the indicators. Finally, the weight coefficients were determined through the AHP-CRITIC combination weight method, and comprehensive evaluation was performed with the TOPSIS method. Results Across academic period and genders, the combined weighted coefficients of the health indicators were as follows: BMI, 0.081-0.095; waist circumference, 0.070-0.081; relative grip strength, 0.101-0.108; myopia, 0.110-0.128; dental caries, 0.055-0.070; psychological symptoms, 0.240-0.262; physical exercise, 0.085-0.115; screen time, 0.097-0.111; and sleep duration, 0.086-0.103. The health index of middle school students in city A (0.626±0.065) was significantly higher than that in city B(0.613±0.066)(t=6.34, P<0.01). Conclusion The comprehensive adolescent CHI evaluation method has good consistency and application value, and may serve as a reference for adolescent health monitoring.

Physical activity of middle school students in January 2023 in Ningxia

YIN Ding, WANG Hui

2023, 44(5): 711-714. doi: 10.16835/j.cnki.1000-9817.2023.05.016

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Objective To investigate physical activity status and associated factors of middle school students in Ningxia in January 2023, and to provide references for the better development of physical activity among middle school students. Methods In February 1-7, 2023, a convenient sampling method was used to select 6 593 middle school students in 5 prefectural cities of Ningxia. Online questionnaires were used to investigate physical activity and its influencing factors in the previous month. Results The detection rates of sedentary behavior, light physical activity, moderate physical activity and vigorous physical activity was 92.25%, 4.66%, 2.72% and 0.38%, respectively. Multivariate Logistic regression analysis showed that being female, older age, overweight, obesity, COVID-19 infection, low-to-moderate family support, low-to-moderate level knowledge of physical activity, insufficient physical activity skills, insufficient physical activity equipment, long distance (>2.5 km or above) were associated with less physical activity (OR=1.22, 2.47, 1.89, 1.39, 2.32, 1.20, 2.61, 1.85, 1.45, 1.23, 1.26, 1.11, 2.05, 1.77, 1.14, 1.43, P<0.05). Conclusion The poor physical activity performance of middle school students in Ningxia is related to BMI, COVID-19 infection, physical activity knowledge and skills, distance from activity places, etc. The influencing factors should be actively controlled to promote students' physical health.

Relationship between family structures and adolescents' mental health and health-associated behaviors

ZOU Chaoyi, GUO Peirong, HUANG Jianping, YANG Jie, AN Na, LU Qingyun

2023, 44(5): 715-719. doi: 10.16835/j.cnki.1000-9817.2023.05.017

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Objective To explore the associations of family structure with adolescent mental health and health-associated behaviors, to support interventions to decrease the occurrence of psychological problems and adverse health-associated behaviors among adolescents in families without two parents. Methods The multi-stage stratified random cluster sampling method was used to select 18 700 adolescents of the 13 districts and cities from Jiangsu Province for a questionnaire survey on mental health and health-associated behaviors, to compare differences in mental health and health-associated behaviors among adolescents with different family structures. Results Among the adolescents, 82.1% had two-parent families, 8.6% had single-mother families, 4.0% had single-father families, and 5.3% had families with both parents absent. After controlling for age, urban/rural areas, gender, academic period and region, Logistic multivariate regression analysis showed that compared with adolescents from two-parent families, the incidence of depression, social anxiety and bullying on campus of adolescents with single-mother families increased significantly(OR=1.31, 1.15, 1.36, P < 0.05). Compared with adolescents in two-parent families, adolescents in families without two parents had significantly more types of health risk behaviors, and those in single-mother families had significantly less frequent intake of a healthful diet(OR=0.81), significantly more smoking(OR=1.20), drinking behaviors(OR=1.22), and significantly less moderate intensity physical activity (OR=0.84) and shorter duration of sleep(OR=0.87)(P < 0.05). Conclusion Psychological and health-associated problems were significantly higher among adolescents in families without two parents than in those with two-parent families. Psychological problems and adverse health-associated behaviors were particularly prominent among adolescents in single-mother families.

Comparison of emotional and behavioral problems of preschool children in only-child and multiple-child families/ FANG Hongying^*

FANG Hongying, GAO Hongqiong, XU Chengheng, GAO Xuemin, TANG Yinxia, CAO Yueting

2023, 44(5): 720-724. doi: 10.16835/j.cnki.1000-9817.2023.05.018

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Objective To explore the emotional and behavioral problems of different only-child and multiple-child families, and to provide a reference for developing effective parenting styles. Methods A stratified random cluster sampling method was adopted to investigate 2 647 guardians of preschool children in Tongling City from April to June, 2022. Children's emotional and behavioral problems were evaluated by using the self-designed parenting questionnaire and the Children's Strengths and Difficulties Questionnaire (SDQ) parent edition. Results The abnormal total score detection rate of emotional and behavioral problems of preschool children was 15.5%, and the rate of abnormal peer interaction was the highest (19.5%). In multiple-child families, the first-born child (17.5%, 20.4%), compared with the second and third child (11.5%, 9.5%), was more likely to exhibit conduct and hyperactivity problems (χ²=8.44, 29.75, P < 0.01). There were differences in parenting attitudes between only-child and multiple-child families(χ²=9.38, P < 0.05). The results of the Logistic regression analysis showed that more frequent parent-child discussion, the persuasive education and consistent family discipline strategy were negatively related to the emotional and behavioral problems of only-children and children in multiple child families (OR=0.15, 0.49, 0.38; 0.34, 0.40, 0.42, P < 0.05). However, harmonious family relationships were only negatively related to emotional and behavioral problems in only-children (OR=0.08, P < 0.01), and a higher education level among mothers was negatively related to emotional and behavioral problems in children from multiple child family environments(OR=0.30, 0.45, P < 0.05). Conclusion The emotional and behavioral problems are serious of preschool children in Tongling City, the psychological development of the oldest children from multiple child and only-child families should be actively followed, as this would help to promote a better understanding of the development of preschool children's physical and mental health.

Suicide attitude and related factors of college students with mental disorders in Shaoxing City

HUANG Lei, ZHENG Chunmei, PANG Luwei, ZHAO Yunfei, JIANG Haichao

2023, 44(5): 725-728. doi: 10.16835/j.cnki.1000-9817.2023.05.019

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Objective To analyze the suicide attitude and influencing factors of college students with mental disorders in Shaoxing City, and to provide a basis for improving the attitude of college students with mentaldisorders towards suicide. Methods From January 2018 to December 2021, 1 100 college students, among which 110 were previously confirmed by medical institutions to have mental disorders, were selected from two schools in Shaoxing, including Shaoxing University and Yuexiu Foreign Languages College, to participate in a questionnaire survey. Univariate and multivariate Logistic regression analysis were used to identify the main factors affecting the suicide attitude of college students with mental disorders. Results Univariate analysis showed that the influence of different nature of college students with mental disorders on suicide attitude was related to age, gender, origin, suicide ideation, whether suicidal thoughts can be controlled, impulsive personality type, problem solving style, the differences were statistically significant (χ²/t=9.01, 15.05, 5.90, 5.86, 6.47, 4.92, 13.48, P < 0.05). Multivariate Logistic regression analysis showed that age, gender, origin, suicidal ideation, uncontrolled suicidal thoughts, impulsive personality type, problem solving style were the main factors influencing the suicidal attitude of college students with mental disorders (OR=3.13, 3.06, 2.89, 3.22, 3.25, 3.13, 3.16, P < 0.05). Conclusion The main influencing factors of suicide attitude of college students with mental disorders in Shaoxing City can be impulsive personality type and problem solving and other factors. The selection of targeted treatment plan can improve the mental disorder condition of college students and promote the recovery of the disease.

Associations among physical activity, screen time and mental health in college students during the COVID-19 pandemic

YE Juan, ZHANG Yulin, ZHANG Yi, WU Xiaoyan

2023, 44(5): 729-732. doi: 10.16835/j.cnki.1000-9817.2023.05.020

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Objective The study was aimed at exploring the relationships among physical activity (PA), screen time (ST) and mental health in college students during the COVID-19 pandemic. Methods A total of 1 709 students from a medical college in Hefei were selected in April 2020. A self-designed questionnaire was used to investigate social demographic indicators, physical activity, screen time, and depression and anxiety symptoms. The relationships among physical activity, screen time and mental health in college students during the COVID-19 pandemic were assessed with a multivariate Logistic regression model. Results The prevalence of depression symptoms among college students was 29.0% (495 students), and the differences in the prevalence of depression symptoms among college students with different grades, different self-rated family economic status, and whether they lived with their parents were statistically significant (χ²=21.95, 15.85, 7.30, P < 0.05). The prevalence of anxiety symptoms was 19.8% (339 students), and there were statistically significant differences in anxiety symptoms among college students of different grades, gender, self-rated family economic status, and whether they lived with their parents (χ²=18.84, 7.80, 8.77, 9.27, P < 0.05). Multivariate Logistic regression analysis showed that 3 or more days per week with duration of physical activity ≥1 h and screen time at 1~ < 2, 2~ < 3, 3~ < 4 h/d reduced the risk of depression symptoms among college students [OR(95%CI)=0.72(0.57-0.90), 0.53(0.38-0.75), 0.57(0.42-0.76), 0.70(0.51-0.96)]. Screen time at 1~ < 2, 2~ < 3, 3~ < 4 h/d reduced the risk of anxiety symptoms among college students [OR(95%CI)=0.47(0.31-0.70), 0.65(0.46-0.90), 0.58(0.40-0.85)](P < 0.05). There was a correlation between the interaction of physical activity and screen time and mental health. Conclusion Low physical activity and short or long screen time durations are associated with elevated risk of depression and anxiety symptoms in college students.

Comparison of emotional and behavioral problems of only and non-only child in the kindergartens in Chengdu

REN Yan, ZHU Diling, YE Liwen, LI Chunrong, CHEN Yue, YANG Liu, QIN Chengjie, LUO Tongyong

2023, 44(5): 733-737. doi: 10.16835/j.cnki.1000-9817.2023.05.021

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Objective To analyze the emotional and behavioral problems and associated factors of the only and non-only child, and to provide some clues for further monitoring and intervention of psychological and behavioral development among preschool children. Methods Using a convenience sampling method, a total of 45 065 children enrolled in 153 kindergartens in 23 districts and counties of Chengdu were selected from May to June 2021 to investigate demographic characteristics and children's psycho-behavioral development through online questionnaires filled out by their guardians. The Chi-square tests were used to analyze whether the differences in abnormality rates of each dimension were statistically significant between the only and non-only children. The emotional and behavioral problems of only children and non-only children were analyzed by propensity score measurement. Results The detection rate of abnormal emotional behavior problems in children was 6.10%, including 6.34% in the only child group and 5.84% in the non-only child group. After matching, total difficulty score, and scores of emotional symptoms, conduct problems, hyperactive attention deficit, peer interaction, and social behavior differed between the only child group and the non-only child group (t=9.91, 8.97, 3.91, 15.57, -5.46, 4.08, P < 0.01). Conclusion In terms of the total score of difficulties, emotional symptoms, moral problems, and hyperactivity attention defects, the non-only child is better than the only child, but the opposite is true in terms of peer interaction and social behavior. Mental health conditions among the only child should be paid more attention. Whether or not the only child should be taken as an important consideration for preschool children's mental health care.

Effect of comprehensive intervention on executive dysfunction in children with attention deficit and hyperactivity disorder aged 7-14 years

LIU Xueqin, HU Chunhua, LUO Ye, ZHANG Pingping, HUANG Changrong, JI Huimei

2023, 44(5): 738-741. doi: 10.16835/j.cnki.1000-9817.2023.05.022

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Objective To analyze the improvement of executive function in children with attention deficit hyperactivity disorder (ADHD) aged 7-14 years with comprehensive intervention and drug therapy alone, to provide a basis for intervention research to improve ADHD. Methods A total of 80 children with ADHD treated in the Third People's Hospital of Ganzhou from January 2021 to June 2022 were randomly divided into intervention group and control group. The intervention group received drug and comprehensive intervention therapy, and sensory integration training once a week for 60 to 90 min each for 12 weeks, and conduct related training for caregivers and school teachers, the control group received only drug therapy. The changes of executive function were assessed by the stroop color-word association test and the Wisconsin Card Sorting Test (WCST) after 12 weeks of intervention. Results After intervention, the results of the Stroop color-word test in the intervention group (3.25±0.98, 4.92±1.40, 10.17±1.28) showed statistically significant differences (t=12.94, 15.36, 26.34, P < 0.01) compared with those before intervention (6.47±1.92, 8.35±1.25, 16.55±1.57). There were also statistically significant differences (t=6.76, 15.01, 16.15, P < 0.01) in the control group (3.95±1.01, 5.45±1.15, 12.35±0.86) compared to those before intervention (6.17±1.87, 8.10±1.03, 16.02±1.38). Before intervention, the number of perseverative errors, non-perseverative errors, and completed categories by WCST in the intervention group were (47.77±4.50, 35.50±2.37, 3.97±1.07), and in the control group were (46.45±7.34, 34.87±2.29, 3.70±1.11). After intervention, those of the intervention group and control group were (31.42±2.01, 24.75±2.05, 5.05±1.13) and (32.82±2.57, 25.55±1.04, 4.25±1.48), respectively. There were significant differences in the two groups before and after intervention (t=21.93, 22.27, -10.37; 10.84, 26.81, -6.90, P < 0.01). After intervention, there were significant differences in the number of Stroop color-word test errors, perseverative errors and non-perseverative errors in WCST between the two groups (t=-2.94, 2.29, -9.07, -2.35, -2.06, P < 0.05). Conclusion Through training for children and the therapy model of comprehensive intervention could significantly improve the executive function of children for a certain extent.

Bidirectional correlation between daily physical activity and emotional state of undergraduates majoring in sports

JIN Haigang, YANG Zhenhao, ZHANG Xiaodan

2023, 44(5): 742-746. doi: 10.16835/j.cnki.1000-9817.2023.05.023

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Objective To explore the bidirectional correlation between daily physical activity and different emotional states of university students with sports major, and to provide theoretical basis for promoting equality between physical and mental health of college students. Methods The accelerometer and daily emotion scale were used to evaluate 219 physical education major college students recruited from Tianjin University of Sport. Correlation analysis, intra-group correlation coefficient analysis and Harman single factor method were used to test the data, and Mplus 7.4 was used to analyze cross hysteria. Results Physical activity was positively correlated with high arousal/low arousal positive emotion, and negatively correlated with low arousal/high arousal negative emotion (r=0.94, 0.63, -0.28, -0.17, P < 0.05). The cross-lag model showed that physical activity on Thursday and Friday positively predicted high arousal positive emotion on Friday and Saturday, and high arousal positive emotion on Thursday and Friday positively predicted physical activity on Friday and Saturday(β=0.91, 0.20; 0.88, 0.39, P < 0.05). Low arousal positive emotion on Thursday and Friday was a positive prediction of physical activity on Friday and Saturday, but only physical activity on Thursday positively predicted low arousal positive emotion on Friday(β=0.68, 0.35, 0.70, P < 0.05). Low arousal negative emotion on Thursdays and Fridays negatively predicted physical activity on Friand and Saturdays(β=-0.37, -0.40, P < 0.05). Conclusion There is a bidirectional correlation between daily physical activity and positive emotion, but a weak correlation with negative emotion. Attention should be paid to the emotional benefits of physical activity and the increasing physical activity by greater mood improvements.

Prevalence of myopia and consistency evaluation of three myopia assessment methods among children and adolescents

XU Zihang, HU Yuanyuan, WEN Ying, WU Ziyun, YU Mingkun, TAO Fangbiao, BI Hongsheng

2023, 44(5): 747-750. doi: 10.16835/j.cnki.1000-9817.2023.05.024

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Objective To evaluate the prevalence and consistency of screening myopia, non-cycloplegic myopia and cycloplegic myopia in children and adolescents, and to provide references for exploring the factors affecting the consistency of different definition methods. Methods A total of 3 868 children and adolescents aged 6 to 17 years from seven schools were included in a school-based cross-sectional study in Shandong Province in September 2020. The prevalence of screening myopia, non-cycloplegic refraction, and cycloplegic refraction at different ages and all children and adolescents were analyzed. With cycloplegic spherical equivalent ≤-0.50 D as the gold standard for myopia, and Kappa test and area under the ROC curve were used to evaluate the consistency. Results The prevalence of cycloplegic myopia and screening myopia were 36.7% and 38.3% among children and adolescents. The prevalence of non-cycloplegic myopia was 62.4%, which was significantly higher than screening myopia and cycloplegic myopia two methods in primary and junior high schools. Among 3 868 subjects, there were 3 628 (93.8%) subjects with screening myopia and 2 862 (74.0%) subjects with non-cycloplegic myopia who were consistent with the gold standard for myopia. The Kappa values of screening myopia and non-cycloplegic myopia were 0.87 and 0.51, and the area under the ROC curve was 0.94 (95%CI=0.93-0.95) and 0.79 (95%CI=0.78-0.81). Compared with other groups, children and adolescents aged 8 to 17 years, in junior or high school, urban residence, better presenting distance visual acuity, and astigmatism ≤1.50 D had a higher consistency in the application of screening myopia (P < 0.05). Conclusion The consistency between screening myopia and cycloplegic myopia is high, and the consistency between non-cycloplegic objective myopia is low.

Potential categories of health risk behaviors of college students in Wuling Mountain Area and its association with campus bullying

WANG Aolun, ZHANG Tiancheng, XU Tao, GUO Shuyuan, ZHANG Fulan

2023, 44(5): 751-755. doi: 10.16835/j.cnki.1000-9817.2023.05.025

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Objective To understand the potential categories of harmful behaviors of college students in Wuling Mountain Area and its relationship with campus bullying, so as to provide a theoretical basis for promoting the development of college students' physical and mental health. Methods The stratified random cluster sampling method was used to select 3 042 college students from six universities in Wuling Mountain Area from October to December, 2022. The "Chinese Youth Health Related/Risk Behaviors Questionnaire" (University Edition) compiled by the National Youth Health Related/Risk Behaviors Survey Group was used to investigate the health risk behaviors. The potential category analysis method was used to analyze the food preference, insecurity, fighting, loneliness, depression, insomnia, heartbreak, suicidal ideation, smoking, drinking, game addiction, Internet addiction of health risk behaviors were used to further analyze the relationship between different categories and campus bullying by using multi category Logistic regression method. Results College students in Wuling Mountain Area were classified into low risk group of category 1 (44.2%), category 2 (5.4%) substance dependent group, category 3(50.4%) emotional disorder group. The distribution of potential categories of health risk behaviors among college students was statistically significant by gender(χ²=31.44, 11.69, P < 0.05). Logistic regression analysis showed that after controlling demographic variables, campus bullying was the risk factor of category 3 emotional disorder group(OR=1.88, P < 0.01). Conclusion Health risk behaviors of college students in Wuling Mountain Area show distinct cluster pattern, and each category has different association with campus bullying. Colleges and universities should attach great importance to the occurrence of campus bullying, formulate intervention programs for different categories of health hazard behaviors, and promote the healthy development of college students' physical and mental health.

Multiple correspondence analysis of the influencing factors of injury among left-behind primary school students in Pingliang

HUO Hong, JIA Xiping, LIU Tao

2023, 44(5): 756-760. doi: 10.16835/j.cnki.1000-9817.2023.05.026

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Objective To explore the distribution characteristics of the influencing factors of injury among left-behind primary school students, so as to provide a reference for identifying high-risk injury groups and carrying out accurate injury intervention. Methods From August 2021 to July 2022, a questionnaire survey was conducted among 3 769 students from grades 4 to 6 from nine primary schools in three townships in Pingliang City by using the a random cluster sampling method. Multiple correspondence analysis was used to analyze the influencing factors of injury. Results The detection rate of injuries among non-left-behind pupils was 21.8%(573/2 631), whereas the detection rate of injuries among left-behind pupils was 40.9%(466/1 138). In addition, a statistically significant difference was observed in the detection rate of injuries between left-behind pupils and non-left-behind pupils (χ²=146.21, P < 0.01). Among the injuries of left-behind pupils, 263 had fall-related injuries, accounting for the highest proportion (56.4%). Whether it was an only child, and different grades, gender, personality, psychological status, monitoring type, and maternal education level were statistically significant (χ²=39.05, 96.69, 143.00, 155.80, 461.39, 285.35, 17.10, P < 0.01). The multiple correspondence analysis category graph showed higher rates of fall injuries, blunt injuries and sharp injuries among boys, extroverted personality types, and left-behind pupils whose grandparents were their legal guardians. Animal bites, burns and other injury types were higher among left-behind pupils with an introverted personality, pupils in peer/other guardianship situations, and those with a sub-mental health status. Unharmed left-behind students mainly included those with intermediate personality and mental health characteristics. Conclusion The injury detection rate among left-behind primary school students is high. Gender, personality type, guardianship type, and mental health status are closely related to injury. Extroverted boys under grandparents guardians are identified as high-risk groups for injury prevention and control. Under the guidance of the precision prevention model, precision intervention strategies for all-round high-risk groups should be carried out in order to effectively reduce the occurrence of injuries among left-behind pupils.

Relationship between physical fitness and energy balance-related behaviors of primary school students in Shaanxi Province

LI Jiale, GAO Haining, CHANG Bo, CUI Ying, LIU Yang, JIANG Yan

2023, 44(5): 761-764. doi: 10.16835/j.cnki.1000-9817.2023.05.027

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Objective To explore the relationship between physical fitness and energy balance-related behaviors (EBRBs), and their influencing factors among primary school students, so as to provide a scientific basis for the improvement of physical fitness in primary school students. Methods By using a random sampling method, a total of 1 451 pupils aged 10-12 were selected from 8 regions of Shannxi Province (Fengxiang, Weibin, Danfeng, Shangzhou, Huazhou, Linwei, Gaoling, Weiyang). According to the total score of physical fitness test, pupils were divided into the excellent-good physical fitness group and the pass-failed group. The students' EBRBs and their influencing factors were investigated cross-sectionally, and the Mann-Whitney U test and stepwise linear regression analysis were used to explore the relationship between physical fitness and EBRBs. Results Breakfasts behavior(r=0.061) and physical activity behavior(r=0.105) among primary school students were positively correlated with total physical scores, with the excellent-good physical fitness group (757.56, 768.57)were higher than that of the pass-failed group(710.93, 705.67) (Z=-2.41, -2.69, P < 0.05). The screen behavior (r=-0.065) was negatively correlated with the total physical fitness scores, with the excellent-good physical fitness group (681.96) was significantly lower than the pass-failed group(747.04) (Z=2.78, P < 0.05). There was no statistically significant correlation between the frequency of beverage behavior and the total score of physical fitness (P>0.05). The excellent-good physical fitness group scored(762.22, 761.19, 758.82, 756.00, 761.20, 755.57, 761.52, 759.48, 781.78) higher than the pass-failed group(708.70, 709.19, 710.32, 711.67, 709.19, 711.88, 709.04, 710.01, 699.36) including health beliefs, parental norms and parental role models for breakfast behaviors, and preferences, self-efficacy, and self-regulation for physical activities, as well as self-efficacy, parental role models, family rules for screen behavior (Z=-2.40, -2.78, -2.35, -2.48, -2.52, -2.27, -2.35, -2.22, -3.65, P < 0.05). Conclusion The physical fitness of primary school students is affected by EBRBs. Parents should model positive behaviors in the family, promote the health behavior of primary school students, improve the physical health of primary school students health.

Screening analysis of flat foot disease among school-age children in Kunming City

ZHANG Yingjie, WU Tong, HUANG Jiazheng, ZHANG Zejin, LIU Luyun, XIONG Ying, XIAO Jiayu

2023, 44(5): 765-768. doi: 10.16835/j.cnki.1000-9817.2023.05.028

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Objective To investigate the prevalence of flat feet and associated factors in school-aged children in Kunming City, to provide evidence supporting the prevention of flat feet. Methods From December 2021 to February 2022, 4 444 children aged 7-13 in five primary schools in Kunming were screened for flat feet with the optical foot assessment and recording device. The incidence of flatfoot was counted, and Logistic regression was used to analyze the influencing factors of flatoccurrence. Results The overall prevalence rate was 29.10%, of which 21.79% were mild, 52.43% were moderate, 25.78% were severe, 89.10% were bipedal, and 10.90% were monopedal. The prevalence rates in the 7-year-old and 13-year-old groups were 36.91% and 10.43%, respectively, and the risk in the former was 5.00 times that in the latter(OR=5.00, 95%CI=3.22-7.52). The prevalence rates in rural and urban students were 38.53%, 22.46%, respectively, and the risk in the former was 2.17 times that in the latter(OR=2.17, 95%CI=1.90-2.47). The prevalence of flat feet in male and female students were 34.21%, 23.29%, respectively, and the risk in male students was 1.71 times higher than that in female students(OR=1.71, 95%CI=1.50-1.95). The incidence of flat feet correlated with BMI, and the risk of flat feet was higher in the group with overweight and obese groups than normal(OR=1.31, 1.10, P < 0.01). Conclusion The prevalence of flat feet in school-age children aged 7-13 years decreased with age. The prevalence and risk of flat feet is lower in girls than boys, and the incidence and risk of flat feet are lower in urban than rural children. The incidence of flat feet in most children is moderate, and the risk increased with increasing BMI. For school-aged children with flat feet, early prevention, detection and treatment are needed.

Association between incidence of injuries and health-related behavior among middle school students in five provinces in China

WANG Rongke, LYU Shuhong, XIANG Hu, YIN Chunyan, CHEN Qingqing, LIU Zhihao

2023, 44(5): 769-772. doi: 10.16835/j.cnki.1000-9817.2023.05.029

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Objective To explore the association between incidence of injuries and health-related behavior among middle school students in China, to provide evidence for injury prevention. Methods A questionnaire survey was conducted among 1 067 students who were selected from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou provinces by using stratified random cluster sampling method. Chi-square test and multiple Logistic regression analyses were used to analyze incidence of injuries and health-related behavior. Results The prevalence of self-injury among middle school students in five provinces was 11.0%, the prevalence of intentional injury was 13.2%. Multiple Logistic regression analyses showed that attempting smoking, not eating breakfast every day, having a low mood more than 2 weeks in the past 6 months were positively correlated with self-injury (OR=3.02, 2.04, 4.30, P < 0.01) after adjusting for region, and the smoking attempt behavior was positively correlated with intentional injury (OR=2.03, P < 0.05) after adjusting for region, urban and rural, residence condition, weekly allowance condition. Conclusion Smoking attempt behavior could be viewed as a shared predictor for both self-injury and intentional injury behavior among middle school students, smoking control intervention should be carried out actively among students.

Cohort study on different BMI and blood pressure levels in children and adolescents

YAO Lijuan, QU Jing, JIANG Weiwei

2023, 44(5): 773-777. doi: 10.16835/j.cnki.1000-9817.2023.05.030

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Objective To analyze the relationship between the baseline BMI level and body mass index (BMI) changes of primary and middle school students and the blood pressure level and the risk of elevated blood pressure after 8 years of follow-up(also known as the end-stage), so as to provide a basis for the prevention and control of blood pressure in children and adolescents. Methods The physical examination data of 9 748 primary and secondary school students were selected from a cohort study design in Longkou City, Shandong Province for 8 years from 2014 to 2022, and analyzed the association of baseline BMI level and BMI changes with end-stage blood pressure level and the risk of elevated blood pressure. Chi-square test was used to compare differences between groups, and the generalized linear model and Logistic regression model were used to analyze the effect of baseline BMI level and BMI changes on blood pressure level and elevated blood pressure after 8-year follow-up. Results Among non-overweight and obesity group at baseline, the prevalence of high blood pressure was 9.1%. Among the overweight and obesity group, the prevalence of high blood pressure was 12.0%. Under different BMI status at baseline, the incidence of high blood pressure in boys was higher than that in girls. Compared with the BMI-Z value≤-1 group, with the increase of BMI-Z value, the systolic blood pressure level and the risk of high blood pressure gradually increased; with the BMI change continuously low as the control, sustained high and increased groups showed an increased risk of end-stage high blood pressure (OR=4.00, 2.21, P < 0.01), and boys had a greater risk of elevated blood pressure. Conclusion Children and adolescents with higher baseline BMI level and increased BMI changes are at a higher risk of elevated blood pressure. Therefore, secondary school students should monitor the occurrence and development of blood pressure level in real time, and take comprehensive and effective measures to control the occurrence of elevated blood pressure level in childhood.

Epidemiological characteristics and secular trend of the HIV/AIDS cases among 15-24 years old population in Hefei from 2004 to 2022

SUN Jing, LI Wei, FENG Jinbao, YAO Hui, CHEN Liqin, WU Meng

2023, 44(5): 778-781. doi: 10.16835/j.cnki.1000-9817.2023.05.031

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Objective To investigate the characteristics of HIV/AIDS cases among 15-24 year old population reported in Hefei from 2004 to 2022, so as to provide insights into AIDS control among adolescents. Methods The epidemiological data regarding HIV/AIDS cases between 15 and 24 years old reported in Hefei from 2004 to 2022 were captured from the AIDS comprehensive prevention and control information system of Chinese disease prevention and control information system, and data regarding temporal distribution, population distribution, and routes of infections and detection were descriptively analyzed by descriptive epidemiological methods. Results From 2004 to 2022, 865 cases of HIV/AIDS were reported in Hefei among 15-24 years old youth, accounting for 21.80% of the total reported cases. Among the HIV/AIDS patients, males accounted for 92.60%(801 cases), the unmarried ones accounted for 93.41% (808 cases), those with college degree or above accounted for 60.12% (520 cases), and 25.78%(223 cases) of them were students. The proportion of student cases increased annually(χ_trends²=47.67, P < 0.01). Homosexual transmission accounted for 81.39%, both showed an increasing trend(χ_trends²=51.23, P < 0.01).Totally 55.49% of cases were found through testing and consultation, and the proportion of cases increased by year(χ_trends²=112.18, P < 0.01). In 2004-2022, the number of newly reported cases among people aged 15-24 showed a rising trend at an average rate of 24.46% by year(Z=4.92, P < 0.01), which was higher than the average rate of 21.54% for the entire population(Z=12.75, P < 0.01). Conclusion The epidemic of HIV/AIDS among population aged 15-24 years is serious in Hefei. Comprehensive measures for HIV education and prevention intervention are desperately needed to be reinforced among targeted students.

Research progress on the association between violet light and myopia

XU Xing, XU Shaojun, LIANG Li, TAO Fangbiao

2023, 44(5): 782-785. doi: 10.16835/j.cnki.1000-9817.2023.05.032

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Myopia has become a major global public health problem. Exposure to outdoor light may explain the protective effect of outdoor activities on myopia. Currently, a growing number of studies focus on the effects of the spectrum on eye health. Recent studies have found that violet light may have a protective effect on myopia, but the mechanism of action between violet light and myopia is not yet fully understood. The paper reviews the association between violet light and myopia prevention and control, and the possible mechanisms of violet light and myopia to provide a reference value for further exploration of the role of violet light on myo-pia.

Research progress on influencing factors of depressive symptoms in adolescents

WU Huipan, GAN Minlei, YIN Xiaojian, MA Yuanyuan, HOU Yuxin, ZHANG Xiang, LI Yong, WANG Jinxian, DENG Ting, ZHANG Yingkun, LIU Yuan

2023, 44(5): 786-790. doi: 10.16835/j.cnki.1000-9817.2023.05.033

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In recent years, mental health problems such as anxiety and depression among adolescents in China have attracted attention from all walks of life. Given that adolescence is a transitional and critical period for individual development, mental health affect the developmental opportunities. Therefore, in the review, the effects of environment, psychosocial factors and behavioral patterns on depressive symptoms are analyzed by combining with the characteristics of physical and mental development among adolescents. It is found that early adolescence and even childhood should be the key period for the prevention and intervention of depression. In order to formulate effective interventions and prevention strategies, it is proposed that future research should combine real situation in China with active exploration of protective factors and early predictors of depression.

Research progress on e-cigarette use among adolescents and associated factors

DENG Hui, ZHANG Lingyun, FANG Ling, YAN Xiaotao, ZHENG Pinpin

2023, 44(5): 791-795. doi: 10.16835/j.cnki.1000-9817.2023.05.034

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Abstract:
E-cigarette has become more and more popular among adolescents, and the awareness and use of e-cigarettes among middle and high school students have shown a significant upward trend. E-cigarette use is not only harmful to adolescent health, but also may become a gateway to other addictive substances. Individual characteristics, products features, environment and other factors were associated with e-cigarette use among adolescents. The purpose of the review is to understand the current status and associated factors of adolescent e-cigarette use, so as to provide scientific suggestions for the prevention of e-cigarette use among adolescents.

Research progress of fear of missing out in mobile social media among college students

WANG Niuniu, ZHANG Yufang, YANG Yuebo, MENG Wenqi, ZHANG Junfu, QIN Rongzhen, MA Shuang

2023, 44(5): 796-800. doi: 10.16835/j.cnki.1000-9817.2023.05.035

Abstract(273) HTML (171) PDF(57)

Abstract:
Fear of missing out is an emerging type of anxiety disorder in the context of the Internet and has showed significant impacts on physical and mental health of college students. The review provides an overview on the connotation, extension, and adverse effects, as well as potential underlying mechanisms of fear of missing out in mobile social media among college students, which aims to highlight future attention, as well as prevention and intervention reference on fear of missing out in college students.

2023 Vol. 44, No. 5