2024 Vol. 45, No. 1

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Science-driven application and transformation for telling better stories of school health research
TAO Fangbiao
2024, 45(1): 1-5. doi: 10.16835/j.cnki.1000-9817.2024020
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The global disease burden of health problems among children and adolescents is becoming increasingly serious and more prominent worldwide, this calls for a more intergrated and effective school health education, and services and system education should be strengthened. This editorial highlights the importance of problem-oriented school health research by telling two stories of school health, including identification of risk factors for health problems and evidence-based interventions. Using high-quality scientific evidence to promote best practices in school health, improve science-driven application and transformation, enhance capacity for comprehensive school health services, and empower child and adolescent health and wellbeing across China.
Promoting healthy lifestyles among children and adolescents to enhance primary prevention of non-communicable diseases
HU Yifei
2024, 45(1): 6-10. doi: 10.16835/j.cnki.1000-9817.2024031
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Healthy lifestyles are the most effective means of promoting the physical and mental health of children and adolescents. In China, unhealthy lifestyles, such as insufficient physical activity, inadequate sleep, poor dietary choices, smoking, and alcohol consumption are prevalent among this population, posing a threat to healthy growth and development. An initial review of global research examining healthy lifestyles reveals a continually evolving landscape, emphasizing the pressing need to update intervention strategies and theories for children and adolescents health promotion in China. The article presents the most recent state-of-the-art healthy lifestyle indicators and the development of healthy lifestyle intervention strategies. In the future, interventions and monitoring of the health lifestyles of children and adolescents should be conducted in conjunction with schools and families which provide optimal settings, while utilizing advanced methods such as the Internet and digital technologies, artificial intelligence, and integrated omics technologies incorporating genetics and the environment.
Historical transformation of healthy promotion patterns among children and adolescents in China
LIU Peijun
2024, 45(1): 11-15. doi: 10.16835/j.cnki.1000-9817.2024036
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In order to identify new pattern and experience of school health, and to elaborate on the progress and trends in children and adolescents' health promotion, the present article presents historical changes in health promotion approaches for children and adolescents in China, making strategic shift from "prevention and treatment of student common disease-centered" to "student healthy development-centered", fostering policy changes from "special school health services" to " comprehensive school health services", enacting the paradigm shift from "biomedical disease prevention and health care" model to "promoting social and behavioral success for learning" model, using various methods including needs analysis, trend research and judgment, system evaluation, and empirical evidence. The fast, substantial and extensive transformation delivers sustainable long-term value and will continue to respond to the needs of the times and make steady and long-term progress.
Status of prepackaged food intake and the association with growth and development in school-aged children of Chengdu City
HE Chunlei, LIU Xueting, WANG Yidi, LI Danting, WANG Xiaoyu, CHENG Guo
2024, 45(1): 16-20. doi: 10.16835/j.cnki.1000-9817.2024032
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  Objective  To determine the association between the intake of five major types of prepackaged foods and the growth and development of school-aged children, so as to provide a theoretical basis for guiding school-aged children and their parents to make healthy prepackaged food choices.  Methods  Based on data from the South-West China Childhood Nutrition and Growth Cohort (SCCNG), 381 children (6-11 years of age) were selected by stratified cluster sampling. Dietary intake and pubertal development were collected using questionnaires, and anthropometric measurements were obtained. Children were followed up until November 2022. Binary Logistic regression models were used to analyze the prospective association between prepackaged food intake and the growth and development of school-aged children.  Results  The total intake of the five major types of prepackaged foods was 316.1(197.1, 501.4) g/d. After 2 years of follow-up evaluations, 16.5% of school-aged children were shown to be overweight and obese. Early spermarche occurred in 12.6% of boys and early menarche occurred in 15.4% of girls. The following findings were suggested after adjusting for the mother's education level, average gross monthly family income, whether or not the family had one child only, geographic area of residence, body mass index Z score, average duration of daily exercise, and total dietary energy intake: convenience food intake might increase the risk of early spermarche (OR=9.37); fruit and vegetable intake might decrease the risk of early spermarche and menarche (OR=0.33, 0.17); and fish, poultry, meat, and egg intake might increase the risk of early menarche (OR=7.59)(P < 0.05). Intake of the five types of prepackaged foods was not associated with being overweight or obese after adjusting for confounders (OR=1.40, 0.57, 0.73, 1.33, 1.57, P>0.05).  Conclusions  The relationship between intake of the five major types of prepackaged foods and pubertal development is inconsistent and no significant correlation was detected between the intake of prepackaged foods and overweight or obese children. Nutrition education should be strengthened to help children and their parents choose healthy prepackaged foods.
Construction of Nomogram prediction model of myopia risk and lifestyle among primary school students in Tianjin City
LIU Shengxin, DU Bei, JIN Nan, TANG Chunyu, SONG Desheng, ZHANG Xin, WEI Ruihua
2024, 45(1): 21-24. doi: 10.16835/j.cnki.1000-9817.2024008
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  Objective  To explore the relationship between lifestyle and myopia and construct Nomogram model to predict myopia risk among primary school students in Tianjin, so as to provide a scientific basis for precision myopia prevention and control.  Methods  From April to July of 2022, a census method was used to conduct vision testing and lifestyle-related questionnaires among 373 180 primary school students in 15 districts of Tianjin. The relationship between lifestyle and myopia was analyzed by the multivariate Logistic regression, and a nomogram prediction model was constructed to predict myopia risk.  Results  The detection rate of myopia among primary school students in Tianjin was 37.6%. The results of the multivariate Logistic regression showed that daily outdoor activity time of 1-2 h (OR=0.94) and >2 h (OR=0.84), time of using daily electronic devices of >2 h (OR=1.03), daily paper materials reading and writing time of 1-2 h (OR=1.02) and >2 h (OR=1.09), weekly fresh vegetable intake of 2-6 times (OR=0.93) and ≥7 times (OR=0.88) were statistically correlated with myopia (P < 0.01). The Nomogram prediction model showed that the factors associated with myopia were grade, family history of myopia, gender, daily outdoor activity time, weekly frequency of fresh vegetable intake, daily paper materials reading and writing time, and time of using daily electronic devices time.  Conclusions  The lifestyle of primary school students in Tianjin is associated with myopia. The constructed nomogram model could provide a scientific basis for identifying key intervention populations for myopia prevention and taking targeted prevention and control measures.
Association of different sleep characteristics and cardiometabolic risk in college students
CAO Yuxuan, TAO Shuman, ZOU Liwei, YANG Yajuan, XIE Yang, LI Tingting, ZHANG Dan, QU Yang, ZHAI Shuang, TAO Fangbiao, WU Xiaoyan
2024, 45(1): 25-29. doi: 10.16835/j.cnki.1000-9817.2024014
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  Objective  To describe the association of different sleep characteristics and cardiometabolic risk among college students, so as to provide reference for health promotion of college students.  Methods  By random cluster sampling method, a questionnaire survey and physical examination including blood pressure, waist circumference and blood lipid indicators, which were conducted in April and May of 2019 among a total of 1 179 college students from the first grade in two universities in Hefei City of Anhui Province and Shangrao City of Jiangxi Province. A total of 729 college students with valid questionnaires were included into analysis. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to investigate sleep behavior, and the Morning And Evening Questionnaire-5 (MEQ-5) was used to investigate sleep characteristics. The cardiometabolic risk score was derived using the sum of the standardized sex-specific Z-scores of waist circumference, mean arterial pressure, HDL cholesterol (multiplied by -1), triglycerides, and insulin resistance index. The rank-sum tests were used to compare differences in cardiometabolic risk scores across demographic characteristics. Generalized linear models were used to compare the association of different sleep characteristics with cardiometabolic risk scores among college students.  Results  The average cardiovascular metabolic risk score of college students was -0.32(-2.03, 1.58). There were statistically significant differences in cardiovascular metabolic risk scores among college students in variables such as smoking, health status, and physical activity levels (t/F=-3.41, 12.88, 51.07, P < 0.01). The results of the generalized linear model showed that nighttime preference (B=1.89, 95%CI=1.02-3.49), insomnia symptoms (B=3.25, 95%CI=1.79-5.90), and short or long sleep duration (B=1.92, 95%CI=1.21-3.05) were positively correlated with the cardiovascular metabolic risk score of college students (P < 0.05).  Conclusions  Poor sleep patterns among college students are positively correlated with the risk of cardiovascular metabolism. The sleep behavior of college students should be actively changed to reduce the risk of cardiovascular disease.
Cardiovascular health status in Chinese school-aged children
WANG Xijie, ZOU Zhiyong, DONG Yanhui, DONG Bin, MA Jun, LIANG Wannian
2024, 45(1): 30-35. doi: 10.16835/j.cnki.1000-9817.2024037
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  Objective  The American Heart Association released the Life's Essential 8 (LE 8) for the overall evaluation of cardiovascular health (CVH) on individual level. The present study aimed to describe the overall CVH in Chinese school-aged children using LE 8 metrics.  Methods  Data of the present analysis came from a national-representative multicentered cross-sectional study conducted in 7 provinces of China in 2013. The original study used a multistage cluster sampling method. A total of 10 326 children aged 5 to 19 years with complete data of health behaviors and health outcomes were included in the study. Children's health behavior indicators included diet, physical activity, nicotine exposure and sleep health. Health outcome factors included body mass index, fast blood glucose, lipid profile and blood pressure.  Results  The median CVH score was 73.3 (IQR=14.4) in boys and 73.4 (IQR=13.5) in girls. Compared to children aged ≤9 years, the health behavior scores were lowest in the 13-15 age group, with boys scoring 7.73 lower (95%CI=-8.35--7.12, P < 0.01) and girls scoring 9.15 (95%CI=-9.83--8.48, P < 0.01) lower. The ≥16 age group had the lowest health outcome scores, with boys scoring 7.85 (95%CI=-9.07--6.63, P < 0.01) lower and girls scoring 6.11 (95%CI=-7.12--5.09, P < 0.01) lower.  Conclusions  Chinese school-aged children are generally at a moderate level of cardiovascular health. Specific LE 8 components vary substantially between groups and therefore require targeted intervention strategies.
Sex differences in cardiovascular health among children aged 6-8 years in Beijing City
GUAN Mengying, JIANG Xiaofeng, SHU Wen, LI Menglong, XIAO Huidi, ASIHAER Yeerlin, HU Yifei
2024, 45(1): 36-40. doi: 10.16835/j.cnki.1000-9817.2024029
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  Objective  To explore sex difference in the cardiovascular health (CVH) status of 6-8 year old children in Beijing, so as to inform the early intervention of CVH-related lifestyles.  Methods  Based on the Beijing Children's Growth and Health Cohort (PROC), baseline physical examination, sequential questionnaire survey, and laboratory tests were conducted among 1 914 grade 1 students. Children's CVH and its subscales (health behaviors and health factors) scores were calculated according to the Life's Essential 8 (LE 8) index and categorized into high, moderate, and low CVH. CVH scores were reported as medians and interquartile ranges; sex differences were compared using the Chi-square test and Wilcoxon test.  Results  Among the 1 914 participants, the percentages of high, moderate, and low CVH were 35.7%, 63.5%, and 0.8%, respectively, and the percentages of high, moderate, and low health behavior scores were 25.9%, 67.5%, and 6.6%, respectively, with no statistically significant differences between sex (χ2=2.30, 0.07, P>0.05). The rates of high, moderate, and low health factor scores for boys and girls were 61.1%, 36.0%, 2.9% and 71.1%, 28.4%, 0.5%, respectively, with a statistically significant sex difference (χ2=31.88, P < 0.01). The overall CVH score was 76.0(70.0, 83.0), 76.0(69.0, 82.0) for boys, and 77.0(71.0, 83.0) for girls. Among the health behavior metrics, sleep scores were the best and physical activity scores were the worst[100.0(90.0, 100.0), 40.0(20.0, 80.0)]; among the health factor metrics, blood glucose scores were the best and lipid scores were the worst[100.0(100.0, 100.0), 60.0(40.0, 100.0)]. In respect to health factors, there were significant gender differences in body mass index, blood lipids, blood sugar, and blood pressure scores (Z=-6.92, 3.01, -6.60, -2.30, P < 0.05), but there were no significant gender differences in diet, physical activity, nicotine exposure, or sleep scores with regards to health behaviors (Z=0.99, 0.88, -0.13, 0.36, P>0.05). Compared to boys, girls in the low and moderate CVH groups had high health factor scores despite low health behavior scores.  Conclusion  Most 6- to 8-year-old children in Beijing were found to have relatively good CVH, and optimization of children's CVH status can be achieved by promoting healthier lifestyles and monitoring health factors, especially among boys.
Mediating effects of metabolic-related indicators on the association between childhood overweight/obesity and left ventricular hypertrophy
LI Huiping, YANG Lili, ZHAO Min, XI Bo
2024, 45(1): 41-45. doi: 10.16835/j.cnki.1000-9817.2024033
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  Objective  To examine the mediating effects of blood pressure, glucose, lipids, and serum uric acid on the association between childhood overweight/obesity and left ventricular hypertrophy (LVH), and to provide scientific evidence for the prevention and control of cardiovascular diseases during childhood.  Methods  One public school in Huantai County, Zibo City was selected to conduct the baseline survey from November 2017 to January 2018 using a convenient cluster sampling method. A total of 1 400 children aged 6 to 11 were included in the study. According to the classification criteria based on body mass index (BMI), participants were divided into the non-overweight/obese group (n=787) and the overweight/obese group (n=613). The mediating effects of metabolic variables on the association between childhood overweight/obesity and left ventricular hypertrophy (LVH) were analyzed using the "mediation" package in R software.  Results  Children who were overweight/obese had higher levels of BMI-Z score (2.0±0.8), systolic blood pressure (SBP) (109.1±8.9 mmHg), diastolic blood pressure (DBP) (65.4±6.8 mmHg), fasting plasma glucose (FPG) (4.8±0.5 mmol/L), insulin (INS) (11.3±7.6 μU/mL), apolipoprotein B (ApoB) (0.7±0.2 g/L), low-density lipoprotein cholesterol (LDL-C) (2.4±0.7 mmol/L), total cholesterol (TC) (4.2±0.9 mmol/L), triglycerides (TG) (0.9±0.4 mmol/L), and serum uric acid (SUA) (321.2±91.4 μmol/L) compared to those who were non-overweight/obese [the corresponding values were (-0.2±0.7), (104.3±8.8) mmHg, (62.2±6.2) mmHg, (4.7±0.6) mmol/L, (6.1±4.2) μU/mL, (0.6±0.2) g/L, (2.2±0.6) mmol/L, (4.1±0.7) mmol/L, (0.7±0.2) mmol/L, and (278.6±74.7) μmol/L, respectively], whereas the levels of high-density lipoprotein cholesterol (HDL-C) were lower in overweight/obese children (1.5±0.3 mmol/L) than in non-overweight/obese children (1.7±0.4 mmol/L). All differences were statistically significant (t=53.66, 9.88, 9.19, 3.60, 16.32, 7.36, 5.11, 2.55, 11.08, 9.58, -10.31, P < 0.05). After adjusting for potential covariates, overweight/obese children had 8.72 times increased risk of developing LVH compared to the non-overweight/obese children (OR=8.72, 95%CI=5.45-14.66, P < 0.01). Mediation analysis showed that INS, HDL-C, LDL-C, TG, ApoB, and SUA partially mediated the association between childhood overweight/obesity and LVH, and among these, INS and TG had relatively strong mediating effects, accounting for 28.05% and 13.71% of the total effects, respectively.  Conclusions  INS, HDL-C, LDL-C, TG, ApoB, and SUA are intermediate risk factors on the association between childhood overweight/obesity and LVH. Keeping metabolic indicators (especially INS and TG) at healthy levels is particularly important for reducing the burden of cardiovascular diseases in overweight/obese children.
Sexuality education at kindergarten and primary and secondary school setting across China
LIU Wenli, LI Jiayang, LI Yiyang
2024, 45(1): 46-50. doi: 10.16835/j.cnki.1000-9817.2024004
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  Objective  To understand the current situation of school-based sexuality education, attitudes and evaluations of teachers and students toward sexuality education, so as to provide evidence for promoting the development of school-based sexuality education.  Methods  From September to October 2021, 2 140 valid data from students in basic education and 2 146 from kindergarten and primary and secondary school teachers were collected by online questionnaire. The data were described and statistically analyzed, and the influencing factors of teachers' willingness to teach sexuality education courses were explored by logistic regression analysis.  Results  About 52.06% of the students had not received sexuality education in school, and 47.53% of the teachers did not carry out sexuality education in the school. Sexuality education in schools mainly focuses on reproductive health and physical development. About 48.93% of the teachers thought that the implementation of sexuality education in schools was not good, and the proportion of high school students who thought sexuality education in schools were "very bad" (32.87%) or "not very good" (21.23%) was the highest. The teachers who undertook sexuality education were mainly mental health teachers (55.51% reported by teachers, 43.96% reported by students). About 71.02% of teachers believe that the best way to carry out sexuality education classes was to set up sexuality education curriculum. Students and teachers reported the need for sexuality education, and more than 50% of primary school students and high school students thought that sexuality education were "very needed" and "somewhat needed". About 51.77% of teachers considered sexuality education "very urgent". All increased recognition of sexuality education, confidence in answering sex questions, external support for sexuality education, and acceptance of sexuality education training increased the likelihood of teachers teaching sexuality education (OR=1.02, 1.95, 1.03, 3.53, P < 0.05).  Conclusion  The current situation of school-based sexuality education is not optimistic, the gap between sexuality education and students' needs is wide, and the abilities of sexuality education teachers are insufficient.
Changes of HIV knowledge and attitude among students in Beijing from 2018 to 2022
WANG Xinxin, LI Yanqi, XIAO Danchao
2024, 45(1): 51-54. doi: 10.16835/j.cnki.1000-9817.2024023
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  Objective  To explore the change of HIV knowledge, information access and attitude among college students in Beijing from 2018 to 2022, so as to provide reference for the formulation of targeted comprehensive prevention and control mesures for AIDS.  Methods  A stratified cluster random sampling method was used to select 3 098 undergraduate students in Beijing from January 2018 to December 2022, and a questionnaire was used to understand knowledge of HIV/AIDS among participants, information access and the attitude towards AIDS patients.  Results  The questionnaire showed that the awareness rate of college students who were correct in more than 8 questions regarding HIV/AIDS related knowledge showed an increasing trend from 2018 to 2022, which were 66.93%, 70.10%, 72.14%, 75.04% and 76.89%, respectively (P < 0.05). In the 5-year survey, the awareness rate of "sharing toothbrush, razor or acupuncture apparatus with others can be infected with AIDS" was the highest, accounting for 82.67%, 83.01%, 84.06%, 84.99%, 87.16%, respectively, and the difference was not statistically significant (χ2=6.14, P>0.05). The awareness rate of "using new drugs will increase the risk of HIV infection" was the lowest, accounting for 50.08%, 50.98%, 52.98%, 54.00% and 59.23%, and the difference was statistically significant (χ2=12.87, P < 0.05). From 2018 to 2022, the main access to HIV/AIDS information were the Internet, AIDS publicity materials, and family and friends' notification. The acquisition of HIV/AIDS knowledge through the Internet showed an increasing trend by year, accounting for 77.90%, 80.88%, 82.13%, 83.03% and 86.04%, respectively, with statistical significance (χtrend2=14.37, P < 0.05). Items of "choosing to gradually distance themselves after knowing that their friends around them are AIDS patients" "accepting to shake hands with AIDS patients", and "supporting and restricting activities of AIDS patients in public places" accounted for a relatively high proportion. During the year of 2018-2022, the diffences were not statistically significant (χ2=7.95, 2.45, 2.17, P>0.05).  Conclusions  HIV/AIDS knowledge among college students in Beijing from 2018 to 2022 needs to be improved. The Internet is the main way for college students to obtain HIV/AIDS knowledge. HIV/AIDS-related discrimination is high among participants. Comprehensive HIV-related knowledge education should be implemented to change the attitude of college students in Beijing.
Analysis of pre-exposure prophylaxis awareness, willingness, uptake patterns, barriers and needs among MSM students and its influencing factors
WANG Jianping, WEI Siyue, XIAN Yidan, ZHAO Jinhua, LIU Yuanyuan, LI Changping, YANG Jie, YU Maohe, CUI Zhuang
2024, 45(1): 55-59. doi: 10.16835/j.cnki.1000-9817.2024002
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  Objective  To explore the pre-exposure prophylaxis (PrEP) awareness, willingness, uptake patterns, barriers and needs among Chinese student men who have sex with men (MSM), so as to provide relevant evidence for targeted interventions with PrEP.  Methods  A proportional sampling method was used to conduct a cross-sectional survey of MSM aged 16 years and older residing in 21 provinces, municipalities, and autonomous regions in mainland China between October 20 and December 20, 2021, to collect information on demographic and sexual behavioral characteristics, and 923 students of them were selected as the subjects of this study. The chi-square test and Fisher's test were used for univariate analysis, followed by multivariate Logistic regression to analyze the influencing factors of PrEP awareness and uptake.  Results  According to the cascade analysis method, the awareness, willingness, uptake and adherence rates of PrEP among the student MSM were obtained as 88.95%, 67.36%, 13.20% and 45.21%, respectively. HIV testing more than once in the last 3 months, and all of them were aware of the HIV test results of their sexual partners, and those with high frequency of condom use had a higher rate of awareness (OR=2.32, 1.79, 1.69, P < 0.05). Willingness rates were higher for those from the pilot city, using substances, and HIV testing more than once in the last 3 months (OR=2.13, 1.65, 1.69, P < 0.05). Higher rates of uptake were found among those from high-risk and pilot areas, presence of commercial sex, substance use, and high literacy (OR=5.60, 3.54, 2.81, 1.92, 4.54, P < 0.05). Adherence rates were higher among those who used one pill per day or both (OR=12.77, 13.26, P < 0.05). The barriers and needs faced by student MSM were primarily personal concerns about medication side effects, preventative effects, and confidence in sexual behavioral styles, and the high cost of medication and related service costs.  Conclusions  The student MSM population in China is characterized by high awareness, low willingness, low uptake, and low adherence to PrEP. Targeted interventions should be considered and tailored by the departments to facilitate PrEP promotion among student MSM.
The effect of mini-basketball on upper limb strength performance in children aged 4-6 years: a Meta-analysis
LIU Shengnan, AN Jing
2024, 45(1): 60-65. doi: 10.16835/j.cnki.1000-9817.2024017
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  Objective  To systematically evaluate the effect of mini-basketball on children's upper limb strength in China, and to provide basis for the development of kindergarten mini-basketball and the improvement of children's upper limb strength performance.  Methods  CNKI, Wanfang Data, VIP, PubMed, and Web of Science databases were searched from the establishment of the database to July 26, 2023. The PICOST model was used for literature screening, and 13 literature with a total of 20 studies were finally included. The Cochrane System Evaluation Criteria was used for literature quality evaluation. Review Manager 5.4 and Stata 17 were used for statistical analysis and publication bias test.  Results  A total of 939 children were included in 20 studies, including 470 in the experimental group and 469 in the control group. Meta-analysis showed that mini-basketball had an extremely significant effect on the improvement of children's upper limb strength (SMD=0.83, 95%CI=0.53-1.13, Z=5.40, P < 0.01). The results of subgroup analysis showed that there was no significant gender difference in the improvement of children's upper limb strength by mini-basketball (P>0.05), mini-basketball exercise with an intervention time of less than or equal to 30 minutes (SMD=0.49, 95%CI=0.29-0.70, Z=4.70, P < 0.01) and an exercise cycle of more than 12 weeks (SMD=1.25, 95%CI=0.54-1.96, Z=3.45, P < 0.01) can achieve a better intervention effect on the upper limb strength of children. Meta-regression results showed that the exercise intervention time was the main source of heterogeneity (t=2.71, 95%CI= 1.38-22.93, P < 0.05). Egger's test showed that the publication bias of the included studies was not statistically significant (t=0.78, P>0.05).  Conclusions  Mini-basketball training can improve the upper limb strength of children, but there is no significant gender difference. The upper limb strength is affected by the restriction of intervention time and exercise cycle. Schools can appropriately add small basketball in physical education classes to improve children's upper limb strength.
Latent classes and associated factors of suicidal ideation among high school students
SU Liyan, MA Jun, YANG Yaming, JIANG Xuanli, WANG Xiaoyu, SHENG Jiating, LIU Fangdu, LI Minhui, ZHANG Xujun
2024, 45(1): 66-71. doi: 10.16835/j.cnki.1000-9817.2024034
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  Objective  To understand current situation epidemiology and associated factors of suicidal ideation among high school students in Yixing, so as to provide basis for targeted intervention.  Methods  From March to May 2019, a questionnaire survey was conducted on 12 799 students from 3 junior high schools and 4 senior high schools in Yixing City, Jiangsu Province, using a stratified cluster random sampling method. Latent profile analysis was used to classify suicidal ideation among high school students, the chi-square test was used to compare the differences in suicidal ideation among different characteristics of students, multiple Logistic regression was used to analyze influencing factors, a risk predictive nomogram model was constructed and then verified.  Results  Three latent classes of suicidal ideation among high school students was divided into three categories were observed: none or mild, moderate, and severe. Among them, 3 034 (23.7%) had moderate suicidal ideation and 753 (5.9%) had severe suicidal ideation. The Logistic regression results showed that gender was female, academic performance was lower mid-range, smoking, drinking, popularity with classmates(less popular and unpopularity), family member relationships(general/occasional contradictions/contradictions), trust in others(more trusted/less trusted/less trusted at all), past or current relationships, physical bullying, relationship bullying, verbal bullying, and sexual bullying were the influencing factors for severe suicidal ideation among students (OR=3.27;2.18;1.63;1.72;2.66, 6.05;3.00, 3.29, 6.38;1.71, 6.04, 12.48; 2.50; 1.59; 2.16; 1.45; 1.63, P < 0.05). The nomogram prediction model had good discrimination.  Conclusions  Suicide ideation is influenced by multiple factors. Family and peer situations, as well as being bullied, are all related to the degree the severity of suicidal ideation. Efforts can be made to improve students' family and interpersonal relationships, control bullying, then reduce their suicidal ideation which might help prevent suicide ideation among students.
Association of 24-hour movement behaviors with emotional and behavioral problems among left-behind children
LOU Jiaying, WANG Yunfeng, LI Rui, ZHOU Yulan
2024, 45(1): 72-76. doi: 10.16835/j.cnki.1000-9817.2024039
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  Objective  To examine the association of 24-hour movement behaviors with emotional and behavioral problems among left-behind children, so as to provide a theoretical reference for the practice of 24-hour activity interventions to promote emotional and behavioral problems in this population.  Methods  From February to May 2023, 1 117 left-behind children in grades 4-6 from 10 primary schools in five cities in Zhejiang Province were selected using a convenient cluster sampling method to conduct a questionnaire survey examining 24-hour movement behaviors, as well as emotional and behavioral problems. The general linear model was adopted to analyze the association between satisfying the 24-hour movement behavior guidelines, and emotional and behavioral problems among left-behind children.  Results  The sleep duration compliance rate was the highest (52.19%), while the moderate-to-vigorous PA (MVPA) compliance rate was the lowest (17.73%). The compliance rate of the three activities accounted for 7.43%. There was a dose-response between the number of guidelines satisfied, and the emotional and behavior of left-behind children; that was, satisfaction of a higher number of guidelines was associated with a lower risk of emotional and behavioral problems among left-behind children (difficulty factor: β=-0.56, 95%CI=-1.23--0.19; strength factor: β=0.50, 95%CI=-0.48-1.22, P < 0.01). Compared to satisfying none of the guidelines, satisfying the guidelines for screen time (β=-0.23, 95%CI=-2.18--0.14) and sleep duration (β=-0.13, 95%CI=-1.66--0.11) was negatively correlated with the difficulty factor, while satisfying the guideline for MVPA (β=0.13, 95%CI=0.09-1.08) and sleep duration (β=0.18, 95%CI=0.09-1.40) was positively associated with the strength factor. In addition, satisfying two or all three of the guidelines was more strongly associated with these outcomes than satisfying one of the recommendations (P < 0.01).  Conclusions  Meeting the 24-hour movement behavior guidelines can improve emotional and behavioral problems among left-behind children. It is necessary to raise their awareness of the effect of satisfying the 24-hour movement behavior guidelines and formulate comprehensive intervention measures.
Association between subthreshold depression and psychotic-like experiences with non-suicidal self-injury among adolescents in Shandong Province
MIN Linggui, LIU Xiaoqun, YIN Xunbao, YU Yue, WANG Zheng
2024, 45(1): 77-81. doi: 10.16835/j.cnki.1000-9817.2024035
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  Objective  To investigate the association between subthreshold depression, psychotic-like experiences (PLEs), and their interactions with non-suicidal self-injury (NSSI) in adolescents from Shandong, so as to provide a reference for the prevention and early intervention of NSSI in adolescents.  Methods  A random cluster sampling method was used to select a total of 6 090 adolescents aged 13-22 from two cities along the coast and inland of Shandong Province. Electronic surveys were administered using the Self-Injurious Behavior Questionnaire, Community Assessment of Psychic Experience-positive 8 items(CAPE-P8), and the Center for Epidemiological Studies Depression Scale(CES-D). The relationship between subthreshold depression, PLEs, and their interaction with NSSI was analyzed using multivariate Logistic regression.  Results  The detection rate of NSSI among adolescents was 21.3%. The highest NSSI reporting rate (27.9%) was found in the age group of 13-15 years.The NSSI reporting rates for those detected with subthreshold depression and PLEs were 49.9% and 30.7%, respectively. Multivariate analysis indicated that individuals with subthreshold depression were 3.47 times more likely to engage in NSSI [OR(95%CI)=3.47(2.68-4.50)]. Those identified with PLEs had 5.32 times higher risk of engaging in NSSI than those without such experiences [OR(95%CI)=5.32(4.10-6.89)]. When both subthreshold depression and PLEs coexist, the risk of engaging in NSSI was 18.47 times higher than in individuals with neither condition [OR(95%CI)=18.47(14.75-23.13)] (P < 0.01). The relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were 11.44, 0.61, and 2.89, respectively, indicating that the combined interaction of subthreshold depression and PLEs accounted for 61% of adolescent NSSI.  Conclusions  Subthreshold depression and psychotic-like experiences are associated NSSI in adolescents and exhibit an additive interaction. Alleviating subthreshold depression in adolescents and reducing psychotic experiences may play a positive role in preventing the occurrence of NSSI.
Association of perceived social support and emotional regulation among college students
GU Manli, XU Jida, JIANG Maomin, LI Zhixiang, ZHANG Honglai
2024, 45(1): 82-86. doi: 10.16835/j.cnki.1000-9817.2024016
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  Objective  To understand the current situation of college students' emotional regulation and its correlation with perceived social support, so as to provide a reference for improving emotional regulation ability among college students.  Methods  From September 15 to October 15, 2022, a total of 15 560 students from 27 colleges and universities in Guangdong, Jiangsu, Shandong, Shanghai, Anhui, Hebei, Yunnan, Shanxi and Gansu were enrolled by stratified random sampling method. The Perceived Social Support Scale (PSSS) and the Emotion Regulation Questionnaire (ERQ) were used to investigate, and multiple stepwise regression was used to explore the relationship between perceived social support and emotion regulation of college students.  Results  The scores of emotion regulation, cognitive reappraisal and expression inhibition were 44(40, 50), 24(20, 28) and 20(19, 24) respectively. There were significant differences in the scores of emotion regulation, cognitive reappraisal and expression inhibition by age, grade, household registration, only-child status, cost of living, and sleep (H/Z=77.72, 49.73, -5.10, -9.77, 7.68, 168.27; 204.55, 317.32, -5.96, -7.60, 131.20, 968.08; 82.18, 148.04, -2.30, -8.03, 64.82, 188.08, P < 0.05). In addition, the multiple stepwise regression found that family support, friend support, and other support in perceived social support all had a positive impact on the emotional regulation state of college students (β=0.137, 0.207, 0.090), and family support and friend support had a significant positive effect on expression inhibition(β=0.079, 0.053) and cognitive reappraisal(β=0.153, 0.296)(P < 0.01).  Conclusion  The perceived social support can directly affect the emotional regulation of college students, and improving the emotional regulation ability has a positive significance to promote the mental health level among college students.
Influence of group psychological counseling on mental health of children with authoritarian mothers
MENG Liangliang, ZHAO Yanhua, GAO Chuanxia, GUO Xuping, ZHANG Yilei, ZHOU Guihua
2024, 45(1): 87-90. doi: 10.16835/j.cnki.1000-9817.2024019
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  Objective  To explore the influence of group psychological counseling on the mental health of children with mother's authoritarian parenting.  Methods  From November 2022 to February 2023, 76 students from grades 4 to 6 whose mother showed authoritarian parenting style, while fathers adopted no authoritative, authoritarian or democratic parenting style and who scored ≥65 on the total MHT were selected using the Parenting Style Questionnaire (PBI) and the Mental Health Diagnostic Test (MHT). All the participants and their mothers were randomly assigned to the intervention and control groups. Before and after the intervention, participants filled out questionnaires on parental bonding instrument and mental health test. Control group: regular delivery of mental health education information, 2 times per week, for 8 weeks, without any other intervention. Intervention group: group counseling activities were conducted once a week. Each intervention lasted 1.5-2 hours and lasts for 8 weeks. Before and after the intervention, participants filled in the family parenting style and mental health screening questionnaires.  Results  After the intervention, compared with the control group, students in the intervention group showed a significant decrease in the total scale score of the MHT, learning anxiety, social anxiety, allergic tendency, physical symptoms, fear tendency, and impulsive tendency (t=-0.43, -1.04, -0.81, P>0.05). After intervention, the intervention group students showed a significant decrease in psychological diagnosis test scores, learning anxiety, anxiety towards others, allergic tendencies, physical symptoms, phobic tendencies, and impulsive tendencies compared to the control group students (t=-20.00, -5.06, -2.09, -3.36, -6.15, -4.76, -5.15, P < 0.05).  Conclusion  Rregular group psychological counseling can effectively improve the academic anxiety, social anxiety, allergic tendencies, physical symptoms, fearful and impulsive tendencies of students whose mothers with authoritarian parenting style, and greatly improve their mental health.
Association of attention deficit hyperactivity disorder symptoms and bullying behavior in children
TANG Jun, WU Xufang, ZHOU Yang, YANG Weiwei, ZHANG Yan, ZHANG Li, LYU Na, SONG Ranran
2024, 45(1): 91-94. doi: 10.16835/j.cnki.1000-9817.2024001
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  Objective  The association between school bullying and attention deficit hyperactivity disorder (ADHD) symptoms among students in primary schools and the moderating role of gender was explored to provide scientific evidence for the prevention and control of school bullying.  Methods  A total of 4 764 students from 2 primary schools in Wuhan were selected using the convenience sampling method in March 2023. The Olweus Bully/Victim Questionnaire and Strengths and Difficulties Questionnaire were used. A Pearson χ2 test was used to compare differences in school bullying rates among children with and without ADHD symptoms. Pearson correlation analysis and Process 3.3 were used to analyse the association between ADHD symptoms, and school bullying behaviour and the moderating role of gender.  Results  The reported rate of bullying victims in primary schools was 24.2% and the rate of bullying perpetration was 3.8%. The rate of ADHD symptom detection among primary school students was 5.9%. ADHD symptoms were positively associated with bullying and bullying victim behaviour (r=0.16, 0.27, P<0.01). Specifically, the association between ADHD symptoms and bullying behavior tended to be stronger among boys than girls (βboy=0.17, t=11.13; βgirl=0.07, t=4.11, P<0.01).  Conclusions  ADHD symptoms are an important factor influencing school bullying behaviors in students, and gender moderates the association. In the process of preventing and controlling school bullying, ADHD symptoms and gender differences should be emphasized and comprehensive interventions should be implemented.
Analysis of influencing factors of asymptomatic arrhythmia in college students
GAO Junying, HAN Meng, CAO Haiying
2024, 45(1): 95-98. doi: 10.16835/j.cnki.1000-9817.2024010
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  Objective  To research the prevalence and influencing factors of asymptomatic arrhythmia among college students, and provide scientific basis for heart rate control and health management of asymptomatic arrhythmia among college students.  Methods  Using cluster sampling method, 3 012 college students who studied in the First Clinical Medical College of Henan University of Traditional Chinese Medicine and the Second Clinical Medical College of Henan University of Traditional Chinese Medicine were selected as the research objects from September to November 2022. After entering school in autumn (September in 2022), all college students were investigated by questionnaire, and the general data and living habits of asymptomatic arrhythmia college students and normal college students were compared. Logistic regression was used to analyze the influencing factors of asymptomatic arrhythmia among college students.  Results  A total of 62 patients with asymptomatic arrhythmia were found. The detection rates of the patients with body mass index(BMI)≥24.0 kg/m2, systolic blood pressure(SBP)≥120 mmHg, diastolic blood pressure(DBP)≥80 mmHg, family history of cardiovascular disease, smoking, drinking, exercising less than three times a week, heavy study pressure, irregular work and rest, depression tendency and anxiety tendency were 5.58%, 4.49%, 5.63%, 6.18%, 4.26%, 4.50%, 3.72%, 4.29%, 4.28%, 9.15%, 9.03%, which were significantly higher than those of patients with BMI<24.0 kg/m2, SBP<120 mmHg, DBP<80 mmHg, no family history of cardiovascular disease, no smoking, no drinking, exercise more than three times a week, little study pressure, regular work and rest, no depression tendency and no anxiety tendency (1.20%, 1.37%, 1.35%, 1.53%, 1.55%, 1.59%, 1.27%, 1.52%, 1.38%, 1.71%, 1.71%), and the differences were statistically significant (χ2=45.33, 25.20, 37.74, 32.24, 16.69, 17.25, 19.57, 17.83, 22.36, 37.23, 39.42, P<0.01). Logistic regression analysis showed that the higher of BMI, SBP and DBP, family history of cardiovascular disease, smoking, drinking, times of exercise, heavy study pressure, irregular work and rest, depression tendency and anxiety tendency were positively correlated with asymptomatic arrhythmia of college students (P<0.05).  Conclusions  The higher of BMI and blood pressure, family history of cardiovascular diseases, bad living habits and psychological status are related to asymptomatic arrhythmia in college students. It is of great significance to control weight and blood pressure reasonably and maintain good living habits and mental state for preventing and improving asymptomatic arrhythmia.
The moderating role of estradiol in the relationship between parenting styles and preschool children's behavioral problems
XIA Moyan, YAN Chao, DONG Suhua, TANG Jinhui, LIU Ying, SONG Xingxing, TAO Lan, YAO Rongying
2024, 45(1): 99-103. doi: 10.16835/j.cnki.1000-9817.2024007
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  Objective  To explore the moderating role of estradiol in the relationship between parenting styles and preschool children's behavioral problems, so as to provide a theoretical basis for improving the development of human's emotional health development in early life stage.  Methods  During September to November in 2022, 354 children aged 3-6 years and their parents from two kindergartens in Bengbu City were chosen by using stratified cluster sampling method for the questionnaire survey. The Parenting Style Scale and the Child Behavior Checklist (CBCL) were used to collect information on parenting style and child behavioral problems. Salivary estradiol of children was collected and tested. Independent samples t test was applied to compare the scores of the scale for parental up-bringing and children's behavioral problems, and Pearson correlation analysis was conducted to explore the relationship among parental up-bringing, estradiol and children's behavioral problems.  Results  Parents' doting, laissez faire, autocratic, and inconsistent parenting styles were positive associated with child behavior problems(r=0.14-0.70); fathers' democratic parenting style was negatively associated with child behavior problems(r=-0.14, -0.22, -0.21, -0.17, -0.27, -0.20); mothers' democratic parenting styles was negatively correlated with scores on all five dimensions of child behavior problems except the withdrawal dimension (r=-0.14, -0.12, -0.13, -0.21, -0.12)(P<0.05). Estradiol levels had significant moderating effects on maternal doting parenting style and children's withdrawal (β=0.68) as well as social problems (β=-1.00), also moderating laissez-faire parenting styles and children's withdrawal problems (β=0.75)(P<0.05). For children with low levels of estradiol, withdrawal problem scores were negatively associated with mother's doting parenting style and positively associated with laissez faire parenting style, and socialization problem scores were associated with mother's doting parenting style; for children with high levels of estradiol, withdrawal problem scores were positively associated with mother's doting parenting style, and socialization problem scores were associated with mother's doting parenting style (t=2.84, 6.24, 3.16, 2.37, 4.49, P<0.05).  Conclusions  Parenting styles are strongly associated with child behavioral problems; estradiol levels play a moderating role in mothers' doting, laissez faire parenting styles and children's withdrawal problems and social problems.Parents should adopt more positive parenting styles and focus on the role of estradiol levels in maternal education to reduce the occurrence of behavioral problems in children.
Correlation between stool form and diversity of intestinal flora among children and adolescents
WANG Bing, WU Yan, JIN Hui, PI Xionge, LIU Wei, XU Yongjie, ZHAO Gang
2024, 45(1): 104-109. doi: 10.16835/j.cnki.1000-9817.2024018
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  Objective  To investigate the differences and diversity changes in gut microbiota between children and adolescents with constipation and diarrhea, and healthy individuals, and to explore the correlation between changes in stool consistency and gut microbiota, in order to provide a scientific reference for the research on intestinal microecology among children and adolescents.  Methods  From October 2021 to March 2022, a total of 42 children and adolescents with constipation and 37 with diarrhea from a tertiary hospital in Hangzhou City, and 43 healthy individuals from 3 primary and secondary schools were included in this study. Fecal samples of children and adolescents were collected and then stool genomic DNA was extracted for 16S rRNA gene high-throughput sequencing, and the sequencing results were analyzed. In the analysis of alpha diversity, the Kruskal-Wallis rank sum test was used to compare the differences between the three groups, and the FDR multiple testing correction was used for pairwise comparisons. In the analysis of beta diversity, the Adonis test was used to compare the overall differences between the three groups, and the ANOSIM test was used for pairwise comparisons. In the LEfSe analysis, the LDA scores obtained through LDA analysis (linear regression analysis).  Results  Alpha diversity analysis showed that there were statistically significant differences in the Shannon index (4.01, 3.81, 4.19) and Simpson index (0.05, 0.06, 0.04) between the diarrhea group, constipation group, and healthy group (H=6.05, 6.35, P<0.1). Further pairwise comparison showed that the Shannon index and Simpson index of the healthy group were higher than those of the constipation group (P<0.1). Beta diversity analysis showed that the impact of grouping factors on inter-group differences was statistically significant (R2=0.045, P<0.1). Community composition analysis showed that there were 234 species in total among the three groups, and 36 unique species in the healthy group, 36 species in the diarrhea group, and 48 species in the constipation group. Species difference analysis showed significant differences in species composition at the genus level among the three groups (H=0.000 05, 0.000 16, 0.000 20, 0.000 21, 0.000 53, 0.001 39, P<0.1), including Lachnospiraceae of Firmicutes phylum, Eubacterium hallii, Veillonellaceae, Qscillospiraceae, Butyricicoccaceae and Staphylococcaceae, respectively. KEGG abundance statistics and COG functional analysis showed that there were no significant differences in gene expression abundance of the same function among the three groups (P>0.1).  Conclusions  The different stool consistency of children and adolescents is related to changes in gut microbiota composition. Compared to the healthy group, children with constipation or diarrhea have disrupted gut microbiota balance, with a shift in dominant bacteria and a higher abundance of opportunistic pathogens.
Effects of group sports game intervention on social skills and quality of life in children with austism spectrum disorders
LIU Li, HU Sunyi, WANG Tianhua, LIU Zhenzhen, GUO Xin, CUI Jianmei
2024, 45(1): 110-114. doi: 10.16835/j.cnki.1000-9817.2024003
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  Objective  To explore the effects of group sports game intervention on social ability and quality of life of children with austism spectrum disorders (ASD), so as to provide reference for rehabilitation intervention of social and quality of life of children with ASD.  Methods  From September 2021 to January 2022, 72 children with ASD aged 4-6 in the children's rehabilitation department of Xiangyang Central Hospital were selected to participate in the study, and were randomly divided into experimental group (n=36) and control group (n=36). The control group received routine rehabilitation training (including individual sports game training), and the experimental group replaced individual sports game training with group sports game training on the basis of routine rehabilitation.The course content mainly included three parts: warm-up before class, group sports games and relaxation after class. The course combined social skills with sports games, and was carried out in a group form (divided into 12 groups with 3 people in each group), and was trained five times a week for 60 minutes, for a total of 12 weeks. The scores of Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Checklist (ATEC), Social Responsiveness Scale (SRS) and Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0) were observed before and after treatment. t-test and χ2 test were used for statistical analysis.  Results  There was no significant difference in SRS scores between the experimental group and the control group before intervention (t=-0.63, P>0.05). After the intervention, the total response rate in the experimental group was 83.33%, higher than 41.67% in the control group (χ2=13.33, P<0.05), and the SRS scores decreased in the experimental group and control group (t=17.75, 8.71, P<0.05). The SRS scale score of the experimental group Social perception (17.67±4.12), social cognition (30.33±4.99), social communication (50.33±9.39), social motivation (24.25±6.78) scores and total scores (152.67±25.82) were lower than those of the control group(22.17±5.34, 36.00±4.13, 62.58±11.07, 34.42±7.13, 186.33±29.03)(t=-4.88, -2.03, -2.13, -3.58, -3.01, P<0.05).After the intervention, the scores of social function (53.33±18.01) and total score (283.83±51.83) on PedsQL 4.0 scale in experimental group were higher than those in control group(23.33±15.13, 218.00±39.01) (t=4.42, 3.52, P<0.05). After the intervention, Autism Treatment Evaluation Scale (ATEC) scores of experimental groups(44.33±14.72) was lower than that in control group (59.33±16.95)(t=-2.32, P<0.05).  Conclusion  The intervention of group sports game has a significant effect on improving social ability and life quality of children with ASD.
Prevalence of overweight and obesity and their associations with sleep duration among primary and secondary school students in Gansu Province
LI Yixuan, CHEN Faqing, ZHANG Jing, ZHANG Chouji
2024, 45(1): 115-120. doi: 10.16835/j.cnki.1000-9817.2024026
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  Objective  To investigate the prevalence of overweight/obesity and its associations with sleep duration among children and adolescents aged 6-17 in Gansu Province, so as to formulate tailored prevention and control strategies and intervention measures.  Methods  Using a multi-stage stratified cluster random sampling method, a questionnaire survey and physical examination were conducted among 2 172 students aged 6-17 from 2 monitoring points in Gansu Province from May to July 2022. Using Chi-square test to analyze the inter group differences in the detection rates of overweight and obesity and the composition of sleep duration, and using Logistic regression model to analyze the correlation between overweight and obesity and sleep duration.  Results  The prevalence of overweight and obesity were 10.45% and 6.86%, respectively. The average sleep duration was (8.28±1.66)h/d. The detection rate of overweight was high among high school students aged 16-17 and those with sleep duration<8 h/d (χ2=12.51, 19.32, 14.96), while the detection rate of obesity was high among male and non residential students (χ2=5.89, 9.59)(P<0.05). For both boys and girls, the rates of overweight and obesity among primary school students increased with the decrease in sleep duration (χ2=38.84, 9.80, 19.61, 41.60, P<0.05). The rates of obesity in boys were higher than girls across varying sleep durations among the general population (sleep duration<8 h/d: 6.07%, 11.11%, 8~<9 h/d: 5.76%, 6.09%, 9~<10 h/d: 6.02%, 8.19%, ≥10 h/d: 4.04%, 6.90%). Multivariate Logistic regression analysis showed that insufficient sleep duration among primary school students was positively associated with the risk of overweight and obesity, and adequate sleep duration among high school students was negatively associated with the risk of overweight and obesity (sleep duration 8~<9 h/d: ORprimary school students=1.89, 9~<10 h/d: ORprimary school students=1.54, 8~<9 h/d: ORhigh school students=0.30, P<0.05).  Conclusions  Insufficient sleep is a risk factor for overweight and obesity among primary and secondary school students at monitoring sites in Gansu Province. Prevention strategies and interventions should be developed for different populations to ensure adequate sleep duration and reduce the risk of overweight and obesity among primary and secondary school students.
Analysis of the clinical and epidemiologic characteristics of 644 children with dental trauma
LI Junzhen, GUO Yiting, YAN Wencheng, SU Da
2024, 45(1): 121-123. doi: 10.16835/j.cnki.1000-9817.2024006
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  Objective  The clinical data involving pediatric dental trauma and the features of dental trauma in children were summarized to provide a reference for the treatment and prevention of dental trauma.  Methods  A retrospective analysis was performed on 644 children with dental trauma who were admitted to the Department of Children's Stomatology, Stomatology Hospital of Xiamen Medical College from January to December 2022. Descriptive methods were used to analyze the general demographic characteristics of the children and clinical features of dental trauma.  Results  The characteristics of the children with dental trauma were as follows: male-to-female ratio, 2.16∶1; mean age, (6.73±3.42) years; most frequently affected age groups, 2-4 and 7-9 years (26.09%, 33.85%); most frequent season for dental trauma, spring (27.61%) and autumn (28.55%); least common season for dental trauma, summer(18.88%); most frequent time of day for dental trauma, evening (51.47%); least common time of day for dental trauma, morning (2.68%); >24 h elapsed from dental trauma-to-treatment (42.08%); most common type of injuries; simple tooth hard tissue and pulp injury in permanent teeth(65.25%) and simple periodontal tissue injury of primary teeth(53.35%); most likely teeth involved, maxillary central incisors (80.10%); and number of affected teeth, 1-2.  Conclusions  The incidence of dental trauma in children has common features, but most children do not see a dentist timely after dental trauma occurs. Educating parents of children with dental trauma should be encouraged to reduce the incidence of dental injury.
Correlation between daily exercise load and physical fitness among primary school students
ZHAO Pengrui, HU Songhan, WU Zhigui, DING Tiancui, XUE Jiao, HOU Lijuan
2024, 45(1): 124-128. doi: 10.16835/j.cnki.1000-9817.2024028
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  Objective  To understand the relationship between daily exercise load and physical fitness of primary school students, so as to provide relevant theoretical basis for the development of on-campus physical education plans and the improvement of procedural physical health management for elementary school students.  Methods  A total of 223 students from 6 classes in a primary school in Beijing were selected by a stratified random cluster sampling method from May to June 2023. The daily exercise load of the students was monitored by Polar Verity Sense heart rate armband. The duration of moderate-to-vigorous physical activity (MVPA) and daily Training Impulse (TRIMP) value were calculated, and the related indexes of daily exercise load were analyzed. Chi-square test and univariate Logistic regression analysis were used to analyze the correlation between daily exercise load and physical fitness assessment levels, and multi-factor ordinal Logistic regression analysis was used to explore the influencing factors of physical fitness assessment levels.  Results  The average time spent in MVPA was (21.65±17.48) min. The TRIMP value was (361.47±124.81). The time spent in MVPA of primary school students in outdoor class, zero point sports, recess and after-class PE were (8.86±8.56, 9.41±10.47, 1.97±3.12, 2.46±2.57) min, respectively. TRIMP values were (68.89±20.84, 72.83±30.27, 51.68±18.23, 19.99±5.78) in outdoor class, zero point sports, recess and after-class PE, respectively. The results of univariate analysis showed that there were statistically significant differences in physical fitness levels among students with different genders, grades, and BMI (χ2=7.13, 19.04, 32.98, P < 0.05). The duration of daily MVPA, along with TRIMP value during outdoor class, zero point sports, recess, and after PE class were all statistically significant with physical fitness levels (OR=1.07, 1.05, 1.02, 1.03, 1.11, P < 0.05). The results of multi-factor ordinal Logistic regression analysis showed that the primary school grade (lower grade: OR=9.24, middle grade: OR=7.81), BMI (abnormal: OR=0.21), duration of daily MVPA in school (OR=1.06), and TRIMP value during outdoor class (OR=1.05) were statistically significant with physical fitness levels (P < 0.05).  Conclusions  There is a positive correlation between physical fitness and different grades, BMI, daily exercise load, and outdoor exercise load. Increasing daily exercise load can improve students' physical health. It is suggested to tailor the school sports program to suit primary school students, increase both the intensity and duration of school daily sports, and promote procedural physical health management for elementary school students.
Population heterogeneity analysis of caries prevention service preferences among children in Anhui Province
YU Hong, HU Lu, WANG Li, CHANG Xiangxiang, JIANG Jiacheng, WANG Lidan, XU Wenhua
2024, 45(1): 129-132. doi: 10.16835/j.cnki.1000-9817.2024015
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  Objective  To determine the heterogeneity for caries prevention service preferences among children in Anhui Province, so as to provide reference for the promotion and popularization of caries prevention services for school-age children.  Methods  Based on a discrete selection experiment, a face-to-face questionnaire survey was administered using a multi-stage sampling method among 785 parents with children 3-12 years of age who were hospitalized in the stomatology clinics of 7 prefectures and cities in Anhui Province from October 2021 to October 2022. A mixed Logit model was used to evaluate caries prevention service preferences for children.  Results  Four discrete choice experiment attributes included in the study were statistically significant for choice preference (P < 0.05). Compared with the control group, parents with a high school education or above preferred caries prevention services with 70%- < 80% preventive effectiveness, 2- < 5 and < 2 km from the service point, and a high service cost (β=0.38, 1.66, 1.64, 0.00); female parents preferred preventive services with 70%- < 80% preventive effectiveness and a high service cost (β=0.35, 0.01); parents of children < 7 years of age preferred services with 70%- < 80% preventive effectiveness (β=0.75); parents of children with oral health preferred preventive services during winter and summer vacations (β=-0.28); parents of children with caries preferred preventive services with a high cost per denticle (β=0.00)(P < 0.05).  Conclusions  Parents with different education levels, gender, child age, and oral health status have heterogeneity in dental caries prevention service preferences. The provision of targeted and precise services can improve the participation and coverage of caries prevention services for school-age children.
Changes of axial length in primary and secondary school students in Yunnan and associated factors
XIAO Jie, SU Meihui, LI Peiqian, HUANG Dafeng, LI Xixi, MA Zixue, LUO Xiao, CHEN Maosen, HUANG Ying
2024, 45(1): 133-137. doi: 10.16835/j.cnki.1000-9817.2024024
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  Objective  To explore the pattern of change of axial length/curvatrue radius ratio (AL/CR) and associated factors in primary and secondary school students in Yunnan, so as to provide scientific basis and prospective guidance for early myopia intervention and control.  Methods  A total of 685 students from grades 2 to 3 and grade 7 in 2 cities/counties in Yunnan Province were selected by multi-stage stratified random cluster sampling method in 2020. All the participants were followed up twice with questionnaire of myopia related factors, uncorrected distance visual acuity, and refractive parameter measurement from October, 2021 and March, 2023, respectivelty. The distribution and change of AL/CR in different classes and groups were analyzed, and the influencing factos of AL/CR cumulative progression were explored using generalized linear model.  Results  AL/CR ratio in primary school students was (2.95±0.09) at baseline, increased to (2.99±0.11) at the first follow-up and (3.04±0.12) at the second follow-up. AL/CR ratio in middle school students(3.08±0.13) at baseline, increased to (3.12±0.15) at the first follow-up and (3.15±0.14) at the second follow-up. The generalized linear model showed that after controlling for environmental factors, ethnicity (β=-0.017), cumulative progression of the SE (β=-0.027) influenced the changes of AL/CR ratio among the primary school students, whereas the changes of AL/CR ratio were associated with baseline AL (β=-0.005), baseline corneal curvatrue radius (β=0.032) and cumulative progression of SE(β=-0.035) among middle school students (P＜0.05).  Conclusions  The AL/CR ratio of primary and secondary school students in Yunnan can be used to judge different refractive status types, but its variation is not only related to SE progression, but also affected by different ethnic groups and baseline ocular biological parameters. so the value of AL/CR application in assessing the progression of myopia needs to be further confirmed.
Association between the risk of tuberculosis outbreak in schools and the visit interval of index cases
ZHANG Xiaolong, CUI Caiyan, FU Ying, WANG Feixian, LI Yun, JIANG Jun
2024, 45(1): 138-141. doi: 10.16835/j.cnki.1000-9817.2024038
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Abstract:
  Objective  To analyze the relationship between the risk of tuberculosis outbreaks in schools and the visit interval of index cases, so as to provide a scientific reference for predicting the risks of tuberculosis outbreak and making preventive measures.  Methods  A total of 630 index cases from school tuberculosis outbreaks were studied during January, 2015 to December, 2022. Data on demographics, consultation history, etiological diagnosis, and methods of detection were collected. Restricted Cubic Splines (RCS), unconditional Logistic regression, and the receiver operating characteristic curve (ROC curve) were used for analysis.  Results  The RCS fitted curve showed that the risk of a tuberculosis outbreak linearly increased when the consultation interval for etiologically negative patients exceeded 5.79 days, or for etiologically positive patients exceeded 8.37 days. After multi-factor adjustment, for every additional day in the visit interval of the index case, the odds ratio (OR) value for a high-risk outbreak was 1.10 (95%CI=1.07-1.13)(P < 0.05). When analyzed by tertiles of visit intervals, compared to an interval of < 14 days, the OR values (95%CI) for high-risk outbreaks in schools with intervals of 14- < 28 days and ≥28 days were 10.32(3.04-35.10) and 82.58(28.42-239.95), respectively(P < 0.01), indicating a trend of increasing outbreak risk with longer visit intervals. Based on the ROC curve analysis, the optimal threshold for predicting a high-risk school tuberculosis outbreak was 23.5 days, with an area under the curve (AUC) of 0.93 (95%CI=0.89-0.98).  Conclusion  An extended visit interval of index cases is a good early warning indicator for high-risk tuberculosis outbreaks in schools and could be considered a key factor in early intervention and risk control strategies.
Progress in the epidemiology of COVID-19 infections in children and adolescents
]QIN Yang, DONG Yanhui, XIE Junqing, SU Binbin, SONG Yi, MA Jun
2024, 45(1): 142-147. doi: 10.16835/j.cnki.1000-9817.2024022
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Abstract:
The COVID-19 pandemic has posed a series of complex challenges. COVID-19 in children and adolescents is generally less severe than in adults and the elderly; however, some children and adolescents may experience severe complications and adverse health effects even after mild or asymptomatic COVID-19 infections. The article focuses on gathering the epidemic characteristics, health impact, risk factors, prevention and control measures, and vaccination status of children and adolescents with COVID-19 infection to provide recommendations for protecting children and adolescents in the post-COVID-19 era.
Application of a polygenic risk score in the early prediction of myopia in children and adolescents
GAO Zhenshan, TAO Fangbiao
2024, 45(1): 148-152. doi: 10.16835/j.cnki.1000-9817.2024012
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Abstract:
Myopia has become a major public health issue of global concern. Scientific and effective myopia prediction models can help identify high-risk groups for myopia, thereby achieving precise prevention. With the rapid development of genome-wide association studies and the establishment of large-scale prospective population cohorts, the polygenic risk score (PRS) model has been used to predict myopia phenotypes, advancing the myopia prediction window and thus predicting high myopia risk for early screening and intervention for at-risk groups. The review aims to systematically elaborate the identification and verification of myopia genes in recent years, briefly describe the practice and effectiveness evaluation of the PRS model in myopia prevention research at home and abroad, reveal the application value in myopia prediction research, and emphasize the relationship between the PRS prediction model and outdoor activities. Close eye use and other preventive measures are of great significance to promote the precise prevention of myopia in children and adolescents.

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