Behaviours related to infectious disease and family factors in primary and middle school students

To analyze and describe the status and characteristics of using electronic screens of primary and middle school students in China from 2016 to 2017. From 2016 to 2017, 275 monitoring points were selected from 31 provinces in China, and 280 primary and middle school students were selected from each monitoring point to complete the survey. Using the suggestion from "Healthy China Initiative(2019-2030)"of which the screen time of primary and middle school students should be less than one hour per day as the standard. A total of 74 314 primary and secondary school students(except grade 9 and grade 12) were included in this study. Among them, there were 37 147 boys(50.0%) and 37 167 girls(50.0%); 44 612 pupils(60.0%), 14 858 junior school students(20.0%), and 14 844 senior high school students(20.0%); 38 995(52.5%) rural students and 35 319(47.5%) urban students; 53 287 boarding students(71.7%) and 20 537 day students(27.6%). From 2016 to 2017, the average daily screen time of Chinese primary school students was 1.45 hours, M(P25, P75) was 1.14(0.57, 1.93) h. That of junior high school students was 1.92 hours, M(P25, P75) was 1.43(0.71, 2.48) h. That of senior high school students was 2.37 hours, M(P25, P75) was 1.71(0.90, 3.02) h. The average daily screen time qualified rates of primary school, junior high and senior high school students were 46.1%, 37.1% and 27.7%, respectively. From 2016 to 2017, the most used electronic screen products of primary school students in China were TV/videos(62%), followed by mobile phones(21%). Junior high school students spent 38% and 37% of the total time watching TV/videos and playing mobile phones, respectively. High school students spend the longest time using mobile phones(49%) of the total time, followed by watching TV/videos(26%). With the increasing of grade, screen time became longer, and screen time qualified rate dropped. Moreover, the most used electronic screens were mobile phones and TV/videos.

The lifestyles change of children and adolescents during the COVID-19 pandemic due to antipandemic measures can affect their sleep health. Existing studies have used convenient samples and focused on the initial months of the pandemic, leaving a knowledge gap on changes in young people's sleep patterns under the "new normal" under COVID-19. As part of a territory-wide epidemiological study in Hong Kong, this cross-sectional study recruited primary and secondary school students by stratified random sampling. Sleep parameters were collected using the structured diagnostic interview for sleep patterns and disorders. We investigated the pandemic's effects on sleep parameters by comparing data of participants recruited pre-COVID and those recruited during COVID using multivariate regression, adjusting for age, sex, household income, seasonality, and presence of mental disorders, and the moderators and mediators of the effects. Between September 1, 2019 and June 2, 2021, 791 primary and 442 secondary school students were recruited and analyzed. Primary school and secondary school participants assessed before COVID had a longer sleep latency on school days (95% confidence interval [CI] = 1.0-5.2 minutes, adjusted P-value = .010; and 95% CI= 3.9-13.0 minutes, adjusted P-value = .004, respectively) and nonschool days (95% CI = 1.7-7.2 minutes, adjusted P-value = .005; 95% CI = 3.4-13.7 minutes, adjusted P-value = .014, respectively). Low household income was a moderator for later bedtime (adjusted P-value = .032) and later sleep onset (adjusted P-value = .043) during nonschool days among secondary school students. Changes associated with COVID have a widespread and enduring effect on the sleep health of school-aged students in Hong Kong. Household income plays a role in adolescent sleep health resilience, and the impact of antiepidemic measures on the health gaps of the youth should be considered. Chau SWH, Hussain S, Chan SSM, etal. A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic. J Clin Sleep Med. 2023;19(4):749-757.

This paper is used to know about the psychological health situation for middle and primary school students in Xianning City and provide a certain empirical basis for meaningful development of psychological health education and psychological assistance. This paper uses the MHT scale prepared by Bucheng Zhou professor et al. to conduct a test for 1000 students in 7 middle and primary schools in Xianning City. The detection rate of psychological health problem accounts for 1.6% where the positive detection rate of study anxiety ranks first (43.2%). The psychological health situations have much difference in sex (t = -4. 624, P<0. 001), and it’s lower in male students than female ones. There is a significant difference between the psychological health situation for only and non-only children (t = -2. 519, P<0. 01).There is a significant difference on the psychological health situation for primary school, middle school and high school students (F = 11. 3, P<0. 001), and the psychological health situation of primary school students is better than that for middle school students. It can be concluded that the psychological health situation of middle and primary school students in Xianning City is fairly good, and the psychological health situation for male student, only children and primary school student is also fairly good.

Objective: To investigate the prevalence of dyslipidemia, and to explore the association between extracurricular physical activity and dyslipidemia among primary, middle and high school students in Guangzhou. Methods: This cross-sectional study selected primary and middle school students in Guangzhou by the stratified cluster sampling method from March to December 2019. Physical examination and blood lipid test were performed. Information about students' basic characteristics and extracurricular physical activity was collected by questionnaire. Multivariate logistic regression analysis was used to determine the association between extracurricular physical activity and dyslipidemia in this cohort. Results: A total of 7 797 participants (mean aged (12.2±2.9) years) were included (4 194 (53.79%) boys and 3 603 (46.21%) girls]. The detection rates of high total cholesterol, high triglycerides, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and dyslipidemia were 12.49% (974/7 797), 6.44% (502/7 797), 6.62% (516/7 797), 11.31% (882/7 797) and 23.83% (1 858/7 797), respectively. Dyslipidemia rate was lower in the junior school students (21.39% (675/3 156)) than in primary school students (25.96% (896/3 451)) and high-school students (24.12% (287/1 190)) (P<0.001). The dyslipidemia rates of boys and girls were similar (23.15% (971/4 194) vs. 24.62% (887/3 603), P>0.05). Dyslipidemia rate was lower in students with extracurricular physical activity than in students without extracurricular physical activity (22.50% (923/4 102) vs. 25.30% (935/3 695), P<0.05). Multivariate logistic regression analysis showed that extracurricular physical activity was associated with lower risk of dyslipidemia (OR=0.88, 95%CI=0.79-0.99, P=0.033). Among all types of extracurricular physical activities, participating in extracurricular large ball game was associated with 28% lower risk among junior school students (OR=0.72, 95%CI=0.57-0.91, P=0.006). Conclusion: The prevalence of dyslipidemia is high among primary, middle and high school students in Guangzhou. Extracurricular physical activity is associated with reduced risk of dyslipidemia in this cohort.

Objective: To examine the purchase behaviors of prepackaged food and its determinants among primary and middle school students in 6 provinces of China. Methods: A multi-stage sampling strategy was adopted to select 2 499 primary and middle school students and their parents from the eastern region of China(Beijing, Jiangsu Province, Guangdong Province), the northeast region(Heilongjiang Province), the central region(Henan Province) and the western region(Sichuan Province) from July 2020 to March 2021. Socio-demographic characteristics of students and their parents, eating-related behaviors and the purchase behaviors of prepackaged food of students, and parents' attitudes towards students' eating behavior were collected through questionnaire towards students and their parents. The χ² test was conducted to compare the purchase behaviors in different groups of students, and multivariate logistic stepwise regression analysis was used to analyze the determinants among primary and middle school students. Results: The age of 2 499 participants was(12.7±2.5) years. There were 1 272(50.9%) females and 1 279(51.2%) middle school students. About 1 404(56.2%) students bought prepackaged food. The top 6 prepackaged foods bought at least once a week were milk and dairy products(74.6%), baked food(58.7%), beverages(42.8%), puffed food(40.8%), chocolate and candy(39.8%), and nuts and dried fruits(37.5%). The multivariate logistic regression model analysis results showed that compared with primary school students, rural students, non-boarding students, students who did not like snacks and students whose parents paid attention to their children eating snacks, middle school students(OR=3.36, 95%CI:2.73-4.12), urban students(OR=1.33, 95%CI:1.11-1.61), boarding students(OR=2.15, 95%CI:1.66-2.79), students who liked snacks(OR=2.01, 95%CI:1.66-2.43), students whose parents did not pay attention to their children eating snacks(OR=1.27, 95%CI:1.05-1.54) were more likely to buy prepackaged food by themselves. Compared with students whose parents had education level of junior high school and below, students whose parents had education level of undergraduate and above(OR=0.70, 95%CI:0.53-0.92) were less likely to buy prepackaged food by themselves. Compared with students whose family monthly income was less than 5 000 yuan, students whose family monthly income was over 10 000 yuan(OR=0.67, 95%CI:0.52-0.87) were less likely to buy prepackaged food by themselves. Conclusion: Many primary and middle school students buy prepackaged food by themselves in 6 provinces of China. Individual characteristics such as grade, place of residence, boarding status, as well as family environment such as parents' education level, monthly income and concern about children eating snacks are the influencing factors of purchasing prepackaged food.

Objective: To analyze the daily drinking behavior and related factors of primary and middle school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) pilot regions. Methods: Multi-stage stratified random cluster sampling method was used to select one to three national pilot counties in 22 provinces in central and western China where the NIPRCES was implemented in 2019. According to different feeding patterns, two primary schools and two middle schools were selected as key monitoring schools. One or two classes were selected from grade 3 to grade 9. The student questionnaire was used to collect the basic information and daily drinking behavior. Taking whether the drinking water ≥5 cups every day as the dependent variable, multivariate logistic regression model was used to analyze the related factors of drinking behavior among students. Results: A total of 27 374 students were included. On average, primary and middle school students in the regions where NIPRCES was implemented had 3.9 cups of water every day. Logistic regression model showed that boys (OR=1.230, P<0.001), primary school students (OR=1.379, P<0.001), father worked outside the home (OR=1.169, P<0.001), both parents worked outside the home (OR=1.228, P<0.001), non-resident students (OR=1.142, P<0.001), the school in the village (OR=1.638, P<0.001) or township (OR=1.358, P<0.001), school feeding (OR=1.252, P<0.001), the school building with flush toilets (OR=1.384, P<0.001) and the central regions (OR=1.300, P<0.001) students were more likely to drink ≥5 cups water every day. Conclusion: The water consumption of primary and middle school students in the pilot regions of NIPRCES is low, and their drinking behaviors are affected by many factors.

Objective To understand the current situation of breakfast consumption and its influencing factors in primary and middle school students in a poor rural area in a city in Guizhou Province, and to provide scientific basis for child nutrition education and intervention. Methods A stratified cluster sampling method was used to conduct a questionnaire survey of breakfast behavior and influencing factors among 2 833 students from 3 primary schools and 3 middle schools in a area of Guizhou Province from April to June 2019. Results The most frequently consumed breakfast was rice noodle products (71.66%), followed by fresh vegetables (45.89%), milk (35.55%), meat/egg/fish (29.33%), beans (19.52%), and fresh fruits (18.74%). The proportion of having breakfast everyday among elementary and middle school students who was 62.97%, and having breakfast 4 一 6 days peer week was 22.80%, and 14.23% with ≤3 days peer week, and the proportion of boys who ate breakfast every day (65.07%) was higher than girls (61.00%) ( χ 2 = 10.01, P <0.05). The proportion of low quality breakfast was 71.87%, and girls (73.68%) were higher than boys (69.94%) (χ 2 = 9.29, P <0.05). Logistic regression analysis showed that grade of school, boarding school, and sleep quality are all influencing factors for whether to eat breakfast every day; grade of school, whether to stay at school were factors that affect breakfast quality ( P <0.05). Conclusion The frequency and quality of breakfast need more improvement among middle and primary school students in a poor rural area of a city in Guizhou Province. Students, parents, and teachers should be educated on nutrition to promote healthy eating and sleeping habits and improve student health. 【摘要】 目的 了解贵州省农村贫困地区中小学生早餐现状及影响因素, 为开展儿童营养教育及制定干预措施提供科学 依据。 方法 采用分层整群抽样方法, 于 2019 年 4—6 月对贵州省某市 3 所小学和 3 所中学 2 833 名学生进行早餐行为与 影响因素问卷调査。 结果 中小学生早餐食用频率最髙的是谷薯类 (71.66%), 其次为新鲜蔬菜 (45.89%)、奶类 (35.55% )、肉/蛋/鱼类 (29.33% )、豆类 (19.52% )、新鲜水果 (18.74% )。中小学生能每天吃早餐的比例为62.97%, 每周吃 4~ 6次早餐的为 22.80%, ≤3 次的为14.23%, 男生每天都吃早餐的比例 (65.07% )髙于女生 (61.00% ), 差异有统计学意义 (χ 2 = 10.01, P <0.05)。早餐营养差的比例达 71.87%, 女生 (73.68%)髙于男生 (69.94%) (χ 2 = 9.29, P <0.05)。Logistic 回归 分析结果显示, 学段、是否住校、睡眠质量均是每天吃早餐的影响因素；学段、是否住校是早餐质量的影响因素 (P值均< 0.05)。 结论 贵州省某市农村贫困地区中小学生每天吃早餐的比例较低, 早餐营养质量差。应对学生、家长、老师开展营 养知识教育, 促使学生养成健康的饮食和睡眠生活习惯, 改善学生健康状况。

Objective To study the core message awareness of tuberculosis(TB) prevention and treatment among the primary and middle school students in rural areas of northern Jiangsu Province and to relevant influencing factors. To evaluate the intervention effects of different methods of health education on Tuberculosis, and provide a health education method which take the best effect. Methods Ten primary and middle schools were selected by stratified random sampling in rural areas of northern Jiangsu Province. There were 6 000 students to finish the questionnaires including the general information, knowledge, attitude, practice of TB prevention and treatment. 100 students per school and three primary and three middle schools were selected by multistage cluster sampling in three rural areas of northern Jiangsu Province. The interviews were divided into two intervention groups (comprehensive intervention and General intervention) and one control group. Results The general awareness rates of core messages on TB were 35.4%. The results of the multiple linear regression analysis showed that sex, age, father education, family type, and family income were significantly associated with increased knowledge scores. The awareness rates of the TB core information of comprehensive intervention group, the general intervention group and the control group were 90.5%, 81.5% and 60.4% after intervention. Conclusion Knowledge on tuberculosis prevention and control should be improved among the primary and middle school students in rural areas of northern Jiangsu Province. Compared with the general intervention group, comprehensive intervention education on TB was suitable for the primary school students in rural areas of northern Jiangsu Province.

To assess the prevalence of depressive symptoms, trends on its longitudinal development and related influencing factors among primary and middle school students in Changfeng county of Anhui province. Through cluster sampling methods, all students from 3 to 9 grades in 5 primary schools and 3 middle schools in Changfeng county of Anhui province were investigated through questionnaire as subjects of baseline survey in December 2009. Subjects of this longitudinal study were students in grades 3, 4 and 7 at the time of the baseline survey and were contacted once a year for two years. At last, a total of 816 students participated in all the three surveys. A structured questionnaire including Children's Depression Inventory, socio-demographic characteristics and some potential influential factors was employed for this study. A Generalized Estimating Equation (GEE) was used to evaluate the related influencing factors of children's depressive symptoms in the longitudinal study. Prevalence rates of depressive symptoms were 11.3% , 10.4% and 8.5% , respectively, at the baseline, 1-year and 2-year follow-up studies, among primary and middle school students. Scores on depressive symptoms of total subjects and children who had always been left at home in the follow-up process showed significant differences at the three surveys (F = 13.423, P < 0.001; F = 5.761, P = 0.003). 25 percent of the 92 students who showed depressive symptoms at the baseline survey remained those depressive symptoms at the 1-year follow-up study and 87 percent of the 23 students who had depressive symptoms at the baseline and 1-year follow-up surveys still showing depressive symptoms at the 2-year follow-up study. Results from the GEE program indicated that grade 3 students, having syblings, family with dysfunction or at low level of self-esteem etc., were prone to development while sex and parents' educational level were not correlated with depressive symptoms. Prevalence of depressive symptoms among primary and middle school students in Changfeng county of Anhui province appeared a decreasing tendency during the follow-up process in our study. Through the longitudinal development, we noticed that the prevalence of depressive symptoms seemed to be related to the personal characteristics, education and family environment of the subjects under our study. Improving the level of family function as well as individual's self-esteem might positively contribute to mental health of those primary and middle school students.

Objective To understand the prevalence and trend of the poor eyesight in primary and middle school students in Beijing, and to provide theoretical basis for eyesight protection and myopia prevention and control. Methods According to “Technical Standard for Student Health Inspection” (GB/T 26343–2010), students were examined with a standard logarithmic visual acuity E chart for naked eye vision. Results The prevalence of poor eyesight among primary and middle school students in 2010-2016 was 63.0%, 62.1%, 62.9%, 60.7%, 59.2% and 58.6% respectively, decreased by 7.0% in 6 years, primary school students dropped by 9.7%, and junior school students, senior high school students and vocational high school students increased by 5.5%, 3.3% and 14.1% respectively. Urban and suburban areas (61.2%, 54.3%) decreased by 9.6% and 2.9% respectively. Regardless of boys and girls, urban and suburb, between 2010 and 2016, the overall composition ratio of students in each school segment was expressed as primary school > junior school > senior high school students > vocational high school, and vocational high school students accounted for the minimum; the overall composition ratio of primary school has become more and more large. Conclusion Eyesight protection and myopia prevention among primary and middle school students in Beijing is still challenging. All departments should take active and effective measures to control the newly onset and progression of low vision and improve eyesight. 【摘要】 目的 了解北京市中小学生视力不良检出率及变化趋势, 为学生视力保护及近视防控提供参考依据。 方法 按照《学生健康检査技术规范》 (GB/T 26343—2010), 采用标准对数视力表对北京市全体中小学生进行裸眼远视力检査。 结果 2010—2016 年北京市中小学生视力不良检出率分别为 63.0%, 62.1%, 62.9%, 60.7%, 59.2% 和 58.6%, 6 年间下降了 7.0%。2015—2016 年小学生、初中生、普通髙中生、职业髙中生视力不良检出率分别为 45.5%, 78.4%, 89.4%和74.5%, 较 2010—2011 年小学生下降了 9.7%, 初中生、普通髙中生和职业髙中生分别增长了 5.5%, 3.3% 和 14.1%; 2015—2016 年, 城 区、郊区学生视力不良检出率分别为 61.2% 和 54.3%, 较 2010—2011 年分别下降了 9.6% 和 2.9%。不论男生、女生, 城区、 郊区, 2010—2016 年, 每年各学段学生总体构成比均表现为小学>初中>普通髙中>职业髙中, 职业髙中学生占比最小; 随着 年份的增加, 小学的构成比增大。 结论 北京市中小学生视力不良防控工作任务艰巨。各部门应采取积极有效的措施, 控 制视力不良新发和加重, 提髙中小学生视力健康水平。

(1) Purpose: To analyze the role of psychological problems in connection with school bullying and non-suicidal self-injury (NSSI) among rural primary and middle school students in developing areas of China. (2) Methods: A multi-stage, stratified, cluster random sampling method was used to select 2284 rural primary and middle school students in Jiangxi Province for study. Questionnaires regarding the health risk behaviors of children in developing areas were left behind at primary and middle schools, and they were later collected and analyzed by using the mental health diagnostic monitoring scale for Chinese primary and middle school students. Pearson correlation, logistic regression, and bootstrap tests were conducted to analyze the association between psychological problems, school bullying, and NSSI. (3) Results: The incidence of NSSI in rural primary and middle school students in Jiangxi Province was 14.84%. Compared with other children with behavioral problems, those who had experienced school bullying and had mild/severe psychological problems were more likely to have engaged in NSSI behaviors (p < 0.001). Psychological problems have a mediating effect between school bullying and NSSI, which accounted for 12.96% of the total effect. (4) Conclusion: Psychological problems are likely an effect modifier in the connection between school bullying and NSSI behaviors. Therefore, effectively targeting psychological problems in rural primary and middle school students in Jiangxi Province may help prevent and control NSSI behaviors in students who have experienced school bullying.

A cross-sectional study on the analysis of the current situation of depression and anxiety among primary and secondary school students in Urumqi City in 2021: A case study of S district

The purpose of this study is to propose improvement strategies for national digital literacy assessment tools based on the analysis of log data from the first performance-based evaluation conducted in 2023. To achieve this, we analyzed log data from a total of 32,804 primary and middle school students. For the analysis, eleven types of data, including problem domain, problem type, and total number of logs, were utilized for the analysis. Students were assessed on their digital literacy level through 26 items, with primary school students given 40 minutes and middle school students given 45 minutes for the assessment. The key findings indicate that primary school learners generated 1.5 million log entries spanning four modules, whereas middle school participants produced 3.2 million log data points. Both primary and middle school students showed an increasing tendency to skip questions without answering as they progressed through the latter part of the assessment. Additionally, the tendency to skip questions increased when the minimum number of clicks required to solve a problem increased or when the problem length was longer. In the future, it is necessary to clearly define which parts of the log should be recorded in advance so that logs are consistently recorded. To accurately perform analyses such as student response type and pattern analysis, and error type analysis, a design for appropriate log data recording should be prioritized. This will enhance the reliability and validity of the tools and serve as a basis for future digital literacy policy development.

To understand the awareness status on malaria control knowledge of residents, primary and middle school students in Huai'an District, Huai'an City, so as to provide the evidences for promoting the malaria elimination process in this district. Three towns in Huai'an District were selected randomly, and one village, one primary school and one junior middle school in each town were chosen as the investigation sites. The residents over 18 years old, the primary school students in Grade 4 to 6, and the junior middle students in the investigation sites were investigated by questionnaires to understand their awareness status on knowledge of malaria control. Totally 305 residents and 618 students were investigated. The awareness rate of students was 89.97%, and the rates of the junior middle school students and primary school students were 85.94% and 94.10%, respectively, the difference between them was statistically significant (P＜0.01). The awareness rate of the residents was 80.98%, which was lower than that of the students (P＜0.05). For the students, the awareness rate on "precaution of malaria" (96.74%) was the highest, while that on "drug of malaria" (68.93%) was the lowest. For the residents, the rate on "transmission route of malaria" (95.08%) was the highest, that on "4·26 is Malaria Day" (64.26%) was the lowest. Expect the items of "transmission route of malaria" and "precaution of malaria" (both P＞0.05), the differences of the awareness rates on all the other items between the students and residents were statistically significant (all P＜0.01). Although the awareness rates of malaria control knowledge in the population of Huai'an District, Huai'an City have achieved the goal of the relevant requirement, the health education on malaria control still should be strengthened, especially for the primary students, female residents and exported labor service personnel.

Application and Practice of MOOCs in the Teaching of Primary and Middle Schools