Objective The purpose of this study was to analyze sleep quality among medical students from China and other countries from 1994 to the present, to provide a reference for promoting research on sleep quality among Chinese medical students. Methods Relevant literature was retrieved from the CNKI, Wanfang, VIP, and Web of Science core collection databases between January 1994 and April 2024. Scimago Graphica software was used to construct a collaborative network graph of the articles’ countries and authors. CiteSpace 6.1.R6 software was used to visualize research hotspots and evolutionary trends in the keywords of the included literature. Results A total of 412 Chinese articles and 759 English articles were included. The visualization results indicated that the number of published literatures has rapidly increased since 2018. China’s ranked third worldwide in the total number of articles (94 articles). “Medical students” “sleep quality” and “sleep disorders” were common high-frequency keywords in domestic and international research, whereas the foreign terms “sleep pattern” and “smartphone addiction” are the strongest citation bursts that have appeared internationally in the past three years. Conclusions In recent years, research on sleep quality among medical students has become a major topic of global concern. Further research on sleep medicine education in psychological and academic performance should be conducted, to improve sleep quality among medical students in China. Research trends should follow changes in sleep patterns and smartphone addiction among medical students.

Objective The purpose of this study was to explore the family factors affecting school bullying among junior high school students, to provide a basis for the prevention of school bullying. Methods The China National Knowledge Infrastructure, VIP, Wanfang, Web of Science, and other databases were searched from inception to December 2023. Two researchers independently screened the literature, and extracted data according to predefined inclusion and exclusion criteria. After evaluation of the quality of the included literature with the Agency for Healthcare Research and Quality scale, quantitative analysis was conducted in CMA 3.3 software. Results A total of 26 studies were included, with a total sample size of 39 893. The seven family factors influencing middle school students’ bullying behavior in school were parenting style (positive parenting r=-0.164, P<0.05; negative parenting r=0.264, P<0.05), parental conflict (r=0.142, P<0.001), childhood maltreatment (r=0.275, P<0.001), family functioning (r=-0.163, P<0.05), family socioeconomic status (r=-0.076, P<0.05), parent-child attachment (r=-0.209, P<0.001), and parent-child conflict (r=0.230, P<0.001). Sensitivity analyses suggested the stability of the study results. Conclusion Bullying behavior among middle school students is closely associated with family dynamics: adolescents exposed to adverse family environments have elevated likelihood of engaging in bullying.

Objective This study was designed to analyze the dynamic characteristics and causes of accidental deaths among primary and secondary school students in Huizhou and provide reliable evidence for developing preventive strategies. Methods With the International Classification of Diseases (ICD-10) of V01-X59 series, a total of 1 206 cases were retrospectively enrolled from the Huizhou Statistical Bureau official data between 2015 and 2021. Results From 2015 to 2021, there were 1 206 deaths in Huizhou, with a mortality rate of 19.37/ 100 000. Among them, Compared with the primary school level, the accidental mortality rates at secondary school level were higher (14.93/ 100 000), with statistically significant differences (P<0.05). The main causes of accidental death were traffic accidents, drowning, and suicide, and the mortality rates of these causes were the highest at the secondary school level. Between 2015 and 2021, the mortality rates from traffic accidents showed an increasing trend, while the mortality rates from suicide and drowning showed a decreasing trend. Conclusions Secondary school students are a key population for preventing accidental deaths, especially those caused by traffic accidents. Moreover, different targeted intervention measures should be taken based on the characteristics of the primary and secondary school to reduce the occurrence of accidental death incidents.

Objective This study was aimed at understanding the current status of overweight and obesity, as well as the associated factors such as dietary and lifestyle habits, among primary and secondary school students in an area of Tianjin, to provide a basis for the development of intervention measures for overweight and obesity among students in this area. Methods We collected overweight and obesity-related monitoring data from the National Student Common Diseases and Health Influencing Factors Surveillance Program in an area of Tianjin, from 2019 to 2023, and analyzed the distribution characteristics and factors influencing overweight and obesity among primary and secondary school students. Results A total of 7 789 students were included in the analysis. The overweight and obesity rate was 41.0%: 49.9% of boys and 31.3% of girls were affected, and the difference was statistically significant (χ2=280.38, P<0.001). Multivariate logistic regression analysis indicated higher risk of overweight and obesity among students drinking sugar-sweetened beverages one or more times per day (OR=1.121, 95%CI: 1.063-1.194), eating fried food one or more times per day (OR=1.085, 95%CI: 1.013-1.183), or having a daily sleep time<8 hours (OR=1.770, 95%CI: 1.201-2.590), and lower risk of overweight and obesity among students exercising>60 min/d more than 2 days per week (OR=0.857, 95%CI: 0.822-0.915) or having two or more weekly physical education classes (OR=0.823, 95%CI: 0.771-0.873). Conclusions The overall overweight and obesity rate among students in the studied area of Tianjin was relatively high, and was associated with factors such as diet, sports, and lifestyle habits. Targeted intervention measures should be adopted to control the occurrence and development of overweight and obesity in students.

Objective To quantify the impact of near-vision behaviors and vision environment among elementary students with electronic intelligent devices, and provide technical support for myopia prevention and control. Methods With a cluster sampling method, participants from an elementary school in Nantong city were selected to receive visual acuity test and refraction test, as well as a five-day monitoring of electronic intelligent devices (weekends included) during October to December 2023. The data on the prevalence of myopia in students, near-vision behaviors, outdoor exposure duration, and environmental light intensity were collected. The correlations of factors, such as genders, grades, and myopia status with both near-vision behaviors and vision environment were analyzed. Results The data were obtained from 343 students (91.5%) with electronic intelligent devices, including 167 myopic students (48.7%). The results revealed that the compliance rates of recommended maximum continuous near-work duration and the average outdoor exposure duration were 8.5% and 2.31%. The compliance rates of nighttime illumination were only 24.21%, while compliance rates of the average light intensity during the day were relatively high, reaching 94.52%. Data showed that only 50.14% of students could maintain a distance of 33 cm from their eyes to the books. Compared with female students, male students had shorter near-work time, longer near-work distance, and longer outdoor exposure time, with the significant differences (P<0.01). The differences in daylight and outdoor exposure duration in these grades were statistically significant (P<0.05). In the non-myopic students, there were better conditions in the some aspects, such as the maximum near-work duration (≥ 80 min), average daily duration (≥ 300 min), average near-work distance (≥ 33 cm), average light intensity (at night), and average effective outdoor exposure duration compared with the myopic students. All differences showed statistically significant (all P<0.05). Conclusions The electronic intelligent devices can quantify the near-vision behaviors and vision environment in students. It also has powerful support for the guidance of students’ near-vision behaviors.

Objective To investigate the factors affecting depression symptoms in middle school students and provide novel insights for preventing and controlling students’ depression with appropriate measures, the relationship of campus bullying and injury-related behaviors with depression symptoms were analyzed. Methods The 10 330 students from junior, senior and vocational high school (37 schools, 11 counties) in Jining City were enrolled, with multi-stage stratified cluster sampling method. A questionnaire survey on injuries, campus bullying, and CES-D depression self-assessment was conducted. Multivariate Logistic regression model analysis was used to analyze the relationships of injuries and campus bullying with depression among middle school students. Results The 232 (2.25%) students suffered campus bullying, 8 257 (79.93%) students had injury-related behaviors, and 1 292 (12.51%) students suffered depression symptoms. Among them, 52.16% of students being bullied and 32.65% of injured students had depression symptoms. After controlling for factors, such as gender, education level and household registration, a multivariate logistic regression analysis was carried out. The results showed that experiencing campus bullying (OR=7.43, 95% CI: 5.61-9.83), suffering serious injuries (OR=2.91, 95% CI: 2.18-3.88), fighting with others (OR=2.72, 95% CI: 2.21-3.34), and being scolded or beaten by parents (OR=4.58, 95% CI: 3.87-5.41) were all positively relationship with the prevalence of developing depression symptoms. Conclusions Suffering from campus bullying, injuries, and being scolded or beaten by parents are related to the risk of depression symptoms among middle school students. Preventing campus bullying and injury-related behavior are particularly important for reducing the incidence of adolescent depression symptoms.

To enhance influenza prevention and control capabilities in schools, this consensus proposes a comprehensive strategy for influenza prevention and control in schools, based on domestic and international research and practices, encompassing the following key components: (1) General prevention strategy: Non-pharmaceutical interventions, including isolating sources of infection, strengthening hand hygiene, and ventilation can effectively reduce transmission in schools, requiring further implementation. (2) Vaccination campaign optimization: Annual influenza vaccination is the most cost-effective measures to protect students from influenza and severe complications, reducing school closures due to outbreaks, minimizing absenteeism, and parental work disruptions. Key strategies include policy requirements, safeguards, and advocacy to improve vaccination accessibility, and convenience for students, through optimized campus vaccination programs. (3) Addressing awareness gaps and prioritizing health campaign: Significant knowledge gaps on the threat of influenza and vaccine safety profiles are found among key stakeholders (parents, school healthcare providers, teachers, school administrators, and students), especially in rural and disadvantaged areas. Targeted health education focusing on differentiating influenza from common colds, vaccine efficacy, and daily protective measures is essential to enhance health literacy through multi-channel campaigns. (4) Strengthening organizational systems and multisectoral collaboration: School healthcare staffing should meet public health demands, with enhanced training for healthcare personnel. A collaborative framework involving schools, CDCs, and communities, health services is essential. Joint efforts by education, health, and CDC authorities are needed to formulate integrated plans, emphasizing surveillance, vaccination oversight, and building a “family-school-community-healthcare” system. (5) Policy support for influenza prevention: Comprehensive policy frameworks are critical to improving prevention efficacy in schools. (6) Contingency plan: Schools should establish emergency response plans to enforce daily health checks, symptom surveillance, ventilation, and disinfection, while standardizing management via the “two plans and nine systems” framework. This consensus emphasizes the importance of policy-driven vaccination campaigns, optimized organization and multi-dimensional health education to establish a scientific, efficient and school-based prevention system, reducing the burden of respiratory infectious diseases and safeguarding children and adolescents’ health and educational continuity.

Objective To investigate the distribution of overweight and obesity among college students in Nanchang, and to analyze the impact of unhealthy lifestyles on the risk of overweight and obesity. Methods From April to May 2024, college students from three universities in Nanchang were randomly surveyed by questionnaire. The distribution of overweight and obesity among college students was investigated. Both the χ2 tests and logistic regression analysis were applied to analyze the impact of unhealthy lifestyles on overweight and obesity. Results A total of 19 790 students were enrolled, with 2 070 cases of overweight (10.46%) and 1 508 cases of obesity (7.62%). After adjusting for gender, grades, and school, we found that smoking was negatively correlated with overweight and obesity (OR=0.45, 95%CI: 0.58-0.71), and those who slept less than 5 hours/day (OR=0.66, 95%CI: 1.42-3.98) were positively correlated with overweight and obesity (P<0.05). In male students, those who slept either 5-8 hours/day or less than 5 hours/day had an increased risk of overweight and obesity (P<0.05), compared with those sleeping more than 8 hours/day. Junior students who sleep 5-8 hours/day and senior students who sleep less than 5 hours/day also showed an increased risk of overweight and obesity (P<0.05). Conclusions Smoking and insufficient sleep both have varying degrees of impact on the overweight and obesity among college students. To prevent and control overweight and obesity of universities should start with cultivating healthy lifestyles.

Objective To analyze the epidemiological characteristics of infectious disease symptoms and the implementation of suspension measures in primary and secondary schools in a district of Beijing, and to provide evidence-based insights for optimizing campus infectious disease prevention strategies. Methods Between February 2023 and February 2025, data were collected from 4 186 primary and secondary school students in a district, Beijing, using a stratified random sampling method. Descriptive statistics and time series analysis were employed to examine the prevalence of symptoms across different categories, school levels, and seasons, as well as the school suspension metrics. Results Fever was the most frequently reported symptom (3 834 cases, 87.1%). Among all symptoms, school suspension measures related to herpes were the most stringent, with a weighted average suspension duration of 9.3 d and an implementation rate of 79.1%. Differences in suspension responses were observed across school levels: In primary schools, the suspension rate for fever cases was 60.5%, compared to 43.2% in secondary schools. For herpes cases, suspension rate reached 86.8% in primary schools, while secondary schools reported only 13 cases, yet related classes still maintained 10 d suspensions. Seasonally, autumn semester fever cases averaged 4.6 d suspensions, exceeding the 3.6 days observed in spring. Conclusions The predominant infectious disease symptom among primary and secondary school students is fever, with herpes posing notable seasonal risks. Primary schools emerged as key targets for prevention and control, while asymptomatic transmission in secondaryschools warrants heightened vigilance.

为贯彻落实《健康中国行动（2019 —2030年）》关于中小学生健康促进的行动，推动新时期儿童青少年健康领域学术交流和学科发展，中华预防医学会儿少卫生分会拟于2025年8月中旬在江苏省徐州市召开第十七届全国儿童青少年健康学术会议。

Objective To analyze the correlations between bedtime procrastination and sleep duration with respect to sleep quality among medical students, and improve the students’ unhealthy sleep behaviors with practical measures. Methods Convenience sampling survey was conducted among students from a university in Xuzhou via the general situation questionnaire, morningness and eveningness questionnaire, sleep procrastination scale. Subsequently, data were pre-processed with Pearson correlation analysis to determine the correlations among various variables. A mediation model was established to determine the masking effect of sleep procrastination between sleep duration and sleep quality. Results Sleep procrastination was negatively associated with sleep duration (r=-0.348, P<0.001), while positively associated with poor sleep quality (r=0.364, P<0.001). Sleep procrastination plays a mask between sleep duration and sleep quality. Conclusion Contemporary medical students should improve unhealthy sleep behaviors, such as sleep procrastination, adjust the sleep duration to morningness, and then improve sleep quality.

Objective To explore the distribution characteristics and differences in body composition among children and adolescents aged 6-18 year with normal weight and obesity, and to provide a scientific basis for precise prevention and intervention of obesity. Methods From September to December 2020, a cross-sectional survey was conducted among 1 204 children and adolescents (aged 6-18 years) from four schools in Beijing, with a stratified cluster random sampling method. Height and body mass were measured through physical examinations, and obesity was determined with the standard of “Screening for overweight and obesity among school-age children and adolescents (WS/T 586-2018)”. Their body composition was measured using Dual-energy X-ray Absorptiometry (DXA), and indicators including fat mass index (FMI), muscle mass index (MMI), fat-to-muscle mass ratio (FMMR) were calculated. Generalized additive models for location scale, and shape (GAMLSS) were employed to fit percentile curves for indicators of body composition. The reference values of children and adolescents with normal weight and obesity by age and sex were obtained. Differences in body composition distributions between the two groups were then compared. Results A total of 1 204 children and adolescents aged 6-18 years were enrolled. Children and adolescents with obesity had higher FMI, MMI, and FMMR than those with normal weight, particularly in the abdominal and trunk regions (P<0.001). FMI showed a trend of rising initially and then falling. Among children with normal weight, FMI gradually decreased after age 11, while that of FMI decreased after age 15 in children with obesity. MMI exhibited a “rapid growth phase” during puberty and the growth rate in the obese group was smaller than that in the normal weight group. FMMR in all regions initially showed a trend of rising and then declining around 10-12 years of age among children with normal weight, whereas in obese children, FMMR P50 in the abdomen, trunk, and hip regions failed to decline until age of 18. Conclusions There are differences in the distribution of body composition among children and adolescents with normal weight and obesity. Children and adolescents with obesity may experience increased fat accumulation in the abdominal and trunk regions, accompanied by slower muscle growth during puberty. These findings support the development of more precise obesity prevention and management strategies in pediatric populations. Further investigation into the underlying causes of abnormal fat distribution in obese children and adolescents are warranted to better inform targeted prevention and treatment efforts.

Nutrition literacy encompasses the collection of knowledge and skills that enable individuals to acquire, comprehend, and process information and services of food nutrition that can be helpful for making food and nutrition decisions. It functions as a bridge connecting individuals, food, and the environment, and holds predictive value for dietary behaviors. Upon the previous studies, this review was undertaken to examine the association between nutrition literacy and dietary behaviors among school-aged children. The findings revealed that the overall nutrition literacy level among school-aged children was linked to healthy dietary behaviors, and enhancing specific facets of nutrition literacy could foster healthier food consumption patterns. Future research endeavors should delve deeper into the associations between various competencies and dietary behaviors, as well as the interplay between children’s nutrition literacy and health outcomes, to furnish scientific basis and clues for the intervention of children’s dietary behaviors and the improvement of children’s nutritional status based on nutrition education.

Objective This study investigated sleep patterns among middle school students in Nanjing and explored factors contributing to sleep disorders, to provide a basis for developing strategies to improve sleep conditions among middle school students. Methods A stratified cluster sampling method was used to conduct a questionnaire survey on sleep quality among 2 187 middle school students in Nanjing from September to November 2023. Sleep conditions were assessed to analyze the influencing factors associated with sleep disorders among middle school students. Results The detection rate of sleep disorders among middle school students in Nanjing was 11.8%; the rates were 10.9% among male and 12.9% among female students, which showed no statistically significant difference (χ2=2.056, P=0.152). The detection rates of sleep disorders were 8.3% among junior high school students, 18.6% among regular high school students, and 11.4% among vocational high school students, and showed statistically significant differences (χ2=44.856, P<0.001). Furthermore, the detection rate of sleep disorders was 6.7% in suburban students and 18.6% in urban students, which also showed a statistically significant difference (χ2=20.915, P<0.001). Multivariate logistic regression analysis identified being enrolled in a regular high school, experiencing parental physical punishment, and alcohol consumption as risk factors for sleep disorders among middle school students. In contrast, residing in suburban areas and engaging in outdoor activities for 1 hour or more were found to be protective factors against the occurrence of sleep disorders. Conclusions Sleep quality among middle school students in Nanjing is generally satisfactory but could be improved. Sleep quality is influenced by multiple factors, and targeted policies should be established to enhance students’ sleep status.

Objective To compare the physical development of children from only-child, two-child, and multi-child families, and investigate the correlation between sibling numbers and both physical development and nutritional status. Methods Data were obtained from physical examinations and questionnaire surveys of 55 631 children aged 7 to 17 in China. Covariance analysis was used to compare the differences of physical development indicators, such as height, weight, and waist circumference, among children from families with different numbers of siblings. Additionally, the correlations of different numbers of siblings with stunting, wasting, and obesity were analyzed using binary logistic regression model. Results Of the 55 631 children, 40 013 (71.93%) were from only-child families, 13 485 (24.24%) from two-child families, and 2 133 (3.83%) from families with multiple children. Statistically significant differences were observed in the prevalence of wasting, obesity, abdominal obesity, and elevated waist-to-height ratio across family types (all P<0.001). Compared with children from only-child families, those from two-child families had lower odds ratios (95% CI) for obesity, abdominal obesity, and elevated waist-to-height ratio, of 0.65 (0.58-0.73), 0.73 (0.67-0.80), and 0.81 (0.74-0.87), respectively; the odds ratios (95% CI) of wasting, obesity, abdominal obesity, and elevated waist-to-height ratio in children from multi-child families were 0.57 (0.38-0.85), 0.56 (0.42-0.73), 0.60 (0.49-0.74), and 0.70 (0.59-0.84), respectively. Conclusions Children from two-child and multi-child families have lower wasting and obesity than those from only-child families. China’s multi-child policy may contribute to both increased births rates and healthier physical development in children.

Objective To assess the cognition level and health needs regarding juvenile diabetes mellitus among residents in the Dali Bai autonomous prefecture, and provide scientific evidence for improving chronic disease management in minority-populated areas of Yunnan. Methods A total of 513 residents from Eryuan County were enrolled with a cluster random sampling method, from July to August 2023. Data were collected with structured questionnaires and in-depth interviews. Data entry and double check were performed using Epidata 3.1, and statistical analysis was carried out with SPSS 25.0. Results Among the respondents, Bai ethnic residents accounted for 52.2%, with children and adolescents covering 56.6%. A total of 77.1% of residents exhibited misconceptions about juvenile diabetes mellitus, with 53.1% believing that adolescents are susceptible to diabetes. Additionally, 40.7% failed to take blood glucose testing, and 57.2% believed that diabetes cannot be asymptomatic. Furthermore, 51.3% considered age to be a direct cause of diabetes, 63.5% believed that diabetes patients with stable blood glucose should continue taking medication, 39.6% were unaware of the diagnostic criteria for diabetes, 18.7% were unfamiliar with the risk factors for juvenile diabetes mellitus, 17.7% lacked knowledge of diabetes management measures, and 18.7% had no understanding of diabetes at all. Further analysis revealed that the awareness and health needs of residents among different age groups regarding juvenile diabetes mellitus differed. Compared with children and adolescents, adult residents had a significantly lower awareness level of juvenile diabetes mellitus (χ2=95.41, P<0.05). Conclusions The cognitive level and knowledge of juvenile diabetes mellitus in Bai autonomous prefecture is limited. Authorities, such as local community and relevant agencies, should strengthen health education and promptly implement targeted prevention and control strategies.

Objective To analyze the status and factors of milk and dairy products consumption among primary and secondary students in Beijing, so as to provide a basis for promoting the appropriate intake of milk and dairy products by students. Methods A questionnaire survey was conducted among students from 16 districts of Beijing, during September 2020 to June 2021. Students from primary and secondary schools were enrolled by a multi-stage stratified cluster sampling method. Chi-square test was applied to analyze the differences in the rate of insufficient intake of milk and dairy products between the groups, and logistic regression was employed to explore its relevant factors. Results A total of 9 959 students were enrolled, and the median daily consumption of milk and dairy products was 319.9 mL. However, 47.4% of these students failed to meet the recommended intake. Factors such as gender, grade, caregiver education, family income, accessibility of dairy products and knowledge of milk consumption were all found to significantly influence milk intake (all P<0.01). The higher risk of insufficient dairy intake was found among female students (OR=1.20, P<0.001), junior high school students (OR=1.50, P<0.001), senior high school students (OR=1.48, P<0.001), and those with limited access to milk and dairy products (OR=1.63, P<0.001). Conclusion Although the overall consumption of milk and dairy products intake among primary and secondary students shows a certain level, 47.4% of students still have insufficient intake.

Objective This study was aimed at understanding the current situation of children and adolescents’ autonomous physical activity and related factors in Yinchuan City, to provide a reference to increase autonomous participation in physical activity among children and adolescents. Methods A stratified cluster random sampling was used to select 1 147 children and adolescents 9-18 years of age in Yinchuan City. A questionnaire was designed on the basis of the socio-ecological model to investigate the current status of voluntary physical activity and analyze related factors. Results The number of children and adolescents who participated in autonomous physical activity at least four times per week accounted for 38.5% of the respondents. The individual level, organizational level, and community level were all associated with the number of times in which respondents participated in voluntary physical activity (r-values of -0.11, -0.07, and -0.07, respectively; all P<0.05). Stepwise linear regression analyses showed that, at the individual level, few motor skills, participation in sports would lower academic performance, and lack of interest in sports; at the inter-individual level, parents do not exercise regularly; at the organizational level, communities or villages do not organize sports regularly, and the atmosphere of physical activity is not strong; and at the policy level, implementation of a “double-decrease” policy by the school is insufficient to influence voluntary physical activity participation and negatively affects autonomous physical activity participation. Personal physical condition, parents’ affirmation of sports, reasonable planning of the exercise environments in communities or villages, schools placing a high degree of importance on sports, and a high degree of knowledge of sports-related policies issued by the state positively influence autonomous physical activity participation (β-scalarization=-0.163-0.154, all P<0.05). Conclusions The poor status of autonomous physical activity among children and adolescents in Yinchuan City was associated with many factors, among which policy level factors had the greatest influence. According to the social-ecological model, multifaceted synergistic co-operation is necessary to promote autonomous physical activity participation among children and adolescents.

Objective To explore the correlations of body mass index (BMI) and body roundness index (BRI) with the ambulatory blood pressure (ABP) and the predictive ability of BMI and BRI for abnormal ABP among college students in Hunan. Methods A total of 1 857 college students were enrolled from May 2021 to June 2024, in Hunan, with a convenience sampling method. Demographic data were collected through questionnaires, and the height, weight, waist circumference as well as 24-hour ABP were measured. BMI and BRI were calculated based on height, weight, and waist circumference. Abnormal ABP was defined as 24-hour ABP ≥130/80 mmHg, or daytime blood pressure ≥135/85 mmHg, or nighttime blood pressure ≥120/70 mmHg. Binary logistic regression analysis was employed to investigate the correlations of BMI and BRI with abnormalities in various ABP indices (24-hour systolic blood pressure /diastolic blood pressure , daytime SBP/DBP, and nighttime SBP/DBP). Receiver operating characteristic curves were used to calculate the area under the curve and 95% confidence interval for BMI and BRI in predicting abnormal ABP. Results A total of 1 411 participants (371 male students and 1 040 female students) were included in the final analysis. The prevalence of abnormal ABP was 9.14%, with daytime abnormal blood pressure of 3.26%, nighttime abnormal blood pressure of 7.23%, and 24-hour abnormal blood pressure of 3.40%. Both BMI and BRI were associated with daytime SBP, nighttime SBP, 24-hour SBP, nighttime DBP and abnormal ABP, and these results showed significant differences (all OR>1, all P<0.05). The predictive ability of BMI for abnormal ABP was higher than that of BRI, with AUCs of 0.677 and 0.650, respectively. Conclusion BMI and BRI are associated with abnormal ABP, while BMI showed a stronger predictive ability for abnormal ABP than that of BRI.

Objective This study was aimed at understanding spinal curvature prevalence and associated factors among middle school students in Liangxi District, to provide a reference for preventive measures and interventions for spinal curvature in children and adolescents. Methods From November to December 2022, students in seventh grade to senior 3 (including those in vocational high school) in Liangxi District, Wuxi City were selected through a stratified cluster random sampling method. Spinal curvature assessment and a questionnaire survey were conducted. Results A total of 1 232 secondary school students from five schools were selected. The detection rate of spinal curvature was 3.33% (41 cases). The detection rate in girls was 4.98%, a value 1.75% higher than that in boys (χ2=10.028, P<0.01). The detection rate in students at ordinary high schools was 4.89%, a value higher than that in students at vocational high schools (2.87%) and junior high schools (2.01%) (χ2=6.549, P<0.05). The detection rate in malnourished students was 9.09%, a value higher than that in non-malnourished students (3.06%) (χ2=5.943, P<0.05). Multivariate logistic regression analysis indicated that female sex (OR=3.791, 95%CI: 1.797-7.998), attending an ordinary high school (OR=2.537, 95%CI: 1.162-5.538), and malnutrition (OR=4.631, 95%CI: 1.590-13.485) were risk factors for spinal curvature. Conclusions The detection rate of spinal curvature among middle school students in Liangxi District was relatively high. Closer attention must be paid to students at ordinary high schools and girls with malnutrition.

Objective To investigate the Knowledge, Attitudes, and Practices (KAP) characteristics of Chinese parents regarding influenza vaccination for school-aged children and the factors, and to provide a scientific basis for optimizing childhood influenza prevention and control strategies. Methods A cross-sectional study was conducted from July to December 2024 in Chengdu, Nanjing, and Wuhan. Stratified cluster sampling was used to recruit parents of elementary and secondary school students. Data on demographic characteristics, vaccine awareness, influenza prevention knowledge, protective behaviors, and health-influencing factors were collected via questionnaires. Multivariate logistic regression analysis was performed to assess KAP levels and their influencing factors. Results A total of 2 656 valid questionnaires were collected. Parents exhibited relatively high overall knowledge (94.99% compliance) and positive attitudes (96.01% compliance) regarding student influenza vaccination, but behavioral compliance was low (38.29%). Parents of junior high and high school students showed lower behavioral compliance (junior high: OR=0.56, 95%CI=0.42-0.75; senior high: OR=0.38, 95%CI=0.22-0.63), while mothers demonstrated reduced compliance (OR=0.49, 95%CI=0.24-0.99). Parents in Chengdu exhibited stronger vaccination engagement (OR=2.84, 95%CI=2.17-3.72). Additionally, parental education level, student health status, family residence location, and parental age significantly influenced KAP levels. Primary barriers to vaccination stemmed from safety concerns (45.44%), whereas drivers included protecting personal health (74.06%), school vaccination requirements (51.55%), and safeguarding family or friends (51.13%). Conclusions This multicity survey reveals that urban parents possess high influenza-related knowledge and positive attitudes but exhibit suboptimal vaccination behaviors, highlighting the complexity of translating KAP into action. Key barriers include vaccine safety concerns, older student age, and maternal roles. Future strategies should enhance school-based influenza prevention and vaccination publicity, provide clear evidence of vaccine safety, and integrate regional healthcare resources. Future strategies should prioritize school-based vaccination campaigns, evidence-based safety communication, and integrated regional healthcare resources to bridge the KAP-behavior gap, thereby enhancing influenza vaccination coverage and refining immunization policies.

Objective To analyze the poor vision situation among primary and secondary students in Yicheng, and provide support and suggestions for students’ vision improvement, based on the current empirical evidences. Methods With the stratified cluster sampling method, the visual acuity screening in students aged 6-18 was conducted in Yicheng (Zhumadian City), during February to June 2023. The detection rates of poor vision in students were compared among different grades and genders. Results A total of 26 000 students were detected, including 20 198 students (77.68%) with poor vision. Among them, 8 953 elementary students were detected, covering 6 100 (68.13%) with poor vision; 8 674 middle school students were detected, encompassing 6 940 (80.01%) with poor vision; 8 373 high school students were detected, spanning 7 158 (85.49%) with poor vision. The differences were statistically significant among school students in these grades (χ2=792.346, P<0.001). The detection rates of students (grade 1-12) with poor vision were 64.21%, 66.15%, 67.05%, 68.04%, 70.19%, 73.21%, 77.97%, 79.52%, 82.58%, 84.00%, 86.08% and 86.39%, respectively. The results showed that the detection rates of poor vision increased with the elevation of grade levels. Of the 13 103 male students detected, 9 457 (72.17%) had poor vision. Among 12 897 female students, 9 759 (75.67%) had poor vision. The differences between male students and female students with poor vision were statistically significant (χ2=41.157, P<0.001). There were significant differences in the detection rate of poor vision between male students and female students in all grades (χ2=14.131, P<0.001; χ2=11.692, P<0.001, χ2=14.682, P<0.001). Conclusion The issue of poor vision among students in Yicheng District, Zhumadian City is rather severe. Notably, the detection rate of poor vision exhibits a significant upward trend with the elevation of grade levels.

Objective To understand the current situation and factors of milk-related knowledge among primary and secondary students’ family caregivers in Beijing, so as to provide scientific basis for ensuring the growth and development of students and enhancing the level of milk-related knowledge of their family caregivers. Methods Family caregivers from 16 districts, whose children are in grade 3 to 12, were surveyed by questionnaires from September to December 2020. The current situation of milk-related knowledge among the family caregivers was analyzed. The binary logistic regression model was adopted to analyze the factors of the milk-related knowledge levels among caregivers. Results The mean score of milk-related knowledge among caregivers was 11.03 ± 2.32, with a compliance rate of 40.12%. Logistic regression analysis revealed that female caregivers; those aged ≤35 years, 35-45 years; those with educational level of high school/secondary vocational school/technical school, junior college/vocational college, as well as bachelor’s degree or above; and those from families with an annual per-capita income of 40 000-69 999 yuan, and≥70 000 yuan demonstrated a significantly higher likelihood of compliance with milk-related knowledge (all P<0.05). Conclusions The compliance rate of milk-related knowledge among primary and secondary students’ primary caregivers in Beijing requires to be improved. The focus should be on popularizing basic knowledge, such as the recommended amount of milk consumption and how to identify dairy products in the “Chinese Dietary Guidelines for School aged Children” among caregivers. In particular, efforts should be strengthened to popularize milk-related knowledge among caregivers who are middle-aged, have low educational level, and come from low-income families.

Objective To analyze the epidemiological characteristics of infectious disease outbreaks in primary and secondary schools and childcare institutions of Peixian, and to provide future references for prevention and control of infectious diseases in schools. Methods Data were collected via the sub-systems of “Public Health Emergency Management Information and China Influenza Surveillance Information” of the China Disease Prevention and Control Information System. Health emergencies and influenza outbreaks in primary and secondary schools and childcare institutions reported in Peixian from 2013 to2023 were included. Epidemiological characteristics of common infectious diseases outbreaks in schools were analyzed with the descriptive epidemiology. Results From 2013 to 2023, a total of 43 outbreaks of common infectious diseases were reported in Peixian, with 12 cases of general events, 31 cases of unrated events (all influenza events) involving 80 690 children. A sum of 934 cases was identified with the incidence of 1.16%, including influenza (36 cases), chickenpox (3 cases), mumps (2 cases), hand, foot, and mouth disease (1 case). Forty-three outbreaks of infectious diseases were found in primary schools (26 cases), middle schools (13 cases), and kindergartens (4 cases). Meanwhile, the distributions of these outbreaks varied in both the urban areas, with 11 cases, and rural areas, with 32 cases, with the incidence of 0.71%, 1.65%, respectively. The difference was significant (χ2=264.272, P<0.001). The incidence of the infectious diseases peaked in these months, such as March to June and from October of one year to January of the following year. Conclusions The common outbreaks of infectious diseases in Peixian are mainly unrated events and general events, with influenza as the main disease. The distributions of outbreaks are seasonal and bimodal. Targeted preventive measures should be taken timely to control the outbreaks of infectious diseases in schools and childcare institutions.