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2019 Vol. 7, No. 4
Published: 2019-12-30

Review
Article
Forum
 
       Forum
199 Medication for attention-deficit/hyperactivity disorder
YANG Binrang
DOI: 10.3969/j.issn.2095-4301.2019.04.001
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with a chronic course. Its core characteristics are inattention, hyperactivity/impulsivity, with comorbid other neurodevelopmental or psychiatric disorders. ADHD can cause negative impacts on the academic, interpersonal, professional, self-evaluation/self-esteem and other functions of patients, which brings heavy economic and mental burdens to patients, families and society. Evidence supports the efficacy and safety of short-term medication, but there is a lack of randomized controlled studies on its long-term efficacy. ADHD practice guidelines recommend regular evaluation to determine whether there is a need for continued treatment.
2019 Vol. 7 (4): 199- [Abstract] ( 3098 ) HTML (1 KB)  PDF (1406 KB)  ( 2219 )
       Article
207 Association between obesity types and blood pressure among  junior middle school students in Shanghai
YAN Qiong, LUO Chunyan, ZHOU Yuefang, YANG Dongling, QI Wenjuan, FENG Xiaogang
DOI: 10.3969/j.issn.2095-4301.2019.04.002
Objective  To analyze the association between blood pressure and obesity types among junior middle school students in Shanghai, and to provide clues for the prevention and control of hypertension among children and adolescents. Methods  Survey on obesity and related factors among students was performed in five districts of Shanghai in 2018. A total of 1 704 junior middle school students were enrolled to explore the relationship between different types of obesity and high blood pressure. Results  The overall obesity prevalence rate of middle school students in Shanghai was 23.59%. The prevalences of peripheral obesity,abdominal obesity and mixed obesity were 0.88%,10.50% and 12.21%,respectively. There were significant differences in gender (χ2=38.17,P<0.01),age (P<0.01) and place of residence (χ2=17.86,P<0.01) in the subjects with different types of obesity. The overall prevalence of hypertension was 4.46%. There were significant differences in age (χ2=18.42,P<0.01),place of residence (χ2=9.36,P<0.01) and obesity types (χ2=24.28,P<0.01) in the subjects with high blood pressure. Significant difference was found in both the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in students with different obesity types (SBP: mixed obesity>abdominal obesity>peripheral obesity>normal [mixed obesity vs. other groups,P<0.05],DBP: mixed obesity>peripheral obesity>abdominal obesity>normal [mixed obesity vs. normal,abdominal obesity vs. normal,P<0.05]. Multivariate logistic regression showed that the greatest risk of hypertension was mixed obesity,followed by abdominal obesity,with OR values of 3.90 and 2.12,respectively. Conclusion  Mixed obesity and abdominal obesity are closely related to hypertension in middle school students. Prevention and treatment of adolescent hypertension should place priority on obesity prevention.
2019 Vol. 7 (4): 207- [Abstract] ( 2786 ) HTML (1 KB)  PDF (810 KB)  ( 2059 )
213 Inducing factors of childhood asthma exacerbation in Shanghai and asthma education
SUN Jingyi, FANG Dingzhu, HUA Li, ZHANG Jianhua, ZHANG Jun
DOI: 10.3969/j.issn.2095-4301.2019.04.003
Objective  To describe the inducing factors and clinical characteristics of childhood asthma exacerbation by conducting a large hospital-based cross-sectional survey,and explore the effects of age,gender,and history of allergic diseases on these inducing factors in order to provide evidence for early identification of inducing factors of childhood asthma exacerbation and individualized patient education. Methods  This cross-sectional study was conducted in the Department of Pediatric Pulmonology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,from June 2015 to January 2016. The subjects were children aged 12 years and younger with a diagnosed asthma by pediatricians according to the definition of the Global Initiative for Asthma (GINA). The demographic characteristics,inducing factors of asthma exacerbation,and individual and family history of allergic diseases of these children were described and analyzed. Multiple logistic regressions were used to estimate the odds ratios(ORs). Results of this study were applied to individualized asthma education to the caregivers of asthmatic children who attended the outpatient department for the first time. The attendance of scheduled follow-up for four weeks was evaluated.
Results  A total of 515 asthmatic children were included in this study. Respiratory tract infection was the most common inducing factor of childhood asthma exacerbation (89.9%),followed by house dust (47.2%),food (29.9%),cold air (28.7%),pollen (15.5%),exercise (11.7%),and chemical odors (8.9%). Boys had a higher proportion of pollen-induced asthma exacerbation compared to girls. School-age children (6 years and older) were more vulnerable to inhaled factors such as house dust and pollen compared to younger children. The proportion of exercise-induced asthma in school-age children was also higher than that of younger children. Asthmatic children with atopic dermatitis (OR=5.046,95%CI: 2.550-9.986),food allergy (OR=4.386,95%CI: 1.922-10.011),and drug allergy (OR=2.721,95%CI: 1.284-5.766) were more likely to have asthma attack with exposure to specific chemical odors. Allergic rhinitis was associated with asthma attack due to house dust(OR=2.591,95%CI:1.594-4.213). Asthmatic children whose caregivers received individualized asthma education had a follow-up rate of 98.0% four weeks later. Conclusion  Respiratory tract infection is the main inducing factor of childhood asthma exacerbation. Age,gender,and allergic diseases or allergic status has a significant impact on the distribution of inducing factors. Individualized asthma education based on the clinical characteristics of children may improve asthma control.
2019 Vol. 7 (4): 213- [Abstract] ( 2736 ) HTML (1 KB)  PDF (1187 KB)  ( 1875 )
220 Analysis of students' class participation based on classroom video
MIAO Jia, YU Dongchuan
DOI: 10.3969/j.issn.2095-4301.2019.04.004
Objective  Students' classroom behavior analysis is important for assessing students' classroom participation. A new analysis and processing model of students' classroom behavior data is proposed to comprehensively assess students' participation in classroom. Methods  Based on classroom video information,Kinect sensor was used to obtain the correlation between limb bones and facial features and observable student behaviors. Relevant features were extracted to construct deep neural network(DNN) classifiers,and different levels of attention concentration were classified. Using the Kinect sensor's limb bones' point information and audio array for multimodal fusion,the frequency of students' putting up hands and answering questions was counted.  
Results  It was verified that there was a correlation between the level of attention and the specific behavior of the students (the correlation coefficients between level 1 and level 2 and the behavior of watching blackboard were 0.63 and 0.55,respectively; the correlation coefficient between level 3 and the behavior of looking around was 0.78). Using the DNN to classify attention levels,the accuracy rate was 91.2%,which was 12.3% higher than the support vector machine (SVM). The accuracy of student location recognition using audio arrays was 89.0%. Finally,each student's attention level picture for each lesson,the proportion of each attention level,and the number of times of the students' raising their hands in the classroom as well as the number of standing up to answer questions formed a student class participation analysis table. Conclusion  By assessing students' classroom behaviors and combining relevant indicators of classroom participation,they can comprehensively and objectively reflect the classroom performance of different students in the classroom,and can be used as a reference for teachers.
2019 Vol. 7 (4): 220- [Abstract] ( 2813 ) HTML (1 KB)  PDF (2432 KB)  ( 2273 )
227 Application of support system based on new media in the management of children with attention-deficit/hyperactivity disorder
WANG Yuqing, ZHU Ping, JIANG Tingting, QI Hongxia, ZHU Mei
DOI: 10.3969/j.issn.2095-4301.2019.04.005
Objective  To explore the application value of support system which is based on new media in the management of children with attention-deficit/hyperactivity disorder (ADHD). Methods  Children with ADHD who were visited and filed at Department of Child Healthcare,Xuzhou Childrens Hospital from October 2017 to July 2018 and their families were selected as the research objects. In the form of voice teaching,interactive communication and so on,the research group (new media management group) achieved 10-month management with the help of Wechat APP. The control group conducted file management through ADHD outpatient follow-up. All objects achieved evaluation by using SNAP-Ⅳ parent rating scale,Conners teacher rating scale,and children's self-awareness scale before and after admission. Results  The factor scores of SNAP-Ⅳ parental rating scale and Conners teacher rating scale all decreased after training as compared with the baseline. The difference was statistically significant (P<0.01). In terms of intelligence,school,happiness,satisfaction,and total scores of children's self-awareness scale,the differences were also statistically significant (P<0.01). In terms of the physical appearance and group factor scores in the research group,there were also significant differences (P<0.01). Attention deficit and impulsive hyperactivity factor score had statistical differences in different management styles and different research groups(P<0.05),and the factor score of opposite and defiance had a statistically significant  difference (P<0.01). There was statistical difference in the application proportion of first-line drugs between the two groups after using different management styles(χ2=3.908,P=0.048). Conclusion  New media management is more efficient and convenient in the management of ADHD. It is beneficial to the whole process,and  the standardized and systematized management of ADHD. The core symptoms of ADHD children,the follow-up rate,and the application rate of first-line drug can be comprehensively improved.
2019 Vol. 7 (4): 227- [Abstract] ( 2877 ) HTML (1 KB)  PDF (804 KB)  ( 1980 )
232 Investigation on mental health of orphans aged 7-12 in Urumq
Nuernisaimu TASHI, Reyila ABULA,GAO Wenyu, Nuerbiya ABUDURESULI, Zaoranmuayi, Asimuguli KELIMU
DOI: 10.3969/j.issn.2095-4301.2019.04.006
Objective  To investigate the mental health status of orphans aged 7-12 in Urumqi so as to provide a scientific basis for carrying out psychological counseling in orphans. Methods  A cross-sectional survey using self-constructed questionnaire and mental health rate scale for pupils (MHRSP) was performed in orphans aged 7-12 (66 cases) and non-orphans matched by age(145 cases). Results  The deviation rate of MHRSP total score in the orphan group (7.58%) was significantly higher than that in the non-orphan group (0.69%). The deviation rates of dimensions except for the learning disability and bad habits were statistically significant between the two groups (P<0.05). The scores of orphans on learning disabilities,mood disorders,character defects,social adjustment disorders,moral defects,bad habits,behavioral disorders and special disorders were higher than those of  non-orphans,so was the MHRSP total score (P<0.05). The scores of orphans in grades 1 to 3 (low grades) on dimensions including mood disorders,character defects,social adjustment disorders,moral defects,behavioral disorders and special disorders as well as MHRSP total score were significantly higher than those of non-orphans in grades 1-3 (P<0.05). However,there was no significant difference in the scores on learning disabilities,and bad habits between low-grade orphans and non-orphans (P>0.05). The scores of orphans in grades 4 to 6 ( senior grades) on learning disability,social adjustment disorders ,moral defects,behavioral disorders as well as MHRSP total score were significantly higher than those of non-orphans in senior grades (P<0.05),while the scores on mood disorders,character defects,bad habits and special disorders were of no difference (P>0.05). There were statistically significant differences in personality type and peer relationship between orphans and non-orphans (P<0.05). Conclusion  The mental health level of 7-12 year old orphans in Urumqi is lower than that of non-orphans,with a higher detection rate for mental health deviation. There are differences in personality characteristics and peer relationship between orphans and non-orphans. Psychological differences are seen between low-grade and senior- grade orphans. There is a need to provide orphans with individual psychological counseling. For low-grade orphans,it is important to cultivate orphans' good psychological quality and improve self-awareness. For senior-grade orphans,attention should be paid to their differences in personality,and development of an equal communication platform,which may provide them with opportunities to know themselves,treat themselves well,and surpass themselves.
2019 Vol. 7 (4): 232- [Abstract] ( 3055 ) HTML (1 KB)  PDF (801 KB)  ( 2200 )
237 General self-efficacy and academic procrastination of college students: mediating effect of proactive personality
WANG Weijing, GONG Liming, LI Dan, GE Haoyu
DOI: 10.3969/j.issn.2095-4301.2019.04.007
Objective  To explore the role of general self-efficacy of college students in academic procrastination and its mechanism. Methods  A total of 278 college students were tested by the simple procrastination assessment scale-students (PASS),general self-efficacy scale (GSES),and proactive personality questionnaire. Results  ① In college students,male students got higher scores in general self-efficacy and proactive personality than female students. ② Academic procrastination had a significantly negative correlation with general self-efficacy and proactive personality. Proactive personality played a completely mediating effect role in the relationship between general self-efficacy and academic procrastination. Conclusion  General self-efficacy affects academic procrastination through the mediating variable of proactive personality.
2019 Vol. 7 (4): 237- [Abstract] ( 3123 ) HTML (1 KB)  PDF (848 KB)  ( 2677 )
242 Comparison of therapeutic effects of two different treatment schemes on children with tic disorders at school age
LI Xueli, YANG Juan
DOI: 10.3969/j.issn.2095-4301.2019.04.008
Objective  To compare the therapeutic effects of two different treatment schemes on children with tic disorders at school age. Methods  A total of 119 children with tic disorders admitted to Huizhou Women and Children's Hospital from November 2017 to August 2018 were selected and divided into control group and observation group by random number table method. Fifty-nine children in the control group were treated with routine intervention (drug + psychological and behavioral intervention). Sixty children in the observation group were treated with biofeedback therapy on the basis of routine treatment. The Yale global tic severity scale (YGTSS) was used to evaluate the symptoms of children before and after treatment. Results  Before treatment,there was no significant difference in motor tic score,vocal tic score,and YGTSS total score between the two groups (P>0.05). After treatment,the motor tic score,vocal tic score,and YGTSS total score in the observation group were significantly lower than those in the control group (P<0.05). After treatment,motor tic score,vocal tic score,and YGTSS total score in the two groups were significantly lower than those before treatment (P<0.05). Conclusion  Biofeedback combined with drug,psychological and behavioral interventions can effectively improve the clinical symptoms of tic disorders in children and increase the clinical therapeutic effect,which is worthy of further promotion in clinic.
2019 Vol. 7 (4): 242- [Abstract] ( 2964 ) HTML (1 KB)  PDF (794 KB)  ( 1934 )
246 Clinical effects of orthokeratology lens on low and moderate myopia correction in Chinese teenagers
XU Jianmin, ZHANG Shisheng, LIU Jiacheng, WU Yanlin, HU Qiwei, ZHANG Qiong
DOI: 10.3969/j.issn.2095-4301.2019.04.009
Objective  To evaluate the clinic effect of the night-wearing orthokeratology (OK) lens in teenagers with low and moderate refractive errors. Methods  A total of 90 adolescent myopia patients [176 eyes,aged (10.5±2.2) years] were enrolled in this retrospective study. Uncorrected visual acurity (UCVA) was measured at baseline and 1 week,1,3,6,12 and 18 months after wearing OK lens. Refractive error (spherical equivalent),central corneal thickness,corneal topography eccentricity (E-value),axial length,keratometry 1 (K1),keratometry 2 (K2),average keratometry,and intraocular pressure were assessed at baseline and 18 months after wearing OK lens. The contributions of all independent variables on axial length change and refractive error change were assessed using univariable regression analysis. According to the refractive baseline,the subjects were divided into two groups: low myopia group (-0.5~-3.0 D,46 cases with 88 eyes) and moderate myopia group (-3.25~-5.75D,44 cases with 88 eyes). The axial length changes and refractive error changes were evaluated. According to the age,the subjects were divided into three groups: group A (≤9 years),group B (9 years<age<12 years),and group C (≥12 years). The axial length and refractive error changes were evaluated. The subjects in the low and moderate myopia groups were divided into three subgroups according to the age,and the changes of axial length and refractive error were evaluated. Results  The refractive baseline was (-2.93±1.09) D and axial length was (24.73±0.78) mm. UCVA was significantly increased after wearing OK lens at each time point of the follow-up (P<0.01). There were significant differences in the axial length,refractive error,K1,K2 and average K between before and 18 months after wearing OK lens (P=0.0001). Univariate analysis showed that the increases of the axial length and refractive error were significantly related to the onset age of OK lens wearing,initial corneal E value,initial axial length,and baseline refractive error. The increases of refractive error and axial length in lower myopia group were significantly larger than those in the moderate myopia group (P<0.01). There was significant difference in the increase of refractive error (group A>group B=group C) and the elongation of axial length (group A>group B>group C). The refractive degrer and axial length were most quickly increased in the teenagers aged ≤9 years in both low and moderate myopia groups. Conclusion  OK lens is effective to correct  myopia to a certain degree. The increases of the axial length and refractive degree in the lower baseline refractive error and lower age subjects develop faster.
2019 Vol. 7 (4): 246- [Abstract] ( 2870 ) HTML (1 KB)  PDF (816 KB)  ( 1996 )
       Review
252 Advances of habit reversal training for children with tic disorder
MI Yunhui, WANG Guanghai, SUN Kexing
DOI: 10.3969/j.issn.2095-4301.2019.04.010
Tic disorder (TD) is a neurodevelopmental disorder that occurs mostly in childhood. It is characterized by involuntary motility and/or vocal tics. It is affected by psychological factors such as fear,stress,and anxiety. The comorbidity includes attention-deficit/hyperactivity disorder,impulsivity,and forced behavior problems. According to the psychological behavior characteristics of TD patients,personalized behavioral intervention can not only improve the tic symptoms and psychological status of patients,but also effectively block the adverse social consequences that may be caused by their behavior problems. This paper reviews the application of the most widely used habit reversal training (HRT) in dysmotility and its comorbidities,and summarizes the problems currently faced in the application of HRT in China.
2019 Vol. 7 (4): 252- [Abstract] ( 2950 ) HTML (1 KB)  PDF (804 KB)  ( 2148 )
257 Epigenetic regulation of exercise on brain cognitive function
HUANG Wenying, LIU Meng
DOI: 10.3969/j.issn.2095-4301.2019.04.011
The power of exercise supports cognitive function,the effects of which can last for considerable time. The action of exercise on epigenetic regulation of gene expression is to establish an “epigenetic memory” to influence long-term brain function and behavior. We discuss new developments in the epigenetic field connecting exercise with changes in cognitive function,including DNA methylation,histone modifications,and miRNA expression regulation. This helps to understand the underlying mechanisms by which exercise improves cognitive ability in the long run,and is crucial to the use of exercise to improve learning.
2019 Vol. 7 (4): 257- [Abstract] ( 2859 ) HTML (1 KB)  PDF (831 KB)  ( 2106 )
264 Construction of assessment system of children’s school readiness
WANG Yapeng
DOI: 10.3969/j.issn.2095-4301.2019.04.012
For children,the transition from kindergarten to primary school is an important milestone in their lives. To be competent for school lives,children must be well prepared for primary school entrance. School readiness is not only closely related to children's school performance,but also it can predict childrens future career achievements,even social status. Despite the importance of school readiness,the current study on school readiness lacks an integrated assessment system. Based on this,combined with the analysis of bibliometrics,from the perspective of domain-general and domain-specific,we construct two dimensions including domain-general cognitive readiness and domain-specific academic readiness,and put forward a children-oriented,children-appropriate,interesting assessment system and corresponding test paradigms and tasks of school readiness.
2019 Vol. 7 (4): 264- [Abstract] ( 2376 ) HTML (1 KB)  PDF (832 KB)  ( 2076 )
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