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2023 Vol. 11, No. 2 Published: 2023-03-30 Review Article Forum        Forum 91 Effect of early intervention in medicine-education integration on early brain development in small for gestational age infant FANG Fang, LI Fei DOI: 10.3969/j.issn.2095-4301.2023.02.001 Small for gestational age infant（SGA）not only affects the growth and metabolism, but also decreases the intelligence and cognitive level in perinatal and long-term periods. Intervention mode in medicine-education integration on SGA and infants with other high-risk factors can reduce or eliminate the abnormality of early brain development and prevent the decline of long-term intelligence and cognitive function. 2023 Vol. 11 (2): 91- [Abstract] ( 725 ) HTML (1 KB)  PDF (944 KB)  ( 582 )        Article 95 Study on compilation and reliability and validity of joint attention to parent self-assessment scales ZHENG Rong, CHEN Zhaoxia, WANG Linyan, HONG Qin, XU Yaqin, ZHANG Min, TONG Meiling, CHI Xia DOI: 10.3969/j.issn.2095-4301.2023.02.002 Objective To develop the joint attention parents self-rating scale（JAPS）, and assess its reliability andvalidity in the identification and screening of autism spectrum disorder（ASD）children. Methods We developed the JAPS through literature researching, in-depth interviewing, expert consulting, and entries screening methods. By using convenient sampling method, a total of 836 parents of typically developing children and 135 children diagnosed with ASD, were randomly selected to complete this survey. The reliability, content validity, and relevance validity of the JAPS were analyzed statistically. Results The internal consistency reliability of the JAPS was 0.90. The coefficients of the three dimensionswere all above 0.70. All the entries in high（top 27% of the scalescore）and low（last 27% of the scalescore）group weresignificantly different（P<0.001）, and there was a significantly positive association between all entries and the total score（r=0.38-0.82, P<0.01）. The exploratory factor analysis indicated that the relationship among entries was good, and the extracted 3 factors were consistent with the dimension-division previously envisaged. There was significant difference between the scores of typically developing children and ASD children. Moreover, a significantly negative correlation between JAPS score and childhood autism rating scale（CARS）score was found in ASD children（r=-0.912, P<0.001）. Conclusion The JAPS reveals good reliability and validity, which can be used as an early screening tool in children with ASD, and provide an effective monitoring tool for early intervention. 2023 Vol. 11 (2): 95- [Abstract] ( 698 ) HTML (1 KB)  PDF (878 KB)  ( 448 ) 99 Analysis on conditions of collective children’s health and health care personnel in Shanghai from 2015 to 2021 MA Fuchan, ZHANG Jing, YANG Lulu, NIU Dayan, YIN Ying, PENG Yongmei DOI: 10.3969/j.issn.2095-4301.2023.02.003 Objective To analyze the conditions of collective children’s health and health care personnel in Shang-hai, and provide reference for further standardizing the health care work of collective children. Methods The data of annual physical examination of children and monthly reports of infectious diseases and accidents in nurseries and kindergartens in Shanghai from 2015 to 2021 were collected and analyzed. The basic situation of health care personnel in 2015 and 2021 was investigated by self-made questionnaires. Results From 2015 to 2021, protein-energy malnutrition of collective chil-dren in Shanghai remained at a low level. Anemia and dental caries showed a downward trend. The rising trend of obesity was controlled but the incidence remained at a high level. Ametropia showed an upward trend. In 2021, the overall health status of collective children in urban areas was better than that in suburban areas. The overall incidence of infectious diseases was decreasing and the incidence of injuries was low from 2015 to 2021. In terms of the ratio of children to health care personnel, the proportion of institutions met the 150 : 1 standard in 2021 and was higher than that in 2015 . In urban areas, the proportions were higher than those in suburban areas. The proportions of health care personnel without professional titles and engaged in this post for less than 10 years increased. Conclusion Obesity and vision care should be focused on in the collective child health care in Shanghai. The increase in the number of health care personnel has played a positive role in collective child health care, but the professionalism and stability of the team still need to be strengthened. 2023 Vol. 11 (2): 99- [Abstract] ( 713 ) HTML (1 KB)  PDF (904 KB)  ( 464 ) 104 Relationship between college students’ shyness and online game addiction: a mediating role of self-regulatory fatigue LI Jiaojiao, XU Bibo, YUAN Hailong, WU Lianning DOI: 10.3969/j.issn.2095-4301.2023.02.004 Objective To explore the effects of shyness on online game addiction of college students, and investigate the mediating effect of self-regulatory fatigue between them. Methods A total of 688 college students were investigated by shyness scale, self-regulating fatigue scale, and online game addiction questionnaire. Results The detection rate of online game addiction of college students was 12.06%. Shyness and self-regulatory fatigue were positively correlated withonline game addiction（r=0.21, P<0.01; r=0.24, P<0.01）. Self-regulatory fatigue played a mediating role betweenshyness and online game addiction（β=0.17, P<0.001）, and the direct and mediating effects were 77.78% and 22.22%. Conclusion Shyness not only directly affects online game addiction of college students, but also indirectly affects online game addiction through self-regulation fatigue. College students’ online game addiction can be alleviated by reducing shyness level and self-regulating fatigue. 2023 Vol. 11 (2): 104- [Abstract] ( 707 ) HTML (1 KB)  PDF (765 KB)  ( 694 ) 109 Correlation between malnutrition and dietary diversification of children aged 0-5 years in 6 counties（cities）in Xinjiang Nubiya WUFUER, Adila SULIDAN, SUN Jingxuan, ZHANG Jun, Xiamusiye MUYIDULI, WANG Wenlei, ZHE Wei, ZHANG Rong, ZHAO Junling DOI: 10.3969/j.issn.2095-4301.2023.02.005 Objective To explore the relationship between malnutrition of children aged 0-5 years and dietarydiversification in 6 counties（cities）in Xinjiang. Methods Multi-stage stratified cluster random sampling method was used to investigate 805 children aged 0 -5 years in 6 counties（cities）in Xinjiang. Through face-to-face survey and physical examination, basic personal information, dietary information, height, and weight values were collected. Dietary diversityscore（DDS）was used to evaluate dietary quality, and Logistic regression was used to analyze the association between DDS9 groups and children’s malnutrition. Results Among the children aged 0-5 years, the low weight rate was 2.48 %, the growth retardation rate was 5.59%, and the wasting rate was 6.21%. The intake frequency of the potato, fruit, meat, milk and milk products in children with low birth weight, the intake frequency of the potato, vegetables, fruit, fish, beans and nuts, milk and milk products in children with growth retardation, and the intake frequency of the potato, vegetables, poultry, fishand shrimp food in thin children were lower than those of normal children（P<0.05）. Logistic regression analysis showed that urban and rural areas and dietary diversification were related to growth and development. Conclusion The malnutrition of the research subjects is related to dietary diversification. It is necessary to scientifically and rationally adjust the dietary structure to improve the nutritional status of children, promote children’s malnutrition, and reduce the incidence of malnutrition. 2023 Vol. 11 (2): 109- [Abstract] ( 695 ) HTML (1 KB)  PDF (759 KB)  ( 515 ) 114 Reliability and validity of virtual simulation teaching scale in evaluation of Harvey simulation teaching GUO Kai, XU Chenhua, MENG Shu DOI: 10.3969/j.issn.2095-4301.2023.02.006 Objective To design the virtual simulation teaching scale, and analyze its reliability and validity in the evaluation of Harvey simulation teaching. Methods By searching the clinical questionnaires databases at home and abroad, and combining the characteristics of Harvey course, a virtual simulation teaching scale was developed. The clarity and content validity of the questionnaire were evaluated by an expert panel composed of clinical teachers and experts. A total of 25 students were randomly selected from Shanghai Jiao Tong University School of Medicine to finish the online questionnaire. The questionnaire was finished again after 1-week interval and the test-retest reliability and internal consistency reliability were tested. Another 65 students were selected for constructing validity and discrimination validity analyses. Results The instruction clarity scores of each item of the virtual simulation teaching scale were 9.5-9.9. The scale-content validity index/average（S-CVI/Ave）was 1.0. The test-retest reliability intraclass correlation coefficient（ICC）for each item ranged from 0.63 to 0.91, as the total score of the scale was 0.75. There was no significant difference between the two tests（P>0.05）. The Cronbach’s α coefficient of internal consistency was 0.82. The KMO（Kaiser-Meyer-Olkin）and Bartlett spherical test approximation χ2 values were 0.64 and 502.9（P<0.01）. Conclusion The virtual simulation teaching scale showed promising reliability and validity in the evaluation of Harvey teaching system. It can be used to evaluate the effect of Harvey teaching system and guide the teaching of cardiovascular medicine. 2023 Vol. 11 (2): 114- [Abstract] ( 698 ) HTML (1 KB)  PDF (753 KB)  ( 571 ) 119 Association between poor visual acuity and nutritional status of middle school students in Urumqi ZUO Zehua, LI Shulin, LI Junhui, HAO Haiya, WANG Qian DOI: 10.3969/j.issn.2095-4301.2023.02.007 Objective To investigate the association between poor visual acuity and nutritional status in middle school students in Urumqi, and provide a reference basis for parents, schools, and society to carry out myopia prevention and control of adolescents. Methods From December 2021 to January 2022, 2 001 students aged 11-18 years in Urumqi were selected by stratified whole-group random sampling for a questionnaire survey, which included a general demograhic questionnaire and a Chinese version of physical activity questionnaire for adolescents. A single-factor analysis of the influencing factors of middle school students’ visual acuity was carried out, and the correlation between visual acuity and nutritional status was explored by using a binary Logistic regression model. Results In middle school students of Urumqi, the rate of poor visual acuity, overweight and obesity rates of boys, overweight and obesity rates of girls, and rates of poor visual acuity in studerts with overweight and obesity were 69.7%, 19.7%, 9.6%, 9.5%, 2.3%, 71.8% and 78.1%, respectively. There was asignificant difference in the detection of poor visual acuity between male and female students（χ2=10.42, P<0.05）. The detection rate of poor vision in the overweight female group was significantly higher than that in the overweight male group, but in the obese group, it was significantly lower. After adjusting the confounding factors such as physical activity score, sleep duration, and parental myopia, the results of multifactorial regression analysis showed that boys in the obese group were atgreater risk of developing poor vision（OR=1.788, 95% CI: 1.006-3.178）. Conclusion Obese boys in Urumqi are more likely to have poor visual acuity. More studies are needed to explore the association between poor visual acuity and nutritional status in order to provide reference for the prevention and control of poor visual acuity in middle school students. 2023 Vol. 11 (2): 119- [Abstract] ( 740 ) HTML (1 KB)  PDF (740 KB)  ( 491 ) 124 Sleep problems and influencing factors among infants aged 0-35 months in Shanghai ZHONG Pingli, JIANG Chunhua, LI Yun, ZHANG Ying, YAO Yi, KANG Shurong, DENG Yujiao, WANG Guanghai DOI: 10.3969/j.issn.2095-4301.2023.02.008 Objective To explore the current status of sleep and influencing factors among infants in Shanghai, and provide reference for the prevention and intervention of infants’ sleep problems. Methods A total of 457 infants aged 0-35 months, who underwent medical inspection in the Child Health Clinic of Maternal and Child Health Care Hospital of MinhangDistrict of Shanghai, were enrolled. Their parents completed the brief infant sleep questionnaire（BISQ）and the general information questionnaire. Univariate factor and Logistic regression were used to analyze the influencing factors of various sleep problems. Results The average sleep time of the infants was（3.95±2.20）h during daytime,（9.41±1.32）h atnight, and（13.37±2.28）h per day, respectively. The infants’ daytime and full day sleep time decreased with age rising（P<0.05）, but the night sleep time increased with age rising（P<0.05）. The proportion of infants whose full day sleep time was in the recommended range was 83.6%, which gradually increased with age rising. The incidence of sleep problemsin all infants was 54.70%, with highest incidence on difficulty in falling asleep（28.45%）, followed by nocturnal awake（19.69%）andsleeprhythm disorder（17.94%）,andthesleep breathingproblemwas the lowest（4.16%）.The univariate factor analysis showed that age, current feeding way, room brightness, room temperature, sleeping room, sleeping bed, and ways to fall asleep were associated with sleep problems. Logistic regression analysis showed that appropriate room temperature（OR=0.21, P=0.045）and not sleeping alone（OR=2.48, P=0 .005）were significant predictors to sleep problems. Conclusion Sleep problems are common among infants aged 0-35 months in Shanghai. It is suggested to strengthen science education related to sleep health knowledge, and guide the parents to provide suitable sleep environment and help infants establish good sleep habits for promoting sleep health. 2023 Vol. 11 (2): 124- [Abstract] ( 737 ) HTML (1 KB)  PDF (793 KB)  ( 695 ) 131 Effect of social support on learning burnout of middle school students during COVID-19 pandemic: a moderated mediation model WANG Yaqi, ZHU Haijuan DOI: 10.3969/j.issn.2095-4301.2023.02.009 Objective To explore the effects of social support on learning burnout, and investigate the mediating roles of resilience and self-efficacy in middle school students during COVID-19 pandemic. Methods A total of 600 middle school students were randomly selected. Adolescent social support scale, learning burnout scale, mental toughness scale, and self-efficacy scale were used, and a moderated mediation model was constructed. Results Social support significantlypredicted learning burnout（β=-0.400, t=-17.72, P<0.01）. Psychological resilience played a mediating role in the relationship between social support and learning burnout. Mesomeric effect accounted for 79.86% of the total effect. Self-efficacy not only moderated the latter half of the mediation path（mental toughness → self-efficacy → learningburnout）（β=-0.008, t=-2.07, P<0.05）, but also moderated the direct effects of independent and dependent variables（β=0.013, t=2.91, P<0.05）. Conclusion Social support can directly affect learning burnout, and it can also affect learning burnout through the mediating effect of mental toughness. Both the mediating effect of mental toughness and the direct effect of social support on learning burnout are moderated by self-efficacy. 2023 Vol. 11 (2): 131- [Abstract] ( 744 ) HTML (1 KB)  PDF (924 KB)  ( 814 ) 136 Influencing factors of college students’ learning quality and improvement strategies CHEN Jingyi, ZHANG Hui DOI: 10.3969/j.issn.2095-4301.2023.02.010 Objective To explore the influencing factors and mechanism of college students’ learning quality, and provide theoretical basis and strategic support for improving college students’ learning quality. Methods Using text analysis and comparative research methods, we analyzed and summarized the major factors and their mechanism affecting the learning quality of college students, in four Chinese and foreign universities’ situation survey index systems. Results Students’ background information and learning concepts affected learning motivation and learning methods, which in turn affected learning behaviors and led to high-quality learning gains. Learning participation, learning initiative, academic challenges, teacher-student relationships, and campus environments affected students’ investment in learning time, choice of learning methods, and academic exchanges between teachers and students. In all, these affected students’ learning efficiency and learning behavior, and then affected learning gains and satisfaction evaluation. Learning gains and satisfaction evaluation were the representation and feedback of college students’ learning quality. Conclusion The improvement of college students’ learning quality requires students to set up constructive learning concepts, adopt in-depth learning methods, optimize learning strategies, and cultivate learning interest. Teachers should pay attention to effective teaching practices in the classroom and build a learning community between teachers and students. Colleges and universities should be learner-centered and motivate students in learning initiative, optimizing the campus learning environment, and creating a good atmosphere. 2023 Vol. 11 (2): 136- [Abstract] ( 727 ) HTML (1 KB)  PDF (817 KB)  ( 706 ) 141 Effects of parent-child bonding on social adjustment of left-behind children: a chain mediating role of loneliness and Internet addiction ZHANG Lulu, WANG Weizhou, SHI Sujuan, HU Shuang DOI: 10.3969/j.issn.2095-4301.2023.02.011 Objective To investigate the effect of parent-child bonding on social adjustment of left-behind children, and explore the mediating effect of loneliness and Internet addiction. Methods A total of 950 left-behind children from 4 primary schools in a certain area of Shandong Province were enrolled. Parent-child bonding scale, child loneliness scale, adolescent pathological Internet use scale, and adolescent social adjustment scale were used. Valid data of 883 children were recovered. Results There were significant differences in parent-child bonding and loneliness among left-behind children in different grades and parents’going out（P<0.05 or P<0.01）. There were significant differences in Internet addiction among left-behind children in different genders, grades, and parents’going out（P<0.01）. There was a significant difference in social adaptation among left-behind children in different grades（P<0.01）. Parent-child bonding of left-behind children was negatively correlated with loneliness and Internet addiction, but positively correlated with social adaptation. Loneliness of left-behind children was positively correlated with Internet addiction, but negatively correlated with social adaptation. Internet addiction was negatively correlated with social adaptation. Loneliness and Internet addiction played a significant mediating role in parent-child bonding and social adjustment. Loneliness and Internet addiction played a significant chain mediating role. Conclusion Parent-child bonding not only directly predicts the social adjustment of left-behind children, but also indirectly affects the social adjustment of left-behind children through the independent mediating effect of loneliness and Internet addiction, and the chain mediating effect of loneliness and Internet addiction. 2023 Vol. 11 (2): 141- [Abstract] ( 741 ) HTML (1 KB)  PDF (808 KB)  ( 724 ) 147 Survey on cognition and behavior among primary and middle school students to COVID-19 and analysis of influencing factors in Chongming District of Shanghai GU Shuangyu, HAN Xiaoli, LI Xin, HUANG Zefan, YUAN Haiyan, GUO Haibin, HUANG Jiaoling, DU Qing DOI: 10.3969/j.issn.2095-4301.2023.02.012 Objective To investigate the cognition and behavior of primary and middle school students in Chongming District of Shanghai during the normalized prevention and control of COVID-19, and analyze its influencing factors. Methods Multistage stratified cluster sampling method was used to randomly select 5 primary schools, 3 junior middle schools, 2 senior high schools, and 1 vocational school between September and October in 2020. From grade 4 to grade 12, at least 80 students were selected from each grade with a whole class as a unit. A total of 1 816 students finished the questionnaire survey of knowledge and behavior of COVID-19. Binary Logistic regression was applied to analyze influencing factors. Results Among the students, 81.00% (1 433/1 769) understood the etiology of COVID-19. They had high executive power in following epidemic prevention and control behaviors such as reducing going out, wearing masks, and cleaning hands. The main ways to acquire knowledge about COVID-19 were school lectures or subject teaching. Binary Logistic regression analysis showed that onlineteaching（OR=3.16）, COVID-19 knowledge in class（OR=1.79）, and age（OR=1.13）promoted the knowledge of COVID-19 amongprimary and middle school students（P<0.05）. Lower age（OR=0.81）, female（OR=1.25）, and advise from doctors（OR=1.41）werethe promoting factors of hand hygiene and other protective behaviors（P<0.05）. Conclusion Most students have a comprehensive knowledge of COVID-19 and can take effective epidemic prevention and control behaviors. For students of different school ages, multiple ways and forms of publicity are adopted to carry out health education, focus on diet, nutrition, physical exercise, and mental health, and guide students to form an active healthy life concept and develop good living habits. 2023 Vol. 11 (2): 147- [Abstract] ( 718 ) HTML (1 KB)  PDF (873 KB)  ( 612 )        Review 154 Language assessment of children with autism spectrum disorder WU Dandan, ZHAO Jinzhu, LI Jinhui, HU Cong, CUI Jinru, HAO Yan DOI: 10.3969/j.issn.2095-4301.2023.02.013 Language disorder is a common comorbidity of children with autism spectrum disorder（ASD）. It is very important to understand the main contents and methods of language assessment for children with ASD. Based on the need to diagnose and establish individualized intervention plans, language assessment not only needs to assess children’s reception and expression ability, but also needs to accurately assess the impairment of the five elements of language, including phonology, morphology, syntax, semantics, and pragmatics. Standardized assessment tools, and non-standardized tools, such as caregiver interviews, questionaires, environmental observations, and language sample analysis, are common methods of language assessment. It more comprehensively evaluates the language ability of children with ASD by combining these two methods. Therefore, we provide an overview of the main contents and methods of language assessment for children with ASD in this review. 2023 Vol. 11 (2): 154- [Abstract] ( 815 ) HTML (1 KB)  PDF (769 KB)  ( 1271 ) 159 Management of non-oral to oral feeding in infants with congenital esophageal atresia WANG Junli, TANG Chunyan, WU Wenjie, SHENG Xiaoyang, WANG Jun DOI: 10.3969/j.issn.2095-4301.2023.02.014 Congenital esophageal atresia（CEA）is a serious congenital digestive tract malformation. Surgical treatment can restore the structure but not the function. Children with CEA face the challenge of non-oral to oral feeding in the long-term survival. Among children with CEA, 21%-84% have dysphagia, which leads to serious complications such as lung disease, language development disorders, and malnutrition. This paper introduces the key factors of non-oral to oral feeding in children with CEA and the family-centered multidisciplinary collaboration model of CEA children based on the clinical swallowing assessment program, so as to give correct feeding information of CEA children and provide an appropriate scheme for their non-oral to oral feeding. 2023 Vol. 11 (2): 159- [Abstract] ( 679 ) HTML (1 KB)  PDF (732 KB)  ( 419 )

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