Relationship between depressive symptoms, negative life events, and resilience in primary and secondary school teachers / 中国学校卫生

Objective@#To explore the relationship between depressive symptoms, negative life events and resilience among primary and secondary school teachers, so as to provide a reference for mental health promotion in school teachers.@*Methods@#During November to December 2022, a questionnaire survey was conducted using convenient cluster sampling method to select 11 332 in service teachers from 38 schools in 8 provinces (cities) including Beijing, Guangdong, Anhui, Hubei, Sichuan, Xinjiang, Liaoning, and Heilongjiang. The Patient Health Questionnaire-9 items, a self developed 21-item Adverse Life Events questionnaire, and a 10-item Conner-Davidson Resilience Scale were used to assess depressive symptoms, experiences of negative life events, and resilience levels of the teachers, respectively. The relationship between depressive symptoms, negative life events and psychological resilience were analyzed by multiple linear regression and stratified regression.@*Results@#The detection rate of depressive symptoms among primary and secondary school teachers was 14.0%. Negative life events of primary and secondary school teachers were positively correlated with depressive symptoms ( r =0.35), while psychological resilience was negatively correlated with depressive symptoms ( r =-0.45) ( P <0.05). After adjusting for possible covariates including gender and marital status, negative life events were positively correlated with depressive symptoms ( β=0.22, P <0.01). Resilience played a moderating role in the association of negative life events with depressive symptoms among primary and secondary school teachers ( B=-0.15, P <0.01).@*Conclusions@#Negative life events experiences are associated with higher level of depressive symptoms among school teachers. However, resilience might mitigate the negative effects of negative life events on depressive symptoms, playing a protective role in teachers mental health.

Preliminary development of Health Literacy Evaluation Scale for Pupils / 中国学校卫生

Objective@#To preliminarily develop Health Literacy Scale for pupils, providing a tool for dynamic monitoring and related health literacy research among pupils.@*Methods@#Through policy and literature review, the health literacy evaluation index system of pupils was established. Through two rounds of expert consultation, the evaluation index system and scale item pool of three levels in primary school were formed, and "Evaluation Scale 1.0" was developed. Through two panel discussions, health education experts, teachers and students were invited to provide advices on the content, expression and structure of scale 1.0, turning it into "Evaluation Scale 2.0", and completing the preliminary development of the scale.@*Results@#The health literacy assessment index system of primary school students includes three levels，including level-1 was Grade 1-2, level-2 was Grade 3-4,level-3 was Grade 5-6, covering two level indexes. The scale for primary school students contained five horizontal dimensions and four vertical dimensions. In the Delphi consultation, the response rate was 100%, and the authority coefficient was 0.85. After item selection and modification, the final version of level-1, level-2 and level-3 scales contained 36, 44 and 50 items respectively.@*Conclusion@#The development of Health Literacy Evaluation Scale for pupils has high applicability and practical value.

The joint influence of subjective social status and life skill level on adolescent health risk behaviors / 中国学校卫生

Abstract@#Subjective social status and life skill level are important influencing factors of adolescent health risk behaviors, and they interact with each other and jointly act on adolescent health risk behaviors, which make the mechanism of adolescent health risk behaviors become more diverse and complex. The current paper reviews the correlations among subjective social status, life skill level and adolescent health risk behaviors, in order to explore the joint influence of subjective social status and life skill level on adolescent health risk behaviors, then provides future directions for exploring possible mechanisms, and proposes recommendations for effective prevention strategies of adolescent health risk behaviors.

Research status and progress of health literacy for children and adolescents / 中国学校卫生

Abstract@#Improving health literacy can effectively reduce the risk of health risk behaviors and adverse health outcomes in children and adolescents. Global research on health literacy of children and adolescents has been increasing in recent years. The paper reviews the existing research and proposes that there is no universal definition and connotation of health literacy for children and adolescents, most of the studies use or make some revisions on the definition of adult health literacy in child and adolescent health literacy, failing to consider developmental characteristics and unique health needs of children and adolescents. Moreover, the assessment index system and instruments are diversified, making the research findings from different studies difficult to compare, and to obtain consistent and reliable conclusions. Future endeavors are encoouraged to expand health literacy researches and to update more comprehensive and practical definition, and to develop a standardized assessment instrument that can be validated in Chinese culture.

Knowledge of comprehensive sexuality education and influencing factors among junior high school teachers / 中国学校卫生

Objective@#To understand knowledge of comprehensive sexuality education and its associated factors among junior high school teachers in six provinces in China, in order to provide a scientific basis for teacher training.@*Methods@#From June to December 2021, a convenience sampling method was used to select 1 016 junior high school teachers from Beijing, Chongqing, Liaoning, Sichuan, Yunnan and Guangdong provinces. A structured questionnaire was used to investigate teachers knowledge of comprehenswe sexuality education. Binary Logistic regression was used to analyze the related influencing factors of the knowledge of comprehensive sexuality education among junior high school teachers.@*Results@#The study showed that the knowledge rate of comprehensive sexuality education among middle school teachers was 58.1%, and the knowledge rate was higher in teachers who had conducted sexuality education to students( χ 2=9.42, P <0.01). The percentage of the correct answer on the prevention and control of sexually transmitted diseases(26.0%), the impact of inequality on love relationships( 33.6 %), and the impact of mass media on sexual cognition(68.8%) was the lowest. Regardless of whether they had implemented sexuality education for students, the knowledge and awareness rate of sexual knowledge among biology teachers, school doctors/health teachers and mental health teachers was higher( OR=2.32, 4.17, P <0.05).@*Conclusion@#Knowledge of comprehensive sexuality education among middle school teachers still needs to be improved. It is advisable to strengthen the training of comprehensive sexuality education for middle school teachers and focus on teachers of subjects related to comprehensive sexuality education.

The Influencing Factors of Comprehensive Sexuality Education Capacity and Its Correlation with Subjective Social Status among Chinese Junior High School Students.

(1) Objective: Evidence suggests that comprehensive sexuality education (CSE) can protect and empower younger generations to advocate for their reproductive health and wellbeing. This survey aims to investigate the current status and influencing factors of CSE among Chinese junior high school students, and to evaluate its correlation with the learning experience of sex education and subjective social status (SSS) to provide evidence for the implementation of CSE in the future. (2) Methods: A total of 4109 participants aged 11 to 16 years were recruited using data from a cross-sectional survey among junior high school students in China in 2021. CSE knowledge, attitude, and skills were used to generate the CSE comprehensive capacity by a principal component analysis. One-way ANOVA was used to assess the different effects of school sex education and family sex education. Multiple linear regression was used to assess the association between CSE comprehensive capacity and SSS. (3) Results: The average score of CSE comprehensive capacity was 82.44 ± 8.60 (with a total score of 100 points) among participants. After the adjustment, subjective social status was positively related to CSE comprehensive capacity (B = 0.28, 95% CI: 0.20-0.36), and SSS (School) (beta = 0.62) had a higher impact on CSE comprehensive capacity compared to SSS (Family) (beta = -0.10). School sex education was associated with the CSE knowledge level with a larger magnitude compared to family sex education (mean deviation = -0.53, p = 0.031), whereas family sex education was related to the CSE skill level with a greater magnitude (mean deviation =1.14, p = 0.005). (4) Conclusions: These findings suggest that sex education at school and within the family might have a different impact on CSE capacity, which was positively associated with SSS among junior high school students.

Comprehensive sexuality education knowledge and associated factors among middle school students / 中国学校卫生

Objective@#To understand comprehensive sexuality education knowledge among junior high school students in China, and to analyze relevant influencing factors to provide scientific basis for the implementation of school based sexuality education or comprehensive sexuality education in the future.@*Methods@#By using convenient sampling method, a cross sectional survey was conducted among 4 545 students at grade 1 to grade 3 from junior middle schools in Beijing, Liaoning, Sichuan, Chongqing, Yunnan, Henan, using an online electronic questionnaire during September to October 2021. The questionnaire included general demographic information, subjective social status, sex education received at home and school, bullying, as well as knowledge, attitude, practice and needs towards comprehensive sexuality education.@*Results@#The average score of the comprehensive sexuality education knowledge was (12.21±3.10) points, which was converted to (71.82±18.21) points based on the percentage based system. The scores varied by grade, sex and sexuality education setting, significantly higher in grade 3 students (12.69±2.99), girls (12.28±3.01) ( P < 0.01), and students who have received sex education at home (12.67±2.88) and students who received sex education at school (12.63±2.91), as well as those who had actively searched for sex information online had a higher score (12.71±2.94) ( t =35.10, 28.78, 10.55, P <0.01).Further analysis using multiple linear regression and Logistic regression, "whether you have received sex education at home" "whether you have received sex education at school" "whether you have searched the Internet actively" and "whether it is necessary to carry out comprehensive sex education" are still correlated with the score of comprehensive sex education knowledge; "self reported bullying" was still associated with "subjective social status" score, correct rate of question 2, and "shyness and inferiority toward the development of secondary sexual characteristics" ( P <0.01).@*Conclusion@#The current comprehensive sexuality education knowledge among junior high school students needs to be improved. The level of implementation of sexuality education in different settings varies, but the implementation of sexuality education in schools can help improve students comprehensive sexuality education knowledge level.

Development of Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students / 中国学校卫生

Objective@#To preliminarily develop the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, as an important measuring tool for assessment of comprehensive abilities in infectious disease prevention of Chinese middle school students.@*Methods@#The basic dimensional framework and item pool were established by literature review in the view of public health. Then Delphi method was used to modify the framework and item pool to scale 1.0. Panel discussion in middle school students was used to adjust the expression and structure of scale 1.0, turning it into scale 2.0. With the confirmation of theory experts subjects, the scale was preliminarily developed.@*Results@#Literature review suggested that the basic dimension framework included five longitudinal dimensions and seven horizontal dimensions. According to Delphi method ( n =18), the Kendall s coefficient of concordance ( W ) of the scale was equal to 0.14 ( P <0.01), the average importance, proportion of full marks, coefficient of variation and weight coefficient of all dimensions and items met the inclusion criteria. According to panel discussion, the scale was finally adjusted into scale 2.0 with 53 items. @*Conclusion@#This study preliminarily established the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, which might be applied in both scientific research and practical use.

Development of the Evaluation Scale for the Comprehensive Ability of HIV/AIDS prevention among Chinese young students / 中国学校卫生

Objective@#To develop the Evaluation Sacle for the Comprehensive Ability of HIV/AIDS prevention among Chinese Young Students(hereinafter referred to as the Evaluation Scale).@*Methods@#The Evaluation Scale was preliminarily developed according to standardized preparation procedures of the scales. Firstly, the item pool of the Evaluation Scale was established via literature review and group discussions, and based on the Fourteen Core knowledge of young students HIV/AIDS prevention and control formulated by the Chinese Center for Disease Control and Prevention. Secondly, the Evaluation Scale was preliminarily formed via using the Delphi method to select items.@*Results@#The Evaluation Scale with 85 items was finally formed including four vertical dimensions of knowledge, attitude, behavior and skills and four horizontal dimensions of hazard, prevention, detection and treatment, laws and regulations via literature research, group discussion and two rounds of Delphi method.@*Conclusion@#The Evaluation Scale developed in this paper is scientific and reasonable for constructing is assumed to be a scientific and reasonable proxy tool for the evaluation of the comprehensive ability of young students to prevent AIDS. It can be used for AIDS prevention education or effect assessment before and after intervention.

Diagnostic accuracy of machine-learning-assisted detection for anterior cruciate ligament injury based on magnetic resonance imaging: Protocol for a systematic review and meta-analysis.

BACKGROUND: Although many machine learning algorithms have been developed to detect anterior cruciate ligament (ACL) injury based on magnetic resonance imaging (MRI), the performance of different algorithms required further investigation. The objectives of this current systematic review are to evaluate the diagnostic accuracy of machine-learning-assisted detection for ACL injury based on MRI and find the current best algorithm. METHOD: We will conduct a comprehensive database search for clinical diagnostic tests in PubMed, EMBASE, Cochrane Library, and Web of science without restrictions on publication status and language. The reference lists of the included articles will also be checked to identify additional studies for potential inclusion. Two reviewers will independently review all literature for inclusion and assess their methodological quality using Quality Assessment of Diagnostic Accuracy Studies version 2. Clinical diagnostic tests exploring the efficacy of machine-learning-assisted system for detecting ACL injury based on MRI will be considered for inclusion. Another 2 reviewers will independently extract data from eligible studies based on a pre-designed standardized form. Any disagreements will be resolved by consensus. RevMan 5.3 and Stata SE 12.0 software will be used for data synthesis. If appropriate, we will calculate the summary sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of machine-learning-assisted diagnosis system for ACL injury detection. A hierarchical summary receiver operating characteristic (HSROC) curve will also be plotted, and the area under the ROC curve (AUC) is going to calculated using the bivariate model. If the pooling of results is considered inappropriate, we will present and describe our findings in diagrams and tables and describe them narratively. RESULT: This is the first systematic assessment of machine learning system for the detection of ACL injury based on MRI. We predict it will provide highquality synthesis of existing evidence for the diagnostic accuracy of machine-learning-assisted detection for ACL injury and a relatively comprehensive reference for clinical practice and development of interdisciplinary field of artificial intelligence and medicine. CONCLUSION: This protocol outlined the significance and methodologically details of a systematic review of machine-learning-assisted detection for ACL injury based on MRI. The ongoing systematic review will provide high-quality synthesis of current evidence of machine learning system for detecting ACL injury. REGISTRATION: The meta-analysis has been prospectively registered in PROSPERO (CRD42019136581).

Quality assessment of kidney cancer clinical practice guidelines using AGREE II instrument: A critical review.

BACKGROUND: Evidence-based guidelines are expected to provide clinicians with explicit recommendations on how to manage health conditions and bridge the gap between research and clinical practice. However, the existing practice guidelines(CPGs) vary in quality. This study aimed to evaluate the quality of CPGs of kidney cancer. METHODS: We systematically searched PubMed, Embase, China Biology Medicine disc, and relevant guideline websites from their inception to April, 2018. We identified CGPs that provided recommendations on kidney cancer; 4 independent reviewers assessed the eligible CGPs using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. The consistency of evaluations was calculated using intraclass correlation coefficients (ICC). RESULTS: A total of 13 kidney cancer CGPs were included. The mean scores for each AGREEII domain were as follows: scope and purpose-76.9%; clarity and presentation-76.4%; stakeholder involvement-62.8%; rigor of development-58.7%; editorial independence-53.7%; and applicability-49.4%. Two CPGs were rated as "recommended"; 8 as "recommended with modifications"; and 3 as "not recommended." Seven grading systems were used by kidney cancer CGPs to rate the level of evidence and the strength of recommendation. CONCLUSIONS: Overall, the quality of CPGs of kidney cancer is suboptimal. AGREE II assessment results highlight the need to improve CPG development processes, editorial independence, and applicability in this field. It is necessary to develop a standardized grading system to provide clear information about the level of evidence and the strength of recommendation for future kidney cancer CGPs.

Efficacy and safety of siponimod for multiple sclerosis: Protocol for a systematic review and meta-analysis.

BACKGROUND: Multiple sclerosis is the most common demyelinating disease of the central nervous system with serious social and economic burden. Siponimod is a sphingosine-1-phosphate receptor agonist, and clinical trials in the past decade have shown good prospects for the treatment of multiple sclerosis. But there is a lack of comprehensive understanding of the dose-effect relationship and safety in different subtypes of multiple sclerosis at present. METHODS: We will perform a systematic review and meta-analysis of clinical randomized controlled trials to evaluate the efficacy and safety of siponimod in multiple sclerosis. We will search PubMed, EMBASE, Cochrane Library, Clinical Trials, Cochrane Central Register of Controlled Trials (CENTRAL) using a comprehensive strategy. The reference lists of the articles we select for inclusion will be checked to identify additional studies for potential inclusion. Two reviewers will review all literature independently. Upon inclusion of articles, another 2 reviewers will extract available data using a standardized form and assess the potential bias. Review Manager will be used to conduct data synthesis. There is no requirement of ethical approval and informed consent. RESULT: This is the first systematic assessment of siponimod for the treatment of multiple sclerosis. We predict it will provide high-quality synthesis of existing evidence for the efficacy and safety of siponimod for multiple sclerosis and a relatively comprehensive reference for clinical practice and clinical trials about siponimod to be conducted. CONCLUSION: The results of the systematic review and meta-analysis will provide updated evidence for the use of siponimod for multiple sclerosis. REGISTRATION: The systematic review and meta-analysis is registered in the PROSPERO international prospective register of systematic review (PROSPERO#CRD42018112721).

Association between alcohol consumption and mild cognitive impairment: A protocol of dose-response meta-analysis.

OBJECTIVE: The objective of this study is to investigate the potential dose-response association between alcohol consumption and the risk of mild cognitive impairment (MCI). METHODS: We will perform a dose-response meta-analysis (DRMA) of cohort studies to explore the dose-response relationship between alcohol intake and MCI. A comprehensive literature search of PubMed, EMBASE, The Cochrane Library, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP, and Wan-Fang Database will be conducted. Two investigators will independently select studies, extract data, and assess the quality of the included study. The Newcastle-Ottawa Scale will be used to assess the quality of include studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and A MeaSurement Tool to Assess systematic Reviews (AMSTAR) will be used to assess the quality of evidence and methodological quality. Any disagreement will be resolved by the third investigator. We will use the hazard ratio as the effect indicator, and piecewise linear regression model and restricted cubic spline model will be used for linear and nonlinear trend estimation, respectively. There is no requirement of ethical approval and informed consent. DISCUSSION: This is the first DRMA to explore the dose-response relationship between alcohol intake and MCI. We predict it will provide high-quality evidence to prevent clinical MCI and dementia. REGISTRATION: The DRMA is registered in the PROSPERO (CRD42019127261) international prospective register of systematic review.

Alcohol consumption and risk of dementia: A dose-response meta-analysis.

OBJECTIVE: To investigate the relationship between alcohol consumption and the incidence of dementia. METHOD: We will conduct a systematic search without language and year restrictions to identify all relevant published studies. The following electronic databases will be searched: PubMed, EMBASE, the Cochrane Library, Chinese BioMedical Literature Database (CBM) and China National Knowledge Infrastructure (CNKI), VIP, Wan-Fang. Cohort studies published in Chinese or English are considered for inclusion. Two authors will independently select studies base on inclusion criteria, extract data and assess the quality of included studies using the Newcastle-Ottawa Scale, the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system will be used to quantify absolute effects and quality of evidence. Any disagreement will be resolved by consensus. We will use the hazard ratio (HR) as the effect indicator, piecewise linear regression model and restricted cubic spline model will be used for linear and nonlinear trend estimation, respectively. REGISTRATION: The dose-response meta-analysis is registered in the PROSPERO (CRD42019127367) international prospective register of systematic review. DISCUSSION: In the previous related dose-response meta-analysis studies, there were some limitations: on the 1 hand, the sex was not taken into account. On the other hand, relative risk (RR) is not the best effect indicator for time-to-event data, but compare with RR, HR is much better. This study intends to use HR as the effect indicator to explore the dose-response relationship and the sex difference between alcohol intake and dementia. Accurate alcohol drinking data can provide high-quality evidence for the prevention of dementia.