To analyze the current situation of internet addiction and its influencing factors among middle school students in Hunan province.

In 2022, a multi-stage stratified cluster sampling method was used to select a total of 127 624 middle school students from various counties and districts in Hunan province as research subjects. The chi-square test was used to compare the differences in internet addiction detection rates between groups, and multi-factor logistic regression analysis was used to analyze the influencing factors of internet addiction.

The detection rate of internet addiction among middle school students in Hunan province was 2.69%, with 2.79% for boys and 2.58% for girls. The internet addiction rate of boys was higher than that of girls, and both showed an upward trend with increasing grade (except for grade 12). Among the middle school students identified as having internet addiction, the most frequent symptoms were withdrawal symptoms (87.75%), tolerance symptoms (83.09%), and internet control disorders (79.45%). Multi-factor logistic regression analysis showed that higher grades (grade 8: OR = 1.681, 95%CI: 1.459 - 1.936; grade 9: OR = 1.881, 95%CI: 1.636 - 2.163; grade 10: OR = 1.756, 95%CI: 1.520 - 2.029; grade 11: OR = 1.853, 95%CI: 1.605 - 2.140; grade 12: OR = 1.612, 95%CI: 1.387 - 1.873), boarding school (OR = 1.748, 95%CI: 1.619 - 1.886), ethnic minority (OR = 1.147, 95%CI: 1.053 - 1.250), being beaten and scolded by parents (OR = 1.797, 95%CI: 1.652 - 1.954), depression (OR = 2.569, 95%CI: 2.376 - 2.778), being injured (OR = 1.342, 95%CI: 1.196 - 1.505), being bullied (OR = 2.022, 95%CI: 1.875 - 2.181), smoking (OR = 1.979, 95%CI: 1.794 - 2.184), and drinking alcohol (OR = 1.909, 95%CI: 1.755 - 2.076) were risk factors for internet addiction among middle school students; while being female (OR = 0.914, 95%CI: 0.850 - 0.983), school location in suburban counties (OR = 0.822, 95%CI: 0.763 - 0.884), and physical activity (exercise 1 - 3 d/week: OR = 0.609, 95%CI: 0.561 - 0.660; exercise 4 - 6 d/week: OR = 0.509, 95%CI: 0.454 - 0.571; exercise 7 d/week: OR = 0.466, 95%CI: 0.404 - 0.538) were protective factors against internet addiction among middle school students.

The phenomenon of internet addiction among middle school students in Hunan province is relatively serious. It is recommended to intervene in high-frequency symptoms of internet addiction and its influencing factors to reduce the occurrence of internet addiction behavior among middle school students.

To establish a nomogram prediction model for the comorbidity risk of myopia and neck and shoulder pain among primary and secondary school students in Nanjing city, Jiangsu province, and to provide a scientific basis for the joint prevention and control of myopia and neck and shoulder pain among these students.

From September to October 2023, a stratified random sampling method was used to select 14 733 primary and secondary school students in urban and suburban areas of Nanjing city for questionnaire surveys and vision tests. A multifactorial unconditional logistic regression analysis was used to screen the influencing factors of myopia and neck and shoulder pain comorbidity among primary and secondary school students in Nanjing city, and a nomogram prediction model was established. The Area Under Curve (AUC) of the Receiver Operating Characteristic (ROC) Curve was used to evaluate the discrimination of the model, and the Hosmer-Lemeshow test and Calibration curve were used to evaluate the goodness of fit of the model.

Among the 12 529 primary and secondary school students finally included in the analysis in Nanjing city, 3 040 had both myopia and neck and shoulder pain, with a comorbidity rate of 24.26%. Multifactorial unconditional logistic regression analysis showed that being in middle or high school, being female, often or always lying down or leaning to read books or electronic screens, continuous near-vision time ≥ 30 min, after-school homework time ≥ 2 h/d, screen time ≥ 2 h/d, and social jet lag > 2 h were risk factors for myopia and neck and shoulder pain comorbidity among primary and secondary school students in Nanjing city. A healthy diet, outdoor breaks between classes, desk and chair height adjusted according to height, often or always keeping a distance of > 1 foot from books when reading and writing, outdoor activity time ≥ 1 h/d, and adequate sleep time were protective factors for myopia and neck and shoulder pain comorbidity among primary and secondary school students in Nanjing city. A nomogram prediction model for the comorbidity risk of myopia and neck and shoulder pain among primary and secondary school students in Nanjing city was established based on these 13 variables. The AUC of the model was 0.741 (95%CI: 0.732 - 0.751). The goodness of fit of the prediction model was good (χ² = 3.933, P = 0.863), and the predicted values were basically consistent with the actual values, indicating that the model had a good predictive effect.

The nomogram prediction model for the comorbidity risk of myopia and neck and shoulder pain among primary and secondary school students in Nanjing city established in this study has a good predictive effect and can provide a reference for the development of personalized intervention measures for myopia and neck and shoulder pain among primary and secondary school students.

To investigate the exposure time and content characteristics of short videos among preschool children and analyze their association with axial length, in order to provide a reference for myopia prevention and control in preschool children.

From April to June 2023, 326 preschool children from 36 classes in one kindergarten each in Pudong New district and Xuhui district, Shanghai city, were enrolled in this study. Online questionnaires were distributed to parents to collect information on children's sociodemographic characteristics, home electronic device environment, and daily behaviors. Axial length, height, and weight were measured on-site. A tablet computer equipped with a "Children′s Screen Exposure" application was used to accurately measure the duration and content of children′s electronic screen use within one week. Data were analyzed using t-tests, linear regression, and quantile regression.

The axial length of boys [(22.69 ± 0.65) mm] was significantly longer than that of girls [(22.00 ± 0.72) mm]. Axial length increased significantly with age (β = 0.269, P < 0.001), height (β = 0.346, P < 0.001), weight (β = 0.342, P < 0.001), and daytime sleep duration (β = 1.2×10⁻³, P = 0.03). Sixty-three (19.33%) preschool children were exposed to short videos, with children's programs accounting for the highest proportion of viewing time (23.18%). 48.40% of the children's viewing time was PG-rated or above, requiring parental guidance or unsuitable for children. The vast majority of the content viewed by children was non-educational (96.09%) and rapidly changing (82.75%). Children also watched a large proportion of reality-based content (52.13%). Children who spent more time watching slow-switching videos had longer axial lengths (β = 0.0385, P = 0.04).

Preschool children are exposed to short videos, mostly children′s programs, non-educational content, and rapidly changing content. The viewing time is mainly spent on reality-based content and PG-rated or above content. Children who spend more time watching slow-switching short videos have longer axial lengths.

To analyze the timeliness of pertussis-containing vaccine (PCV) uptake among children born in Henan province from 2012 to 2021 and to provide a basis for pertussis prevention and control.

PCV uptake information from 2012 to 2021 was collected through the Henan Provincial Immunization Program Information Management System, and the timely vaccination rate of PCVs in Henan province was descriptively analyzed.

A total of 14 890 226 children were born in Henan province from 2012 to 2021. The average PCV uptake rate gradually increased from 93.92% in 2012 to 98.82% in 2021, and has remained above 98% since 2016. The overall PCV uptake rate from 2012 to 2021 decreased with increasing doses, with rates of 97.32%, 96.82%, 96.46%, and 94.62% for the first to fourth doses, respectively. The timely PCV uptake rate within one month from 2012 to 2021 also gradually decreased with increasing doses, with rates of 81.26%, 68.43%, 54.83%, and 42.74% for the first to fourth doses, respectively. The non-National Immunization Program (NIP) vaccine replacement rate for PCV doses 1 to 4 ranged from 0.60% to 21.95%, 0.50% to 21.80%, 0.57% to 21.48%, and 0.47% to 20.77%, respectively.

The PCV uptake rate in Henan province has remained stable at a high level for a long time, but the timely vaccination rate, especially for the third and fourth doses, needs to be further improved. Increasing the timely PCV uptake rate will be an important measure for effective pertussis control.

To investigate the anemia status and its influencing factors among students in the Nutrition Improvement Program areas of Jilin province, and to provide a reference for formulating targeted nutrition improvement measures.

A stratified cluster sampling method was used to select a total of 2 258 primary school students (grade 3 and above) and junior high school students from two key monitoring counties implementing the "Rural Compulsory Education Student Nutrition Improvement Program" in Jilin province in 2023. Questionnaires, physical examinations, and hemoglobin tests were conducted. The chi-square test and multivariate binary logistic regression analysis were used to analyze the anemia status and its influencing factors among the students.

The anemia prevalence among primary and secondary school students in the Nutrition Improvement Program areas of rural Jilin province was 6.55%, all of which were mild (3.63%) and moderate anemia (2.92%). The anemia prevalence in girls (8.97%) was higher than that in boys (4.25%), and the difference was statistically significant (χ² = 20.534, P < 0.001). Among boys, the detection rates of anemia differed significantly among students with different nutritional statuses and snacking frequencies (P < 0.05). Among girls, the detection rates of anemia differed significantly among students with different maternal education levels, school stages, age groups, whether they had diarrhea in the past two weeks, whether they had menstruated, frequency of dairy product consumption, snacking frequency, whether they liked the food provided by the school, whether they usually had leftover food, and daily snack expenditure (P < 0.05). Multivariate binary logistic regression analysis showed that, compared with the corresponding reference groups, overweight and obesity were protective factors against anemia in boys, while snacking 3-6 times per week was a risk factor for anemia. Consuming dairy products 3-6 times a week and ≥ 1 pack (200 mL/pack) daily were protective factors against anemia in girls, while having menstruated and having a mother with a primary school education or below were risk factors for anemia in girls. The risk of anemia in boys and girls in Dunhua city was 6.091 times and 3.309 times higher than that in Da'an city, respectively.

There are gender differences in the prevalence of anemia among students in the Nutrition Improvement Program areas of Jilin province. The influencing factors of anemia and the detection rates of anemia also vary by region. Individualized nutritional intervention measures are needed to improve the anemia status of students.

To investigate the willingness of parents of children in Anshun city, Guizhou province, to participate in supplementary insurance for adverse events following immunization (AEFI) (hereinafter referred to as supplementary insurance) and its influencing factors.

From March to June 2024, a stratified random sampling method was used to select 14 vaccination clinics from seven counties (districts) in Anshun city. Questionnaires were administered to 1 634 parents of children aged 0-1 year and 14 medical staff. A two-level logistic regression model and random forest analysis were used to analyze the factors influencing parents′ willingness to participate in the insurance.

The willingness of parents to participate in supplementary insurance was 56.90%. Two-level logistic regression analysis showed that parents′ willingness to participate in the insurance was clustered at the vaccination clinic level. The length of time vaccination clinic staff were responsible for education work (1 year - < 2: OR = 1.697, 95%CI: 1.241 - 2.320; ≥ 2 years: OR = 2.061, 95%CI: 1.328 - 3.198), and the presence of insurance company staff on-site to assist with education (OR = 1.443, 95%CI: 1.039 - 2.004) positively influenced parents′ willingness to participate. Having three or more education staff at the vaccination clinic (OR = 0.635, 95%CI: 0.464 - 0.868) negatively influenced parents′ willingness to participate. At the individual level, educational level (junior high school: OR = 1.544, 95%CI: 1.015 - 2.351; senior high school or secondary vocational school: OR = 1.994, 95%CI: 1.240 - 3.207; junior college: OR = 2.319, 95%CI: 1.410 - 3.814; bachelor′s degree or above: OR = 2.217, 95%CI: 1.317 - 3.731), monthly household income (¥5000 - < 8000: OR = 1.629, 95%CI: 1.159 - 2.289; ¥8000 - < 10000: OR = 1.787, 95%CI: 1.044 - 3.058), having purchased other insurance for their children (OR = 2.801, 95%CI: 1.886 - 4.160), understanding of AEFI (OR = 1.612, 95%CI: 1.133 - 2.294), and having received information about the compensation insurance policy during maternity care (OR = 1.551, 95%CI: 1.039 - 2.313) positively influenced parents′ willingness to participate. Grandparents or other relatives being the primary caregiver (OR = 0.539, 95%CI: 0.297 - 0.978), belonging to an ethnic minority group (OR = 0.763, 95%CI: 0.599 - 0.973), and having two or more children (OR = 0.688, 95%CI: 0.546 - 0.868) negatively influenced parents′ willingness to participate. Random forest results showed that the top five factors influencing parents′ willingness to participate were parental education level, monthly household income, having purchased other insurance for their children, length of time responsible for education work, and level of understanding of AEFI.

The willingness of parents in Anshun city to participate in supplementary insurance for AEFI is relatively low. Influencing factors include those at both the individual parent level and the vaccination clinic level. Measures should be taken at multiple levels to increase parents′ willingness to participate.

To investigate the digital literacy, digital health literacy, and mental health status of the elderly in Heilongjiang province, and to explore the relationships among these three factors, thereby providing a reference for improving the mental health of this population.

A face-to-face interview was conducted among 800 residents aged ≥ 60 years, recruited using stratified cluster sampling in two cities of Heilongjiang province in August 2024. A self-developed questionnaire on demographics, digital literacy, and digital health literacy, along with the simplified version of the Center for Epidemiologic Studies Depression Scale (CES-D), the six-item UCLA Loneliness Scale (ULS-6), and the Satisfaction with Life Scale (SWLS), was used in the survey. AMOS 28 software was used to analyze the relationships among the three, and the bootstrap method was used to test the mediating effect.

Valid information was collected from all participants. Participants′ total scores and scoring indices were as follows: digital literacy (15.30 ± 14.23, 31.9%), digital health literacy (30.60 ± 16.56, 40.8%), and mental health (55.59 ± 11.96, 84.2%). Digital literacy positively predicted digital health literacy (standardized beta = 1.021, 95% confidence interval [95%CI]: 1.006 - 1.034), and digital health literacy positively predicted mental health (standardized beta = 0.601, 95%CI: 0.014 - 2.526). The mediating effect of digital health literacy on the relationship between digital literacy and mental health was significant (standardized beta = 0.613, 95%CI: 0.013 - 2.522).

The digital literacy and digital health literacy of the elderly in Heilongjiang province are relatively low. Digital health literacy plays a mediating role in the relationship between digital literacy and mental health. Improving the digital literacy of the elderly is of great importance in promoting their digital health behaviors and mental health.

To understand the relationship between smartphone use and self-rated health among rural middle-aged and older adults, investigate its heterogeneity among different groups, and explore the mediating effect of health-promoting behaviors, so as to provide scientific recommendations for promoting healthy aging in rural areas.

Based on data from the 2020 China Rural Revitalization Survey (CRRS), multiple linear regression models were established to examine the direct effect of smartphone use (including whether to use, difficulty of use, and duration of use) on self-rated health among rural middle-aged and older adults. Heterogeneity tests were conducted based on gender, age, and education level. The mediating effect of health-promoting behaviors between smartphone use and self-rated health was analyzed using a three-step regression method and the Bootstrap test.

A total of 2 876 respondents were included, with an average age of (58.82 ± 8.54) years. Among them, 2 266 (78.79%) were male, 2 221 (77.23%) used smartphones, 958 (43.13%) reported no difficulty using smartphones, the average daily smartphone use duration was (2.44 ± 1.86) h, the average health-promoting behavior score was (4.66 ± 2.14) points, and 476 (16.55%) self-rated their health as very good. Multiple linear regression results showed that smartphone use among rural middle-aged and older adults had a significant positive impact on their health-promoting behaviors (β = 0.182) and self-rated health (β = 0.135). Smartphone use duration had a significant positive impact on their health-promoting behaviors (β = 0.076) and self-rated health (β = 0.032). Smartphone use difficulty had a significant negative impact on their health-promoting behaviors (β = -0.173) and self-rated health (β = -0.169) (all P < 0.05). The positive impact of smartphone use on self-rated health varied among rural middle-aged and older adults of different genders, ages, and education levels. Health-promoting behaviors played a mediating role between smartphone use (three dimensions) and self-rated health (indirect effect values were 0.125, -0.161, and 0.030, respectively), accounting for 91.91%, 95.27%, and 90.91% of the total effect, respectively.

Smartphone use among rural middle-aged and older adults has a positive effect on improving self-rated health, with variations among groups with different genders, ages, and education levels. Health-promoting behaviors play a mediating role between smartphone use and self-rated health among rural middle-aged and older adults.