To explore the relationship between sleep quality and mental health among middle school students, so as to provide scientific basis for improving mental health among adolescents.

From September to December 2023, a stratified cluster random sampling method was employed to select 5 713 middle school students aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Sleep quality and mental health were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Brief Adolescent Mental Health Assessment Questionnaire. Spearman correlation analysis and linear regression analysis were used to explore the relationship between sleep quality and various dimensions of mental health among middle school students.

There was a statistically significant difference in the total PSQI score among middle school students of different age groups (H=226.49, P < 0.01), and there was no statistically significant difference in the psychological health scores of middle school students in different age groups (H=5.37, P>0.05). In terms of gender, the total PSQI score for girls [5.00 (3.00, 6.00)] was higher than that for boys [4.00 (2.00, 6.00)]; additionally, boys had higher mental health scores [85.00 (75.00, 90.00)] than females [83.00 (70.00, 89.00)], with statistically significant differences (Z=-10.90, -8.16, P < 0.01). Spearman correlation analysis revealed a negative correlation between total PSQI scores and mental health scores (r=-0.51, P < 0.05) among middle school students. After controlling for variables such as maximum oxygen uptake, physical activity and nutritional status, linear regression analysis further confirmed that higher PSQI scores were associated with lower mental health scores (B=-3.76, 95%CI=-4.15 to -3.38, P < 0.01).

There is a negative correlation between PSQI scores and mental health scores among middle school students, indicating that improving sleep quality may contribute to better mental health among middle school students.

To explore the relationship between sleep quality and executive function among middle school students, so as to provide theoretical support for the promotion of adolescents' physical and mental health development.

From September to December 2023, 5 713 junior and senior high school students aged 13 to 18 were selected by stratified cluster random sampling method from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Pittsburgh Sleep Quality Index was used to conduct sleep quality survey. And conduct executive function was tested on middle school students, including inhibitory function, refresh function and conversion function tests. Spearman correlation and linear regression were used to analyze the relationship between sleep quality and executive function of middle school students.

The total Pittsburgh Sleep Quality Index (PSQI) score of boys was [4.0(2.0, 6.0)] and that of girls was [5.0(3.0, 6.0)], and the difference was statistically significant (Z=-10.90, P < 0.01). The total PSQI score of boys was positively correlated with both 2-back reaction time and conversion function of executive function (r=0.04, 0.04); the total PSQI score of girls was negatively correlated with 2-back reaction time (r=-0.04) (P < 0.05). After controlling for variables such as mental health, physical activity and nutritional status, linear regression analyses showed that PSQI total score of middle school students was positively correlated with the inhibitory function and the conversion function response time [B(95%CI)=1.28(0.21-2.34), 7.62(2.34-12.90), P < 0.05]; the associations of total PSQI scores among middle school students with both 2-back and 1-back response time were not statistically significant [B(95%CI)=-5.88(-16.14-4.37), 8.05(-3.39-19.50), P>0.05].

Positive correlations are observed on sleep quality with inhibitory and conversion functions of executive function among middle school students.

To explore relationship of sleep quality with overweight and obesity among middle school students, so as to provide a reference basis for improving adolescent sleep health.

From September to December 2023, 5 713 middle school students aged 13 to 18 were selected by stratified cluster random sampling method in six regions, including Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi. Sleep quality survey was conducted on middle school students by Pittsburgh Sleep Quality Index. Height and weight were measured, and World Health Organization's standards for growth and development of children and adolescents was used to evaluate their nutritional status. Both χ² test and Logistic regression analysis were used to analyze the association between sleep quality and nutritional status of middle school students.

The non-compliance detection rate of sleep quality was 38.4% among girls, but 29.2% among boys, and the difference was of statistical significance(χ²=54.08, P < 0.01). The detection rate of substandard sleep quality was 34.2% in the group with normal nutritional status, 38.3% in the group with overweight, 43.7% in the group with obesity and 26.0% in the group with emaciation, and the difference in the rates of substandard sleep quality among middle school students of different nutritional status was statistically significant (χ²=68.15, P < 0.01). Logistic regression analysis showed that, after controlling for mental health and physical activity, the detection rate of substandard sleep quality in the obese groups was 1.30 times higher than that in the normal group, respectively(OR=1.30, 95%CI=1.06-1.59, P < 0.01).

Sleep quality is correlated with overweight and obesity among middle school students, and there are gender differences. Intervention policies should be formulated according to the characteristics of different genders.

To explore the association between physical activity and sleep quality among middle school students, so as to provide reference for adolescent sleep improvement.

From September to December 2023, 5 713 middle school students aged 13-18 years were selected from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi by stratified cluster random sampling method. Pittsburgh Sleep Quality Index (PSQI) and Evaluation of Physical Activity Levels of Children and Adolescents Aged 7-18 Years were used to investigate and evaluate sleep quality and physical activity. Comparisons between groups were made using the t-test, Mann-Whitney U test, and associations between physical activity and sleep quality of middle school students were analyzed using Spearman correlation and linear regression methods.

The total PSQI scores were 4.0(2.0, 6.0) and 5.0(3.0, 6.0) for boys and girls, respectively, with significant sex difference (Z=-10.90, P < 0.01); light physical activity(LPA) and moderate to vigorous physical activity(MVPA) of boys were 18.57 (2.86, 42.86) and 68.57 (35.71, 119.18)min, and girls were 14.29 (0.00, 30.00) and 55.71 (31.43, 92.86)min respectively, and the differences were statistically significant (Z=3.65, -8.65, P < 0.01). The results of Spearman correlation regression showed that adolescents' MVPA was negatively correlated with the total PSQI score (r=-0.04, P < 0.01). After controlling for variables such as mental health, nutritional status and maximum oxygen uptake, the results of linear regression analysis showed that PSQI total score negatively predicted MVPA among middle school students (B=-4.76, 95%CI=-7.16 to -2.36, P < 0.05).

The longer the duration of physical activity among middle school students, the better the quality of sleep.

To analyze the features of unhealthy lifestyle patterns among primary and secondary school students in the nutrition improvement program for rural compulsory education students (NIPRCES) areas in China in 2021 and 2023, so as to provide data support for lifestyle promotion and healthy development among primary and secondary school students.

Adopting a cluster random sampling method, data on primary and secondary students aged 7-15 years from nutrition and health surveillance of China NIPRCES in 2021 and 2023 were collected. The prevalence of unhealthy lifestyles among primary and secondary students such as physical inactivity, outdoor inactivity, excessive screen time, and sleep deprivation by gender, school section, urban/rural, and region were analyzed. The reporting rates of the above indicators among primary and secondary students were compared by Chi-square test.

In 2021 and 2023, the rates of moderate to vigorous physical inactivity among primary and secondary school students were 79.2% and 80.4%, the rates of outdoor inactivity were 42.8% and 49.3%, the rates of excessive video time were 2.6% and 2.9%, the rates of sleep deprivation were 32.9% and 22.6%, and the differences were statistically significant(χ²=51.86, 1 071.48, 18.36, 3 296.99, P < 0.05). In 2023, the rate of outdoor inactivity for primary and secondary students increased by 6.5 percentage points compared with 2021, and the rate of sleep deprivation decreased by 10.3 percentage points compared with that in 2021. In 2021 and 2023, the reporting rates of moderate to vigorous physical inactivity, outdoor inactivity, and sleep deprivation among girls and junior high school students were higher than those among boys (χ²=174.41, 180.11; 175.75, 85.46;92.22, 151.35) and elementary school students (χ²=136.64, 5.75; 40.55, 4.71;162.80, 3 291.61); the reporting rates of moderate to vigorous physical inactivity(χ²=194.43, 118.60) and sleep deprivation (χ²=969.66, 983.72) among urban students were higher than those among rural students; the reporting rates of excessive video time for boys and junior high school students were higher than those for girls (χ²=103.62, 84.85) and elementary school students (χ²=810.09, 626.51)(P < 0.05). From a regional distribution perspective, the reporting rates of moderato to vigorous physical inactivity, outdoor inactivity, and excessive video time among primary and seconday school students in the central and western regions were lower than those in the eastern region (χ²= 663.44, 302.78; 356.97, 82.10;50.89, 81.83) (P < 0.05).

Unhealthy lifestyles remain prevalent among primary and secondary students in NIPRCES areas of China. These findings underscore the need to strengthen policy implementation for promoting healthy lifestyles among primary and secondary school students.

To explore the iodine nutrition status of children in Wuhan from 2019 to 2023, and to evaluate the effect of iodine deficiency disorders control in focus groups in Wuhan, so as to provide a basis for consolidating elimination of iodine deficiency disorders.

A total of 13 000 non-boarding primary school students aged 8-10 were selected from 13 districts of Wuhan by stratified random sampling method.Household salt samples were collected to measure salt iodine content, random urine samples were analyzed for urinary iodine concentration. And B-ultrasound was used to measure thyroid volume in students. The median of salt iodine, coverage rate of iodized salt, consumption rate of qualified iodized salt, median of urinary iodine, and the goiter rate were calculated. And Mann-Whitney U test, Kruskal-Wallis H test and Chi-square test were applied to compare between groups. Chi-square trend test was used to analyze the changing trends of coverage rate of iodized salt, consumption rate of qualified iodized salt and goiter rate among children in Wuhan.

The median of iodine content of children's household salt was 23.8 (21.7, 26.1) mg/kg, and the coverage rate of iodized salt was 98.7%, and the consumption rate of qualified iodized salt was 94.5%. The consumption rates of qualified iodized salt showed an overall upward trend from 2019 to 2023 (χ_trend²=5.57, P < 0.05). The median of urinary iodine of children was 220.1 (136.7, 326.0) μg/L, and boys had higher median of urinary iodine than girls (Z=6.60, P < 0.01). The median of urinary iodine of children in suburbs was higher than those in urban areas (Z=11.00, P < 0.01). A total of 4 600 children were examined for thyroid volume, and the range of goiter rates were 1.1% to 3.4%, with an average goiter rate of 2.5%, which showed an overall downward trend from 2019 to 2023 (χ_trend²=5.11, P < 0.05).

The iodine nutrition is sufficient and iodine nutrition status is good among children in Wuhan. It should continue to carry out monitoring and evaluation of children's iodine nutrition, guide the public to supplement iodine scientifically, so as to maintain the appropriate level of iodine for children.

To investigate the impact of transfer cognition on healthy dietary behaviors among Tibetan and Yi ethnic junior high school students by analyzing the pathway within the pre-intention phase of the health action process approach (HAPA), so as to provide a basis for developing the intervention of healthy dietary behavior among ethnic minority adolescents.

A questionnaire on healthy dietary behavior and general conditions was self-designed. From November 2023 to May 2024, a cross-sectional survey was conducted on 1 228 freshmen in junior high school(447 Yi and 781 Tibetan ethnic students) from Lhasa City, Xizang and Liangshan Yi Autonomous Prefecture, Sichuan Province, with a stratified cluster random method. A structural equation model was constructed to analyze the relevant factors of healthy dietary behavior.

The scores for healthy dietary behavior and behavior intention, among Tibetan and Yi adolescents were (35.72±7.43) and (11.71±2.43). The analysis results of the mediation model showed that the direct path of transfer cognitions had no statistical significance on healthy dietary behavior, as well as risk perception on healthy dietary behavior intention [standard path coefficients (95%CI) were 0.07 (-0.01-0.14), 0.04 (-0.04-0.13), P>0.05]; the other direct paths were statistically significant [standard path coefficients (95%CI)=0.15-0.52 (0.04-0.61), P < 0.05]. The mediating effect of transfer cognitions on healthy dietary behavior through healthy dietary behavior intention among Tibetan and Yi junior high school students was 0.06 (95%CI=0.04-0.09), and the chain mediation effect through action self-efficacy and healthy dietary behavior intention on healthy dietary behavior was 0.06 (95%CI=0.04-0.09) (P < 0.01). All mediating effects accounted for 30.6% of the total effect.

Transfer cognitions could not directly influence healthy dietary behavior among Tibetan and Yi junior high school students, but rather exert an indirect effect through multiple pathways in the pre-intentional phase of the HAPA model. Interventions targeting dietary behavior should focus on enhancing adolescents' transfer cognitions.

To analyze the implementation status and challenges of sex education in special education schools, so as to provide a scientific basis for formulating effective promotion strategies.

From November 2023 to January 2024, a census survey was conducted among 120 in-service teachers from 7 special education schools in Luzhou. The questionnaire covered the current status of sex education in schools, teachers' attitudes and knowledge toward sex education, and their coping methods for students' inappropriate sexual behaviors.

About 77.5% of teachers reported having provided sex education to students, but 93.2% indicated a lack of specialized sex education textbooks for special children, 90.4% reported no full-time teachers for sex education, and the methods of sex education were relatively limited (50.0% mainly based on lecture method). Nearly 95.8% of teachers held a positive attitude toward sex education, with 98.3% supporting its implementation. Only 26.7% of teachers demonstrated a good grasp of sex education knowledge, with the best-understood topic being "recognition and protection of private parts" (21.6%). When dealing with students' inappropriate sexual behaviors, the active response rate of teachers was 23.9%, with the highest active response rate observed for "intentionally hugging or kissing the opposite sex" (39.7%).

The special education schools in Luzhou lack comprehensive sex education curricula, teaching materials and full-time teachers, sufficient knowledge among teachers, and adequate proactive responses to students' inappropriate sexual behaviors. Greater emphasis should be placed on sex education for special children, including the training of dedicated teachers, to provide comprehensive and high-quality sex education services for special children.

To systematically review the effect of physical activity (PA) on health-related quality of life (HRQoL) among children and adolescents and the magnitude of association, so as to provide an evidence-based support for optimizing health promotion strategies for children and adolescents.

Medline (PubMed), EMBASE, the Cochrane Library, SCIELO, PEDro, CNKI, Wanfang and VIP databases were searched to collect literature on PA and HRQoL in children and adolescents, which were published up to January 1, 2025. Cochrane ROB tool and specific evaluation system were used to assess literature quality, Stata 16.0 software was used for Meta-analysis. For descriptive studies, correlation(r) and 95% confidence interval(CI) were used as effect indicators, and the inverse variance method was used to merge the data. Standardized mean difference(SMD) and 95%CI were used to calculate the combined effect size of intervention studies.

A total of 22 studies involving 27 303 healthy children and adolescents were included, including 9 descriptive studies and 13 intervention studies. The results of descriptive analysis showed that PA level was positively correlated with HRQoL (r=0.27, 95%CI=0.21-0.32, P < 0.01). The analysis of intervention studies showed that PA had significant effects on overall HRQoL (SMD=0.10, 95%CI=0.05-0.16), physical functioning (SMD=0.16, 95%CI=0.08-0.23), and mental functioning (SMD=0.17, 95%CI=0.10-0.25)(P < 0.01). Subgroup analysis found that the effects of physical activity on overall HRQoL, physiological function, and psychological function in children and adolescents were maximized when the intervention duration was less than 6 months (SMD=0.13, 0.18, 0.20), the frequency was≥5 times per week (SMD=0.13, 0.19, 0.24) and there was a supplementary plan(SMD=0.10, 0.18, 0.23)(P < 0.01).

PA is an important factor affecting the HRQoL of healthy children and adolescents, and the systematic PA intervention has a effect on improving the HRQoL.

To investigate the impact of disposable plastic food container usage on the executive function among primary school students, so as to provide the evidence for the formulation of relevant health policies.

From November 2023 to May 2024, a convenience sampling method was employed to select 1 118 grade 1-3 students from three primary schools in a central district of Chongqing. A self-developed questionnaire was used to collect demographic characteristics and data on disposable plastic food container usage. Executive function of primary school students was assessed using the Childhood Executive Functioning Inventory (CHEXI). Multivariate linear regression analysis was conducted to explore the associations between disposable plastic food container usage and heating with executive function among primary school students.

Median scores for working memory, inhibition and total executive function among primary school students were 32 (26, 39), 33 (28, 38), and 66 (54, 75), respectively. Multivariate linear regression analysis showed that among girls, higher frequencies of eating meals from plastic lunchboxes were associated with higher CHEXI working memory scores (β=1.29), inhibition scores (β=1.57), and total executive function scores (β=2.85) (P < 0.05). Compared to girls who did not use plastic cups or drank bottled water, those who used plastic cups for drinking or drank bottled water had higher scores in working memory (β=2.63), inhibition (β=2.10), and total executive function (β=4.73); compared to girls who did not eat canned food from metal cans, those who ate such food had higher scores in working memory (β=3.62), inhibition (β=1.89), and total executive function (β=5.50) (P < 0.05).Among boys, higher frequencies of eating meals from plastic lunchboxes were associated with higher inhibition scores (β=1.13) (P < 0.05). Compared to girls who ate with a plastic lunch box and did not heat it when they ate, girls who more frequent heating plastic lunchboxes with food inside had higher working memory scores (β=5.39), inhibition scores (β=4.29), and total executive function scores (β=9.68) (P < 0.05).

The use of disposable plastic food containers may adversely affect executive function of primary school students, with a more pronounced effect observed in girls. Strengthened regulation of disposable plastic products and health education are urgently needed.