Preventing and treating childhood overweight and obesity in children up to 5 years old: A systematic review by intervention setting

The prevalence of childhood obesity is increasing worldwide with long‐term health consequences. Effective strategies to stem the rising childhood obesity rates are needed but systematic reviews of interventions have reported inconsistent effects. Evaluation of interventions could provide more practically relevant information when considered in the context of the setting in which the intervention was delivered. This systematic review has evaluated diet and physical activity interventions aimed at reducing obesity in children, from birth to 5 years old, by intervention setting. A systematic review of the literature, consistent with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, was performed. Three electronic databases were searched from 2010 up to December 2020 for randomised controlled trials aiming to prevent or treat childhood obesity in children up to 5 years old. The studies were stratified according to the setting in which the intervention was conducted. Twenty‐eight studies were identified and included interventions in childcare/school (n = 11), home (n = 5), community (n = 5), hospital (n = 4), e‐health (n = 2) and mixed (n = 1) settings. Thirteen (46%) interventions led to improvements in childhood obesity measures, including body mass index z‐score and body fat percentage, 12 of which included both parental/family‐based interventions in conjunction with modifying the child''s diet and physical activity behaviours. Home‐based interventions were identified as the most effective setting as four out of five studies reported significant changes in the child''s weight outcomes. Interventions conducted in the home setting and those which included parents/families were effective in preventing childhood obesity. These findings should be considered when developing optimal strategies for the prevention of childhood obesity.     

对接大健康产业发展的康复治疗学人才培养体系的构建

在大健康产业发展背景下,康复服务产业发展模式和服务理念逐步转变。康复人力资源是康复服务产业发展的基石,文章基于《国际功能、残疾和健康分类》(international classification of functioning,disability and health,ICF)康复科学理论体系,切合康复服务产业化和专业化需求,重构康复治疗学专业人才培养的课程体系,强化实践教学,探讨构建康复治疗学专业人才培养新模式。     

支气管哮喘临床教学课程整合的探索与实践

医学整合课程教学模式并不是一种新型的教学模式,它起源于20世纪50年代,已经过六十多年的不断完善和调整,目前逐步成为国内外医学院校的主要医学教学模式。整合医学教学模式坚持用整体、求实创新、动态发展、相互联系和既对立又统一的思想和观点进行教学,符合临床学习规律,是现代医学教育发展的必然趋势。我院教研室近些年来陆续在各个临床专业之间试行课程整合模式,在有限的课时内把课程内容有机整合,避免不同学科间相关教学内容和学习要点的交叉重复,提高学生学习的积极性,有利于学生提高学习效率,并形成一个连贯的知识框架,教学效果较好,同时能够促进教师教学综合能力的提高,有利于培养学生多方面的能力及综合素质。我们以支气管哮喘这一章的教学为代表,具体阐述了儿科、内科临床教学课程整合模式的实践及经验。临床教学课程整合教学效果较好,发展前景良好,但在实施和实践过程中还需要医学教育者投入更多的心血和智慧。     

COVID-19-related fear,stress and depression in school principals: impacts of symptoms like COVID-19, information confusion,health-related activity limitations,working hours,sense of coherence and health literacy

BackgroundSchool principals have been reported to have a higher prevalence of burnout and psychological problems than their colleagues. During the pandemic, extra workload and pressure from unprecedented situations potentially cause fear, stress and depression. Therefore, we aimed to explore associated factors of stress, fear of COVID-19 (F-CoV-19S) and depressive symptoms among school principals.MethodsA cross-sectional online survey was conducted in Taiwan from 23 June to 16 July 2021. Data of 413 school principals were collected, including socio-demographic factors, COVID-19-related factors, work-related information, health status, sense of coherence (SoC), health literacy (HL), F-CoV-19S, stress and depression. Multiple linear and logistic regression models were utilized to explore associations.ResultsSchool principals with symptoms like COVID-19 (S-COVID-19-S), or with health-related activity limitations had a higher score of stress (B = 0.92; p = .039) (B = 1.52; p < .001) and a higher depression likelihood (OR = 3.38; p < .001) (OR = 3.06; p < .001), whereas those with a better SoC had a lower stress score (B = −1.39; p < .001) and a lower depression likelihood (OR = 0.76; p = .020). School principals confusing about COVID-19-related information had a higher score of stress (B = 2.47; p < .001) and fear (B = 3.77; p < .001). The longer working time was associated with a higher fear score (B = 1.69; p = .006). Additionally, school principals with a higher HL score had a lower stress score (B = −1.76; p < .001), a lower fear score (B = −1.85; p < .001) and a lower depression likelihood (OR = 0.53; p = .043).ConclusionsHealth-related activity limitations, S-COVID-19-S, COVID-19-related information confusion and longer working hours were positively associated with at least one mental health problem (e.g. stress, fear and depression), whereas better SoC and HL showed the benefits to mitigate fear, stress and depressive symptoms in school principals. Our study provides evidence for appropriate strategies to improve principals’ mental health during the pandemic.

Key messages:

• School principals with health-related activity limitations or with symptoms like COVID-19 were more likely to be stressed and depressed.
• Higher levels of stress and fear were observed in school principals who confused about COVID-19-related information, and who had longer working time than before the pandemic.
• Better sense of coherence and higher health literacy could potentially mitigate the fear, stress and depressive symptoms in school principals.

     

The Ultra-Processed Food Content of School Meals and Packed Lunches in the United Kingdom

British children have the highest levels of ultra-processed food (UPF) consumption in Europe. Schools are posited as a positive setting for impacting dietary intake, but the level of UPFs consumed in schools is currently unknown. This study determined the UPF content of school food in the UK. We conducted a pooled cross-sectional analysis of primary (4–11 years, n = 1895) and secondary schoolchildren (11–18 years, n = 1408) from the UK’s National Diet and Nutrition Survey (2008–2017). Multivariable quantile regression models determined the association between meal-type (school meal or packed lunch) and lunchtime UPF intake (NOVA food classification system). We showed that on average, UPF intake was high in both primary (72.6% total lunch Kcal) and secondary schoolchildren (77.8% total lunch Kcal). Higher UPF intakes were observed in packed lunch consumers, secondary schoolchildren, and those in lower income households. This study highlights the need for a renewed focus on school food. Better guidance and policies that consider levels of industrial processing in food served in schools are needed to ensure the dual benefit of encouraging school meal uptake and equitably improving children’s diets.     

初中生行为问题相关因素分析

目的 探讨初中生行为问题及其相关因素。方法 应用Achenbach儿童行为量表（CBCL），自拟儿童情况调查表，父母养育方式评价量表（EMBU），对本市随机抽取两所普通中学1585名在校学生进行调查，对其行为问题及相关因素进行单因素及多元逐步回归分析。结果 初中生行为问题检出率为10.9%,男孩的行为问题主要为不成熟，多动，攻击性，敌意等，女孩的行为问题主要为体诉多，焦虑强迫，抑郁退缩等，与初中生行为问题相关的因素有：父母对儿童管教态度是否一致，家居住地附近风气，与其他儿童关系。母孕期情绪及营养等。结论 初中生行为问题的发生受多因素影响，应采取综合干预措施。     

儿童少年卫生学与儿童保健学课程合并的优势

目的：探讨儿童少年卫生学与儿童保健学课程合并的理论基础以及课程合并后的优势所在。方法进行儿童少年卫生学与儿童保健学课程的讲授内容、教学大纲、教学进度表以及公共卫生执业医师考试大纲的对比分析。结果两门课程的教材内容出现大量的重复,并且相同知识点单独讲两门课的时候用的学时多。进行教学大纲的比较后分析出了相同知识点在合并课程还是处于重要的地位,而且符合公共卫生执业医师考试大纲内容。结论课程合并可以避免有关内容的重复,缩减相同内容重复讲解的课时,加强两门课程的内容联系,合并课程符合公共卫生执业医师资格考试大纲内容。     

医学遗传学课程建设浅析

人类基因组计划和分子生物学所取得的巨大成就,使得医学遗传学已成为现代医学中发展最为迅猛、变化最为剧烈的领头学科,逐步融入医学科学的主流。教师必须掌握学科的前沿进展,注意其在临床疾病诊治中的应用,才能培养出高质量的医学生,以崭新的知识体系适应分子医学的时代。     

军队高等医学院校课程教学质量评估指标体系的设计

采用特尔裴法设计指标,用层次分析法(AHP)分配指标权重,探讨了课程教学质量评估的标准、指标设计及权重分配,增强了指标设计和权重分配的科学性、可测性.     

医疗美容技术专业《临床医学概论》模块化课程体系的构建与探讨

针对医疗美容技术专业《临床医学概论》教学不能满足能力本位的职业教育要求,笔者对《临床医学概论》进行了模块化课程体系的构建,并从构建的必要性、原则、思路、步骤及应用前景等方面进行较为深入的探讨。