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Our objective was to investigate the status and influence of myopia among primary school students in Fushun, Liaoning Province, China. We aimed to provide a theoretical and epistemological basis for implementing myopia prevention initiatives. We employed cluster sampling and surveyed 5216 primary school students from grades 1-6 across eight primary schools in Fushun City. Our participants included 2606 males and 2610 females whose average age was 9.25 ( SD = 1.76) years. The rate of myopia among these primary school students was 29.54%, with statistically significant differences among students of different genders and grades. Logistic regression analysis further identified several possible protective factors, including appropriate reading distance, adequate home lighting, regular breaks between classes, conscientious eye exercises, and daily outdoor physical activity. Conversely, the associated risk factors were being female, being in a higher grade level, spending more than 4 hours on homework, occasionally reading while lying down, and having one or both parents with myopia. Overall, our results indicated a high incidence of myopia, highlighting the need for scientifically controlled interventions to manage and mitigate the occurrence and progression of myopia in this population., Competing Interests: Declaration of Conflicting InterestsThe author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To evaluate the effect of information-knowledge-attitude-practice (IKAP) theory-based health education interventions on clonorchiasis control among community residents and primary school students in Torch High-tech Development Zone of Zhongshan City, so as to provide insights into formulation of clonorchiasis control strategies among different types of populations., Methods: Residents were randomly sampled from two communities and students from two primary schools using a random cluster sampling method in Torch High-tech Development Zone, Zhongshan City from 2019 to 2021, and health education pertaining to clonorchiasis control was performed based on the IKAP theory. The changes in the awareness of basic clonorchiasis control knowledge and belief, self-reported risk of Clonorchis sinensis infections and dietary behaviors were compared among community residents and primary school students before and after health education interventions., Results: The participants included 146 male and 151 female community residents and 158 male and 153 female primary school students, with no significant difference detected in gender distribution (χ 2 = 0.16, P > 0.05). The mean awareness of basic clonorchiasis control knowledge increased by 44.71% and 43.28% among primary school students and community residents 6 months following health education, and there were significant differences in the awareness of each item of basic clonorchiasis control knowledge before and after health education (χ 2 = 41.53 to 284.44, all P values < 0.05). The proportions of primary school students and community residents thinking very high and high risks of C. sinensis infections increased from 9.35% and 6.71% before health education to 22.15% and 37.75% after health education, but only the difference of the attitudes in community residents achieve statistical significance (χ 2 = 92.18, P < 0.05). The frequency of separation of raw and cooked foods with chopping board and knife significantly increased among community residents and primary school students following health education (χ 2 = 16.04 to 62.65, all P values < 0.05). The frequency of eating raw freshwater fish (χ 2 = 32.85, P < 0.05), fish congee (χ 2 = 7.02, P < 0.05) and fish fillet hot pot (χ 2 = 4.88, P < 0.05) significantly reduced among primary school students following health education, while only the frequency and proportions of eating raw freshwater fish have significantly reduced in community residents (χ 2 = 11.77, P < 0.05)., Conclusions: Health education interventions based on the IKAP theory are effective to increase the awareness of clonorchiasis control knowledge and improve dietary behaviors associated with C. sinensis infections among community residents and primary school students in Zhongshan City.

Objective: Although previous studies have noted that emotional intelligence (EI) might be a significant protective factor for aggressive behavior, the specific mechanisms involved is largely unknown. Based on the General Aggressive Model, this cross-sectional study aims to investigate whether EI will influence aggressive behavior through the mediating roles of positive affect (PA) and negative affect (NA)., Methods: A total of 410 primary school students (45.4% females; M age  = 10.35, SD  = 0.48, range from 10 to 11 years) from Shenzhen, China, completed questionnaires on EI, aggressive behavior, PA, and NA. SPSS 22.0 was used for reliability test and correlation analysis, and (Hayes, 2013) [1] PROCESS macro (Model 6) was used to examine the multiple mediation model., Results: The results show that (a) EI was negatively associated with children's aggressive behavior; (b) NA partially mediated the link between EI and aggressive behavior in children, and (c) PA and NA sequentially mediated the above link., Conclusion: This study would not only deepen our understanding of how EI is associated with aggressive behavior but also provide valuable suggestions for teachers and parents to more effectively prevent and intervene children's aggressive behavior., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Computational thinking (CT) is important for students because it is one of the 21st century's skills. Reverse engineering pedagogy (REP) can improve students' CT due to its ability to develop students' cooperativity, algorithmic thinking, creativity, and problem-solving in discipline education. Thus, this study aimed to explore the effect of REP on primary school students' CT skills in STEM learning activities. A total of 101 fifth graders in a primary school participated in the study for one semester (16 weeks), including 51 students in the experimental group (EG) with REP, and 50 students in the control group (CG) with the demonstration method (DM). The computational thinking scale (CTS) was used to measure the CT skills of students in the pretest and posttest. The Wilcoxon signed-rank test and the Mann-Whitney U test were used to analyze the data. The results verified that REP had a fine effect on the improvement of students' CT skills compared to the DM. The findings can provide some ideas for researchers to develop students' CT skills in STEM learning activities. Teachers can use different teaching methods to reasonably arrange teaching activities to develop primary school students' CT skills., Competing Interests: The authors declare no conflict of interest.

The Malaysian national school curriculum currently lacks resources and tools to enforce CPR education. The aim of this study was to investigate the efficacy of a compression-only cardiopulmonary resuscitation and automated external defibrillator course among primary school students to increase their knowledge and technical skills and improve their attitudes. A quasi-experimental study was conducted using a pre−post non-equivalent design involving 38 students aged 10−12. Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) knowledge, technical skills, and attitude towards CPR were assessed in a post test with three-month follow-up. Results of the MANOVA analysis showed significant differences in the level of knowledge (F = 10.29, p < 0.001) and attitude (F = 13.87, p < 0.001) based on the students’ age group at the time of the post test. The proportion of students who passed the technical skills component differed significantly by age (χ2 = 12.12; p = 0.002) and BMI (χ2 = 6.34; p = 0.041). No significant decay was reported in the total mean scores for knowledge, technical skills, and attitude (F = 0.727, p = 0.54) at 3-month follow-up. The course helped students perform CPR and utilize AED effectively while promoting a positive attitude with up to 3 months of retention, demonstrating the feasibility of extending the course within the Malaysian primary school curriculum.

School-age children increasingly use smartphones to conduct their learning activities; increasing reports of disorders related to smartphone use exist, including visual-related symptoms, stress, and musculoskeletal pain. This study aimed to examine risk factors for musculoskeletal pain among primary school students using smartphones. A cross-sectional study was conducted with 233 school-aged children in Nakhon Si Thammarat, Thailand. Data collection used a questionnaire for musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire with ISO 11,226:2000. Through Chi-square, t -test, and logistic regression analysis, factors independently associated with musculoskeletal pain were determined. An important factor in the development of musculoskeletal pain was the prolonged use of smartphones for longer than 60 min, particularly among children aged 6-9 years old. In regards to musculoskeletal pain, almost 53% of the students used their smartphones while lying down. Posing in a prone position while using a smartphone was 7.37 times more dangerous than sitting. The laying position tilts numerous organs at varying angles, especially the upper arm. The risk of musculoskeletal complaints must be reduced by educating parents, children, and the relevant government organizations about safe smartphone usage. The mentioned factors may be used to anticipate the onset of musculoskeletal pain caused by smartphone use in young children.

Objective: To evaluate the effect of peer education on knowledge, attitude and practices towards schistosomiasis control among primary school students in endemic foci of Wuhan City., Methods: Yucai Hankou Primary School in Jiang' an District, Wuhan City was selected in 2021, and all students at grades 4 and 5 were sampled using a cluster sampling method to receive peer education about schistosomiasis. The changes of knowledge, attitude and practices towards schistosomiasis control were compared before and after peer education to evaluate the effect of peer education on knowledge, attitude and practices towards schistosomiasis control., Results: The overall awareness of schistosomiasis control knowledge and the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors increased from 51.50%, 93.70% and 92.99% before peer education to 86.50%, 98.98% and 98.72% after peer education among primary school students, respectively (χ 2 =149.457, 21.692 and 20.691, all P values < 0.05). The overall awareness of schistosomiasis control knowledge and the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors were 49.19%, 92.20% and 92.72% among Grade 4 primary school students and 53.83%, 95.21% and 93.28% among Grade 5 primary school students prior to peer education (χ 2 = 1.214, 2.034 and 0.096, all P values > 0.05), and increased to 75.93%, 98.09% and 97.59% among Grade 4 primary school students and 97.16%, 99.87% and 99.87% among Grade 5 primary school students after peer education, respectively (χ 2 = 40.798, 9.572, 7.207, 133.194, 9.678 and 14.926, all P values < 0.05). The overall awareness of schistosomiasis control knowledge and the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors were 51.25%, 76.92% and 77.97% among male primary school students and 51.80%, 94.42% and 95.70% among female primary school students prior to peer education, the differences in the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors between male primary school students and female primary school students were significant (χ 2 = 30.462 and 33.416, both P values < 0.05), and increased to 86.23%, 98.25% and 97.79% among male primary school students and 86.83%, 99.85% and 99.85% among female primary school students after peer education (χ 2 = 0.081, 3.529 and 3.335, all P values > 0.05), respectively., Conclusions: Peer education is effective to improve the knowledge, attitude and practices towards schistosomiasis control among primary school students in endemic foci of Wuhan City, which may be more effective to improve the awareness of schistosomiasis control knowledge and proportion of correct schistosomiasis-related behaviors among primary school students at high grades.

Background: Evidence of the effectiveness of intervention against extreme heat remains unclear, especially among children, one of the vulnerable populations. This study aimed to evaluate the effectiveness of a primary school-based intervention program against heatwave and climate change in China to provide evidence for development of policies for adaptation to climate change., Methods: Two primary schools in Dongtai City, Jiangsu Province, China, were randomly selected as intervention and control schools (CTR registration number: ChiCTR2200056005). Health education was conducted at the intervention school to raise students' awareness and capability to respond to extreme heat during May to September in 2017. Knowledge, attitude, and practice (KAP) of students and their parents at both schools were investigated by questionnaire surveys before and after intervention. The changes in KAP scores after intervention were evaluated using multivariable difference-in-difference (DID) analysis, controlling for age, sex, etc. Results: The scores of knowledge, attitude, and practice of students and their parents increased by 19.9% (95%CI: 16.3%, 23.6%) and 22.5% (95%CI: 17.8%, 27.1%); 9.60% (95%CI: 5.35%, 13.9%) and 7.22% (95%CI: 0.96%, 13.5%); and 9.94% (95%CI: 8.26%, 18.3%) and 5.22% (95%CI: 0.73%, 9.71%), respectively, after intervention. The KAP score changes of boys were slightly higher than those of girls. Older students had higher score changes than younger students. For parents, the higher the education level, the greater the score change, and change in scores was greater in females than in males. All the health education activities in the program were significantly correlated with the changes in KAP scores of primary school students after intervention, especially those curricula with interesting activities and experiential learning approaches., Conclusions: Heat and health education program in primary school was an effective approach to improve cognition and behavior for both students and their parents to better adapt to heatwaves and climate change. The successful experience can be generalized to respond to the increasing extreme weather/climate events in the context of climate change, such as heatwaves, and other emergent occasions or public health education, such as the control and prevention of COVID-19.

This study examined the effect of self-support on loneliness, the mediation effect of school belonging, and the moderation effect of self-esteem using a sample comprising 1,126 Chinese mainland primary school students, 621 are boys and 505 are girls, and their mean age was 10.51 years ( SD = 1.63, range 8-13). Participants completed questionnaires regarding self-support, loneliness, school belonging and self-esteem. In the model hypothesis, self-support is an independent variable, loneliness is an outcome variable, school belonging is a mediating variable, and self-esteem is a regulatory variable. After controlling the demographic variables, the data were analyzed, and the results showed that: (1) self-support had a significantly negative predictive effect on loneliness; (2) the relation between self-support and loneliness was mediated by school belonging; and (3) the relation between school belonging and loneliness was moderated by self-esteem, supporting the moderated mediation model. Moderated mediation analysis further indicated that the mediated path make loneliness weaker for pupils with higher levels of self-esteem. These results revealed the formation mechanism of loneliness in primary school students and have certain enlightenment significance for the intervention of loneliness in primary school students. These results revealed the formation mechanism of loneliness among primary school students and have significant implications for interventions against loneliness in the primary school context., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Yao, Pang, Yu, Xiao and Peng.)

Objective: To compare the changes of knowledge, attitude and practice (KAP) related to taeniasis and cysticercosis among primary school students before and after health education interventions in disease-elimination pilot areas of Henan Province, so as to evaluate the effectiveness of health education interventions., Methods: A primary school was selected from each of Dushu, Bowang and Yangji townships, Fangcheng County, Henan Province from 2017 to 2019; then, 2 to 3 classes were randomly selected from grade 4 to 6 in each primary school, and finally, all students in these classes were enrolled as study subjects. A thematic health education lecture pertaining to taeniasis and cysticercosis was given once each year by means of "health education in class". The KAP towards taeniasis and cysticercosis was investigated among primary school students using selffilled structured questionnaires, and the changes of awareness of taeniasis and cysticercosis control knowledge and percentage of healthy behaviors formation were compared in primary school students among years and following various frequencies of health education interventions., Results: More than 10 thousand person-time primary school students received health education interventions during the period from 2017 to 2019, and a total of 1 223 person-time primary school students were investigated during the 3-year study period, including 633 person-time men and 590 person-time women and 88.55% of primary school students at ages of 10 to 12 years. The proportion of households raising pigs and using dry toiliets decreased from 5.30% (24/453) and 18.10% (82/453) in 2017 to 3.60% (13/361) and 11.08% (40/361) in 2019, respectively. The awareness rate of taeniasis and cysticercosis control knowledge increased significantly from 0.22% (1/453) in 2017 to 62.59% (256/409) in 2018 and 76.73% (277/361) in 2019 (χ 2 = 567.60, P < 0.001), and the awareness rate was 85.25% (104/122) among primary school students attending the thematic special health education courses for successive three times. The awareness rates of taeniasis and cysticercosis control knowledge were 0.44% (1/225), 58.00% (116/200) and 71.63% (149/208) among male students and 0 (0/338), 66.99% (140/209) and 83.66% (128/153) among female students from 2017 to 2019, and there was a significant difference in the awareness of taeniasis and cysticercosis control knowledge between male and female students in 2019 (χ 2 = 7.14, P = 0.01). On-site teaching by doctors was the students' favorite way to receive health education interventions (70.07%, 857/1 223), followed by watching health education videos (58.63%, 717/1 223) and seeing parasite specimens (48.9%, 598/1 223). The proportion of students' families who used cutting boards for raw and cooked food separately increased from 7.28% (33/453) in 2017 to 47.37% (171/361) in 2019, was 67.21% (82/122) among students attending the health education courses for successive three times. The proportion of students who frequently washed their hands before meals and after using toilet increased from 71.96% (324/453) in 2017 to 89.47% (319/361) in 2019 and was 95.90% (117/122) among students attending the health education courses for successive three times. In addition, the percentage of students washing hands frequently in families using dry toilets was significantly lower in those who did not use dry toilets (χ 2 = 9.21, P = 0.002), and the proportion of students with a habit of eating raw or undercooked meat decreased significantly from 35.76% (162/453) in 2017 to 6.65% (24/361) in 2019 (χ 2 = 69.11, P < 0.01)., Conclusions: The thematic health education activity of "health education in class" contributes greatly to the increase in the awareness of taeniasis and cysticercosis control knowledge and the rate of healthy behaviors formation among primary school students in diseaseelimination pilot areas of Henan Province.

Objective: To investigate the effectiveness of a new health education pathway for echinococcosis control among primary school students in regions highly prevalent for echinococcosis in China., Methods: Six primary schools were randomly selected from echinococcosis hyper-endemic regions, with 13 classes assigned to the intervention group and 9 to the control group, and all students in these 21 classes were recruited as the study subjects. Echinococcosis health education was performed through the pathway of assessing the current status-strengthening the building of teaching resources-focusing on practices in the intervention group, while routine health education was given in the control group. A questionnaire survey was performed to assess the score of echinococcosis control knowledge (including theoretical knowledge score and mean daily practical capability score) before and after the health education interventions to evaluate the effectiveness of this new health education pathway for echinococcosis control., Results: The mean score of echinococcosis control knowledge was 68.86 ± 18.70 points at baseline, with the mean theoretical knowledge score of 40.97 ± 10.75 points, and the mean daily practical capability score of 27.89 ± 12.50 points. Clustering analysis showed three types of populations, including "unsatisfactory", "learn and apply creatively", and "rote learning", which accounted for 24.62% (240/975), 45.74% (446/975) and 29.64% (289/975), respectively. The mean score of echinococcosis control knowledge was 81.08 ± 18.15 points in the intervention group during the final assessment, with the mean theoretical knowledge score of 43.65 ± 9.40 points, and the mean daily practical capability score of 37.43 ± 12.22 points, and both were significantly higher relative to baseline ( t = -4.201 and -15.202, both P values < 0.01). The mean score of echinococcosis control knowledge was comparable between at baseline (70.55 ± 19.46 points) and final assessment (71.74 ± 19.37 points) in the control group ( t = -0.87, P > 0.05)., Conclusions: The awareness of echinococcosis control knowledge is fair among primary school students in echinococcosis hyper-endemic regions; however, the capability of combining theoretical learning and practices requires to be improved. The health education mode based on the pathway of assessing the current status-strengthening the building of teaching resources-focusing on practices seems to remarkably improve the understanding of echinococcosis control knowledge among primary school students in echinococcosis hyper-endemic regions.

Objective: To investigate the prevalence and risk factors of Blastocystis infections among primary school students in Jiangjin District, Chongqing City., Methods: A cross-sectional questionnaire survey was conducted among students sampled from a primary school in Jiangjin District, Chongqing City on April, 2018, and their stool samples were collected for microscopic examinations, in vitro culture and PCR assays to analyze the prevalence of Blastocystis infections and subtype of the parasite. In addition, the risk factors of Blastocystis infections among primary school students were identified using univariate analysis and multivariate logistic regression analysis., Results: A total of 466 primary students were surveyed, and the subjects had a mean age of (9.81±1.66) years and included 236 males (50.64%) and 230 females (49.36%). The prevalence of Blastocystis infections was 15.24% (71/466) among the study students, and there was no significance difference in the prevalence between male and fe- male students (16.52% vs. 13.91%; χ 2 = 0.616, P = 0.433). In addition, there was a significant difference in the prevalence of Blastocystis infections among grade 1 (6.35%, 4/63), grade 2 (5.17%, 3/58), grade 3 (21.74%, 15/69), grade 4 (25.30%, 21/83), grade 5 (10.19%, 11/108) and grade 6 students (20.00%, 17/85) ( χ 2 = 15.410, P = 0.009). There were four Blastocystis subtypes characterized (ST1, ST3, ST6 and ST7), in which ST6 was the most common subtype (45.07%, 32/71), followed by ST3 (25.35%, 18/71). Multivariate logistic regression analysis revealed that minority ethnicity [odds ratio ( OR ) = 4.259, 95% confidential inter- val ( CI ) : (1.161, 15.621)] and low maternal education level (primary school and below) [ OR = 9.038, 95% CI : (1.125, 72.642)] were identified as risk factors of Blastocystis infection among primary school students in Jiangjin District, Chongqing City., Conclusions: There is a high prevalence of Blastocystis infections detected among primary school students in Jiangjin District, Chongqing City, and ST6 and ST3 are predominant subtypes. Minority ethnicity and low maternal education level (primary school and below) are risk factors for Blastocystis infections in primary school students.

Although the emphasis on behaviors of hand-washing and mask-wearing was repeated during the pandemic of Coronavirus Disease 2019 (COVID-19), not everyone paid enough attention to this. A descriptive statistic was used to make sense of the status of hand hygiene and mask-wearing among primary school students in Wuhan, China. A binary logistic regression analysis was conducted to identify the risk factors affecting the behaviors of hand-washing and mask-wearing. p < 0.05 (two-sides) was considered as significant at statistics. 42.05% of the primary school students showed a good behavior of hand-washing, while 51.60% had a good behavior of mask-wearing. Gender, grade, out-going history, father's occupation, mother's educational background, and the time filling out the survey were significantly associated with hand hygiene, whereas grade, mother's educational background, and residence were associated with mask-wearing. The behaviors of hand-washing and mask-wearing among primary school students were influenced by gender, grade, and other factors, therefore, parents should make efforts of behavior guidance whereas governments should enlarge medium publicity.

Objective: To study the acute effects of compound ambient air pollution on small airway lung functions among school children in Shanghai. Method: A longitudinal survey on lung functions was conducted among 233 school-children from three schools (A, B and C, located in innerring, mid-ring and outer-ring areas). Lung function test was performed once a week for 3 times respectively, among children in school A and B in Dec. 2013 and in school C in Dec. 2014. The fourth lung function test was tested in Jun. 2014 and May 2015 in the respective schools. Results: from the lung function would include items as: forced mid-expiratory flow at 25% of forced vital capacity (MEF(25%)), mid-expiratory flow at 50% of forced vital capacity (MEF(50%)), mid-expiratory flow at 75% of forced vital capacity (MEF(75%)) and mid-expiratory flow between 25% and 75% of the forced vital capacity (FEF(25%-75%)). Data regarding the daily air quality real-time of PM(2.5), PM(10), SO(2) and NO(2) in Dec. 2013, Dec. 2014, Jun. 2014 and May. 2015 from the three environmental monitoring spots and meteorological data from the Shanghai Meteorological Service system which were physically close to the three schools, were collected simultaneously. Linear mixed effect model was used to examine the levels of correlation between lung function indicators and ambient air pollutants. Results When confounding factors on meteorology and individuals were controlled, the lag effects and accumulated lag effects were found to have existed between the internal quarter rang (IQR) concentration of PM(2.5) and PM(10) in lag2 day and lag02 days, IQR concentration of SO(2) in lag02 day and IQR concentration of NO(2) lag0 day, when small airway lung functions like MEF(25%), MEF(50%), MEF(75%) and FEF(25%-75%)( P <0.05) were inspected. Results from the two air pollutants model analysis showed that SO(2) and NO(2) presenting interactive effects with PM(2.5), PM(10) and lag effects more significant than the individual SO(2) and NO(2), respectively ( P <0.05). Conclusion: Contents on the ambient air pollutants as PM(2.5), PM(10), SO(2) and NO(2) were negatively associated with the lung functions in the small airways of children, in Shanghai.