The academic value of the "Hu Line" has been extended to other related disciplines. Considering China's large population and obvious differences in distribution, this study draws on the research results of population geography to explore the population density and distribution criteria of the "Hu Line".
To investigate and analyze the current situation of health literacy and sedentary time among urban and rural high school students in the southeast and northwest halves of the "Hu Line", and to provide a basis for improving the physical and mental health of high school students in China.
A stratified cluster random sampling method was used to study the health literacy and sedentary time of freshmen and sophomores in 62 schools in 31 provinces (municipalities directly under the central government and autonomous regions) of China from January to March 2019 (12 400 questionnaires on health literacy and 12 400 questionnaires on sedentary time each were uniformly mailed and distributed in advance). Multiple linear regression models were used to analyze the coefficient of variance expansion, and after correcting for confounding factors, we analyzed the factors affecting the length of meditation time of high school students in the southeastern and northwestern halves of both sides of the "Hu Line".
Finally, 9 057 health literacy questionnaires were included, of which 7 489 (82.7%) were from the southeast half of China and 1 568 (17.3%) from the northwest half of China, and 8 031 questionnaires on sedentary time were included, of which 6 614 (82.4%) were from the southeast half of China and 1 417 (17.6%) from the northwest half of China. Health literacy scores and sedentary time of high school students in the southeast half of China were higher than those in the northwest half of China (Z=-4.009, -9.198; P<0.001). The health literacy scores of high school students in the southeastern half of China aged 17 and 18, female, urban and rural, with father's education of less than college and college, mother's education of college and bachelor's degree, annual family income of 10 000-, 50 000-, 80 000-, and >100 000 yuan, and family size of 1, 3, 7, 9, and ≥10 were higher than those of the northwestern half of China (P<0.05) ; Those high school students in the southeastern half of China aged 15, 16, 18, and male and female, urban and rural, father's education less than college, college, mother's education less than college, annual family income <10 000, 25 000-, 50 000-, 80 000-, and >100 000 yuan, and the number of people in the family of 3, 4, 5, and 6 people were higher than those in the northwestern half of China in terms of the number of hours spent in meditation (P<0.05). The results of the multiple linear regression model analysis showed that after correcting for confounders, the length of time high school students in the southeastern half of China spent sedentary still was positively correlated with annual family income (β=0.324) and mother's educational attainment (β=0.644) but negatively correlated (P<0.05) with both the health literacy scores (β=-0.015) and the father's educational attainment (β=-0.212) were negatively correlated (P<0.05) ; standardized regression coefficients β were compared with annual family income (0.164) > mother's educational attainment (0.131) > father's educational attainment (-0.056) > health literacy score (-0.050). The length of sedentary time of high school students in the northwestern half of China was positively correlated with health literacy score (β=0.017), father's education (β=0.789), and mother's education (β=0.540) (P<0.05) ; standardized regression coefficients β were compared with father's education (0.163) > mother's education (0.111) > health literacy score (0.056) .
Health literacy scores and meditation hours of high school students in the southeastern half of China were higher than those in the northwestern half of China. Meditation duration of high school students in the southeastern half of China was positively correlated with annual family income and mother's education, but negatively correlated with health literacy scores and father's education, while meditation duration of high school students in the northwestern half of China was positively correlated with health literacy scores parent's education. Annual family income had the highest weight on the effect of meditation duration for high school students in the southeast half of China, and father's education had the highest weight on the effect of meditation duration for high school students in the northwest half of China.
Current research on the physical fitness test scores of high school students is more localized within provinces and cities, with few multicenter, large-sample-size, domain-wide research results. The prevalence of blended online and offline teaching in schools of all types has inevitably prolonged the already long sedentary time of high school students. Whether this trend has some impact on the physical health of high school students is an urgent need for a region-wide study.
To investigate and analyze the levels of physical fitness test scores and related influencing factors of urban and rural high school first- and second-year students in seven regions of China, and to explore the empowering paths for the balanced improvement of physical fitness levels of first- and second-year high school students.
Stratified randomized cluster sampling method was used to conduct stratified sampling according to urban counties and townships and villages in high school schools in seven regions (East China, South China, North China, Central China, Northwest China, Southwest China, Northeast China) of 31 provinces (municipalities directly under the central government and autonomous regions) of China from January to March 2019, and then randomized clusters of 1 high school school in urban counties and 1 high school school in townships and villages in total of 62 schools were selected respectively. A total of 42 523 freshmen and sophomores in high schools were randomly selected to conduct the research, and the data on students' physical fitness test scores were collected at the same time (BMI reflects the level of physical development; lung capacity reflects the level of physical function; sit-and-reach reflects the level of flexibility; pull-up, 50 m run, standing long jump reflects the level of explosive strength of upper and lower limbs; 1 min sit-up reflects the level of core strength of the torso; 800 m run, 1 000 m run reflects the level of cardiorespiratory endurance), and non-parametric tests and multiple linear regression analysis were used to explore the influencing factors of the level of physical fitness test scores.
The age distribution of 42 523 high school students was 16.0 (16.0, 17.0) years; 20 074 (47.2%) boys and 22 449 (52.8%) girls, 21 725 (51.1%) in cities, counties and districts, and 20 798 (48.9%) in towns and villages. Comparison of the gender and urban-rural distribution of high school students in the seven regions showed statistically significant differences (P<0.05). Comparison of male high school students' scores on various physical fitness tests in the seven regions showed statistically significant differences (P<0.05) ; the top three regions in terms of scores on various physical fitness tests were as follows: height (North China>Northeast China>Central China), body mass (Northeast China>North China>Central China), BMI (Central China>Northeast China>North China), lung capacity (Northeast China>Central China>South China), 50 m run (South China>Central China>East China), standing long jump (South China>North China>Northwest China), sit-and-reach (South China>Southwest China>Central China), pull-up (South China>Southwest China>Northwest China), and 1 000 m run (South China>Central China>Southwest China). High school boys in the city, county and districts had higher lung capacity scores than those in the town and country, and lower scores than those in the town and country in the 50 m run, standing long jump, sit-and-reach, pull-up, and 1 000 m run (P<0.001). The differences in height, weight and BMI between high school boys in cities, counties and towns and villages were not statistically significant (P>0.05). The differences in the scores of high school girls in each physical fitness test in the seven regions are statistically significant (P<0.05) ; the top three regions in the scores of each physical fitness test are as follows: height (North China>Northeast China>Northwest China), body mass (Northeast China>North China>Northwest China), BMI (Northeast China>North China>Northwest China), lung capacity (Northeast China>South China>Central China), 50 m run (South China>Central China>East China), standing long jump (South China>North China>Central China), sit-and-reach (Northeast China>Central China>South China), 1 min sit-up (North China>Central China>East China=Southwest China), 800 m run (Northeast>Central China>South China). High school girls in the city and county districts had higher height, body mass, and BMI scores than those in the town and country, and lower scores than those in the town and country in lung capacity, 50 m run, standing long jump, sit-and-reach, 1 min sit-up, and 800 m run (P<0.001). The results of the multiple linear regression analysis showed that boys' pull-up scores were negatively correlated with BMI and the 1 000 m run scores, and positively correlated with the 50 m run, standing long jump and sit-and-reach scores (P<0.05), with sit-and-reach being the most important influence factor, followed by 1 000 m run; 1 000 m run scores were negatively correlated with BMI, lung capacity, and pull-up scores, and positively correlated with 50 m run, standing long jump and sit-and-reach scores (P<0.05), with pull-up being the most important influence factor, followed by sit-and-reach. The girls' 1 min sit-up scores were positively correlated with BMI, lung capacity, standing long jump, and 800 m run scores, and negatively correlated with 50 m run and sit-and-reach scores (P<0.05), with BMI being the most important influence factor, followed by sit-and-reach; the 800 m run scores were negatively correlated with BMI, 50 m run, and sit-and-reach scores, and positively correlated with standing long jump and 1 min sit-up scores (P<0.05), with sit-and-reach being the most important influence factor, followed by BMI.
The physical development levels of first and second year high school boys in Chinese city, county and districts were comparable to those of town and country, but the physical development levels of first and second year high school girls in the city, county and districts were higher than those of town and country. Upper and lower extremity explosive strength, trunk core strength, and cardiorespiratory endurance levels of first and second year high school students in city, county and districts were significantly lower than those of town and country. In addition to the level of physical development, the dominance of the performance levels of first and second year male high school students on all tests of physical fitness and health was evident in South China.
Stigma in adolescents with type 1 diabetes mellitus (T1DM) is closely associated with their health outcomes. Currently, there is a lack of stigma assessment tools for this population.
To translate the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) and test its reliability and validity in Chinese adolescents with T1DM.
A total of 194 patients with T1DM admitted to the First Affiliated Hospital with Nanjing Medical University and Children's Hospital of Nanjing Medical University were selected as the study subjects by using the convenient sampling method from March 2022 to March 2023. The English version of DSAS-1 was directly translated, back-translated and culturally adapted by using Brislin's classical back translation model to form a Chinese version. The Self-designed General Information Questionnaire, the Chinese version of the DSAS-1, the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale was used to conduct investigation. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity of the scale, and the internal consistency of the version was evaluated by calculating the Cronbach's α coefficients. Correlation analyses with the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale were conducted to confirm the effect of the Chinese version of DSAS-1 in detecting stigma among adolescents.
A total of 194 valid questionnaires were recovered. The exploratory factor analysis and confirmatory factor analysis results showed that the Chinese version of DSAS-1 for adolescents was categorized into three dimensions of differential treatment, complaints and comments and identity concerns, with good structural validity (all factor load>0.55, cumulative variance=67.98%), convergent validity (AVE>0.5), and discriminant validity (correlation coefficients of each dimension less than the square root of AVE). The reliability test results showed good internal consistency of the scale (Cronbach's α coefficient of 0.930). The total score of the Chinese version of DSAS-1 for adolescents was negatively correlated with the total scores of the Diabetes Strengths and Resilience Measure for Adolescents (r=-0.425, P<0.001), the Parent-child Relationship Scale (r=-0.302, P<0.001), and the Quality of Life Scale (r=-0.408, P<0.001) .
The Chinese version of DSAS-1 for adolescents has good reliability and validity and is simple and easy to conduct, which can provide a reliable quantitative assessment tool for the stigma of adolescents with T1DM in China.
