Association between psychological stress, anxiety and oral health status among college students during the Omicron wave: a cross-sectional study (preprint)

Background Within 3 years of the COVID-19 pandemic, increasing interest has been given to its potential influence on health status due to lockdowns caused by the pandemic. However, the impact is inadequately understood, especially for college students. This study aimed to investigate the potential association between psychological stress, anxiety and oral health status of college students during the Omicron wave of the COVID-19 pandemic.Methods An online survey with measurements of psychological stress, anxiety and oral health was completed by 1770 Chinese college students. The Perceived Stress Scale-14 (PSS-14) and Generalized Anxiety Disor-der-7 (GAD-7) were used to measure psychological stress and anxiety, respectively. Oral health status was self-reported including toothache, gingival bleeding, and oral ulcer. Multivariable logistic regressions were per-formed to determine underlying associations for outcome variables. Structural equation modeling (SEM) was conducted to confirmed the relationship between mental and oral health status.Results Of the 1770 subjects, 39.2% presented high psychological stress and only 41.2% expressed no anxiety. A significant association was found between psychological stress, anxiety and oral health status. Anxiety has significant impacts on toothache (OR = 0.358, p < 0.01), gingival bleeding (OR = 0.431, p < 0.01), and oral ulcer (OR = 0.535, p < 0.01). Anxiety also significantly mediated the relationship between psychological stress and self-reported oral symptoms.Conclusions COVID-19 may be a significant risk indicator for mental health among college students and shows a significant correlation with the occurrence of self-reported oral symptoms. Maintaining good mental health is favorably associated with self-reported oral health status.

Current status and correlates of screen time among children in Guangdong during the COVID-19 pandemic

Objective To investigate the current status of online classes, screen time and its influencing factors among primary school students in Guangdong during the 2019 novel coronavirus pandemic. Methods Using the convenience sampling method, a total of 5 266 pupils aged 6-12-years-old from Guangzhou, Zhanjiang, and Zhongshan participated in the online questionnaire. ANOVA or chi-square tests were performed to compare differences in online classes and screen time between grades, and multinomial Logistic regression was performed to analyze the correlates of recreational screen time. Results The prevalence of prolonged recreational screen time was 42.2% and 55.2% on weekdays and weekends, respectively. Recreational screen time increased by 40.31 min/d on weekdays and 33.07 min/d on weekends, compared to usual school semesters. The average duration of an online class was (26.07+or-9.62) min, which totaled (110.41+or-51.98)min per day. Sex, grade, being the only child, and parents' education levels were identified as the influencing factors of prolonged recreational screen time. Children who practiced moderate levels (weekdays: OR=1.27;weekends: OR=1.40;P < 0.05) or lower levels of physical activity (weekdays: OR=1.86;weekend: OR=1.84;P < 0.05) were at a higher risk of prolonged recreational screen time than those who practiced more vigorous physical activity. Children whose parents limited their screen time to a moderate (weekdays: OR=1.61, P < 0.05) or lower level (weekdays: OR=1.32, P < 0.05) had a higher risk of prolonged recreational screen time than those with a higher frequency. Children with parents' recreational screen time 2 h/d had a higher risk of prolonged recreational screen time than the reference group;children who exhibited moderate to vigorous levels of physical activity < 1 h/d (weekdays: OR=1.31, P < 0.05), and those used electronic devices for learning 1-2 h/d (weekdays: OR=2.65;weekend: OR=2.65;P < 0.05) or for 2 h/d (weekdays: OR=4.05, weekend: OR=5.24, P < 0.05) were at a higher risk of prolonged recreational screen time than the reference group. Conclusion During the COVID-19 pandemic, the level of screen time among children in Guangdong was high. Behavioral monitoring and targeted interventions are needed to promote children's health.

Emotional and behavioral problems and determinants among primary and middle school students aged 6 to 17-year-old in Guangdong Province during the COVID-19 pandemic

Objective: To gain a better understanding of the emotional and behavioral problems associated determinants of primary and middle school students from Guangdong Province during the COVID-19 pandemic, so as to provide a basis for developing targeted intervention strategies.