Objective:To explore the association between left-behind status, screen time (ST) and behavior of autism in rural preschool children.Methods:Cross section study was used in this study.A sample of 3 636 rural preschool children aged from 3 to 6 years old in 26 kindergartens were selected from four counties in Anhui province of China.The contents of the questionnaire include: basic information questionnaire, self-made left behind status questionnaire, self-made screen time questionnaire, Clancy autism behavior scale.EpiData 3.2 and SPSS 23.0 software were used for data entry and statistical analysis.Chi-square test was used to analyze the difference of positive rate of autism behavior.Logistic regression analysis was used to further explore the relationship between left-behind status, screen time and autism behavior of rural preschool children.Results:Compared with non-left-behind children (NLBC), the risk of autism behavior for left-behind children (LBC) increased 36%.The risk of autism behavior increased by 40% for 1 h/d 2 h/d when compared with ST ≤ 1 h/d.While comparing to NLBC with ST ≤ 1 h/d, the risk of autism behavior increased by 97% in LBC with 1 h/d 2 h/d.Conclusions:There is an additive effect on the risk of autism behavior when left-behind experience and excessive ST combined together.The daily ST should be strictly controlled within 2 h/d for NLBC, and within 1 h/d for LBC in order to reduce the risk of autism behavior in preschool children of rural areas.

Objective: To explore the mediating role of depression in the association between life events and Internet addiction, and to provide evidence for the intervention of Internet addiction. Methods: A total of 3 536 students randomly selected from 3 vocational colleges in Anhui Province completed the questionnaire survey, which included adolescents’ demographic characteristics, the Young Internet Addiction Inventory, the Adolescent Life Events Scale, and the Zung Self-Rating Depression Scale. Results: Of the 3 536 students surveyed, 427 were Internet addicts (12.08%), including 183 boys (14.89%) and 244 girls (10.58%). Negative life events were associated with depression and Internet addiction (r=-0.30，0.28, P<0.01); depression was mediated indirectly between negative life events and Internet addiction. There was statistical significance (a=0.30, b=0.13, P<0.01). Depression-mediated indirect effects accounted for 14.67% of the total effects. Conclusion Depression plays a mediating role in the relationship between negative life events and adolescents’ Internet addiction, suggesting that we can reduce the incidence of Internet addiction by reducing students’ depression through early psychological diagnosis and psychological quality training.

Objective: To understand effects of timing and duration of separation experiences from parents on emotion regulation of left-behind preschoolers,and to provide the reference for phychological instruction and intervention among the special groups of children. Methods: Children’s emotion regulation strategy and the relevant information among 1 373 left-behind preschool children from Funan county in Fuyang.Qianshan county in Anqing,Changfeng county and Fexi county inFeixi were investigated. Results: Children with left-behind experiences younger than 18 months old tend to use less cognitive restructuring (P=0.03) and alternative action strategies (P=0.00) than non-left behind children. Children separated from father less than 47 months (median) and 36 months (median) from mother tend to use less cognitive restructuring (P=0.00) and alternative action strategies (P=0.00) than non-left behind children. Conclusion Separation experiences from parents younger than 18 months old exert severe damage on children’s emotional regulation. With the duration of separation increases, children show resilience of emotion regulation, which might be a protective factor for negative emotion due to parent-child separation.

Objective To know the anxiety status of preschool children in rural areas and to explore its influential factors. Methods Subjects of 1363 rural preschool children aged 3-6 years were selected from Anhui Province( Changfeng and Feixi county of Hefei city; Qianshan county of Anqing city; Funan county of Fuyang city) . The primary caregivers of preschool children were investigated by Chinese version of Spence Preschool Anxiety Scale (SPAS),Devereux Early Childhood Assessment for Preschoolers (DECA-P2) ,Neglect Norms for Children Aged 3 to 6 Years in Rural Areas of China,Adaptation Partnership Growth Affection Resolve (APGAR),Self-rating anxiety scale (SAS) and Self-rating depression (SDS). Result-s Among the 1363 preschool children,the positive rate of anxiety was 14. 7％. Physical injury fears score was highest (1. 24±0. 84),followed by social phobia anxiety (0. 86±0. 75) and separation anxiety (0. 85± 0. 74) . Except for obsessive compulsive disorder,the other four types of anxiety and total anxiety scores were negatively correlated with the total protective factors of mental resilience (r=-0. 054- -0. 070,P<0. 05). Besides,all anxiety scores were positively correlated with behavioral problems(r=0. 121-0. 237,P<0. 05)and neglect degree (r=0. 157-0. 269,P<0. 05). The results of multiple linear regression analysis of different anxiety types showed that gender,family type,family income status,parental rearing pattern was consistent or inconsistent,children' s neglect degree,behavior problem and anxiety/depression status of primary caregivers were the main factors affecting the anxiety level of preschool children in rural areas. Conclusions In order to reduce or avoid anxiety of preschool children,it is necessary to establish a good family environment,im-prove parents' upbringing level,and take effective education intervention.

Objective To investigate the clinical validity of the Chinese version of John Hopkins Adapted Cognitive Exam (ACE) for in-patients in neurological intensive care unit (NICU). Methods From May, 2014 to June, 2015, 94 inpatients in NICU and 52 healthy persons were assessed with the Chinese version of ACE and Mini-Mental State Examination (MMSE). Results The total score of ACE correlated with the total score of MMSE (r=0.805, P<0.001). There was a significant difference in the total score and the scores of the subtests of both the ACE and MMSE between the patients and the controls (t>2.458, P<0.05). The area under the receiver operating curve was not different between ACE and MMSE (Z=0.707, P=0.480). Conclusion The Chinese version of ACE can be the tool for assessment of cognition for pa-tients in NICU.

Objective To investigate the clinical efficacy of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery for patients at the early stage of traumatic brain injury (TBI). Methods 72 patients with TBI hospitalized from January, 2013 to October, 2014 and 30 healthy controls matched gender, age and educational background were assessed with the Chinese version of LOTCA battery and Mini-Mental State Examination (MMSE) respectively. Results The score of MMSE and LOTCA were correlated (r=0.56, P<0.01). Compared with the controls, the scores of all the subtests of LOTCA decreased (P<0.01) in the patients, especially the orientation, visuomo-tor organization and thinking operation;with the more incidence of medium and serious dysfunction of all the subtests of LOTCA except perception (P<0.01), in which thinking operation was the most and attention was the least. The area under the receiver operating curve (ROC) was (0.84±0.04) in LOTCA, less than that of (0.91±0.03) in MMSE (P<0.05). Conclusion Cognition is widely impaired in patients after TBI, most involved thinking operation. LOTCA is less effective to identify cognitive dysfunction than MMSE, and can be used as an al-ternation or a supplement.

Objective To test the reliability and validity of the Chinese version of the John Hopkins Adapted Cognitive Exam ( ACE) in NICU patients. Methods The English ACE was translated and adapted into the Chinese version . Cognitive functions of 40 critically ill patients in NICU were assessed with the Chi?nese version of ACE and MMSE battery.The scores of ACE and MMSE were analyzed to test the content va?lidity,construct validity,concurrent validity,internal consistency,inter?rater reliability and test?retest reliabil?ity.Result The correlation coefficient between each factor and the total score ranged from 0.617 to 0.938, and the content validity was good.The ACE was significantly correlated with MMSE( r=0.822, P<0.05). Five factors were extracted by main principle analysis, the cumulative contribution was 85. 90%, the factor loading of each item was all over 0.5,the scale had good construct validity.There existed a good internal con?sistency ( Cronbach’ α=0.756 ) as well as a good inter?rater reliability ( ICC>0.95) and test?retest reliabil?ity (ICC=0.652?0.979) of the Chinese version of ACE.Conclusions The Chinese version of ACE has been proved to be a reliable and valid screening tool for cognitive impairment in NICU patients.

Objective To evaluate the Montreal cognitive assessment (MoCA) for detecting the mild cognitive impairment (MCI) in brain trauma patients with normal mini-mental state examination (MMSE) scores.Methods Fifty brain trauma patients with normal MMSE scores hospitalized from January 2013 to June 2014 were subjected to the MoCA test.The patients were classified as cognitive impairment group scored less than 26 on the MoCA and cognitive normal group scored 26 or above on the MoCA.Differences in MMSE and MoCA scores of the two groups were compared.Receiver operative characteristic (ROC) curve was used to determine the optimal cut-off scores in screening for MCI.Results Overall MMSE and MoCA scores were (27.84 ± 0.89) points and (23.24 ± 2.90) points.There was a positive correlation between MoCA and MMSE total scores (r =0.355 2,P ＜ 0.05).MCI was found in 79％ of the brain trauma patients using the MoCA.MMSE total score and subscores were all similar between the two groups.MoCA total score and subscores of attention,language,abstraction and delayed recall were much higher in cognitive normal group than in cognitive impairment group (P ＜0.05),but there were no significant differences in visuospatial,naming and oritention domains.Area under the ROC curve for MoCA(0.871 ± 0.038) was larger compared with MMSE (0.796 ± 0.054) (Z =3.592,P ＜ 0.05).The optimal cut-off scores of MoCA and MMSE for the identification of MCI were 25.5 and 28.5 respectively.Conclusions MoCA and MMSE total scores are positively correlated.MoCA is a better detector for the identification of MCI in brain trauma patients than the MMSE.

Delirium and cognitive impairment are common in the intensive care units (ICU). The Confusion Assessment Method Inten-sive Care Unit (CAM-ICU), Intensive Care Delirium Screening Checklist (ICDSC), Cognitive Test for Delirium (CTD), Nursing Delirium Scale (Nu-DESC) and Delirium Rating Scale (DRS) are recommended to assess delirium. CAM-ICU and ICDSC are the best in the reliabili-ty, validity, sensitivity and specification. Mini-Mental State Examination (MMSE), Abbreviated Mental Status Examination (AMSE), the Johns Hopkins Adapted Cognitive Exam are used commonly for cognitive impairment, and Johns Hopkins Adapted Cognitive Exam is one of the suitable scales for ICU as it is simple, comprehensive, and with higher reliability and validity.

Objective To explore the risk factors of dysphagia in the patients with traumatic brain injuries (TBI). Methods 141 TBI patients were assessed with Gugging Swallowing Screen, and divided into the dysphagia (n=36) and normal (n=105) groups. The related factors were compared between 2 groups. Results The frequency increased in severe brain injury, brain stem injury, bilateral brain injury, tracheotomy, nasal-gastric tube insertion and cognitive defect in the dysphagia group compared with those in the normal group (P<0.05). Conclusion The severe brain injury, brain stem injury, bilateral brain injury, tracheotomy, nasal-gastric tube insertion and cognitive defect may be related with the dysphagia post TBI.