Search Results (10)

Background: School bullying is a global problem. Although previous studies showed rural adolescents were at higher risk of being bullied compared to their urban counterparts, the rural–urban differences in the risk of bullying or poly-bullying victimization in relation with different characteristics and the joint association of internet addiction and depressive symptoms with the observed urban–rural disparities are unclear. Objective: We aim to investigate the rural–urban differences in bullying or poly-bullying victimization among adolescents and whether the observed rural–urban differences are associated specifically with internet addiction or depression. Methods: This cross-sectional study considered a total of 25,377 Grade 7 to 12 adolescents from the ‘Surveillance for Common Disease and Health Risk Factors among Students’ project implemented in Jiangsu Province in 2019. Rurality of residence was ascertained via the Regulation of Statistical Classification. We used Poisson regression to estimate the age–sex adjusted rate ratios (RRs) and 95% confidence interval (CI) for bullying and poly-bullying victimization. Results: Approximately 20.26% (95%CI: 16.11–25.47%) and 7.67% (5.48–10.74%) rural adolescents experienced bullying and poly-bullying, in comparison with 16.50% (12.65–21.52%) and 5.81% (4.34–7.78%) urban adolescents, respectively. Rural adolescents had 14% and 23% higher rates of bullying victimization (RR: 1.14, 95%CI: 1.03–1.26) and poly-victimization (RR: 1.23, 95%CI: 1.05–1.44) than their urban counterparts. When further controlled for internet addiction, the observed rural–urban disparities increased among adolescents with depressive symptoms, whereas diminished among those without depressive symptoms. Full article

Many studies have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate the association of 13 common types of ACEs with NSSI, suicidal ideation (SI), and suicide attempts (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 (994 male, 777 female) students aged 11–16 (12.9 ± 0.6) years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included in the analysis. ACEs, including childhood maltreatment, other common forms of ACEs, and smoking, were measured via the Chinese version of the Child Trauma Questionnaire (CTQ) and a series of valid questionnaires that were derived from previous studies. NSSI was measured using the Chinese version of the Functional Assessment of Self-mutilation. SI and SA were measured using questions derived from the Global School Based Student Health Survey. Depressive symptoms were measured via the Chinese version of the Center for Epidemiologic Studies Depression Scale, and anxiety symptoms were measured via the General Anxiety Disorder-7. Of the included participants, 92.0% reported one or more category of ACEs. Smoking, parent–child separation, emotional abuse, physical abuse, and being bullied were positively associated with NSSI; smoking, parent–child separation, emotional abuse, physical abuse, emotional neglect, and being bullied were positively associated with SI; smoking, emotional abuse, and being bullied were positively associated with SA. The associations of ACEs with NSSI, SI, and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse, and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms. In conclusion, not all the types of ACEs are independently associated with NSSI, and suicidality and other associations may mediate through depressive and anxiety symptoms. Target interventions for adolescents’ NSSI and suicidality should focus on those who have a history of ACEs and depressive and anxiety symptoms. Full article

Objective: To describe the secular trends of cause-specific mortality among adolescents aged 10 to 24 years from 2004 to 2019 and explore the association between mortality and economic status, education level as well as health investment. Methods: Mortality data of adolescents aged 10 to 24 years were obtained from the national disease surveillance points system. The age-standardized mortality rate (ASMR) was calculated by using the population data from the sixth national population census in 2010. GDP per capita, urbanization rate, illiteracy rate of the population over 15 years old, government education expenditure per capita, number of health service providers per 1000 people, and number of health beds per 1000 people were collected from China’s Economic and Social Big Data Research Platform. Age-period-cohort analysis was used to analyse the net age, period, and cohort effects of mortality among adolescents, while panel data regression was used to explore the association between mortality and economic status, education level as well as health investment. Results: Overall, the ASMR was 28.84 per 100,000 and the top five causes of mortality were road injuries, drowning, intentional self-harm and sequelae, leukaemia, and falls among adolescents aged 10 to 24 years in China in 2019. All-cause mortality declined with an annual percentage change of 4.02% (95% Confidence interval: 3.74% to 4.30%) from 2004 to 2019 yet with persistent differences across different demographic (gender and age) and geographical (urban-rural, and regional) subgroups. Notably, the ASMR for HIV/AIDS in males, lower respiratory infections in urban adolescents, and iron deficiency anaemia as well as cervical cancer in adolescents aged 20 to 24 years showed an increase over time. The multivariate panel data regression showed that the ASMR decreased by 5.18 (3.27, 7.08) per 100,000 for every increase in the number of health beds per 1000 population, but with insignificant association with GDP per capita and illiteracy rate in the total sample. Health beds investment was positively associated with ASMR at almost all subgroups except for adolescents aged 10 to 14 years; GDP per capita increase was helpful to males and rural adolescents while an increasing literacy rate was beneficial for females and adolescents aged 15 to 19 years. Conclusion: Given the persistent differences between subgroups, further investments including improving health services, especially increasing health bed investment, GDP per capita, and reducing the illiteracy rate and concern for adolescents in males, rural areas, the western regions, and aged 15 to 24 years are needed. Additionally, the increased burden of some diseases, such as HIV/AIDS, must be of further concern. Full article

(1) Background: Previous studies have shown that stress increases the risk of bullying (including perpetration and victimization) in adolescents, and depressive symptoms are associated with both stress and bullying. However, the relationship between stress, depressive symptoms, and bullying has not been fully elucidated. In addition, previous studies have focused only on stressors but have ignored the role of resilience in evaluating individual’s stress. This study aimed to incorporate resilience into the assessment of an individual’s stress, which we named comprehensive stress; to examine the relationship between comprehensive stress and bullying; and then to investigate the potential role of depressive symptoms in this relationship. (2) Methods: We recruited 6353 middle and high school students from the 2021 Shanghai CDC Youth Risk Behavior Surveillance Project. After signing informed consent, participants provided demographic information and completed effective measures of stressors, resilience, depressive symptoms, and bullying. (3) Results: Latent profile analysis revealed four profiles of comprehensive stress, labeled as Low stressor–High resilience (37.57%, n = 2216), Moderate high stressor–Average resilience (14.38%, n = 848), Average stressor–Moderate low resilience (33.33%, n = 1966), and High stressor–Low resilience (14.72%, n = 868). In comparison to students in the Low stressor–High resilience profile, students in other profiles demonstrated higher likelihoods of engaging in bullying victimization and perpetration, as well as higher levels of depressive symptoms. Specifically, students in the High stressor–Low resilience profile had the highest odds of bullying victimization (OR = 6.74, 95% CI: 4.92–9.22) and perpetration (OR = 5.15, 95% CI: 3.56–7.46), along with the highest level of depressive symptoms (β = 11.35, Se(β) = 0.17). Students in the Average stressor–Moderate low resilience profile had a moderate increase in the odds of bullying victimization (OR = 2.21, 95% CI: 1.63–3.00) and perpetration (OR = 2.69, 95% CI: 1.91–3.80), as well as a moderate level of depressive symptoms (β = 5.03, Se(β) = 0.13). Students in the Moderate high stressor–Average resilience profile also showed increased odds of bullying victimization (OR = 2.99, 95% CI: 2.12–4.20) and perpetration (OR = 2.80, 95% CI: 1.88–4.20), as well as a moderate level of depressive symptoms (β = 4.44, Se(β) = 0.16). Depressive symptoms were positively correlated with both perpetration and victimization. Furthermore, the mediating role of depressive symptoms between comprehensive stress and bullying was observed. (4) Conclusions: Combining stressors and resilience is crucial when evaluating an individual’s stress. Comprehensive stress is associated with bullying, and depressive symptoms may partially mediate this relationship. Full article

The sexual health of young people during the youth age period is of utmost importance, as it sets the stage for sexual well-being over the life course. In addition to the existing challenges that youth face concerning their sexual health, electronic cigarettes may also negatively impact their sexual well-being. Specifically, through issues such as stuttering priapism, reduced sperm quality and quantity, and erectile dysfunction. Electronic cigarette use among youth is prevalent. Therefore, given the negative sexual health impacts associated with electronic cigarette use, coupled with the prevalent use of electronic cigarettes, it is necessary for youth to receive adequate support and guidance, so they understand the potential impacts that electronic cigarette use can have on their sexual well-being. Urologists are uniquely situated to play an important role in supporting the sexual health of youth, given their medical and surgical knowledge, however, it appears that they do not receive adequate training to carry out discussions about sexual health with youth. This paper aims to support urologists to have discussions with youth patients on the impact that electronic cigarettes have on their sexual health through a proposed four-step framework. This four-step framework involves: (i) establishing the relationship, (ii) assessing current electronic cigarette use, (iii) sharing research examining the impact of electronic cigarettes on sexual health, and (iv) discussing strategies to prevent/reduce or stop electronic cigarette use. It is necessary to acknowledge that this framework is only a small component of efforts to educate youth on the impacts that electronic cigarettes have on their sexual health. Moving forward, implementation and evaluation of this framework is needed. Full article

Background: Attention deficit hyperactivity disorder (ADHD) affects approximately 2–7% of children worldwide and has become a global public health concern. The health effects of green space on ADHD in young children are unclear. We investigated associations between school-surrounding greenness and hyperactivity behaviors in preschool children. Methods: We performed a cross-sectional analysis using data of 66,678 preschool children (mean age: 3.53 years) from an on-going cohort in Shenzhen, China. The greenness surrounding kindergartens was measured using satellite-derived Normalized Difference Vegetation Index (NDVI) values at buffers of 250 m, 500 m, and 1000 m. Children’s hyperactivity behaviors were measured using the validated Conners’ Parent Rating Scale-Revised. We used generalized linear mixed models to assess the associations of greenness exposure with hyperactivity behaviors with adjustment for a variety of covariates. Results: Exposure to higher school-surrounding greenness was associated with lower prevalence of hyperactivity behaviors. In fully adjusted models, the odds ratio of hyperactivity behaviors in relation to an IQR (0.1) increase in NDVI at the 250 m buffer was 0.91 [confidence interval (CI): 0.84,0.98]. Consistent results were observed for greenness at the 500 m and 1000 m buffers. The negative association between greenness and hyperactivity behaviors was more pronounced in boys than in girls. Conclusions: Our findings suggest that higher levels of school-surrounding green spaces are associated with a lower risk of hyperactivity behaviors in preschool children. Full article

Data on factors influencing multiple sexual partners that can inform cost-effective interventions are limited in Bhutan. This study examined factors associated with multiple sexual partners among adolescents. We analyzed the data of 7437 school-going adolescents from the 2016 Bhutan Global School-based Student Health Survey. Multivariable logistic regression stratified by sex was conducted. The prevalence of sex with multiple partners was 7.39%, with a much higher prevalence among males than females. In the overall sample, males, those >15 years of age, who smoked, consumed alcohol, used drugs, exhibited truancy, and were unmonitored by parents, had higher odds of having sex with multiple partners. In both males and females, being >15 years old, smoking, and drug use were associated with having multiple sexual partners. Alcohol use and truancy were significant only among males, whereas a lack of parental monitoring was significant only among females. The findings suggest that reducing substance use and enhancing parental support, and targeting males and older adolescents may yield larger gains. Full article

This cohort was set up to capture pubertal onset among children in China and to analyze how timing of pubertal onset would influence cardiovascular disease risk in later life. Pubertal onset was defined as secondary sexual characteristics (SSC) attained Tanner II stage, which was breast development for girls and testis of 4 mL for boys. Meanwhile, height growth spurt, defined as age of take-off and age of peak height velocity, were also involved to observe the consistency between the three indicators in discriminating pubertal onset. The study was conducted in Xiamen, China from November 2017 to November 2020 with 6-month gaps. One thousand, four hundred and sixteen children from four project schools who had not yet started puberty were involved at baseline. By November 2020, 1272 children were still under follow-up, with 945 (74.3%) of them reaching Tanner II stage. We would continue to follow the pubertal development, as well as change in crucial risk factors for cardiovascular disease in these participants. Evidence from the present cohort study would help to reveal the influence of pubertal growth on long-term cardiovascular health and would be one of the very first studies to provide such evidence from Asian countries. Full article

The recent consensus regarding children’s and adolescents’ health and development is that focus should not only be devoted to what sounds serious now but that our perspective should extend to considering the roots, where a healthy childhood and adolescence is essential to achieving full potential as an adult—i [...] Full article