Cross-cultural climate engagement: a latent profile analysis of young adults in China and New Zealand

Gout, a disabling inflammatory arthritis, closely linked to metabolic diseases such as hyperuricemia, obesity, hypertension, and diabetes, is increasingly prevalent among young adults in China. Understanding the burden of gout and its risk factors among young adults in China is crucial for developing effective prevention and management strategies. We analyzed data from the Global Burden of Disease Study 2021 (GBD 2021) on gout prevalence, incidence, and disability-adjusted life years (DALYs) among young adults (individuals aged 15-39 years) in China from 1990 to 2021. Joinpoint regression and the AutoRegressive Integrated Moving Average (ARIMA) model were used to assess trends and predict future burden. Summary exposure values (SEVs) were used to evaluate risk factors. The study found that the burden of gout among young adults in China is significantly higher than the global average and shows a continuous upward trend. Males have a higher burden and age-standardized rates on all indicators, including prevalence, incidence, and DALYs. Joinpoint regression analysis revealed that from 1990 to 2021, the burden of gout has experienced rapid growth, stabilization, and a resurgence of acceleration since 2019. ARIMA model projects different epidemiological trends for gout across 2022-2036, with age-standardized prevalence rate (ASPR) and age-standardized incidence rate (ASIR) declining while age-standardized DALYs rate (ASDR) gradually rise. Gender-specific disparities persist. Females demonstrate a predictable rise in ASPR, ASIR and ASDR. Despite males facing higher baseline burdens and accelerating ASDR growth, their ASPR and ASIR exhibit downward trends. A significant rise in gout risk factors among Chinese aged 15-39 from 1990 to 2021 highlights the need to face the upcoming gout burden and carry out targeted measures for this population. The rising burden of gout among young Chinese adults demands immediate gender- and age-specific public health action. Targeted interventions focusing on modifiable risk factors such as dietary habits and lifestyle are crucial to reduce the impact of gout on young adults.

An increasing cancer incidence among adults younger than 50 years has been reported for several types of cancer in multiple countries. We aimed to report cancer profiles and trends among young adults in China. Data from the China Cancer Registry Annual Report were used to estimate incidence and mortality among young adults (ages 20-49 years) in China in 2017, and an age-period-cohort model was employed to estimate the average annual percent change (AAPC) in incidence and mortality from 2000 to 2017. All 25 cancer types were grouped into obesity- or overweight-associated cancers (12 cancer types) and additional cancers (13 cancer types). In 2017, there were 681,178 new cases and 214,591 cancer deaths among young adults in China. Among young adults, the most common cancers were thyroid, breast, cervical, liver, lung, and colorectal cancer, and the leading causes of cancer deaths were liver, lung, cervical, stomach, breast, and colorectal cancer. From 2000 to 2017, the cancer incidence increased for all cancers combined among young adults, with the highest AAPC (1.46%) for adults aged 20-24 years, while cancer mortality decreased, with the highest AAPC (-1.63%) for those aged 35-39 years. In conclusion, the cancer incidence in China has increased among young adults, while cancer mortality has decreased for nearly all ages. Cancer control measures, such as obesity control and appropriate screening, may contribute to reducing the increasing cancer burden among young adults.

Data on average iodine requirements for the Chinese population are limited following implementation of long-term universal salt iodisation. We explored the minimum iodine requirements of young adults in China using a balance experiment and the 'iodine overflow' hypothesis proposed by our team. Sixty healthy young adults were enrolled to consume a sequential experimental diet containing low, medium and high levels of iodine (about 20, 40 and 60 μg/d, respectively). Each dose was consumed for 4 d, and daily iodine intake, excretion and retention were assessed. All participants were in negative iodine balance throughout the study. Iodine intake, excretion and retention differed among the three iodine levels (P < 0·01 for all groups). The zero-iodine balance derived from a random effect model indicated a mean iodine intake of 102 μg/d, but poor correlation coefficients between observed and predicted iodine excretion (r 0·538 for μg/d data) and retention (r 0·304 for μg/d data). As iodine intake increased from medium to high, all of the increased iodine was excreted ('overflow') through urine and faeces by males, and 89·5 % was excreted by females. Although the high iodine level (63·4 μg/d) might be adequate in males, the corresponding level of 61·6 μg/d in females did not meet optimal requirements. Our findings indicate that a daily iodine intake of approximately half the current recommended nutrient intake (120 μg/d) may satisfy the minimum iodine requirements of young male adults in China, while a similar level is insufficient for females based on the 'iodine overflow' hypothesis.

This dissertation describes young adults in China who pursue self-definition through self-help psychology, focusing especially on people studying public speaking and social skills. The dissertation engages with academic theories of autonomy and identity by showing how young adults in China discuss, practice, and promote self-definition. It also contributes to a growing social science literature on the therapeutic, cultural, and political effects of the psychological disciplines as they spread worldwide. Anthropologists have demonstrated that a range of psychological interventions aim to create autonomous, self-managing subjects; they have critiqued these interventions as depoliticizing and economically exploitative. However, autonomy is not only a political logic or a cultural ideal, but also a condition of life in mobile mass societies. This dissertation demonstrates that young college graduates in China draw on self-help psychology as a set of resources for adapting to the possibilities, dangers, and psychosocial demands of life outside of interpersonal networks. It shows that self-help psychology is teaching people in China ways to define who they are in relation to two elements of a liberal society: among strangers, and before an impersonal law. Young adults studying social skills are learning to derive a social identity by being humorous and confident, and also by asserting individual interests and ideals. However, while young adults in China are studying self-presentation skills, the dissertation argues the way in which they bind themselves to their visible personality is deeply shaped by Chinese historical, cultural, and social logics.,The dissertation draws on a year and half of participation in personal growth groups in Beijing; interviews with psychotherapists and psychology writers; collaborations with cultural activists; and a survey of self-help texts. By shifting between the perspectives of professional and self-help psychology, the chapters show how the concepts of autonomy and identity are translated between Western psychological expertise and Chinese social discourse. As young adults learn to construct an identity through voluntary association, on stage before a distant audience, and in relation to the image of a perfected self, they develop a liberal sense of being individuals in tension with a reified society. In China, psychologists who are promoting autonomy are continuing a long tradition of modernist reforms that aim to create a civil society of responsible individuals; these efforts now gain strength from experiences of mobility and fragmentation that make stranger relations normal and personal projects vital. But while social changes are teaching young people in China the power of actively crafting an identity, even exposure to Western technologies of self-definition does not make for a Western subjectivity.,Drawing on critical strands of Western and comparative philosophy, the dissertation suggests that the autonomous individual is defined by antagonism, and is subject to a temporality that stakes identity on an eternal moment. Since young adults in China are now worrying about job interviews and dates, they are anxious about fleeting social interactions; they are working to acquire confident self-presentation skills that may help them to secure a social identity. But the self is most tightly bound to its social image not by the eyes of strangers but by the gaze of a transcendent judge, by a trial that finds one either guilty or righteous. Under this gaze, which has been comparatively less central to Chinese people’s psychic economy, the individual becomes a self-justifying political actor. The psychological doctrines now entering China imply a distant law. Self-help concepts including communication, will power, positivity, intimacy, and self-esteem all invoke legalistic and confessional understandings of discourse, and a heroic, antagonistic view of personal efficacy. These terms change their meaning as they are translated into Chinese contexts.,The most revolutionary aspect of the psychological disciplines that are proliferating in China is the way in which they reinforce emerging connections between personal identity, public image, and social performance. For young adults in urban China, self-help psychology offers a set of techniques for defining oneself among strangers, for acquiring confidence and establishing an identity. As young adults in China learn to define who they are by their interests and ideals, they are beginning to develop a transcendent sense of identity, binding the self to the object in the eyes of strangers. The mask of social performance becomes a mirror, in which people hope to find themselves.

Unhealthy lifestyles during adolescence are significant factors leading to chronic diseases in the future. Enhancing health-promoting lifestyles among young adults in China is crucial for preventing and reducing the risk factors of chronic diseases. This study aims to explore the relationships between life satisfaction, family health, physical activity, and health-promoting lifestyles among young adults in China. It also seeks to confirm the chain mediation role of family health and physical activity in the influence of life satisfaction on health-promoting lifestyles in this population. This study, conducted from August 2023 to November 2023, employed a random sampling method to recruit young adult participants aged 18-40 in the southwestern region of China. Variables were measured using the Satisfaction with Life Scale (SWLS), the Family Health Scale-Short Form (FHS-SF), the Physical Activity Rating Scale-3 (PARS-3), and the Health-Promoting Lifestyle Profile II Revised (HPLP-IIR). Data analysis was performed using SPSS 27.0 and the PROCESS macro version 4.1. The results indicated that life satisfaction was positively correlated with family health (r = 0.225), physical activity (r = 0.245), and health-promoting lifestyles (r = 0.506). Family health was positively correlated with physical activity (r = 0.320) and health-promoting lifestyles (r = 0.312). Physical activity was positively correlated with health-promoting lifestyles (r = 0.429). Additionally, life satisfaction could influence health-promoting lifestyles directly (effect = 0.369) and through three mediation pathways: (a) family health (effect = 0.033); (b) physical activity (effect = 0.050); (c) family health and physical activity (effect = 0.020). This study supports the mediating role of family health and physical activity in the influence of life satisfaction on health behaviors among young adults in China. Therefore, we recommend that future public health initiatives place greater emphasis on family health and create conditions that facilitate physical activity for this group. This could be an important direction for further enhancing health-promoting lifestyles among young adults in China.

The creation of graffiti in bathrooms is a common practice in colleges and universities in China and abroad. This private form of expression provides a unique way to understand young adults in contemporary China. The investigators conducted two studies in order to explore this social phenomenon. Study one qualitatively analyzed toilet graffiti from five universities in Central China. Results show: (1) sex, love, and self-exploration are the most common themes in bathroom graffiti; (2) male graffiti was dominated by sex while female graffiti focused on love and sex. Study two investigated the willingness of college students to engage in bathroom graffiti creation. Results show: (1) males were more willing to create pieces about sex, comments on social phenomena, verbal bullying, and teasing than female students; (2) students in year two and three were more willing to create bathroom graffiti than students in year one. Discussion focuses on the possible psychological and cultural influences on the practice of bathroom graffiti.

Eating disorders and obesity are commonly recognized as key public health concerns worldwide. Although rates of obesity and disordered eating have traditionally been lower in China than Western countries, these rates are on the rise. As such, interest is growing in identifying mechanisms that may address these conditions. While associations between body weight and dissatisfaction are well established, burgeoning research aims to examine how these factors are related to dietary restraint and body image inflexibility. This study aimed to explore the possible mediation effect of body dissatisfaction and body image inflexibility between body weight (body mass index) and dietary restraint. Furthermore, we explored how these relationships differed across men and women. A sample of 1068 young adults (563 females and 505 males) in China participated in the study. Participants completed the Eating Disorder Inventory and Three-Factor Eating Questionnaire as well as the Body Image-Acceptance and Action Questionnaire. Results showed that: (1) body dissatisfaction and body image inflexibility fully mediated the relationship between body mass index and dietary restraint; (2) this model fit both genders, although differences were found in the regression coefficients between the mediation model for men and women. These findings support body image dissatisfaction and inflexibility as mediators of the relationship between body weight and dietary restraint, highlighting these as potential mechanisms for treatment. Level III, case-control analytic study.

To estimate the rate of death, and disability-adjusted life years (DALYs) and project the disease burden of ischemic stroke due to relevant risk factors in young adults age 20–49 years by sex in China. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used. The age-standardized mortality (ASMR), age-standardized DALYs rate (ASDR), and estimated annual percentage changes (EAPC) were calculated to evaluate the temporal trends from 1990 to 2019. We also used the NORDPRED model to predict ASMR for ischemic stroke due to related risk factors in Chinese young adults over the next 10 years. From 1990 to 2019, the general age-standardized mortality [from 2.39 (1.97 to 2.99) in 1990 to 1.8 (1.41 to 2.18) in 2019, EAPC = − 1.23] and DALYs rates (from 171.7 (140.34 to 212.36) in 1990 to 144.4 (114.29 to 177.37) in 2019, EAPC = − 0.86) decreased for ischemic stroke in young adults in China. ASMR and ASDR decreased for all level 1 risk factors (including behavioral, environmental/occupational, and metabolic) from 1990 to 2019, with the slightest decrease for metabolic risks [ASMR from 1.86 (1.39 to 2.41) in 1990 to 1.53 (1.15 to 1.92) in 2019, ASDR from 133.68 (99.96 to 173.89) in 1990 to 123.54 (92.96 to 156.98) in 2019] and the largest decrease for environmental/occupational risks [ASMR from 1.57 (1.26 to 1.98) in 1990 to 1.03 (0.78 to 1.29) in 2019, ASDR from 110.91 (88.44 to 138.34) in 1990 to 80.03 (61.87 to 100.33) in 2019]. In general, high body-mass index, high red meat intake, and ambient particulate matter pollution contributed to the large increase in ASMR and ASDR between 1990 and 2019. Significant reductions in ASMR and ASDR were observed in low vegetables intake, household air pollution from solid fuels, lead exposure, and low fiber intake. In addition, there were sex differences in the ranking of ASMR attributable to risks in ischemic stroke. The disease burden of ischemic stroke attributable to relevant risk factors in young adults in China is greater and has a faster growth trend or a slower decline trend in males than in females (except for secondhand smoke). The apparent increasing trend of ASMR attributable to high fasting plasma glucose, high systolic blood pressure, high body-mass index, and high red meat intake was observed in males but not in females. The projected analysis showed an increasing trend in ASMR between 1990 and 2030 for all specific metabolic risks for males, but a decreasing trend for females. ASMR attributable to ambient particulate matter pollution showed an increasing trend from 1990 to 2030 for both males and females. The burden of ischemic stroke in young adults in China showed a downward trend from 1990 to 2019. Specific risk factors associated with the burden of ischemic stroke varied between the sexes. Corresponding measures need to be developed in China to reduce the disease burden of ischemic stroke among young adults.

INTRODUCTIONLittle is known about the perception and use of e-cigarettes by the Chinese, particularly the young people. This study reveals the awareness, attitudes, and use of e-cigarettes among young adults in China, examines the relationship between smoking behavior and e-cigarette perception and use, and demonstrates the phenomenon of e-cigarette gifting.METHODSWe used results from a mobile app-based survey conducted in November 2015 that included 10477 young Chinese adults aged between 19 and 29 years. Bivariate tests were conducted to analyze perception and use of e-cigarettes by respondents of different smoking status. Multivariate logistic regressions were applied to examine the correlates of e-cigarette use and perception and e-cigarette gifting behavior, particularly the factors of tobacco smoking status and quitting behavior.RESULTSAmong the surveyed young adults, 88.40% were aware of e-cigarettes, and nearly a quarter of all respondents had used e-cigarettes by the time of our survey. Multivariate regression results demonstrated that current smokers with quitting experience were more likely to be aware of and to use e-cigarettes than current smokers with no quitting experience. Smokers with quitting experience also were more inclined to promote e-cigarettes to others by either recommending them or giving them as gifts.CONCLUSIONSE-cigarettes have gained popularity among young adults in China and smokers, especially those who had tried quitting, were more likely to have known and used e-cigarettes. More empirical research on the relationship between e-cigarette use and smoking cessation is warranted to better inform a potential regulatory framework in China.

The incidence of stroke among young adults was rising globally, but the death burden of stroke in young adults in China is lacking. We aimed to examine the temporal trends in mortality and years of life lost (YLLs) caused by stroke among young adults from 2005 to 2020 across China. Based on the data from the National Mortality Surveillance System in China, we estimated the number and age-standardized rate of mortality and YLLs due to stroke and its subtypes among young adults aged 15-49 years during 2005-2020, for both China and its 31 mainland provinces. During 2005-2020, the age-standardized mortality rate of stroke among young adults aged 15-49 years in China decreased by 21.0%, from 5.9/100,000 to 4.7/100,000, and the YLL rate decreased from 286.9/100,000 to 229.5/100,000. The age-standardized mortality rate among young adults due to intracerebral hemorrhage (ICH) showed a significant downward trend with a decrease of 26.3% while that of ischemic stroke (IS) and subarachnoid hemorrhage (SAH) decreased by 4.5% and 0.6%, respectively. In 2020, the mortality rate of ICH was 3.5 times higher than that of IS (3.3/100,000 vs 0.9/100,000) among young adults in China. The male/female ratio of age-standardized mortality rate of stroke in young adults increased from 2.0 in 2005 to 3.1 in 2020. The age-standardized mortality rate of IS and SAH in young men increased by 11.0% and 2.5%, respectively. In 2020, Tibet (18.4/100,000), Jilin (10.4/100,000), and Qinghai (8.3/100,000) were the top 3 provinces holding the highest age-standardized mortality rate due to stroke among young adults. Tibet was found to have the highest mortality rate due to ICH and SAH while that of IS was higher in northeast China. In China, the death burden caused by ICH among young adults was substantially higher than that of IS. The increasing death burden of IS and SAH among young men requires special attention. Evidence-based intervention strategies are needed to improve the outcomes of stroke and alleviate the death burden due to stroke among young adults in Chinese population.

BackgroundResearch has revealed that childhood neglect may be a risk factor for problematic smartphone use among young adults in China. However, few studies have examined the mediating roles of peer attachment and the fear of missing out in the relationship between childhood neglect and problematic smartphone use. To fill this gap, the present study proposes a multiple mediation model to understand the relationships among childhood neglect, peer attachment, fear of missing out, and problematic smartphone use among young adults.MethodsA total of 869 young adults in China completed questionnaires for evaluating different levels of the relationships between childhood neglect, peer attachment, the fear of missing out, and problematic smartphone use. The collected data were analyzed using SPSS 23.0 and MPLUS8.3.ResultsThe results showed that childhood neglect was positively associated with problematic smartphone use among young adults in China. Moreover, peer attachment and the fear of missing out had partial mediating effects as well as sequential mediating effects in the relationship between childhood neglect and problematic smartphone use among young adults.ConclusionBased on these findings, peer attachment and the fear of missing out, as mediators, could be considered proximal factors affecting problematic smartphone use among young adults. These findings broaden our understanding of the psychological processes that underlie the association between childhood neglect and problematic smartphone use and afford practical guidance on reducing the risks associated with problematic smartphone use.

Validation of the Body Acceptance by Others Scale-2 (BAOS-2) and assessment of its associations with prospective changes in body image among young adults in China

Studies from several countries have reported an increasing trend in heart failure (HF) among young adults, but comprehensive data on HF burden among young Chinese adults are lacking. Using data from the Global Burden of Disease Study 2021, we analyzed trends in prevalence and years lived with disability (YLDs) of HF among Chinese adults aged 20-49 years from 1990 to 2021. We examined age-standardized rates per 100,000 population, stratified by age groups, sex, severity levels, and underlying causes. Joinpoint regression, age-period-cohort analysis, decomposition analysis, frontier analysis and projection models were applied. From 1990 to 2021, HF prevalence cases increased from 448,261.89 to 897,595.61, while YLDs rose from 44,025.76 to 88,416.28. Age-standardized prevalence rates increased from 88.44 to 141.27 per 100,000 population, and YLD rates increased from 8.70 to 13.90, with average annual percentage changes (AAPC) of 1.53 (95% CI: 1.40-1.65) and 1.52 (95% CI: 1.42-1.61), respectively. Ischemic heart disease remained the leading cause (51.68 per 100,000), followed by hypertensive heart disease (29.25) and cardiomyopathy (15.83), while atrial fibrillation showed the highest relative increase (446%). Frontier analysis revealed a moderate gap (effective difference: 51.68) between China's current and potentially achievable HF prevalence. Epidemiological changes (66.9%) drove the increased burden, with projections indicating continued rises through 2030. The burden of HF among young Chinese adults has increased substantially over the past three decades, with traditional cardiovascular causes remaining predominant. These findings highlight the urgent need for enhanced prevention strategies targeting young adults in China.

This study examines the living arrangements of never-married urban young adults in China and South Korea from 2003 to 2018. Using data from the Chinese General Social Survey and the Korean General Social Survey, we investigate the relationship between socioeconomic status and young adults’ living arrangements. Our findings show that a majority of Korean young adults lived with their parents during the observed time period, while Chinese young adults experienced large shifts in their living arrangements. Findings from weighted logistic models demonstrate that employed or high-income young adults were more likely to leave the parental home than those who were not working, suggesting the important role of economic security in independent living. Highly educated young adults in China tended to have residential independence, while education was not significantly associated with Korean young adults’ living arrangements. Korean young adults with highly educated fathers were more likely to stay with parents. The interconnection between family socioeconomic characteristics at the micro level and variations in opportunity structures at the macro level results in country-specific patterns of living arrangements.

Younger adults in China who are transgender and gender nonconforming (TGNC) and lesbian, gay, and bisexual (LGB) experience high levels of minority stress (eg, stigma and bullying) and adverse mental health symptoms. However, there is a lack of research documenting mental health disparities compared with their cisgender and heterosexual peers. Studies that disaggregate TGNC and LGB individuals and are conducted in nonmetropolitan regions are also needed. To examine whether younger adult students' psychiatric symptoms and suicide risk vary by sexual orientation and gender identity and identify risk factors within LGB younger adults and TGNC younger adults. This cross-sectional study surveyed students at 63 universities in Jilin Province, China, between October 24 and November 18, 2021. Analyses were completed May 6, 2022. Gender identity (TGNC vs cisgender) and sexual orientation (LGB vs heterosexual). Psychiatric outcomes included depression, anxiety, traumatic stress, and nonsuicidal self-injury (NSSI), which were measured by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Trauma Screening Questionnaire, and self-reported NSSI behaviors. The Suicide Behaviors Questionnaire-Revised was used to assess suicide risk. The analytic sample included 89 342 younger adults (mean [SD] age, 19.60 [1.75] years), including 51 438 assigned female at birth and 37 904 assigned male at birth. The sample included 2352 individuals who were TGNC, 6501 who were cisgender LGB, and 80 489 who were cisgender heterosexual. Compared with their cisgender heterosexual peers, TGNC and LGB younger adults were more likely to experience increased psychiatric symptoms across categories and suicide risk, as well as more severe forms of symptoms. In particular, overall suicide risk was 43.03% among TGNC individuals, 36.21% among LGB individuals, and 11.70% among cisgender heterosexual younger adults. Controlling for demographic variables and compared with cisgender heterosexual peers, TGNC young adults had higher odds of suicide risk (adjusted odds ratio, 5.38; 95% CI, 4.94-5.86; P < .001) and of past-year NSSI (adjusted odds ratio, 6.55; 95% CI, 5.87-7.30; P < .001). Separate within-group analyses for LGB and TGNC younger adults highlighted the vulnerability of bisexual women and gender nonbinary groups, as well as the relevance of minority stress-related risk factors, including peer bullying and assault and loneliness. This study noted disparities of mental health issues among LGB, transgender, or queer or questioning younger adults in China and suggests a high urgency to address psychological health and prevent suicide in this population. Targeted public health initiatives may be needed to reduce stigma and discrimination, train competent health care professionals, and create affirmative mental health policies and systems of care.