Gender disparities in the burden of vision impairment and regional environmental susceptibility among Chinese children and adolescents.

Introduction: Physical activity is a key component of a healthy lifestyle for youths with visual impairments (i.e., blindness or low vision). This study aims to examine the habitual physical activity and sedentary time of Chinese children and adolescents with visual impairments and to determine whether age, gender, and body composition significantly influence their behavior. Methods: A purposeful sample method was utilized to recruit 137 Chinese youths with visual impairments from a special school for individuals with visual and hearing impairments. A total of 72 students with visual impairments (aged 7–17 years; M age = 13.4) participated in this study. ActiGraph GT3X accelerometers were used to measure the habitual physical activity and sedentary time. Results: Youths with visual impairments in this study spent an average of 287.86 (standard deviation [ SD] = 45.67) minutes of light physical activity, 146.79 ( SD = 56.95) minutes of moderate physical activity, 18.47 ( SD = 15.15) minutes of vigorous physical activity, 165.26 ( SD = 69.83) minutes of moderate-to-vigorous-intensity physical activity, and 979.51 ( SD = 109.10) minutes of sedentary time per day. Children with visual impairments in elementary school engaged in more habitual physical activity and had less sedentary time than did students in middle and high school. Differences in gender and body composition with regard to time spent being active or sedentary were insignificant. Discussion: Findings demonstrated that Chinese youths with visual impairments in this study had sufficient health-enhancing physical activity and were habitually active. Future research is needed to identify the factors that account for the high habitual physical activity levels of Chinese youths with visual impairments. Implications for practitioners: Transition planning for students with visual impairments to facilitate active habitual physical activity participation when children grow up is warranted.

BackgroundAssociations of dietary patterns in Chinese adolescents and children with later obesity have not previously been investigated. The purpose of the present study was to evaluate the associations between dietary patterns and the risk of obesity in Chinese adolescents and children by using a longitudinal design.MethodsData from the China Health and Nutrition Survey (CHNS), a nationally representative survey, were used for our analysis. 489 participants 6–14 years of age were followed from 2006 to 2011. Factor analysis was used to identify the dietary patterns in Chinese adolescents and children. Ordered logistic regression models were used to examine the association between dietary patterns and later obesity.ResultsTwo dietary patterns were revealed by factor analysis, the traditional Chinese dietary pattern (with high intake of rice, vegetables, poultry, pork and fish and the modern dietary pattern (with high intake of wheat, processed meat and fast food). Children in the highest quartile and the second-highest quartile of the traditional Chinese dietary pattern was inversely associated with later obesity compared with children in the lowest quartile over 5 years (OR = 0.19, 95%CI: 0.09, 0.40 for Q4; OR = 0.47, 95%CI: 0.33, 0.67 for Q3); Children in the highest quartile of the modern dietary pattern was positively associated with later obesity compared with children in the lowest quartile over 5 years (OR = 2.02, 95%CI: 1.17, 3.48).ConclusionsDietary patterns in Chinese adolescents and children are associated with later obesity. These findings further confirm the importance of children’s dietary patterns in later obesity and lay groundwork for dietary culture-specific interventions targeted at reducing rates of obesity in children and adolescents.

Depressive symptoms in Chinese children and adolescents: Parent, teacher, and self reports

To explore the epidemiological characteristics and gender difference of depressive symptoms among Chinese children and adolescents. Based on the cluster sampling method, 50 boys and 50 girls from each 9.0-18.9 year-olds in both urban and rural areas, were recruited from each research center. Children's Depression Inventory(CDI)was administered to all the participating students from grade 4 to 12 while physical examination indices including pubic hair were provided to both boys and girls. Development of breast in girls and genital development in boys were also measured. The overall prevalence on depressive symptoms was 14.81% for the Chinese adolescents. Boys reported more depressive symptoms (15.35%) than that of girls (14.43%). Prevalence related to depressive symptoms among children and adolescents from rural areas (16.41%)was higher than that of the urban areas(13.23%). Prevalence of depression was higher in boys than in girls in both 10-year-old and 11-year-old groups (χ(2) = 11.625, P < 0.005;χ(2) = 5.807, P < 0.005). In the 17 year-old group, prevalence of depression (21.5%)was seen higher in girls than in boys (17.26%) (χ (2) = 6.192, P < 0.005). Only in the Tanner stage II , the gender difference of depression showed statistically significant (χ(2) = 6.593, P < 0.005), with boys as 18.4% and girls as 15.8% . The gender differences of depression appeared in both special age groups and developmental stages in Chinese children that called for further longitudinal study to understand the nature of these findings.

Using optimized voxel-based morphometry (VBM), this study systematically investigated gender differences in brain development through magnetic resonance imaging (MRI) data in 158 Chinese normal children and adolescents aged 7.26 to 22.80 years (mean age 15.03&plusmn;4.70 years, 78 boys and 80 girls). Gender groups were matched for measures of age, handedness, education level. The customized brain templates, including T₁-weighted image and gray matter (GM)/white matter (WM)/cerebro-spinal fluid (CSF) prior probability maps, were created from all participants. Results showed that the total intracranial volume (TIV), global absolute GM and global WM volume in girls were significantly smaller than those in boys. The hippocampus grew faster in girls than that in boys, but the amygdala grew faster in boys than that in girls. The rate of regional GM decreases with age was steeper in the left superior parietal lobule, bilateral inferior parietal lobule, left precuneus, and bilateral supramarginal gyrus in boys compared to girls, which was possibly related to better spatial processing ability in boys. Regional GM volumes were greater in bilateral superior temporal gyrus, bilateral inferior frontal gyrus and bilateral middle frontal gyrus in girls. Regional WM volumes were greater in the left temporal lobe, right inferior parietal and bilateral middle frontal gyrus in girls. The gender differences in the temporal and frontal lobe maybe be related to better language ability in girls. These findings may aid in understanding the differences in cognitive function between boys and girls.

To understand the features of sedentary behavior of Chinese children and adolescents and its relationship with poor visual acuity, a self-administered "Questionnaire on Sedentary Behavior of Children and Adolescents" was used to survey 4,203 students in grades 4-12 in six administrative regions of China. (1) The average time spent in sedentary behaviors (SB) of Chinese children and adolescents was about 8.1 h per day, of which the academic sedentary time was the longest, accounting for 79.2% of total sedentary time. The total time spent on SB and the time spent on studying SB were more in the upper grades and less in screen SB and cultural leisure SB, respectively. There were significant sex differences in total SB time (p < 0.05) and weekend sedentary behaviors time (SB-WD) (p < 0.01) among Chinese children and adolescents, with girls being more likely to be higher than boys. There were also significant differences in sedentary time across different regions (p < 0.05), and the longest total sedentary time in East China. (2) Reduction parents' sedentary time and limitation of sedentary behaviors and the use of electronics among children and adolescents can effectively reduce sedentary time among Chinese children and adolescents. (3) Sedentary time was significantly higher in children and adolescents with poor vision than in those with normal vision (p < 0.01), and study SB and screen SB were important independent factors affecting vision. (4) Timing of breaks in SB can play a positive role in promoting vision health. There were significant grade, sex, and regional differences in the SB of Chinese children and adolescents, and sedentary time was strongly related to the prevalence of poor vision detection rate.

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BackgroundsMany literature reviews summarized relationships between screen time and child health, but they only included a few studies conducted in Chinese children and adolescents. The potential influence of screen time may vary by social context. The current systematic review and meta-analysis aimed to evaluate relationships between screen time and health issues among Chinese school-aged children and adolescents.MethodsPeer-reviewed articles written in Chinese and English were retrieved from CNKI, Wanfang, PubMed, Embase, and Web of Science from inception to June 2020. The Downs & Black checklist was applied to assess study quality. Meta analyses used random effect models and mixed effects model to calculate pooled adjusted odds ratios and 95% confidence intervals. Heterogeneity, sensitivity, and publication bias were assessed using Q and I2 statistics, “one-study removed” analysis, the funnel plot, trim and fill analysis, and classical fail-safe N, respectively.ResultsIn total, we identified 252 articles reporting 268 studies with unique samples. These studies investigated relationships between screen time and health issues of adiposity, myopia, psycho-behavioral problems, poor academic performance, cardiometabolic disease risks, sleep disorder, poor physical fitness, musculoskeletal injury, sub-health, and miscellaneous issues of height and pubertal growth, injury, sick leave, and respiratory symptoms. Proportions of studies reporting positive relationships with screen time were lowest in adiposity (50.6%) and higher in myopia (59.2%) and psycho-behavioral problems (81.8%). Other health issues were examined in 10 or less studies, all of which had more than half showing positive relationships. The pooled odds ratio from 19 studies comparing health risks with the screen time cutoff of 2 hours per day was 1.40 (95% CI: 1.31 to 1.50, I2 = 85.9%). The pooled effect size was 1.29 (95% CI: 1.20 to 1.39) after trimming 7 studies for publication bias adjustments.ConclusionsFindings exclusively generated from Chinese school-aged children and adolescents resonate those mainly from western countries. Evidence suggests that higher levels of screen time are related with greater risks of various health issues, although the relationships appear to be weak and intertwined with other confounding factors. Future studies need to investigate health-specific dose effects and mechanisms of screen time.

Due to limited access to timely and affordable eye care, the burden of visual impairment is disproportionately high in low- and middle-income countries, including Ethiopia. However, the quality of eye care services and patients' satisfaction with these services among visually impaired individuals has not been adequately studied. This study aimed to assess the main causes of visual impairment, satisfaction with eye care services, and identify associated factors among visually impaired follow-up patients attending Hawassa University Comprehensive Specialized Hospital-Eye Care and Training Center (HUCSH-ECTC), Southern Ethiopia, 2024. An institution-based cross-sectional study was conducted from June 22 to August 2, 2024, on adult visually impaired follow-up patients using a stratified sampling technique. Data were collected through medical chart reviews and pre-tested, structured interviewer-administered questionnaires. The data were analyzed using Stata version 17. Binary logistic regression analysis was performed, and variables with a p value of less than 0.05 were considered statistically significant. Four hundred fourteen (98.1% response rate) adult visually impaired follow-up patients were included in this study. Cataract, uncorrected refractive error, and glaucoma were found to be the top three causes of visual impairment. The prevalence of satisfaction was 43.0% (95% CI 38.3-47.8). Health insurance (AOR 2.06, (95% CI 1.24-3.43)), substance use (AOR 2.95, (95% CI 1.35-6.45)), mild and moderate level visual impairment (AOR 2.94, (95% CI 1.47-5.89)), and systemic comorbidity (AOR 4.22, (95% CI 2.41-7.40)) were significant factors associated with satisfaction. The top three causes of visual impairment were cataract, uncorrected refractive error, and glaucoma. Relatively lower eye care service-related satisfaction was observed among adult visually impaired follow-up patients attending the HUCSH-ECTC, Southern Ethiopia. The significant factors affecting satisfaction were valid health insurance, current substance use, visual impairment level, and systemic comorbidity occurrence. For visual impairment patients visiting eye care centers, better treatment, assistance, and targeted rehabilitation services are suggested.

Background The difference in growth and nutritional status, both important indices of population quality, between Chinese and Japanese children and adolescents is unknown. Aim This study aimed to compare growth and nutritional status between Chinese and Japanese children and adolescents. Subjects and methods The height-for-age and BMI-for-age distribution of 9,226 children and adolescents aged 7–18 years from China and Japan were described with the Lambda Mu and Sigma method. Wasting, overweight and obesity were evaluated based on BMI-for-age cut-offs of the 2007 WHO Child Growth Reference. Results For boys, the overall average height, weight and BMI of Chinese participants were 3.0 cm, 4.8 kg and 1.2 kg/m2 greater compared with Japanese participants, respectively; for girls, these were 4.6 cm, 3.9 kg and 0.6 kg/m2, respectively. Compared with Japanese children, the 3rd, 50th and 97th percentiles of height-for-age, 1Z-score, and 2Z-score of BMI-for-age of Chinese children were greater, whereas the minus 2Z-scores of Chinese children were less. The prevalence of wasting, overweight and obesity among Chinese participants was greater. Conclusions Compared with Japanese children, Chinese children tended to be taller. The worrying burden of overweight, obesity and wasting was recognised among Chinese children.

This study aims to explore the association between hearing impairment, visual impairment, dual sensory impairment, and depressive symptoms in middle-aged and elderly populations in China, with an analysis of gender differences. This research is based on data from the nationally representative sample survey CHARLS, conducted from 2013 to 2020. A total of 9,780 participants were included in the study. These participants were divided into four groups based on their hearing and vision status: no impairment, hearing impairment only, visual impairment only, and dual sensory impairment. A longitudinal analysis was conducted using Cox regression models to assess the hazard ratios (HR) for the occurrence of depressive symptoms associated with hearing, visual, and dual sensory impairments. The Cox regression model indicated that, in the unadjusted model, hearing impairment, visual impairment, and dual sensory impairment were all risk factors for depression (P < 0.05). After adjusting for multiple confounding factors, compared to the no impairment group, the risk of depressive symptoms was 1.017 times higher (95% CI 0.886–1.167) in the hearing impairment group, with a gender-specific risk of 1.072 times (95% CI 0.880–1.305) for males and 0.962 times (95% CI 0.793–1.168) for females. The visual impairment group had a 1.118 times higher risk (95% CI 1.017–1.231), with a risk of 1.092 times (95% CI 0.946–1.262) for males and 1.155 times (95% CI 1.017–1.311) for females. The dual sensory impairment group had a 1.274 times higher risk (95% CI 1.165–1.393), with a gender-specific risk of 1.291 times (95% CI 1.131–1.473) for males and 1.267 times (95% CI 1.123–1.429) for females. Visual impairment and dual sensory impairment are independent risk factors for the occurrence of depressive symptoms, with notable gender differences. Understanding these associations and gender differences can help in developing more effective interventions to improve the mental health of middle-aged and elderly populations.

Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment—Is there a gender difference?

Introduction: Few studies have examined the association between the individual-, family-, and school-level ecological correlates and physical fitness among Chinese children and adolescents, which is the purpose of the present study.Methods: A total of 157,168 children and adolescents, 10-18 years of age, with physical fitness data in 2014, participated in the study. Physical fitness was assessed, using six tests: forced vital capacity, standing long jump, sit and reach, body muscle strength, 50-m dash, and endurance running. Scores were aggregated to form a summary physical fitness indicator (PFI), which was then classified into five levels: low, low-middle, middle, middle-high, and high. Each option of individual-, family-, and school-level measures were constructed into a positive or negative correlate of physical fitness and then accumulated as a composite ecological score.Results: Among the 20 individual-, family-, and school-level correlates, 18 were found to be significantly associated with PFI, with high PFI levels being correlated with the positive group of correlates and low PFI levels correlated with the negative group of correlates (p < 0.05). High scores of ecological correlates were associated with a high level of PFI [adjusted odds ratio (OR) = 1.06, 95% CI: 1.06, 1.07)] whereas low scores were associated with a low level of PFI (OR = 0.95, 95% CI:0.95, 0.95). The ecological correlates at the individual, school- and family-levels were shown to be significantly related to high PFI among Chinese children and adolescents aged 10-18 years with different ORs of 5.97 (95% CI: 5.51, 6.47), 3.94 (3.66, 4.24), and 1.25 (1.19, 1.31). The PAR% of 20 cumulative factors effects due to the negative and positive responses for low PFI levels were 35.9 and 16.1%, and, for high PFI levels, were 15.3 and 24.1%, among Chinese children and adolescents, respectively. Compared with the correlates at family and school levels, the correlates at individual levels had the largest PAR%.Conclusion: Individual-, family-, and school-multilevel factors had a significant cumulative association with either improving or worsening aspects of physical fitness. Individual level factors remain at the core of physical fitness improvement. Comprehensive policies and measures are urgently needed to enhance the physical fitness of Chinese children and adolescents through involving further individual and environmental factors.

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence.

Bone mass acquisition from different genders and races of children and adolescents may vary. To explore gender- and age-related differences in bone mineral density (BMD) measurements in Chinese children and adolescents, we used the dual-energy X-ray absorptiometry (DXA) bone densitometer to take BMD measurements at the posteroanterior (PA) and lateral spine, hip, and forearm in 1286 healthy children and adolescents, ranging from 6 to 24 years of age. Our results show a correlation between BMD measurements taken from different skeletal sites and from different ages of subjects. Male data were best fit to a power regression model, yielding the largest determinant coefficients (R (2)), whereas S regression was the best fitting model for females. In individuals younger than 17 years of age, the rate of BMD accumulation in the PA spine is more rapid in females than in males, whereas in individuals older than 19 years of age, the converse was found to be true. In children younger than 14 years of age, BMD measurements, taken from the lateral spine, the neck and trochanter of the femur, and the total hip, correlated with age similarly in both genders. Additionally, in measurements taken from the forearm ultradistal and 1/3 region, BMD measurements from similar ages of both genders are similar. With increasing age, BMD measurements in males become significantly higher than those of females. However, volumetric BMD (vBMD) measurements from both genders show good uniformity at the lateral spine with a near overlap of the two models. Our findings suggest that vBMD acquisition measurements in Chinese children and adolescents show no gender differences, with gender differences only demonstrated in areal BMD (aBMD) measurements taken from different skeletal sites.