Adolescents In Shanghai Research Articles

Unraveling the role of social support in eating behavior among children and adolescents in Shanghai, China: exploring the mediating role of self-efficacy and the moderating influence of BMI and weight concern.

This study explores the intricate relationship between social support and eating behaviors in children and adolescents, considering the mediating role of eating self-efficacy and the moderating effects of body mass index (BMI) and weight concern. Data from 1986 primary and secondary school students aged 8 to 17 in Shanghai, China, were analyzed using moderated mediation analysis. The results demonstrate a robust positive association between social support and eating self-efficacy, particularly prominent among individuals with low BMI (effect = 0.506, 95% CI [0.376, 0.636]). Moreover, the study highlights that eating behavior is influenced not only by eating self-control (β = -0.054, 95% CI [-0.062, -0.046]) but also by the interaction term between individuals' perceptions of their body weight (β = -0.0008, 95% CI [-0.0015, -0.0001]). Eating self-efficacy serves as a mediator in the relationship between social support and eating behavior, modulated by BMI and weight concern. Importantly, high weight concern significantly strengthens the mediating effect of eating self-efficacy on the relationship between social support and eating behavior, regardless of BMI.

The Impact of School Reopening on Chinese Adolescents' Mental Health During COVID-19: Considering the Role of Academic Stress and Academic Orientation

PurposeExisting studies found that school closure during the COVID-19 pandemic negatively influenced adolescents' mental health. Yet, it remains unclear how adolescent mental health changed during the transition of school reopening as well as the academic-related risk and protective factors. MethodsImmediately before (April 2020) and three months (July 2020) after school reopening, 879 adolescents in Shanghai, China (mean age = 13.14 years, standard deviation = 1.31, 51% girls) completed online surveys and reported on their mental health (i.e., depressive symptoms, anxiety symptoms, and anger problems). Adolescents also reported perceived academic stress and academic orientations (i.e., performance orientation and mastery orientation) before school reopening. ResultsAdolescents reported decreased depressive symptoms, anxiety symptoms, and anger problems three months after school reopening. Adolescents who reported higher perceived academic stress and performance orientation showed elevated mental health symptoms after school reopening, whereas those reported higher mastery orientation showed decreased anger problems. Higher mastery orientation buffered the negative influence of academic stress on mental health. DiscussionThe findings not only demonstrate the positive influence of school reopening on Chinese adolescents' mental health but also highlight the role of perceived academic stress and academic orientations in contributing to individual differences during this transition.

Associations between different types of screen-based leisure time and different eating behaviors among adolescents in shanghai, China

Associations between different types of screen-based leisure time and different eating behaviors among adolescents in shanghai, China

Social support systems involved in suicide prevention and intervention among adolescents: A Delphi study in Shanghai

The rotes of attempted and completed suicide among adolescents are increasing globally. Social support can help decrease the risk of adolescent suicide, but this aspect has been rarely studied in China. The present study aimed to use the Delphi methodology to establish a set of guidelines for the development of social support resources, with the goal of collectively reducing suicide risks among adolescents in Shanghai. We commenced the study in April 2021, established a research team, searched the keywords using Web of Science from 2016 to 2021 and ultimately designed a pre-evaluation index. Next, following Donabedian’s Structure–Process-Outcome model, the research developed a questionnaire comprising 3 level-1, 12 level-2, and 73 level-3 indicators. Ten experts were enlisted to conduct three rounds of e-mail inquiries in order to finalize the indicator system, resulting in 2 level-1, 11 level-2, and 52 level-3 indicators, as well as expert consensus. Our findings indicate that the social support systems should include parents, schools, psychiatric hospitals, social organizations, and government departments, with the government sector being the most important ((M = 9.4). Furthermore, our study revealed that school counselors and psychologists play similar roles to psychiatrists within the interdisciplinary team (M ± S = 9.2 ± 1.1). As per the expert consensus, social support systems should strengthen government-led and interdisciplinary collaboration, prioritize suicide prevention in schools and encourage greater involvement from social organizations.

Association between breakfast patterns and executive function among adolescents in Shanghai, China.

The aim of this cross-sectional study was to investigate the association between breakfast patterns and executive function among adolescents in Shanghai, China. In 2022, we randomly recruited 3,012 adolescents aged 12-13 years from all administrative districts in Shanghai. Breakfast information was collected by parents using a one-day recall method. Executive function was measured using the Behavior Rating Inventory of Executive Function-Parent Version. Latent Class Analysis was performed to identify breakfast patterns based on the food groups in the Diet Quality Questionnaire for China. Breakfast patterns were classified into three categories: "Egg and milk foods", "Grain foods", and "Abundant foods", except for adolescents who skipped breakfast. Logistic regression was used to estimate the multivariate odds ratio (ORs) and 95% confidence intervals (95% CI) for the association between breakfast patterns and potential executive dysfunction. Adolescents in the "Abundant foods" class had a lower risk of executive dysfunction in terms of initiate (OR: 0.36; 95% CI: 0.17-0.76), and organization of materials (OR: 0.18; 95% CI: 0.04-0.94), compared to those who skipped breakfast. Similarly, the breakfast patterns of "Grain foods" and "Egg and milk foods" were associated with a lower risk of executive dysfunction, including initiate and working memory. Our findings suggest that breakfast patterns were associated with executive function. The improvement of breakfast patterns among adolescents should be a significant public health intervention.

Influence of high altitude on choroid thickness, retinal thickness, and myopia: A cross-sectional study comparing adolescents in Shanghai and Tibet.

This study aimed to explore the influence of high altitude on myopia, macular choroidal thickness (mCT), and macular retinal thickness (mRT) in adolescents. Two schools, one in Shanghai (at sea level) and one in Shigatse, Tibet (more than 4000 m above sea level), were selected. Refractive error was measured by an autorefractor instrument and subjective refraction, and mCT and mRT were measured at three concentric circles by optical coherence tomography. Student's t -test, Chi-square test, and multiple linear regression analyses were used to analyze the data. A total of 1114 participants (657 and 457 in Shanghai and Tibet, respectively) were enrolled in this cross-sectional study. The average age of the participants was 18.81 ± 1.10 years, and 44.34% were males. The spherical equivalent (SE) of adolescents in Shanghai was significantly lower than that of adolescents in Tibet (-4.14 ± 2.37 D and -2.12 ± 1.87 D, P < 0.01). The prevalence of myopia and high myopia among adolescents in Shanghai (94.52%, 19.48%) was significantly higher than those among adolescents in Tibet (44.74%, 2.41%) ( P < 0.01). The mCT of Tibetan adolescents was significantly thicker than that of Shanghai adolescents (295.80 ± 62.46 μm and 218.71 ± 61.42 μm, P < 0.01), especially the central mCT. The mRT of Tibetan adolescents was also thicker than that of Shanghai adolescents (301.42 ± 23.26 μm and 281.04 ± 12.24 μm, P < 0.01). Compared with Shanghai adolescents, the choroid of Tibet adolescents is thicker, and the myopia prevalence is lower. It is speculated that increased altitude is associated with the thickening of mCT and a low myopia prevalence.

Nonlinear effects of humidex on risk of outpatient visit for allergic conjunctivitis among children and adolescents in Shanghai, China: A time series analysis.

Various epidemiological studies have focused on the adverse health outcomes of meteorological factors. However, there has been little research on the impact of humidex on allergic conjunctivitis, especially in child and adolescent populations. We aimed to explore the impact of humidex, a comprehensive index of relative humidity and temperature, on child and adolescent allergic conjunctivitis admissions. Outpatient visit data for allergic conjunctivitis, meteorological factors and air pollutants in Shanghai for the 2017-2022 period were retrieved. For the purpose of analysing the nonlinear connection and lag impact between humidex and admissions for paediatric and adolescent allergic conjunctivitis, the distributed lag nonlinear model (DLNM) was fitted. A total of 147 090 cases were included in our cohort. We found a significantly nonlinear effect on humidex and allergic conjunctivitis. In the single-day lag pattern, the relative risks (RR) of allergic conjunctivitis were significant at lag 0 (RR = 1.08, 95% confidence interval (CI) = 1.05-1.11) to lag 2 (RR = 1.01, 95% CI = 1.00-1.01), lag 5 (RR = 1.01, 95% CI = 1.00-1.01) to lag 9 (RR = 1.01, 95% CI = 1.00-1.01), and lag 14 (RR = 1.02, 95% CI: 1.01-1.03). In the cumulative-lag day pattern, the RR of allergic conjunctivitis were significant at lag 0-0 (RR = 1.08, 95% CI = 1.05-1.11) to lag 0-14 (RR = 1.21, 95% CI = 1.13-1.28). We found that boys, children aged 7-17 years, and children in the warm season were more vulnerable to humidex. In addition, the highest attributable fraction (AF) and attributable number (AN) of humidex are at lag 0-14 (AF = 0.17, AN = 25 026). Humidex exposure markedly increased the risk of allergic conjunctivitis, especially in highly high humidex. Appropriate public health management is needed for disease management and early intervention.

Prevalence and influencing factors of malocclusion in adolescents in Shanghai, China

BackgroundThe main purpose of the study was to investigate the prevalence and related risk factors of malocclusion in permanent dentition among adolescents in Shanghai, and provide basic data for government’s preventive strategies and intervention plans.Methods1799 adolescents aged 11–15 years old from 18 middle schools in 6 districts of Shanghai were recruited to investigate oral health status and related risk factors using cluster random sampling method in 2021. Malocclusion and caries were examined by on-site inspection. The investigation criteria referred to Bjoerk and the recommendation of the WHO. The malocclusion inspection items included molars relationship, canine relationship, overbite, overjet, midline displacement, anterior crossbite, posterior crossbite, scissors bite, crowding and spacing. The subjects were asked to fill in a questionnaire including parents’ education level, oral health behaviors and dietary habits. The chi-square test and logistic regression analysis were used to analyze the relationship between malocclusion and risk factors.Results1799 adolescents were included in the study and the prevalence of malocclusion in adolescents in Shanghai was 83.5%, and the proportion of molar relationship class I, class II, and class III was 48.9%, 14.7%, and 19.0%, respectively. The most common occlusal characteristic of malocclusion was anterior crowding, followed by midline irregularities and deep overbite, with prevalence rates of 44.8%, 39.0% and 38.6%, respectively. The prevalence rate of adolescents with caries was 34.3%. Those who had dental caries and preferred soft food were more likely to have abnormal occlusal characteristics (p < 0.05).ConclusionThe prevalence of malocclusion in adolescents in Shanghai is high, so it is of great significance to strengthen oral health education, allocate proper preventive strategies and carry out the early correction if necessary.

Physical activity maintenance and increase in Chinese children and adolescents: the role of intrinsic motivation and parental support.

This longitudinal study aimed to examine the association of intrinsic motivation, parental physical activity, and parental support with physical activity maintenance and increase among children and adolescents. A sample of 2,424 children and adolescents in Shanghai, China participated in the two-wave survey before and during the COVID-19 pandemic. The questionnaire measured children and adolescents' physical activity and intrinsic motivation, as well as their parental physical activity and support (concern for their child and co-activity with their child). Multivariable logistic regressions were performed by groups to examine the associations between these factors and physical activity change. Most children and adolescents exhibited a decline in physical activity participation during the pandemic, as indicated by a mere 15.0 and 8.0% of individuals maintaining and increasing their pre-pandemic levels, respectively. Among the initially active participants, perceived self-choice [OR = 1.341 (95%CI: 1.173-1.533)] and parental concern [OR = 1.922 (95%CI: 1.204-3.068)] predicted maintained physical activity. Increased physical activity was predicted by perceived enjoyment [OR = 1.193 (95%CI: 1.046-1.362)] and parental co-activity (OR = 1.995 [95%CI: 1.095-3.633]). This study provides longitudinal evidence that intrinsic motivation and parental support can have a positive impact when physical activity levels change significantly. Effective interventions targeting multilevel factors are needed to maintain or increase children and adolescents' physical activity.

The role of only-child status in the effect of childhood trauma and parental rearing style on depressive symptoms in Shanghai adolescents.

After decades of the one-child policy, China changed its rules to allow two children in 2016, which altered family dynamics. Few studies have examined the emotional problems and the family environment of multi-child adolescents. This study aims to explore the role of only-child status in the impact of childhood trauma and parental rearing style on depressive symptoms of adolescents in Shanghai, China. A cross-sectional study was conducted on 4,576 adolescents (M = 13.42 years, SD = 1.21) from seven middle schools in Shanghai, China. Childhood Trauma Questionnaire-Short Form, the Short Egna Minnen Beträffande Uppfostran, and Children's Depression Inventory were used to evaluate childhood trauma, perceived parental rearing style, and depressive symptoms of adolescents, respectively. Results showed that girls and non-only children reported more depressive symptoms, while boys and non-only children perceived more childhood trauma and negative rearing styles. Emotional abuse, emotional neglect, and father's emotional warmth significantly predicted depressive symptoms in both only children and non-only children. Father's rejection and mother's overprotection were related to adolescents' depressive symptoms in only-child families, but not non-only child families. Therefore, depressive symptoms, childhood trauma, and perceived negative rearing styles were more prevalent among adolescents in non-only child families, while negative rearing styles were especially associated with depressive symptoms in only children. These findings suggest that parents pay attention to their impacts on only children and give more emotional care to non-only children.

The characteristics and risk factors of e-cigarette use among adolescents in Shanghai: A case-control study.

This study was conducted to explore the characteristics and risk factors of e-cigarette use in adolescents, aiming for tobacco control and reducing e-cigarette use in this population. Using 1:1 matching, 88 students from three vocational high schools in Shanghai were recruited to conduct a case (using e-cigarettes) - control (not using e-cigarettes) study. Group interviews and questionnaire surveys were used for this qualitative and quantitative mixed-methods study. The keywords were extracted from the interview data and analyzed by the Colaizzi seven-step method. The characteristics of adolescents' use of e-cigarettes include young age at first use, consumption of a large amount, as well as smoking in discrete locations in order to hide from adults. The reasons for using e-cigarettes include curiosity and wanting to replace traditional cigarettes. The risk factors of using e-cigarettes include insufficient understanding of the harm of e-cigarettes at the individual level (The positive outcome expectancy points: Z= -3.746, p<0.001; The negative outcome expectancy points: Z= -3.882, p<0.001), peer influence at the interpersonal level (χ2=6.510, p<0.01), and the influence of social and environmental factors such as e-cigarette sales in the stores and WeChat Moments (p<0.05 for all associations). Having friends who use e-cigarettes, curiosity and sales exposure about e-cigarettes are important factors affecting the use of e-cigarettes by adolescents. It is necessary to strengthen the publicity of the potential hazards of e-cigarettes and to reduce overall usage by improving relevant laws and regulations.

Demirjian method and Willems method to study the dental age of adolescents in Shanghai before and after 10 years.

The aim of this study was to assess whether the difference in dental ages between 2009 to 2011 and 2021 is affected by environmental factors such as environmental pollution, floating population, and dietary habits. Demirjian and Willems dental age estimation methods were conducted for a Han population of children aged 8 to 14 in Shanghai, China. A total of 1259 digital panoramic radiographs of children aged 8.00-14.99 were estimated. All digital panoramic radiographs were estimated using the Demirjian and Willems methods. Data collected in 2009 to 2011 and 2021 were statistically analysed by paired t-tests. The results show that the Demirjian method overestimates 2009 to 2011 and underestimates 2021 the children's chronological age. When using the Willems method, the age of males was overestimated and the age of females was underestimated from 2009 to 2011, and it was underestimated for both genders in 2021. In conclusion, the difference in dental ages between 2009 to 2011 and 2021 was statistically significant. Factors such as environment and dietary habits have been found to be affected by dental development. However, there are disputes among some researchers about the exact factors, so it is suggested to further study the effects of environmental factors on tooth development.

Association of health-risk behaviors with perceived academic performance among middle and high school students: A cross-sectional study in Shanghai, China.

Adolescence is a susceptible period to establish health-risk behaviors, which may have an impact on academic performance. The aim of this study was to investigate the association between health-risk behaviors (HRBs) and perceived academic performance (PAP) of adolescents in Shanghai, China. The data of the present study included three-round Shanghai Youth Health-risk Behavior Survey (SYHBS). This cross-sectional survey investigated multiple HRBs of students involved in dietary behaviors, physical activity and sedentary behaviors, intentional and unintentional injury behaviors, and substance abuse behaviors, as well as PAP by using self-reported questionnaire. Using a multistage random sampling method, 40,593 middle and high school students aged 12 to 18 years were involved. Only participants with complete data on HRBs information, academic performance and covariates were included. A total of 35,740 participants were involved in analysis. We used ordinal logistic regression to analyze the association between each HRB and PAP adjusting for sociodemographic, family environment and duration of extracurricular study. The results showed that students who did not eat breakfast or drink milk everyday were more likely to have a lower PAP, with a decreased odds of 0.89 (95%CI: 0.86-0.93, P<0.001) and 0.82 (95%CI: 0.79-0.85, P<0.001), respectively. The similar association was also found in students who did exercise ≥60 minutes for less than 5 days/week, spend time on watch TV beyond 3 hours/day and other sedentary behaviors. Most intentional and unintentional injuries, and ever smoked were associated with a lower PAP. Our finding suggests that multiple HRBs negatively associated with PAP of adolescents. It needs to raise public health concerns with HRBs in adolescents, and to develop and implement comprehensive interventions on HRBs.

The rate of orthokeratology lens use and associated factors in 33,280 children and adolescents with myopia: a cross-sectional study from Shanghai

ObjectivesTo investigate the rate of orthokeratology lens (ortho-k lens) use and its associated factors in children and adolescents with myopia.MethodsCross-sectional study. Children from 104 primary and middle schools in Shanghai were enrolled by cluster sampling. Ophthalmic examinations were conducted and information was obtained using questionnaires for associated factors analysis.ResultsA total of 72,920 children and adolescents were included, among which 32,259 were the potential population for ortho-k lens use. A total of 1021 participants used ortho-k lenses, equating to a use rate of 1.4% in the total population and 3.1% in the potential population. Age (OR 0.91, 95% CI: 0.88–0.95, p < 0.001), BMI (≥95th percentile: OR 0.48, 95% CI: 0.35–0.66, p < 0.001), age at initiation of refractive correction (≤12 years: OR 1.75, 95% CI: 1.31–2.33, p < 0.001), and parental myopia (either: OR 2.09, 95% CI: 1.58–2.75, p < 0.001; both: OR 3.94, 95% CI: 3.04–5.11, p < 0.001) were independently associated with ortho-k lens use. Of the ortho-k lenses users, 12.4% had a logMAR CVA of ≥0.3. A correction target (SE) of ≤−3.0 D (OR 2.05, 95% CI: 1.38–3.05, p < 0.001) and a sleeping duration of ≤6 h (OR 4.19, 95% CI: 2.03–8.64, p < 0.001) were factors independently associated with CVA ≥ 0.3.ConclusionsA certain proportion of children and adolescents in Shanghai chose to wear ortho-k lenses, related to the situation of parents and children themselves. Health education and follow-ups should be strengthened to ensure orthokeratology application quality.

Values mediated emotional adjustment by emotion regulation: A longitudinal study among adolescents in China.

Values have a direct impact on adolescents' mental health. However, its potential mediated mechanism has received little attention. A 1-year longitudinal survey design was used to explore the mediating role of emotion regulation in the relationships between self-transcendence (vs. self-enhancement) values and emotional adjustment among adolescents. Participants were 863 senior school students from Shanghai and Qingdao, Shandong Province. Data on self-transcendence and self-enhancement values, loneliness, depression, and emotion regulation were collected at 2019 and 2020 by using self-report measures. The results showed that (1) adolescents' endorsement with self-transcendence values decreased and self-enhancement values increased; compared to adolescents in Qingdao, adolescents in Shanghai were more depressed, (2) emotion regulation only mediated the effect of self-transcendence values on loneliness, and (3) not only the relationship between self-transcendence values and depression, but also the relationships between self-enhancement values and loneliness and depression were suppressed by emotion regulation. The study may provide more empirical evidences for the benefits of self-transcendence values and may also give more references on how to improve adolescents' emotional adjustment.

Social environment exposure to electronic cigarettes and its association with e-cigarette use among adolescents in Shanghai, China.

This study investigated adolescents' social-environmental exposure to e-cigarettes in association with e-cigarette use in Shanghai, China. We also explored these differences by gender and school type. Sixteen thousand one hundred twenty-three students were included by a stratified random cluster sampling, and the number was weighted according to selection probability. Association between social environment exposure and e-cigarette use was examined by multivariate logistic regressions. There were 35.07, 63.49, 75.19, 9.44, and 18.99% students exposed to secondhand e-cigarette aerosol (SHA), e-cigarette sales, e-cigarette information, parents' and friends' e-cigarette use. Students exposed to SHA (aOR = 1.73, 95% CI 1.40-2.14), e-cigarette sales from ≥2 sources (aOR = 1.55, 95% CI 1.18-2.03), e-cigarette information exposure from ≥2 sources (aOR = 1.39, 95% CI 1.05-1.83), and having a social e-smoking environment (friends' e-cigarette use: aOR = 2.56, 95% CI 2.07-3.16; parents' e-cigarette use: aOR = 1.54, 95% CI 1.17-2.02) were significantly associated with their intention to use e-cigarettes. More girls were exposed to e-cigarette sales in the malls, e-cigarette information at points of sale and on social media (P < 0.01), and exposure to sales from ≥2 sources were associated with girls' intention to use e-cigarettes (aOR = 1.84, 95% CI 1.22-2.78). However, boys were more likely to be exposed to friends' e-cigarette use (P < 0.001), and having friends using e-cigarettes was associated with greater intention to use them in boys (aOR = 2.64, 95% CI 1.97-3.55). Less vocational high school students were exposed to parents' e-cigarette use (P < 0.001), but they were more likely to use e-cigarettes in the future after being exposed (aOR = 2.27, 95% CI 1.50-3.43). A similar phenomenon was observed between junior high students and their exposure to SHA. This study reported adolescents' high exposure rates to the social environment of e-cigarettes. Exposure to SHA, e-cigarette sales from ≥2 sources, e-cigarette information from ≥2 sources and having a social e-smoking environment were related to adolescents' intention to use e-cigarettes. Differences in gender and school type were observed. More attention should be paid to girls, and different interventions should be designed for different types of school students. Additionally, comprehensive tobacco control policies are needed.

Association Between Mastery Of Multiple Sports And Physical Fitness Among Adolescents In Shanghai

PURPOSE: To investigate the mastery of multiple sports (e.g., football, swimming, dance) among adolescents in Shanghai and explore its association with physical fitness. METHODS: The study data were obtained from the 2019 Physical Activity and Fitness Monitoring in Shanghai Children and Adolescents, a cross-sectional survey covering 16 districts in Shanghai, China. Physical fitness was assessed according to the 2014 revised Chinese National Student Physical Fitness Standard (CNSPFS); the overall physical fitness performance was categorized as “excellent,” “good,” “pass,” or “no pass” (Zhu et al. 2017). Participants completed a survey including demographics, mastery of multiple sports (classes: “0,” “1,” and “2 or more” items), and physical activity levels (Chen et al. 2018). A total of 54,576 adolescents’ surveys (median age 14 years, 50.2% male, grades 7-12) were completed and included in the analysis. Binary logistic regression (odds ratio [OR], 95% confidence interval [CI]) was used to determine the association between the study variables. P-values <0.05 were considered statistically significant. RESULTS: Overall, the percentages of students mastering “0,” “1,” and “2 or more” sports were 13.6%, 27.7%, and 58.7%, respectively. On the physical fitness standards, 4.2% of the adolescents received an “excellent” rating, 22.7% received a “good” rating, 59.9% received a “pass” rating, and 13.2% received a “no pass” rating. Results of binary logistic regression showed that the students who had mastered multiple sports were more likely to achieve excellent/good physical fitness standards (OR: 1.499, 95% CI: 1.453-1.546), after adjusting for age, sex, grade, residence locale (urban, suburban), and physical activity level. CONCLUSIONS: Mastery of multiple sports is positively associated with physical fitness among adolescents in Shanghai. Promoting the acquisition of sports skills could be an effective approach to improve adolescent health.

Association of Changes of lifestyle behaviors before and during the COVID-19 pandemic with mental health: a longitudinal study in children and adolescents

BackgroundWe examined the prospective associations of changes in lifestyle behaviors before/during the COVID-19 pandemic, namely physical activity and screen time, with mental health. Furthermore, the impacts of physical activity and screen time on mental health during the pandemic were examined cross-sectionally.MethodsA two-wave longitudinal study was conducted among 2423 children and adolescents in Shanghai, China. Lifestyle behavior variables (physical activity and screen time) and psychological variables (depressive symptoms, anxiety, and stress) were measured using a self-reported questionnaire in January and March 2020. A series of multivariable logistic regressions were performed to examine the associations between changes in lifestyle behaviors in two waves and psychological problems. The combined associations of physical activity and screen time with psychological problems were also explored using the second wave data.ResultsCompared to students with persistently short screen time before and during the COVID-19 pandemic, those with prolonged screen time (OR = 1·36 for depression, OR = 1·48 for anxiety) and those with persistently long screen time (OR = 1·70 for depression, OR = 2·13 for anxiety) reported a higher risk of psychological symptoms. The association between changes in physical activity and psychological symptoms was not statistically significant after adjustment for demographic factors, socioeconomic status, and screen time. During the COVID-19 pandemic, engaging in longer screen time (OR = 1·44 for depression, OR = 1·55 for anxiety) was associated with worsened psychological conditions, while engaging in increased physical activity (OR = 0·58 for depression, OR = 0·66 for anxiety) was associated with better psychological conditions.ConclusionsOur study suggests that promoting physical activity and limiting leisure screen time during the COVID-19 pandemic are important to prevent and mitigate psychological problems in children and adolescents. Therefore, effective interventions targeting lifestyle behaviors are needed to protect children and adolescents’ physical and mental health.

A prospective study of total urinary deoxynivalenol in adolescents in Shanghai, China

There is growing interest in deoxynivalenol (DON) exposure during puberty because experimental evidence shows that DON-exposed to adolescents are more sensitive to DON and have limited detoxification ability. Nevertheless, there have been few surveys of DON exposure for adolescents in China. Furthermore, little is known about the effects of collection times on risk exposure. In the study, we estimated the risk of DON exposure for adolescents in Shanghai and explore the effects of collection time, areas, sex and BMI on intake estimates. A total of 315 adolescents aged 14–16 years, including 161 boys and 154 girls, were recruited. Urine samples were collected for three consecutive days and digested with β-glucuronidase and then purified using a DON-immunoaffinity column (IAC). Total deoxynivalenol levels were measured using liquid chromatography-tandem mass spectrometry (LC–MS/MS) in combination with a stable isotope dilution assay (SIDA). DON was detected in 945 morning urine samples taken from 315 individuals for three consecutive days. The mean estimated dietary intake of DON did not exceed the tolerable daily intake (TDI) of l μg/kg·bw/day, showing that exposure of adolescents in Shanghai is not of concern. However, 10–20% of probable daily intake (PDI) values exceed the TDI, indicating potential adverse effects. In addition, the DON concentration at the population level did not differ for urine samples collected at different times except for those of overweight adolescents. Therefore, assessment of exposure to DON by monitoring the morning urine of a healthy adolescent, except for overweight people, provides an appropriate estimate of exposure and related risk at the population level, but intake estimates for individuals are uncertain; these could be used to assess exposure of adolescents to DON rapidly and effectively for epidemiological investigations.

Smartphone Use Time and Total Screen Time Among Students Aged 10–19 and the Effects on Academic Stress: A Large Longitudinal Cohort Study in Shanghai, China

ObjectiveThis study aimed to assess smartphone use time and total screen time among students aged 10–19 in Shanghai, China, and examine their effects on academic stress.MethodsBaseline and follow-up surveys were conducted in December 2017 and December 2018, respectively, using a cohort study design with 1,771 participants. Questionnaire surveys and physical examinations of participants were conducted by trained investigators and professional school physicians, respectively. The self-administered questionnaire mainly covered demographic information, academic stress, smartphone use time, total screen time, and other lifestyle behaviors.ResultsThe average smartphone use time of primary, middle, and high school students was 0.76 ± 0.90, 1.34 ± 1.29, and 2.39 ± 1.66 h/day, respectively; total screen time was 2.60 ± 2.63, 2.65 ± 3.39, and 3.52 ± 2.7 h/day, respectively (P < 0.001). The academic stress scores of primary, middle, and high school students were 9.25 ± 3.96, 11.97 ± 4.58, and 15.06 ± 5.10 (out of 30), respectively. The smartphone use time and total screen time were positively associated with academic stress score, with β values of 0.307 (95% CI: 0.164–0.450) and 0.171 (95% CI: 0.088–0.255), respectively. The longer the smartphone use time and total screen time, the higher the risk of abnormal academic stress, with OR values of 1.199 (95% CI: 1.103–1.303) and 1.104 (95% CI: 1.056–1.154), respectively. After stratifying by grade group, positive associations between smartphone use time or total screen time and abnormal academic stress were observed in primary and middle school students; for high school students; however, only smartphone use time had a positive association.ConclusionsThis study confirmed that the academic stress is widespread among students aged 10–19 in Shanghai, China. From a public health perspective, smartphone use time and total screen time should therefore be restricted for reducing academic stress and preventing related problems among adolescents in Shanghai, China, in school, family, and other environments.