Adolescents In Shanghai Research Articles

Sleep Habits, Sleep Problems, Sleep Hygiene, and Their Associations With Mental Health Problems Among Adolescents.

Studies in adults suggested that sleep could be a significant contributor to mental health. However, little is known about their relationship in adolescents. The present study aimed to examine the overall associations of full-spectrum sleep behaviors, including sleep habits, sleep problems, and sleep hygiene, with mental health problems among adolescents in Shanghai, China. A stratified, cluster random sample of 4,823 adolescents aged 11 to 20 years participated in a cross-sectional survey. The Adolescent Sleep Disturbance Questionnaire and the modified Adolescent Sleep Hygiene Scale were used to examine sleep behaviors. The Strengths and Difficulties Questionnaire was used to evaluate mental health problems. Five sleep variables were found to be associated with adolescents' mental health. The five factors covered three sleep domains: sleep habits (later bedtime during weekdays), sleep problems (maintaining sleep difficulties, disorders of arousal), and sleep hygiene (poor emotion at bedtime, unstable sleep schedule). The clinical significance of the findings lies in the emphasis of comprehensive screening of sleep in the predicting, diagnosis, nursing, and intervention of adolescents' mental health problems.

The Correlations Between Types of Families and Physical Activity Levels of Adolescents in Shanghai, China

The Correlations Between Types of Families and Physical Activity Levels of Adolescents in Shanghai, China

중국 상하이·허쩌 중·고등학생의 식습관과 비만도 및 영양지식과의 관련성 연구

The aim of this study was to investigate the relationships between eating habits and health among adolescents in Shanghai and Heze, China. A cross-sectional study was conducted in 2013 on 2,089 adolescents; 1,089 students were from Shanghai and 999 students from Heze region. Eating habits, weight, height, and nutritional knowledge were assessed using a self-administered questionnaire. Eating habits score was classified into two categories: healthy eating habits and unhealthy eating habits, based on Korean Youth Risk Behavior Web-based Survey, for statistical data analysis. Associations between eating habits, BMI, and nutritional knowledge were examined using a general linear model with adjustment of potential confounding factors such as region, gender, age, parents` education level, and pocket money. Statistical analyses were performed using the SAS (version 9.3) program. Proportions of healthy eating habits group were 90.0% for breakfast (3-7 times/wk), 29.1% for fruit (), 12.5% for vegetable (), 7.3% for milk (), 90.0% for fast food (

Effects of physical factors on neck or shoulder pain and low back pain of adolescents

To explore the incidence of self-reported neck or shoulder pain (NSP) and lower back pain (LBP) among Chinese adolescents in Shanghai and identify the influencing factors for the incidences of NSP and LBP. A total of 3 600 students were selected from 30 high schools randomly chosen from 237 regular full-time high schools registered in Shanghai. From each school, 40 students were selected from each of the tenth, eleventh and twelfth grades for a total of 120 students per school. The questionnaire involved questions pertaining to demographic profiles, learning environment and exercise habits of each student. And it also contained questions regarding the amount of weight carried by each student while commuting to and from school, and it was also used to collect specific information related to the occurrence of NSP and LBP. Logistic regression was performed to analyze the potential risk factors for NSP and LBP. Among 3 600 questionnaires, a total of 2 842 valid ones were returned. The results revealed that the incidence of NSP and LBP in the Chinese adolescent population was 41.1% and 32.8% respectively. Both NSP and LBP were more common in girls than in boys, and 6.3% students reported at least one NSP- or LBP-induced absence from school. A relatively large portion of Chinese adolescents reported experiencing problems such as sedentary behavior (26.7% of the students continued to sit for more than 3 hours after school), a lack of exercise (29.3% exercised less than once each week and 38.2% of students reported that their exercise duration was less than half an hour each time) and overweight backpacks (53.0% complained that their backpack was too heavy). Multivariate logistic regression analysis revealed that gender, grade, physical activity and learning environment were all significantly correlated with the occurrences of NSP and LBP. The incidences of NSP and LBP are relatively high among adolescents in Shanghai. And several factors, including sedentary behavior, personal exercise habits and backpack weight, influence the occurrences of NSP and LBP in adolesents.

Effects of a summer program for weight management in obese children and adolescents in Shanghai.

To investigate the effects of a combined intervention of diet and physical activity on body composition, resting energy expenditure (REE) and metabolic factors in obese children and adolescents. Twenty obese children and adolescents aged 7 to 17 years completed a 4-week summer camp program which focussed on personal behaviour, including energy-restricted diets and supervised physical activity. Anthropometry, bioelectrical impedance, ultrasonography (US) for subcutaneous and hepatic fat, and abdominal Magnetic Resonance Imaging assessments were made and blood pressure (BP) recorded before and after the 4-week intervention. 1) Weight loss was 7.2 ± 2.2 kg, with losses of 5.5 ± 2.2 kg and 1.7 ± 1.2 kg in fat mass (FM) and fat free mass (FFM), respectively, with associated reductions in abdominal and hip fat and in the waist/hip circumference ratio and in BP. 2) There were no significant changes in REE or in its ratio with weight. 3) Reductions in uric acid, total cholesterol, triglycerides, LDL cholesterol, HbA1C, insulin, C-Peptide and insulin resistance (HOMA-IR) and the ratio of fatty liver were observed, but not in the inflammatory marker hsCRP. With behavioural intervention during a summer camp, body fat and its distribution were favourably changed, but with some loss of lean mass. However, there were no detectable reductions in REE. Weight management programs which achieve fat loss with maintenance of REE ought to be more sustainable.

Correlational Analysis of neck/shoulder Pain and Low Back Pain with the Use of Digital Products, Physical Activity and Psychological Status among Adolescents in Shanghai

PurposeThis study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status.MethodsAn anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model.ResultsThree thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student’s grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score.ConclusionsHigh school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP.

Futher increase of obesity prevalence in Chinese children and adolescents - cross-sectional data of two consecutive samples from the city of Shanghai from 2003 to 2008

Results: The standardized prevalence of overweight significantly increased from 12.75 to 14.2% (p < 0.01), and the prevalence of obesity significantly increased from 3.35 to 3.94% (p < 0.01) during the study period. In contrast to data from developed countries, the prevalence of obesity decreased with age in both boys and girls. The prevalence of obesity and overweight in boys was significantly higher than that in girls (p < 0.01). Interestingly, the prevalence of overweight and obesity in the urban area was also significantly higher than that in suburb area (p < 0.01). Conclusion: Over a 5-yr period, there was a significant increase in the prevalence of obesity in children and adolescents in Shanghai. The high percentage of overweight and obesity in the young age groups is of particular concern. Urbanization might be a causative factor for the increase in obesity prevalence in Chinese children in the Shanghai area.

Glycolipid metabolic status of overweight/obese adolescents aged 9- to 15-year-old and the BMI-SDS/BMI cut-off value of predicting dyslipidemiain boys, Shanghai, China: a cross-sectional study

BackgroundThe prevalence of adolescents’ obesity and overweight has dramatically elevated in China. Obese children were likely to insulin resistance and dyslipidemia, which are risk factors of cardiovascular diseases. However there was no cut-off point of anthropometric values to predict the risk factors in Chinese adolescents. The present study was to investigate glycolipid metabolism status of adolescents in Shanghai and to explore the correlations between body mass index standard deviation score (BMI-SDS) and metabolic indices, determine the best cut-off value of BMI-SDS to predict dyslipidemia.MethodsFifteen schools in Shanghai’s two districts were chosen by cluster sampling and primary screening was done in children aged 9-15 years old. After screening of bodyweight and height, overweight and obese adolescents and age-matched children with normal body weight were randomly recruited in the study. Anthropometric measurements, biochemical measurements of glycolipid profiles were done. SPSS19.0 was used to analyze the data. Receiver operating characteristic (ROC) curves were made and the best cut-off values of BMI-SDS to predict dyslipidemia were determined while the Youden indices were maximum.ResultsFive hundred and thirty-eight adolescents were enrolled in this research, among which 283 have normal bodyweight, 115 were overweight and 140 were obese. No significant differences of the ages among 3 groups were found. There were significant differences of WC-SDS (p<0.001), triacylglycerol (p<0.05), high and low density lipoprotein cholesterol (p<0.01), fasting insulin (p<0.01) and C-peptide (p<0.001) among 3 groups. Significant difference of fasting glucose was only found between normal weight and overweight group. Significant difference of total cholesterol was found between obese and normal weight group. There was no significant difference of glycated hemoglobin among 3 groups. The same tendency was found in boys but not in girls. Only HDL-C reduced and TG increased while BMI elevated in girls. The best cut-off value of BMI-SDS was 1.22 to predict dyslipidemia in boys. The BMI cut-off was 21.67 in boys.ConclusionOverweight and obese youths had reduced insulin sensitivity and high prevalence of dyslipidemia.When BMI-SDS elevated up to 1.22 and BMI was higher than 21.67 in boys, dyslipidemia may happen.

Prevalence of latent tuberculosis infection and its risk factors in schoolchildren and adolescents in Shanghai, China

As tuberculosis (TB) infection in childhood contributes to the pool of individuals with latent tuberculosis infection (LTBI) from which future tuberculosis cases arise, this study aimed to determine the prevalence and risk factors associated with LTBI in schoolchildren and adolescents from Shanghai, China. In this cross-sectional study, we administered T-SPOT.TB and TB infection risk factor questionnaire to children and adolescents aged between 10 and 18 years in 2010 in Shanghai. LTBI cases were defined by positive T-SPOT.TB test results and X-ray confirmation. A total of 1106 schoolchildren and adolescents were enrolled, of which 46.1% were male, and 91.8% were vaccinated with Bacille Calmette Guerin (BCG). Overall, 52 (4.7%) children had a positive T-SPOT.TB result, with significant increase in age distribution. However, none of the participants demonstrated TB-related abnormality on X-ray examination. Multivariate analysis showed that LTBI was associated with no BCG vaccination (odds ratio: 2.40; 95% confidence interval: 1.182-5.335) and a history of TB exposure (odds ratio: 6.89; 95% confidence interval: 3.095-15.35). For 46 children and adolescents with history of TB exposure, contact hours per week of TB cases were significantly associated with risk of LTBI. Prevalence of LTBI in schoolchildren and adolescents in Shanghai is relatively low compared with other high epidemic areas of TB. A higher risk of LTBI was observed among children with no BCG vaccination and those with a history of TB exposure, which suggests that the prevalence of LTBI among schoolchildren could be further reduced by strengthening BCG vaccination under the national immunization programme and enhancing contact investigation of active TB patients.

Prevalence of headache among children and adolescents in Shanghai, China

The aims of this study were to estimate the prevalence of headache subtypes and headache-specific disability among children and adolescents in Shanghai, China, and to assess the validity and reliability of the ID-migraine questionnaire in this population. Of 4812 students who completed the questionnaire, 466 (9.68%) had experienced a headache in the past 3 months. Of the 466 headache sufferers, 44.85% were classified as having migraine. The proportion of migraine varied with age from 23.29% to 43.48%, and high proportions were found at ages 14 years and 15 years. The average proportion of: tension-type headache was 29.18%, and the proportions of cluster and other headache were 6.22% and 19.74%, respectively. According to the Paediatric Migraine Disability Assessment Score classification, the percentage of headache sufferers with grade I disability ranged from 40.54% to 71.43% across age groups and was 61.24% overall. The overall sensitivity of the ID-migraine screening questionnaire was 39.71% and the specificity was 46.63%.

Social, Psychological, and Environmental-Structural Factors Associated with Tobacco Experimentation among Adolescents in Shanghai, China

Objective: To estimate the prevalence and social, psychological and environmental-structural determinants of tobacco experimentation among adolescents in Shanghai, China. Methods: We conducted a cross-sectional study based on a two-stage cluster sample design by using the Chinese version of the Global Youth Tobacco Survey (GYTS) to investigate smoking behavior among 19,117 students from 41 junior and senior high schools in Shanghai, China. The association between potential factors and tobacco experimentation were assessed using complex samples procedure logistic regression. Results: Of the 19,117 respondents, 10.5% (15.3% boys and 6.2% girls) reported the tobacco experimentation. The main social, psychological, and environmental-structural factors associated with tobacco experimentation were having close friends who smoke (AOR = 8.21; 95% CI: 6.49–10.39); one or both parents smoking (AOR 1.57; CI: 1.39–1.77); a poor school tobacco control environment (AOR 1.53; CI: 1.37–1.83); a high acceptance level of tobacco use (AOR 1.44; CI: 1.28–1.82); and a high level of media tobacco exposure (AOR 1.23; CI: 1.10–1.37). Peer smoking might contribute to smoking experimentation among girls (AOR 8.93; CI: 5.84–13.66) more so than among boys (AOR 7.79; CI: 5.97–9.94) and media tobacco exposure had no association with tobacco experimentation among female students. Conclusions: Social, psychological, and environmental factors are closely associated with tobacco experimentation among adolescents. Prevention programs aimed at reducing teen tobacco experimentation should be conducted at home and school with support by parents, peers and teachers. Our findings should prove useful for future development of intervention strategies among adolescents in Shanghai, China.

Further increase of obesity prevalence in Chinese children and adolescents - cross-sectional data of two consecutive samples from the city of Shanghai from 2003 to 2008

Putative changes in the prevalence of obesity in Chinese children and adolescents in Shanghai, one of the most urbanized areas in China, were analyzed in a cross-sectional manner in 2003-2008. One urban and one suburban district were randomly selected. 70,582 students in 2003 and 86,355 students in 2008 from schools from within the two districts were examined. Anthropometric parameters were measured in all. Adiposity status was estimated using body mass index according to International Obesity Task Force standards. The prevalence of obesity was analyzed. The standardized prevalence of overweight significantly increased from 12.75 to 14.2% (p < 0.01), and the prevalence of obesity significantly increased from 3.35 to 3.94% (p < 0.01) during the study period. In contrast to data from developed countries, the prevalence of obesity decreased with age in both boys and girls. The prevalence of obesity and overweight in boys was significantly higher than that in girls (p < 0.01). Interestingly, the prevalence of overweight and obesity in the urban area was also significantly higher than that in suburb area (p < 0.01). Over a 5-yr period, there was a significant increase in the prevalence of obesity in children and adolescents in Shanghai. The high percentage of overweight and obesity in the young age groups is of particular concern. Urbanization might be a causative factor for the increase in obesity prevalence in Chinese children in the Shanghai area.

Shyness‐Sensitivity, Aggression, and Adjustment in Urban Chinese Adolescents at Different Historical Times

The market‐oriented economic reform in China over the past two decades has resulted in considerable changes in social attitudes regarding youth's behaviors. This study examined the relations of shyness and aggression to adjustment in Chinese adolescents at different historical times. Participants came from two cohorts (1994 and 2008) of adolescents in Shanghai (N = 540 and 728, respectively; M age = 13 years), and data were obtained from multiple sources. Although aggression was associated with adjustment problems in both cohorts, there were significant cross‐cohort differences in the relations between shyness and adjustment. In the 1994 cohort, shyness was positively associated with teacher‐rated competence, leadership, and academic achievement. In the 2008 cohort, however, shyness was negatively associated with peer preference and positively associated with loneliness.

High prevalence of irritable bowel syndrome with poor sleep quality in children and adolescents in Shanghai

This study explored the prevalence of irritable bowel syndrome (IBS) and investigated the relation-ship between IBS and disturbed sleep in school-age children in Shanghai, China. Primary, middle and high school students (n = 1542) were recruited from schools in Shanghai. Students completed two questionnaires: the questionnaire for IBS in children and adolescents and the Pittsburgh Sleep Quality Index (PSQI). The overall prevalence of IBS adjusted for cluster effects among students was 18.81%, and prevalence increased with age. Relative to non-IBS students, more IBS students tended to have poor sleep, including quality and duration. IBS is common among children and adolescents in Shanghai, China, and its prevalence increases with age. A tendency toward poor sleep also increases with age. The causal relationship between sleep and IBS needs to be further studied.

Gender Differences in Adolescent Premarital Sexual Permissiveness in Three Asian Cities: Effects of Gender-Role Attitudes

Gender is an important factor in understanding premarital sexual attitudes and behaviors. Many studies indicate that males are more likely to initiate sexual intercourse and have more permissive perceptions about sex than females. Yet few studies have explored possible reasons for these gender differences. With samples of unmarried adolescents in three Asian cities influenced by Confucian cultures, this article investigates the relationship between underlying gender norms and these differences in adolescents' premarital sexual permissiveness (PSP). In a collaborative survey conducted in 2006-2007 in urban and rural areas of Hanoi, Shanghai, and Taipei, 16,554 unmarried participants aged 15-24 years were recruited in the three-City Asian Study of Adolescents and Youth, with 6,204, 6,023, and 4,327 respondents from each city, respectively. All the adolescents were administered face-to-face interviews, coupled with computer-assisted self-interview for sensitive questions. Scales on gender-role attitudes and on PSP for both male and female respondents were developed and applied to our analysis of the data. Multilinear regression was used to analyze the relationship between gender-role attitudes and sexual permissiveness. Male respondents in each city held more permissive attitudes toward premarital sex than did females, with both boys and girls expressing greater permissiveness to male premarital sexual behaviors. Boys also expressed more traditional attitudes to gender roles (condoning greater inequality) than did girls in each city. Adolescents' gender-role attitudes and permissiveness to premarital sex varied considerably across the three cities, with the Vietnamese the most traditional, the Taiwanese the least traditional, and the adolescents in Shanghai in the middle. A negative association between traditional gender roles and PSP was only found among girls in Shanghai and Taipei. In Shanghai, female respondents who held more traditional gender-role attitudes were more likely to exercise a double standard with respect to male as opposed to female premarital sex (odds ratio [OR] = 1.18). This relationship also applied to attitudes of both girls and boys in Taipei (OR = 1.20 and OR = 1.22, respectively). Although with variation across sites, gender differences in PSP and attitudes to gender roles among adolescents were very significant in each of the three Asian cities influenced by Confucian-based values. Traditional gender norms may still be deeply rooted in the three cities, especially among females; while it is important to advocate gender equity in adolescent reproductive health programs, the pathway of traditional gender norms in influencing adolescent reproductive health outcomes must be understood, as must differences and similarities across regions.

The effects of social connections on self-rated physical and mental health among internal migrant and local adolescents in Shanghai, China

BackgroundChina is in the midst of history's largest flow of rural-urban migration in the world; a flow that includes growing numbers of children and adolescents. Their health status is an important public health issue. This study compares self-rated physical and mental health of migrant and local adolescents in China, and examines to what extent layered social connections account for health outcomes.MethodsIn 2010, we conducted a cross-sectional study among middle school students in Pudong New Area, Shanghai. Information about health status, social connections, and demographic factors were collected using a questionnaire survey. After controlling for sociodemographic factors, we used the t-test, Chi-square analysis, and a series of regression models to compare differences in health outcomes and explore the effects of social connections.ResultsMigrant adolescents reported significantly higher rates of good physical health. However, they also had significantly fewer social connections, lower self-esteem, and higher levels of depression than their native peers. Family cohesion was associated with depressive symptoms and low self-esteem among all adolescents; peer association and social cohesion played major roles in migrants' well-being. Gender, age, and socioeconomic (SES) factors also affected adolescents' self-rated physical and mental health.ConclusionsSelf-rated data suggest that migrant adolescents enjoy a physical health advantage and a mental health disadvantage. Layered social connections, such as peer association and social cohesion, may be particularly important for migrants. A public health effort is required to improve the health status of migrant youth.

Perceived parental behavioral control and psychological control in Chinese adolescents in Shanghai

Perceived parental behavioral control and psychological control in Chinese adolescents in Shanghai

Socio-demographic and family correlates of hopelessness among adolescents in Shanghai, China

Socio-demographic and family correlates of hopelessness among adolescents in Shanghai, China

Perceived parent-child relational qualities and parental control in Chinese adolescents in Shanghai

Perceived parent-child relational qualities and parental control in Chinese adolescents in Shanghai

Sitzung 9; Vortrag 3: Die Sicht des Marketing-Managers

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.