Children Andadolescents Research Articles

Safety, effectiveness and hesitancy of COVID-19 vaccination in children: A cross-sectional study in Pakistan.

The elevated risk of serious complications like myocarditis and pericarditis after COVID-19 vaccination, especially in adolescent has been reported in some instances that need to be tested in regional populations and different ethnicity groups. The purpose of the study was to evaluate the side effects, hesitancy, and effectiveness outcomes following COVID-19 vaccination among children in Pakistan. The study was planned using a cross-sectional design and data from Children and Adolescents (CA) was collected through a convenient sampling method using a validated questionnaire between February to July 2022. A total of 1,108 CA between the age of 12-18 years who received one or two doses of vaccine were selected and data were collected through direct interviews with respondents. The results showed that among 99.8% of respondents who received the Pfizer COVID-19 vaccine, 72.3% of respondents were partially vaccinated (with one dose) while 27.7% were fully vaccinated (with two doses). COVID vaccination regime had a favorable safety profile in children as compared to adults. Vaccine hesitancy in children was reported to be 52.4% and the most common reasons for hesitance were the assumption that the vaccine is not safe (23.7%), the vaccine is not required (19.6%) and the vaccine is not effective (10.4%). The reported side effects were mainly mild (88.5%) followed by moderate (10.6%) and only 0.8% were of severe intensity. Post-vaccination local side effects of mild intensity were common with an onset of an average of 24 h (68%) and a duration of 2-3 days (60.6%). The reported side effects were significantly associated with gender (p = 0.00) while age had no significant effect on the occurrence of side effects. Overall, the vaccine was well tolerated by children and adolescents and was effective in preventing the reoccurrence of COVID-19 infection in 99.9% of participants. COVID-19 vaccine by Pfizer approved by the FDA for use in CA 12-18 years of age was well tolerated with a good safety profile and no serious adverse drug reactions were reported. The vaccine side effects were mild (88.5%) and lasted for an average of 2-3 days only (60.4%). The vaccine was effective in safeguarding Children against COVID-19 infection.

INFLUENCE OF AUDIOVISUAL PRODUCTS CONSUMED BY CHILDREN AND TEENAGERS ON THEIR PROPER BIOPSYCHOSOCIAL DEVELOPMENT

The constant advancement and development of information and communication technologies has caused the classic forms of leisure for infants and adolescents to vary every day. Such is the case of audiovisual consumption, an activity that enjoys great preference on the part of these age groups, displacing the performance of other fundamental activities for these stages. Therefore, this research aims to determine how the audiovisual products consumed by children and adolescents infl uence their adequate biopsychosocial development; in addition to describing the role played by parents in the consumption activity carried out by their children. For this, a qualitative methodology was implemented, focused on documentary analysis. From which it was possible to verify that the programs preferred by children and adolescents are mostly intended for the adult public, as well as being of foreign manufacturing. In the same way, it was found that the mediating role of adults focuses on the establishment of limits and the control of schedules, the exposure time and the content of these materials, avoiding joint viewing and active discussion of the content consumed. Elements that lead to a considerable risk in the proper development of children and adolescents when exposed to materials of the content not appropriate for these ages.

ФАКТОРЫ РИСКА НЕУДАЧИ ЛЕЧЕНИЯ ТУБЕРКУЛЕЗА ОРГАНОВ ДЫХАНИЯ У ДЕТЕЙ И ПОДРОСТКОВ

Objective: to identify the major risk factors for treatment failure among children and adolescents with pulmonary TB. Materials and methods: aretrospective comparative study enrolled 141 patients aged 2–17 years with different forms of pulmonary TB. Upon completion of the main chemotherapy course consisting of the intensive and continuation phases, the patients were divided into two groups: group 1 – patients with treatment failure, group 2 – patients with treatment success. We compared the patients’ gender and age, social status of the families, the presence of medical or biological risk factors (the absence of anti-TB vaccination, concomitant chronic diseases, acute infectious diseases during the treatment, TB process at detection, drug resistance patterns in the patients and infection sources, the time of drug resistance development, the information about chemotherapy regimens and treatment administration, the occurrence and duration of treatment interruptions) in the groups. The obtained data were processed using binary logistic regression carried out by the SPSS 21.0 software. Results: we built a mathematical statistical model of the individual risk for treatment failure among children and adolescents with pulmonary TB. Conclusion: the major risk factors for treatment failure among children andadolescents with pulmonary TB were associated with inadequate chemotherapy: ignorance of drug resistance patterns on the initial treatment phase, defective use of chemotherapy potentials, wrong choice of treatment administration form. Late detection of TB (lung destruction, advanced TB process) was a more frequent factor in group 2 than group 1 but did not significantly influence treatment outcome.

INTERNET USE AND RISKS FOR COLOMBIAN CHILDREN AND ADOLESCENTS

Online life offers possibilities for individual and social development but it also promotes the emergence of new risks such as sexting, cyberbullying, and cyber dependence. The EU Kids Online survey was used to research these behaviours. The questionnaire was adapted for the Colombian population through expert review and cognitive validation to children and adolescents in Medellin, Cali, and Cartagena (Colombia). The adaptation followed the procedures and standards of Kids Online Brasil and Kids Online Chile. The stratifi ed and non-probabilistic sample consisted of  children and adolescents aged  to  years from ten cities in Colombia. Descriptive statistics of uses and risks assumed by Colombian children and adolescents when they connect to the Internet are presented.

INTERNET USE AND RISKS FOR COLOMBIAN CHILDREN AND ADOLESCENTS

Online life offers possibilities for individual and social development but it also promotes the emergence of new risks such as sexting, cyberbullying, and cyber dependence. The EU Kids Online survey was used to research these behaviours. The questionnaire was adapted for the Colombian population through expert review and cognitive validation to children and adolescents in Medellin, Cali, and Cartagena (Colombia). The adaptation followed the procedures and standards of Kids Online Brasil and Kids Online Chile. The stratifi ed and non-probabilistic sample consisted of  children and adolescents aged  to  years from ten cities in Colombia. Descriptive statistics of uses and risks assumed by Colombian children and adolescents when they connect to the Internet are presented.

The Internet as a threat source of propagating alcohol consumption by children and adolescents

The aim of the study is to draw attention to the problem of alcohol consumption bychildren and adolescents. In time transfers these behaviors to a virtual backyard, wherethe law is violated on websites and social networks every day, and advertising and18+ content related to alcohol consumption attack every possible way of children andadolescents. Statistics show that the age of alcohol initiation is decreasing, and onetimeepisodes of alcoholic libations are more and more frequent among adolescents.Additionally, the so-called pathostream, which consists in recording behavior considereddeviant and publishing it on the web, often live. This has increasingly serious consequencesfor the childs physical and mental health.

Using the ICF Framework to Assess Communicative Competence in Dyadic Communication among Children and Adolescents Who Use Augmentative and Alternative Communication Devices in Taiwan.

Augmentative and alternative communication (AAC) devices enable children and adolescents (CAD) with communication disorders to communicate competently and develop friendships through communicative competence (CC). Existing assessment tools are unable to indicate whether CAD aged 0 to 18 years would competently use the subsidized AAC devices provided by the Ministry of Health and Welfare in Taiwan. This study, thus, aimed to develop an assessment tool by using the International Classification of Functioning, Disability and Health (ICF) to measure CC in dyadic communication among CAD using AAC devices. Five speech-language pathologists (SLPs), five special education teachers, and four AAC experts (14 in total) selected codes relevant to the four domains of CC via the Delphi method. Next, they categorized the selected codes into one of the four domains of CC through a face-to-face expert panel. A total of 112 codes were listed in the tool and fully classified into the four domains of CC. Among these, seven codes were concurrently placed under two domains of CC. Consequently, this study developed an assessment tool by employing the ICF for children and youth core set using universal qualifiers to measure the relative levels of CC in dyadic communication among CAD who use AAC devices in their daily life.

Patterns and temporal trends in the incidence of childhood and adolescence cancer in Cyprus 1998–2017: A population-based study from the Cyprus Paediatric Oncology Registry

BackgroundDespite its rarity, cancer in children and adolescents (CAC) is a major health issue worldwide. The lack of appropriate cancer registries is an obstacle for defining its incidence and survival, and informing cancer control. As in Cyprus, CAC epidemiology has not previously been comprehensively examined, we determined incidence rates and temporal trends of cancer in the 0–19 age group during 1998–2017. MethodsWe established the population based Paediatric Oncology Registry of Cyprus (PORCY) for the period 1998–2017. World age standardised incidence rate per million children and adolescents per year (ASRW) were calculated and time trends were assessed using Joinpoint regression analysis. Comparisons were made with other countries using the International Incidence of Childhood Cancer, third volume. ResultsFor all cancers combined, for ages 0–19-years, ASRW was 203.54 (95% CI 189.49, 217.59) one of the highest rates globally. The most frequent CAC were leukaemias followed by lymphomas, specified epithelial neoplasms and central nervous system tumours, differing to what is described in most other countries. For all cancers, both combined and individual types, except thyroid carcinoma (where incidence was rising), no significant temporal variation was found. ConclusionsTo inform cancer control activities, we conducted the first ever population-based epidemiological study of childhood and adolescent cancer (0–19 years) in Cyprus. The striking findings indicate high overall incidence rates that are among the world’s highest, a higher frequency of lymphomas and thyroid cancer than brain tumours, and rising incidence for thyroid, but not for other, cancers. These novel findings, will help the formulation of hypotheses to provide explanation for the high rates for all CAC in Cyprus and may contribute to the global efforts for improving prevention of cancer in this age group.

Post-vaccination infection rates and modification of COVID-19 symptoms in vaccinated UK school-aged children and adolescents: A prospective longitudinal cohort study.

SummaryBackgroundWe aimed to explore the effectiveness of one-dose BNT162b2 vaccination upon SARS-CoV-2 infection, its effect on COVID-19 presentation, and post-vaccination symptoms in children and adolescents (CA) in the UK during periods of Delta and Omicron variant predominance.MethodsIn this prospective longitudinal cohort study, we analysed data from 115,775 CA aged 12-17 years, proxy-reported through the Covid Symptom Study (CSS) smartphone application. We calculated post-vaccination infection risk after one dose of BNT162b2, and described the illness profile of CA with post-vaccination SARS-CoV-2 infection, compared to unvaccinated CA, and post-vaccination side-effects.FindingsBetween August 5, 2021 and February 14, 2022, 25,971 UK CA aged 12-17 years received one dose of BNT162b2 vaccine. The probability of testing positive for infection diverged soon after vaccination, and was lower in CA with prior SARS-CoV-2 infection. Vaccination reduced proxy-reported infection risk (-80·4% (95% CI -0·82 -0·78) and -53·7% (95% CI -0·62 -0·43) at 14–30 days with Delta and Omicron variants respectively, and -61·5% (95% CI -0·74 -0·44) and -63·7% (95% CI -0·68 -0.59) after 61–90 days). Vaccinated CA who contracted SARS-CoV-2 during the Delta period had milder disease than unvaccinated CA; during the Omicron period this was only evident in children aged 12-15 years. Overall disease profile was similar in both vaccinated and unvaccinated CA. Post-vaccination local side-effects were common, systemic side-effects were uncommon, and both resolved within few days (3 days in most cases).InterpretationOne dose of BNT162b2 vaccine reduced risk of SARS-CoV-2 infection for at least 90 days in CA aged 12-17 years. Vaccine protection varied for SARS-CoV-2 variant type (lower for Omicron than Delta variant), and was enhanced by pre-vaccination SARS-CoV-2 infection. Severity of COVID-19 presentation after vaccination was generally milder, although unvaccinated CA also had generally mild disease. Overall, vaccination was well-tolerated.FundingUK Government Department of Health and Social Care, Chronic Disease Research Foundation, The Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK Research and Innovation London Medical Imaging & Artificial Intelligence Centre for Value Based Healthcare, UK National Institute for Health Research, UK Medical Research Council, British Heart Foundation and Alzheimer's Society, and ZOE Limited.

Dupilumab Improves Clinical Scores in Children and Adolescents With Moderate to Severe Atopic Dermatitis: A Real-World, Single-Center Study

Dupilumab has proven safe and effective in children and adolescents with atopic dermatitis (AD) in clinical trials. However, comprehensive real-world studies in the pediatric AD population are still needed. To characterize the long-term treatment responsesand adverse events of dupilumab-treated children andadolescents with AD during dermatology follow-up assessments. We reviewed electronic medical records from March 2017 to September 2021 of moderate to severe AD patients starting dupilumab at less than age 18 years. Demographics, AD scores (body surface area [BSA], EczemaArea and Severity Index [EASI], and Investigator'sGlobal Assessment [IGA]) as well as safety data were collected. A total of 89 patients, 50 females (56.2%) and 39 males (43.8%), were included. Mean ± SD treatment duration was 1.3 ± 0.9 years. Of these, 73 had score assessments at baseline and weeks 12 to 24. Mean ± SD improvements in BSA, EASI, and IGA were 63.1% ± 29.2%, 39.6% ± 29.9%, and 59.6% ± 30.7%, respectively. All patients (n= 23) who received dupilumab for 1 year or more achieved 75% improvement in EASI and IGA 0/1, and 60.8% achieved 90% improvement in EASI. Positive history of atopy was associated with greater percent improvement in BSA at weeks 12 to 24 (P < .05). Twelve patients had adverse events (13.5%), of which conjunctivitis (5.6%) and joint pain (2.2%) were most common. There were no serious adverse events. Dupilumab was well-tolerated and effective in treating pediatric and adolescent AD regardless of age, sex, race, or ethnicity.

Internet-delivered psychological treatment of functional gastrointestinal disorders in youth: Study protocol for exploration of cognitive biases

Introduction Functional gastrointestinal disorders (FGID) are common in children and adolescents (CA), cause functional disability and high health care use. Internet based cognitive behavioral therapy (i-CBT) have shown promising effect in Sweden. The treatment is exposure based and target avoidance behavior. Cognitive biases regarding bodily symptoms are suggested to be part of development and maintenance of functional disorders in adults, and could therefore be an important treatment target. Little is known about cognitive biases in CA with FGID, and hence the potential importance, it is crucial to explore more in depth. This study is embedded in The Danish FGID Treatment Study which aims to test Swedish i-CBT treatment in a Danish context.Objectives1) Examine cognitive biases in CA with FGID, compared with healthy controls. 2) Asses these biases before and after treatment for FGID to investigate changes and impact on treatment effect.MethodsWe developed a novel experimental approach to examine possible cognitive biases in CA. It consists of a picture task and a FGID-specific version of the Health Norms Sorting Task. We will examine 60 CA with FGID, who are included in The Danish FGID Treatment Study before and after treatment. In addition we will perform the test on 100 healthy controls.ResultsThe results are expected to improve our understanding of maintaining cognitive factors in CA with FGID, and how these may affect outcome and change during treatment, and how they differ from the general population.ConclusionsThis study can provide new targets for treatment approaches.DisclosureNo significant relationships.

Management of childhood MDR-TB in Europe and Central Asia: report of a Regional WHO meeting.

BACKGROUND: As the WHO European Region has the highest proportion of multidrug-resistant TB (MDR-TB) among total incident TB cases, many children and adolescents are at risk of MDR-TB infection and disease.METHODS: We performed an electronic survey of clinicians and TB programme personnel who attended the 2020 Regional Consultation on child and adolescent TB organised by the WHO Regional Office. We characterised access to diagnostics and drugs, and practices in the prevention and management of child and adolescent MDR-TB.RESULTS: Children and adolescents are inconsistently represented in national guidelines and budgets; child-friendly drug formulations for MDR-TB treatment are insufficiently available in 57% of countries, and 32% of countries reported paediatric drug stock-outs. The novel drugs, bedaquiline and delamanid, are accessible by respectively 80% and 60% of respondent countries. Respondents were asked how many children were diagnosed with MDR-TB in 2019, and a comparison of this number to modelled estimates of incidence (to identify the case detection gap) and WHO notifications (to identify the case reporting gap) showed substantial differences in both comparisons.CONCLUSIONS: Better representation of this patient group in guidelines and budgets, greater access to drugs and improved reporting are essential to reach TB elimination in this Region.

Association of Physical Fitness, Screen Time, and Sleep Hygiene According to the Waist-to-Height Ratio in Children and Adolescents from the Extreme South of Chile.

Objective: To analyze the perception of physical fitness, screen time, and self-reported sleep hygiene in children and adolescents (CA) from the extreme south of Chile and its associations with waist-to-height ratio (WtHr). Material and methods: An observational cross-sectional study was conducted in a sample of 594 schoolchildren from 5th to 8th grade of primary education, belonging to municipal educational establishments in the Magallanes region, Chile. Cardiorespiratory fitness was assessed through the 20-m shuttle run test, muscle strength through handgrip and the standing broad jump test, physical fitness perception through the International Fitness Scale, and central obesity through the waist-to-height index. In addition, sleep hygiene and screen time were measured. Results: More than 92% of CA spent more than two hours a day watching or using screens. In addition, CA with excess central adiposity had a lower perception of physical fitness, and lower muscle strength and cardiorespiratory fitness compared to CA with normal values of adiposity. Conclusions: CA of the present study spent a high number of hours watching or using screens and had poor sleep quality. In addition, excessive central adiposity was associated with lower physical fitness.

Evaluating Children and Adolescents with Suspected Exercise Induced Asthma: Real Life Data.

Exercise-induced bronchoconstriction (EIB) occurs frequently in children and adolescents and may be a sign of insufficient asthma control. EIB is often evaluated by respiratory symptoms, spirometry, eNO measurement and methacholine testing (MCT) instead of time consuming exercise test. Aim of this study was to analyse the amount of patients for which an exercise challenge in a cold chamber (ECC) was needed for a clear EIB diagnosis, to characterize EIB phenotypes and the incidence of exercise induced laryngeal obstruction (EILO) in a large cohort of patients with EIB. A retrospective analysis was performed in 595 children and adolescents (mean age 12.1 years) with suspected EIB from January 2014 to December 2018. Complete data sets of skin prick test, spirometry, eNO and MCT were available from 336 patients. An ECC to confirm the EIB diagnosis was performed in 125 (37.2%) of patients. Three EIB phenotypes were detected: group 1: EIB without allergic sensitization (n=159); group 2: EIB with other than house dust mite (HDM) sensitization (n=87) and group 3: EIB with HDM sensitization (n=90). MCT and eNO showed significant differences between the subgroups: An eNO>46 ppb and/or a MCT<0.1 mg was found in 23.9% vs. 50.6% vs. 57.8% in group 1-3, respectively. Significantly more patients suffered from EILO in group 1 compared to group 2 and 3 (n=13 vs. n=1). EIB without sensitization is as often as EIB with sensitization. In patients without sensitization, EILO has to be considered as a possible cause of symptoms during exercise.

Nutritional Habits of Preschool Children

Introduction. Proper nutrition is crucial for maintaining good health and provides the basis for proper growth and development of children and adolescents. Insufficient physical activity and inadequate nutrition are among the leading causes of mortality and morbidity. Aim. The aim of this research paper was to examine the nutritional habits of preschool children. Methods. The study was conducted in April 2018 and included a survey of kindergarten children and their parents. A questionnaire consisting of 24 questions was created for the purposes of the study. The survey was conducted entirely anonymously and voluntarily. Of the 100 respondents included in the study, 52% (52) were boys and 48% (48) were girls. The average age of the respondents was 5.12 years. Results. Out of a total of 100 children, 98% (98) have a hot meal every day, while 2% (2) do not. Cereals and cereal products are consumed by 97% of children, while 3% stated that they do not consume cereals. As with cereals, 97% of children use milk and dairy products, while only 3% do not consume them. 29 (76%) boys have normal body weight. Four (5%) were malnourished and 3 (8%) boys were overweight. 30 (70%) girls have normal body weight, 3 (7%) are malnourished, and one (2%) girl is overweight. 8 (21%) girls were obese. Conclusion. According to the obtained research results, it can be concluded that most of the examined children ate properly and had normal body weight. It is a worrying fact that most of the children consume sweets/snacks on a daily basis, while on the other hand a large number of surveyed children do not consume vegetables and fruits on a daily basis. Nurses in preschools face the challenging task of integrating their professional knowledge into the educational process.

Creative Self-Efficacy Scale for Children and Adolescents (CASES): A Development and Validation Study.

.Creative self-efficacy has emerged as one of the most striking constructs in education. Yet, instruments to assess it in children and adolescents are scant. This article introduces the CASES, a new creative self-efficacy scale designed to address this concern. The process of development and initial validation of the scale are presented herein. Following the items’ conception, exploratory, and confirmatory factorial analysis was performed. The final structure comprises nine items, evenly distributed by three factors: fluency, elaboration, and personality. Preliminary reliability and validity analysis display good psychometric properties, highlighting CASES as a potentially relevant addition to the creative self-efficacy assessment instruments array. Designed for children and adolescents (ages 3 to 16), it can uphold a developmental approach of creative self-efficacy, with potential implications within educational settings. Thus, it might be of interest for parents, educators, educational psychologists, researchers, and policymakers involved in designing curricula and interventions to nurture and enhance creative potential.

Prevalence and trend of low vision among primary and secondary school students in Wuhan from 2019 to 2020

Objective To provide a large-scale assessment the prevalence of poor vision in 2020 among children and adolescents in Wuhan City, Hubei province and to provide basis for healthy vision promotion. Methods This cross-sectional epidemiological study was conducted among 156 783 students, who lived in Wuhan during the COVID—19 period participated the vision screening through the online applet designed by Wuhan Center for Adolescent Poor Vision Prevetion and Control under the guidance of their guardians between June 19 and July 6, 2020. The demographic information and daily hours spent on various activities in the past week were investigated. The corresponding visual acuity data of students in 2019 before the COVID-19 outbreak was extracted from school vision monitoring records for each semester, which was measured by the experienced eye care professionals. Results The detection rate of poor vision (51.04%) in 2020 was significantly higher than that in 2019 (43.04%) (χ 2 = 68 944.95, P<0.01). After adjustment for covariates, the odds ratio and 95% confidence interval for poor vision were 1.17 (1.13-1.20), 1.07 (1.04-1.10), 0.67 (0.65-0.69) and 0.62 (0.60-0.64) in students with online class time, recreational screen time, indoor and outdoor activity time in the highest tertile, compared with the lowest tertile groups. Conclusion Increased rate of poor vision among primary and secondary schoool students deserves further concern. It is necessary to strengthen intervention of eyesight protection. Policies and programs aimed at improving opportunities for physical activities and decreasing multiple screen behaviors should be given priority. 【摘要】 目的 了解新型冠状病毒肺炎 (新冠肺炎) 疫情居家隔离及线上学习后, 武汉市中小学生视力不良检出率情况, 为中小学生视力防控提供科学依据。 方法 2020 年 6 月 19 日至 7 月 6 日, 利用武汉市青少年视力低下防制 (预防控制) 中心设计的在线视力筛査工具对 156 783 名中小学生进行视力筛査, 同时调査前 1 周学生室内外活动及视屏时间。学生 相应的 2019 年新冠肺炎疫情暴发前的裸眼视力从学校视力监测记录中获取。 结果 2020 年视力不良检出率 (51.04%) 髙 于 2019 年 (43.04%) (χ 2 = 68 944.95, P<0.01)。经协变量调整后, 相对于低分位数的网课时间、视屏娱乐时间、室内活动时 间、室外活动时间, 髙分位数的各类活动时间对于视力不良 OR 值 ( OR 值 95% CI) 分别为 1.17(1.13~1.20)、1.07(1.04~ 1.10)、0.67(0.65~0.69)、0.62(0.60~0.64)。 结论 武汉市中小学生 2020 年视力不良检出率较 2019 年显著增髙, 应加强 中小学生视力保护的广泛干预, 优先考虑改善体育活动机会和减少多种屏幕行为的政策措施。

Prevalence of eating out and its association with overweight and obesity among children and adolescents in Hebei Province

Objective To investigate the prevalence and associated factors of eating out among children and adolescents aged 6-17 in Hebei Province, and to explore the association between eating out and overweight/obesity. Methods Data came from Children and Nurse Nutrition Health Monitoring of China during 2016-2017. Questionnaire surveys and anthropometric measures was conducted among 3 330 children aged 6-17 in 12 survey sites. Multivariate Logistics stepwise regression model was used to analyze the influencing factors of eating out and the relationship between eating out and overweight/obesity. Results The proportion of eating out was 16.19%, and the rate of overweight and obesity was 29.43%. Multivariate analysis showed that the older children (junior high school students: OR = 1.36; high school students: OR = 3.57, both P<0.05) and adolescents from high-income families (10 000~<20 000 CNY: OR = 1.48; ≥20 000 CNY: OR = 2.93, both P<0.05) were more likely to eat out. Children and adolescents living in rural areas ( OR = 0.20, P<0.01), non-only-child ( OR = 0.76, P = 0.02), day school students ( OR = 0.21, P<0.01), and the primary caregivers of the elderly ( OR = 0.69, P = 0.03) were less likely to eat out. In addition, eating out was statistically associated with an increased risk of overweight and obesity ( OR = 1.31, P<0.01). Conclusion Eating out is common among children and adolescents aged 6-17 in Hebei Province. Residency, age, household income, one-child family, boarding and and eating out behaviors of primary caregivers are associated with eating out among children and adolescents. Eating out may increase the risk of overweight/obesity in children. 【摘要】 目的 分析河北省 6~17 岁儿童青少年在外就餐现状及其与超重肥胖的关系, 为指导儿童青少年建立健康的饮 食习惯和遏制肥胖流行趋势提供参考。 方法 调査数据来自 2016—2017 年中国儿童与乳母营养健康状况监测, 通过问卷 调査和体格检査收集河北省 12 个监测点 3 330 名 6~17 岁儿童青少年最近 1 周的就餐情况、家庭基本情况和体检信息等 资料。采用多因素 Logistic 逐步回归的方法, 对调査对象在外就餐情况, 在外就餐影响因素及与超重肥胖的关系进行分析。 结果 河北省 6~17 岁儿童青少年在外就餐率为 16.19%, 超重肥胖率为 29.43%。多因素 Logistic 回归分析显示, 年龄较大 (初中生： OR = 1.36, 髙中生 OR = 3.57, P 值均<0.05) 和家庭人均收人髙的儿童青少年 (1~ <2 万元: OR = 1.48, ≥2 万元: OR = 2.93, P 值均<0.05) 在外就餐的可能性更髙;居住地为农村 ( OR = 0.20)、非独生子女 ( OR = 0.76)、走读生 ( OR = 0.21) 以及 主要抚养人为老人的儿童青少年 ( OR = 0.69) 在外就餐的可能性更低 ( P 值均<0.05)。在外就餐与超重肥胖风险增髙存在 统计学关联 ( OR = 1.31, P<0.01)。 结论 河北省 6~17 岁儿童青少年在外就餐现象较为普遍。居住地、年龄段、人均年收 人、是否为独生子女、是否住校、主要抚养人是在外就餐的相关因素, 在外就餐可能会增加儿童青少年超重肥胖的风险。

Characteristics of fat-free mass among middle and high school adolescents in Yinchuan City

Objective To elucidate age-and sex-specific characteristics in fat-free mass (FFM) among middle and high school adolescents in Yinchuan City, China, and to provide a scientific basis for healthy development, chronic disease prevention and intervention in children and adolescents. Methods Using a convenient cluster sampling method, 1 175 middle and high school adolescents, aged 10 to 20 years old, from Yinchuan, China, were selected to participate in a questionnaire survey and physical examination, which involved body composition by bioelectrical impedance analysis (BIA). Results For adolescents aged 12 to 18 years, FFM and the fat-free mass percentage (FFMP) of boys increased with age (from 39.78 to 52.63 kg; 77.51% to 83.80%, respectively), the age trends of the FFM and FFMP of body parts were in the similar pattern, and were significantly higher than those of girls (all P<0.05). In girls, the FFM reached a peak of 40.96 kg at 15 years old, and decreased slightly between the ages of 15 and 18 years, the age trends of the FFM of body parts were in the similar pattern, and the FFMP decreased with age (from 75.63% to 71.91%). In addition, in girls, the age trends of the FFMP of left and right legs were the same as the general trend, while the FFMP of left and right arms increased with age. The FFMP of the trunk reached a minimum of 29.93% at 15 years old and increased from 15 to 18 years old (all P<0.05). Conclusion For middle and high school adolescents aged 12 to 18 years old in Yinchuan City, China, the distribution of FFM changed in accordance with age and gender differences, in accordance with the characteristics of the adolescents’ growth and development. 【摘要】 目的 了解银川市中学生瘦体重分布的年龄变化趋势和性别差异, 为儿童青少年健康发育、预防慢性疾病和制 定干预措施提供科学依据。 方法 于 2017—2019 年 9—12 月使用方便整群抽样的方法, 随机抽取银川市 1 175 名 12~18 岁中学生进行问卷调査、体格检査, 米用生物电阻抗分析法 (bioelectrical impedance analysis, BIA) 测量其体成分。 结果 男生总瘦体重 (fat free mass, FFM) 和总瘦体重率 (fat free mass percentage, FFMP) 随年龄增加而增加 (39.78 ~ 52.63 kg, 77.51%~83.80%), 身体各部分 FFM、FFMP 年龄趋势同总趋势, 且均髙于女生 ( P 值均<0.05); 女生 FFM 15 岁达峰值 40.96 kg, 15~18 岁略有下降, 身体各部分 FFM 年龄趋势同总 FFM 趋势, FFMP 随年龄增加呈下降趋势 (由 75.63% 下降至 71.91%)、左右下肢 FFMP 的年龄趋势同 FFMP, 左右上肢 FFMP 随年龄增加而增加, 躯干 FFMP 在 15 岁达最低值 29.93%, 15~18 岁上升 ( P 值均<0.05)。 结论 银川市 12~18 岁中学生瘦体重随年龄变化特点及性别差异, 符合其生长发育特征。

The Participation of Children and Adolescents in the Protection System: The Case of the Spanish Legislation

Children’s right to participation is enshrined in the Convention on the Rights of the Child (CRC), specifically in Article 12; however, the participation of children in the protection system continues to be a challenge. There is a need for a paradigm shift, in which children and adolescents (CA) are considered as active subjects of rights in all areas of their lives, and that means allowing them to participate in decisions that concern them. The study analysed 20 Spanish laws, both national and autonomous, that regulate child protection and the rights of CA in the protection system. It focuses on examining the participation of children in the protection system, divided into its three dimensions: the right to be informed, the right to be heard and the right to be involved. There is complexity in the different regulations. All of them are consistent with the CRC and provide for participation, but not all to the same extent. There is a lack of harmonisation between the legislation of autonomous communities, leading to practical difficulties for the professionals who have to implement the legislation on a daily basis.