Tibetan Adolescents Research Articles

Association between soybean product consumption and executive function in Chinese Tibetan children and adolescents.

This sought to explore the association between soybean product consumption and executive function (EF) in Chinese Tibetan adolescents in high-altitude areas. A total of 1,184 Tibetan children and adolescents were tested on demographic variables, soybean product consumption, and executive function in Lhasa and Nagchu regions of Tibet, China, using stratified whole population sampling. One-way ANOVA, linear regression analysis, and logistic regression analysis were used to analyze the associations existing between soybean product consumption and executive function. The proportions of Hardly ever, Occasionally, and Often in Soy Consumption among Tibetan children and adolescents in high altitude areas of Tibet, China were 21.7, 50.3, and 28.0%, respectively. The difference in 2 back reaction time among Tibetan children and adolescents with different soybean product consumption was statistically significant (F = 6.374, p = 0.002). The difference in conversion function reaction time was also statistically significant (F = 8.129, p < 0.001). Taking the soybean product consumption ≥6 t/w group as the reference group, after adjusting the relevant factors, those with soybean product consumption ≤1 t/w showed a statistically significant increase in Inhibit Function Dysfunction (OR = 1.844, 95% CI: 1.152, 2.951) and Conversion Function Dysfunction (OR = 2.008, 95% CI: 1.106, 3.646) had an increased risk of Conversion Function Dysfunction (OR = 2.008, 95% CI: 1.106, 3.646), which was significantly different (p < 0.05). There is an association between soybean product consumption and inhibitory control and translational flexibility of brain executive functions in Chinese Tibetan children and children and adolescents at high altitude.

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.

Relationship between cardiorespiratory fitness and executive function of Chinese Tibetan adolescents aged 13–18

ObjectivesExplore the correlation between cardiorespiratory fitness (CRF) and execution function (EF) of Chinese Tibetan adolescents at high altitude (HA) areas. DesignA cross-sectional survey was used to study 1138 participants aged 13–18 (47.72% boys) at baseline. MethodsLhasa (3650 m), Nagqu (4500 m), Qamdo (3500 m), and Nyingchi (3100 m) in China were chosen. CRF was measured by the 20 m shuttle run test (20mSRT) and a subsequent estimation of their maximal oxygen consumption (V̇O2max) was calculated using the Léger equations. The three core EFs (inhibition, working memory, and cognitive flexibility) were tested by a modified Eriksen flanker, N-back, and a more-odd shifting. The association between CRF and EF was explored by Pearson correlation, one-way ANOVA, and stratified regression. ResultsThe reaction time (RT) of 1-back, cognitive flexibility with V̇O2max showed a declining trend, (F = 34.475, 27.498, P < 0.01). Interestingly, 2-back RT went up and then went down with V̇O2max. (F = 29.55, P < 0.01). After increasing V̇O2max as a variable, a stratified regression analysis with the RT for 1-back, 2-back, and cognitive flexibility showed that ΔR2 equaled 0.107 ms, 0.071 ms, and 0.091 ms, respectively (P < 0.01). With V̇O2max increased by 1 mL/kg/min, the RT of 1-back, 2-back, and cognitive flexibility shortened 14.697 ms, 15.689 ms, and 11.771 ms, respectively. ConclusionsCRF was positively associated with working memory, and cognitive flexibility development among Chinese Tibetan adolescents living at HA areas, respectively.

Physical fitness of Tibetan adolescents at different high altitudes in Tibet, China: A comparative study.

High altitude hypoxic environment has a certain negative impact on physical fitness of adolescents. We aimed to understand the physical fitness status of Tibetan adolescents in different high-altitude areas in Tibet, China. Physical fitness items, such as grip strength, standing long jump, sit and reach, 50 m dash, 1000 m run for boys, and 800 m run for girls were tested on 3806 Tibetan adolescents by using stratified whole group sampling method in class units. The mean age of the participants was (15.51 ± 1.69) years for Tibetan males and (15.54 ± 1.69) years for females. One-way analysis of variance (ANOVA) and other methods were used to make cross-sectional comparisons of physical fitness performance of Chinese Tibetan adolescents in different high-altitude regions. The standing long jump scores of boys (203.37 ± 28.36) were higher than that of girls (152.97 ± 19.46) and the lowest standing long jump scores of adolescents in Shigatse region (166.39 ± 35.04). The highest level of sit and reach was found among boys (10.69 ± 5.34) in Nyingchi and the lowest level of sit and reach was found among girls (8.42 ± 5.84) in Shigatse. Shigatse region adolescents had the lowest performance in 50 m dash (9.09 ± 1.72) while the best performance in 1000 m run (266.23 ± 35.82) and 800 m run (245.40 ± 27.92). There is variability in the physical fitness of Tibetan adolescents in different high-altitude regions of Tibet, China. Targeted physical fitness interventions should be carried out for Tibetan adolescents in different high-altitude regions. The focus should be on improving the endurance quality of Tibetan adolescents in Lhasa and the lower limb muscle strength, flexibility, and speed quality of adolescents in Shigatse.

Association between muscle strength and executive function in Tibetan adolescents at high altitude in China: Results from a cross-sectional study at 16-18 years of age.

In recent years, adolescents have shown a trend of decreasing muscle strength, especially in the upper limbs, and it affects the development of executive functions. However, few studies have been conducted on Tibetan adolescents in high-altitude regions of China. To this end, this study investigated upper limb muscle strength and executive function in Tibetan adolescents in Tibetan regions of China and analyzed the association between them. A three-stage stratified whole-group sampling method was used to test and investigate grip strength, executive function, and basic information in 1093 Tibetan adolescents from Tibet, a high-altitude region of China. A chi-square test and one-way ANOVA were used to compare the basic status and executive function of Tibetan adolescents with different muscle strength. Multiple linear regression analysis and logistic regression analysis were used to analyze the correlations that existed between muscle strength and each sub-function of executive function. The differences between the inconsistently and congruent reaction times of Tibetan adolescents with different grip strength levels (<P25 , P25-75 , >P75 ) at high altitude in China were statistically significant (F-values of 32.596 and 31.580, respectively; P-values <.001). The differences between the 1-back and 2-back response times for the refresh memory function were also statistically significant (F-values of 9.055 and 6.610, respectively; P-values <.01). Linear regression analysis showed that after adjusting for the relevant covariates, the 1-back reaction time of Tibetan adolescents in the grip strength < P25 group increased by 91.72 ms (P < .01); the 2-back reaction time of Tibetan adolescents in the grip strength < P25 group increased by 105.25 ms (P < 0.01), using grip strength > P75 as the reference group. Logistic regression analysis showed that, after adjusting for relevant covariates, Tibetan adolescents in the grip strength < P25 group had a higher risk of developing 2-back dysfunction (OR = 1.89, 95% CI: 1.24,2.88), using grip strength >P75 as the reference group (P < .01). The risk of cognitive flexibility dysfunction (OR = 1.86, 95% CI: 1.16, 2.98) was also increased (P < .05). There was a significant correlation between grip strength and executive function of refresh memory function and cognitive flexibility in Tibetan adolescents in high altitude areas of China. Those with higher upper limb muscle strength had shorter reaction time, that is, better executive function. In the future, we should focus on improving the upper limb muscle strength of Tibetan adolescents at high altitude in China to better promote the development of executive function.

Take you to know the Tibetan adolescents: Their main social relationships and the effect on the prosocial behavior

Tibetan adolescents in the Tibet Autonomous Region are gradually becoming the mainstay of the development and construction of the Tibet Autonomous Region and the construction of a harmonious society, and it is necessary to explore the positive attitudes and behaviors of this group. For this reason, this study collected 544 valid teacher-student paired questionnaires through the questionnaire survey method, and based on social support theory, explored the influence of the main social relationships (parent–child, teacher–student, and peer relationships) of Tibetan adolescents on their prosocial behaviors as well as the mechanism underlying this influence. The results showed that (1) the main social relationships of Tibetan adolescents were unique; (2) the parent–child, teacher–student, and peer relationships of Tibetan adolescents had significant positive effects on their prosocial behaviors and the teacher-student relationship had the greatest effect; (3) social support mediated the relationship between parent–child, teacher–student, and peer relationships of Tibetan adolescents, on the one hand, and their prosocial behaviors on the other; and (4) the psychological resilience of Tibetan adolescents positively moderated the relationship between their parent–child, teacher–student, and peer relationships and social support, while psychological resilience had a positive moderating effect on the mediating effect. This study conducts empirical research based on detailed data on Tibetan adolescents to provide scientific guidance for stimulating positive behaviors in this group. Moreover, based on the social support theory, it helps to understand the mechanisms of the main social relationships of Tibetan adolescents on their prosocial behaviors.

Associations between waist circumference and executive function among Chinese Tibetan adolescents living at high altitude.

Associations between body composition and execution function (EF) were currently studied in low altitude (LA) areas. However, the research on the correlation between waist circumference (WC) and EF among adolescents living at high altitude (HA) was limited. We sought to explore the association between WC and EF in Chinese Tibetan adolescents aged 13-18 years in HA areas. After excluding invalid data and extreme values, 1,228 participants (583 boys and 645 girls) were eventually included. The areas of Lhasa (average elevation of 3650 m), Nagqu (4500 m), Qamdo (3500 m), and Nyingchi (3100 m) in China were chosen as study sites. Participants completed tasks to measure inhibitory control, working memory, and cognitive flexibility. The predictive association between WC and EF was explored by One-way ANOVA, Pearson correlation, and linear regression analysis. After controlling for concomitant variables, the reaction time (RT) of responding to inhibitory control (difference incongruent and congruent), working memory (1-back, 2-back), and cognitive flexibility (heterogeneous, difference in heterogeneous and homogeneous) stimuli in subjects with WC ≥ 85th percentile was longer than that in those with WC of the 15th percentile or below [by 1.785 ms (95% CI: 0.078, 3.491), 208.734 ms (95% CI: 96.886, 320.582), 106.679 ms (95% CI: 16.485, 196.873), 82.307 ms (95% CI: 19.171, 145.442), and 58.397 ms (95% CI: 0.343,116.452), respectively], (P < 0.05). After adjustment for concomitant variables, WC was significantly positively associated with the RT of inhibitory control, working memory, and cognitive flexibility among Chinese Tibetan adolescents in HA areas.

Regional variation in growth status: A cross-sectional survey among Tibetan adolescents living at three different high altitudes in Tibet, China.

To explore the regional and age variation in growth status and age-by-site interaction effect on the growth status among Chinese Tibetan adolescents at different altitudes in Tibet, China. The research was conducted in three regions of Tibet, China: Nyingchi (average altitude 3100 m), Lhasa (average altitude 3650 m), and Nagqu (average altitude 4500 m). A total of 3817 Chinese Tibetan adolescents aged 12-18 years were tested for height, weight, chest circumference, and waist circumference. One-way ANOVA was used to compare the growth status of Chinese Tibetan adolescents. Two-way ANOVA was used to explore the age-by-site interaction effect on the growth status of Chinese Tibetan adolescents. The height, weight, and chest circumference of Chinese Tibetan adolescents in Nagqu are the lowest among the three cities. Age and site have an interaction effect influence on the growth status of Chinese Tibetan adolescents (p < .01). The growth indicators (height, weight, chest circumference, WC) of Chinese Tibetan adolescents differed with altitudes. Policies to improve the growth status of Chinese Tibetan adolescents in Nagqu are urgently needed.

The predictive equations of resting metabolic rate for Tibetan adolescents aged 13-18 in Tibet, China.

The resting metabolic rate (RMR) predictive equations suitable for Tibetan adolescents in Tibet, China, were developed to provide a reference for their reasonable energy intake. We measured RMR by indirect calorimetry and body composition by bioelectrical impedance analysis in 325 Tibetan adolescents aged 13-18 years in Tibet, China. Stepwise regression analysis was used to develop the predictive equations. Pearson correlation analysis, paired sample t test, bias rate, concordance correlation coefficient (CCC) and Bland-Altman were used to verify the validity of the predictive equations. The R2 of Model 8 (0.642) was larger than Model 2 (boys, 0.642; girls, 0.533) and Model 7 (0.540), and Model 10 (0.534) was larger than Model 4 (boys, 0.531; girls, 0.443) and Model 9 (0.477).Compared with the existing predictive equations, the correlation (0.68-0.84) between the predicted values and the measured values, CCC (0.74-0.81) and consistency (Similar proportions within the upper and lower limits but lower differences) were higher and the bias rate (-1.0%to -2.5%) and root mean square error (207.4-263.7kcal/day) were lower in this study. By comprehensive comparison, Model 8 and Model 10 were more valid. The existing predictive equations cannot accurately predict the RMR of Tibetan adolescents in Tibet, China. In this study, the age segmentation predictive equations with age, sex, and fat free mass (FFM) as independent variables were more valid. The predictive equations were as follows: RMR (kcal/day)=50.1 × FFM (kg)-202.8 × Sex (F: 0; M: 1)-72.1 × Age + 930.3, 13-15 years; RMR (kcal/day)=58.4 × FFM (kg)-441.1 × Sex (F: 0; M: 1)-702.2, 16-18 years.

Comparison of Cardiorespiratory Fitness of Chinese Tibetan Adolescents with Their Han Counterparts: A Cross-Sectional Retrospective Study.

Cardiorespiratory fitness (CRF) is a core element of healthy physical fitness. Foreign attention to CRF in adolescents at different altitudes is high, while less research has been conducted on Chinese adolescents. In order to compare the CRF of Chinese Tibetan adolescents with their Han counterparts born and raised at high altitude and Chinese Han adolescents at sea level. A total of 2748 participants, including Chinese Tibetan adolescents, Chinese Han adolescents born and raised at high altitudes, and Chinese Han adolescents at sea level aged 12-18 years old, were obtained using convenience sampling and random cluster sampling. The method of the 20 m shuttle run test (20 m SRT) test was used to derive VO2max by equation. One-way ANOVA and LSD methods were conducted, and effect sizes were calculated to compare the CRF of the three types of adolescents. Regression analysis was used to analyze the relationship between altitude and VO2max. The VO2max scores of Chinese Tibetan adolescents and Chinese Han adolescents at sea level were higher than Chinese Han adolescents born and raised at high altitudes. For both boys and girls, the VO2max scores of Chinese Tibetan adolescents exceeded Chinese Han adolescents at sea level after the age of 16 years old. Regression analysis showed that altitude was inversely associated with VO2max. The pace of lung growth may distinguish Chinese Tibetan adolescents from Chinese Han adolescents born and raised at high altitudes. The results of the study suggest that we should focus on the changes in CRF in adolescents at different altitudes and should adopt different CRF interventions for adolescents at different altitudes.

Association Between Sugar-Sweetened Beverage Consumption and Executive Function Among Chinese Tibetan Adolescents at High Altitude.

ObjectiveTo estimate the association between sugar-sweetened beverage (SSB) consumption and executive function (EF) among Chinese Tibetan adolescents.MethodUsing three stages by stratified cluster sampling, 1,427 Chinese Tibetan adolescents were recruited from Tibet, China. SSB consumption status was obtained by questionnaires and the three core EFs (inhibition, working memory, and cognitive flexibility) were tested by a modified Eriksen flanker task, N-back shift, and a more-odd shifting task. One-way ANOVA or Chi-square test was used to compare SSB consumption in different categories. Taking the SSB consumption 0 time/week group as the reference, general linear regression (for continuous variable) or Logical regression (classified variable) in three Models was conducted to analyze the relationship between SSB consumption and EF for Chinese Tibetan children and adolescents.ResultAfter adjustment of all the covariant in Model 2, all the EF indexes were higher in Chinese Tibetan adolescents with SSB consumption ≥2 times/week than that with SSB consumption of 0 times/week by 21.33 ms (95%CI: 6.72, 35.93), 8.21 ms (95%CI: 7.06, 9.35), 90.46 ms (95%CI: 28.69, 152.23), 147.61 ms (95%CI: 81.42, 213.80), 116.18 ms (95%CI: 74.48, 157.87), 112.41 ms (95%CI: 71.30, 153.52) for incongruent RT, RT difference in incongruent and congruent, 1-back RT, 2-back RT, Heterogeneous RT, RT difference in Heterogeneous and Homogeneous respectively.ConclusionsThe results suggested that SSB consumption was associated with poorer EF in Chinese Tibetan adolescents. SSB consumption should be controlled for healthy brain development of Chinese Tibetan adolescents.

Changes of Cognitive Ability and Circulatory Physiological Parameters Among Adolescents Moving From Altitudes of 3600 m to 500 m in China: A 50-Day Follow up Study

Background: Travelling across altitude is increasing these days. The effects of travelling from high to low altitude on cognitive and physiological parameters of native highlander adolescents is not clear. The present study aimed to measure the changes of cognitive ability and circulatory physiological parameters when Tibetan adolescents move from high to low altitude, and to test the association between cognitive function change and changes in circulatory parameters.Method: General fluid intelligence, oxygen saturation, hemoglobin concentration, heart rate and blood pressure of 71 Tibetan adolescents were measured twice, initially at Lhasa city (altitude 3600 m) and again 50 days after arriving at Chengdu (altitude 500 m).Results: The mean intelligence scores remained unchanged when students moved from high to low altitude. However, the mean hemoglobin concentration, diastolic blood pressure and heart rate decreased while mean oxygen saturation and systolic blood pressure increased. No associations between change of intelligence and changes of circulatory physiological parameters were detected.Conclusions: Travelling from high to low altitude altered the mean value of circulatory physiological parameters but not cognition of Tibetan adolescents. Change of cognitive function was not associated with changes in physiological parameters.

Factors related to the resilience of Tibetan adolescent survivors ten years after the Yushu earthquake

Resilience is crucial for adolescent survivors' recovery from natural disasters. The holistic empirical studies on multiple influencing factors of resilience among adolescent survivors after natural disasters are rarely reported, especially for those from culturally diverse groups. This study aimed to examine the resilience level and its influencing factors among Tibetan adolescent survivors ten years after the 2010 Yushu earthquake. Tibetan adolescent survivors were recruited from four Yushu middle schools from April to July 2020. They filled in the questionnaires about resilience, academic achievement attribution, academic procrastination, self-esteem, coping style, interpersonal competence, and earthquake preparedness. Independent t-test, one-way analysis of variance, Pearson correlation, and hierarchical regression analysis were used to analyze the data. A total of 559 questionnaires were included for analysis. Adolescents’ resilience was positively predicted by grade (senior two), gender (male), academic performance, effort attribution of academic achievement, self-esteem, problem-focused coping, interpersonal competence, and earthquake preparedness, while negatively predicted by academic procrastination. The investigated factors had an explanatory power of 34.6 %. The resilience of Tibetan adolescents is at the middle level, which is involved with Tibetan culture and psychosocial factors. To design a resilience intervention for this population, trainings on learning competence, self-esteem, coping, interpersonal competence, and earthquake preparedness may be beneficial.

Developing a resilience intervention approach for adolescents living with natural hazards risks: A pilot randomized controlled trial

Increasing natural disasters have caused immediate and chronic psychosocial problems on adolescent survivors. Resilience-related skills are crucial for adolescents' recovery from and prevention against negative consequences, but relevant interventions are limited, especially for Tibetan adolescents. This study aimed to develop, implement, and preliminarily evaluate a culturally-attuned resilience intervention for Tibetan adolescent survivors living with natural hazards risks in China. The intervention was developed based on the 7Cs model of resilience (competence, confidence, connection, character, contribution, coping, and control), and Tibetan adolescents' resilience characteristics by interviewing adolescents, their teachers and experts. A pilot randomized controlled trial was conducted at three Yushu senior middle schools among Tibetan adolescent survivors at nine years after the 2010 Yushu earthquake in 2019. The intervention group attended nine 90-min sessions on learning competence, self-confidence, coping, interpersonal competence, and earthquake preparedness, and provided feedback after intervention. Both groups completed questionnaires about resilience, mental health, learning competence, self-esteem, coping, and interpersonal competence before and after the project. Compared with the control group (n = 28), the intervention group (n = 28) showed significant improvement in mental health, learning competence, coping, and interpersonal competence, but no significant difference in resilience and self-esteem was found. Most adolescents had a good impression (58.3%–100%) and high or moderate participation (91.7%–100%) of each intervention session. The intervention is feasible and acceptable, and shows preliminary effect in improving Tibetan adolescents’ psychosocial well-being. Future research can tailor this resilience intervention to other developmental stages of adolescent survivors in other contexts with a large sample to benefit wider populations.

Prevalence of thinness, overweight and obesity among Tibetan adolescents aged 12-17 years.

To estimate the prevalence of thinness, overweight and obesity among Tibetan adolescents aged 12-17 years. Cross-sectional survey. Shigatse City of Tibet municipality, with an average altitude of more than 4000 m. Study participants included 2642 adolescents aged 12-17 years selected from six schools using a convenient cluster sampling method. The prevalence of thinness/overweight/obesity among Tibetan adolescents was 9·4 %/5·4 %/1·4 % (China definition), 14·7 %/4·4 %/0·7 % (International Obesity Task Force (IOTF) definition), and 2·8 %/5·7 %/0·9 % (WHO definition). The prevalence of thinness and overweight was significantly different between both sexes based on each of three BMI classification criteria (P < 0·001). There was no significant difference in the prevalence of obesity between both sexes according to each of three BMI criteria. There was no clear trend in the prevalence of thinness across ages according to the China or IOTF definition (both P > 0·05), whereas an upward trend was observed for thinness in boys according to the IOTF definition (Pfor trend <0·05). In contrast, the prevalence of thinness tended to decrease with increasing age in girls according to the IOTF definition and in total sample according to the WHO definition (Pfor trend <0·05). Among Tibetan adolescents, the prevalence of overweight and obesity is relatively low, while the prevalence of thinness is high, especially in boys. These data suggest urgent attention is needed to control adolescent thinness in Tibet.

Effect of blood pressure measurement on detection of elevated blood pressure in Tibetan adolescents

Objective: To analyze the influence of different number of blood pressure measurement on the detection of elevated blood pressure in Tibetan adolescents and provide scientific reference for standardizing the number of blood pressure measurement and accurately diagnosing elevated blood pressure in adolescents. Methods: Data were from the project "survey of the risk factors for elevated blood pressure among Tibetan adolescents" conducted from August to September 2018 in Shigatse in Tibet. A total of 2 822 Tibetan adolescents aged 12-17 years, including 1 275 boys (45.2%), were recruited by a convenient, stratified cluster sampling method. Each participant underwent three consecutive blood pressure measurements. Elevated blood pressure was defined according to the Health Industry Criterion of China: WS/T 610-2018 "Reference of screening for elevated blood pressure among children and adolescents aged 7-18 years" . Analysis of variance and χ(2) test were used to analyze the effect of different blood pressure measurement on blood pressure levels and detection of elevated blood pressure, respectively. Results: SBP and DBP decreased substantially across three consecutive blood pressure measurements[SBP: (112.7±9.7), (110.7±9.7) and (110.2±9.5) mmHg (1 mmHg=0.133 kPa); DBP: (62.7±8.2), (61.1±8.5) and (60.6±8.5) mmHg; P value for trend<0.001]. The detection rates of elevated blood pressure based on three blood pressure measurements were 12.8%, 8.7% and 7.9%, respectively (P value for trend <0.001). Of note, the difference in the detection of elevated blood pressure based on the second blood pressure measurement or based on the average value of the second and third blood pressure measurements showed no significance (8.7% and 7.2%, P=0.039). Conclusions: Blood pressure levels and the detection of elevated blood pressure in adolescents decreased substantially across three consecutive blood pressure measurements. The second blood pressure measurement might be sufficient for screening elevated blood pressure in adolescents.

Factors associated with the resilience of Tibetan adolescent survivors five years after the 2010 Yushu earthquake.

Resilience contributes to the recovery of disaster victims. The resilience of Tibetan adolescents after the Yushu earthquake has not been properly studied. This study aimed to examine the current resilience and associated factors in Tibetan adolescent survivors in the hardest-hit area 5 years after the Yushu earthquake. This cross-sectional survey was conducted in the area hit the hardest by the Yushu earthquake. Data were collected from 4681 respondents in October and November 2015. Measurements included the participant characteristics, traumatic earthquake experience, the Connor-Davidson resilience scale (CD-RISC), and the social support appraisals (SS-A) scale. The individual datasets were randomized as 80% for the training set and 20% for the validation set. The mean resilience score of the Tibetan adolescent survivors was 55.0±12.3. Thirteen variables were entered into the regression equation. The three dimensions of social support (from family, from friends, from others than family/friends) were positively associated with resilience (all P<0.05), among which support from others than family/friends was the strongest (r = 0.388, P<0.001). Academic performance, activeness of participation in school activities, harmonious relationship with teachers/classmates, health over the last year, and regular physical exercise were positively associated with resilience (all P<0.05). Being female and being extremely worried about their own lives were negatively associated with resilience (both P<0.05). In conclusion, among Tibetan adolescent survivors to the Yushu earthquake of 2010, support from others than family/friends was the strongest positive factor associated with resilience, while being female and extreme worry about their own lives were negative factors. These results expand our knowledge regarding resilience in Tibetan adolescent disaster survivors.

Impact of life skills training on psychosocial well-being of Tibetan refugee adolescents

Purpose The purpose of this paper is to investigate the effectiveness of life skills training (LST) to promote psychosocial well-being of Tibetan refugee adolescents in India. Design/methodology/approach A total of 300 students having low coping strategies, self-confidence and emotional intelligence (EI) participated in the study. They were randomly assigned to experimental (n=150) and control group (n=150). LST consisting of ten core skills was implemented on the experimental group. Findings ANCOVA and regression analysis revealed that LST was effective in enhancing coping strategies, self-confidence and EI among Tibetan refugee adolescents. Research limitations/implications This study was quantitative in its statistical design and approach. Further research combined with qualitative tools must be explored to gain deeper insight into the personal journey of these young refugees and to corroborate the impact of LST on their psychosocial well-being. Practical implications Results from this study will help to integrate LST into regular school curriculum, thereby ensuring its implementation on a daily basis. Originality/value Previous studies on Tibetan refugees have focused on physical and mental hardships experienced by them. There is limited research on strategies adopted to address the needs of these young refugees after migration. This is the first school-based intervention study that tailored the WHO recommended ten core skills to suit the social and cultural contexts of these young refugees and equip them with psychosocial skills to increase their capacity to cope with the complexity of migration.

Post-Traumatic Stress and School Adaptation in Adolescent Survivors Five Years after the 2010 Yushu Earthquake in China.

(1) Background: The devastating Ms 7.1 earthquake struck Yushu city, China, in 2010, leading to serious consequences and damage in the central Tibetan Plateau. This study aimed to assess school adaptation and post-traumatic stress disorder (PTSD) symptoms of adolescent survivors five years after the Yushu earthquake. (2) Methods: A large-scale, school-based mental health survey was conducted 5 years after the earthquake among Tibetan students in the city of Yushu using the Adolescent’s School Adaptation Scale (ASAS) and the PTSD Checklist. (3) Results: A total of 1976 questionnaires were collected. A total of 30.7% of Tibetan adolescents had poor school adaptation and 19.5% were estimated as having probable PTSD. Logistic regression showed that females (OR = 0.73, 95% CI: 0.60–0.89), senior students (OR = 0.48, 95% CI: 0.39–0.59), and those who participated in post-disaster reconstruction (OR = 0.68, 95% CI: 0.54–0.85) were less likely to have poor school adaptation, while a positive association was observed among those buried under a collapsed building (OR = 1.47, 95% CI: 1.04–2.09) and those who experienced bereavement (OR = 1.77, 95% CI: 1.27–2.45). Students who had experienced bereavement were also more likely to have PTSD (OR = 1.60, 95% CI: 1.12–2.28). (4) Conclusions: The post-traumatic effects of the Yushu earthquake on Tibetan adolescents were severe and long-lasting. Sustainable long-term mental health services to help adolescents to restructure their mental health are necessary.

Empathy and Psychosocial Adjustment in Tibetan and Han Adolescents: A Person-Centered Approach.

Although prior research has shown potential academic difficulties for Tibetan adolescents when coping with the mainstream Han culture, little is known about their psychosocial adjustment. Adopting a person-centered approach, the current study explores psychosocial adjustment profiles based on internalizing indicators (i.e., depression, loneliness, life satisfaction, positive affect, and negative affect) and externalizing indicators (i.e., prosocial behavior and antisocial behavior). Moreover, guided by the empathy theory, this study also examines the direct and interactive effects of empathy (affective and cognitive empathy) and ethnicity (Tibetan vs. Han adolescents) on psychosocial adjustment profiles. A total of 306 Tibetan adolescents (66.3% girls) and 321 Han adolescents (55.1% girls) were involved in this study, and participants were asked to fill in a set of self-report questionnaires. A latent profile analysis revealed five psychosocial adjustment profiles: adaptive, maladaptive, externalizing, internalizing, and moderate. Furthermore, a multiple multinomial analysis showed Han adolescents were more likely than Tibetan adolescents to be a member of adaptive and moderate profiles than of the externalizing profile. Individuals with low affective empathy and high cognitive empathy were prone to be adequate in terms of psychosocial functioning, and the effects of low affective empathy and high cognitive empathy on psychosocial functioning were highlighted in Han adolescents only.