Special Issue "Recent Advances of Adolescents and Children Health Research"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (15 September 2019).

Special Issue Editor

Prof. Dr. Jitse P. van Dijk
Website SciProfiles
Guest Editor
Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Ant. Deusinglaan 1, 9713 AV Groningen, The Netherlands
Interests: adolescents and health; chronic disease; ethnicity and health
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Special Issue Information

Dear Colleagues,

The International Journal of Environmental Research and Public Health (IJERPH) welcomes submissions for a Special Issue focusing on “Recent Advances of Adolescents and Children Health”.

IJERPH is a peer-reviewed scientific journal with a current impact factor (2016) of 2.101 (5-year impact factor of 2.54) that publishes research articles and communications in the interdisciplinary area of environmental health sciences and public health. More details about the journal can be found at https://www.mdpi.com/journal/ijerph.

The Special Issue on “Recent Advances of Adolescents and Children Health” is meant to show the recent trends in studying the health of adolescents and children. Such an overview is also necessary to nuance statements such as the following: “most children in the WHO European Region have a happy, healthy childhood and adolescence where they grow and develop into prosperous adults”. In this period of the life-course identity is formulated, experimentations are made, and independence is developed. Furthermore, the inequality issue is relevant for children and adolescents. Inequality between and within all WHO’s Member States, unequal access to quality services, maltreatment and unhealthy lifestyles, are negatively affecting health among the most vulnerable groups in our societies—children and adolescents.

We are interested in topics such as, though not limited to:

  • Factors influencing child and adolescent public health at various levels (individual, family, peers, society, etc.)
  • Physical health, as well as mental health
  • Quality of life, social participation
  • Innovative interventions in the broad field of care and prevention
  • The role of key stakeholders (e.g., children themselves, peers, parents, teachers)
  • Various settings (e.g., home, school, neighborhood, care, communities)
  • Organizational and/or policy changes

Researchers are invited to contribute novel work to be considered for publication in this Special Issue. Submissions should include original articles, critical reviews (systematic reviews or meta-analyses), or brief reports. Articles that focus on the above-mentioned key aspects, or that can be brought into a relationship with them, are welcomed. Additionally, articles that focus on underrepresented or disadvantaged communities are encouraged.

Assoc. Prof. Dr. Jitse van Dijk
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Physical and mental health
  • Youth
  • Care
  • Environment
  • Social factors
  • Interventions
  • Health promotion
  • Parental influence
  • School’s or Teacher’s influence
  • Health disparities
  • Policy

Published Papers (47 papers)

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Open AccessArticle
Spirituality, Religious Attendance and Health Complaints in Czech Adolescents
Int. J. Environ. Res. Public Health 2020, 17(7), 2339; https://doi.org/10.3390/ijerph17072339 - 30 Mar 2020
Abstract
Research in some religious countries shows that religiosity and spirituality positively affect adolescent health. We studied whether religiosity and spirituality also have positive associations with adolescent health in a secular country. We tested the associations between religious attendance and spirituality and self-reported health [...] Read more.
Research in some religious countries shows that religiosity and spirituality positively affect adolescent health. We studied whether religiosity and spirituality also have positive associations with adolescent health in a secular country. We tested the associations between religious attendance and spirituality and self-reported health and health complaints using a representative sample of Czech adolescents (n = 4182, 14.4 ± 1.1 years, 48.6% boys) from the 2014 health behavior in school-aged children (HBSC) study. We used religious attendance, the adjusted shortened version of the spiritual well-being scale (SWBS), and its two components—religious well-being (RWB) and existential well-being (EWB)—as independent variables and the eight item “HBSC symptom checklist” and self-reported overall health as dependent variables. A higher level of spirituality was associated with lower chances of health complaints and self-reported health, ranging from a 9% to 30% decrease in odd ratios (OR). Religious attendance was not associated with any of the observed variables. The EWB showed a negative association with all of the observed variables, with associations ranging from a 19% to 47% decrease. The RWB was associated with a higher risk of nervousness (OR = 1.12), while other associations were not significant. Non-spiritual but attending respondents were more likely to report a higher occurrence of stomachache (OR = 2.20) and had significantly worse overall health (OR = 2.38). In a largely secular country, we found that spirituality and the EWB (unlike religious attendance and the RWB) could have a significant influence on adolescent health. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Informing Behaviour Change: What Sedentary Behaviours Do Families Perform at Home and How Can They Be Targeted?
Int. J. Environ. Res. Public Health 2019, 16(22), 4565; https://doi.org/10.3390/ijerph16224565 - 18 Nov 2019
Cited by 1
Abstract
Home-based interventions targeting children’s sedentary behaviours have had limited and inconsistent effectiveness, possibly due to a mismatch between the behaviours targeted, the behaviours actually performed, and health-risk messages parents need to initiate change. Between October 2017–February 2018, 540 parents completed an online survey [...] Read more.
Home-based interventions targeting children’s sedentary behaviours have had limited and inconsistent effectiveness, possibly due to a mismatch between the behaviours targeted, the behaviours actually performed, and health-risk messages parents need to initiate change. Between October 2017–February 2018, 540 parents completed an online survey indicating their own and their child’s participation in 15 home-based sedentary behaviours (child mean age 11.1 ± 2.61 years, 52% male; parent mean age 40.7 ± 6.14, 93% female). Parents also indicated which home-based sedentary behaviours they and their child could reduce, and what health-risk messages would make them change their child’s behaviours. The most prevalent sedentary behaviours among children (particularly older children) and parents were screen-based leisure-time activities, specifically TV/video/DVD use (67.5 and 62.5 min/day, respectively) and using a tablet/smart phone for leisure (53.6 and 80.8 min/day, respectively). Importantly, these were also perceived as the most feasible behaviours parents and children could reduce. Parents reported that the following messages would help them reduce their child’s sedentary behaviour: sitting may increase the risk of poor mental health (85.2% of parents) and adversely impact future health as an adult (85.1%). These findings highlight feasible behavioural targets and intervention content for programs aiming to reduce sedentary behaviours in the home environment. Further research is needed to test these strategies. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Does Life Satisfaction Mediate the Association between Socioeconomic Status and Excessive Internet Use?
Int. J. Environ. Res. Public Health 2019, 16(20), 3914; https://doi.org/10.3390/ijerph16203914 - 15 Oct 2019
Cited by 3
Abstract
Excessive Internet use is becoming a rapidly increasing problem in today’s society. Our aim was to assess the association between socioeconomic status (SES) of the family and excessive Internet use (EIU), and whether life satisfaction mediates this association. We analyzed data from a [...] Read more.
Excessive Internet use is becoming a rapidly increasing problem in today’s society. Our aim was to assess the association between socioeconomic status (SES) of the family and excessive Internet use (EIU), and whether life satisfaction mediates this association. We analyzed data from a representative sample of 2844 Slovak adolescents (mean age 14.34, 50.5% boys) from the 2014 Health Behavior in School aged Children (HBSC) study, based on self-report questionnaires. We assessed the association of SES, measured by several indicators, such as perceived family wealth, parental education, and (un)employment, and adolescent EIU using linear regression, adding life satisfaction as a mediator. Adolescents whose father was unemployed and whose perceived family wealth was low tended to score higher on EIU. Neither gender nor age affected this relationship. Life satisfaction mediated a part of the association between SES and EIU in the case of low perceived family wealth and father’s (un)employment. Adolescents with a low SES are more likely to become excessive Internet users, and life satisfaction mediates this association. Prevention of EIU among adolescents should be targeted at those with low SES, with life satisfaction being the topic to address. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Executive Function and Attention Performance in Children with ADHD: Effects of Medication and Comparison with Typically Developing Children
Int. J. Environ. Res. Public Health 2019, 16(20), 3822; https://doi.org/10.3390/ijerph16203822 - 10 Oct 2019
Cited by 1
Abstract
The emerging literature reports that children with Attention-Deficit/Hyperactivity Disorder (ADHD) show deficits in executive functioning. To date, the combination of drug therapy with certain evidence-based non-medication interventions has been proven to be the most effective treatment for ADHD. There is a gap in [...] Read more.
The emerging literature reports that children with Attention-Deficit/Hyperactivity Disorder (ADHD) show deficits in executive functioning. To date, the combination of drug therapy with certain evidence-based non-medication interventions has been proven to be the most effective treatment for ADHD. There is a gap in the literature regarding comparing the executive functions (EF) of treatment naïve and medicated children with ADHD with both each other and typically developing children. Altogether, 50 treatment naïve and 50 medicated children with ADHD and 50 typically developing children between the ages of six and 12 were enrolled. The Mini International Neuropsychiatric Interview for Children and Adolescents (Mini Kid) and the Test of Attentional Performance for Children (KiTAP) measures were employed. Treatment naïve children with ADHD showed weaker performance on most executive function measures (12 out of 15) than either the medicated ADHD group or the controls. There were no significant differences between the medicated ADHD children and typically developing children in most KiTAP parameters (10 out of 15). Executive function impairments were observable in treatment naïve ADHD children, which draws attention to the importance of treating ADHD. Future studies should focus on the specific effects of stimulant medication on executive functions. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
The Angle of Trunk Rotation in School Children: A Study from an Idiopathic Scoliosis Screening. Prevalence and Optimal Age Screening Value
Int. J. Environ. Res. Public Health 2019, 16(18), 3426; https://doi.org/10.3390/ijerph16183426 - 16 Sep 2019
Cited by 2
Abstract
(1) Background: Idiopathic scoliosis is a deformity of the growing spine. It affects 2–3% of adolescents; yet its cause is still unknown. At the early stage of idiopathic scoliosis (IS), the signs are not very noticeable. That is why the primarily school-based screening [...] Read more.
(1) Background: Idiopathic scoliosis is a deformity of the growing spine. It affects 2–3% of adolescents; yet its cause is still unknown. At the early stage of idiopathic scoliosis (IS), the signs are not very noticeable. That is why the primarily school-based screening for scoliosis is so important. (2) Methods: This was a cross-sectional analysis of 6850 respondents. Participants were elementary school students in the metropolitan area of Poland. The suspicion of IS was based on detection of three-dimensional deformity of the spine using scoliometer. (3) Results: Respondents were divided into two groups: Angle of trunk rotation (ATR) = 0–3º and ATR > 3º. Presented research using a referral criterion of 5º ATR showed that in the group of participants who had ATR > 3º the largest percentage of 5 degree values was recorded at the second and third measurement level of the spine (30.5%, 31.1%, respectively). Analyzing the differences between the two groups of girls (ATR = 0–3º, ATR > 3º), statistically significant differences were recorded between 9 and 11 years of age (p = 0.0388). Girls with ATR > 3º at all measuring levels are significantly slimmer than girls with ATR 0–3º; (4) Conclusions: Age; sex, and risk of developing angle of trunk rotation are very closely associated. The main thoracic (level 2) and thoraco-lumbar (level 3) level of measuring of the spine appears to be the most differentiating in the diagnosis of scoliosis. Girls with a lower degree of trunk deformity (4–6º trunk rotation), which can present mild scoliosis and those with a higher degree (7º trunk rotation) have lower body mass than girls within the norm. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Body Dissatisfaction in Adolescents: Differences by Sex, BMI and Type and Organisation of Physical Activity
Int. J. Environ. Res. Public Health 2019, 16(17), 3109; https://doi.org/10.3390/ijerph16173109 - 27 Aug 2019
Cited by 3
Abstract
The aim of this study was to assess the differences in body dissatisfaction (BD) of male and female adolescents by body max index (BMI) and the quantity, type and organisation of physical activity (PA). To do so, 652 adolescents aged 12–17 years participated [...] Read more.
The aim of this study was to assess the differences in body dissatisfaction (BD) of male and female adolescents by body max index (BMI) and the quantity, type and organisation of physical activity (PA). To do so, 652 adolescents aged 12–17 years participated in a cross-sectional study. The cognitive-affective component of BD was assessed with the Body Shape Questionnaire (BSQ) and the perceptual component with Gardner’s scale for the assessment of, body image (BI). PA was measured with the International Physical Activity Questionnaire (IPAQ-SF) and the item 1 from the Physical Activity Questionnaire for Adolescents (PAQ-A). The results show that sex and BMI are key variables when determining BD. Moderate-to-vigorous PA (MVPA) was moderately associated with a greater body satisfaction in males but no association was found between BD and the participation and organisation of PA. Moreover, the results suggest that participants in aesthetic/lean PA are at a higher risk of suffering from BD than participants in other PA types. These findings provide useful information for the design of programmes promoting healthy lifestyles, weight control and BI concern during the school period. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Higher Levels of Early Childhood Caries (ECC) Is Associated with Developing Psychomotor Deficiency: The Cross- Sectional Bi-Township Analysis for The New Hypothesis
Int. J. Environ. Res. Public Health 2019, 16(17), 3082; https://doi.org/10.3390/ijerph16173082 - 24 Aug 2019
Abstract
The aim of this study was to reassess and confirm the relationship between early childhood caries (ECC) and manifestations of psychomotor deficiency in 4–6-yr-old kindergarteners, which has remained elusive to date. A cross-sectional study with bi-township analysis was designed whereby 353 kindergarteners, aged [...] Read more.
The aim of this study was to reassess and confirm the relationship between early childhood caries (ECC) and manifestations of psychomotor deficiency in 4–6-yr-old kindergarteners, which has remained elusive to date. A cross-sectional study with bi-township analysis was designed whereby 353 kindergarteners, aged 4–6 whose caries were greater (dmft (decayed, missing and filled teeth, dmft index) = 5.25) than that of the national average, located in a rural township of central Taiwan were recruited using simple random-selection. Besides the personal, demographic, and dietary information, the measurements for caries and the amended comprehensive scales (CCDI) of children’s psychomotor development were used to address their relationship. One-way ANOVA vs. multiple linear regression were employed to compare the differences of variables between age, gender, BMI (Body Mass Index), and dmft scores vs. relationships among all variables, respectively. The results confirmed that there was a positive relationship between severe ECC (dmft > 3~8) and psychomotor deficiency (i.e., expressive language and comprehension-concept scales, etc.) amongst the kindergarteners analyzed. Our cross-sectional bi-township analysis has confirmed that there is indeed an association between severe ECC and psychomotor deficiency in kindergarteners, and we suggest that this may arise through critical stages of growth, not only via personal language communications, but psycho-social engagements as well. Therefore, a new hypothesis is proposed. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Changes in Undergraduate Students’ Psychological Well-Being as They Experience University Life
Int. J. Environ. Res. Public Health 2019, 16(16), 2864; https://doi.org/10.3390/ijerph16162864 - 10 Aug 2019
Cited by 5
Abstract
The onset of most lifetime mental disorders occurs during adolescence, and the years in college, as the final stage of adolescence in a broad sense, deserve attention in this respect. The psychological well-being of undergraduate students can influence not only their academic and [...] Read more.
The onset of most lifetime mental disorders occurs during adolescence, and the years in college, as the final stage of adolescence in a broad sense, deserve attention in this respect. The psychological well-being of undergraduate students can influence not only their academic and professional success, but also the development of society as a whole. Although previous studies suggested psychiatric disorders are common in the adult population, there was little consistent information available about undergraduate students’ mental health problems. This research aimed to describe the changes in depression, anxiety, and stress of Chinese full-time undergraduate students as they experienced university life using the Depression Anxiety Stress Scales-21 (DASS-21). The main conclusions of our study were as follows: (1) on average, students’ severity scores of depression during the four academic years varied between 7.22 and 7.79, while stress scores ranged from 9.53 to 11.68. However, the anxiety scores of college students in the first three years turned out to be 7.40, 7.24 and 7.10, respectively, slightly overtaking the normal threshold of 7. These results indicated that Chinese college students, in general, were mentally healthy with regard to depression and stress, but their average anxiety levels were beyond normal in the first three years. (2) As for the proportions of students with different degrees of severity, approximately 38% to 43% of college students were above the normal level of anxiety, about 35% above the normal level of depression, and around 20% to 30% above the normal level of stress. (3) There were significant differences in the psychological health states of students of different years, especially among the sophomores, juniors, and seniors; the highest score of depression, anxiety, and stress all appeared in the first or second year on average, but some improvements were achieved in the third and last years. The findings suggested that colleges and universities need to pay special attention to psychologically unhealthy students, and with concerted efforts by the government, formulate mental health policies in the prevention, detection, and treatment of students’ psychiatric disorders, rather than just focusing on their average levels of mental health. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Effects of Self-Esteem on the Association between Negative Life Events and Suicidal Ideation in Adolescents
Int. J. Environ. Res. Public Health 2019, 16(16), 2846; https://doi.org/10.3390/ijerph16162846 - 09 Aug 2019
Abstract
Negative life events (NLEs) increase the risk of suicidal ideation (SI) in adolescents. However, it is not known whether the association between NLEs and SI can be moderated by self-esteem and varies with gender. The aim of the current paper was to examine [...] Read more.
Negative life events (NLEs) increase the risk of suicidal ideation (SI) in adolescents. However, it is not known whether the association between NLEs and SI can be moderated by self-esteem and varies with gender. The aim of the current paper was to examine gender differences in the association of SI with NLEs in adolescents, and assess the effects of self-esteem on the association and their gender variations. We conducted a school-based health survey in 15 schools in China between November 2013 and January 2014. A total of 9704 participants aged 11–19 years had sociodemographic data reported and self-esteem (Rosenberg self-esteem scale), NLEs, and SI measured. Multivariate-adjusted logistic regression was used to calculate the odds ratio (OR) of having SI in relation to NLEs. Increased risk of SI was significantly associated with NLEs (adjusted OR 2.19, 95%CI 1.94–2.47), showing no gender differences (in females 2.38, 2.02–2.80, in males 1.96, 1.64–2.36, respectively). The association was stronger in adolescents with high esteem (2.93, 2.34–3.68) than those with low esteem (2.00, 1.65–2.42) (ORs ratio 1.47, p = 0.012). The matched figures in females were 3.66 (2.69–4.99) and 2.08 (1.61–2.70) (1.76, p = 0.006), while in males these figures were 2.27(1.62–3.19) and 1.89 (1.41–2.53) (1.20, p = 0.422), respectively. Self-esteem had moderate effects on the association between NLEs and SI in adolescents, mainly in females. NLEs, self-esteem, and gender need to be incorporated into future intervention programs to prevent SI in adolescents. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Physical Activity as a Regulatory Variable between Adolescents’ Motivational Processes and Satisfaction with Life
Int. J. Environ. Res. Public Health 2019, 16(15), 2765; https://doi.org/10.3390/ijerph16152765 - 02 Aug 2019
Cited by 1
Abstract
Framed within Self-Determination Theory, the objective of this study was to analyze the relationship between satisfaction and frustration of basic psychological needs, levels of motivation, physical activity, and satisfaction with life. Methods: A total of 487 students participated, comprising males (n = [...] Read more.
Framed within Self-Determination Theory, the objective of this study was to analyze the relationship between satisfaction and frustration of basic psychological needs, levels of motivation, physical activity, and satisfaction with life. Methods: A total of 487 students participated, comprising males (n = 262) and females (n = 225), aged between 14 and 16 years (M = 15.02; SD = 0.87), from different secondary schools. Results: A regression analysis was carried out (structural equation modeling) that revealed the existence of two theoretical lines, one positive and the other negative, where the satisfaction of basic psychological needs was positively related to autonomous motivation and physical activity, which predicted satisfaction with life. On the other hand, the frustration of basic psychological needs was positively related to controlled motivation, whereas controlled motivation (introjected regulation and extrinsic regulation) was inversely associated with physical activity and satisfaction with life. Conclusion: The results show the importance of motivational processes in physical activity, and the effects of physical activity on satisfaction with life in adolescents who spend more time engaged in physical activity. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
The Number of Adverse Childhood Experiences Is Associated with Emotional and Behavioral Problems among Adolescents
Int. J. Environ. Res. Public Health 2019, 16(13), 2446; https://doi.org/10.3390/ijerph16132446 - 09 Jul 2019
Abstract
This study aims to examine the association of adverse childhood experiences (ACE) with emotional and behavioral problems (EBP) among adolescents and the degree to which this association is stronger for more ACE. In addition, we assessed whether socioeconomic position (SEP) modifies the association [...] Read more.
This study aims to examine the association of adverse childhood experiences (ACE) with emotional and behavioral problems (EBP) among adolescents and the degree to which this association is stronger for more ACE. In addition, we assessed whether socioeconomic position (SEP) modifies the association of ACE with EBP. We obtained data from 341 adolescents aged 10–16 (mean age = 13.14 years; 44.0% boys), the baseline of a cohort study. We measured EBP with the strengths and difficulties questionnaire and socioeconomic position (SEP) with self-reported financial status. We used generalized linear models to analyze the association between ACE (0 vs. 1–2 vs. 3 and more) and EBP, and the modifying effect of SEP. Adolescents with 1–2 ACE (regression coefficient: 0.19; 95%-confidence interval (CI): 0.06–0.32) and with 3 ACE and over (0.35; 0.17–0.54) reported more overall problems compared with adolescents without ACE. Moreover, adolescents with 1–2 ACE (0.16; −0.01–0.32, and 0.16; 0.03–0.29) and with 3 and over ACE (0.33; 0.10–0.56, and 0.28; 0.09–0.47) reported more emotional problems and behavioral problems, respectively. The interactions of SEP with ACE were not significant. ACE are related to EBP among adolescents, with a clear dose-response association, and this association similarly holds for all SEP categories. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Differences in Cardiorespiratory Fitness between Chinese and Japanese Children and Adolescents
Int. J. Environ. Res. Public Health 2019, 16(13), 2316; https://doi.org/10.3390/ijerph16132316 - 30 Jun 2019
Abstract
Background: This study aimed to compare the difference in cardiorespiratory fitness between Chinese and Japanese children and adolescents. Methods: Participants comprised 9025 children and adolescents aged 7–18 years from China and Japan. Cardiorespiratory fitness (CRF) was measured by performance in the 20 m [...] Read more.
Background: This study aimed to compare the difference in cardiorespiratory fitness between Chinese and Japanese children and adolescents. Methods: Participants comprised 9025 children and adolescents aged 7–18 years from China and Japan. Cardiorespiratory fitness (CRF) was measured by performance in the 20 m shuttle run test (20mSRT) and estimated maximal oxygen consumption (VO2max). Differences in CRF between countries were evaluated by t-tests. Centile curves for the 20mSRT and VO2max values were constructed for Chinese and Japanese children and adolescents, respectively, using the Lambda Mu and Sigma (LMS) method. Results: (1) For most of the age groups, the 20mSRT and VO2max performances among Chinese participants were lower than among Japanese participants. (2) Japanese children had the most apparent gains in P10, P50, and P90 VO2max values in primary school; however, they gradually decreased in middle school. For Chinese girls, the P10, P50, and P90 VO2max values decreased gradually with age. (3) The VO2max value among Japanese children increased; however, it decreased or remained flat among Chinese children in primary school. Conclusions: CRF among Chinese participants was lower than among Japanese participants while the VO2max value showed different trends in primary school. Effective measures should be taken to improve CRF among children and adolescents. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Patent Landscape Analysis of Dental Caries in Primary Teeth
Int. J. Environ. Res. Public Health 2019, 16(12), 2220; https://doi.org/10.3390/ijerph16122220 - 24 Jun 2019
Cited by 1
Abstract
Inventions from the field of health research are mostly protected by patents. The main objective of this study is to identify the research and development trends of dental innovations for children, with a special focus on the inventions for dental caries in primary [...] Read more.
Inventions from the field of health research are mostly protected by patents. The main objective of this study is to identify the research and development trends of dental innovations for children, with a special focus on the inventions for dental caries in primary teeth and early childhood caries (ECC) by performing a patent landscape analysis on a global scale with special attention to the role of European countries in patenting activities. A patent landscape analysis is a tool used to identify trends in different areas of innovations. Patents and patent applications were extracted from Orbit Intelligence. The keyword based search process was refined by manual selection and grouped into prevention, treatment and diagnosis categories. The absolute number and legal status of patent families, priority years, priority countries, and assignees were examined. The total number of patents of dental caries in primary teeth was 61. According to the legal status of the patents, 27% are granted, 19% pending and 54% are dead. The earliest patent is from 1931 and the most recent is from 2018. Regarding the field of inventions, 37 patents were identified as prevention, 16 patents were treatment and 8 were diagnostics related. China holds the most patents. The huge burden of dental caries in primary teeth is poorly represented in global research and development. Additionally, inventions in dental caries of the primary dentition from the European Union lagged far behind China and the US, highlighting our insufficient research initiatives and programs. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Screening of the Maturity Status of the Tibial Tuberosity by Ultrasonography in Higher Elementary School Grade Schoolchildren
Int. J. Environ. Res. Public Health 2019, 16(12), 2138; https://doi.org/10.3390/ijerph16122138 - 17 Jun 2019
Cited by 1
Abstract
This study aimed to obtain screening data on the maturity status of the tibial tuberosity in schoolchildren of higher elementary school grades for risk management of Osgood–Schlatter disease (OSD). The maturity stages and cartilage thicknesses at the tibial tuberosity were determined by ultrasonography [...] Read more.
This study aimed to obtain screening data on the maturity status of the tibial tuberosity in schoolchildren of higher elementary school grades for risk management of Osgood–Schlatter disease (OSD). The maturity stages and cartilage thicknesses at the tibial tuberosity were determined by ultrasonography on the occasion of a school-based musculoskeletal examination for 124 grade 5–6 elementary schoolchildren, and their associations with the students’ demographic characteristics and OSD were examined. The time-dependent changes of the maturity status of the tibial tuberosity were also examined in grade 5 students (n = 26) by a longitudinal survey. The cross-sectional survey showed that the epiphyseal stage was reached in 89% of girls and 35% of boys. The girls who had experienced menarche (n = 28) were all in the epiphyseal stage and had a decreased cartilage thickness (p = 0.004, after adjusting maturity stages). Students with OSD (n = 5) were all girls in the epiphyseal stage, and only two of them had an increased cartilage thickness. During the longitudinal survey, a marked increase in cartilage thickness from the previous measurement was observed in three boys (without clinical symptoms) and a girl who newly developed OSD. Two students with OSD without chronic pain had thin cartilage. In conclusion, for schoolchildren of higher elementary school grades, the risk of OSD is higher among girls with the epiphyseal stage. Cartilage thickness may not contribute to the diagnosis of OSD, since thick cartilage is not very common in OSD. However, cartilage thickness may reflect the status of OSD. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Health-Related Quality of Life in Pediatric Patients with Leukemia in Singapore: A Cross-Sectional Pilot Study
Int. J. Environ. Res. Public Health 2019, 16(12), 2069; https://doi.org/10.3390/ijerph16122069 - 12 Jun 2019
Cited by 4
Abstract
There has been a paradigm shift in health service delivery to a more holistic approach, which considers Quality of Life (QoL) and overall functioning. Health-Related Quality of Life (HRQoL) is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of [...] Read more.
There has been a paradigm shift in health service delivery to a more holistic approach, which considers Quality of Life (QoL) and overall functioning. Health-Related Quality of Life (HRQoL) is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. This study explored factors related to HRQoL in Asian pediatric patients with leukemia in Singapore. The available variables included: age, treatment duration, household income, gender, ethnicity, religion, diagnosis, and phase of treatment. It is hypothesized that the relationships will be significant. In the current study, there were 60 patients (60% males) with leukemia; their ages ranged from 1 to 21 years (Mean = 8.03, Standard Deviation = 4.55). The hypothesis was partially supported. Age had a significant positive relationship with physical functioning, r(60) = 0.28, p < 0.05, physical health, r(60) = 0.28, p < 0.05, and the total HRQoL score, r(60) = 0.29, p < 0.05. Treatment duration had a positive relationship with school functioning, r(60) = 0.28, p < 0.05. All other correlations were statistically non-significant. The effects of the available psychosocial variables of gender, ethnicity, and religion were examined on scores from the Pediatric Quality of Life Inventory (PedsQL). Ethnicity had a significant effect on social functioning, U = 292.00, p < 0.05, r = 0.3 (medium effect size). Specifically, Chinese (Median = 85.00, n = 33) had significantly higher scores on social functioning than others (Median = 70.00, n = 27). The remaining comparisons were statistically non-significant. The current findings added to QoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Singapore. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Media Access is Associated with Knowledge of Optimal Water, Sanitation and Hygiene Practices in Tanzania
Int. J. Environ. Res. Public Health 2019, 16(11), 1963; https://doi.org/10.3390/ijerph16111963 - 03 Jun 2019
Abstract
The importance of water, sanitation and hygiene (WASH) behaviors in low- and middle-income countries in preventing childhood illness is well established. Tanzania is known to have high rates of chronic malnutrition and childhood stunting—both of which have been linked to poor WASH practices. [...] Read more.
The importance of water, sanitation and hygiene (WASH) behaviors in low- and middle-income countries in preventing childhood illness is well established. Tanzania is known to have high rates of chronic malnutrition and childhood stunting—both of which have been linked to poor WASH practices. Interviews were conducted with 5000 primary caregivers of children aged 0–23 months. Four composite WASH knowledge variables were created to assess the relationship between WASH knowledge and access to different forms of media, such as television, radio, and mobile phones. WASH knowledge variables measure knowledge of when to wash hands, the need for soap when washing hands, when to wash a baby’s hands, and how eating soil or chicken feces can affect a baby’s health. Logistic and linear regression analyses were conducted to measure the association between media access and WASH knowledge. Having watched television was positively associated with higher WASH knowledge indicators (all p < 0.05). Higher WASH knowledge was positively associated with more frequent handwashing after cleaning a baby’s bottom (all p < 0.0001). The quantity of media access also had a positive linear effect on handwashing; more media items owned was associated with increases in handwashing. Study findings indicate media access is associated with WASH knowledge among caregivers in resource-poor settings. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Trends in Health-Risk Behaviors among Chinese Adolescents
Int. J. Environ. Res. Public Health 2019, 16(11), 1902; https://doi.org/10.3390/ijerph16111902 - 29 May 2019
Cited by 2
Abstract
Adolescent health-risk behaviors can have long lasting negative effects throughout an individual’s life, and cause a major economic and social burden to society. This study aimed to estimate the prevalence of the health-risk behaviors among Chinese adolescents and to test the trends in [...] Read more.
Adolescent health-risk behaviors can have long lasting negative effects throughout an individual’s life, and cause a major economic and social burden to society. This study aimed to estimate the prevalence of the health-risk behaviors among Chinese adolescents and to test the trends in health-risk behaviors without and with adjusting for sociodemographic characteristics. Data were drawn from the School-based Chinese Adolescents Health Survey, which is an ongoing school-based study about the health-risk behaviors among Chinese adolescents (7th to 12th grade). During the first wave through the third wave, the prevalence of lifetime, past 12-month, and past 30-day use of opioid decreased by 4.19%, 0.63%, and 0.56%, respectively. Moreover, the prevalence of lifetime, past 12-month, and past 30-day sedative use decreased by 3.03%, 0.65%, and 0.35%, respectively. During the three waves, most trends in the prevalence of health-risk behaviors were downward, with a few exceptions: The prevalence of lifetime smoking, drinking, methamphetamine use, and sleep disturbance increased by 7.15%, 13.08%, 0.48%, and 9.06%, respectively. The prevalence of lifetime 3,4-methylene dioxy methamphetamine use (from 0.49% to 0.48%), lifetime mephedrone use (from 0.30% to 0.24%), or suicide attempts (from 2.41% to 2.46%) remained stable. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Crisis in the Family and Positive Youth Development: The Role of Family Functioning
Int. J. Environ. Res. Public Health 2019, 16(10), 1678; https://doi.org/10.3390/ijerph16101678 - 14 May 2019
Cited by 1
Abstract
The family is a very important institution that provides relationships and contexts in which adolescents are included and where the trajectory of positive development can be activated. A family crisis can affect family functioning and endanger adolescent development. Therefore, we aimed to explore [...] Read more.
The family is a very important institution that provides relationships and contexts in which adolescents are included and where the trajectory of positive development can be activated. A family crisis can affect family functioning and endanger adolescent development. Therefore, we aimed to explore the association of crisis in the family with positive youth development (PYD), and further, whether adolescent-perceived family functioning mediates or moderates this relation. The sample consisted of Slovak adolescents (N = 341, 44% boys, mean age = 13.16) who completed questionnaires that included questions on family crisis and joint family activities, the Alabama parenting questionnaire and the Very Short PYD questionnaire in the baseline measurement of the Care4Youth cohort study. We found a positive association of perceived positive parenting (B = 0.51; p < 0.001) and family activities (B = 0.50; p < 0.001) with PYD, whereas crisis in the family (B = −0.42; p = 0.01) and perceived poor supervision (B = −0.30; p < 0.001) were negatively associated with PYD. Using serial mediation model, we found following pathway which connected crisis in the family with PYD: crisis in the family → perceived poor parental supervision → joint family activities → PYD. This implies that family interventions and counselling to support parenting skills, especially parental supervision and family activities, to those with the signs of an ongoing family crisis may help to counteract the negative effect of the family crisis on PYD. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Effectiveness of Structural–Strategic Family Therapy in the Treatment of Adolescents with Mental Health Problems and Their Families
Int. J. Environ. Res. Public Health 2019, 16(7), 1255; https://doi.org/10.3390/ijerph16071255 - 08 Apr 2019
Abstract
Mental health problems during adolescence constitute a major public health concern today for both families and stakeholders. Accordingly, different family-based interventions have emerged as an effective treatment for adolescents with certain disorders. Specifically, there is evidence of the effectiveness of concrete approaches of [...] Read more.
Mental health problems during adolescence constitute a major public health concern today for both families and stakeholders. Accordingly, different family-based interventions have emerged as an effective treatment for adolescents with certain disorders. Specifically, there is evidence of the effectiveness of concrete approaches of systemic family therapy on the symptoms of adolescents and family functioning in general. However, few studies have examined the effectiveness of other relevant approaches, such as structural and strategic family therapy, incorporating parent–child or parental dyadic measurement. The purpose of this study was to test the effectiveness of a structuralstrategic family therapy with adolescents involved in mental health services and their families. For this purpose, 41 parents and adolescents who participated in this treatment were interviewed at pre-test and post-test, providing information on adolescent behavior problems, parental sense of competence, parental practices, parenting alliance, and family functioning. Regardless of participants’ gender, adolescents exhibited fewer internalizing and externalizing problems after the treatment. Parents reported higher family cohesion, higher satisfaction and perceived efficacy as a parent, and healthier parental practices (less authoritarian and permissive practices, as well as more authoritative ones). An interaction effect between parenting alliance and gender was found, with more favorable results for the mothers. In conclusion, this paper provides evidence of the usefulness of structuralstrategic family therapy for improving family, dyadic, and individual facets in families with adolescents exhibiting mental health problems. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Maternal Employment Status and Minimum Meal Frequency in Children 6-23 Months in Tanzania
Int. J. Environ. Res. Public Health 2019, 16(7), 1137; https://doi.org/10.3390/ijerph16071137 - 29 Mar 2019
Abstract
As women in developing world settings gain access to formal work sectors, it is important to understand how such changes might influence child nutrition. The purpose of this paper is to examine the relationship between maternal employment status and minimum meal frequency (MMF) [...] Read more.
As women in developing world settings gain access to formal work sectors, it is important to understand how such changes might influence child nutrition. The purpose of this paper is to examine the relationship between maternal employment status and minimum meal frequency (MMF) among children in Tanzania. Interviews were conducted with 5000 mothers of children ages 0–23 months. The questionnaire used in these interviews was developed by adopting questions from Tanzania’s latest Demographic and Health Survey (2015–2016) where possible and creating additional questions needed for programmatic baseline measurements. MMF was used as proxy for child nutrition. Logistic regression analyses were used to identify associations between employment status and parenting practices of Tanzanian mothers and MMF of their children. After adjusting for confounders, informal maternal employment [OR = 0.58], lack of financial autonomy [OR = 0.57] and bringing the child with them when working away from home [OR = 0.59] were negatively associated with meeting MMF. Payment in cash [OR = 1.89], carrying food for the child [OR = 1.34] and leaving food at home for the child [OR = 2.52] were positively associated with meeting MMF. Informal maternal employment was found to be negatively associated with meeting MMF among Tanzanian children. However, behaviors such as bringing or leaving prepared food, fiscal autonomy and payment in cash showed significant positive associations. These findings could help direct future programs to reduce child stunting. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Is Repeat Abortion a Public Health Problem among Chinese Adolescents? A Cross-Sectional Survey in 30 Provinces
Int. J. Environ. Res. Public Health 2019, 16(5), 794; https://doi.org/10.3390/ijerph16050794 - 05 Mar 2019
Cited by 1
Abstract
The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have limited access. This cross-sectional study aims to identify risk factors related to repeat abortions in Chinese adolescents receiving abortions. Data were collected using a questionnaire for all [...] Read more.
The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have limited access. This cross-sectional study aims to identify risk factors related to repeat abortions in Chinese adolescents receiving abortions. Data were collected using a questionnaire for all women seeking abortions within 12 weeks of pregnancy during a period of 2 months in 297 participating hospitals randomly selected across 30 provinces of China in 2013. Only the adolescents (younger than the minimum legal married age of 20 years) were included in this study. Of the 2370 adolescents who were receiving abortions, 927 (39%) were undergoing repeat abortions. The primary reason for the current unintended pregnancies was non-use of contraception (68%). Adolescents receiving abortions who had an increased risk of repeat abortions were those who had children (OR 2.57, 95% CI 1.80–3.67), those who resided in a middle-developed region (OR 1.81, 95% CI 1.30–2.50), those who resided in a relatively poor region (OR 2.40, 95% CI 1.78–3.23), and those who had used contraception during the 6 months preceding the survey (OR 1.38, 95% CI 1.12–1.71 for condom use). The occupation as a student was a protective factor for adolescents (OR 0.64, 95% CI 0.50–0.83). Adolescents should be offered equal access to FP to that of married women in China to reduce unintended pregnancies and repeat abortions. Correct and consistent contraception practice should be promoted. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Parents’ Willingness and Perception of Children’s Autonomy as Predictors of Greater Independent Mobility to School
Int. J. Environ. Res. Public Health 2019, 16(5), 732; https://doi.org/10.3390/ijerph16050732 - 28 Feb 2019
Cited by 4
Abstract
The present study aimed to examine the factors associated with different forms of independent mobility (IM) to school (IM one way and IM both ways) according to their parents’ opinions. To do so, several variables were evaluated: how parents assess their children’s autonomy, [...] Read more.
The present study aimed to examine the factors associated with different forms of independent mobility (IM) to school (IM one way and IM both ways) according to their parents’ opinions. To do so, several variables were evaluated: how parents assess their children’s autonomy, the difficulty they perceive for IM to school, reasons for IM/no IM to school, parents’ willingness for IM to school, frequency of children’s IM for leisure activities, children having house keys and dangers perceived in the neighborhood. Family-related socio-demographic variables were also assessed: number of children, position occupied by them in the family, family composition, living with both parents or just one, and each parent’s nationality, level of education and job status. This study examined the data collected from 1450 parents (mothers and fathers) with children studying Primary Education years 4, 5 and 6 (M age = 10.53, SD = 0.90). The results showed that 42.3% of the schoolchildren did not practice IM to school, 18.1% practiced IM one way (they went to or from school alone), and 39.5% practiced IM both way (they went to/from school alone). These findings underline the importance of parents’ willingness for IM to school, and how the balance between how they perceive their children’s autonomy and difficulty for IM is relevant for greater IM to school. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
The Great Recession and Children’s Mental Health in Australia
Int. J. Environ. Res. Public Health 2019, 16(4), 537; https://doi.org/10.3390/ijerph16040537 - 13 Feb 2019
Abstract
This paper analyzes the effects of “shocks” to community-level unemployment expectations, induced by the onset of the Great Recession, on children’s mental well-being. The Australian experience of the Great Recession represents a unique case study as despite little change in actual unemployment rates, [...] Read more.
This paper analyzes the effects of “shocks” to community-level unemployment expectations, induced by the onset of the Great Recession, on children’s mental well-being. The Australian experience of the Great Recession represents a unique case study as despite little change in actual unemployment rates, levels of economic uncertainty grew. This affords us the ability to examine the effects of shocks to economic expectations independent of any actual changes to economic conditions. We draw on and link data from multiple sources, including several waves of the Longitudinal Study of Australian Children (2004–2010), a consumer sentiment survey, and data on local economic conditions. Using our purpose-built data set, we estimate difference-in-differences models to identify plausibly causal effects. We find, for boys, there is no detectable effect of community-level unemployment expectations shocks on mental health. For girls, however, there are modest increases in mental health problems and externalizing behaviors, as measured by the Strengths and Difficulties Questionnaire (SDQ). We additionally find no discernible change in mother’s psychological distress as a result of expectations shocks. These results are stable after controlling for actual labor market conditions. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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The Asti Study: The Induction of Oxidative Stress in A Population of Children According to Their Body Composition and Passive Tobacco Smoking Exposure
Int. J. Environ. Res. Public Health 2019, 16(3), 490; https://doi.org/10.3390/ijerph16030490 - 09 Feb 2019
Cited by 7
Abstract
Obesity and exposure to second-hand tobacco smoking (SHS) may influence oxidative stress (OS) levels, especially in children. This study investigated body composition and SHS influence on OS induction in the paediatric population. The first purpose was identifying an appropriate BMI standard for adiposity [...] Read more.
Obesity and exposure to second-hand tobacco smoking (SHS) may influence oxidative stress (OS) levels, especially in children. This study investigated body composition and SHS influence on OS induction in the paediatric population. The first purpose was identifying an appropriate BMI standard for adiposity assessment in OS investigations. Secondly, SHS and obesity were analysed as inductors of OS. The epidemiologic sample involved 330 children. Three BMI (body mass index) references (IOTF, CDC, and WHO) and an impedentiometric scale supplied body-composition measurements. Partecipants filled out a questionnaire and provided urinary samples for biomarker quantifications: isoprostane (15-F2t IsoP) and cotinine as OS and SHS biomarker, respectively. Obesity prevalence changed over different BMI references (14%, 21%, and 34% for IOTF, CDC, and WHO, respectively). Obese children, by IOTF, showed an increase of 56% in 15-F2t IsoP compared to those normal weight (p = 0.020). Children belonging to the third and the fourth cotinine quartile compared to those of the first quartile had higher 15-F2t IsoP (1.45 ng/mg, 95% CI: 1.06–1.97, p = 0.020 and 2.04 ng/mg, 95% CI: 1.55–2.69, p < 0.0001, respectively). Obesity assessment in children requires appropriate BMI reference depending on research field. Both SHS exposure and obesity may increase OS in children. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Growth Hormone (GH) Therapy During the Transition Period: Should We Think about Early Retesting in Patients with Idiopathic and Isolated GH Deficiency?
Int. J. Environ. Res. Public Health 2019, 16(3), 307; https://doi.org/10.3390/ijerph16030307 - 23 Jan 2019
Cited by 3
Abstract
To investigate growth hormone (GH) secretion at the transition age, retesting of all subjects who have undergone GH replacement therapy is recommended when linear growth and pubertal development are complete to distinguish between transitional and persistent GH deficiency (GHD). Early retesting of children [...] Read more.
To investigate growth hormone (GH) secretion at the transition age, retesting of all subjects who have undergone GH replacement therapy is recommended when linear growth and pubertal development are complete to distinguish between transitional and persistent GH deficiency (GHD). Early retesting of children with idiopathic and isolated GHD (i.e., before the achievement of final height and/or the adult pubertal stage) can avoid possible over-treatment. Here, we report data from our population with idiopathic and isolated GHD to encourage changes in the management and timing of retesting. We recruited 31 patients (19 males) with idiopathic GHD who received recombinant GH (rGH) for at least 2 years. All of the patients were retested at the transition age at least 3 months after rGH discontinuation. Permanent GHD was defined as a GH peak of <19 ng/mL after administration of growth hormone–releasing hormone (GHRH) + arginine as a provocative test. Permanent GHD was confirmed in only five of 31 patients (16.13%). None of these patients presented low serum insulin-like growth factor (IGF)-1 levels (<−2 standard deviation score (SDS)). Only one male patient with an IGF-1 serum level lower than −2 SDS showed a normal GH stimulation response, with a GH peak of 44.99 ng/mL. Few patients with idiopathic and isolated GHD demonstrated persistence of the deficit when retested at the transition age, suggesting that the timing of retesting should be anticipated to avoid overtreatment. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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The Relationship between Objectively Measured and Self-Reported Sedentary Behaviours and Social Connectedness among Adolescents
Int. J. Environ. Res. Public Health 2019, 16(2), 277; https://doi.org/10.3390/ijerph16020277 - 18 Jan 2019
Cited by 4
Abstract
Adolescents spend significant amounts of time engaged in various types of sedentary behaviour (SB). This study examined associations between adolescents’ objectively measured sedentary time, sitting time, specific self-reported SBs and social connectedness. Adolescents (n = 429, 15.5 years, 41% male) completed an [...] Read more.
Adolescents spend significant amounts of time engaged in various types of sedentary behaviour (SB). This study examined associations between adolescents’ objectively measured sedentary time, sitting time, specific self-reported SBs and social connectedness. Adolescents (n = 429, 15.5 years, 41% male) completed an online survey reporting time in seven SBs (TV/videos/DVDs, computer/video games, internet, homework, reading, car and bus travel; examined individually and summed for screen time and total SB), and social connectedness using the eight-item Social Connectedness Scale. A subsample (n = 353) also wore an ActiGraph GT3X+ (model GT3X+, Pensacola, FL, USA) accelerometer to measure sedentary time (<100 cpm) and n = 237 wore an activPAL (PAL Technologies Ltd., Glasgow, Scotland) inclinometer to measure sitting time. Multiple linear mixed models determined associations between each SB variable and social connectedness, adjusting for confounders. Adolescents spent on average 7.8 h/day in self-reported total SB, 4.4 h/day in screen time, 9.1 h/day in ActiGraph-measured sedentary time, and 9.5 h/day in activPAL-measured sitting time. After adjusting for age, sex and area level socioeconomic status, total SB (−0.24, 95%CI: −0.37, −0.11), screen time (−0.23, 95%CI: −0.41, −0.05) and two individual SBs (computer/video games (−1.07, 95%CI: −1.53, −0.60), homework (−0.61, 95%CI: −1.04, −0.18) were negatively associated with social connectedness. There were no associations with the objective measures. The relationships may be bi-directional; therefore, future research should involve longitudinal designs and explore other potential contributing factors. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Preschool Environmental Factors, Parental Socioeconomic Status, and Children’s Sedentary Time: An Examination of Cross-Level Interactions
Int. J. Environ. Res. Public Health 2019, 16(1), 46; https://doi.org/10.3390/ijerph16010046 - 25 Dec 2018
Cited by 2
Abstract
Preschool children’s high levels of sedentary time (ST) is a public health concern. As preschool reaches a large population of children from different socioeconomic status (SES) backgrounds, more knowledge on how the preschool setting is associated with children’s ST is relevant. Our aims [...] Read more.
Preschool children’s high levels of sedentary time (ST) is a public health concern. As preschool reaches a large population of children from different socioeconomic status (SES) backgrounds, more knowledge on how the preschool setting is associated with children’s ST is relevant. Our aims were to examine (1) the associations of preschool setting (covering social, physical, and organizational level) with children’s ST, and (2) the moderating role of the setting on the association between parental SES and children’s ST. In the cross-sectional DAGIS (increased health and wellbeing in preschools) study, the participating children (n = 864, aged 3–6 years) were asked to wear an accelerometer for one week. In total, 779 children had valid ST accelerometer data during preschool hours. Preschool setting and parental SES was assessed by questionnaires and observation. Multilevel linear regression models with cross-level interactions were applied to examine the associations. Early educators’ practice of breaking children’s ST often, more frequent physical activity (PA) theme weeks, and higher number of physical education (PE) lessons were associated with lower children’s ST. Higher parental SES was associated with higher children’s ST in preschools (1) with organized sedentary behavior theme weeks, (2) with a lower number of PA theme weeks, and (3) with a lower number of PE lessons. The factors identified in this study could be targeted in future interventions. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Profile Resemblance in Health-Related Markers: The Portuguese Sibling Study on Growth, Fitness, Lifestyle, and Health
Int. J. Environ. Res. Public Health 2018, 15(12), 2799; https://doi.org/10.3390/ijerph15122799 - 10 Dec 2018
Cited by 1
Abstract
The co-occurrence of health-related markers and their associations with individual, family, and environmental characteristics have not yet been widely explored in siblings. We aimed to identify multivariate profiles of health-related markers, analyze their associations with biological, sociodemographic, and built environment characteristics, and estimate [...] Read more.
The co-occurrence of health-related markers and their associations with individual, family, and environmental characteristics have not yet been widely explored in siblings. We aimed to identify multivariate profiles of health-related markers, analyze their associations with biological, sociodemographic, and built environment characteristics, and estimate sibling resemblance in these profiles. The sample includes 736 biological siblings aged 9–20 years. Body fat was measured with a portable bioelectrical impedance scale; biological maturation was assessed with the maturity offset; handgrip strength, standing long jump, one-mile run, and shuttle run were used to mark physical fitness. Health behaviors, sociodemographic, and built environmental characteristics were recorded by questionnaire. Latent profile analysis and multilevel logistic regression models were used; sibling resemblance was estimated with the intraclass correlation (ρ). Two multivariate profiles emerged: “P1 = fit, lower fat and poorer diet” (86.7%) and “P2 = higher fat and lower fit, but better diet” (13.3%). Siblings whose fathers were less qualified in their occupation were more likely to belong to P2 (OR = 1.24, p = 0.04); those whose fathers with Grade 12 and university level education were more likely to fit in P2 compared to peers living with fathers having an educational level below Grade 12 (OR = 3.18, p = 0.03, and OR = 6.40, p = 0.02, Grade 12 and university level, respectively). A moderate sibling profile resemblance was found (0.46 ≤ ρ ≤ 0.55). In conclusion, youth health-related markers present substantial differences linked with their body composition, physical fitness and unhealthy diet. Furthermore, only father socio-demographic characteristics were associated with profile membership. Sibling´s profile resemblance mirrors the effects of genetics and shared characteristics. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Spirituality but not Religiosity Is Associated with Better Health and Higher Life Satisfaction among Adolescents
Int. J. Environ. Res. Public Health 2018, 15(12), 2781; https://doi.org/10.3390/ijerph15122781 - 07 Dec 2018
Cited by 6
Abstract
Careful conceptualization and differentiation of both spirituality and religiosity is a necessary precondition for understanding the potential role they play in health, whether physical or mental. The aim of this study was to explore the associations of spirituality with self-rated health, health complaints, [...] Read more.
Careful conceptualization and differentiation of both spirituality and religiosity is a necessary precondition for understanding the potential role they play in health, whether physical or mental. The aim of this study was to explore the associations of spirituality with self-rated health, health complaints, and life satisfaction of adolescents with the moderating role of religiosity. Data from the Health Behaviour in School-aged Children study conducted in 2014 in Slovakia were used. The final sample consisted of 658 adolescents (mean age = 15.37; 50.6% boys). Data regarding spirituality, religiosity, self-rated health, health complaints, and life satisfaction were obtained. Binary logistic models revealed spirituality to be associated with self-rated health, health complaints, and life satisfaction. A moderating role of religiosity was not confirmed. The presented findings indicate the need to distinguish between the concepts of religiosity and spirituality in connection with subjective health and life satisfaction. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Children’s Weight Gain and Cardiovascular Fitness Loss over the Summer
Int. J. Environ. Res. Public Health 2018, 15(12), 2770; https://doi.org/10.3390/ijerph15122770 - 07 Dec 2018
Cited by 2
Abstract
The purpose of this study was to examine the impact of summer breaks on the body composition and cardiovascular fitness of elementary school children who participated in a multi-year school-based physical activity intervention. Participants were 404 children who had their height and weight [...] Read more.
The purpose of this study was to examine the impact of summer breaks on the body composition and cardiovascular fitness of elementary school children who participated in a multi-year school-based physical activity intervention. Participants were 404 children who had their height and weight measured and completed the Progressive Aerobic Cardiovascular Endurance Run (PACER) during physical education classes at the beginning and end of the school year for three consecutive years. To examine the effects of time on health-related fitness data, general linear mixed effects models were employed. The results indicate that there was a trend toward an increase in body mass index (BMI) after the summer of 2015 (p = 0.958), and a significant increase in BMI after the summer of 2016 compared to time point 1 (p < 0.001). For PACER laps, there were trends toward decreases in PACER laps after the summers of 2015 (p = 0.515) and 2016 (p = 0.073). Summer breaks tended to attenuate the BMI and PACER lap improvements that were observed during the intervention. While school-based physical activity programming has had some successes in improving health-related fitness markers, the loss of these improvements over the summer is of concern to both practitioners and researchers. It is clear that additional efforts are needed to limit obesogenic behaviors during the summer months. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Selected Risk Factors of Developmental Delay in Polish Infants: A Case-Control Study
Int. J. Environ. Res. Public Health 2018, 15(12), 2715; https://doi.org/10.3390/ijerph15122715 - 02 Dec 2018
Cited by 1
Abstract
Despite a number of studies on the risk factors of developmental delay (DD) in children conducted in developed countries, Polish data are scarce, which hinder an early diagnosis and initiation of prevention/control measures. Objective: To assess selected risk factors of DD in infants. [...] Read more.
Despite a number of studies on the risk factors of developmental delay (DD) in children conducted in developed countries, Polish data are scarce, which hinder an early diagnosis and initiation of prevention/control measures. Objective: To assess selected risk factors of DD in infants. A case-control survey was conducted in 2017–2018 on 50 infants (≤1 year old) with DD and 104 healthy controls from three outpatient clinics in Szczecin, Poland. Data were collected using an anonymous questionnaire distributed among mothers. The most common risk factors in infants with DD were: Caesarian section (68%), infections (46%), and chronic diseases during pregnancy (48%). DD was significantly correlated with maternal infections and chronic diseases during pregnancy (both: p < 0.001), caesarian section (p < 0.001), preterm birth (p = 0.004), birth weight <2500 g (p = 0.03), Apgar score ≤7 (p < 0.01), prolonged hyperbilirubinemia (p < 0.001), and no breast-feeding (p = 0.04). This study reinforces multiple etiologies of DD. Preventive strategies regarding DD in Polish infants should focus on the pre/peri/postnatal risk factors identified in this study. Strategies that prevent and control such risk factors and those on early detection and intervention in high-risk infants are highly recommended. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Association between Problematic Internet Use and Sleep Disturbance among Adolescents: The Role of the Child’s Sex
Int. J. Environ. Res. Public Health 2018, 15(12), 2682; https://doi.org/10.3390/ijerph15122682 - 28 Nov 2018
Cited by 5
Abstract
Use of the Internet has become an integral part of daily life. Adolescents are especially at a higher risk of developing problematic Internet use (PIU). Although one of the most well-known comorbid conditions of PIU is sleep disturbance, little is known about the [...] Read more.
Use of the Internet has become an integral part of daily life. Adolescents are especially at a higher risk of developing problematic Internet use (PIU). Although one of the most well-known comorbid conditions of PIU is sleep disturbance, little is known about the sex disparity in this association. This school-based survey in students of grades 7–9 was conducted to estimate the prevalence of PIU and sleep disturbance among Chinese adolescents, to test the association between PIU and sleep disturbance, and to investigate the role of the child’s sex in this association. A two-stage stratified cluster sampling method was used to recruit participants, and two-level logistic regression models were fitted. The mean Internet addiction test score was 37.2 (SD: 13.2), and 15.5% (736) met the criteria for PIU. After adjusting for control variables, problematic Internet users were at a higher risk of sleep disturbance (adjusted odds ratio = 2.41, 95% confidence interval (CI) = 2.07–3.19). Sex-stratified analyses also demonstrated that association was greater in girls than boys. In this respect, paying more attention to the sleep patterns of adolescents who report excessive Internet use is recommended, and this early identification may be of practical importance for schools, parents, and adolescents themselves. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
The Association between Low Body Weight and Scoliosis among Korean Elementary School Students
Int. J. Environ. Res. Public Health 2018, 15(12), 2613; https://doi.org/10.3390/ijerph15122613 - 22 Nov 2018
Cited by 4
Abstract
Background: The prevalence of scoliosis in Korean elementary school students is increasing, leading to various physical and psychological problems. This study aimed to investigate the association between low body weight and scoliosis among Korean elementary school students. Methods: This was a cross-sectional analysis. [...] Read more.
Background: The prevalence of scoliosis in Korean elementary school students is increasing, leading to various physical and psychological problems. This study aimed to investigate the association between low body weight and scoliosis among Korean elementary school students. Methods: This was a cross-sectional analysis. Participants were 1062 elementary school students in the metropolitan areas of Korea. Participants were evaluated for scoliosis based on body composition, including weight and height, and with spine structure analysis equipment. Scoliosis diagnosis was defined as having a Cobb’s angle greater than 10°. Results: Participants were divided into Normal Weight (NW), Underweight (UW), and Severely Underweight (SUW) groups. Results show that the UW and SUW groups had significantly higher risks of developing scoliosis (odds ratio (OR): 1.43, 95% CI (confidence interval): 1.07–1.90; OR: 1.45, 95% CI: 1.02–2.05) compared to the NW group; after controlling for age and gender, the OR were 1.44 (95% CI: 1.08–1.92) and 1.46 (95% CI: 1.01–2.09), respectively. Conclusions: Low weight and the risk of developing scoliosis are very closely associated. Maintenance of appropriate and normal weight in Korean elementary school students appears to be a very effective method for preventing and reducing the risk of scoliosis. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Chinese Sexual Minority Male Adolescents’ Suicidality and Body Mass Index
Int. J. Environ. Res. Public Health 2018, 15(11), 2558; https://doi.org/10.3390/ijerph15112558 - 15 Nov 2018
Cited by 1
Abstract
Excess weight status may increase the risk of suicidality among sexual minority females, but few studies have examined this suicidality disparity in sexual minority males. This study examined the association between sexual minority status and suicide attempts in Chinese male adolescents and tested [...] Read more.
Excess weight status may increase the risk of suicidality among sexual minority females, but few studies have examined this suicidality disparity in sexual minority males. This study examined the association between sexual minority status and suicide attempts in Chinese male adolescents and tested whether body mass index (BMI) had a moderating effect on that association. Data were collected from 7th to 12th graders from seven randomly selected provinces of China in the 2015 School-Based Chinese Adolescents Health Survey. In total, 72,409 male students completed the questionnaires regarding sexual attraction, self-reported weight and height, and suicide attempts. After adjustment for covariates, sexual minority status was associated with suicide attempts among male students (AOR = 1.74, 95% CI = 1.57–1.93). Stratification analyses showed that BMI category moderated this association; compared with the results before stratification analyses, sexual minority males who were obese had increased risk of suicide attempts (AOR = 2.15, 95% CI = 1.09–4.24), sexual minority males who were overweight had reduced odds of suicide attempts (AOR = 1.40, 95% CI = 1.01–1.92), and no significant association change was found in sexual minority males who were underweight (AOR = 1.82, 95% CI = 1.43–2.33). Our study indicated that BMI moderated the risk of suicide attempts in sexual minority males. Suicide prevention targeting sexual minority males should be focused on weight status disparity and the creation of a positive climate to reduce minority stressors due to body image. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
“In my day…”- Parents’ Views on Children’s Physical Activity and Screen Viewing in Relation to Their Own Childhood
Int. J. Environ. Res. Public Health 2018, 15(11), 2547; https://doi.org/10.3390/ijerph15112547 - 13 Nov 2018
Cited by 3
Abstract
Physical activity and screen viewing are associated with cardio-metabolic risk factors, psychological wellbeing, and academic performance among children. Across the last generation, children’s physical activity and screen viewing behaviours have changed, coinciding with changes to the home and neighbourhood environment. This study aimed [...] Read more.
Physical activity and screen viewing are associated with cardio-metabolic risk factors, psychological wellbeing, and academic performance among children. Across the last generation, children’s physical activity and screen viewing behaviours have changed, coinciding with changes to the home and neighbourhood environment. This study aimed to qualitatively explore parents’ views on their 8–9-year-old child’s childhood and how this compares to experiences from their own childhood, with a specific focus on physical activity and screen viewing behaviours. Semi-structured telephone interviews were conducted with 51 parents (mean age = 41.2 years, range 31.5 to 51.5 years), between July and October 2016. Inductive and deductive content analyses were used to explore parents’ perceptions of their child’s physical activity and screen viewing behaviours in comparison to their own childhood behaviours. Interview data revealed that compared to the relative freedom they recalled as children, parents restrict their children’s independent mobility and outdoor play due to concerns about safety. Despite their children having greater access to structured activities than they did as children, parents feel their children are “missing out,” and perceived their own childhood as better with regards to maximising independent and outdoor play and limiting screen viewing. Innovative strategies are needed to change the social norms surrounding children’s independent mobility and outdoor play. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
A Comparison of Preschoolers’ Physical Activity Indoors versus Outdoors at Child Care
Int. J. Environ. Res. Public Health 2018, 15(11), 2463; https://doi.org/10.3390/ijerph15112463 - 05 Nov 2018
Cited by 3
Abstract
The aims of this study were to quantify and examine differences in preschoolers’ indoor and outdoor sedentary time and physical activity intensity at child care using GPS devices and accelerometers. We conducted an observational study of 46 children (mean age 4.5 years, 30 [...] Read more.
The aims of this study were to quantify and examine differences in preschoolers’ indoor and outdoor sedentary time and physical activity intensity at child care using GPS devices and accelerometers. We conducted an observational study of 46 children (mean age 4.5 years, 30 boys, 16 girls) from five child care centers who wore accelerometers and GPS devices around their waists for five days during regular child care hours. GPS signal-to-noise ratios were used to determine indoor vs. outdoor location. Accelerometer data were categorized by activity intensity. Children spent, on average, 24% of child care time outdoors (range 12–37% by site), averaging 74 min daily outdoors (range 30–119 min), with 54% of children spending ≥60 min/day outdoors. Mean accelerometer activity counts were more than twice as high outdoors compared to indoors (345 (95) vs. 159 (38), (p < 0.001)), for girls and boys. Children were significantly less sedentary (51% of time vs. 75%) and engaging in more light (18% vs. 13%) and moderate-to-vigorous (MVPA) (31% vs. 12%) activity when outdoors compared to indoors (p < 0.001). To achieve a minute of MVPA, a preschooler needed to spend 9.1 min indoors vs. 3.8 min outdoors. Every additional 10 min outdoors each day was associated with a 2.9 min increase in MVPA (2.7 min for girls, 3.0 min for boys). Preschool-age children are twice as active and less sedentary when outdoors compared to indoors in child care settings. To help preschoolers achieve MVPA recommendations and likely attain other benefits, one strategy is to increase the amount of time they spend outdoors and further study how best to structure it. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
What Protects Adolescents with Youth Subculture Affiliation from Excessive Internet Use?
Int. J. Environ. Res. Public Health 2018, 15(11), 2451; https://doi.org/10.3390/ijerph15112451 - 03 Nov 2018
Abstract
Youth subculture affiliation (SA) appears to be an important risk factor with regard to adolescents’ problem behavior. Excessive Internet use (EIU) has emerged as a new type of problem behavior; however, it has not yet been studied in adolescents affiliated with youth subcultures. [...] Read more.
Youth subculture affiliation (SA) appears to be an important risk factor with regard to adolescents’ problem behavior. Excessive Internet use (EIU) has emerged as a new type of problem behavior; however, it has not yet been studied in adolescents affiliated with youth subcultures. Thus, the aim of this study was to assess the association between SA and EIU and to explore the role of selected protective factors. We used data from the Health Behaviour in School-aged Children (HBSC) study conducted in 2014 in Slovakia. The final sample for this study comprised 532 adolescents (mean age: 15.4; 49.6% boys). Hierarchical linear regression analysis was conducted to examine the associations of EIU with SA. Adolescents with SA were more likely to report EIU. Adjustment for protective factors decreased the association between EIU and SA. From all tested interactions, only the interaction of SA with family support was found to be significant. The relationship between family support and EIU was mediated via Monitoring by the mother only in adolescents without SA. Our findings imply that the risk of EIU is higher in adolescents with SA. There was a difference in how protective factors worked in adolescents with and without SA. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessArticle
Self-Reported vs. Measured Height, Weight, and BMI in Young Adults
Int. J. Environ. Res. Public Health 2018, 15(10), 2216; https://doi.org/10.3390/ijerph15102216 - 11 Oct 2018
Cited by 16
Abstract
Self-reported height and weight, if accurate, provide a simple and economical method to track changes in body weight over time. Literature suggests adults tend to under-report their own weight and that the gap between self-reported weight and actual weight increases with obesity. This [...] Read more.
Self-reported height and weight, if accurate, provide a simple and economical method to track changes in body weight over time. Literature suggests adults tend to under-report their own weight and that the gap between self-reported weight and actual weight increases with obesity. This study investigates the extent of discrepancy in self-reported height, weight, and subsequent Body Mass Index (BMI) versus actual measurements in young adults. Physically measured and self-reported height and weight were taken from 1562 students. Male students marginally overestimated height, while females were closer to target. Males, on average, closely self-reported weight. Self-reported anthropometrics remained statistically correlated to actual measures in both sexes. Categorical variables of calculated BMI from both self-reported and actual height and weight resulted in significant agreement for both sexes. Researcher measured BMI (via anthropometric height and weight) and sex were both found to have association with self-reported weight while only sex was related to height difference. Regression examining weight difference and BMI was significant, specifically with a negative slope indicating increased BMI led to increased underestimation of weight in both sexes. This study suggests self-reported anthropometric measurements in young adults can be used to calculate BMI for weight classification purposes. Further investigation is needed to better assess self-reported vs measured height and weight discrepancies across populations. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Relationship between Problematic Internet Use, Sleep Problems, and Oral Health in Korean Adolescents: A National Survey
Int. J. Environ. Res. Public Health 2018, 15(9), 1870; https://doi.org/10.3390/ijerph15091870 - 29 Aug 2018
Cited by 7
Abstract
We examined the relationship between Problematic Internet Use (PIU), sleep (sleep satisfaction, sleep duration), and experience of oral disease symptoms in Korean adolescents by gender. This cross-sectional study utilized the 6th (2010) Korean Youth Risk Behavior Web-based Survey. Participants comprised 74,980 students from [...] Read more.
We examined the relationship between Problematic Internet Use (PIU), sleep (sleep satisfaction, sleep duration), and experience of oral disease symptoms in Korean adolescents by gender. This cross-sectional study utilized the 6th (2010) Korean Youth Risk Behavior Web-based Survey. Participants comprised 74,980 students from 400 middle schools and 400 high schools nationwide. Among these, 73,238 students from 799 schools (38,391 boys, 34,847 girls, aged 13–18 years) were included in the analysis (inclusion rate = 97.7%). Multiple logistic regression and analysis of moment structures (AMOS) analyses were performed to identify meaningful relationships between the three factors. The “high risk group” of problematic internet usage had increased experience of oral disease symptoms (boys: adjusted odds ratio (AOR) = 1.92, 95% confidence interval (CI) = 1.63–2.28, girls: AOR = 1.98, 95% CI = 1.50–2.63) compared to the general group. Boys who used the Internet for “5–6 h” had a higher risk of oral disease symptoms compared to those who used it for “less than 1 h” (OR = 1.24, 95% CI = 1.01–1.53); however, this difference was not significant in Models II and III. For girls, the risk of 5–6 h of use (Model I: OR = 1.69, 95% CI = 1.40–2.04) was higher than that of the boys. In addition, the difference was significant in Models II and III for girl students who used the Internet for 5–6 h. In subgroup analysis, the high-risk group had a higher odds ratio for mild symptoms of bad breath to severe symptoms such as sore and bleeding gums. In addition, in the path analysis, PIU affected sleep and indirectly affected oral health. Direct and indirect causal relationships between the three factors were confirmed. Therefore, it is important to recognize that PIU can have a detrimental effect on mental, physical, and oral health. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessArticle
Early Infant Feeding of Formula or Solid Foods and Risk of Childhood Overweight or Obesity in a Socioeconomically Disadvantaged Region of Australia: A Longitudinal Cohort Analysis
Int. J. Environ. Res. Public Health 2018, 15(8), 1685; https://doi.org/10.3390/ijerph15081685 - 07 Aug 2018
Cited by 6
Abstract
In southwestern Sydney the timing of introduction of formula and solids may be associated with risk of childhood overweight or obesity, and this may vary by age at breastfeeding cessation during first year. We included 346 infants from southwestern Sydney using the longitudinal [...] Read more.
In southwestern Sydney the timing of introduction of formula and solids may be associated with risk of childhood overweight or obesity, and this may vary by age at breastfeeding cessation during first year. We included 346 infants from southwestern Sydney using the longitudinal study for Australian children (LSAC), who at baseline were singleton, full term, and normal weight births. The outcome risk of overweight or obesity was measured at every two-year interval of children aged 0 or 1 year at baseline until they reached age 10 or 11, defined by body mass index (BMI) ≥ 85th percentile, using the Centre for Disease Control and Prevention growth charts. Age at introduction to formula or solids was dichotomized at four months. We used mixed effects logistic regression for performing all analyses with and without adjusting for mother’s BMI, age during pregnancy, and social disadvantage index. Missing data were estimated using multivariate normal imputation having 25 imputations. The odds of overweight or obesity were significantly higher among infants introduced to formula or solids at ≤4 months compared to those introduced at >4 months in both unadjusted (odds ratio = 2.3262, p = 0.023) and adjusted (odds ratio = 1.9543, p = 0.0475) analyses. The odds of overweight or obesity when age at formula or solids introduction was held fixed at ≤4 months, increased significantly (odds ratio = 2.0856, p = 0.0215) for children stopping breastfeeding at age ≤4 months compared to >4 months. Thus, increasing the prevalence of breast-feeding without any formula or solids to 4–6 months in southwest Sydney should be a worthwhile public health measure. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Review

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Open AccessReview
Effect of High-Intensity Interval Training versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness in Children and Adolescents: A Meta-Analysis
Int. J. Environ. Res. Public Health 2019, 16(9), 1533; https://doi.org/10.3390/ijerph16091533 - 30 Apr 2019
Cited by 2
Abstract
Enhancing cardiorespiratory fitness (CRF) can lead to substantial health benefits. Comparisons between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on CRF for children and adolescents are inconsistent and inconclusive. The objective of this study was to perform a meta-analysis to compare [...] Read more.
Enhancing cardiorespiratory fitness (CRF) can lead to substantial health benefits. Comparisons between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on CRF for children and adolescents are inconsistent and inconclusive. The objective of this study was to perform a meta-analysis to compare the effects between HIIT and MICT on CRF in children and adolescents. We searched MEDLINE, PubMed, Web of Science, and Google Scholar to identify relevant articles. The standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated to determine the pooled effect size of HIIT and MICT on CRF. A total of 563 subjects from 17 studies (18 effects) were identified. The pooled effect size was 0.51 (95% CI = 0.33–0.69) comparing HIIT to MICT. Moreover, intervention duration, exercise modality, work and rest ratio, and total bouts did not significantly modify the effect of HIIT on CRF. It is concluded that compared with endurance training, HIIT has greater improvements on cardiorespiratory fitness among children and adolescents. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessReview
Different Clinical Presentations and Management in Complete Androgen Insensitivity Syndrome (CAIS)
Int. J. Environ. Res. Public Health 2019, 16(7), 1268; https://doi.org/10.3390/ijerph16071268 - 09 Apr 2019
Cited by 4
Abstract
Complete androgen insensitivity syndrome (CAIS) is an X-linked recessive genetic disorder resulting from maternally inherited or de novo mutations involving the androgen receptor gene, situated in the Xq11-q12 region. The diagnosis is based on the presence of female external genitalia in a 46, [...] Read more.
Complete androgen insensitivity syndrome (CAIS) is an X-linked recessive genetic disorder resulting from maternally inherited or de novo mutations involving the androgen receptor gene, situated in the Xq11-q12 region. The diagnosis is based on the presence of female external genitalia in a 46, XY human individual, with normally developed but undescended testes and complete unresponsiveness of target tissues to androgens. Subsequently, pelvic ultrasound or magnetic resonance imaging (MRI) could be helpful in confirming the absence of Mullerian structures, revealing the presence of a blind-ending vagina and identifying testes. CAIS management still represents a unique challenge throughout childhood and adolescence, particularly regarding timing of gonadectomy, type of hormonal therapy, and psychological concerns. Indeed this condition is associated with an increased risk of testicular germ cell tumour (TGCT), although TGCT results less frequently than in other disorders of sex development (DSD). Furthermore, the majority of detected tumoral lesions are non-invasive and with a low probability of progression into aggressive forms. Therefore, histological, epidemiological, and prognostic features of testicular cancer in CAIS allow postponing of the gonadectomy until after pubertal age in order to guarantee the initial spontaneous pubertal development and avoid the necessity of hormonal replacement therapy (HRT) induction. However, HRT is necessary after gonadectomy in order to prevent symptoms of hypoestrogenism and to maintain secondary sexual features. This article presents differential clinical presentations and management in patients with CAIS to emphasize the continued importance of standardizing the clinical and surgical approach to this disorder. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessReview
What Do We Know about Diet and Markers of Cardiovascular Health in Children: A Review
Int. J. Environ. Res. Public Health 2019, 16(4), 548; https://doi.org/10.3390/ijerph16040548 - 14 Feb 2019
Cited by 4
Abstract
Chronic diseases such as cancer, diabetes, and cardiovascular diseases (CVD) are the main health concerns in the 21st century, with CVD as the number one cause of mortality worldwide. Although CVD hard endpoints such as stroke or heart attack do not usually occur [...] Read more.
Chronic diseases such as cancer, diabetes, and cardiovascular diseases (CVD) are the main health concerns in the 21st century, with CVD as the number one cause of mortality worldwide. Although CVD hard endpoints such as stroke or heart attack do not usually occur in children, evidence shows that the manifestation of CVD risk factors begins in childhood, preceding clinical complications of CVD in adulthood. Dietary intake is a modifiable risk factor that has been shown to make a substantial contribution to the risk of CVD in adulthood. However, less is known about the association between dietary intake and markers of cardiovascular health in children. This review summarises the current evidence on the relationship between dietary intake and markers of cardiovascular health including traditional CVD risk factors, physical fitness, and indices of arterial stiffness and wave reflection in children. Original research published in English, between January 2008 and December 2018 fulfilling the objective of this review were screened and included. Findings show that adaptation of a healthy lifestyle early in life can be beneficial for reducing the risk of CVD later in life. Furthermore, keeping arterial stiffness low from a young age could be a potential CVD prevention strategy. However, limited studies are available on diet-arterial stiffness relationship in children, and future research is required to better understand this association to aid the development and implementation of evidence-based strategies for preventing CVD-related complications later in life. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)

Other

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Open AccessConcept Paper
Child and Youth Health Literacy: A Conceptual Analysis and Proposed Target-Group-Centred Definition
Int. J. Environ. Res. Public Health 2019, 16(18), 3417; https://doi.org/10.3390/ijerph16183417 - 14 Sep 2019
Cited by 2
Abstract
(1) Background: This article adopts an interdisciplinary perspective to analyse, examine, and reflect upon prominent health literacy (HL) understandings in childhood and youth. (2) Method: The conceptual analysis combined Rodgers’ and Jabareen’s approaches to conceptual analysis in eight phases. (3) Results: First, we [...] Read more.
(1) Background: This article adopts an interdisciplinary perspective to analyse, examine, and reflect upon prominent health literacy (HL) understandings in childhood and youth. (2) Method: The conceptual analysis combined Rodgers’ and Jabareen’s approaches to conceptual analysis in eight phases. (3) Results: First, we present exploratory entry points for developing a child-specific HL understanding based on the six dimensions of a ‘health-literacy 6D model’. Second, we describe and reflect upon five meta-level dimensions covering the HL definitions and models for children and youth found in the conceptual analysis. Third, we integrate our findings into a target-group-centred HL definition for children and youth. (4) Discussion/Conclusion: This article raises awareness for the heterogeneity of the current conceptual HL debate. It offers a multidisciplinary approach for advancing the existing understanding of HL. Four recommendations for future actions are deduced from the following four principles, which are inherent to the proposed target-group-centred HL definition: (a) to characterize HL from an asset-based perspective, (b) to consider HL as socially embedded and distributed, (c) to recognize that HL develops both in phases and in flexible ways, and (d) to consider the multimodal nature of health-related information. Further research is necessary to test the feasibility and applicability of the proposed definition and conceptual understanding in both research and practice. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessCase Report
A Cheek Nodule in a Child: Be Aware of Idiopathic Facial Aseptic Granuloma and Its Differential Diagnosis
Int. J. Environ. Res. Public Health 2019, 16(14), 2471; https://doi.org/10.3390/ijerph16142471 - 11 Jul 2019
Abstract
Background: Idiopathic facial aseptic granuloma (IFAG) is a rare skin disease that typically presents in children with one or more nontender, erythematous to violaceous nodules located on the cheeks or eyelids. Lesions are not accompanied by other skin abnormalities. IFAG remains a [...] Read more.
Background: Idiopathic facial aseptic granuloma (IFAG) is a rare skin disease that typically presents in children with one or more nontender, erythematous to violaceous nodules located on the cheeks or eyelids. Lesions are not accompanied by other skin abnormalities. IFAG remains a diagnostic challenge in pediatric dermatology, because several diseases may present with similar signs. Case presentation: A three-year-old girl with a previous negative clinical history was referred to our hospital for the evaluation of some asymptomatic nodules on the convexity of the left cheek. The nodules had appeared two months before, and had gradually increased in size. Her mother denied any association with trauma or insect bites. The nodules had a hard-elastic consistency, were moderately firm, and were not fluctuant. No associated lymphadenopathy was observed. The girl was afebrile and in good general condition. A histologic evaluation of a biopsy specimen revealed an inflammatory, granulomatous-diffuse infiltrate in the superficial and deep dermis consisting of giant cells, histiocytes, lymphocytes, neutrophils, eosinophils, and plasma cells. The Ziehl–Neelsen stains, Gram-stains, and cultures were negative. Suspecting an IFAG, treatment with topical fusidic acid and oral clarithromycin for 14 days was started. After two months, the lesion resolved and did not recur. Conclusion: This case shows how to differentiate IFAG from other dermatologic diseases associated with a negative evolution. Treatment with oral clarithromycin was effective in our patient. However, more scientific evidence is needed to evaluate the most suitable antibiotic therapy. Further studies are also needed to establish whether antibiotics actually impact IFAG prognosis. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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Open AccessCase Report
Corticosteroids in Moderate-To-Severe Graves’ Ophthalmopathy: Oral or Intravenous Therapy?
Int. J. Environ. Res. Public Health 2019, 16(1), 155; https://doi.org/10.3390/ijerph16010155 - 08 Jan 2019
Cited by 1
Abstract
Background: Ophthalmopathy is a rare extra-thyroid manifestation of Graves’ disease, in paediatrics. Intravenous corticosteroids are the main treatment of moderate-to-severe Graves’ orbitopathy. In this paper, we describe a moderate-to-severe active Graves’ ophthalmopathy in a child and the response to oral therapy with prednisone. [...] Read more.
Background: Ophthalmopathy is a rare extra-thyroid manifestation of Graves’ disease, in paediatrics. Intravenous corticosteroids are the main treatment of moderate-to-severe Graves’ orbitopathy. In this paper, we describe a moderate-to-severe active Graves’ ophthalmopathy in a child and the response to oral therapy with prednisone. Case presentation: A nine-year-old male child suffering for a few months, from palpitations, tremors, and paresthesia was hospitalized in our Pediatric Clinic. At admission, the thyroid function laboratory tests showed hyperthyroidism with elevated free thyroxine (FT4) and free triiodothyronine (FT3) levels and suppressed thyroid-stimulating hormone (TSH) levels. These findings, combined with the clinical conditions—an ophthalmologic evaluation (that showed the presence of exophthalmos without lagophthalmos and visual acuity deficiency), thyroid ultrasound, and TSH receptor antibody positivity—led to a diagnosis of Graves’ disease. Therefore, methimazole was administered at a dose of 0.4 mg/kg/day. After 4 months, thyroid function was clearly improved, with normal FT3 and FT4 values and increasing TSH values, without adverse effects. Nevertheless, an eye examination showed ophthalmopathy with signs of activity, an increase in the exophthalmos of the right eye with palpebral retraction, soft tissue involvement (succulent and oedematous eyelids, caruncle and conjunctival hyperaemia and oedema) and keratopathy, resulting from exposure. We began steroid therapy with oral administration of prednisone (1 mg/kg/day) for four weeks, followed by gradual tapering. After one week of therapy with prednisone, an eye assessment showed reduced retraction of the upper eyelid of the right eye, improvement of right eye exophthalmometry and reduction of conjunctival hyperaemia. After four weeks of therapy with prednisone, an eye assessment showed reduction of the right palpebral retraction without conjunctival hyperaemia and no other signs of inflammation of the anterior segment; after twelve weeks, an eye assessment showed a notable decrease in the right palpebral retraction and the absence of keratitis, despite persisting moderate conjunctival hyperaemia. No adverse event associated with steroid use was observed during the treatment period and no problem in compliance was reported. Conclusion: Prednisone seems a better choice than intravenous corticosteroids, for treating moderate-to-severe and active Graves’ ophthalmopathy, keeping in mind the importance of quality of life in pediatric patients. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Open AccessProtocol
“C.H.A.M.P. Families”: Description and Theoretical Foundations of a Paediatric Overweight and Obesity Intervention Targeting Parents—A Single-Centre Non-Randomised Feasibility Study
Int. J. Environ. Res. Public Health 2018, 15(12), 2858; https://doi.org/10.3390/ijerph15122858 - 14 Dec 2018
Cited by 4
Abstract
Childhood obesity represents a significant global health challenge, and treatment interventions are needed. The purpose of this paper is to describe the components and theoretical model that was used in the development and implementation of a unique parent-focussed paediatric overweight/obesity intervention. C.H.A.M.P. Families [...] Read more.
Childhood obesity represents a significant global health challenge, and treatment interventions are needed. The purpose of this paper is to describe the components and theoretical model that was used in the development and implementation of a unique parent-focussed paediatric overweight/obesity intervention. C.H.A.M.P. Families was a single-centre, prospective intervention offered to parents of children aged between 6–14 years with a body mass index (BMI) ≥85th percentile for age and sex. The intervention included: (1) eight group-based (parent-only) education sessions over 13-weeks; (2) eight home-based activities; and (3) two group-based (family) follow-up support sessions. The first section of the manuscript contains a detailed description of each intervention component, as well as an overview of ongoing feasibility analyses. The theoretical portion details the use of evidence-based group dynamics principles and motivational interviewing techniques within the context of a broader social cognitive theory foundation. This paper provides researchers with practical examples of how theoretical constructs and evidence-based strategies can be applied in the development and implementation of parent-focussed paediatric obesity interventions. Given the need for transparent reporting of intervention designs and theoretical foundations, this paper also adds to the areas of implementation science and knowledge translation research. Full article
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
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