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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 Health".

Deadline for manuscript submissions: 1 June 2019

Special Issue Editor

Guest Editor
Assoc. Prof. Jitse P. Van Dijk

Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Ant. Deusinglaan 1, 9713 AV Groningen, The Netherlands
Website | E-Mail
Interests: Roma health; Roma health disadvantage; chronic disease; adolescents and health

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 1800 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 (21 papers)

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Research

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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
Received: 12 December 2018 / Revised: 30 January 2019 / Accepted: 11 February 2019 / Published: 13 February 2019
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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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Open AccessArticle 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
Received: 11 January 2019 / Revised: 1 February 2019 / Accepted: 7 February 2019 / Published: 9 February 2019
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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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Open AccessArticle 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
Received: 15 October 2018 / Revised: 1 January 2019 / Accepted: 22 January 2019 / Published: 23 January 2019
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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)
Open AccessArticle 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
Received: 1 November 2018 / Revised: 8 January 2019 / Accepted: 11 January 2019 / Published: 18 January 2019
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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
Received: 22 October 2018 / Revised: 27 November 2018 / Accepted: 18 December 2018 / Published: 25 December 2018
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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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Open AccessArticle 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
Received: 15 November 2018 / Revised: 6 December 2018 / Accepted: 7 December 2018 / Published: 10 December 2018
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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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Open AccessArticle 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
Received: 10 October 2018 / Revised: 18 November 2018 / Accepted: 3 December 2018 / Published: 7 December 2018
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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
Received: 9 November 2018 / Revised: 27 November 2018 / Accepted: 5 December 2018 / Published: 7 December 2018
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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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Open AccessArticle 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
Received: 22 October 2018 / Revised: 16 November 2018 / Accepted: 26 November 2018 / Published: 2 December 2018
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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
Received: 22 October 2018 / Revised: 22 November 2018 / Accepted: 27 November 2018 / Published: 28 November 2018
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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
Received: 4 October 2018 / Revised: 1 November 2018 / Accepted: 19 November 2018 / Published: 22 November 2018
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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
Received: 10 October 2018 / Revised: 2 November 2018 / Accepted: 9 November 2018 / Published: 15 November 2018
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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
Received: 4 October 2018 / Revised: 26 October 2018 / Accepted: 8 November 2018 / Published: 13 November 2018
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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
Received: 1 October 2018 / Revised: 25 October 2018 / Accepted: 29 October 2018 / Published: 5 November 2018
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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
Received: 14 September 2018 / Revised: 23 October 2018 / Accepted: 28 October 2018 / Published: 3 November 2018
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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
Received: 6 September 2018 / Revised: 5 October 2018 / Accepted: 8 October 2018 / Published: 11 October 2018
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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
Received: 13 June 2018 / Revised: 25 July 2018 / Accepted: 20 August 2018 / Published: 29 August 2018
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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
Received: 16 May 2018 / Revised: 15 July 2018 / Accepted: 21 July 2018 / Published: 7 August 2018
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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 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
Received: 2 February 2019 / Revised: 7 February 2019 / Accepted: 11 February 2019 / Published: 14 February 2019
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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)

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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
Received: 21 November 2018 / Revised: 30 December 2018 / Accepted: 7 January 2019 / Published: 8 January 2019
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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
Received: 7 November 2018 / Revised: 7 December 2018 / Accepted: 10 December 2018 / Published: 14 December 2018
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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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