HIV Vulnerability in Out-of-School Adolescents and Youth in Yunnan, China

This study investigated multiple aspects of vulnerability to HIV in out-of-school adolescents and youth in Yunnan Province, a high HIV risk region in China. The findings show that socially disadvantaged adolescents and youth were overrepresented in the out-of-school young people in Yunnan. The out-of-school young people in Yunnan exhibited 1) limited knowledge about HIV transmission and prevention, 2) a high prevalence of unprotected sexual activity, 3) high exposure to illicit drugs and alcohol use and a high prevalence of drug use in themselves, and 4) limited access to health services. There is an indication of higher exposure to risk behaviours in the younger age group. The study population used multiple media, particularly television, internet and radio, to obtain information about HIV transmission and prevention, particularly in the younger age group. These media may be an effective way of reaching this population in future HIV education and prevention programs in the region.

Socio-Cultural Barriers Influencing Utilization of Sexual and Reproductive Health (SRH) Information and Services among Adolescents and Youth 10 - 24 Years in Pastoral Communities in Kenya

Background: As in other developing countries, sexual and reproductive ill-health continues to mostly affect adolescents and youths. Samburu and Turkana counties in Kenya have some of the highest levels of total fertility rates (TFR) at 6.3 and 6.9 respectively placing them well above the national TFR of 3.9. Establishing factors that influence utilization of SRH services among adolescent and youth aged 10 - 24 years is critical in developing an effective program. Method: We used primary data from qualitative and purposeful study design. Data collection used Focus group discussions (FGD), In-depth interviews (IDIs) and Key informant interviews (IDIs). The target groups were adolescents and youth aged 10 - 24 years, health care providers, community health volunteers (CHVs), chemist assistants, parents of adolescents and youth, teachers, spiritual leaders and traditional activists. Findings and Conclusion: Socio-cultural factors were found to influence utilization of SRH services and information. Early marriage, being youth, male only decisions on sexuality matters and fear of family contribute to unprotected sex while myths and misconceptions on contraceptives affected utilization. The findings revealed that youth needs to know sources, how contraceptives work and how to use them. The findings suggest capacity building of health care providers, CHVs, teachers, parents and community leaders on adolescence, sexuality needs of adolescents and disadvantages of female genital mutilation (FGM) including early marriage.

Seroprevalence of Hepatitis B Virus Infection and Risk Factors among Adolescents and Youth in Secondary School in 2018, Commune of Covè, Benin

Background: Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus. The study aimed to determine the prevalence and associated factors of hepatitis B infection in adolescents and youth attending secondary school in Covè, urban area in Benin. Methods: From 4th to 10th February 2018, a cross-sectional survey was conducted among adolescents and youth aged 15 to 24 years old. Subjects were randomly selected. Hepatitis B surface antigenaemia (HBsAg) was assayed in blood using rapid enzyme-linked immunosorbent assay kits. Univariate and multivariate analyses were performed. Results: Two hundred adolescents and youth were recruited. The seroprevalence of hepatitis B virus infection was 18.50%. According to the multivariate logistic regression model, being infected by hepatitis B was 4.32 times higher in the age group of 15 - 19 years old than in 20 - 24 years age group (PR = 4.32 95% CI [1.51 - 12.34], p = 0.0063). Similarly, students who had not been aware of hepatitis B were more infected than those who were sensitized (PR = 14.60 [95% CI 4.98 - 4.27], p = 0.0001). With regard to lifestyle, individuals with tattoos or piercings were 8.60 times more likely to have been infected by HBV than those without tattoos or piercings, (PR = 8.60;95% CI [3.41 - 21.70], p < 0.0001). Conclusion: The seroprevalence of hepatitis B among adolescents and youth attending secondary school was high. Regular screening of HVB infection status should be included in school health services in Benin. Awareness campaigns and health education on HVB transmission and prevention should be promoted and strengthened.

Waist Circumference Distribution of Chinese School-age Children and Adolescents

Background Waist circumference （WC）, a proxy measure of central body fat, is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. WC cutoffs have been established in many countries, but the national WC reference has not been developed in China. Objective To study the distribution of WC in a representative group of Chinese children for establishing Chinese WC cutoff points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 160 225 children and adolescents aged 7-18 years old in total. The subjects were divided into five regional groups namely costal city, other city, noah rural, south rural, and Hong Kong, for analyzing the distribution of WC. Results A large variation in WC distribution was found among the five groups for both sexes. Coastal city group had the highest P85 WC values consistently from the early school ages to 18-year-old compared with other groups. In contrast, south rural group had P85 values consistently lagged behind not only the city groups but also the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the north rural groups. Catch-up trend was found in the two rural groups since the peak of puberty. These disparities were caused by not only socioeconomic and urban-rural factors but also north-south differences. Because of the regional variation of WC, a ＂gradient＂ prevalence of central obesity was prospected among these groups. Comparisons of WC distributions between the Chinese and the U.S.A or Netherlands demonstrated the necessary of setting up China＇s own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using LMS method. Conclusion The data obtained from this study could be used to develop national WC cutoff points for Chinese children and adolescents.

Vulnerability to HIV Infection and Related Health Risk Behaviors of the Out of School Adolescents Migrated with Their Parents to Beijing

Objective To explore the vulnerability to HIV infection and related risk behaviors of the out-of-school adolescents who migrated with their parents from rural areas to cities. Methods From September to October 2005, 260 out-of-school adolescents aged 14-20 years were interviewed through a questionnaire. Results Out-of-school adolescents lacked HIV/AIDS knowledge and related life skills, and their psychosocial competency was relatively low. The interviewed adolescents were open in their sexuality, showing a low rate of condom use. Their attitudes towards people living with HIV/AIDS and HIV/AIDS prevention competency were positively correlated with family well-being, harmonious relations between their parents, a stable job, knowledge, life skill, and psychosocial competency for emotion control and empathy. Conclusion Out-of-school adolescents are highly vulnerable to HIV/AIDS infection and transmission. Practical and feasible health and life skill education and psychosocial competency are the keys to effective HIV/AIDS prevention among out-of-school adolescent migrants.

Relationship between Migration and HIV Risky Behavior: a Comparative Study of Returning Migrants and Non Migrants Based on Rural Out-of-school Youth in Jilin, China

Objective To estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China. Methods A cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China. Results 58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse（4.3% for males and 5.5% for females, P〈0.01）, multiple sexual partners（24.1% for males and 44.1% for females, P〈0.01）, and HIV knowledge rate（35.2% for males and 25.5% for females, P〈0.001）. While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration. Conclusion Among rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration.

Physical activity, physical fitness, and body mass index in the Chinese child and adolescent populations： An update from the 2016 Physical Activity and Fitness in China The Youth Study

In this special issue of the Journal of Sport and Health Science, analyses of the most recent national prevalence esti- mates from the 2016 Physical Activity and Fimess in China-- The Youth Study （PAFCTYS） are presented. These include the prevalence of moderate-to-vigorous physical activity （MVPA）.

Caretaker-Adolescent Communication on Sexuality and Reproductive Health: My Perceptions Matter;A Qualitative Study on Adolescents’ Perspectives in Unguja-Zanzibar

This study was conducted to explore the perceptions of adolescents on caretaker-adolescent communication on sexuality. Using an Information-Motivation-Behavioural Skills model, this article highlights areas to emphasise when planning strategies to improve caretaker-adolescent communication on sexuality. Twelve focus group discussions were held with adolescents aged between 15 and 19 years, and data were analysed using content analysis. The participants found it important for caretakers to communicate with adolescents about sexuality to avoid sexual and related health risks. Caretakers were the most preferred communicators, by adolescents, on sexuality matters. It became apparent that information about the use of condoms was the most unpopular topic during the discussions, while information about the use of contraceptives seemed to be more interesting to the majority of the participants. From the adolescents’ point of view, the barriers to communication about sexuality on the caretakers’ side, include, the belief that such information might encourage promiscuity;some caretakers do not find it easy to discuss matters related to sexuality with their children;and others feel that some adolescents know more about sexuality than themselves. On the other hand, barriers on adolescents’ side include, “fear” of the caretakers, some of whom seem harsh, unfriendly, and sometimes unapproachable. Following the findings, it is being suggested that intervention strategies that would help to alleviate communication barriers would consequently facilitate caretaker-adolescent discussions about sexuality and reproductive health.

Adolescent and Unmarried Youth Reproductive Health:Status,Perspectives and Strategies

The United Nations International Conference on Population and Development(ICPD), held in Cairo in 1994, recognized that adolescents and young people have

Examination of Urinary Chlorpyrifos Biomarker Concentrations and Heart Rate in a Sample of US Children and Adolescents

Objective: The purpose of the investigation is to determine if a relationship exists between heart rate and urinary biomarkers of chronic, subacute chlorpyrifos pesticide exposure in youth. Methods: Using 2001-2002 NHANES data, a sample of 1233 children ages 6 - 18 was grouped based on detection status of 3,5,6-trichloropyridinol (TCPy) in urine. Radial pulse and brachial pulse were recorded as measures of heart rate by physicians. T-tests and linear regression analyses were performed to test for associations between TCPy concentrations and heart rate. Results: None of the associations between TCPy levels and heart rate outcomes were found to be significant. Nonsignificant effects in the TCPy-detected groups included a slightly reduced heart rate in girls, as well as a slightly elevated heart rate in boys when compared to the undetected controls. Neither was there any significant observable difference in heart rate due to detection status in the sample overall. Conclusions: At this time, an effect on heart rate attributable to chronic, low-level chlorpyrifos exposure in youth cannot be determined. Children and adolescents detected did not demonstrate a substantial change in pulse measures when compared to controls. It is recommended that subsequent studies examine chlorpyrifos biomarkers as they may relate to other indicators of cardiovascular health.

The Powerful Role of Mothers in Adolescent Purpose Development

Adolescence is a critical time for the cultivation of life purpose,also known as a meaningful long-term aim focused on contribution to others.Youth with purpose,especially marginalized youth,report a number of positive outcomes.Relationships with caring adults appear to be particularly helpful in guiding young people on their path to purpose,but little work has focused specifically on the role of mothers.This qualitative study,approved by a Institutional Review Board,examines how twenty adolescents from marginalized communities describe their sense of purpose and its relationship to their caregivers.The sample size was determined based on saturation,a process in qualitative research when the researchers begin to observe redundancy in the data.Through content analysis,a major theme emerged:the role of mothers and their impact on purpose development on their children.Results showed that mothers helped their adolescents develop their sense of purpose through serving as a sense of inspiration,providing the adolescents with support,sparking a desire for the adolescents to make their mothers proud,and through the mothers and adolescents in engaging in conversations about one’s future.

体育社交媒体健康传播与青少年体育行为互动影响研究——健康信念的中介作用

目的:探讨新媒介环境下体育社交媒体健康传播、青少年健康信念与青少年体育行为之间的互动影响机制。方法:以14~24岁学生为研究对象,共收集258份有效问卷数据,运用SPSS和SmartPLS进行描述性统计分析、PLSSEM和PLS-MGA分析。结果:1)体育社交媒体健康传播与青少年健康信念相互促进;2)青少年健康信念与体育行为相互促进;3)体育社交媒体健康传播与青少年体育行为相互促进;4)青少年健康信念在体育社交媒体健康传播与体育行为的双向互动中均起到部分中介作用,但直接作用更强;5)体育社交媒体健康传播对青少年健康信念和体育行为的影响在性别和年龄层面上具有一致性。结论:1)体育社交媒体健康传播与青少年健康信念和体育行为之间存在显著的双向互动,其中健康信息传递、自我效能提升和体育价值认知是关键影响维度;2)青少年健康信念在体育社交媒体健康传播与体育行为之间发挥部分中介作用,但直接传播和行为促进仍是主要驱动力;3)体育社交媒体健康传播通过健康信念与体育行为的双向互动,形成了自我增强的传播闭环,显著推动了健康传播和体育行为的持续发展。

Youth friendly health services and role of outreach activities to improve access to services

An attempt has been made to assess the Youth Friendly Health Services (YFHS) from the clients’ perspectives and the role of outreach community-based approach (Youth Information Center, YIC) in improving access to services. A cross- sectional study was undertaken in Arajiline and Hoskote blocks in Varanasi and Bangalore districts respectively using primarily a quantitative technique. A consecutive sample of 120 clients from 4 selected clinics was interviewed after seeking services from YFHS. Additionally, facility assessment of clinics and 8 FGDs were conducted among community members and the young people in the community. Majority of the clients (90.8%) are aware that YFHS provide services to young males and females separately on specific day and time. Nearly 66% clients visited YFHS to sought treatment for three key health problems i.e. menstruation problems (25.4%) followed by general illness (22.8%) and swelling/itching of private parts (21.1%). In Hos- akote privacy was maintained during the con- sultation with the doctor, however, situation was relatively not better in Arajiline. Out of those clients who had visited YIC atleast once, 49 out of 53 in Arajiline and 51 out of 60 in Hasokote reported that the YIC staff/activities had motivated them to sought services at YFHS. Study concludes that while majority of the clients were satisfied with the services at YFHS, there is a need for strengthening the existing “package” of the services. At facility level, reassurance about the privacy and confidentially and alternative ways to promote access and utilization of services by active involvement of young people is recommended. On the other hand, at outreach level, new technologies should be introduced to generate demand, intensive focus on adults in the community and integration of YIC with local governance and school environment is suggested so as to protect young people against poor health outcomes.

Operationalizing Adolescent Health Services at Primary Health Care Level in India: Processes, Challenges and Outputs

Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra;assess impact of need based interventions on quality of services;and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents;it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.

基于ICF-CY残疾儿童青少年运动功能评价量表内容和心理测量指标的Scoping综述

目的基于《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论与方法,分析儿童青少年常用运动功能评估工具的内容和心理测量指标。方法基于ICF-CY分类架构和编码系统,应用ICF编码规则、匹配原则,选择4种儿童青少年常用的功能评估工具,分析其运动功能测量方法和心理测量指标。结果最终纳入11篇文献,其中英文9篇,中文2篇,来自韩国、西班牙、中国、巴西,主要发表在临床医学、神经科学、公共健康、康复科学等领域期刊,发表时间为2011年至2021年。研究对象的年龄为0~16岁,涉及的总样本量为987,健康情况为痉挛型脑瘫、神经发育障碍等。纳入文献中,采用粗大运动功能测试(GMFM-88)6篇,精细运动功能测试(FMFM)2篇,Peabody运动发育评定量表(PDMS-2)2篇,残疾儿童能力评定量表-功能技能量表(PEDI-FSS)2篇,残疾儿童能评定量表(PEDI)3篇;测量方式为客观评估、主观评估、主试观察等;测量次数为2~6次。运动功能测量指标主要涉及两个层面,其中身体活动层面包括粗大运动、精细运动和运动控制能力;活动功能层面主要为日常生活活动能力和功能独立性等。结论本研究基于ICF-CY对儿童运动功能和活动与参与评估,主要分为两个层面。身体功能层面主要的评定指标涉及b730、b760、b770等;活动与参与层面主要的评定指标涉及d410、d440、d445等。GMFM-88关注身体移动和活动功能的评估,如坐、站、躺、行走与跑跳功能,主要涉及b760、d410、d455等;FMFM关注自主运动、运动动机和运动的协调性,主要用于评估0~3岁脑瘫儿童上肢的功能状态,主要涉及b760、d155、d440等;PDMS-2更注重评估儿童青少年整体运动发育水平和运动功能状态,主要涉及b750、b760、d415等;PEDI-FSS移动分区专注儿童在日常生活活动中的实际运动功能表现,评估儿童在日常生活活动中运动功能的应用和实用性,主要涉及b760、d410、d450等。在测量方式上,运动功能的测量主要有客观评估和主观评估;活动功能的测量主要有客观评估和主试观察。这些标准化的身体运动功能和活动功能的评定工具均有常模,根据动作发展,建立了不同年龄段的常模,评估者需要经过专业培训,才能使用上述评定工具,以提升评估信度、效度和适应性。

基于共享决策的青少年与青年癌症患者生育力保存研究进展

癌症相关治疗会损害癌症幸存者的生育力。生育力保存可帮助癌症幸存者保护其生殖内分泌功能或保存生殖潜能。在青少年与青年癌症患者中开展生育力保存的共享决策,有助于患者做出最符合自己价值观和偏好的生育力保存决策,减少决策冲突和决策后悔。本文对青少年与青年癌症患者生育力保存的共享决策的相关概念、发展现状、决策模式、挑战及其对策进行综述,为促进青少年和青年患者生育力保存共享决策和提升生活质量提供参考。

家庭环境二手烟暴露对青少年情绪行为的影响

目的分析家庭环境二手烟暴露对青少年情绪行为的影响,为从家庭环境方面干预青少年情绪行为问题的发生发展提供理论支持。方法调查重庆市主城某区1002名青少年的家庭基本信息、家庭环境二手烟暴露、青少年自评量表(Youth Self-Report,YSR)等情况,使用多因素Logistic回归模型分析青少年家庭环境二手烟暴露与其情绪行为间的关系。结果48.2%的青少年存在家庭环境二手烟暴露问题。家庭环境二手烟暴露与未暴露的青少年整体情绪行为问题平均得分分别为(26.83±22.28)分和(23.61±20.33)分,整体情绪行为问题的检出率分别为12.2%和8.3%。多因素Logistic回归分析结果显示,存在整体情绪行为问题的青少年中,家庭环境二手烟暴露的青少年多于未暴露的,OR值为1.838(95%CI:1.161~2.911);女性青少年多于男性,OR值为2.476(95%CI:1.546~3.964);年龄较大的青少年多于年龄较小的,OR值为1.440(95%CI:1.186~1.749);父亲在外地工作的青少年多于父亲没有在外地工作的,OR值为2.511(95%CI:1.271~4.959);自觉父母间关系一般和较差的青少年多于自觉父母间关系较好的,OR值分别为2.791(95%CI:1.643~4.743)和3.879(95%CI:1.607~9.367);且家庭环境二手烟暴露的青少年内化行为问题多于未暴露的青少年,OR值为1.568(95%CI:1.015~2.422)。结论本研究中约50%的青少年存在家庭环境二手烟暴露问题,家庭环境二手烟暴露是影响青少年内化行为问题和整体情绪行为问题的重要因素。

Obstructive Sleep Apnea Syndrome is Associated with Metabolic Syndrome among Adolescents and Youth in Beijing： Data from Beijing Child and Adolescent Metabolic Syndrome Study

Background： Obstructive sleep apnea （OSA） syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome （MS）.Methods： A total of 558 subjects aged 14-28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study. Each underwent a 2-h oral glucose tolerance test （OGTT）, echocardiography, and liver ultrasonography. Anthropometric measures, blood levels of glucose, lipids, and liver enzymes were assessed. Subjects with high or low risk for OSA were identified by Berlin Questionnaire （BQ）. Results： Among the subjects in obesity, 33.7% of whom were likely to have OSAby BQ. Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA （P 〈 0.001 ）. Moreover, significant differences in levels of lipids, glucose after OGTT, and liver enzymes, as well as echocardiographic parameters were found between the two groups with high or low risk for OSA （P 〈 0.05）. The rates of nonalcoholic fatty liver disease （71.0% vs. 24.2%）, MS （38.9% vs. 7.0%）, and its components in high-risk group were significantly higher than in low-risk group. Conclusions： The prevalence of OSA by BQ was high in obese adolescents and youth. A high risk for OSA indicates a high cardiometabolic risk. Mechanisms mediating the observed associations require further investigation.

青少年早期专项化训练学者共识

青少年早期专项化训练(Early sport specialization,ESS)是关乎青少年竞技运动训练科学化的重要问题,也是国内外体育科学领域持续关注的热点问题。通过文献资料法,明晰青少年早期专项化的概念,梳理早期专项化的基本内涵,归纳青少年早期专项化训练的国际经验及可能导致的负面影响,提出青少年专项化训练科学化的应对之策。基于此,拟定如下学者共识:第一、青少年早期专项化训练是指在青春期之前围绕一个特定运动项目进行的高强度的训练;第二、尽管诸如体操、跳水等运动项目要求很早(6~9岁)进行专项化训练,但绝不能忽视早期专项化训练极易对动作技能学习、运动技能学习、体能训练科学化、长期职业生涯发展及身体健康等造成的不良影响;第三、对于大多数运动项目来说,青少年相对较晚的进行专项化训练、或早期进行多样化训练且在晚期进行高水平专项化训练,成年后在竞技体育领域获得成功的概率更高;第四、技术主导类项目可以在正确动作模式基础上开展早期专项化训练,训练过程中应高度关注动作质量,避免出现动作模式异常诱发运动损伤;第五、青少年专项训练科学化的根本在于建立集体能、技术、战术、心理、运动智商及人文素养于一体的训练体系;第六、青少年专项训练科学化的关键在于依据生理年龄和身体机能发育特征,强化青少年各个时期体能训练科学化;第七、青少年早期专项化训练的综合应对策略为:选择合适的早期专项化训练时机、构建青少年长期发展模型、强化青少年多样化训练、训练与监控充分结合,以及建立与年龄相适应的赛事体系;第八、倡导以健康和快乐作为青少年参与体育运动的价值导向,以培养终身体育素养作为青少年参与体育运动的根本目标。

广州青少年语言使用与语言态度调查与分析

本研究以462名广州青少年为样本进行城市语言调查,认为广州青少年的语言使用现状可表述为"普通话与粤方言并重";普通话使用比例的快速增加,并未对粤方言造成冲击,而原本有不少使用者的其他方言则趋于边缘化;广州青少年在语言态度方面总体上略偏爱粤方言,这种偏爱主要来自情感认同维度。研究还发现,对普通话的语言态度与性别有关,但在探讨语言态度与性别的关系时,需要排除与语言态度无关的其他因素,否则会高估性别对于语言态度的影响。