High-Sensitivity C-Reactive Protein, Its Change, and Cognitive Function: A National Population-Based Cohort Study.

This study aimed to evaluate the associations of baseline high-sensitivity C-reactive protein (Hs-CRP) and its change with subsequent cognitive decline and cognitive impairment. Data for this study were obtained from the China Health and Retirement Longitudinal Study, a national community-based prospective cohort study. Hs-CRP level and cognitive function were measured repeatedly over a 7-year follow-up. Linear mixed models and cox proportional hazard models were used to evaluate the associations. The study comprised 7385 participants (50.67% women, mean age 59.08 ± 8.86 years) with baseline Hs-CRP ranging from 0.03 to 178.10 mg/L (median: 1.01 mg/L, IQR: 0.55-2.11 mg/L). During a median of 5.79 years follow-up, the highest quartile of the Hs-CRP group showed a faster rate of cognitive decline (-0.0053 SD/year, p = 0.006) and a higher risk of cognitive impairment (HR 1.0814, p = 0.044) than those in the lowest quartile. Individuals in the elevated group of Hs-CRP change had a significantly faster cognitive decline (-0.0070 SD/year, p = 0.016) compared with those in the stable group. In this study, significant longitudinal associations between baseline Hs-CRP, elevated Hs-CRP, and long-term cognitive deterioration were observed. Hs-CRP level could perhaps serve as a predictor for cognitive deterioration in middle-aged and older adults.

Early menarche and its relationship to paternal migrant work among middle-school-aged students in China.

Associations have been shown between father's absence and menarcheal age, but most studies have focused on absence resulting from divorce, abandonment or death. Little research has been conducted to evaluate the effect on menarcheal age of paternal absence through migrant work. In a sample of 400 middle school students, this study examined the association between paternal migrant work and menarcheal age against a backdrop of extensive rural-to-urban migration in China. Data were collected through a self-reported questionnaire, including social-demographic characteristics, aspects of family relationships, information about father's migrant work and age at menarche. After adjusting for BMI, parent marital status and perceived relationship with mother, lower self-perceived quality of father-daughter relationship (both 'father present, relationship poor' and 'father absent, relationship poor') and lower frequency of contact with the father were associated with higher odds for early menarche. These findings suggest that the assumption that father's absence for work influences the timing of menarche needs to be examined in the context of the quality of the father-daughter relationship and paternal care, which appear to play a critical role in the timing of menarche. These findings also emphasize the importance of enhancing paternal involvement and improving father-daughter relationships in the development of appropriate reproductive strategy in daughters.

Eating Frequency Is Not Associated with Obesity in Chinese Adults.

The prevalence of overweight and obesity has been increasing globally. Recent studies suggest that eating frequency (EF) might be a factor influencing the development of overweight and obesity. This study aims to explore the association between eating frequency and obesity in Chinese adults. A cross-sectional study was conducted in Wuhan, China, from March to June 2016. A self-administered questionnaire and 24-h dietary recall were used to collect data on sociodemographic variables, lifestyle factors, nutrition knowledge, and eating frequency. Participants were divided into four groups according to eating frequency and meal timing: traditional time pattern (TTP), traditional time plus late snack pattern (TTLSP), irregular time pattern (ITP), and all-day pattern (ADP). We performed the chi-squared test and multiple logistic regression to assess associations among variables using JMP statistical software version 14.0.0 (SAS Institute Inc., Cary, NC, USA). Respondents were Chinese adults (N = 2290; range 29⁻74 years; 1162 men). Lower education level, higher food budget, and lower nutrition knowledge were associated with higher likelihood of irregular EF patterns (TTLSP, ITP, or ADP). Men, non-smokers, and participants with less physical activity, lower education level, or lower nutrition knowledge were more likely to be obese. Body mass index (BMI) categorization was significantly different among EF pattern groups (χ² = 25.40, p = 0.003); however, this association was no longer significant in the regression model after adjustment for age, sex, education, smoking, food budget, nutrition knowledge, and physical activity. Thus, EF is not associated with obesity in Chinese adults.

An ecological perspective on risk factors for repeat induced abortion in China.

INTRODUCTION: Repeated induced abortion (RIA) is a challenging public health issue. Although many studies have investigated the characteristics of women who experience multiple abortions, most have focused only on limited intrapersonal variables. To frame the analysis, this study used an ecological model integrating intrapersonal, interpersonal and environmental variables to explore factors associated with RIA. METHODS: Single-site (Maternal and Child Health Hospital, Hubei, China) cross-sectional data were collected from 405 women between July 2015 and November 2015 using a self-administered questionnaire. Characteristics of women who experienced only one abortion were compared to those who had RIA (≥2 abortions). RESULTS: Among the 316 eligible women who completed the questionnaire, 110(34.8%) experienced one abortion, 206 (65.2%) experienced two or more. Multivariate binary logistic regression analysis showed a higher odds of RIA among women who were older, reported earlier age at sexual debut and reported higher abortion frequency among close female friends. Factors appearing to protect against RIA included higher frequency of partner agreement to women's contraceptive preference. CONCLUSIONS: Adapting an ecological perspective, this study examined social and environmental factors related to RIA. Our findings emphasize the importance of developing interventions that target both women and their male partner. Group norms relating to contraceptive use also need to be addressed to improve contraceptive use and reduce the risk of repeat abortions.

Associations among Screen Time and Unhealthy Behaviors, Academic Performance, and Well-Being in Chinese Adolescents.

Screen time is negatively associated with markers of health in western youth, but very little is known about these relationships in Chinese youth. Middle-school and high-school students (n = 2625) in Wuhan, China, completed questionnaires assessing demographics, health behaviors, and self-perceptions in spring/summer 2016. Linear and logistic regression analyses were conducted to determine whether, after adjustment for covariates, screen time was associated with body mass index (BMI), eating behaviors, average nightly hours of sleep, physical activity (PA), academic performance, and psychological states. Watching television on school days was negatively associated with academic performance, PA, anxiety, and life satisfaction. Television viewing on non-school days was positively associated with sleep duration. Playing electronic games was positively associated with snacking at night and less frequently eating breakfast, and negatively associated with sleep duration and self-esteem. Receiving electronic news and study materials on non-school days was negatively associated with PA, but on school days, was positively associated with anxiety. Using social networking sites was negatively associated with academic performance, but positively associated with BMI z-score, PA and anxiety. Screen time in adolescents is associated with unhealthy behaviors and undesirable psychological states that can contribute to poor quality of life.

Cost-effectiveness of Community-Based Minigrants to Increase Physical Activity in Youth.

CONTEXT: American youth are insufficiently active, and minigrant programs have been developed to facilitate implementation of evidence-based interventions in communities. However, little is known about the cost-effectiveness of targeted minigrant programs for the implementation of physical activity (PA) promoting strategies for youth. OBJECTIVE: To determine the cost-effectiveness of a minigrant program to increase PA among youth. DESIGN: Twenty community grantees were pair-matched and randomized to receive funding at the beginning of year 1 (2010-2011) or year 2 (2011-2012) to implement interventions to increase PA in youth. Costs were calculated by examining financial reports provided by the granting organization and grantees. SETTING: Twenty counties in North Carolina. PARTICIPANTS: A random sample of approximately 800 fourth- to eighth-grade youth (per year) from the approximately 6100 youth served by the 20 community-based interventions. MAIN OUTCOME MEASURE: Cost-effectiveness ratios (CERs) were calculated at the county and project levels to determine the cost per child-minute of moderate-to-vigorous PA (MVPA) increased by wave. Analyses were conducted utilizing cost data from 20 community grantees and accelerometer-derived PA from the participating youth. RESULTS: Of the 20 participating counties, 18 counties displayed increased youth MVPA between at least 2 waves of observation. Of those 18 counties, the CER (US dollars/MVPA minutes per day) ranged from $0.02 to $1.86 (n = 13) in intervention year 1, $0.02 to $6.19 (n = 15) in intervention year 2, and $0.02 to $0.58 (n = 17) across both years. CONCLUSION: If utilized to implement effectual behavior change strategies, minigrants can be a cost-effective means of increasing children's MVPA, with a low monetary cost per minute of MVPA.

Effectiveness of Community-Based Minigrants to Increase Physical Activity and Decrease Sedentary Time in Youth.

OBJECTIVE: To determine the effectiveness of targeted grant funding for the implementation of multilevel community interventions to increase moderate to vigorous physical activity (MVPA) and decrease time spent sedentary among a large sample of youth in North Carolina. DESIGN: A repeated, cross-sectional, group-randomized controlled trial design with a delayed treatment group. SETTING: Twenty counties in North Carolina. PARTICIPANTS: Analyses were conducted on 2138 youth, grades 4 to 8, who provided complete data across the 3 waves. INTERVENTION: The North Carolina Eat Smart, Move More Community Grants program consisted of 20 separate community interventions implemented by grantees that targeted increasing physical activity and/or decreasing sedentary time in youth. County grantees were pair-matched and randomized to receive funding for implementation in year 1 (2010-2011) or year 2 (2011-2012). MVPA/sedentary time was assessed via accelerometer with demographics assessed via self-report in 3 waves of data collection (fall 2010, 2011, and 2012). MAIN OUTCOME MEASURE: MVPA and sedentary time measured via accelerometry. RESULTS: After adjusting for covariates, there was no difference in MVPA between counties implementing in year 1 (2010-2011) and those implementing in year 2 (2011-2012; ie, waitlist controls) comparing data collection wave 1 to wave 2 (fall 2010-2011). A significant increase of 2.32 minutes per day of MVPA was observed following the implementation year across all counties as compared with the baseline year. Differences were largely driven by increased MVPA in elementary school youth (fourth and fifth grades). No significant changes in sedentary time were observed. CONCLUSIONS: Low-cost, high-reach mini-grants can have a small, but meaningful effect on children's MVPA, with greater effects seen in younger children. Future studies should examine characteristics of mini-grants projects that are associated with the greatest increases in MVPA among youth.