The Link Between Temporomandibular Disorders and Jaw Functional Limitations Among Chinese Adolescents.

BACKGROUND: Currently, there is still controversy surrounding the relationship between temporomandibular disorders (TMDs) symptoms and jaw functional limitations. We investigated the distribution of TMDs in senior high school students, including both the number and types of symptoms, and assessed their association with jaw functional limitations. Furthermore, we explored sex differences in these associations. METHODS: This study was conducted at a public high school in Hefei, Anhui Province, China, with data collected from September to October 2022. All subjects completed questionnaires assessing the anamnestic symptoms of TMDs and the Jaw Functional Limitation Scale (JFLS), and examinations were performed by trained dentists according to the Diagnostic Criteria for TMD. Data were analysed using the Kruskal-Wallis, Mann-Whitney U, and Chi-square tests. RESULTS: The mean age of the participants (N = 2890) was 17.2 ± 0.14 years and 38.9% were females (61.1% were males). Limitations in self-assessed jaw function were associated with the presence of TMDs (P < .05). Participants with more symptoms reported significantly high levels of functional limitations (P < .05). Compared to male adolescents, female adolescents more commonly experienced TMDs pain and tended to have more symptoms (P < .05). However, no sex differences were observed in most associations between TMDs and jaw functional limitations. CONCLUSION: TMDs-positive symptoms are common in adolescents. Female adolescents were more affected by TMDs symptoms than male adolescents. Individuals with more TMDs symptoms have greater jaw functional limitations.

Association of maternal and paternal adverse childhood experiences with emotional and behavioral problems among preschool children.

Although maternal adverse childhood experiences (ACEs) are known to be related to the emotional and behavioral problems (EBPs) of offspring, few studies have surveyed the intergenerational effects of paternal ACEs. In addition, no study has yet explored the combination and interaction effects of maternal and paternal ACEs on preschool children's EBPs in China, and the gender differences in these relationships also remain to be explored. A total of 3,575 preschool children from 12 preschools from Hefei city of Anhui province were included in this study. We used a binomial logistic regression to examine the relationship between maternal ACEs, paternal ACEs and children's EBPs. Logistic regression analysis indicated that maternal and paternal ACEs were significantly related to EBPs in children, respectively. The high maternal ACEs + high paternal ACEs group had the greatest association with children's EBPs. Interaction analysis results showed that, compared with the reference group (low maternal ACEs×low paternal ACEs), the other group (high maternal ACEs×high paternal ACEs ) were significantly related to children's EBPs (OR = 1.84, 95%CI: 1.55-2.19). We found that there were no gender differences in the combination and interaction effects (P>0.05). When fathers and mothers were jointly exposed to high levels of ACEs, children had a higher risk of developing EBPs than when they were exposed independently. Future studies should fully explore the intergenerational health effects of parental ACEs so that references for promoting the physical and mental health of preschool children can be developed.

Patterns of maternal adverse childhood experiences and the intergenerational association of preschool children's emotional and behavioral problems.

Introduction: Children of whose mothers exposed to adverse childhood experiences (ACEs) are at increased risk for developmental problems. This study aims to investigate the relationship between types and patterns of maternal ACEs and preschool children's emotional and behavioral problems (EBPs) in China, and to explore gender differences associated with these problems. Methods: In this cross-sectional study, we selected 9,647 children from 36 preschools in three cities of Anhui province, China. Questionnaires were used to report the details of maternal ACEs and children's EBPs. We used the latent class analysis (LCA) to identify "patterns" in the types of maternal ACEs. Binomial logistic regressions was performed to examine the relationship between types and patterns of maternal ACEs and preschoolers' EBPs. Results: Latent class analysis (LCA) revealed four different classes of maternal ACEs. Logistic regression analysis showed that compared with the low ACEs class, children of mothers in the high abuse and neglect class had the highest risk of developing EBPs (OR = 5.93, 95%CI: 4.70-7.49), followed by moderate ACEs class (OR = 2.44, 95%CI: 1.98-3.00), and high household dysfunction class (OR = 2.16, 95%CI: 1.19-3.90). We found gender differences in the effects of high abuse and neglect/moderate ACEs class and maternal childhood physical abuse/neglect on children's EBPs, which had a stronger impact on EBPs in boys than girls (P<0.05). Discussion: This study supports and refines existing research that confirms an intergenerational association between types and patterns of maternal ACEs and children's EBPs in a large Chinese sample, so as to provide references for the early prevention and control of children's EBPs.

Physical activity and social anxiety symptoms among Chinese college students: a serial mediation model of psychological resilience and sleep problems.

BACKGROUND: Social anxiety symptoms are common and harmful psychological illness in college students. Although some studies have illustrated that physical activity could reduce social anxiety symptoms, the specific mechanism is still unclear. Based on theoretical studies on resilience and sleep, this study constructed a serial mediation model to explore whether they mediate between physical activity and social anxiety symptoms among college students. METHODS: This study surveyed 9,530 college students from three colleges in China to explore the mediating effect of physical activity and sleep problems between physical activity and social anxiety symptoms. Participants were investigated with the International Physical Activity Questionnaire, Connor-Davidson Resilience Scale, Sleep-related problems, and the Social Interaction Anxiety Scale and the Social Phobia Scale. Correlations between variables were analysed using Pearson correlation analysis and mediation analyses were performed using SPSS PROCESS macro 3.3 software. RESULT: The study found that physical activity was negatively associated with social anxiety symptoms and sleep problems, but positively with psychological resilience. After controlling for sociodemographic variables, physical activity can not only indirectly alleviate social anxiety symptoms through the separate mediation of psychological resilience and sleep problems, but also through the serial mediation of psychological resilience and sleep problems. CONCLUSION: These results suggest that improving physical activity levels could reduce social anxiety scores by increasing psychological resilience and sleep quality. This is of great reference significance for the prevention and intervention of college students' mental health.

Lifestyle-specific association between adversity dimensions with group-based mental health trajectories.

BACKGROUND: Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems. METHODS: This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle. RESULTS: Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: ß = 2.01, P < 0.001; high-deprivation: ß = 1.03, P < 0.001; high-unpredictability: ß = 0.83, P = 0.001; high-overall adversity: ß = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys. LIMITATIONS: The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data. CONCLUSIONS: This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.

Association between green space and multiple ambient air pollutants with depressive and anxiety symptoms among Chinese adolescents: The role of physical activity.

OBJECTIVE: To explore the association between green space, multiple ambient air pollutants and depressive/anxiety symptoms and the mediating role of physical activity (PA) in Chinese adolescents. METHOD: A school-based health survey was conducted in eight provinces in China in 2021. 22,868 students aged 14.64 (±1.77) years completed standard questionnaires to record details of depressive, anxiety symptoms and PA. We calculated the average normalized difference vegetation index (NDVI) in circular buffers of 200 m, 500 m and 1000 m and estimated the concentrations of PM10, PM2.5, CO, NO2, O3, SO2 around the adolescents' school addresses. RESULTS: The exposure-response curves showed that the lower the NDVI value, the higher the risk of depressive and anxiety symptoms. CO, PM2.5 and SO2 and air pollution score were associated with increased risk of depressive and anxiety symptoms. NDVI in all circular buffers decreased the risk of depressive and anxiety symptoms at low levels of PA, but the associations were not significant at high levels of PA. In the subgroup analysis, PM10, PM2.5, CO, NO2, SO2, AQI and air pollution score increased the risk of depressive and anxiety symptoms at low PA levels, but the associations were not significant at high levels of PA. Mediation analysis indicated that the mediating effect of PA on the association between NDVI, NDVI-200 m NDVI-500 m, CO, PM10, PM2.5, SO2, AQI and depressive/anxiety symptoms was statistically significant（p < 0.05）. CONCLUSION: Middle-high level PA could reduce the strength of association between air pollution and depressive and anxiety symptoms. Meanwhile, the association between green space/air pollution and depressive/anxiety symptoms was partly mediated by PA.

Real-ambient bedroom light at night increases systemic inflammation and disrupts circadian rhythm of inflammatory markers.

BACKGROUND: Exposure to light at night (LAN) has been associated with multiple adverse health outcomes. However, evidence is limited regarding the impacts of LAN exposure on human inflammation. OBJECTIVES: To examine the association between real-ambient bedroom LAN exposure with systemic inflammation and circadian rhythm of inflammatory markers. METHODS: Using data from a prospective cohort study of Chinese young adults. At baseline, bedroom LAN exposure was measured with a portable illuminance meter; fasting blood sample for high-sensitivity C-reactive protein (hs-CRP) assay was collected. At 3-year follow-up, 20 healthy young adults (10 LANavg < 5 lx, 10 LANavg ≥ 5 lx) were recruited from the same cohort; time-series venous blood samples were sampled every 4 h over a 24 h-cycle for the detection of 8 inflammatory markers. Circadian rhythm of inflammatory markers was assessed using cosinor analysis. RESULTS: At baseline, the average age of the 276 participants was 18.7 years, and 33.3 % were male. Higher levels of bedroom LAN exposure were significantly associated with increased hs-CRP levels. The association between bedroom LAN exposure and systemic inflammation was only significant in the inactive group (MVPA < 2 h/d) but not in the physically active group (MVPA ≥ 2 h/d). In addition, exposure to higher levels of nighttime light (LANavg ≥ 5 lx) disrupted circadian rhythms (including rhythmic expression, circadian amplitude and circadian phase) of some inflammatory cytokines and inflammatory balance indicators. CONCLUSION: Exposure to bedroom nighttime light increases systemic inflammation and disrupts circadian rhythm of inflammatory markers. Keep bedroom darkness at night may represent important strategies for the prevention of chronic inflammation. Additionally, for people living a community with higher nighttime light pollution, regular physical activity may be a viable option to counteract the negative impacts of LAN exposure on chronic inflammation.

Effects of social-ecological risk factors and resilience on the relationship between metabolic metrics and mental health among young adults.

The correlation between metabolic metrics and mental health remains underexplored, with few in-depth studies examining whether this association exists among college students and whether it might be moderated by socio-ecological risk factors (SERFs) and mediated by resilience. A follow-up study design investigated the association between baseline metabolic metrics, SERFs and resilience and mental health. A multivariable linear regression model using the PROCESS method established the relationship of SERFs, resilience and metabolic metrics with mental health. Participants were 794 adolescents (mean age: 18.64 [±0.90] years). In multivariable linear regression, the high-level SERFs (ß = 0.124), resilience (ß = -0.042), LCI (ß = 0.072), and RFM (ß = 0.145) were associated with higher depression symptoms, while CVH (ß = 0.602), TyG (ß = 0.295), TyG-BMI (ß = 0.004), and RC (ß = -0.041) were not. An association was also observed between SERFs, resilience, RFM and anxiety. Resilience mediated the relationship between metabolic metrics and depression and anxiety, and SERFs moderated this relationship, demonstrating the relationship between resilience, metabolic metrics, SERFs and mental health. By revealing the potential sociological mechanism underlying the relationship between metabolic metrics and adolescents' mental health, this study provides a theoretical basis for further exploration of the biological foundations of mental health.

Association of sleep fragmentation with general and abdominal obesity: a population-based longitudinal study.

OBJECTIVE: To evaluate the causal relationship between sleep fragmentation (SF) parameters with general and abdominal obesity in free-living conditions. METHODS: SF parameters were assessed by ActiGraph accelerometers for 7 consecutive days. Obesity was measured at baseline and 1-year follow-up with InBody S10 body composition analyzer. RESULTS: At baseline, the mean age of the study population was 18.7 years old (SD = 0.9) and 139 (35.7%) were male. Each 1-unit increase of baseline sleep fragmentation index (SFI) was associated with 0.08 kg/m2-increase of body mass index (BMI) (95% CI: 0.03, 0.14), 0.20%-increase of percentage of body fat (PBF) (95% CI: 0.07, 0.32), 0.15 kg-increase of fat mass (FM) (95% CI: 0.03, 0.27), 0.15 cm-increase of waist circumference (WC) (95% CI: 0.03, 0.26) and 0.91 cm2-increase of visceral fat area (VFA) (95% CI: 0.36, 1.46) at the 1-year follow-up. In addition, each 1-unit increase of baseline SFI was associated with 15% increased risk of general obesity (OR = 1.15, 95% CI = 1.04-1.28; p = 0.006) and 7% increased risk of abdominal obesity (OR = 1.07, 95% CI = 1.01-1.13; p = 0.021) in the following year. CONCLUSIONS: Fragmented sleep is independently associated with an increased risk of both general and abdominal obesity. The result highlights SF as a modifiable risk factor for the prevention and treatment of obesity.

Sex-Specific Association Between Childhood Adversity and Accelerated Biological Aging.

Is childhood adversity associated with biological aging, and if so, does sex modify the association, and do lifestyle and mental health mediate the association? A lifespan analysis is conducted using data on 142 872 participants from the UK Biobank to address these questions. Childhood adversity is assessed through the online mental health questionnaire (2016), including physical neglect, physical abuse, emotional neglect, emotional abuse, sexual abuse, and a cumulative score. Biological aging is indicated by telomere length (TL) measured from leukocyte DNA using qPCR, and the shorter TL indicates accelerated biological aging; a lifestyle score is constructed using body mass index, physical activity, drinking, smoking, and diet; mental disorder is assessed using depression, anxiety, and insomnia at the baseline survey. The results reveal a sex-specific association such that childhood adversity is associated with shorter TL in women after adjusting for covariates including polygenic risk score for TL, but not in men. Unhealthy lifestyle and mental disorder partially mediate the association in women. The proportions of indirect effects are largest for sexual and physical abuse. These findings highlight the importance of behavioral and psychological interventions in promoting healthy aging among women who experienced childhood adversity, particularly sexual and physical abuse.

Different correlation between depressive symptoms and sleep duration on weekdays/weekends among adolescents in Taiyuan, North China.

OBJECTIVE: In Chinese adolescents, the co-occurrence of depressive symptoms and short sleep duration constitute a serious public health issue. This study investigates the association between depressive symptoms and sleep duration of Chinese adolescents on weekdays as well as weekends. METHODS: A multistage random cluster selection was utilized to select 2660 adolescents in Taiyuan, China. The survey contents included demographic characteristics, sleep duration, and depressive symptoms. RESULTS: About 41.95 % of students reported depressive symptoms with an average sleep duration of 7.71 ± 0.90 h. After adjusting for covariates, depressive symptoms were found to be positively correlated with sleep duration <6 h (OR = 1.88, 95 % CI: 1.20, 2.95) and 6 ~ h (OR = 1.61, 95 % CI: 1.18, 2.20) on weekdays, and sleep duration <6 h (OR = 2.10, 95 % CI: 1.17, 3.79) and 6 ~ hours (OR = 1.74, 95 % CI: 1.16, 2.62) on weekends compared with a sleep duration of 8 ~ hours. Only on weekdays, sleep duration of 7 ~ hours was positively correlated with depressive symptoms (OR = 1.39, 95%CI: 1.05, 1.84). On weekends, it was not associated with depressive symptoms (OR = 1.06, 95%CI: 0.82, 1.39). In subgroup analyses, female students (OR = 2.88, 1.97, 1.50) and middle school students (OR = 3.50, 2.07, 1.50) were more likely to experience depressive symptoms on weekdays with a sleep duration of <6 h, 6 ~ hours and 7 ~ hours. LIMITATIONS: Sleep duration and depressive symptoms were self-reported measures. CONCLUSION: The study highlights that short sleep duration (< 7 h) increases the risk of depressive symptoms among adolescents regardless of weekdays or weekends. Just on weekdays, the sleep duration of 7 ~ hours was a risk factor for depressive symptoms. Further, gender, grade, and the only-child played significant modification effects between depressive symptoms and sleep duration. To conclude, this study will assist in the effective promotion of the education of adolescents' sleep health.

Interaction effect of screen time and sugar-sweetened beverages with depressive symptoms in adolescents: evidence from a large sample-based survey in China.

Excessive screen time and the consumption of sugar-sweetened beverages are found to be independent predictors of depressive symptoms. However, the potential interaction effect of screen time and sugar-sweetened beverages, that is, whether one exposure factor strengthens the association of another with depressive symptoms, remains unclear. A large-scale adolescent health surveillance survey was conducted in 27 schools in eight regions across China. A total of 22,868 students were recruited to complete an eligible questionnaire to provide details of their screen time and sugar-sweetened beverage consumption. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Multiplicative and additive interaction models were performed to estimate the interaction effects of screen time and sugar-sweetened beverages on depressive symptoms, and whether the relationship varied by age group was also examined. The multivariate logistic regression model showed that even if the confounding factors were controlled, screen time and sugar-sweetened beverages were still risk factors for depressive symptoms in adolescents. Interaction models indicated that screen time and sugar-sweetened beverages in combination were related to greater odds of depressive symptoms. Compared with late adolescents, early adolescents had a higher probability of depressive symptoms when exposed to the joint effects. Our study may hopefully deepen the understanding of the association between screen time and sugar-sweetened beverages and depressive symptoms. Future research should further explore how and why screen time and sugar-sweetened beverages affect individuals more profoundly in early adolescence than in late adolescence and how to mitigate this.

Exposure to real-ambient bedroom light at night delayed circadian rhythm in healthy Chinese young adults: A cross-sectional study.

BACKGROUND: Light at night (LAN) have attracted increased research attention on account of its widespread health hazards. However, the underlying mechanism remains unknown. The objective of this study was to investigate the effects of real-ambient bedroom LAN exposure on circadian rhythm among young adults and potential sex differences. METHODS: Bedroom LAN exposure was measured at 60-s intervals for 2 consecutive days using a portable illuminance meter. Circadian phase was determined by the dim light melatonin onset (DLMO) time in 7 time-series saliva samples. RESULTS: The mean age of the 142 participants was 20.7 ± 0.8 years, and 59.9% were women. The average DLMO time was 21:00 ± 1:11 h, with men (21:19 ± 1:12 h) later than women (20:48 ± 1:07 h). Higher level of LAN intensity (LANavg ≥ 3lx vs. LANavg < 3lx) was associated with an 81.0-min later in DLMO time (95% CI: 0.99, 1.72), and longer duration of nighttime light intensity ≥ 5lx (LAN5; LAN5 ≥ 45 min vs. LAN5 < 45 min) was associated with a 51.6-min later in DLMO time (95% CI: 0.46, 1.26). In addition, the delayed effect of LAN exposure on circadian phase was more pronounced in men than in women (all P-values <0.05). CONCLUSIONS: Overall, bedroom LAN exposure was significantly associated with delayed circadian rhythm. Additionally, the delayed effect is more significant in men. Keeping bedroom dark at night may be a practicable option to prevent circadian disruption and associated health implications. Future studies with more advanced light measurement instrument and consensus methodology for DLMO assessment are warranted.

The relationship between cumulative ecological risk and health risk behaviors among Chinese adolescents.

OBJECTIVES: To explore the relationship between cumulative ecological risk and individual risky behavior and multiple forms of aggregated behaviors among adolescents, and examine the gender differences. METHODS: A large-scale, nationally representative, and students-based investigation was conducted in rural and urban areas of eight provinces in China from October to December 2021. A total of 22 868 adolescents with an average age of 14.64 years completely standardized questionnaire in which the sociodemographic characteristics, socio-ecological risk factors and risky behaviors were used to analyze. RESULTS: Of included students, 48.4% encountered the high level of social-ecological risk. The prevalence of breakfast intake not daily, alcohol use (AU), smoking, physical inactivity, prolonged screen time (ST) on weekdays and weekends, suicidal ideation, suicidal plan, suicidal attempt, and non-suicidal self-injury (NSSI) was 41.0%, 11.9%, 3.4%, 61.9%, 15.1%, 51.1%, 27.7%, 13.9%, 6.5% and 27.0% respectively. 22.2% of participants engaged in high-risk behaviors. All were significantly influences of increased cumulative ecological risk on individual behavior and low-risk clustering behaviors separately. The odds ratio of breakfast intake not daily, AU, smoking, physical inactivity, prolonged ST in weekday and weekend, suicidal ideation, suicidal plan, suicidal attempt, and NSSI for the adjusted model in low versus high level of cumulative ecological risk was respectively significant in both boy and girls, and the ratio of odds ratios (ROR) was separately 0.95 (p = 0.228), 0.67 (p < 0.001), 0.44 (p < 0.001), 0.60 (p < 0.001), 0.78 (p = 0.001), 0.83 (p = 0.001), 0.80 (p = 0.001), 0.83 (p = 0.022), 0.71 (p = 0.005), 0.75 (p = 0.001). Girls encountering a high level of cumulative ecological risk were more likely to engage in multiple forms of clustering risky behaviors than boys (RORs: 0.77, p = 0.001). CONCLUSIONS: Research and effective inventions at the social-ecological environment, based on the view of cumulative risk, are needed to promote the healthy development of behaviors in adolescence, and pay more attention to decreasing the occurrence of risky behaviours in girls than boys.

Substitutions of physical activity and sedentary behavior with negative emotions and sex difference among college students.

BACKGROUND: A growing number of studies have found that physical activity (PA) benefits mental health, and sedentary behavior (SB) increases the risk of psychological symptoms, but it remains unclear whether substituting the duration of different activities may affect the association, and whether sex difference exists among college students. METHODS: A longitudinal survey was conducted in three colleges in Anhui province, China. A total of 8049 participants validly answered the questionnaire, which included demographic variables, PA, SB and negative emotions (depressive, anxiety, and stress symptoms). RESULTS: Substituting 30 min per day of SB with equivalent walking was associated with lower scores of depressive symptoms. Stress symptoms were reduced when SB was substituted by moderate intensity PA (MPA) and walking. Substituting 30 min per day of MPA in place of walking and SB was associated with an amelioration of depressive and stress symptoms in females, and a reallocation of 30 min walking was associated with lower depressive and stress symptom scores when SB was replaced in males. CONCLUSIONS: Replacing SB with walking and MPA ameliorates the depressive and stress symptoms in young adults. The results suggest a reallocation of time from SB or walking to MPA in females while from SB to walking in males may markedly reduce the depressive and stress symptoms in college population.

Maternal parenting stress and social-emotional problems of Chinese preschoolers: The role of the mother-child relationship and maternal adverse childhood experiences.

BACKGROUND: Previous research suggests that maternal parenting stress is a significant predictor of social-emotional problems in children. However, little is known regarding the mother-child relationship and the effect of maternal adverse childhood experiences (ACEs) on this association. METHODS: Three waves of longitudinal panel data were collected from 2893 Chinese preschoolers with a follow-up interval of 6 months. The mothers of preschoolers were asked to complete anonymous questionnaires concerning demographic variables, maternal ACEs and parenting stress in Wave 1, mother-child relationships in Wave 2, and children's social-emotional problems in Wave 3. The parallel mediation model was conducted to analyze the mediating role of three dimensions of mother-child relationships, and the moderation model was conducted to examine the moderating role of maternal ACEs. RESULTS: The results showed that maternal parenting stress predicted children's social-emotional problems directly or indirectly through the mother-child relationship, with an intimate mother-child relationship mediating this main effect negatively but a conflicted and dependent mother-child relationship mediating this main effect positively. In addition, moderating results indicated that the main effect of maternal parenting stress on children's social-emotional problems was more marked among participants with at least one maternal ACEs than those without maternal ACEs. Furthermore, the moderating effect was only detected in children whose mothers had a high school education or less. LIMITATIONS: The subjectivity of mothers' reports may somewhat reduce the credibility due to the possible overestimation or underestimation of children's social-emotional problems. CONCLUSION: These findings provide new evidence for the effects of maternal parenting stress on children's social-emotional development and highlight the need for more attention to children with mothers having ACE exposure, lower educational level and poor parent-child relationships.

Association Between Bedroom Light Pollution With Subjectively and Objectively Measured Sleep Parameters Among Chinese Young Adults.

PURPOSE: To investigate the cross-sectional associations between real-world multiperiod bedroom light at night and sleep parameters among 365 Chinese young adults. METHODS: Bedroom light exposure was estimated at the individual level for two consecutive days using a portable illuminance meter. Subjective sleep parameters were measured with the Pittsburgh Sleep Quality Index, and objective sleep parameters were assessed by wrist-worn ActiGraph accelerometers for seven consecutive days. RESULTS: Compared with the low-exposure group (average light intensity < 3lx), the high-exposure group (average light intensity ≥ 3lx) was associated with decreased 1.15% in sleep efficiency (sleep efficiency, 95% CI: -1.78, -0.52; p < .001), increased 3.94 minutes in wake after sleep onset (wake after sleep onset, 95% CI: 1.55, 6.33; p = .001), increased 1.05 unit in movement index (95% CI: 0.20, 1.89; p = .015), and increased 2.16 unit in sleep fragmentation index ( 95% CI: 0.63, 3.68; p = .006). In comparison, each interquartile increase in 2h-average and 1h-average intensity of preawake light (PAL) (PAL-2h and PAL-1h) was associated with 7.04 minutes of increases in total sleep time (95% CI: 0.87, 13.22; p = .025) and 6.69 minutes of increases in total sleep time (95% CI: 0.51, 12.87; p = .034), respectively. DISCUSSION: Altogether, our results support the role of bedroom light exposure in sleep and imply the importance of bedroom light exposure management as a potential strategy to reduce the public health burden of sleep problems. Keeping the bedroom environment dark at night and allowing moderate morning light exposure may be important measures for improving the sleep quality of young adults.

Modifiable factors associated with cognitive performance in Chinese adolescents: a national environment-wide association study.

Growing evidence exists about the candidate factors of childhood cognitive performance, but mainly limited to single-exposure studies. We sought to systematically and simultaneously identify and validate a wide range of potential modifiable factors for childhood cognitive performance. We used data from five waves of data from the China Family Panel Studies (CFPS-2010, 2012, 2014, 2016 and 2018). Our analytical sample was restricted to those children aged 2-5 at baseline with valid exposure information. A total of 80 modifiable factors were identified. Childhood cognitive performance was assessed using vocabulary and mathematics test at wave 5. We used an environment-wide association study (EnWAS) to screen all exposure-outcome associations independently and used the least absolute shrinkage and selection operator (LASSO) variable selection algorithm to identify factors associated with cognitive performance. Multivariable linear model was then used to evaluate causal relationships between identified factors and cognitive performance. Of the 1305 participants included in the study (mean ± SD, 3.5 ± 1.1 years age at baseline, 45.1% girls). Eight factors were retained in the LASSO regression analysis. Six factors across community characteristics (percentage of poverty in the community; percentage of children in the community), household characteristics (family size), child health and behaviors (mobile internet access), parenting behaviors and cognitive enrichment (parental involvement in child' s education), and parental wellbeing (paternal happiness) domains were significantly associated with childhood cognition. Using a three-stage approach, this study validates several actionable targets for improving childhood cognitive performance.

Longitudinal associations between smartphone multitasking and depressive symptoms in college students / 中国学校卫生

Objective@#To explore the longitudinal correlation between smartphone multitasking and depressive symptoms, so as to provide an evidence based basis for promoting the mental health of college students.@*Methods@#A total of 967 college students were recruited from one university in Taiyuan, Chongqing, and Shenzhen cities, China, by using multi stage randomized cluster sampling from October to December 2021 at baseline, and a follow up survey was conducted in May 2022. Smartphone multitasking behaviors were assessed by means of the Assessment of Smartphone Multitasking for Adolescents (ASMA), and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) among college students. Chi square tests were performed to compare the differences in depressive symptoms between different groups of demographic characteristics, and binary Logistic regression models were employed to analyze the associations between smartphone multitasking and depressive symptoms among college students.@*Results@#The rates of depressive symptoms among college students at baseline and follow up were 35.2% and 42.3%, respectively. Compared to the low level smartphone multitasking index group at baseline, the moderate and high level groups were more likely to experience depressive symptoms at baseline (moderate level group: OR=1.74, 95%CI =1.22-2.50, high level group: OR=2.77, 95%CI =1.94-3.95) and followup (moderate level group: OR=1.41, 95%CI =1.01-1.95, high level group: OR=1.64, 95%CI =1.17-2.29) ( P <0.05). In addition, compared to the persistently low smartphone multitasking index, increased risk of depressive symptoms was associated with maintaining a moderate to high ( OR=2.94, 95%CI =1.83-4.71), and a higher ( OR=2.07, 95%CI =1.31-3.27) or lower smartphone multitasking index ( OR=2.02, 95%CI =1.27-3.19) ( P <0.05). Moreover, higher smartphone multitasking index scores were positively associated with the risk of new-onset depressive symptoms at follow up ( OR=1.87, 95%CI=1.07-3.27, P <0.05).@*Conclusions@#Smartphone multitasking behaviors are find to be associated with an increased risk of depressive symptoms in college students. There is a need to reduce smartphone multitasking in order to decrease depressive symptoms and promote students mental health.

Association between biorhythm disorders and the co occurrence of health risk behaviors in adolescence / 中国学校卫生

Objective@#To elucidate the association between biorhythm disorders and health risk behaviors in adolescence, so as to provide reference for appropriate interventions.@*Methods@#From March to April 2023, 2 381 adolescents in Shanghai were selected as research objects using convenience sampling and stratified random cluster sampling methods. The Self rating Questionnaire of Biological Rhythm Disorders for Adolescents (SQBRDA) and the self report health risk behaviors questionnaire were used to investigate the status of adolescent biorhythm disorders and nine kinds of health risk behaviors, while a multivariate Logistic regression model was employed to analyze the association between the two variables.@*Results@#The average SQBRDA score was (68.25±0.42) The incidence and detection rates of health risk behaviors in the groups with no co occurrence, mild co occurrence, moderate co occurrence, and severe co occurrence were 234(9.83%), 1 176(49.39%), 830(34.86%) and 141(5.92%), respectively. The total SQBRDA score was positively correlated with the risk of co occurrence of health risk behaviors. The risk of mild co occurrence, moderate co occurrence, and severe co occurrence of health risk behaviors was 9.05 times (95% CI =4.25-19.15, P <0.01), 44.55 times (95% CI =20.75-96.05, P <0.01) and 110.05 times (95% CI =40.65-297.95, P <0.01) higher, respectively, among adolescents with higher scores of biorhythm disorders compared to adolescents with lower scores of biorhythm disorders.@*Conclusions@#Health risk behaviors among adolescents in Shanghai draw attention to a serious phenomenon whereby biorhythm disorders are positively correlated with the risk of co occurrence. Comprehensive interventions aimed at addressing adolescent health risk behaviors should focus on regulating biorhythm disorders.