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Prenatal and neonatal factors for the development of childhood visual impairment in primary and middle school students: a cross-sectional survey in Guangzhou, China.

ABSTRACT: OBJECTIVES:In this cross-sectional survey, we sought to determine the prevalence of and the influence of prenatal and neonatal factors on childhood visual impairment without correction (VIUC) in a paediatric population from Guangzhou, China. SETTING:The health survey covered 11 administrative districts in Guangzhou, including 991 schools. PARTICIPANTS:All of the primary and middle school students in Guangzhou were invited to complete an online questionnaire with the help of their parents. The results of physical examinations were reported by school medical departments. The results of the questionnaire were collected by the researchers. In total, 253?301 questionnaires were collected. PRIMARY OUTCOME MEASURES:The students' uncorrected visual acuity (UCVA) was examined by trained optometrists by standard logarithmic visual acuity charts. VIUC was defined by UCVA (of the better eye) (UCVA <6/12) with three levels: light VIUC (UCVA ?6/18 to <6/12), mild VIUC (UCVA ?6/60 to <6/18) and severe VIUC (UCVA <6/60). RESULTS:A total of 39?768 individuals (15.7%) had VIUC, and the rate was much higher among grade 10 to 12 students (51.4%) than among grade 1 to 6 students (6.71%). The following factors were significantly associated with an increased risk of VIUC: female gender, high birth weight, formula feeding, not having siblings, higher level of parents' education, parental myopia, much homework time and little outdoor activity. Delivery mode was not associated with the risk of VIUC. CONCLUSIONS:This study validates known major prenatal/genetic, perinatal and postnatal factors for childhood VIUC. In conclusion, prenatal and perinatal factors can affect the onset of childhood VIUC, but parental myopia and postnatal factors are the main factors.

SUBMITTER: Yu B

PROVIDER: S-EPMC7482504 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Prenatal and neonatal factors for the development of childhood visual impairment in primary and middle school students: a cross-sectional survey in Guangzhou, China.

Yu Bolan B Dai Lijuan L Chen Juanjuan J Sun Wen W Chen Jingsi J Du Lili L Deng Nali N Chen Dunjin D

BMJ open 20200909 9

<h4>Objectives</h4>In this cross-sectional survey, we sought to determine the prevalence of and the influence of prenatal and neonatal factors on childhood visual impairment without correction (VIUC) in a paediatric population from Guangzhou, China.<h4>Setting</h4>The health survey covered 11 administrative districts in Guangzhou, including 991 schools.<h4>Participants</h4>All of the primary and middle school students in Guangzhou were invited to complete an online questionnaire with the help of ...[more]

PMID: 32912936

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Project description:BACKGROUND:Allergic diseases, such as asthma, dermatitis, rhinitis, and eczema, are highly prevalent in Chinese school children. Environmental factors, including air pollution and automobile exhaust, play an important role in the etiology of these diseases. However, prenatal and neonatal factors, such as gender, maternal diseases during pregnancy, and premature birth, may also be associated with allergic disease occurrence. The objective of this study was to explore prenatal and neonatal factors that are involved in the development of allergic diseases among primary and middle school students in Guangzhou, China. METHODS:A cross-sectional survey was launched by the Health Promotion Centre for Primary and Secondary Schools of the Guangzhou Municipality in October 2017. All primary and middle school students in Guangzhou were notified to participate in the questionnaire online under the direction of their parents. The results of the physical examination were reported by the schools' medical department. The results of the questionnaire were collected and analyzed by the researchers. The prevalence of asthma, allergic rhinitis, allergic dermatitis, and eczema was identified. RESULTS:Based on reported 183,449 questionnaires and medical records, the data indicate that the sex, birth weight, neonatal feeding type, delivery mode, and students' father smoking status were significantly associated with the prevalence of all four allergic diseases in primary and middle school children. In further stratified analyses of the children with normal birth weight (2500-4000 g) and without any maternal diseases during pregnancy, the factors of male sex, high birth weight, cesarean delivery, and father smoking status all increased the risk of asthma, dermatitis, rhinitis, and eczema. Also, unlike exclusive breastfeeding, breast plus formula feeding increased these risks, but pure formula feeding had the opposite effect. CONCLUSION:Prenatal and neonatal factors, including male sex, high birth weight, cesarean delivery, only child, and father smoking status are associated with the risks of allergic diseases in school children.

Project description:BackgroundVisual impairment (VI) is a growing public health concern among students as a result of the COVID-19 pandemic.ObjectiveThis study investigated the change in VI before and during the pandemic among students.MethodsData on 547,864 and 497,371 students were obtained from the Guangzhou Survey on Students' Constitution and Health (GSSCH) collected in October 2019 and October 2020, respectively. VI was defined as the unaided distance visual acuity lower than 20/25 Snellen equivalent (LogMAR 0.10) in the worse eye. Change in VI based on age and sociodemographic variables were evaluated by chi-square test for trend as appropriate. Comparisons of different categorical variables were tested by contingency tables-based chi-square test. We have further analysis of the students who went through both of the 2019 and 2020 examinations for evaluating the VI incidence during the COVID-19 pandemic.ResultsMore than 1,045,235 students were involved in our study, among whom 271,790 (54.65%) out of 497,371 students in Guangzhou suffered from VI during the COVID-19 compared with 293,001(53.48%) visually impaired students (total tested participants = 547,864) before the COVID-19 pandemic. During the pandemic, the overall prevalence of VI actually showed an increased age tendency and reached the highest level in the 17 [80.04%, 95%Confidence interval (CI):79.53 to 80.54%] and the 18 (79.64, 95%CI: 79.06 to 80.23%) age groups. Rapid growth was detected among students aged between 9 and 16 years old (raised by 46.21) while older students were more likely to get moderate and severe VI than younger ones. Students involved in more screen-based activities [(64.83%, 2019); (66.59%, 2020)] appeared to have a higher prevalence of VI than those involved in less [(49.17%, 2019); (49.26%, 2020)].ConclusionA rising trend of VI among students was detected before and during the COVID-19 pandemic. Moreover, the pandemic appeared to be associated with a rapid VI shift in younger and boy populations. Potential danger may arise when public health emergencies occur in the school, and more effort should be made to improve students' vision.

Project description:BackgroundIn recent years, the number of adolescents engaging in premarital sex has increased, and an increasing number of childhood sexual abuse (CSA) cases have been reported in China. Many studies have indicated that CSA has a well-established association with risky sexual activities. However, only a limited number of studies have explored possible reasons for this association among middle school students, a population that may engage in premarital sex, which is critical for the development of interventions to prevent risky sexual behavior. Based on random samples of middle school students from a Chinese city, this article investigated the relationship between CSA and students' premarital sexual permissiveness (PSP).MethodsIn a cross-sectional study conducted between 2016 and 2017 in Luzhou, China, 2292 middle school and high school students aged 12-18 years were recruited by multistage random sampling. All students were administered anonymous questionnaires. Multiple linear regression and binary logistic regression analyses were conducted to analyze the relationship between CSA and PSP.ResultsThe prevalence of CSA was 15.4% (354/2292; 95% CI: 14-16.9%). A higher percentage of male respondents (18.2%) than female respondents (12.9%) had experienced CSA. A positive association between CSA and PSP was found among students. Respondents who had suffered CSA exhibited greater PSP, and this relationship was observed in the male sample, female sample and the total student sample in Luzhou (β = - 3.76, P < 0.05; β = - 2.79, P < 0.05; and β = - 2.84, P < 0.05, respectively). Respondents who had suffered CSA were also more likely to express a double standard about premarital sex (odds ratio [OR] =1.41, P < 0.05), especially among male students (odds ratio [OR] =1.63, P < 0.05).ConclusionsSex differences in CSA and the relationship between CSA and PSP were significant among this large sample of middle school students in Luzhou (China). The findings suggest that experiencing CSA may be closely related to youth attitudes toward premarital sex, especially among males. Therefore, it is important to emphasize the prevention of CSA and provide adolescent reproductive health programs to reduce the impact of CSA on sexual cognition and attitude, prevent premarital sex and promote positive attitudes toward sexual equality for middle school students.

Project description:ImportanceThe suicide mortality rate per 100 000 population (SMRP) consistently decreased before the COVID-19 pandemic outbreak in Japan and then unexpectedly increased during the pandemic. However, the underlying mechanisms remain poorly understood.ObjectiveTo identify trends in and factors associated with suicidal mortality and motives among students in Japan from 2007 to 2022.Design, setting, and participantsIn this cross-sectional study, data on SMRPs among Japanese middle-school, high-school, and university students were obtained from the government suicide database Suicide Statistics of the National Police Agency.Main outcomes and measuresAge-dependent and temporal fluctuations in annual SMRPs, disaggregated by suicidal motive (7 categories and 52 subcategories), sex, and school, were analyzed using linear mixed-effect and joinpoint regression models, respectively.ResultsTotal suicide numbers from 2007 to 2022 were as follows: 760 male middle-school students, 635 female middle-school students, 2376 male high-school students, 1566 female high-school students, 5179 male university students, and 1880 female university students. The mean (SD) student populations from 2007 to 2022 were as follows: 1 752 737 (81 334) male middle-school students, 1 675 572 (78 824) female middle-school students, 1 648 274 (67 520) male high-school students, 1 614 828 (60 032) female high-school students, 1 652 689 (32 724) male university students, and 1 229 142 (57 484) female university students. Among male students, the leading motives were school-related factors (underachievement and worrying about the future), followed by family-related and health-related motives. Among female students, school-related and family-related motives decreased, but health-related motives showed an age-dependent increase. The SMRPs of middle-school male students and female students were almost equal (mean [SD], 2.7 [1.0] vs 2.4 [1.4]), but the age-dependent increase in SMRPs among male students was pronounced (mean [SD], high-school vs university male students, 9.1 [2.4] vs 19.6 [3.0]; high-school vs university female students, 6.1 [2.4] vs 9.6 [1.8]). However, the incidence of suicide among high-school students associated with health-related motives was greater in female students. The majority of suicides associated with major impactable suicidal motives (school-related, health-related, and family-related motives) began increasing before the pandemic. Changes in SMRP associated with interpersonal relationships, such as conflict with classmates or parents, were not significant, but the rates increased greatly during the pandemic.Conclusions and relevanceSchool-related, health-related, and family-related problems were major motives, whereas the impacts of health-related and family-related motives increased and decreased with age, respectively. Notably, most SMRPs associated with major impactable motives (underachievement, conflict with a parent or classmate, and mental illnesses) had already begun increasing in the late 2010s, indicating that recent increasing SMRPs among school-aged individuals were associated with pandemic-related factors and other factors affecting this generation before the pandemic. It may be inappropriate to uniformly apply research findings based on school-aged individuals to school-based suicide prevention programs for students in middle school, high school, and university.

Project description:IntroductionSports and physical activities are a frequent cause of traumatic brain injury, primarily concussions, among adolescents. These concussions may adversely affect students' ability to learn and impair academic achievement in educational settings.MethodsThe 2017 Youth Risk Behavior Survey, conducted among a nationally representative sample of 14,765 U.S. high school students, was analyzed in 2018 to examine associations between self-reported sports- and physical activity-related concussions and symptoms of cognitive impairment (difficulty concentrating, remembering, or making decisions) and self-reported academic grades (mostly A's=4.0, mostly B's=3.0, mostly C's=2.0, mostly D's=1.0, mostly F's=0.0). Adjusted prevalence ratio and the difference in self-reported estimated grade point average were adjusted for sex, race/ethnicity, grade, and athlete status (participation on sports teams) and considered statistically significant if p<0.05.ResultsMale students were more likely than female students (17.1% vs 13.0%), and athletes were more likely than nonathletes (21.4% vs 7.6%) to have a self-reported sports- and physical activity-related concussion in the 12 months preceding the survey. Students with a reported sports- and physical activity-related concussion were more likely than students without one to report symptoms of cognitive impairment regardless of whether they were male (adjusted prevalence ratio=1.49), female (adjusted prevalence ratio=1.37), athletes (adjusted prevalence ratio=1.45), or nonathletes (adjusted prevalence ratio=1.42). Self-reported grade point averagedecreased significantly from 3.14 among students who reported no concussions (referent), to 3.04 among students who reported a single concussion, and 2.81 among students who reported ≥2 concussions.ConclusionsSchool-based programs are needed to monitor students' academic performance and provide educational support and resources to promote academic success following a concussion.

Project description:ImportanceThere are racial and ethnic inequities in exclusionary school discipline (ESD) (ie, a disciplinary action that removes students from their classroom or school environment, eg, referrals, suspensions, and/or expulsions) practices in the US. Exclusionary school discipline has been associated with negative education, health, and criminal justice outcomes.ObjectivesTo investigate whether experiencing an ESD event was associated with decreased grade point average (GPA) and whether minoritized students (eg, Black or Latine [description used in database]) are disproportionately affected compared with White students.Design, setting, and participantsIn a cohort study using retrospective administrative longitudinal data of children in the 6th to 10th grades (August 18, 2014, to May 26, 2017) in a large, single urban school district in California, linear mixed models were applied to compare the timing of the first exclusionary event and the average change in GPA and evaluate the relative variation among minoritized students experiencing an exclusionary event. Data analysis was conducted from August 18, 2018, to August 21, 2023.ExposureYear at which students experienced first ESD events over the study period.Main outcomes and measuresThe primary outcome of interest was change in average grade point average (GPA); students' GPA averaged across courses was averaged across each year.ResultsOf the 16 849 students (8756 [52.0%] male), 21.4% experienced at least 1 ESD event. The mean (SD) age was 14.3 (1.6) years, and 7.5% identified as Black, 25.6% Latine, and 10.0% White. Black and Latine students experienced exclusionary events at nearly 10 and 3 times more than White students (mean [SD]: Black, 6.69 [12.80] events; Latine, 2.01 [6.18] events; White, 0.71 [4.46] events; P < .001). When controlling for gender, maternal educational level, race and ethnicity, and school year, having experienced an ESD event in the first year was associated with an average decrease in GPA by 0.88 (95% CI, -0.91 to -0.84) points compared with no ESD events; experiencing ESD events also had significant differences in the second (-0.63 [95% CI, -0.67 to -0.59]) and third (-0.52 [95% CI, -0.57 to -0.47]) years. Black and Latine race and ethnicity was associated with the greatest decrease in GPA compared with White students (Black, -0.56 [95% CI, -0.61 to -0.51]; Latine, -0.51 [95% CI, -0.54 to -0.47]; P < .001).Conclusion and relevanceThis study observed racial and ethnic inequities in ESD prevalence and its association with educational attainment. The findings suggest that it may be beneficial for pediatricians and other health care professionals to screen for exclusion, as experiencing ESD events may affect health across the life course. In addition, it may be useful to categorize ESD events as an adverse childhood experience and abolish the practice from schools as a disciplinary measure.

Dataset Information

Prenatal and neonatal factors for the development of childhood visual impairment in primary and middle school students: a cross-sectional survey in Guangzhou, China.

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Prenatal and neonatal factors for the development of childhood visual impairment in primary and middle school students: a cross-sectional survey in Guangzhou, China.

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