Sexual practices in Malaysia: determinants of sexual intercourse among unmarried youths.

This paper describes findings on selected determinants of sexual intercourse among 468 unmarried adolescents from a survey in Malaysia. Data on respondents' background, sexual experience, contraceptive use, and sexual attitudes are provided. Based on multiple logistic regressions, factors significantly predictive of sexual experience are gender, employment, and sexual attitudes.     

Effects of a parent-child communications intervention on young adolescents' risk for early onset of sexual intercourse

CONTEXT: The quality of parent-child communications about sex and sexuality appears to be a strong determinant of adolescents' sexual behavior. Evaluations of interventions aimed at improving such communications can help identify strategies for preventing early onset of sexual behavior. METHODS: A school-based abstinence-only curriculum was implemented among 351 middle school students, who were randomly assigned to receive either the classroom instruction alone or the classroom instruction enhanced by five homework assignments designed to be completed by the students and their parents. An experimental design involving pretest and posttest surveys was used to assess the relative efficacy of the curriculum delivered with and without the parent-child homework assignments. RESULTS: In analyses of covariance controlling for baseline scores, immediately after the intervention, adolescents who received the enhanced curriculum reported greater self-efficacy for refusing high-risk behaviors than did those who received the classroom instruction only (mean scores, 16.8 vs. 15.8). They also reported less intention to have sex before finishing high school (0.4 vs. 0.5), and more frequent parent-child communications about prevention (1.6 vs. 1.0) and sexual consequences (1.6 vs. 1.1). In all significant comparisons, the direction of the findings favored adolescents who received the enhanced curriculum. Dose-response relationships supported the findings. CONCLUSIONS: Parent-child homework assignments designed to reinforce and support school-based prevention curricula can have an immediate impact on several key determinants of sexual behavior among middle school adolescents.     

Reborn a virgin: adolescents' retracting of virginity pledges and sexual histories

OBJECTIVES: We examined retractions of virginity pledges and of sexual histories among adolescents taking part in waves 1 and 2 of the National Longitudinal Study of Adolescent Health. METHODS: Logistic regression analyses were used to compare respondents' reports of virginity pledges and sexual histories at waves 1 and 2.Results. Among wave 1 virginity pledgers, 53% denied having made a pledge at wave 2; after control for confounders, pledgers who subsequently initiated sexual activity were 3 times as likely to deny having made a pledge as those who did not initiate sexual activity (odds ratio [OR] = 3.21; 95% confidence interval [CI] = 2.04, 5.04). Among wave 1 nonvirgins who subsequently took virginity pledges, 28% retracted their sexual histories at wave 2; respondents who took virginity pledges were almost 4 times as likely as those who did not to retract reports of sexual experience (OR=3.88; 95% CI=1.87, 8.07). CONCLUSIONS: Adolescents who initiate sexual activity are likely to recant virginity pledges, whereas those who take pledges are likely to recant their sexual histories. Thus, evaluations of sexual abstinence programs are vulnerable to unreliable data. In addition, virginity pledgers may incorrectly assess the sexually transmitted disease risks associated with their prepledge sexual behavior.     

Prevalence of hypertension among schoolchildren aged 13-18 years in Gemlik, Turkey

Arterial hypertension is the permanent elevation of blood pressure(BP). Previous studies have documented that hypertension maybegin in adolescence, perhaps even in childhood. The purposeof this study was to determine the prevalence of hypertensionamong adolescents in the Gemlik Research and Training Area,Turkey. Between January and March 1994, all secondary and highschool students aged 13–18 years were included in thisstudy. An elevated BP was defined according to the Report ofthe Second Task Force on Blood Pressure Control in Children.Of the 3,641 students screened, 262 (7.2%) had elevated systolicand/or diastolic BP, 161 (4.4%) students had significant hypertensionand 101 (2.8%) students had severe hypertension. We found thatsystolic and diastolic BP increased with age, height and weight.BP measurements should be included in physical examinationsas part of the continuing care of the child.     

A matched case-control study: investigating the relationship between youth assets and sexual intercourse among 13- to 14-year-olds

BACKGROUND: The number of teenagers engaging in sexual intercourse has consistently changed over the past several years. This can become a major challenge when trying to determine why teens continue to have sex. The purpose of this paper was to investigate the relationship between youth assets and sexual intercourse among 13- to 14-year-olds. METHODS: Cross-sectional data were collected using in-person at-home interviews from a random sample of inner-city neighbourhood 13- to 14-year-old teenagers (n = 64 matched pairs; 36% 13-year-olds, 53% female, 45% white, 28% African-American, 16% Hispanic and 11% Native American). Nine individual youth assets were analysed using conditional logistic regression (matching for several demographic variables) to assess the association between assets and abstinence in younger teens. RESULTS: Conditional logistic regression analyses showed that two assets, positive Peer Role Models [odds ratios (OR) = 4.67, 95% confidence intervals (CI) = 1.93, 11.27] and Use of Time (Religion) (OR = 2.20, 95% CI = 1.04, 4.65), were significantly related (P < 0.05) to younger teens never having engaged in sexual activity. CONCLUSION: These findings suggest, when considering abstinence behaviour, involvement in religious activities and having positive peer role models appear to be protective factors related to delaying sexual intercourse among teens aged 13-14 years.     

Dietary patterns associated with functional constipation among Japanese women aged 18 to 20 years: a cross-sectional study

Although several nutrients and foods have been suggested to be preventive for constipation, all previous studies have examined a single nutrient or food in each analysis. In contrast, analysis of dietary patterns may provide new insights into the influence of diet on functional constipation. We conducted a cross-sectional examination of the association between dietary pattern and functional constipation in 3,770 Japanese female dietetic course students aged 18-20 y from 53 institutions in Japan. Diet was assessed with a validated self-administered diet history questionnaire with 148 food items, from which 30 food groups were created and entered into a factor analysis. Functional constipation was defined using the Rome I criteria, which has previously been used in several epidemiologic studies on constipation. The prevalence of functional constipation was 26.0% (n=979). Four dietary patterns were identified: (1) "Healthy", (2) "Japanese traditional", (3) "Western," and 4) "Coffee and dairy products." After adjustment for several confounding factors, the "Japanese traditional" pattern, characterized by a high intake of rice, miso soup, and soy products and a low intake of bread and confectionaries, was associated with a significantly lower prevalence of functional constipation. In comparison with the lowest quintile, the multivariate adjusted odds ratio (95% confidence interval) was 0.52 (0.41-0.66) in the highest quintile (p for trend < 0.0001). Other dietary patterns were not associated with functional constipation. The Japanese traditional dietary pattern, characterized by a high intake of rice and a low intake of bread and confectionaries, may be beneficial in preventing functional constipation in young Japanese women.     

Initiation of sexual intercourse among middle school adolescents: the influence of psychosocial factors.

PURPOSE: To explore potential psychosocial predictors for initiation of sexual intercourse among middle-school, inner-city youth, using longitudinal data from the Healthy and Alive! project. METHODS: We conducted hierarchical, logistic regression with adjustment for intraclass correlation over two sequential periods, including seventh and eighth grades (N = 3163), to assess the independent influence of psychosocial and demographic factors. Internally reliable scales to assess psychosocial influences were created, based on major theories of behavior. The sample was 52% female, 51% black, 30% Hispanic, 9% white, and 3% Asian. At baseline, 13% of girls and 39% of boys reported already having initiated sexual intercourse. RESULTS: Personal and perceived peer norms about refraining from sex were a strong and consistent protective factor. Alcohol and other drug use, poor academic performance, male gender, and black race were consistent risk factors. Self-efficacy showed a mixed effect: protective in the seventh grade but increasing risk in the eighth grade. Speaking a language other than English was a protective factor in seventh grade. Both psychosocial and demographic factors provided independent explanatory power. CONCLUSIONS: Psychosocial factors, particularly norms about having sex, influence initiation of sexual intercourse. These data suggest that programs to delay initiation of sexual intercourse should reinforce norms about refraining from sex.     

宁夏汉族中小学生2000—2014年血压变化趋势

目的分析2000—2014年宁夏7～18岁汉族中小学生血压变化趋势,为预防控制儿童青少年高血压提供科学依据。方法基于2000—2014年4次学生体质调研中宁夏地区7～18岁汉族中小学生的血压、身高、体重等数据,采用SPSS 21.0进行趋势分析。结果 2000—2014年,宁夏汉族学生收缩压呈先下降后上升的趋势(F=357.44,P<0.05),平均下降3.37 mm Hg(1 mm Hg=0.133 kpa);舒张压总体呈先下降后上升的趋势(F=172.95,P<0.05),平均下降4.18 mm Hg;脉压差总体呈先下降后上升的趋势(F=311.86,P<0.05),平均下降1.98 mm Hg。宁夏汉族学生体质量指数总体呈上升趋势(F=128.15,P<0.05)。血压偏高、单纯收缩压偏高、单纯舒张压偏高检出率分别增长了1.0,0.4和0.9百分点。结论宁夏7～18岁汉族学生血压水平逐年升高。应高度重视该现象,做好学生的健康教育与健康促进工作,提前预防高血压等慢性病的发生。     

2014年通辽市蒙古族7～18岁青少年维尔维克指数的逐步回归分析

目的 分析7～18岁蒙古族青少年生长发育状况及维尔维克指数,为探讨各项指标与维尔维克指数的影响作用,以及少数民族学生体质情况提供科学的评价方法。方法 采用分层整群随机抽样的方法选取通辽市2 949名7～18岁蒙古族青少年为研究对象,对18个指标进行分析,并采用逐步回归分析的方法对蒙古族青少年的维尔维克指数及各种指标进行了分析。结果 单因素分析结果表明:男生组与女生组的身高、体重、体质指数和维尔维克指数均随年龄增长而增加,身高:男生为124.3～170.7,女生为123.2～156.9;体重:男生为26.4～63.2,女生为24.8～53.3;体质指数:男生为16.9～21.6,女生为16.3～21.6;维尔维克指数:男生为60.3～86.9,女生为67.4～85.3,发展规律正常。多因素分析结果表明:进入男生组维尔维克指数回归模型的影响因素有4个,分别为脉搏、握力、力量和坐高;进入女生组维尔维克指数回归模型的影响因素有7个,分别为城乡、年龄、脉搏、握力、力量、耐力和坐高。结论 脉搏、握力、坐高和力量对维尔维克指数产生了一定的影响。     

中国9~14岁青春期女生睡眠时间与月经初潮的关系

目的 探讨2014年中国9~14岁青春期女生月经初潮与睡眠时间的关系,为进一步研究青春期发育的影响因素提供科学依据。方法 选取2014年全国学生体质与健康调研数据中9~14岁青春期女生的身高、体重、月经初潮情况和睡眠时间等数据。将研究对象分为睡眠充足组和睡眠不足组,月经初潮情况由女性内科医师询问,只询问“已”、“未”,不问具体日期。采用Logistic回归模型和多水平模型进行统计学分析。 结果 研究共纳入48 096名女生。其中,9~14岁女生的平均睡眠充足报告率为31.34%(15 074/48 096),平均月经初潮报告率为50.13%(24 112/48 096)。从总体上看,月经初潮报告率随年龄增加而增加。其中,在睡眠充足女生组中,月经初潮报告率从9岁的0.97%(22/2 258)增长到14岁的95.87%(1 832/1 911);睡眠不足女生组中,月经初潮报告率从9岁的1.52%(52/3 423)增长到14岁的97.32%(6 720/6 905)。除9岁外,各年龄段中睡眠不足组的女生月经初潮的比例均高于睡眠充足组,且差异有统计学意义(P<0.05)。在控制片区、身高、BMI等因素后,相对于睡眠不足组,睡眠充足组女生月经初潮发生较晚(OR＝0.73,95%CI:0.69~0.77),在各年龄段(除9岁外)中,相对于睡眠不足组,睡眠充足组女生月经初潮发生较晚(OR<1,P<0.05)。多水平模型分析发现,在控制其他因素后,睡眠时间越长,月经初潮的发生越晚(OR＝0.90,95%CI:0.87~0.92)。同时,月经初潮与睡眠时间的关系在省份水平不具有组内聚集性(ICC<0.01),在年龄水平具有较明显的组内聚集性(ICC=0.61)。 结论 青春期女生的睡眠情况与月经初潮是否发生有着密切联系,进一步影响女生青春期的发育与性成熟。应当采取有效的措施确保儿童青少年的正常睡眠时间,保证儿童青少年的健康成长。     

基于我国慢性病防治管理现状的慢性病自我管理项目研究

目的 探讨中国≥18岁成年居民慢性病患病的影响因素,为慢性病的预防控制提供参考依据。 方法 检索中国知网数据库（CNKI）、万方数据库和维普中文科技期刊数据库（VIP）,并辅以手工检索和文献追溯法收集2005年1月 — 2017年9月公开发表的关于中国≥18岁成年居民慢性病患病影响因素的相关文献,采用RevMan 5.3和Stata 12.0软件对纳入的文献进行meta分析。 结果 最终纳入21篇中文文献,累计≥18岁成年居民84 140人,其中慢性病患者36 432例,患病率为43.30 %;meta分析结果显示,女性（OR = 1.29,95 % CI = 1.23～1.36）、年龄≥45岁（OR = 4.96,95 % CI = 4.47～5.50）、吸烟（OR = 1.61,95 % CI = 1.52～1.71）、饮酒（OR = 1.12,95 % CI = 1.05～1.20）、超重/肥胖（OR = 1.88,95 % CI = 1.75～2.03）和口味偏咸（OR = 1.50,95 % CI = 1.38～1.64）是中国≥18岁成年居民慢性病患病的危险因素,文化程度为高中及以上（OR = 0.69,95 % CI = 0.63～0.76）、婚姻状况为在婚（OR = 0.47,95 % CI = 0.40～0.56）、月平均收入 ≥ 2 000元（OR = 0.70,95 % CI = 0.66～0.74）、锻炼（OR = 0.64,95 % CI = 0.52～0.78）和睡眠时间 ≥ 8 h/d（OR = 0.52,95 % CI = 0.40～0.67）是中国≥18岁成年居民慢性病患病的保护因素;敏感性分析和发表偏倚评估结果均显示,纳入的文献不存在发表偏倚,结果较为可靠。 结论 性别、年龄、文化程度、婚姻状况、月平均收入、吸烟情况、饮酒情况、体质指数、是否口味偏咸、是否锻炼和睡眠时间是中国≥18岁成年居民慢性病患病的主要影响因素。     

拉萨市3~18岁儿童青少年棘球蚴病流行现状

了解拉萨市儿童青少年棘球蚴病流行现状与特征,为制定棘球蚴病防控措施提供基础数据和理论支持.方法 利用2017年拉萨市人群棘球蚴病筛查数据,选取3~18岁人群资料进行统计分析.采用便携式B超和血清棘球蚴抗体检测进行筛查,结合流行病史和临床表现进行棘球蚴病诊断.结果 拉萨市3~18岁儿童青少年棘球蚴病检出率为0.12%(114/95 835).在不同年龄组人群中,16~18岁儿童青少年棘球蚴病检出率最高(0.17%);不同文化程度中,小学文化程度的儿童青少年棘球蚴病检出率最高(0.45%);不同职业中,牧民棘球蚴病检出率最高(0.59%);不同居住方式中,冬季定居夏季游牧人群棘球蚴病检出率最高(0.70%);家庭生产方式为牧业和半农半牧的儿童青少年棘球蚴病检出率最高(均为0.20%);不同流行县(区)中,当雄县和墨竹工卡县儿童青少年棘球蚴病检出率最高,均为0.18%,以上组间差异均有统计学意义(x2值分别为16.77,23.76,69.76,16.49,14.74,25.25,P值均<0.01).男、女生棘球蚴病检出率差异无统计学意义(P>0.05).结论 年龄较大且文化程度较低、生产生活方式涉及牧业的、所在县(区)海拔较高的儿童青少年更易被检出棘球蚴病.针对儿童青少年人群的棘球蚴病防控特别是健康教育应成为政府工作的重点.     

北京市18岁以上居民对低焦油卷烟危害的认知状况调查

目的了解目前北京市居民对低焦油卷烟危害的认知现况及其相关因素,为今后开展控烟工作提供参考。方法资料来自2011年北京市居民吸烟状况流行病学调查项目。分析居民对低焦油卷烟危害的认知,及其在不同社会人口学信息和吸烟状况等因素中的分布差别及相关因素。结果居民对低焦油卷烟具有低危害认知回答正确的比例仅为32.75%,且回答正确率在不同年龄、性别、文化程度和月人均收入分组中的分布存在统计学意义（χ2值分别为30.24、87.52、25.13和62.73,均P〈0.05）。多元Logistic回归分析显示,尼古丁依赖得分、婚姻状况、文化程度、收入状况是影响低焦油危害认识正确率的因素（其OR值及其95%CI分别是0.92（0.87~0.98）、1.90（1.15~3.14）、1.59（1.02~2.48）、2.71（1.36~5.40）、3.55（1.46~8.62）、1.48（1.06~2.06）、0.56（0.36~0.87）。结论北京居民对低焦油卷烟的危害认识比较缺乏,建议在全社会进一步普及有关低焦油卷烟健康危害的相关宣传,加大对低焦油卷烟等减害烟草产品的生产和宣传的监管力度。     

Geographical variations and contextual effects on age of initiation of sexual intercourse among women in Nigeria: a multilevel and spatial analysis

Background  

The age of initiation of sexual intercourse is an increasingly important issue to study given that sexually active young women are at risk of multiple outcomes including early pregnancies, vesico-vaginal fistula, and sexually transmitted infections. Much research has focused on the demographic, familial, and social factors associated with sexual initiation and reasons adolescents begin having consensual intercourse. Less is known, however, about the geographical and contextual factors associated with age of initiation of sexual intercourse. Therefore, the purpose of this study was to examine the extent of regional and state disparities in age of initiation of sexual intercourse and to examine individual- and community-level predictors of early sexual debut.     

中国18省市大学生首次性行为年龄的人群分布特征及其影响因素

目的 了解中国大学生首次性行为年龄的人群分布特征,为制定适宜的性教育提供依据.方法 采取无记名自填问卷方式,按照分层整群抽样方法,对18个省(市、区)33 653名大学生进行中国青少年健康危险行为问卷调查.结果 中国大学生14岁前发生性行为的报告率为1.9%,男、女生分别为2.8%和1.1%(P＜0.01);15～18岁发生性行为的报告率男、女生分别为6.4%和2.1%;19岁后发生性行为的报告率男、女生分别为6.9%和2.6%.大学生首次性行为的发生年龄与父母学历、所在地区和家庭结构密切相关.来自大家庭和核心家庭、居住在东中部地区、父母文化程度较低的大学低年级学生,首次性行为发生年龄较晚.结论 应加强对两部地区、父母文化程度较高以及家庭结构不完整的青少年的性教育.

Abstract：

Objective To describe the characteristics of sexual debut among college students in China to provide appropriate sex education in that population. Methods An anonymous questionnaire survey was conducted among 33 653 college students selected by multi-stage stratified cluster sampling method in 18 provinces and cities of China. Results The percentage of students who had initiated sexual intercourse before age 14 was 1.9%. Overall, male students (2.8%) were significantly more likely to have initiated sexual intercourse before age 14, than female students (1.1%). The percentage of students who had initiated sexual intercourse from age 15 to 18 was 6.4% in males versus 2.1% in females. while the rates of students who had initiated sexual intercourse after age 19 were 6.9% in males and 2.6% in females. The first sexual intercourse was significantly associated with parental educational attainment, geographic location and family structure. Students whose parents were relatively well educated, living in the western areas of the country China, or with nucleus/extensive families were more likely to have early sex in their puberties. Conclusion Sexual education should be strengthened especially in the western areas, and targeted on the students whose parents with relatively higher educational background or who were from extensive families.     

上海市某区7~13岁学生超重和肥胖流行趋势

目的 本研究旨在描述《学龄儿童青少年超重与肥胖筛查》新标准下儿童肥胖率变化趋势,为开展干预及预防工作提供线索。方法 本研究于2018年9月选取前期群组随机对照试验研究中对照组学生929人作为研究对象,描述研究对象从小学一年级(7岁)至初中一年级(13岁)肥胖、超重、超重或肥胖检出率及体重指数Z分值(BMI-Z)变化趋势。结果 研究对象平均年龄范围6.91~13.58岁。“新”标准下,小学一年级(7岁时)肥胖率、超重或肥胖率均处于高峰,男生肥胖率已高达28.52%,女生为15.59%。总体上,随年龄增长,男、女生肥胖率、超重或肥胖率呈降低趋势;男生肥胖率、超重或肥胖率分别从28.52%、48.83%降低为15.55%和39.68%;女生肥胖率、超重或肥胖率分别从15.59%、33.81%降低为8.56%和21.66%。 男、女生BMI-Z分值均呈现先增高后稍下降的趋势(小学五年级为峰值点)。结论 “新标准”下,小学生肥胖形势严峻,尤其是小学一年级,是肥胖发生的高峰期,这增加了儿童肥胖预防工作的紧迫性。小学作为儿童肥胖干预的重要关口应进一步加强其肥胖的干预。     

State trends in uninsurance among individuals aged 18 to 64 years: United States, 1992-2001

OBJECTIVES: We analyzed state-specific uninsurance trends among US adults aged 18 to 64 years. METHODS: We used logistic regression models to examine Behavioral Risk Factor Surveillance System data for uninsurance from 1992 to 2001 in 47 states. RESULTS: Overall, uninsurance rates increased in 35 states and remained unchanged in 12 states. Increases were observed among people aged 30 to 49 years (in 34 states) and 50 to 64 years (in 24 states), and increases were also observed among individuals at middle and low income levels (in 39 states and 19 states, respectively), individuals employed for wages (in 33 states), and the self-employed (in 18 states). CONCLUSIONS: Among adults aged 18-64, rates of uninsurance increased in most states from 1992 through 2001. Decreased availability of employer-sponsored health insurance, rising health care costs, and state fiscal crises are likely to worsen the growing uninsurance problem.     

基于Framingham模型的苏州市9～18岁学生近视风险模型的构建

目的　探讨苏州市学生近视主要影响因素,建立近视的风险模型,为学生近视综合防控提供依据。方法　分层整群随机抽样招募苏州市四至十二年级学生为调查对象,通过标准化问卷收集学生年龄、性别、饮食习惯、用眼环境、读写习惯、近距离用眼、户外活动、睡眠及父母近视史等,现场测量教室照明,对每名学生进行屈光检测和裸眼远视力检查。Logistic回归分析近视的影响因素,Framingham模型构建近视风险评分模型。结果　本次纳入9～18岁学生2 859人,近视2 264人,近视检出率为79.19%。Logistic回归分析显示,女性（OR = 1.544,95%CI:1.258～1.896）、年龄（OR = 1.404,95%CI:1.325～1.487）、父母近视（一人近视:OR = 2.114,95%CI:1.694～2.638;均近视:OR = 3.450,95%CI:2.590～4.594）、黑板面照度不合格（OR = 1.316,95%CI:1.017～1.703）和躺着或趴着看书或电子屏幕（OR = 1.464,95%CI:1.099～1.950）是中小学生近视的危险因素。Framingham近视风险模型ROC曲线下面积为0.755（95%CI:0.733～0.777）,最佳临界值点为6.6,灵敏度为68.3%,特异度为70.9%,约登指数为39.21%（95%CI:34.90%～42.35%）。结论　Framingham近视风险评分模型具有较好的近视预测能力,可用于近视的健康管理和干预。     

Incidence and remission rates of overweight among children aged 5 to 13 years in a district-wide school surveillance system

OBJECTIVES: To monitor annual changes in weight status, we determined incidence and remission rates of overweight among school-aged children with longitudinal school-based surveillance. METHODS: We estimated 1-year changes in weight status among students enrolled in public schools in Cambridge, Mass. Physical education teachers measured height and weight annually. Adjusted odds ratios (ORs) were estimated via multivariate logistic regression, accounting for repeated observations of individual children across years. RESULTS: The 1-year incidence of overweight was 4%, and the remission rate was 15%. Among overweight children, 85% remained overweight at a 1-year follow-up, while 18% of children at risk for overweight became overweight. Overweight incidence rates were higher among children aged 7 and 8 years than among those aged 11 to 13 years (boys: OR=1.68; 95% confidence interval [CI]=1.14, 2.47; girls: OR=1.86; 95% CI=1.25, 2.77). CONCLUSIONS: Both incidence and remission rates were higher among younger children. Children who were at risk for overweight were more likely to change their weight status than those who were already overweight. Our results support targeting overweight prevention efforts toward younger children and children at risk for overweight.     

中国13～18岁儿童青少年体质水平及其与心理困扰的关联研究

目的描述2019年中国13～18岁儿童青少年的体质水平, 并且分析其与心理困扰之间的关联。方法使用2019年全国学生体质与健康调研数据, 研究对象为90 633名13～18岁汉族儿童青少年。按照《国家学生体质健康标准》(2014年修订)对测量的体质指标进行评价。根据凯斯勒心理困扰量表的得分对心理困扰程度进行判定:≤19、20～、25～、≥30分别表示无、轻度、中度、重度心理困扰, 中度和重度心理困扰合称高心理困扰。使用χ2检验比较性别差异, 采用Cochran-Armitage检验分析趋势, 建立混合效应模型中的无序多分类logistic回归模型分析体质水平与心理困扰程度的关联。结果 2019年中国13～18岁儿童青少年体质不及格率为17.2%;优良率为18.2%, 男生体质优良率(15.9%)低于女生(20.5%), 差异有统计学意义(P<0.05)。体质优良率随年龄的增加呈降低的趋势(趋势检验P<0.05)。2019年中国13～18岁儿童青少年高心理困扰率为39.3%, 男生高心理困扰率(37.0%)低于女生(41.6%), 差异有统计学意义(P<0.05), 且...