中学生情感、躯体虐待与网络成瘾的相关性研究

目的 探讨中学生情感、躯体虐待与网络成瘾的关系,为网络成瘾的防治提供依据.方法 在合肥市选取5所中学,以班级为单位整群抽取初一、初二、高一和高二共76个班级的学生进行匿名问卷调查,内容包括中学生的社会人口统计学特征、Young网络成瘾量表和亲子冲突策略量表等.在单因素分析的基础上,以网络成瘾作为因变量,儿童虐待作为自变量,以性别、年龄、家庭类型等因素为协变量,进行多因素非条件logistic回归分析.结果 在所有调查的3798名学生中,有81.1%的学生报告发生情感虐待,55.1%的学生报告发生躯体虐待;在所有使用网络的3507名学生中,有182名(5.2%)学生被诊断为网络成瘾.多因素非条件logistic回归分析结果显示,中度躯体虐待和重度躯体虐待OR值及95%CI分别为3.02(1.63～5.58)和4.00(2.01～7.93).结论 中度躯体虐待、重度躯体虐待可能是中学生网络成瘾发生的危险因素.     

Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents

BACKGROUND: Low socioeconomic status (SES) is a risk factor for obesity. However, few studies have used a multilevel analysis to determine the influence of both individual- and area-level determinants of SES on obesity, and these studies have been limited to adults. OBJECTIVE: The primary objective was to examine associations between individual- and area-level measures of SES and obesity among adolescents by using a multilevel analytic approach. A secondary objective was to examine associations between individual- and area-level measures of SES with unhealthy eating and physical inactivity. DESIGN: The study sample consisted of 6684 youth in grades 6-10 from 169 schools across Canada. Individual-level SES exposures included material wealth and perceived family wealth. Area-level SES exposures included unemployment rate, percentage of adult residents with less than a high school education, and average employment income from head of household. Associations between SES and the outcome measures were examined by using multilevel logistic regression procedures that modeled students (individual level) nested within schools (area level). RESULTS: Both individual-level and all 3 area-level SES measures were inversely associated with obesity. The odds for unhealthy eating were increased for those living in an area with a low percentage of residents with a high school education. The odds of being physically inactive increased with decreasing levels of material wealth and perception of family wealth. CONCLUSIONS: Individual- and area-level SES measures were independently related to obesity, which suggests that both individual and environmental approaches may be required to curtail adolescent obesity.     

家庭中儿童躯体虐待及影响因素分析

目的 了解长沙市4～8年级儿童家庭躯体虐待的发生情况及影响因素。方法 采取分层随机整群抽样的方法，在长沙市四个区的中、小学抽取1481名学生，男生793名，女生688名。使用父母—儿童冲突策略量表和儿童自身、父母、家庭因素调查表对儿童躯体虐待现况进行调查和分析。结果 儿童躯体虐待率达62．4％，轻微的52．2％，严重的47．4％，非常严重的21．3％。儿童躯体虐待主要与儿童的性别、年龄、学习成绩、父母的健康相关行为、父母关系、家庭经济状况及家具面积等因素有关联。结论 长沙市4～8年级学生中受父母躯体虐待的现象非常普遍，应引起重视。制定预防措施时应综合考虑儿童自身的、家庭的和父母的等影响因素。     

Bullying in Pattani primary schools in southern Thailand

Background   The purpose of this research was to examine risk factors that affect the likelihood of students in Pattani primary schools bullying other children. Risk factors investigated include school rural/urban location, age, gender, religion, family physical abuse and preference of cartoon type. Identifying students who are at high risk of bullying could assist educational authorities to introduce better strategies for reducing the problem.
Methods   A total of 1440 students at public and private primary schools in Pattani province were interviewed to collect relevant data. Pearson's chi-square test was used to assess the associations between the likelihood of bullying and possible risk factors. Logistic regression was used to investigate independent associations between the predictor variables and the outcome.
Results   We found that 32.9% reported that they had (ever) bullied other children. Bullying was significant associated with age (odds ratio 1.56 for 11+ years, 95% confidence intervals 1.23, 2.18) and family physical abuse (odds ratio 4.50, 95% confidence intervals 3.40, 5.89). In addition, Those students who preferred action cartoons tended to bully others 1.87 times more than those who preferred watching comedy cartoons.
Conclusions   There are significant differences in our population in rates of bullying others that vary according to age, preferred cartoon type and whether or not family (parental) physical abuse has been witnessed. The factor 'preference for cartoon type', not examined in previous research, remained significant after multivariable adjustment. Although there is an association, the cause of this is not clear but merits further examination.     

The epidemiology of child abuse: findings from the Second National Incidence and Prevalence Study of Child Abuse and Neglect.

The epidemiology of child abuse was investigated with data from the Second National Incidence and Prevalence Study of Child Abuse and Neglect. A statistical comparison of incidence rates suggested that age, family income, and ethnicity were risk factors for both sexual abuse and physical abuse, but county metrostatus was not. Gender was a risk factor for sexual abuse but not for physical abuse. A logistic regression analysis showed that ethnicity, county metrostatus, and a gender-by-income interaction distinguished sexual abuse from physical abuse.     

1762名大专学生童年期虐待经历及影响因素分析

目的 了解大学生儿童期虐待发生情况及其影响因素,为制定干预策略提供科学依据.方法 用自填式问卷,对1 762名大专学生就有关儿童时期受虐待经历进行不记名回顾性调查.结果 在被调查的1 762名大学生中,76.2％的人在儿童期有遭受虐待经历,儿童期躯体虐待发生率为59.4％,男生为76.0％,女生为49.2％;精神虐待为61.5％,男生为69.0％,女生为57.0％;性虐待为10.2％,男生为8.1％,女生为11.5％.男生躯体虐待(x2=124.139,P=0.000)和精神虐待(x2=25.338,P=0.000)发生率均高于女生,女生性虐待发生率高于男生(x2=5.387,P=0.020).多因素非条件Logistic回归分析显示:父母婚姻状况不良是发生儿童虐待的危险因素(OR=2.407),女童(OR=0.409)、母亲文化程度高(OR=0.718)是儿童虐待发生的保护因素.结论 儿童虐待现象比较普遍,应加强对儿童虐待问题的重视,促进学生健康成长.     

Cardiovascular risk factors and the neighbourhood environment: a multilevel analysis

BACKGROUND: This article examines whether the neighbourhood environment influences intermediate cardiovascular disease (CVD) risk factors, such as obesity (body mass index [BMI]), and lifestyle factors, such as no physical activity and smoking, when adjusted for the individual socioeconomic status (SES). METHODS: The study consists of face-to-face interviews from the Swedish Annual Level of Living Survey (SALLS) matched with the social status of the respondents' residential areas measured by two composite indices, the Care Need Index (CNI) and the Townsend score. The response rate was about 80%. This study was limited to the residents aged 25-74 years and consists of 9240 interviews from the years 1988-1989, when there were extended items in the SALLS about health and lifestyle. The data were analysed using a hierarchical logistic regression model. RESULTS: There was a gradient within every SES group so that respondents with a low (or intermediate or high) educational level exhibited an increasing proportion of daily smokers, physically inactive people and obese individuals with increasing neighbourhood deprivation. The multilevel model showed that respondents living in the most deprived neighbourhoods had an increased risk for being a daily smoker, engaging in no physical activity and being obese when adjusted for the individual SES. CONCLUSIONS: We showed that the area level has an important influence on risk factors for CVD which goes beyond the individual educational attainment. An increased level of living standard, more resources for primary health care and health promotion targeting the community level should be beneficial.     

Socioeconomic risk factors for breast cancer: distinguishing individual- and community-level effects

BACKGROUND: Women are at higher risk of breast cancer if they have higher socioeconomic status (SES) or live in higher SES or urban communities. We examined whether women living in such communities remained at greater risk of breast cancer after controlling for individual education and other known individual-level risk factors. METHODS: Data were from a population-based, breast cancer case-control study conducted in Wisconsin from 1988 to 1995 (n = 14,667). Data on community SES and urbanicity come from the 1990 census, measured at the census tract and zip code levels. We evaluated relationships between individual- and community-level variables and breast cancer risk using multilevel logistic regression models with random community intercepts. RESULTS: After controlling for individual education and other individual-level risk factors (age, mammography use, family history of breast cancer, parity, age at first birth, alcohol intake, body mass index, hormone replacement use, oral contraceptive use, and menopausal status), women living in the highest SES communities had greater odds of having breast cancer than women living in the lowest SES communities (1.20; 95% confidence interval = 1.05-1.37). Similarly, the odds were greater for women in urban versus rural communities (1.17; 1.06-1.28). CONCLUSIONS: Community SES and urbanicity are apparently not simply proxies for individual SES. Future research should examine why living in such communities itself is associated with greater risk of breast cancer.     

广西壮族地区中小学生儿童虐待影响因素及心理影响调查

目的 分析广西壮族地区中小学生的儿童虐待发生的影响因素及其对心理健康的影响。方法 采用多阶段整群抽样的方法,抽取4~9年级的中小学生3 936人。采用自填问卷方式填写学生基本情况调查表、儿童受虐筛查表、儿童社交焦虑量表和自尊量表。通过非条件Logistic回归分析儿童虐待发生的影响因素。进行了儿童虐待与儿童社交焦虑及自尊的相关分析,以明确儿童虐待与社交焦虑及自尊之间的联系强度。结果 结果表明,壮族地区儿童虐待受到中小学、性别、民族、社交焦虑及自尊等5个因素的影响,除中小学、性别和自尊的OR值小于1外,其余因素OR值均大于1。儿童社交焦虑量表总分与儿童虐待显著相关(r=0.201,P<0.01);自尊量表总分与儿童虐待呈显著负相关(r=-0.135,P<0.05)。结论 中小学、性别、民族、社交焦虑及自尊为儿童虐待的影响因素。其中,中学相对于小学是儿童虐待的保护因素;女童相对于男童是保护因素;汉族相对于壮族是儿童虐待的危险因素。社交焦虑与儿童虐待呈正相关,自尊程度与儿童虐待成负相关。     

Research on Environmental Influencing Factors of Overweight and Obesity in Children and Adolescents in China

This study aimed to explore the impact of environmental factors such as latitude, altitude, family socioeconomic status (SES), and level of urbanization on overweight and obesity (ow/ob) in children and adolescents. The participants comprised 26,120 children and adolescents aged 10–18 from 16 provinces in China. Differences in the prevalence of ow/ob under different environmental conditions were evaluated by the chi-square test. The influence of various environmental factors on ow/ob was obtained by logistic regression analysis. We found that (1) the prevalence of ow/ob fell between from 19.2% to 11.9% at 10 years old and from 13.8% to 6% at 18 years old; (2) latitude, family SES, income, and urbanization level are positively correlated with the prevalence of ow/ob; and (3) altitude has a negative correlation with the prevalence of ow/ob. The prevalence of ow/ob decreased with age in children and adolescents aged 10–18, and the risk of ow/ob showed significant differences in latitude, altitude, family SES level, gross domestic product (GDP), and level of urbanization.     

室内环境因素对儿童青少年呼吸道疾病影响的横断面研究

目的探讨影响儿童青少年呼吸道疾病的室内环境因素,为呼吸道疾病的预防和控制提供依据。方法采用横断面研究方法,调查上海市城区16所中小学和幼儿园的4~17岁6551名儿童青少年的呼吸道疾病、家庭社会经济状况、儿童个体特征、父母哮喘与过敏疾病史以及家庭、教室的室内环境因素等。应用多因素logistic回归分析方法,分析环境危险因素对呼吸道疾病影响。结果调整了潜在混杂因素后,哮喘患病的危险因素有父或母吸烟、室内霉斑、室内渗漏潮湿、居室附近50 m内有车辆繁忙的街道或公路;支气管炎患病的环境危险因素有父、母亲室内吸烟、室内经常使用空气清洁化学品和居室附近50 m之内有车辆繁忙的街道或公路。结论本研究表明,父母吸烟是增大4~17岁儿童与青少年呼吸道疾病风险的重要危险因素,室内潮湿、室内霉斑可能增加呼吸道疾病的风险;居室环境因素和地理位置的改变可以预防儿童与青少年呼吸道疾病。     

童年期虐待与青少年不良饮食心理行为的研究

目的了解童年期虐待对青少年不良饮食心理行为的影响.方法采用问卷调查方式.在安徽省2个地区整群选取9所中学的5141名学生进行童年期虐待和青少年不良饮食心理行为的调查.结果童年期重度躯体虐待、中度躯体虐待、精神虐待、身体接触性性虐待和非身体接触性性虐待发生率分别为29.9%、64.8%、51.4%、5.3%和24.5%.初中、高中和职高男生童年期的重度躯体虐待、非身体接触性性虐待和身体接触性性虐待发生率均高于女生,差异有统计学意义;总体上,女生（53.1%）童年期精神虐待发生率高于男生（49.8%）,差异有统计学意义（x2=5.484,P＜ 0.05）.初中学生5种类型虐待的发生率相对较低,高中学生的中度躯体虐待和精神虐待发生率相对较高.在初中、高中和职高学生11种不良饮食心理行为中,有9种发生率女生高于男生,差异有统计学意义.多因素非条件logistic回归分析显示,童年期虐待是11种青少年不良饮食心理行为的危险因素.结论童年期虐待对青少年的饮食行为产生负面影响.     

北京市两所医学院校大学一年级学生自杀意念形成的影响因素

目的 研究医学生的人格、健康危险行为对自杀意念的影响.方法 采用整群抽样方法,应用医学生健康危险行为问卷、人格诊断问卷(第四版)(PDQ-4),对北京市两所医学院校在校大学一年级1204名大学生进行调查,并进行logistic回归分析.结果 单因素分析选出12个具有统计学意义的因素,包括打架行为、严重伤害行为、被迫性行为、不安全性行为、吸烟、醉酒行为、孤独感、情绪不好、失眠、无望感、PDQ-4得分高、网络成瘾行为.logistic回归主效应模型显示男生自杀意念的主要可疑危险因素是失眠(OR=4.98)、严重伤害行为(OR=4.43)、不安全性行为(OR=2.63)、不良情绪(OR=2.32)、无望感(OR=1.98)和PDQ-4得分高(OR=1.09);女生自杀意念的主要可疑危险因素是打架行为(OR=7.10)、孤独感(OR=4.42)、被迫性行为(OR=4.19)和网络成瘾行为(OR=1.39).结论 医学生自杀意念的产生与多种因素有关,且存在明显的性别差异.     

青春早、中期城区男生忽视现况及影响因素研究

目的 了解青春早、中期在校男生受忽视现况及影响因素,为其良好地度过此特殊时期提供科学依据和理论支持。方法 采用整群随机抽样的方法抽取青春早期的男生299人、青春中期的男生471人,采用“中国城区12~17岁中学生忽视评价量表”进行问卷调查,使用Epi Data 3.1建立数据库,SPSS 19.0 进行统计分析。结果 青春早期男生总忽视度为（49.40±7.27）分,青春中期男生总忽视度为（51.25±8.84）分,青春中期男生忽视度高于青春早期男生（t=-3.179,P=0.002）。除教育和社会层面外,在其他层面上,青春中期男生忽视度均高于青春早期男生（均有P<0.05）。青春早期、中期男生忽视度主要影响因素为青春期时期、父亲年龄、母亲文化程度以及与父亲关系。结论 处于青春早期和中期男生受忽视程度深,影响因素主要为自身因素、父母因素及家庭因素,因此应加强家长对青春期的科学理解以及如何度过青春期的相关教育,从而保证青春期男生健康成长。     

西安市高校学生视频显示终端综合征现状及影响因素

探究西安市高校学生视频显示终端(video display terminal,VDT)综合征影响因素,为开展综合防治提供理论依据.方法 采用多阶段分层整群抽样法,随机选取西安市1 491名在校大学生进行VDT综合征相关问卷调查,应用因子分析和多因素Logistic回归分析探讨VDT综合征罹患的可能影响因素.结果 高校学生VDT综合征检出率为73.6%.自我报告的VDT操作相关健康问题中,眼干、眼痛、眼胀、视力下降、视物模糊等眼部症状的检出率最高,分别为69.4%,62.6%,62.4%,59.0%,56.1%.进一步单因素和多因素Logistic回归分析结果显示,视力异常、饮食习惯差、身体健康状况欠佳、不良VDT操作习惯可增加VDT综合征的发生风险[OR值(95%CI=1.14(1.011.29),1.15(1.011.30),1.51(1.331.71),1.18(1.041.33)]);良好的睡眠精神状态、适宜的工作环境条件与VDT综合征罹患危险性的降低有关[OR值(95%CI=0.68(0.600.77),0.67(0.590.76).结论 高校学生VDT综合征检出率较高,眼部健康、饮食习惯、睡眠精神状态、环境、个人体质及计算机使用习惯等多种因素共同参与其发展,应加强相关健康教育.     

Health-risk behaviours: examining social disparities in the occurrence of stillbirth

While an association between low socio-economic status (SES) and increased risk of stillbirth has been observed consistently over several decades, the pathways through which SES exerts these effects have not been established. Given that some key health-risk behaviours for stillbirth, including smoking and pre-pregnancy obesity, have strong relationships with SES, health-risk behaviours may serve as a channel through which low SES contributes to stillbirth outcomes. The objective of this study was to estimate the proportion of the relationship between low SES and the occurrence of stillbirth that is explained by health-risk behaviours in populations of Eastern Ontario and Nova Scotia (112 stillbirth cases and 398 controls). Both area and individual level influences of SES were assessed. The study population consisted of 112 cases (women delivering stillborn infants) and 398 controls. Odds ratios and 95% confidence intervals estimated by multivariable logistic regression were used to approximate relative risks. The contribution of health-risk behaviours to relationships between SES and stillbirth was assessed by a change in the relative risk estimate following omission of each health-risk behaviour from the model. Of the three measures of individual level SES examined (household income, education, Blishen occupational index), only household income was a statistically significant predictor of stillbirth. After controlling for individual level SES, no community level SES effects were observed for stillbirth. Adjustments for key health-risk behaviours (smoking) resulted in an 18.5% reduction in the odds ratio estimate for low SES, from 3.31 to 2.79. This large unexplained SES effect that remained highlights the need for research into other potential pathways that may account for increased risk of stillbirth among those of lower SES.     

Determinants of foster care placement for the maltreated child.

This study examined the records of the North Carolina Central Registry of Child Abuse and Neglect to determine which social, family, and child characteristics were most influential in the decision to place a child in foster care. These records contained all theoretically relevant factors as well as demographic data. Analysis included the computation of odds ratios for foster care for each of 250 variables. A maximum likelihood logistic regression model was constructed to obtain the independent and cumulative contribution of each factor. Some expected variables such as parental stress factors (substance abuse) and types of abuse (burns and scalds) placed a child at a significant risk for placement in foster care (p less than 0.01). However, less obvious factors such as referral source (law enforcement agencies) or geographic area also placed children at risk. Overall, the model explained little of the variance of these decisions (R2 = 0.168) and poorly predicted placement (sensitivity 66.3 per cent, specificity 74.6 per cent). Using existing data, we were unable to adequately describe the decision process in selecting foster care.     

Parental beliefs and child-rearing attitudes and mental health problems among schoolchildren

OBJECTIVE: To verify the prevalence and identify the risk factors related to mental health problems among schoolchildren and its possible association with the beliefs and educational attitudes of parents/caretakers. METHODS: Cross-sectional study with a stratified probabilistic sample (n=454) of first to third-graders from public and private schools in Southeastern Brazil. Standardized instruments were administered to parents/caretakers by trained interviewers, including screening questionnaires for mental health problems among children and parents/caretakers; a questionnaire on beliefs and attitudes; and a questionnaire for socio-economic status. Chi-square tests and logistic regression models were used for statistical analysis. RESULTS: We found 35.2% prevalence of clinical/borderline cases among students. Parents/caretakers that believed in corporal punishment as a child-rearing method used physical aggression towards their children more frequently (64.8%). Logistic regression models showed that the act of hitting the child with a belt was associated to conduct problems and to overall mental health problems among schoolchildren in the presence of other risk factors: child gender (male), parents/caretakers with mental health problems, and adverse socioeconomic conditions. CONCLUSIONS: The high prevalence of mental health problems among schoolchildren and its association with child-rearing methods and mental health problems among parents/caretakers indicate the need for psycho-educational interventions aimed to reduce physical abuse and mental health problems in childhood.     

成都市18～34岁男性青年性暴力现况及相关危险因素分析

目的 了解成都市18 ～ 34岁男性青年性暴力现况及相关危险因素,为预防和减少性暴力、性暴力所致各种危害的发生提供科学依据.方法 采用多阶段随机抽样方法,以成都市18 ～ 34岁青年男性为调查对象,进行入户自填式问卷调查,利用logistic多元回归方法分析性暴力的危险因素.结果 成都市18 ～ 34岁男性青年性暴力检出率为17.8％.儿童期目睹家庭暴力(P＜0.01)、儿童躯体虐待(P＜0.01)、酒精滥用(P＜0.01)、焦虑(P＜0.01)、不良婚姻状况(离婚/丧偶/分居等)(P＜0.01)、已婚(P＜0.05)、抑郁(P＜0.05)可能是调查人群性暴力的危险因素.结论 成都市男性青年性暴力问题不容忽视,应对高危人群实施针对性的干预.     

Association of socio-economic factors with health risk behaviours among high school students in rural Nova Scotia

OBJECTIVE: To determine the association of socio-economic (SES) factors with risk behaviours among adolescents. METHODS: A cross-sectional survey was carried out on students in four high schools in northern Nova Scotia, Canada. Associations between SES variables and substance use behaviours, having early intercourse and suicide attempt in the past year were examined using multivariate analysis (logit regression). Negative binomial regression was performed for associations of SES with a total risk score summing risk behaviours. RESULTS: Participants included 2,198 students (48% males; 52% females) ranging in age from 14 to 20 years. Almost 25% of youth smoked regularly, 19% of males smoked marijuana > or = 10 times monthly, more than 40% of males regularly drank excessively, and 10% of students > 14 years old had had intercourse before age 15. Smoking was the behaviour most often associated with lower SES in both genders. Mother's not being employed was protective against all substance use variables except driving after drinking. Living both with lone mother and in any family arrangement other than with both parents was associated with smoking, using marijuana, and early sex. Higher risk score was associated with living with a lone mother or other family arrangement. Lower risk score was associated with father having more than high school education and mother not working. INTERPRETATION: Lower socio-economic status is associated with adolescent risk behaviours. These findings point to the importance of these factors to risk-taking in youth, their relevance to social policy, and also their importance as factors to consider in targeted interventions.