福建省女生月经初潮年龄变化趋势及与体质的关系

目的了解福建省女生月经初潮的发生现状及其变化规律。探讨月经初潮与形态、机能、素质的关系，为青春期健康教育工作提供依据。方法以分层整群抽样法，对7～18岁3847名女生进行现状调查，采用概率单位回归法计算月经初潮平均年龄（MMA）。结果女生月经初潮平均年龄为12．5岁，城乡月经初潮年龄差异有统计学意义（P〈0、05）。女生形态指标（身高、体质量、胸围、坐高）、维尔维克指数、劳累尔指数、肺活量，均为来潮组明显大于未来潮组，两组差异均有统计学意义（P〈0．01）。马氏躯干腿长指数则表现为未来潮组高于来潮组，差异有统计学意义（P〈0．05）。结论福建省学生月经初潮平均年龄提前趋势依然存在。形态发育、机能指标与青春期发育有密切关系。     

安徽省女生月经初潮年龄与体脂指标关联的生态学研究

了解安徽省女生月经初潮年龄与体脂指标的关系以及不同地区测量分布情况,探寻月经初潮年龄的影响因素.方法 按照2014年全国学生体质与健康调研的相关要求,测量安徽省合肥、宿州、池州3个地区城乡7~18岁汉族女生共4 844人的上臂、腹部、肩胛下皮褶厚度以及身高、体重、腰围、臀围等指标,计算体脂率、体质量指数(BMI)、腰高比和腰臀比;利用问卷调查女生月经初潮年龄,应用概率单位回归法计算月经初潮年龄.结果 安徽省女生半数月经初潮平均年龄为11.95岁,合肥、池州和宿州3个地区女生月经初潮平均年龄分别为12.11岁、12.32岁和11.40岁.城乡女生半数月经初潮平均年龄分别为11.68岁和12.21岁,城乡相差0.53岁.9~13岁组初潮组中体脂率高的人数百分比比未初潮组多,差异均有统计学意义(P值均<0.05).应用对应分析体脂率、皮褶厚度与月经初潮年龄呈负相关.结论 BMI、腰高比和腰臀比与月经初潮只存在一定关联性.安徽省女童月经初潮年龄与体脂指标密切相关.     

Exploring the relationship between timing of menarche and eating disorder symptoms in Black and White adolescent girls.

OBJECTIVE: This study examined the relationship between timing of sexual maturation and eating disorders symptoms in adolescent girls. METHOD: Data were collected over 10 years for a cohort of 1,213 Black girls and 1,166 White girls who were either 9 or 10 years old at study entry. Annually, girls' height and weight were measured and, biannually, girls completed self-report measures of eating disorders symptoms. RESULTS: Early-onset menarche is a risk factor for the development of body image and dieting concerns, but the effect of timing is due to the impact of early and late maturation on body weight. DISCUSSION: Findings underscore the importance of adiposity as a risk factor for poor mental health.     

The association between physical exercises and health-related quality of life in subjects with mental disorders: results from a cross-sectional survey

OBJECTIVES: The present study examines the relationship between health-related quality of life and physical activity among adults with affective, anxiety, and substance dependence disorders. METHODS: Analyses were conducted among participants in the German National Health Interview and Examination Survey (GHS), a nationally representative multistage probability survey, conducted from 1997 to 1999. Multiple linear regression analyses were used to determine the relationship between health-related quality of life and physical activity among subjects with mental disorders. RESULTS: Affective, anxiety, and substance dependence disorders were associated with substantial impairment in health-related quality of life. Higher levels of physical activity were associated with higher health-related quality of life among persons with mental disorders. Even after controlling for sociodemographic characteristics, physically inactive subjects reported poorer quality of life. CONCLUSIONS: Physical activity can be considered as beneficial for people suffering from mental disorders. The promotion of a physically active lifestyle is an important public health objective.     

云南省女生月经初潮与形态发育关系

了解云南省女生月经初潮与形态发育之间的关系,为研究学生生长发育规律和开展青春期教育提供依据.方法 利用2010年全国学生体质健康调研数据,对云南省7个民族9~18岁女生月经来潮对身高、体重、胸围、维尔威克指数的影响进行统计检验.结果 2010年云南省女生半数月经初潮年龄最小为汉族(12.62岁)、纳西族(12.64岁),最大为佤族(13.06岁)、哈尼族(13.12岁).11~ 14岁各民族来潮组女生形态发育优于未来潮组(P<0.01).月经来潮早的汉族、纳西族各年龄段女生的身高、体重均值均高于其他民族女生,并一直持续到18岁成年期之后.结论 女生月经初潮与形态发育关系密切.初潮年龄与经济水平、营养状况有关,且受儿童期体格发育水平的影响.     

The Internet as a source of reproductive health information among adolescent girls in an urban city in Nigeria

Background:

The US military is currently involved in large, lengthy, and complex combat operations around the world. Effective military operations require optimal health of deployed service members, and both mental and physical health can be affected by military operations.

Methods:

Baseline data were collected from 77,047 US service members during 2001–2003 as part of a large, longitudinal, population-based military health study (the Millennium Cohort Study). The authors calculated unadjusted, adjusted, and weighted means for the Medical Outcomes Study Short Form 36-item Survey for Veterans physical (PCS) and mental component summary (MCS) scores over a variety of demographic and military characteristics at baseline.

Results:

The unadjusted mean PCS and MCS scores for this study were 53.4 (95% confidence interval: 53.3–53.4) and 52.8 (95% confidence interval: 52.7–52.9). Average PCS and MCS scores were slightly more favorable in this military sample compared to those of the US general population of the same age and sex. Factors independently associated with more favorable health status included male gender, being married, higher educational attainment, higher military rank, and Air Force service. Combat specialists had similar health status compared to other military occupations. Having been deployed to Southwest Asia, Bosnia, or Kosovo between 1998 and 2000 was not associated with diminished health status.

Conclusion:

The baseline health status of this large population-based military cohort is better than that of the US general population of the same age and sex distribution over the same time period, especially in older age groups. Deployment experiences during the period of 1998–2001 were not associated with decreased health status. These data will serve as a useful reference for other military health studies and for future longitudinal analyses.     

中国青春期女生月经初潮较早与形态发育的关系

目的 探讨中国青春期女生月经初潮较早与身体形态发育的关系.方法 资料均来自2010年全国学生体质与健康调查数据,采用概率单位回归法计算月经初潮年龄的第10百分位数(P10)概率界值,将界值以前已来月经者定义为月经初潮较早(9.0～11.6岁),共筛选出初潮较早女生1072名,按城乡、年龄(精确到0.1岁)1∶2频数匹配未来潮女生2144名,并选取其身高、体重、坐高、胸围、BMI和身高坐高指数进行分析.采用t检验、wilcoxon秩和检验分析9.0～11.6岁各组中月经初潮较组与未来潮女生各项指标的差异,采用x2检验分析超重、肥胖率的差异;采用多水平模型分析月经初潮较早与各项形态指标及超重肥胖的关系.结果 纳入1072名月经初潮较早者以及2144名未来潮者.初潮较早组女生身高、坐高、胸围、体重和BMI分别为(151.42±7.46) cm、(80.86±4.21)cm、(73.88 ±7.72)cm、(44.32±9.35)kg和(19.18 ±3.03) kg/m2,未来潮组分别为(144.86±7.55)cm、(76.96±4.05)cm、(67.25±6.94) cm、(36.07 ±7.88)kg和(16.64±2.48) kg/m2,差异均有统计学意义(Z值分别为-22.20、-23.69、-24.38、-23.12、-20.17、-6.33,P值均＜0.01);多水平分析结果显示,9.0～11.6岁组月经初潮较早与各项身体形态发育指标均具有相关性(P值均＜0.05),初潮较早组女生与未来潮组比较,身高、坐高、胸围、体重和BMI分别高5.28 cm、3.37 cm、5.53 cm、6.37 kg、1.79 kg/m2;分年龄段分析,发现初潮较早组与未来潮组之间身高、坐高和体重的差异随年龄增加呈抛物线型变化趋势,胸围呈“U”形变化;9.0～10.8、10.9～11.0、11.1 ～11.2岁组初潮较早女生出现超重肥胖的风险分别是未来潮组的2.98倍(95％ CI:1.92 ～4.63)、6.76倍(95％ CI:2.79 ～16.39)、2.99倍(95％CI:1.40～6.40).结论 中国青春期女生月经初潮较早与身高、坐高、体重和胸围等生长发育指标有关,且与超重肥胖密切相关.     

Do mental health and behavioural problems of early menarche persist into late adolescence? A three year follow-up study among adolescent girls in Oslo,Norway

Early menarche has been linked to mental health and behavioural problems in several studies. Most of these studies are cross-sectional, the data gathered during puberty. Thus, there is a lack of research on the long-term effect of early menarche on mental health. The main aim of this study was to explore whether the differences in mental health problems between girls with early and late menarche persist into late adolescence. The data consisted of responses from a large school-based survey of all 10th grade girls (15 years of age) in Oslo, Norway. Of the 1860 participating girls in the 2001 survey, 1377 were included in the three year follow-up study in 2004, giving a response rate of 74%. Mental distress was measured with the Hopkins Symptom Check list 10-version. Additional items assessed were number of sexual partners, weight and body satisfaction. All information was self-reported, including age of menarche. We found a clear gradient in the cross sectional analyses at baseline of higher odds for mental distress at lower age of menarche even after adjustment for socio demographic and other factors. In the analysis of the follow-up data there was no statistically significant difference in mental distress across age of menarche, even though the differences in body and weight satisfaction and average body mass index remained at the same level between baseline and follow-up. We therefore conclude that the effects of age of menarche on mental health problems are a transitory problem during puberty.     

Prevalence and severity of malnutrition and age at menarche; cross-sectional studies in adolescent schoolgirls in western Kenya

OBJECTIVE: Nutritional status is an important marker of overall health and linear growth retardation has serious long-term physiological and economic consequences. Approximately 35 and 29% of preschool children in sub-Saharan Africa are stunted and underweight, respectively. There is relatively little information available about the nutritional status in adolescents, the age group with the highest growth velocity after infancy. We conducted a series of cross-sectional surveys to determine the prevalence and main risk groups for malnutrition and to describe the associations between age, sexual maturation and nutritional status in adolescent schoolgirls in western Kenya. DESIGN: Three cross-sectional surveys; one in Mumias, using random sampling in all schools, and two surveys in Asembo, using a multi-stage random sample design. SETTING: Public primary schools in two different rural malaria endemic areas in western Kenya with high levels of malnutrition in preschool children. SUBJECTS: In all, 928 randomly selected adolescent schoolgirls aged 12-18 y. RESULTS: Overall prevalence of stunting and thinness was 12.1 and 15.6%, respectively. Of the total, 2% were severely stunted. Menarche and start of puberty were delayed by approximately 1.5-2 y compared to a US reference population. The prevalence of stunting and thinness decreased with age and mean height for age z-scores converged towards the median of the US reference curve. Girls who had not yet started menstruating were more likely to be stunted than the girls of the same age who were post-menarche. CONCLUSIONS: Stunting and thinness are common in young adolescent schoolgirls in these poor rural settings in western Kenya, but the prevalence decreases with age, providing observational support that children catch up on incomplete growth attained earlier in life due to a maturational delay of 1.5-2 y allowing prolonged growth.     

The relationship between unsupervised time after school and physical activity in adolescent girls

Background  

Rising obesity and declining physical activity levels are of great concern because of the associated health risks. Many children are left unsupervised after the school day ends, but little is known about the association between unsupervised time and physical activity levels. This paper seeks to determine whether adolescent girls who are without adult supervision after school are more or less active than their peers who have a caregiver at home.     

Serum PBDEs and age at menarche in adolescent girls: analysis of the National Health and Nutrition Examination Survey 2003-2004

Background

Polybrominated diphenyl ethers (PBDEs), widely used as flame retardants since the 1970s, have exhibited endocrine disruption in experimental studies. Tetra- to hexa-BDE congeners are estrogenic, while hepta-BDE and 6-OH-BDE-47 are antiestrogenic. Most PBDEs also have antiandrogenic activity. It is not clear, however, whether PBDEs affect human reproduction.

Objectives

The analysis was designed to investigate the potential endocrine disruption of PBDEs on the age at menarche in adolescent girls.

Methods

We analyzed the data from a sample of 271 adolescent girls (age 12–19 years) in the National Health and Nutrition Examination Survey (NHANES), 2003–2004. We estimated the associations between individual and total serum BDEs (BDE-28, -47, -99, -100, -153, and -154, lipid adjusted) and mean age at menarche. We also calculated the risk ratios (RRs) and 95% confidence intervals (CI) for menarche prior to age 12 years in relation to PBDE exposure.

Results

The median total serum BDE concentration was 44.7 ng/g lipid. Higher serum PBDE concentrations were associated with slightly earlier ages at menarche. Each natural log unit of total BDEs was related to a change of −0.10 (95% CI: −0.33, 0.13) years of age at menarche and a RR of 1.60 (95% CI: 1.12, 2.28) for experiencing menarche before 12 years of age, after adjustment for potential confounders.

Conclusion

These data suggest high concentrations of serum PBDEs during adolescence are associated with a younger age of menarche.     

The relationship between iron status and thyroid hormone concentration in iron-deficient adolescent Iranian girls

Extensive data from animal and human studies indicate that iron deficiency impairs thyroid metabolism. The aim of this study was to determine thyroid hormone status in iron-deficient adolescent girls. By stepwise random sampling from among all public high schools for girls in Lar and its vicinity in southern Iran, 103 out of 431 iron deficient subjects were selected. Urine and serum samples were collected and assayed for urinary iodine and serum ferritin, iron, total iron binding capacity (TIBC), thyroid stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), free thyroid hormones (fT4 and fT3), triiodothyronine resin uptake (T3RU), reverse triiodothyronine (rT3), selenium and albumin concentrations. Hematological indices for iron status confirmed that all subjects were iron-deficient. There was a significant correlation between T4 and ferritin (r = 0.52, P < 0.001) and between TSH and ferritin (r = -0.3, P < 0.05). Subjects with low serum ferritin had a higher ratio of T3/T4 (r = -0.42, P < 0.01). Using stepwise regression analysis, only ferritin contributed significantly to the rT3 concentration (r = -0.35, P < 0.01). The results indicate that the degree of iron deficiency may affect thyroid hormone status in iron-deficient adolescent girls.     

安徽省汉族女生月经初潮与肥胖度关系的研究

目的:了解安徽省汉族女生月经初潮年龄变化情况及不同经济状况地区月经初潮年龄的差异并进一步分析月经初潮年龄与肥胖度的关系。方法:按照2010年全国中小学生体质调研的相关要求,采用分层随机抽样和随机整群抽样方法对安徽省南、北、中3个地区的城乡7～18岁中小学女生共6 840人进行调查,测量身高、体重、腰围、臀围及腹部、上臂、肩胛下皮褶厚度等指标,并对她们是否有月经初潮进行了问卷调查。结果:安徽省汉族女生半数月经初潮平均年龄为12.44岁,与往年相比呈现提前趋势。城乡女生半数月经初潮平均年龄分别为12.39及12.49岁。体质指数、腰高比及3个部位皮下脂肪厚度等指标的均值来潮组均大于未来潮组,差异有统计学意义(P<0.05)。结论:月经初潮年龄与体脂因素关系密切,呈现负相关;应该提前加强中小学生的性教育及让中小学生加强锻炼、控制饮食,减缓月经初潮年龄提前的长期趋势。     

Delayed discharge from mental health hospitals: results of an English postal survey

This paper reports findings from a postal survey conducted by the UK's NHS Confederation to explore the rate and cause of delayed hospital discharges in mental health inpatient services. With delayed discharges the subject of considerable UK government activity in general hospital settings, there has been debate about extending recent financial penalties to mental health, fining social services departments for delayed discharges (a system known as reimbursement). Against this background, the NHS Confederation sent a postal survey to all 83 English mental health trusts and Primary Care Trusts with responsibility for providing mental health services. This asked respondents about delayed discharges from mental health inpatient beds in terms of number of delays, duration of delay, specialty and cause. Responses were then analysed quantitatively (in terms of number and extent of delays) and qualitatively (attitudes to reimbursement and other policies that might help resolve the issue). Overall, the survey reveals high levels of delayed discharges (with from 4% to 16% of beds affected and some 25 to 2,366 bed days lost depending on specialty). The causes of delayed discharge are varied, with a range of factors interacting. Although opinion was divided on the benefits of extending reimbursement, closer analysis revealed greater agreement than may at first be apparent. In particular, those favouring extension tended not to be 'pro-reimbursement' per se, but rather desperate to tackle delayed discharges and prepared to consider any policy that might help. This is an important addition to the current literature and debate, as it suggests that those seemingly in favour of reimbursement may actually be more motivated by a desire to try anything that might reduce delays rather than by commitment to this particular policy.     

The association between mental distress and the use of alternative medicine among cancer patients in North Norway

Purpose of the study: To study the association between mental distress and the use of alternative medicine (AM) among cancer patients. Patients and methods: A longitudinal questionnaire-based study was carried out at the Department of Oncology, University Hospital of Tromsø, Norway, during the period 1990–1991. The level of mental distress in 158 patients aged less than 75 years was assessed 4 months after first admission to the cancer ward. The patients answered five questions about mental distress selected from the General Health Questionnaire (GHQ). The questions were scored continuously according to the Likert scoring procedure. The level of mental distress was also ranked from 1 (little or no mental distress) to 3 (high mental distress). Results: A total of 53 of the 158 patients reported use of AM at inclusion of the study or during the 4 months of follow-up. Among patients with low mental distress, 21% were users of AM, 36% of patients with medium distress and 48% in patients with high level of mental distress (p-value for linear trend = 0.02). Adjusted for all known relevant variables, patients with medium level of mental distress had 1.9 times higher prevalence of use of AM than patients with low level of mental distress, patients with high mental distress had a 2.9 times higher prevalence (p = 0.15 and 0.07, respectively). Analyzed as a continuous variable (Likert score between 5 and 20), mental distress was associated with use of AM (p = 0.007). Conclusion: These findings suggest that seeking alternative treatment is more common among mentally distressed cancer patients.     

中国10个地区成年女性初潮年龄与身高和腿长的关联研究

目的 描述中国慢性病前瞻性研究（CKB）项目覆盖的10个地区30～79岁成年女性初潮年龄与身高和腿长的地区及出生年代分布,并分析初潮年龄与身高和腿长的关联性。方法 剔除初潮年龄缺失或初潮年龄在生理范围外（<9岁或>18岁）个体后,285 187名女性纳入分析。使用多元线性回归模型分析初潮年龄与身高和腿长的关系,并根据出生年代和城乡进行亚组分析。结果 10个项目地区女性的平均初潮年龄为（15.2±1.7）岁,平均身高和腿长分别为（154.2±6.0）cm和（71.0±3.7）cm。女性身高和腿长呈现出随出生年代逐渐增加的趋势（线性趋势检验均P<0.001）。而初潮年龄在1940-1949年代出生的个体略有推迟,之后出生的女性则表现为逐渐提前的趋势（线性趋势检验P<0.001）。在调整了年龄、地区、教育程度和臀围（仅在分析腿长时调整）后,初潮年龄每晚一岁,身高和腿长分别平均增加0.17 cm和0.20 cm（P值均<0.001）。相比出生年代较早的女性,出生年代越晚的女性中,初潮年龄与身高和腿长的回归系数越大（交互检验P值均<0.001）。结论 CKB的10个项目地区女性的初潮年龄与身高和腿长均存在正相关关联。