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Loy JK, Klam J, Dötsch J, Frank J, Bender S. Exploring adolescent mental health during the COVID-19 crisis - strengths and difficulties. Front Public Health 2024; 12:1357766. [PMID: 38638467 PMCID: PMC11024382 DOI: 10.3389/fpubh.2024.1357766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/08/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction The SARS-CoV-2 pandemic has significantly impacted children and adolescents, leading to mental health challenges. Knowledge on their resources and difficulties is crucial and there is a need for valid instruments to assess their psychosocial condition especially in this exceptional situation. We assessed psychopathological symptoms using the SDQ during the pandemic, comparing to pre-pandemic data. Our study aims to understand adolescents' strengths and difficulties amidst COVID-19, evaluating the SDQ's utility in crisis settings. Methods Within the German school-based surveillance study ("B-Fast"), we assessed behavioral strengths and difficulties in 664 adolescents aged 11-17 years during the peak of the German COVID-19 pandemic using the validated Strengths and Difficulties Questionnaire (SDQ) for both external and self-assessed data collection. Data were collected between November 2020 and April 2021. We compared self-assessed SDQ-scores to pre-pandemic data from a comparable sample and examined adolescent classification as "normal" or "borderline/abnormal" based on both external and self-assessed SDQ subscale scores using established cut-off values. Additionally, we conducted sex and rater-based score comparisons. Results In our study, we observed a significant worsening of "Emotional Symptoms" compared to pre-pandemic levels, while "Conduct Problems" and "Prosocial Behavior" showed improvement. Variations in classification to "normal" and "abnormal" emerged when applying German versus British cut-off values. Females scored higher on "Emotional Symptoms" while males scored higher on "Hyperactivity Symptoms." Correlations between external and self-assessed SDQ ratings ranged from 0.43 (p < 0.001) for "Prosocial Behavior" among girls to 0.62 (p < 0.001) for "Peer Problems" among boys, indicating moderate to high consistency. Discussion/conclusion Our study contributes to understanding the psychosocial impact of the COVID-19 pandemic on German adolescents. Compared to other symptoms, we observed a particular worsening in "Emotional Symptoms" based on our data. Despite the moderate correlation between parental and self-reported evaluations, there appears to be a certain discrepancy in the perception of adolescent quality of life. Therefore, it seems prudent to assess both the external and self-reported evaluations and amalgamate the results from both parties to obtain a comprehensive problem profile of the individual. These findings underscore the importance of using country-specific cutoff values and reaffirm the utility of the SDQ as a valuable assessment tool, even within the unique circumstances posed by a pandemic.
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Affiliation(s)
- Johanna K. Loy
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Janina Klam
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jörg Dötsch
- Department of Pediatric and Adolescent Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Frank
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Neuperdt L, Beyer AK, Junker S, Mauz E, Hölling H, Schlack R. [Parental strain, inattention/hyperactivity symptoms and parent-reported ADHD in children and adolescents: results of the KiGGS study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:429-438. [PMID: 38536438 PMCID: PMC10995013 DOI: 10.1007/s00103-024-03859-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND A child's attention deficit hyperactivity disorder (ADHD) is associated with strain for the parents. In turn, psychosocial parental strain is associated with higher probabilities for the occurrence of inattention/hyperactivity symptoms (IHS) in their children. The aim of this paper is to assess the association between parental strain, IHS, and a parent-reported ADHD diagnosis of the children. METHODOLOGY Based on data from n = 4596 participants of the KiGGS cohort (wave 2: 2014-2017), the type and extent of parental strain was set in relation to IHS and an ADHD diagnosis of the child in cross-sectional analysis. Frequencies, means, beta coefficients, and odds ratios adjusted for sex, age, socioeconomic status, and migration background are reported. RESULTS In individual consideration, a greater number of parental strains were associated with IHS than with an ADHD diagnosis. In a multivariate analysis, financial worries and parenting problems/conflicts with the children were significant predictors of IHS and an ADHD diagnosis, respectively. In addition, four or more types of parental strain were associated with a higher likelihood of both IHS and an ADHD diagnosis. DISCUSSION Financial and child-rearing strain are relevant to parents of children with IHS and an ADHD diagnosis. Interrelationships between parental stress and a child's IHS or an ADHD diagnosis can be assumed. To relieve their burden, prevention can either aim at improving the situation of ADHD-affected families or at improving the family's handling of the child's ADHD.
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Affiliation(s)
- Laura Neuperdt
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Ann-Kristin Beyer
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Stephan Junker
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Elvira Mauz
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Heike Hölling
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Robert Schlack
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
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Milatz F, Hansmann S, Klotsche J, Niewerth M, Kallinich T, Dressler F, Haas JP, Berendes R, Horneff G, Hufnagel M, Weller-Heinemann F, Windschall D, Trauzeddel R, Klaas M, Girschick H, Oommen PT, Foeldvari I, Cantez SM, Jansson AF, Hartmann M, Peitz-Kornbrust J, Minden K. Level and correlates of physical activity among children and adolescents with juvenile idiopathic arthritis compared to controls: results from a German nationwide prospective observational cohort study. Pediatr Rheumatol Online J 2024; 22:39. [PMID: 38509613 PMCID: PMC10953124 DOI: 10.1186/s12969-024-00976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Physical active lifestyles are essential throughout growth and maturation and may offer potential preventive and therapeutic benefit in patients with juvenile idiopathic arthritis (JIA). Insufficient physical activity (PA), in contrast, can lead to aggravation of disease-related symptoms. This study aimed to i) examine PA levels in children and adolescents with JIA compared to general population controls and ii) investigate correlates of pronounced physical inactivity in order to identify risk groups for sedentary behaviour. METHODS Data from children and adolescents with JIA and population controls aged 3 to 17 years documented in the National Pediatric Rheumatologic Database (NPRD) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) were used. Self-reported PA was collected from parents/guardians of children up to 11 years of age or adolescents 12 years of age and older. To compare PA-related data, age- and sex-specific pairwise analyses were conducted considering NPRD/KiGGS participants' data from 2017. Correlates of physical inactivity among patients were identified using a linear regression model. RESULTS Data of 6,297 matched-pairs (mean age 11.2 ± 4.2 years, female 67%, patients' disease duration 4.5 ± 3.7 years, persistent oligoarthritis 43%) were available for evaluation. Almost 36% of patients aged 3-17 years (vs. 20% of controls) achieved the WHO recommended amount of PA, while PA steadily decreased with age (18% of patients aged ≥ 12 years) and varied between JIA categories. Female adolescents and patients with enthesitis-related arthritis were least likely to achieve the minimum recommended level of PA. Physical inactivity was associated with female sex, higher age at disease onset, longer disease duration, more functional disability (C-HAQ) and higher disease activity (cJADAS-10). CONCLUSIONS Depending on JIA category, children and adolescents with JIA were similarly or even more likely to achieve the WHO recommended minimum level of PA compared to general population controls. However, since a large proportion of young JIA patients appear to be insufficiently physically active, engagement in targeted efforts to promote PA is urgently needed.
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Affiliation(s)
- Florian Milatz
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany.
| | - Sandra Hansmann
- Department of Neuropediatrics, Developmental Neurology and Social Paediatrics, University of Tuebingen, Tuebingen, Germany
| | - Jens Klotsche
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Martina Niewerth
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Tilmann Kallinich
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Programme area Systems Rheumatology, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Frank Dressler
- Department of Paediatric Pneumology, Allergology and Neonatology, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Johannes-Peter Haas
- German Centre for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - Rainer Berendes
- Pediatric Rheumatology, Children's Hospital St. Marien, Landshut, Germany
| | - Gerd Horneff
- Department of Pediatric Rheumatology, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin, Germany
- Department of Paediatric and Adolescent Medicine, University Hospital of Cologne, Cologne, Germany
| | - Markus Hufnagel
- Division of Pediatric Infectious Diseases and Rheumatology, Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
| | - Frank Weller-Heinemann
- Department of Pediatrics and Adolescent Medicine, Pediatric Rheumatology, Eltern-Kind-Zentrum Prof. Hess, Klinikum Bremen-Mitte, Bremen, Germany
| | - Daniel Windschall
- Clinic of Paediatric and Adolescent Rheumatology, Northwest German Centre for Rheumatology, St. Josef-Stift Sendenhorst, Sendenhorst, Germany
- Medizinische Fakultät, Universität Halle-Wittenberg, Halle, Germany
| | - Ralf Trauzeddel
- Department of Paediatrics, Helios Klinik Berlin-Buch, Berlin, Germany
| | - Moritz Klaas
- Children's Hospital, Vivantes Klinikum Friedrichshain, Berlin, Germany
| | - Hermann Girschick
- Children's Hospital, Vivantes Klinikum Friedrichshain, Berlin, Germany
| | - Prasad T Oommen
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Division of Pediatric Rheumatology, University Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Ivan Foeldvari
- Hamburg Centre for Paediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - Serdar Mustafa Cantez
- Department of Pediatrics and Neonatology, Division of Pediatric Rheumatology, University Hospital of Marburg and Gießen, Gießen, Germany
| | - Annette F Jansson
- Department of Rheumatology & Immunology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Matthias Hartmann
- German Centre for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - Joachim Peitz-Kornbrust
- Department of Pediatric Rheumatology, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin, Germany
| | - Kirsten Minden
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Deckert A, Runge-Ranzinger S, Banaschewski T, Horstick O, Elwishahy A, Olarte-Peña M, Faber C, Müller T, Brugnara L, Thom J, Mauz E, Peitz D. Mental health indicators for children and adolescents in OECD countries: a scoping review. Front Public Health 2024; 11:1303133. [PMID: 38414565 PMCID: PMC10898649 DOI: 10.3389/fpubh.2023.1303133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/19/2023] [Indexed: 02/29/2024] Open
Abstract
Background This scoping review is a further step to build up the Mental Health Surveillance System for Germany. It summarizes and analyzes indicators used or described in Organization for Economic Co-operation and Development (OECD) countries for public mental health monitoring in children and adolescents aged 0-18 years. Methods We searched PubMed-MEDLINE, PsycINFO, Cochrane Databases, and Google Scholar from 2000 to September 2022. The search used five general keyword categories: 1) "indicators/monitoring/surveillance" at the population level, 2) "mental/psychological," 3) "health/disorders," 4) "children and adolescents," and 5) 38 OECD countries. The search was complemented with an extensive grey literature search, including OECD public health institutions and an internet search using Google. A predefined set of inclusion and exclusion criteria was applied. Results Over 15,500 articles and documents were screened (scientific search N = 10,539, grey literature search more than 5,000). More than 700 articles and documents have been full-text assessed, with 382 being ultimately included. Out of 7,477 indicators extracted, an initial set of 6,426 indicators met our inclusion criteria for indicators. After consolidating duplicates and similar content, this initial set was categorized into 19 topics, resulting in a final set of 210 different indicators. The analysis highlighted an increasing interest in the topic since 2008, but indicators for the younger age, particularly those aged 0 to 2 years, were less readily available. Conclusion Our research provides a comprehensive understanding of the current state of mental health indicators for children and adolescents, identifying both (1) indicators of public mental health noted in a previous scoping review on adults and (2) new indicators specific to this age group. These findings contribute to the development of effective public health surveillance strategies for children and adolescents and inform future research in this field.
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Affiliation(s)
- Andreas Deckert
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Tobias Banaschewski
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters Zentralinstituts für Seelische Gesundheit, Mannheim, Germany
| | - Olaf Horstick
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Abdelrahman Elwishahy
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Margarita Olarte-Peña
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
- evaplan GmbH am Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Claudia Faber
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Müller
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lucia Brugnara
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
- evaplan GmbH am Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Julia Thom
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Diana Peitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Boettcher C, Tittel SR, Reschke F, Fritsch M, Schreiner F, Achenbach M, Thiele-Schmitz S, Gillessen A, Galler A, Nellen-Hellmuth N, Golembowski S, Holl RW. Diabetes and gender incongruence: frequent mental health issues but comparable metabolic control - a DPV registry study. Front Endocrinol (Lausanne) 2024; 14:1240104. [PMID: 38317711 PMCID: PMC10841572 DOI: 10.3389/fendo.2023.1240104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/30/2023] [Indexed: 02/07/2024] Open
Abstract
Context The condition when a person's gender identity does not match the sex assigned at birth is called gender incongruence (GI). Numbers of GI people seeking medical care increased tremendously over the last decade. Diabetes mellitus is a severe and lifelong disease. GI combined with diabetes may potentiate into a burdensome package for affected people. Objective The study aimed to characterize people with GI and diabetes from an extensive standardized registry, the Prospective Diabetes Follow-up Registry (DPV), and to identify potential metabolic and psychological burdens. Methods We compared demographic and clinical registry data of persons with type 1 or type 2 diabetes and GI to those without GI and used propensity score matching (1:4) with age, diabetes duration and treatment year as covariates. Results 75 persons with GI, 49 with type 1 and 26 with type 2 diabetes were identified. HbA1c values were similar in matched persons with type 1 or 2 diabetes and GI compared to those without GI. Lipid profiles showed no difference, neither in type 1 nor in type 2 diabetes. Diastolic blood pressure was higher in the type 1 and GI group than in those without, whereas systolic blood pressure showed comparable results in all groups. Depression and anxiety were significantly higher in GI people (type 1 and 2). Non-suicidal self-injurious behaviour was more common in type 1 and GI, as was suicidality in type 2 with GI. Conclusion Mental health issues are frequent in people with diabetes and GI and need to be specially addressed in this population.
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Affiliation(s)
- Claudia Boettcher
- Paediatric Endocrinology and Diabetology, University of Bern Faculty of Medicine, Bern, Switzerland
| | - Sascha R. Tittel
- Institute of Epidemiology and Medical Biometry (ZIBMT), University of Ulm, Ulm, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Felix Reschke
- Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
| | - Maria Fritsch
- Department of Paediatric and Adolescent Medicine, Division of General Paediatrics, Medical University of Graz, Graz, Austria
| | - Felix Schreiner
- Paediatric Endocrinology Division, Children’s Hospital, University of Bonn, Bonn, Germany
| | - Maike Achenbach
- Department of Gastroenterology and Diabetology, Vivantes Klinikum Kaulsdorf, Berlin, Germany
| | - Susanne Thiele-Schmitz
- Diabetes Centre for Children and Adolescents, St. Louise Women’s and Children’s Hospital, Paderborn, Germany
| | - Anton Gillessen
- Department of Internal Medicine, Herz-Jesu-Hospital, Muenster, Germany
| | - Angela Galler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Sozialpädiatrisches Zentrum, Paediatric Endocrinology and Diabetology, Berlin, Germany
| | - Nicole Nellen-Hellmuth
- Centre of Child and Adolescent Medicine, Leopoldina Clinic Schweinfurt, Schweinfurt, Germany
| | - Sven Golembowski
- Department of Paediatrics, Sana Hospital Lichtenberg, Berlin, Germany
| | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry (ZIBMT), University of Ulm, Ulm, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Königstein K, Büschges JC, Schmidt-Trucksäss A, Neuhauser H. Cardiovascular Risk in Childhood is Associated With Carotid Intima-Media Thickness and Stiffness in Adolescents and Young Adults: The KiGGS Cohort. J Adolesc Health 2024; 74:123-129. [PMID: 37815767 DOI: 10.1016/j.jadohealth.2023.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/03/2023] [Accepted: 08/18/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Cardiovascular risk factors are widespread among children and adolescents and may lead to accelerated vascular aging in middle adulthood. However, data are scarce on shorter-term consequences, for example, on associated distinctive vascular properties before age 30 years. This study analyzes the association of childhood exposure to cardiovascular risk factors with carotid properties in adolescents and young adults. METHODS Four thousand thirty one participants from the population-based German Health Interview and Examination Survey for Children and Adolescents cohort (aged 3-17 years) had carotid intima-media thickness (CIMT) and distensibility coefficient (DC) measurements at the second follow-up (aged 14-28 years). The assessment of cardiovascular risk factors at baseline included information about arterial hypertension, obesity, dyslipidemia, and passive smoking. RESULTS Single risk factors and the exposure to multiple cardiovascular risk factors were associated with elevated CIMT and decreased DC. Relative risks for CIMT ≥ 90th centile and/or DC ≤ 10th centile were increased in participants exposed to two (RRCIMT = 1.45 [95% confidence interval 1.11-1.91], p < .05; RRDC = 1.37 [1.02-1.84], p < .05) and ≥ three risk factors (RRCIMT = 1.66 [1.05-2.62], p < .05; RRDC = 1.25 [0.71-2.21], p > .05). DISCUSSION Exposure to multiple cardiovascular risk factors starting in childhood is associated with measurably increased CIMT and carotid stiffness in late adolescence and early adulthood. These findings underline the importance of population-wide preventive measures to promote optimal cardiovascular health.
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Affiliation(s)
- Karsten Königstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Switzerland; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany.
| | - Julia Charlotte Büschges
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Arno Schmidt-Trucksäss
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Switzerland; Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland
| | - Hannelore Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
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Zhou Y, Wengler A, Doblhammer G. Association between the starting age of non-parental Early Childhood Education and Care (ECEC), and psycho-social problems in adolescence in West and East Germany - a natural experiment using data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). BMC Psychol 2023; 11:403. [PMID: 37986110 PMCID: PMC10658975 DOI: 10.1186/s40359-023-01447-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION The study aimed to investigate the association between the start age of non-parental Early Childhood Education and Care (ECEC) and psycho-social problems in adolescence. The similarities and differences between West and East Germany were also investigated in a natural experiment. METHODS Our sample consisted of 1022 children (621 from West Germany, 401 from East Germany) aged 3-4 years at wave 2003-2006 that were followed up to wave 2014-2017 as adolescents (mean ± SD age = 14.4 ± 0.03 years) in the KiGGS study. The psycho-social problems were measured by the parent-reported Strengths and Difficulties Questionnaire (SDQ) at wave 2014-2017. Linear regression was used to explore the relationship between ECEC-start-age and psycho-social problems in adolescence in Germany, and stratified by West and East Germany. RESULTS Those who started ECEC between 2 and 3 years old (reference) had the lowest scores of psycho-social problems in the whole Germany and in West Germany in adolescence. In comparison, those who started ECEC older than 3 years old had higher scores of internalizing psycho-social problems in both West Germany (with statistically significant results) and East Germany (with a relatively larger effect size but insignificant results). Those who started ECEC younger than 1 year old had statistically significant higher scores for externalizing psycho-social problems in West Germany, even though less children started ECEC younger than 1 in West Germany compared to East Germany. This significant association was not found in East Germany. Those who started ECEC between 1 and 2 years old tended to have higher scores of externalizing psycho-social problems in both West and East Germany. CONCLUSION The results suggest that if children start ECEC older than 3 years or younger than 2 years, more attention needs to be given to internalizing or externalizing psycho-social problems respectively. The regional differences for children younger than 1 year old may suggest a selection effect in West Germany where only fewer parents bring babies to ECEC, while the regional similarities for children over 3 years old indicate the importance of providing access to ECEC for children over 3 years old.
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Affiliation(s)
- Ying Zhou
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Gabriele Doblhammer
- Institute for Sociology and Demography, University of Rostock, Rostock, Germany.
- German Center for Neurodegenerative Disease, Bonn, Germany.
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Maurer J, Meyrose AK, Kaman A, Mauz E, Ravens-Sieberer U, Reiss F. Socioeconomic Status, Protective Factors, and Mental Health Problems in Transition from Adolescence to Emerging Adulthood: Results of the Longitudinal BELLA Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01582-1. [PMID: 37632556 DOI: 10.1007/s10578-023-01582-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 08/28/2023]
Abstract
Lower familial socioeconomic status (SES) is associated with more mental health problems in adolescence. The aim of this study was to identify factors that may protect adolescents from families with lower SES from developing mental health problems in emerging adulthood. Data of the population-based longitudinal BELLA study included n = 426 participants aged 13 to 17 years at t0 (2009-2012) and 18 to 24 years at t1 (2014-2017). Hierarchical multiple linear regressions with interaction terms were conducted, examining three selected protective factors (self-efficacy, family climate, and social support). Self-efficacy had a small protective effect for adolescents from families with lower SES for mental health problems in emerging adulthood. However, social support had a small protective effect for adolescents from families with higher SES. No moderating effect was found for family climate. Instead, better family climate in adolescents predicted fewer mental health problems in emerging adulthood with a small effect regardless the SES in adolescence. Results indicate the need for prevention measures for adolescents from families with lower SES for becoming mentally healthy emerging adults.
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Affiliation(s)
- Jenny Maurer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Developmental and Educational Psychology, Helmut Schmidt University, University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Clinical Psychology and Psychotherapy, Helmut Schmidt University, University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Boemanns L, Staab J, Meyer T. Associations of attention-deficit/hyperactivity disorder with inflammatory diseases. Results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023:10.1007/s40211-023-00479-8. [PMID: 37589869 DOI: 10.1007/s40211-023-00479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/06/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Despite conflicting data, some studies have suggested a pathophysiological relationship between inflammation and attention-deficit/hyperactivity disorder (ADHD). METHODS Using data from the nationwide and representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS; n = 6922 study participants aged 11-17 years), this post hoc analysis assessed the associations between ADHD and three common inflammatory diseases. RESULTS Results showed univariate associations between ADHD and lifetime inflammatory diseases including atopic dermatitis (p = 0.002), otitis media (p = 0.001), and herpes simplex infection (p = 0.032). In logistic regression models adjusted for clinically relevant confounders, we found that ADHD remained a significant predictor of all three inflammatory diseases (atopic dermatitis, Exp(β) = 1.672, 95% confidence interval [CI] 1.239-2.257, p = 0.001; otitis media, Exp(β) = 1.571, 95% CI 1.209-2.040, p = 0.001; herpes simplex, Exp(β) = 1.483, 95% CI 1.137-1.933, p = 0.004). CONCLUSION Our findings demonstrate a positive link between ADHD and peripheral inflammatory diseases, including atopic dermatitis, otitis media, and herpes simplex infection. Further studies are needed to understand the exact pathophysiological mechanisms underlying these associations.
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Affiliation(s)
- Lena Boemanns
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Julia Staab
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Thomas Meyer
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, German Center for Cardiovascular Research, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany.
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10
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Cohen J, Alexander S, Signorelli C, Williams K, Sim KA, Chennariyil L, Baur LA. Clinician and healthcare managers' perspectives on the delivery of secondary and tertiary pediatric weight management services. J Child Health Care 2023; 27:128-144. [PMID: 34719287 DOI: 10.1177/13674935211052148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinician and healthcare managers' (HCMs) views on weight management service delivery are imperative for informing the nature of future services to treat children with obesity. This qualitative study used semi-structured focus groups and one-on-one semi-structured interviews. Participants were 27 clinicians (medical, nursing, or allied health) and nine HCMs (senior executives in the hospital) who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. Clinicians reported that using a combination of group and individual sessions improved engagement with families and reduced attrition rates. Clinicians and HCMs recommended integrating clinics into community centers and providing specific programs for sub-groups, such as children from culturally and linguistically diverse communities or children with developmental delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. To improve the likelihood of future funding for pediatric weight management clinics and to optimize models of care, centers must embed research into their practice. Addressing common barriers to current pediatric weight management services and designing future models of care based on key stakeholders' preferences is critical to achieving optimal care provision for this high-risk population.
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Affiliation(s)
- Jennifer Cohen
- Weight Management Services, 8538The Children's Hospital at Westmead, Westmead, NSW, Australia.,Discipline of Paediatrics, School of Women's & Children's Health, 7800The UNSW Sydney, Sydney, NSW, Australia
| | - Shirley Alexander
- Weight Management Services, 8538The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Christina Signorelli
- Discipline of Paediatrics, School of Women's & Children's Health, 7800The UNSW Sydney, Sydney, NSW, Australia.,Kids Cancer Centre, 63623Sydney Children's Hospital, Randwick, NSW, Australia
| | - Kathryn Williams
- Charles Perkins Centre, 4334The University of Sydney, Camperdown, NSW, Australia.,Nepean Family Metabolic Health Service, 223690Nepean Blue Mountains Local Health District, Kingswood, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Kyra A Sim
- Charles Perkins Centre, 4334The University of Sydney, Camperdown, NSW, Australia.,Obesity Prevention and Management, 222415Sydney Local Health District, Camperdown, NSW, Australia
| | - Lenina Chennariyil
- Discipline of Paediatrics, School of Women's & Children's Health, 7800The UNSW Sydney, Sydney, NSW, Australia.,Department of Paediatrics, 36666Canterbury Hospital, Campsie, NSW, Australia
| | - Louise A Baur
- Weight Management Services, 8538The Children's Hospital at Westmead, Westmead, NSW, Australia.,Charles Perkins Centre, 4334The University of Sydney, Camperdown, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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11
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Huber F, Schulz J, Schlack R, Hölling H, Ravens-Sieberer U, Meyer T, Rothenberger A, Wang B, Becker A. Long-term changes in serum levels of lipoproteins in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). J Neural Transm (Vienna) 2023; 130:597-609. [PMID: 36826608 PMCID: PMC10050056 DOI: 10.1007/s00702-022-02583-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/26/2022] [Indexed: 02/25/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting approximately 5% of children worldwide. The causal mechanisms of ADHD remain unclear as the aetiology of this disorder seems to be multifactorial. One research field addresses the impact on lipid metabolism and particularly serum lipid fractions on the development of ADHD symptoms. This post hoc analysis aimed to investigate long-term changes in serum levels of lipoproteins in children and adolescents with ADHD and controls. Data of German children and adolescents from the nationwide and representative "Kinder- und Jugendgesundheitssurvey (KiGGS)" study were analysed at baseline and at a ten-year follow-up. At the two time points, participants in the control group were compared with those in the ADHD group, both before and after propensity score matching. Differences in total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins (HDL) and triglycerides were assessed between matched children with and without ADHD. In addition, subgroups with versus without methylphenidate use were compared at both time points. At baseline before matching, there were no significant differences for lipid parameters between participants in the ADHD group (n = 1,219) and the control group (n = 9,741): total cholesterol (Exp(ß) = 0.999, 95%-CI 0.911-1.094, p = .979), LDL (Exp(ß) = 0.967, 95%-CI 0.872-1.071, p = .525), HDL (Exp(ß) = 1.095, 95%-CI 0.899-1.331, p = .366) and triglycerides (Exp(ß) = 1.038, 95%-CI 0.948-1.133, p = .412). Propensity score matching confirmed the non-significant differences between the ADHD and non-ADHD group at baseline. At the 10-year follow-up, n = 571 participants fulfilled complete inclusion criteria, among them 268 subjects were classified as ADHD. The two groups did not significantly differ in lipid fractions, neither cross-sectionally nor with regard to long-term changes. There was also no significant difference between methylphenidate subgroups. In this sample of children and adolescents we could not reveal any significant associations between serum lipid fractions and the diagnosis of ADHD, neither cross-sectionally nor longitudinally; even when methylphenidate use was considered. Thus, further studies using larger sample sizes are required to investigate putative long-term changes in serum lipid fractions related to ADHD.
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Affiliation(s)
- Franziska Huber
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Jan Schulz
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Unit Mental Health, Berlin, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Unit Mental Health, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Partner Site Göttingen, German Centre for Cardiovascular Research, Göttingen, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Biyao Wang
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Andreas Becker
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Von-Siebold-Str. 5, 37075 Göttingen, Germany
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Hoebel J, Waldhauer J, Blume M, Schienkiewitz A. Socioeconomic Status, Overweight, and Obesity in Childhood and Adolescence. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:839-845. [PMID: 36345700 PMCID: PMC9981977 DOI: 10.3238/arztebl.m2022.0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/06/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Overweight and obesity in early life increase the risk of chronic disease and ill health later on. We studied secular trends in the prevalence of overweight and obesity among young people in Germany, with consideration of socioeconomic status (SES). METHODS We used repeated cross-sectional data from 3- to 17-year-olds from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Overweight and obesity were defined according to the body mass index, based on measured height and weight from the KiGGS baseline survey (2003-2006) and the KiGGS second wave (2014-2017). SES was assessed with a composite index of parental education, occupation, and income. RESULTS In both study periods, the prevalence of overweight and obesity was highest among girls and boys from families of low SES. In the group with lowest SES, the prevalence of overweight rose from 20.0% in 2003-2006 (95% CI [18.0; 22.1]) to 25.5% [20.5; 31.2] in 2014-2017 (p = 0.043). Thus, social differences in the prevalence of overweight increased over time. No such trend was found for the prevalence of obesity. CONCLUSION Social differences in the prevalence of overweight among children and adolescents increased from the early 2000s to the mid-2010s. Structural measures are needed to help prevent overweight among young people in socially disadvantaged circumstances.
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Affiliation(s)
- Jens Hoebel
- Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin,*Fachgebiet Soziale Determinanten der Gesundheit Abteilung für Epidemiologie und Gesundheitsmonitoring Robert Koch-Institut General-Pape-Str. 62–66, 12101 Berlin, Germany
| | - Julia Waldhauer
- Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin
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13
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Physical Activity and Recurrent Pain in Children and Adolescents in Germany—Results from the MoMo Study. CHILDREN 2022; 9:children9111645. [PMID: 36360373 PMCID: PMC9689024 DOI: 10.3390/children9111645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022]
Abstract
Recurrent pain can be a significant disruption in the activities of daily life, and is not only a health problem in adults but also in children and adolescents. This study analyzed the prevalence of recurrent pain in the current sample (n = 1516; 11–17 years (meanage = 14.4 ± 2.0 years); 50.8% female) of a nationwide study in Germany, evaluated the association of participants’ device-based physical activity (PA) with the prevalence of recurrent pain, and assessed whether children and adolescents who reported pain for the last three months accumulated less PA than those who did not. A higher prevalence was found in girls for recurrent headaches (42.2% vs. 28.7%), abdominal pain (28.2% vs. 20.1%), and back pain (26.9% vs. 19.5%). We found higher odds for recurrent headaches in girls (OR = 1.54) and in participants that did not reach at least 60 min of moderate to vigorous PA (MVPA) per day (OR = 2.06). Girls who reported recurrent headaches accumulated 4.7 min less MVPA per day than those without. The prevalence of pain remains at a high level in the German youth and underscores the need for interventions to improve the health situations of children and adolescents.
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Hirtz R, Hölling H, Grasemann C. Subclinical Hypothyroidism and Incident Depression in Adolescents and Young Adults: Results from a Nationwide Representative Prospective Study. Thyroid 2022; 32:1169-1177. [PMID: 35946076 DOI: 10.1089/thy.2022.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Although the relationship between subclinical hypothyroidism and major depressive disorder (MDD) has been studied in adults in cross-sectional and prospective population-based studies, this has not yet been done in adolescents. However, since thyroid function and MDD risk are subjected to maturational processes and ramifications of illness duration over the life span, these findings may not readily transfer to adolescents. Methods: The relationship between subclinical hypothyroidism and MDD was studied in a representative subsample of the nationwide KIGGS ("The German Health Interview and Examination Survey for Children and Adolescents") survey. A total of 4118 adolescents were examined over a median period of 6 years, and data were analyzed by a logistic regression approach accounting for important covariates related to thyroid function and/or MDD risk. The same approach was chosen to investigate the relationship between quartiles of thyrotropin (TSH) and free thyroxine (fT4) levels and incident MDD in euthyroid participants to broaden the focus on the relationship between thyroid hormone levels and MDD in a dose-response manner. Results: During the observation period, 121 cases of MDD were reported. There was no association between subclinical hypothyroidism and MDD when comparing 111 adolescents with subclinical hypothyroidism with 4007 euthyroid adolescents, representative of ∼106,000 and 3,610,000 adolescents from the general pediatric population, respectively. This also applied when studying the relationship between quartiles of TSH and fT4 levels and MDD in euthyroid participants. All results were confirmed by sensitivity analyses accounting for thyroid autoimmunity. Conclusions: Consistent with findings in adults, there is no association between subclinical hypothyroidism or quartiles of TSH and fT4 levels in the normal range and MDD in adolescents, despite potential age-related differences regarding thyroid function and MDD risk.
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Affiliation(s)
- Raphael Hirtz
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Corinna Grasemann
- Department of Pediatrics and Center for Rare Diseases Ruhr CeSER, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
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Ganjeh P, Hagmayer Y, Meyer T, Kuhnert R, Ravens-Sieberer U, von Steinbuechel N, Rothenberger A, Becker A. Physical activity and the development of general mental health problems or attention-deficit hyperactivity disorder (ADHD) symptoms in children and adolescents: A cross-lagged panel analysis of long-term follow-up epidemiological data. Front Behav Neurosci 2022; 16:933139. [PMID: 36177095 PMCID: PMC9513200 DOI: 10.3389/fnbeh.2022.933139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Studies have shown that physical activity (PA) can provide a helpful, low-risk, and cost-effective intervention for children and adolescents suffering from mental health problems. This longitudinal study aimed to assess whether PA prevents the development of mental health problems, such as attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Data were analyzed from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected from more than 15.000 children and adolescents at three different time points over a period of more than 10 years. Parents scored the PA of the study participants on three frequency levels according to WHO recommendations, and mental health problems were assessed by means of the Strengths and Difficulties Questionnaire (SDQ). The total problem score (SDQ-Total) and the hyperactivity/inattention symptoms sub-scale (SDQ-H/I) were used in an autoregressive cross-lagged model to examine their relationship with PA. The results showed that PA of boys and girls at preschool age was inversely associated with the occurrence of mental health problems and, in particular, ADHD symptoms about 6 years later. Higher levels of PA were associated with better general mental health and fewer ADHD symptoms at the next time point (Wave 1). These effects were not observed from preadolescence (Wave 1) to adolescence (Wave 2), neither for girls nor for boys. These findings indicate that medium-to-high PA may be a supportive factor for good mental health in children in preschool and elementary school. Future studies will have to show whether PA may be a helpful add-on for interventional programs for improving general mental health and alleviating ADHD symptoms among children and adolescents.
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Affiliation(s)
- Parisa Ganjeh
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- *Correspondence: Parisa Ganjeh
| | - York Hagmayer
- Department of Cognitive Science and Decision Psychology, Georg-Elias-Müller-Institute for Psychology, University of Göttingen, Göttingen, Germany
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Ronny Kuhnert
- Unit Mental Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicole von Steinbuechel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
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Nigg C, Niessner C, Burchartz A, Woll A, Schipperijn J. The geospatial and conceptual configuration of the natural environment impacts the association with health outcomes and behavior in children and adolescents. Int J Health Geogr 2022; 21:9. [PMID: 35953832 PMCID: PMC9366780 DOI: 10.1186/s12942-022-00309-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Studies investigating associations between natural environments and health outcomes or health behaviors in children and adolescents yielded heterogenous results to date. This may be the result of different geospatial configurations of the natural environment and confounding characteristics of the study population. Thus, we investigated how the relationship between the natural environment and mental health, muscular fitness, and physical activity varies depending on the geospatial configuration of nature and children’s and adolescents’ characteristics. Methods Data were derived from the German Motorik-Modul (MoMo) cohort study (2018–2020) that investigates physical activity, muscular fitness, and health parameters in a national sample of children and adolescents (N = 2843) between four and 17 years (Mage = 10.46 ± 3.49 years; 48.3% girls). Mental health was assessed via questionnaire, muscular fitness via standing long jump, and physical activity with 7-day accelerometer measurement. Using geographic information systems, land cover, and land use data, three different nature definitions were applied. Both circular buffers (100–1000 m) and street-network buffers (1000–5000 m) were created for each of the nature definitions. Associations were explored with linear regression models, and interaction analysis was used to investigate how those relationships vary by gender, age, and socio-economic status. Results The relationship between the three outcomes and the natural environment varied considerably depending on the nature definition, buffer size, and buffer type, as well as socio-demographic characteristics. Specifically, when comparing youth with a high socio-economic status to those with a medium socio-economic status, smaller circular buffer distances were related to less physical activity, but larger street-network buffer distances were related to greater mental health problems. Distinct relationships also occurred for youth with low socio-economic status in those relationships, with the pattern being less clear. Conclusions For future health research studies that investigate the role of the natural environment, we argue for the development of an a-priori model that integrates both geospatial considerations (nature definition, buffer type, and buffer size) and conceptual considerations (health outcome/behavior, sample characteristics) based on potentially underlying mechanisms that link the natural environment and the health outcome or behavior under investigation to theoretically underpin the geospatial configuration of the natural environment. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-022-00309-0.
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Affiliation(s)
- Carina Nigg
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland. .,Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Claudia Niessner
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Alexander Burchartz
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Alexander Woll
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
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Nowak N, Diouf F, Golsong N, Höpfner T, Lindtner O. KiESEL - The Children's Nutrition Survey to Record Food Consumption for the youngest in Germany. BMC Nutr 2022; 8:64. [PMID: 35836299 PMCID: PMC9284799 DOI: 10.1186/s40795-022-00527-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background With KiESEL, the Children’s Nutrition Survey to Record Food Consumption, the German Federal Institute for Risk Assessment (BfR) collected representative food consumption data for children aged six months up to five years. KiESEL was one of five modules of KiGGS Wave2 (German Health Interview and Examination Survey for Children and Adolescents) conducted by the Robert Koch Institute (RKI). The objective was to update the consumption data for children in Germany and to fill a data gap for the age group of five-year-old children. The study provides an up-to-date and comprehensive database that will be used for exposure assessment, as part of risk assessment of Germany’s youngest consumers. Methods In the years 2014 to 2017, 1104 children from all over Germany participated in KiESEL. During home visits, survey staff conducted a questionnaire-based interview including a food propensity questionnaire (FPQ) on seldom eaten foods and questions concerning consumption outside home, dietary habits and diet during first year. The interviewer measured the children’s height and weight. Families and childcare workers filled out a food record, covering three consecutive days and one independent day. Data are based on the FPQ and present consumption frequencies. Depending on the question, socioeconomic status (SES) and migration background were considered. Results 1104 participants had an interview and filled out the questionnaire on usual food intake, seldom eaten foods and consumption away from home. They were included in sample1. 1008 of these participants additionally reported food consumption of at least three days (sample2). 91.2% of the children follow no special diet and 0.8% are vegetarians. 7% of the older children consuming soya-drink. For some foods differences in consumption across SES or migration status were noted. Children from families with higher SES consume more often soya-based substitute milk as families with lower SES (p < 0.00005). Conclusions KiESEL gathered up-to-date consumption data for more than 1000 children living in Germany, aged six month up to including five years. The data will be used for risk assessments of the BfR and provided to national and international partners. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00527-6.
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Affiliation(s)
- Nicole Nowak
- German Federal Institute for Risk Assessment, Berlin, Germany.
| | | | - Nadine Golsong
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - Tobias Höpfner
- German Federal Institute for Risk Assessment, Berlin, Germany
| | - Oliver Lindtner
- German Federal Institute for Risk Assessment, Berlin, Germany
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Nigg C, Burchartz A, Reichert M, Woll A, Niessner C. Children and adolescents do not compensate for physical activity but do compensate for sedentary behavior. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00808-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractLittle is known about behavioral transfer and compensation within and between moderate-to-vigorous physical activity (MVPA) and sedentary behavior. Thus, taking a within-person perspective, this study investigated across 1 week whether (a) children and adolescents compensate for increased MVPA and sedentary behavior with less of the respective behavior the next day and (b) transfer and compensation occur between these behaviors within 1 day and across 2 days. We obtained data from 2676 participants (6–17 years) of the national Motorik-Modul (MoMo) study in Germany. Participants wore an ActiGraph accelerometer (Pensacola, FL, USA) for 7 days. We analyzed within- and between-day associations using hierarchical linear modeling. If youth engaged in 2 h more sedentary behavior than typical on any given day, they engaged in 37.20 min less MVPA the same day (B = −0.31, p < 0.001) as well as in 4.80 min more MVPA (B = 0.04, p < 0.001) and 7.20 min less sedentary behavior (B = −0.06, p < 0.001) the next day. If youth engaged in 1 h more MVPA than typical on any given day, they engaged in 97.80 min less sedentary behavior the same day (B = −1.63, p < 0.001) and in 5.40 min less sedentary behavior the next day (B = −0.09, p < 0.001). No association with next-day MVPA was observed. Our results indicate that children do not compensate for enhanced MVPA but transfer to less sedentary behavior, while more sedentary behavior is compensated with less sedentary behavior and more MVPA the next day. This provides essential information for the design of intervention studies to tackle physical inactivity and sedentary behavior.
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Rittsteiger L, Hinz T, Oriwol D, Wäsche H, Schmidt S, Kolb S, Woll A. Changes of Self-Rated Health Status, Overweight and Physical Activity During Childhood and Adolescence-The Ratchet Effect of High Parental Socioeconomic Status. Front Sports Act Living 2022; 4:781394. [PMID: 35308596 PMCID: PMC8931189 DOI: 10.3389/fspor.2022.781394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Childhood and adolescence are important life periods for the development of health status and physical activity (PA) behaviours. This study analyses the stability and potential changes of self-rated health status, overweight and PA behaviour over time, specifically focusing on the age and the socioeconomic status of children and adolescents. We employ representative longitudinal data for German children and adolescents from the Motorik-Modul Study and the German Health Interview and Examination Survey. Using four different dichotomous health status and PA indicators (self-rated health status [SRHS]; overweight; moderate-to-vigorous PA; and leisure sports engagement), we report within-person transition rates across the panel waves when the survey was taken (2003-2006, 2009-2012, and 2014-2017). Additionally, we report results of logistic regressions estimating the impact of children's age, gender, migration background, and their parents' socioeconomic status on these transition rates. The transition rates show mixed results. While children and adolescents from highly problematic states reporting bad SRHS and no leisure sports engagement at an early stage tend to improve later on, overweight children mostly stay overweight. Age and social inequality indicators correlate with some of the chances of improving or worsening the health and PA states. Most clearly, high parental status prevents the health status and PA from worsening over all transitions, particularly becoming overweight, representing a ratchet effect. The results of the present study underline that health policy needs to target specific groups to reduce social inequality in the health status and PA of children and adolescents.
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Affiliation(s)
- Lea Rittsteiger
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Thomas Hinz
- Department of History, Sociology, Empirical Educational Research and Sport Science, University of Konstanz, Konstanz, Germany
| | - Doris Oriwol
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Hagen Wäsche
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Steffen Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Simon Kolb
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
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Gao D, Zou Z, Li Y, Chen M, Ma Y, Chen L, Wang X, Yang Z, Dong Y, Ma J. Association between urinary phthalate metabolites and dyslipidemia in children: Results from a Chinese cohort study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 295:118632. [PMID: 34906593 DOI: 10.1016/j.envpol.2021.118632] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
Rising evidence of both experimental and epidemiological studies suggests that phthalate exposure may contribute to increased risks of metabolic disorders. But there is limited research on the childhood dyslipidemia. Our cohort study was conducted in Xiamen city, Fujian Province, China. A total of 829 children (mean age 8.5 years) were included with collection of urine, blood samples and demographic data in May 2018 and followed up once a year from 2018 to 2020. We performed adjusted log-binomial regressions to examine associations between sex-specific tertiles of seven phthalate metabolites and dyslipidemia in visit 1, as well as persistent dyslipidemia and occasional dyslipidemia. We also used generalized estimating equation models (GEE) to explore the relationships between log-transformed phthalate metabolites and lipid profiles. In adjusted models, the prevalence and RRs of dyslipidemia increased with tertile group of mono-n-butyl phthalate (MnBP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), and summed di-(2-ethylhexyl) phthalate (∑DEHP) metabolites with a dose-response relationship in visit 1, as well as persistent dyslipidemia. Higher MnBP, ∑LMWP, MEHHP, MEOHP, and ∑DEHP concentrations were also associated with higher levels of log-transformed triglycerides (TG). Boys were more vulnerable to phthalates exposure than girls. In conclusion, children in China were widely exposed to phthalates, and phthalates exposure during childhood might significantly increase the risk of dyslipidemia and a higher level of lipid profiles, particularly in boys.
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Affiliation(s)
- Di Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yanhui Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Xijie Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
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21
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Schlecht J, König J, Urschitz MS. [Chronically ill at School - School Performance in Children with Special Health Care Needs. Results of the Child Health Study ikidS]. KLINISCHE PADIATRIE 2022; 234:88-95. [PMID: 35139545 DOI: 10.1055/a-1672-4709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The association between health status in childhood and later educational achievement is unknown. We describe the association between a chronic health condition (CHC) and school performance at the end of first grade. PATIENTS As part of the child health survey ikidS, 2,003 preschoolers from the Mainz-Bingen area (Rhineland-Palatinate; Germany) were recruited. METHOD In a prospective cohort study, children with CHC were identified by the children with special health care needs screener. At the end of first grade, classroom teachers evaluated the child's school performance on a rating scale ranging from - 2 through+2 in 5 domains: numeracy, science, reading, writing, and social competencies. Associations between special health care needs (SHCN) and each domain were assessed by linear mixed regression models adjusted for potential confounders. RESULTS 1,463 children (51% males) were analyzed. Of these, 15% had SHCN. Compared to their classmates, children with SHCN performed poorer in numeracy (adjusted mean difference: - 0.40; 95% CI[- 0.57; - 0.23]) and writing (- 0.22; 95% CI[- 0.39; - 0.05]). DISCUSSION For the first time in a German sample, we found an indication which educational competencies might be negatively impacted by SHCN early in school. This could have long-lasting effects on educational attainment and later socio-economic status. CONCLUSION Our results question the uptake and/or effectiveness of existing medical care as well as educational support concepts for children with a CHC.
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Affiliation(s)
- Jennifer Schlecht
- Abteilung für Pädiatrische Epidemiologie; Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Jochem König
- Abteilung für Pädiatrische Epidemiologie; Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Michael S Urschitz
- Abteilung für Pädiatrische Epidemiologie; Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
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22
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Opper E, Kunina-Habenicht O, Oriwol D, Hanssen-Doose A, Krell-Roesch J, Schlack R, Worth A, Woll A. Development of coordination and muscular fitness in children and adolescents with parent-reported ADHD in the German longitudinal MoMo Study. Sci Rep 2022; 12:2073. [PMID: 35136188 PMCID: PMC8827093 DOI: 10.1038/s41598-022-06139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 01/24/2022] [Indexed: 11/09/2022] Open
Abstract
This study examined the development of muscular fitness and coordination in children and adolescents with and without attention deficit hyperactivity disorder (ADHD) over a period of 11 years. Data was collected in three measurement waves as part of the longitudinal, representative Motorik-Modul (MoMo) study in Germany (2003-2006, 2009-2012, 2014-2017). The overall sample comprised 2988 participants (253 with ADHD, 65% males; 2735 non-ADHD, 47% males; mean age 9 years). Structural equation modeling was conducted, and the estimated models had a good fit. No differences in muscular fitness were observed between participants with and without ADHD. Participants with ADHD had a lower coordinative performance at first measurement than those without ADHD. The difference in coordinative performance persisted throughout the study period.
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Affiliation(s)
- Elke Opper
- University of Education Karlsruhe, Bismarckstr, 10, 76133, Karlsruhe, Germany.
| | - Olga Kunina-Habenicht
- University of Education Karlsruhe, Bismarckstr, 10, 76133, Karlsruhe, Germany.,Department of Rehabilitation Sciences, T U Dortmund University, Dortmund, Germany
| | - Doris Oriwol
- University of Education Karlsruhe, Bismarckstr, 10, 76133, Karlsruhe, Germany.,Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Anke Hanssen-Doose
- University of Education Karlsruhe, Bismarckstr, 10, 76133, Karlsruhe, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany
| | - Annette Worth
- University of Education Karlsruhe, Bismarckstr, 10, 76133, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Remer T, Hua Y, Esche J, Thamm M. The DONALD study as a longitudinal sensor of nutritional developments: iodine and salt intake over more than 30 years in German children. Eur J Nutr 2022; 61:2143-2151. [PMID: 35043251 PMCID: PMC9106614 DOI: 10.1007/s00394-022-02801-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022]
Abstract
Purpose Mild-to-moderate iodine deficiency was present in large parts of Germany up to the beginning 1990s and improved from then on. Current epidemiological data on spot urine iodine measurements in German children strongly suggest the re-occurrence of an impaired iodine status. We thus examined whether this re-occurrence is identifiable in more detail, through iodine analyses of 24-h urine samples of a well-characterized cohort of German children in whom samples have been systematically collected from 1985 onward. As iodized salt is a major source for iodine supply, urinary sodium excretion was additionally studied. Methods Daily iodine and sodium excretions were measured in 2600 24-h urine samples collected between 1985 and 2018 by 677 healthy children aged 6–12 years (participants of the DONALD study). These data were compared with 24-h iodine and sodium excretion estimates obtained from spot urine samples collected in the representative German Health Interview and Examination Surveys for Children and Adolescents KiGGS-baseline (2003–2006) and KiGGS-wave-2 (2014–2017). Results Between 1985 and1992, DONALD participants started with a median daily iodine excretion level of 40.1 µg/d. Then, during 1993–2003, iodine excretions mounted up to an approximate plateau (~ 84.8 µg/d). This plateau lasted until 2012. Thereafter, iodine concentrations started to decrease again resulting in a median iodine excretion of only 58.9 µg/d in 2018. Sodium excretion, however, had increased. The marked decrease in iodine status along with an abundant sodium excretion corresponded closely with nationwide KiGGS data. Conclusions As exemplified for the clearly worsening iodine status in German children, longitudinal cohort studies collecting detailed biomarker-based prospective data have the potential to reliably capture health-relevant nutritional changes and trends, applicable on a more comprehensive and even representative population level. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02801-6.
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Affiliation(s)
- Thomas Remer
- DONALD Study Center Dortmund, Department of Nutritional Epidemiology, Institute of Nutrition and Food Science, University of Bonn, Heinstück 11, 44225, Dortmund, Germany.
| | - Yifan Hua
- DONALD Study Center Dortmund, Department of Nutritional Epidemiology, Institute of Nutrition and Food Science, University of Bonn, Heinstück 11, 44225, Dortmund, Germany
| | - Jonas Esche
- DONALD Study Center Dortmund, Department of Nutritional Epidemiology, Institute of Nutrition and Food Science, University of Bonn, Heinstück 11, 44225, Dortmund, Germany
| | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
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24
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Loenenbach A, Pawlita M, Waterboer T, Harder T, Poethko-Müller C, Thamm M, Lachmann R, Deleré Y, Wichmann O, Wiese-Posselt M. Seroprevalence of mucosal and cutaneous human papillomavirus (HPV) types among children and adolescents in the general population in Germany. BMC Infect Dis 2022; 22:44. [PMID: 35012452 PMCID: PMC8751243 DOI: 10.1186/s12879-022-07028-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background In Germany, HPV vaccination of adolescent girls was introduced in 2007. Nationally representative data on the distribution of vaccine-relevant HPV types in the pre-vaccination era are, however, only available for the adult population. To obtain data in children and adolescents, we assessed the prevalence and determinants of serological response to 16 different HPV types in a representative sample of 12,257 boys and girls aged 1–17 years living in Germany in 2003–2005. Methods Serum samples were tested for antibodies to nine mucosal and seven cutaneous HPV types. The samples had been collected during the nationally representative German Health Interview and Examination Survey for Children and Adolescents in 2003–2006. We calculated age- and gender-specific HPV seroprevalence. We used multivariable regression models to identify associations between demographic and behavioral characteristics and HPV seropositivity. Results We found low but non-zero seroprevalence for the majority of tested HPV types among children and adolescents in Germany. The overall seroprevalence of HPV-16 was 2.6%, with slightly higher values in adolescents. Seroprevalence of all mucosal types but HPV-6 ranged from 0.6% for HPV-33, to 6.4% for HPV-31 and did not differ by gender. We found high overall seroprevalence for HPV-6 with 24.8%. Cutaneous HPV type seroprevalence ranged from 4.0% for HPV-38 to 31.7% for HPV-1. In the majority of cutaneous types, seroprevalence did not differ between boys and girls, but increased sharply with age, (e.g., HPV-1 from 1.5% in 1–3-years-old to 45.1% in 10–11-years-old). Associations between behavioral factors and type-specific HPV prevalence were determined to be heterogeneous. Conclusions We report the first nationally representative data of naturally acquired HPV antibody reactivity in the pre-HPV-vaccination era among children and adolescents living in Germany. These data can be used as baseline estimates for evaluating the impact of the current HPV vaccination strategy targeting 9–14-years-old boys and girls. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07028-8.
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Affiliation(s)
- Anna Loenenbach
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany. .,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Harder
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | | | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Raskit Lachmann
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | | | - Ole Wichmann
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Miriam Wiese-Posselt
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany.,Institute of Hygiene and Environmental Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
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25
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Königstein K, Büschges JC, Sarganas G, Krug S, Neuhauser H, Schmidt-Trucksäss A. Exercise and Carotid Properties in the Young-The KiGGS-2 Study. Front Cardiovasc Med 2022; 8:767025. [PMID: 35071349 PMCID: PMC8766972 DOI: 10.3389/fcvm.2021.767025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Carotid intima-media thickness (cIMT) and stiffness (cS) are predictive markers of early vascular aging and atherosclerotic risk. This study assessed, whether exercise has protective effects on carotid structure and function or on vascular risk in the young. Methods: Volume and change of exercise (recreational and organized sports participation) of German adolescents and young adults was assessed within the prospective population-study KiGGS at KiGGS-Wave-1 (2009-2012) and KiGGS-Wave-2 (2014-2017) using standardized self-reporting questionnaires. CIMT and cS were measured by real-time B-mode ultrasound sequences with semi-automated edge-detection and automatic electrocardiogram-gated quality control in 2,893 participants (14-28 years, 49.6% female). A cumulative index for atherosclerotic risk (CV-R) included z-scores of mean arterial pressure, triglycerides, total/HDL-cholesterol-ratio, body mass index, and HbA1c. Results: At KiGGS-Wave-2 cross-sectional CV-R but not cS and cIMT was lower in all exercise-groups compared to "no exercise" (B = -0.73, 95%-CI = -1.26 to 0.19, p = 0.008). Longitudinal volume of exercise was negatively associated with CV-R (B = -0.37, 95%-CI = -0.74 to 0.00, p = 0.048) but not with cS and cIMT. Cross-sectional relative risk of elevated CV-R but not cS and cIMT was lower in all exercise-groups compared to "no exercise" (RR = 0.80, 95%-CI = 0.66 to 0.98, p = 0.033). High exercise volumes were associated with lower relative risk of elevated CV-R (RR = 0.80, 95%-CI = 0.65-0.97, p = 0.021) and cS in tendency but not with cIMT. Conclusions: Increased levels of exercise are associated with a better cardiovascular risk profile in young individuals, but not with cS and cIMT. Our study confirms previous recommendations on exercise in this age group without demonstrating a clear benefit on surrogate markers of vascular health.
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Affiliation(s)
- Karsten Königstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Julia Charlotte Büschges
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Giselle Sarganas
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Susanne Krug
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Hannelore Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Arno Schmidt-Trucksäss
- Division Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Diefenbach C, Schmidt MF, Huss M, König J, Urschitz MS. Age at school entry and reported symptoms of attention-deficit/hyperactivity in first graders: results of the prospective cohort study ikidS. Eur Child Adolesc Psychiatry 2022; 31:1753-1764. [PMID: 34089381 PMCID: PMC9666310 DOI: 10.1007/s00787-021-01813-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 05/23/2021] [Indexed: 12/03/2022]
Abstract
Young age at school entry (ASE) is related to attention-deficit/hyperactivity disorder in higher grades. The reason for this association is unclear, but medical oversupply and stress-related factors are discussed. We aimed to investigate whether ASE is associated with reported symptoms of attention-deficit/hyperactivity (ADH) already in first grade. Data of a population-based prospective cohort study (N = 2003; Mainz-Bingen region; Rhineland-Palatinate; Germany) with baseline assessments prior to school entry and two follow-ups during first grade were analysed. ADH symptoms were assessed by parent and teacher versions of the Strengths and Difficulties Questionnaire. Associations between ASE and scores of the hyperactivity/inattention subscale (range 0-10) were investigated by regression analysis and adjusted for potential confounders and baseline symptoms prior to school entry. In total, 1633 children (52% boys, mean ASE 6.5 years) were included. There were no relationships between ASE and parent-reported scores of the hyperactivity/inattention subscale prior to school entry and 3 months thereafter. However, at the end of first grade, ASE was negatively associated with the hyperactivity/inattention subscale in parent (- 0.7 subscale points per year ASE, standard error = 0.16, p < 0.0001) and teacher reports (- 1.2 subscale points per year ASE, standard error = 0.25, p < 0.0001). This ASE effect appeared more pronounced in girls than in boys. Young ASE is related to more reported symptoms of ADH at the end of first grade, but not before. The evolvement of this effect during first grade may be a clue to ASE-related stress factors.
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Affiliation(s)
- Christiane Diefenbach
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany.
| | - Martina F Schmidt
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescence Psychiatry, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jochem König
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
| | - Michael S Urschitz
- Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
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27
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Birmili W, Daniels A, Bethke R, Schechner N, Brasse G, Conrad A, Kolossa-Gehring M, Debiak M, Hurraß J, Uhde E, Omelan A, Salthammer T. Formaldehyde, aliphatic aldehydes (C 2 -C 11 ), furfural, and benzaldehyde in the residential indoor air of children and adolescents during the German Environmental Survey 2014-2017 (GerES V). INDOOR AIR 2022; 32:e12927. [PMID: 34473382 DOI: 10.1111/ina.12927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Indoor air concentrations of formaldehyde, furfural, benzaldehyde, and 11 aliphatic aldehydes (C2 -C11 ) were measured in residences of 639 participants in the German Environmental Survey for Children and Adolescents 2014-2017 (GerES V). Sampling was conducted using passive samplers over periods of approximately seven days for each participant. The most abundant compounds were formaldehyde and hexanal with median concentrations of 24.9 µg m-3 and 10.9 µg m-3 , respectively. Formaldehyde concentrations exceeded the Guide Value I recommended by the German Committee on Indoor Guide Values (Ausschuss für Innenraumrichtwerte - AIR) (0.10 mg m-3 ) for 0.3% of the participating residences. The sum of aliphatic n-aldehydes between C4 (butanal) and C11 (undecanal) exceeded their Guide Value (0.10 mg m-3 ) for 2.0% of the residences. The geometric mean concentrations of most aldehydes were lower than in the earlier GerES IV (2003-2006) study. Formaldehyde and hexanal concentrations, however, were comparable in both studies and showed no significant difference. Indoor aldehyde concentrations did not exhibit significant correlations with factors collected in questionnaires, such as the age of the participants, their socio-economic status, the location of the residence (former East/West Germany), migration background, tobacco exposure, and the type of furniture used. The validity of the passive sampler measurements was verified against active sampling techniques in a test chamber experiment.
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Affiliation(s)
- Wolfram Birmili
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Anja Daniels
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Robert Bethke
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Nadine Schechner
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Gregor Brasse
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - André Conrad
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Marike Kolossa-Gehring
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Malgorzata Debiak
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
| | - Julia Hurraß
- Department II 1 "Environmental Hygiene", German Environment Agency (Umweltbundesamt), Berlin, Germany
- Department of Infection Control and Environmental Hygiene, Cologne Health Authority, Cologne, Germany
| | - Erik Uhde
- Department of Material Analysis and Indoor Chemistry, Fraunhofer WKI, Braunschweig, Germany
| | - Alexander Omelan
- Department of Material Analysis and Indoor Chemistry, Fraunhofer WKI, Braunschweig, Germany
| | - Tunga Salthammer
- Department of Material Analysis and Indoor Chemistry, Fraunhofer WKI, Braunschweig, Germany
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Adebayo FA, Itkonen ST, Öhman T, Kiely M, Cashman KD, Lamberg-Allardt C. Safety of Vitamin D Food Fortification and Supplementation: Evidence from Randomized Controlled Trials and Observational Studies. Foods 2021; 10:foods10123065. [PMID: 34945616 PMCID: PMC8701201 DOI: 10.3390/foods10123065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/18/2021] [Accepted: 11/29/2021] [Indexed: 12/31/2022] Open
Abstract
The safety considerations of food-based solutions for vitamin D deficiency prevention, such as fortification and supplementation, are critical. On the basis of collective data from 20 randomized controlled trials (RCTs) and 20 national healthy surveys, as well as prospective cohort studies (PCSs) across the ODIN project (“Food-based solutions for optimal vitamin D nutrition and health through the life cycle”, FP7-613977), we analyzed the potential safety issues arising from vitamin D intakes and/or supplementation. These adverse consequences included high serum 25-hydroxyvitamin D (S-25(OH)D) concentrations (>125 nmol/L), high serum calcium concentrations, and vitamin D intakes in excess of the tolerable upper intake levels (ULs). In the RCTs (n = 3353, with vitamin D doses from 5–175 µg/day), there were no reported adverse effects. The prevalence of high S-25(OH)D was <10% when vitamin D supplements were administered, and <0.1% for fortified foods. Elevated serum calcium was observed among <0.5% in both administration types. No ODIN RCT participants exceeded the age-specific ULs. In observational studies (n = 61,082), the prevalence of high 25(OH)D among children/adolescents, adults, and older adults was <0.3%, with no evidence of adverse effects. In conclusion, high S-25(OH)D concentrations >125 nmol/L were rare in the RCTs and PCSs, and no associated adverse effects were observed.
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Affiliation(s)
- Folasade A. Adebayo
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, P.O. Box 66, FI-00014 Helsinki, Finland; (F.A.A.); (S.T.I.); (T.Ö.)
| | - Suvi T. Itkonen
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, P.O. Box 66, FI-00014 Helsinki, Finland; (F.A.A.); (S.T.I.); (T.Ö.)
| | - Taina Öhman
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, P.O. Box 66, FI-00014 Helsinki, Finland; (F.A.A.); (S.T.I.); (T.Ö.)
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland; (M.K.); (K.D.C.)
| | - Kevin D. Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland; (M.K.); (K.D.C.)
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, P.O. Box 66, FI-00014 Helsinki, Finland; (F.A.A.); (S.T.I.); (T.Ö.)
- Correspondence:
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Influence of socioeconomic variables on physical activity and screen time of children and adolescents during the COVID‑19 lockdown in Germany: the MoMo study. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [PMCID: PMC8641541 DOI: 10.1007/s12662-021-00783-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The COVID‑19 (coronavirus disease 2019) pandemic created a multitude of natural experiments about the change of human behavior in a widely unfamiliar situation. Besides physical and mental health, physical activity (PA) and people’s movement behaviors were of particular interest to researchers all over the world. In a recent study, we found that among youth in Germany, sports activity declined, whereas recreational screen time and habitual activity increased during the first COVID‑19 lockdown. In the present study, we analyze the influence of the socioeconomic status and the housing situation on the changes in PA behavior and recreational screen-time before and during the first COVID‑19 lockdown among children and adolescents living in Germany. We found an alignment of PA behavior among youth from families with different socioeconomic backgrounds during the first lockdown and identified the housing situation to be a meaningful predictor of the increase in habitual activity. We conclude that restriction policies, communities, and in the last instance parents need to enable access to nonorganized PA to all children and adolescents every day and especially during potential future lockdowns.
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Hanssen-Doose A, Oriwol D, Niessner C, Schmidt SCE, Klemm K, Woll A, Worth A. Dauerhaftes Sporttreiben im Sportverein und motorische Entwicklung: Ergebnisse der MoMo-Längsschnittstudie (2003–2017). FORUM KINDER- UND JUGENDSPORT 2021. [PMCID: PMC8607402 DOI: 10.1007/s43594-021-00054-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
ZusammenfassungBereits im Kindes- und Jugendalter gilt die motorische Leistungsfähigkeit als wichtiger Gesundheitsmarker. Auf Basis von Daten der Motorik Modul-Studie wird in diesem Artikel längsschnittlich über die Jahre 2003–2017 untersucht, inwieweit sich Sportvereinsmitglieder, die konstant im Sportverein aktiv waren, hinsichtlich ihrer motorischen Entwicklung von denjenigen unterscheiden, die nie im Sportverein aktiv waren. Es wurden Daten aus drei Messwellen untersucht: T1 (2003–2006), T2 (2009–2012) und T3 (2014–2017). Aus insgesamt N = 1092 Teilnehmenden, von denen über T1 bis T3 Daten zur Motorik vorlagen, wurden all diejenigen mit konstanter Mitgliedschaft und Nicht-Mitgliedschaft im Sportverein über drei Messwellen ausgewählt. Das sind 46 % der Gesamtstichprobe (N = 498). Von den N = 498 Teilnehmer*innen (Alter T1: 8,9 ± 3,8 Jahre, T2: 15,1 ± 3,9 Jahre, T3: 20,3 ± 4,0 Jahre) waren 15 % dauerhafte Sportvereinsmitglieder mit Wettkampfengagement, 53 % dauerhafte Sportvereinsmitglieder ohne Wettkampfengagement sowie 32 % dauerhaft Sportvereinsabstinente. Zur Ermittlung der motorischen Leistungsfähigkeit wurden konditionelle und koordinative Fähigkeiten anhand des MoMo-Testprofils erhoben (Kondition: Standweitsprung, Liegestütz, Fahrrad-Ausdauertest, Koordination: Seitliches Hin- und Herspringen, Einbeinstand, Balancieren rückwärts). Die Unterschiede in der Entwicklung wurden anhand von alters- und geschlechtsadjustierten Perzentilen mittels Varianzanalysen mit Messwiederholung berechnet, mit dem Sozialstatus als Kovariate. Innerhalb der Sportvereinsmitglieder waren Teilnehmende mit niedrigem Sozialstatus deutlich unterrepräsentiert. Insgesamt betrachtet, ist die Entwicklung der koordinativen und konditionellen Fähigkeiten bei Sportvereinsmitgliedern als signifikant besser zu beurteilen im Vergleich zu Sportvereinsabstinenten (Modell Koordination * Sportverein: df = 3,870 | F = 2,931 | p = 0,021 | ETA = 0,015 | f = 0,123; Modell Kondition * Sportverein: df = 4 | F = 3,794 | p = 0,005 | ETA = 0,048 | f = 0,225). Die Ergebnisse untermauern die Wichtigkeit der Sportvereine für die motorische Entwicklung von Kindern, Jugendlichen und jungen Erwachsenen in Deutschland.
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Affiliation(s)
- Anke Hanssen-Doose
- Institut für Bewegungserziehung und Sport, Arbeitsbereich Bewegungsbildung, Diagnostik und Sport, Pädagogische Hochschule Karlsruhe, Bismarckstr. 10, 76133 Karlsruhe, Deutschland
| | - Doris Oriwol
- Institut für Bewegungserziehung und Sport, Arbeitsbereich Bewegungsbildung, Diagnostik und Sport, Pädagogische Hochschule Karlsruhe, Bismarckstr. 10, 76133 Karlsruhe, Deutschland
- Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Gebäude 40.40, Engler-Bunte-Ring 15, 76131 Karlsruhe, Deutschland
| | - Claudia Niessner
- Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Gebäude 40.40, Engler-Bunte-Ring 15, 76131 Karlsruhe, Deutschland
| | - Steffen Christian Eckehard Schmidt
- Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Gebäude 40.40, Engler-Bunte-Ring 15, 76131 Karlsruhe, Deutschland
| | - Katja Klemm
- Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Gebäude 40.40, Engler-Bunte-Ring 15, 76131 Karlsruhe, Deutschland
| | - Alexander Woll
- Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Gebäude 40.40, Engler-Bunte-Ring 15, 76131 Karlsruhe, Deutschland
| | - Annette Worth
- Institut für Bewegungserziehung und Sport, Arbeitsbereich Bewegungsbildung, Diagnostik und Sport, Pädagogische Hochschule Karlsruhe, Bismarckstr. 10, 76133 Karlsruhe, Deutschland
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Schlack R, Peerenboom N, Neuperdt L, Junker S, Beyer AK. The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort. JOURNAL OF HEALTH MONITORING 2021; 6:3-19. [PMID: 35146318 PMCID: PMC8734087 DOI: 10.25646/8863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/06/2021] [Indexed: 11/18/2022]
Abstract
Mental health problems in childhood and adolescence may have effects into adulthood. With the KiGGS cohort, data are available for the first time that can be used to track the effects of internalising and externalising problems in childhood or adolescence into young adulthood on a national database. From the KiGGS baseline survey (2003-2006) to KiGGS Wave 2 (2014-2017), a total of 3,546 children and adolescents aged 11 to 17 years were tracked over a period of eleven years into young adulthood. Mental health problems in childhood or adolescence were variously associated with impaired mental health, lower life satisfaction and poorer quality of life and indicators of sexual and reproductive health in young adulthood. When psychosocial protective factors at the time of the KiGGS baseline survey were considered, the longitudinal correlations of internalising and externalising problems with indicators of mental health, life satisfaction and physical and psychological quality of life decreased, as did, to a lesser extent, the correlations with indicators of sexual and reproductive health and, for externalising disorders, also with low educational status (reference: medium). Implications for prevention and intervention are discussed.
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Affiliation(s)
- Robert Schlack
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Nele Peerenboom
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
- University of Cambridge, Department of Psychiatry
| | - Laura Neuperdt
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Stephan Junker
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Otto C, Kaman A, Erhart M, Barkmann C, Klasen F, Schlack R, Ravens-Sieberer U. Risk and resource factors of antisocial behaviour in children and adolescents: results of the longitudinal BELLA study. Child Adolesc Psychiatry Ment Health 2021; 15:61. [PMID: 34686200 PMCID: PMC8539834 DOI: 10.1186/s13034-021-00412-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/08/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Antisocial behaviour is a common phenomenon in childhood and adolescence. Information on psychosocial risk and resource factors for antisocial behaviour are important for planning targeted prevention and early intervention programs. The current study explores risk and resource factors of antisocial behaviour in children and adolescents based on population-based longitudinal data. METHODS We analysed longitudinal data from the German BELLA study (n = 1145; 11 to 17 year-olds) measured at three measurement points covering two years. Latent growth analysis, linear regression models and structural equation modelling were used to explore cross-sectional and longitudinal data. RESULTS Based on baseline data, we found that stronger self-efficacy and worse family climate were each related to stronger antisocial behaviour. Longitudinal data revealed that more severe parental mental health problems, worse family climate at baseline, deteriorating family climate over time, and more social support were each associated with increasing antisocial behaviour over time. We further found a moderating effect for family climate. CONCLUSIONS Our study provides important exploratory results on psychosocial risk, resource and protective factors in the context of antisocial behaviour in children and adolescents, which need confirmation by future research. Our exploratory results point in the direction that family-based interventions for antisocial behavior in children and adolescents may benefit from considering the family climate.
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Affiliation(s)
- Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
- Alice Salomon University of Applied Sciences, Berlin, Germany
- Apollon University of Applied Sciences, Bremen, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Fionna Klasen
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, General-Pape- Straße 62-66, D-12101, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W29, D-20246, Hamburg, Germany.
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Hanssen-Doose A, Jaeschke R, Niessner C, Oriwol D, Worth A. Physical fitness of children and youth with asthma in comparison to the reference population : Cross-sectional results of the population-based MoMo study in Germany. BMC Sports Sci Med Rehabil 2021; 13:131. [PMID: 34686219 PMCID: PMC8539881 DOI: 10.1186/s13102-021-00359-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 10/12/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Physical fitness is an essential marker of health. The literature regarding the question of whether individuals with asthma have reduced physical fitness compared to their non-asthmatic peers is inconsistent and focuses on the cardiorespiratory endurance dimension. This study provides a comparison of different dimensions of physical fitness in individuals with and without asthma on the basis of the German population-based study "KiGGS" (German Health Interview and Examination Survey for Children and Adolescents) and its in-depth study "MoMo" (2009-2012: wave 1 and 2014-2017: wave 2). METHODS In total, 7731 individuals aged 6-30 years were included in this cross-sectional analysis at two measurement waves, including 353 individuals with and 7378 without asthma. The 12-month prevalence of physician-diagnosed asthma was assessed by interview. Physical fitness was measured by six test items of the MoMo test profile. "Cardiorespiratory endurance" was measured by an ergometric test, "muscular strength" by standing long jump, push-ups and sit-ups and "coordination" by jumping sideways and balancing backwards. Because of the broad age range of the sample, age- and sex-specific percentiles were used. Physical activity, age, gender and general state of health were assessed by questionnaire. RESULTS The individuals with asthma reported a poorer general state of health at both measurement waves. However, the results of the fitness tests indicated that they were as physically fit as their peers without asthma in relation to cardiorespiratory endurance and muscular strength. The mean percentiles were all within the same range. The results of the comparisons of coordination performance were inconsistent. At wave 1 they were within the same range, at wave 2 individuals with asthma showed a poorer coordination performance (p = 0.041; HL = 4.125, CI of HL 0.155-8.125). CONCLUSIONS To the best of our knowledge, this is the first study to compare the physical fitness of individuals with and without asthma by considering several dimensions of physical fitness. The study demonstrates that cardiorespiratory endurance and muscular strength are not reduced in individuals with asthma. The results of the comparisons at the two measurement waves were remarkably stable.
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Affiliation(s)
- Anke Hanssen-Doose
- University of Education Karlsruhe, Bismarckstr. 10, 76133, Karlsruhe, Germany.
| | - Robert Jaeschke
- Rehabilitation Centre for Children With Respiratory Diseases, Fachkliniken Wangen, Am Vogelherd 14, 88239, Wangen, Germany
| | - Claudia Niessner
- Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Doris Oriwol
- University of Education Karlsruhe, Bismarckstr. 10, 76133, Karlsruhe, Germany
- Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Annette Worth
- University of Education Karlsruhe, Bismarckstr. 10, 76133, Karlsruhe, Germany
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Nigg C, Niessner C, Nigg CR, Oriwol D, Schmidt SCE, Woll A. Relating outdoor play to sedentary behavior and physical activity in youth - results from a cohort study. BMC Public Health 2021; 21:1716. [PMID: 34548057 PMCID: PMC8456698 DOI: 10.1186/s12889-021-11754-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/08/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Outdoor play, sedentary behavior (SB), and moderate-to-vigorous physical activity (MVPA) are related to youth's health, however, there are research gaps regarding 1) associations between outdoor play, SB, and MVPA across a broad pediatric age range (6-17 years), and 2) longitudinal associations between outdoor play, SB, and MVPA across childhood and adolescence. Two studies were conducted to address those research gaps: Study 1 aimed to investigate relationships between outdoor play and accelerometer-assessed SB and MVPA in a cross-sectional nationwide sample of children and adolescents in Germany. Study 2 aimed to investigate prospective associations between outdoor play and self-reported screen-time SB and MVPA and in a sample of children with three measurement timepoints across 11 years. METHODS Data were obtained of the German national representative Motorik-Modul (MoMo) Study and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). In Study 1, N = 2278 participants (6-17 years) were included with self-reported outdoor play and accelerometer-assessed SB and MVPA. Associations were examined via multiple linear regressions. In Study 2, N = 570 participants (baseline: 4-7 years) were included in the longitudinal analysis with follow-ups six and 11 years later. Screen-time SB (TV watching and PC/Gaming), MVPA, and outdoor play were self-reported. Associations were investigated through a path prediction model. RESULTS Study 1 showed that compared to <1 h outdoor play, higher engagement in daily outdoor play was related to lower SB (1-2 h: - 9.75 min/day, P = 0.017; ≥2 h: - 17.78 min/day, P < 0.001) and higher MVPA (≥2 h: + 3.87 min/day, P = 0.001). The cross-sectional relationship between MVPA and outdoor play was moderated by sex (in favor of males) and age (in favor of younger children). Study 2 showed that outdoor play in early childhood negatively predicted PC use/Gaming in later childhood, but was unrelated to MVPA. CONCLUSION In Study 1, outdoor play was negatively related to SB cross-sectionally. In Study 2, outdoor play in early childhood was negatively related to PC and Gaming time in later childhood. Thus, providing outdoor play opportunities, especially during early childhood, has potential to prevent SB. Future research should investigate longitudinal relationships using device-based assessments for SB and MVPA.
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Affiliation(s)
- Carina Nigg
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Claudio R Nigg
- Institute of Sport Science, University of Bern, Bremgartenstrasse 145, 3012, Bern, Switzerland
| | - Doris Oriwol
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Steffen C E Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
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Sung JY, Seo JD, Ko DH, Park MJ, Hwang SM, Oh S, Chun S, Seong MW, Song J, Song SH, Park SS. Establishment of Pediatric Reference Intervals for Routine Laboratory Tests in Korean Population: A Retrospective Multicenter Analysis. Ann Lab Med 2021; 41:155-170. [PMID: 33063677 PMCID: PMC7591287 DOI: 10.3343/alm.2021.41.2.155] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/08/2020] [Accepted: 09/08/2020] [Indexed: 12/24/2022] Open
Abstract
Background Reference intervals defined for adults or children of other ethnicities cannot be applied in the evaluation of Korean pediatric patients. Pediatric reference intervals are difficult to establish because children are in their growing stage and their physiology changes continuously. We aimed to establish reference intervals for routine laboratory tests for Korean pediatric patients through retrospective multicenter data analysis. Methods Preoperative laboratory test results from 1,031 pediatric patients aged 0 month–18 years who underwent minor surgeries in four university hospitals were collected. Age- and sex-specific reference intervals for routine laboratory tests were defined based on the Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. Results The pediatric reference intervals determined in this study were different from existing adult reference intervals and pediatric reference intervals for other ethnicities. Most tests required age-specific partitioning, and some of those required sex-specific partitioning for at least one age-partitioned subgroup. Erythrocyte sedimentation rate, monocyte percentage, basophil percentage, activated partial thromboplastin time, glucose, cholesterol, albumin, bilirubin, chloride, and C-reactive protein did not show any difference between age- or sex-partitioned subgroups. Conclusions We determined Korean pediatric reference intervals for hematology, coagulation, and chemistry tests by indirect sampling based on medical record data from multiple institutions. These reference intervals would be valuable for clinical evaluations in the Korean pediatric population.
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Affiliation(s)
- Ji Yeon Sung
- Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Jong Do Seo
- Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Dae-Hyun Ko
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Min-Jeong Park
- Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sang Mee Hwang
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sail Chun
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Junghan Song
- Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea.,Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Hoon Song
- Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
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The German Environmental Survey for Children and Adolescents 2014-2017 (GerES V) - Study population, response rates and representativeness. Int J Hyg Environ Health 2021; 237:113821. [PMID: 34375847 DOI: 10.1016/j.ijheh.2021.113821] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/16/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022]
Abstract
The German Environmental Survey (GerES) is a population-representative, cross-sectional study on environmental exposures of the general population of Germany. GerES has repeatedly been conducted since 1985 by the German Environment Agency (UBA) in close collaboration with the Health Interview and Examination Surveys of the Robert Koch Institute (RKI). In the German Environmental Survey for Children and adolescents 2014-2017 (GerES V) pollutants and other environmental stressors were measured in human samples as well as in the homes of 3- to 17-year-old children and adolescents. Interviews were conducted about health-related behaviors and living conditions. The GerES V basic program encompassed examinations of whole blood, blood plasma, morning urine and drinking water samples, measurements of ultrafine particles and noise levels, comprehensive standardized interviews, and self-administrated questionnaires. Additional modules on volatile organic compounds and aldehydes, particulate matter (PM2.5) in indoor air, organic compounds in drinking water and pollutants in house dust were conducted in subsamples. Potential GerES V participants were identified and attained by the RKI from those participants who were examined and interviewed for the cross-sectional component of the second follow-up to the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2). The gross sample of GerES V comprised 3031 children and adolescents of which 2294 finally took part in the survey. This equals a total response rate of 75.7 %. Response rates varied, depending on region, type of municipality, age and sex, from 66.0 % to 78.3 %. By calculating individual case weights, discrepancies due to sample design and non-response between the GerES V sample and the whole population could be considered in statistical analysis. Therefore, the representativeness of the GerES V results with regard to age, sex, community size and region was assured.
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Neu MA, Schlecht J, Schmidt MF, Robinson AL, Spix C, Grabow D, Kaatsch P, Erdmann F, Faber J, Urschitz MS. Mental health and health-related quality of life in preschool-aged childhood cancer survivors. Results of the prospective cohort study ikidS-OEVA. Pediatr Blood Cancer 2021; 68:e29039. [PMID: 33960635 DOI: 10.1002/pbc.29039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Long-term survivors of childhood cancer are at increased risk for sequelae such as poor mental health (MH) or impaired health-related quality of life (HrQoL). We aimed to evaluate early adverse effects on MH and HrQoL in young childhood cancer survivors (YCCS) before school entry. METHODS In a nationwide prospective cohort study, children with cancer other than brain tumors diagnosed at preschool age and completed cancer treatments were identified from the German Childhood Cancer Registry. The comparison group was children of the same age without a cancer diagnosis who participated in the prospective population-based health survey ikidS. MH problems and HrQoL were assessed by parental versions of the Strengths and Difficulties Questionnaire (SDQ) and the questionnaire for health-related quality of life in children (KINDL), respectively. Associations between cancer and MH as well as HrQoL were analyzed by multivariable linear regression. RESULTS Of 382 YCCS contacted, 145 were enrolled (mean age 6.6 years) and 124 analyzed. Compared to children without a cancer diagnosis (3683 contacted, 2003 enrolled, 1422 analyzed), YCCS had more MH problems (13% vs. 3%) and slightly worse HrQoL (median 78.7 vs. 80.2 points). In the adjusted analysis, YCCS had higher SDQ scores (2.2 points, 95% confidence interval [CI] 1.3, 3.0) and lower KINDL scores (-2.4 points, 95% CI -3.7, -1.1) compared to children without cancer diagnosis. CONCLUSION Already at preschool age, YCCS may be at increased risk of MH problems and impaired HrQoL. This could have impacts on subsequent school performance and educational attainment. Follow-up health care for YCCS may include early screening for MH problems and reasons for HrQoL deficits.
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Affiliation(s)
- Marie A Neu
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jennifer Schlecht
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Martina F Schmidt
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Abigale L Robinson
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Spix
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Desiree Grabow
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter Kaatsch
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Rittsteiger L, Hinz T, Oriwol D, Wäsche H, Santos-Hövener C, Woll A. Sports participation of children and adolescents in Germany: disentangling the influence of parental socioeconomic status. BMC Public Health 2021; 21:1446. [PMID: 34294081 PMCID: PMC8299646 DOI: 10.1186/s12889-021-11284-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participation in sports and physical activity (PA) is a critical resource for children's health and social development. This study analyzes how the parental socioeconomic status (SES) of children and adolescents affects their PA in sports clubs (organized sports) and outside of sports clubs (unorganized sports) and tests whether the potential impact of parental SES is mediated by the opportunity structure of their residential area (walkability, infrastructure, etc.) and by family and peer support for PA. Furthermore, PA is analyzed respecting differences by gender and migration background. METHODS Using representative data from the MoMo/KiGGS study (2009-2012 and 2014-2017), we take into account about 8000 measurements from about 7000 subjects. We estimate hurdle regression models to analyze the minutes per week spent on sports activities. RESULTS Results show that children with a higher parental SES, children living in areas with many opportunities for PA, and children receiving family and peer support are more physically active than children without these features. Controlled for opportunities and support, status effects are small but visible. The differences regarding parental SES are much more apparent for organized sports than for unorganized sports, indicating the relevance of economic resources. Boys are more active than girls, whereas there is no clear effect of migration background. CONCLUSIONS The coefficient of parental SES on organized sports most probably relates to the resources needed to participate in sports clubs, including fees and equipment. Lower membership fees might potentially help to integrate children with low parental SES into sports clubs and thereby make organized sports more accessible to all social classes.
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Affiliation(s)
- Lea Rittsteiger
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Thomas Hinz
- Department for History and Sociology, University of Konstanz, Konstanz, Germany
| | - Doris Oriwol
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Hagen Wäsche
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | | | - Alexander Woll
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
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Staubach P, Mann C, Peveling-Oberhag A, Lang BM, Augustin M, Hagenström K, Garbe C, Petersen J. Epidemiologie der Urtikaria bei Kindern in Deutschland. J Dtsch Dermatol Ges 2021; 19:1013-1020. [PMID: 34288485 DOI: 10.1111/ddg.14485_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/16/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Kristina Hagenström
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Claudia Garbe
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Jana Petersen
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
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Woll A, Klos L, Burchartz A, Hanssen-Doose A, Niessner C, Oriwol D, Schmidt SCE, Bös K, Worth A. Cohort Profile Update: The Motorik-Modul (MoMo) Longitudinal Study-physical fitness and physical activity as determinants of health development in German children and adolescents. Int J Epidemiol 2021; 50:393-394. [PMID: 33709121 DOI: 10.1093/ije/dyaa281] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/06/2021] [Indexed: 01/10/2023] Open
Affiliation(s)
- Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Leon Klos
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Burchartz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Anke Hanssen-Doose
- Institute of Physical Education and Sports, University of Education Karlsruhe, Karlsruhe, Germany
| | - Claudia Niessner
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Doris Oriwol
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Steffen C E Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Klaus Bös
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Annette Worth
- Institute of Physical Education and Sports, University of Education Karlsruhe, Karlsruhe, Germany
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Geisler I, Rausch TK, Göpel W, Spiegler J. Extremely and very preterm-born children <1500 g show different weight development in childhood compared to their peers. Acta Paediatr 2021; 110:2093-2099. [PMID: 33533506 DOI: 10.1111/apa.15785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Abstract
AIM To develop reference growth charts for body mass index (BMI), weight, length and head circumference in children born extremely preterm (EPT) or very preterm (VPT) with a birth weight <1500 g. METHODS We analysed EPT and VPT children from the German Neonatal Network born between 2009 and 2013 without chronic diseases or medications influencing growth. These data of EPT and VPT datasets were split into a training dataset and a validation dataset. In the validation dataset, data from 385 EPT and 491 VPT children from birth to age 6 years were analysed to calculate growth charts. RESULTS The percentiles of length of EPT and VPT children were comparable to German reference percentiles. The BMI peak in infancy was attenuated, and BMI was lower in all the EPT and VPT children analysed. From 2 years until 6 years of age, head circumference was lower in EPT and VPT boys and girls. CONCLUSION Deficits in height described in EPT cohorts born during the 1980 s and 1990 s were not seen in our cohort. However, EPT and VPT born children showed growth patterns that differed from national reference curves for BMI. The growth charts provided here can be used to judge the growth of EPT and VPT born children.
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Affiliation(s)
- Inga Geisler
- Department of Paediatrics University of Luebeck Luebeck Germany
| | - Tanja Katrin Rausch
- Department of Paediatrics University of Luebeck Luebeck Germany
- Institut für medizinische Biometrie und Statistik University of Luebeck Luebeck Germany
| | - Wolfgang Göpel
- Department of Paediatrics University of Luebeck Luebeck Germany
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Reimers AK, Marzi I, Schmidt SCE, Niessner C, Oriwol D, Worth A, Woll A. Trends in active commuting to school from 2003 to 2017 among children and adolescents from Germany: the MoMo Study. Eur J Public Health 2021; 31:373-378. [PMID: 33011779 DOI: 10.1093/eurpub/ckaa141] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Inactivity in children and adolescents is a global issue requiring interventions that target different domains of physical activity, such as active transport. The aim of this study was to assess the prevalence, historical trends and socio-demographic correlates of active commuting to school (ACS) in a nationwide sample of girls and boys from Germany. METHODS Data of commuting behaviour and socio-demographic factors were collected, covering three measurement points from 2003 to 2017. The MoMo Study derived its data from a representative sample of children and adolescents aged 4-17 years who answered a questionnaire (N = 11 387). Statistically significant differences between Baseline, Wave 1 and Wave 2 were determined via 95% confidence intervals (CIs) for complex samples. RESULTS Overall, ACS decreased from 84.4% at the first measurement point to 78.3% in the third measurement point. The proportion of cases in which children opted for passive modes of commuting increased predominantly in those aged 4-5 years, in children with a low-to-medium socio-economic status, and in children residing in small- or medium-sized towns. No gender differences were found in active commuting. The results of multinomial logistic regression identified age, migration background and residential area as correlates of walking for boys. For girls, the likelihood of walking, cycling and taking public transport instead of opting for motorized transport increased with age. CONCLUSIONS Intervention programmes to increase active transport in children and adolescents should target different age groups and also consider parental influence in determining the child's choice of transport mode.
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Affiliation(s)
- Anne K Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Isabel Marzi
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Steffen C E Schmidt
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Claudia Niessner
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Doris Oriwol
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Annette Worth
- Institute of Movement and Sport, University of Education Karlsruhe, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
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Lemke N, Murawski A, Lange R, Weber T, Apel P, Dębiak M, Koch HM, Kolossa-Gehring M. Substitutes mimic the exposure behaviour of REACH regulated phthalates - A review of the German HBM system on the example of plasticizers. Int J Hyg Environ Health 2021; 236:113780. [PMID: 34126298 DOI: 10.1016/j.ijheh.2021.113780] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/30/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022]
Abstract
The population is constantly exposed to potentially harmful substances present in the environment, including inter alia food and drinking water, consumer products, and indoor air. Human biomonitoring (HBM) is a valuable tool to determine the integral, internal exposure of the general population, including vulnerable subgroups, to provide the basis for risk assessment and policy advice. The German HBM system comprises of five pillars: (1) the development of suitable analytical methods for new substances of concern, (2) cross-sectional population-representative German Environmental Surveys (GerES), (3) time trend analyses using archived samples from the Environmental Specimen Bank (ESB), (4) the derivation of health-based guidance values as a risk assessment tool, and (5) transfer of data into the European cooperation network HBM4EU. The goal of this paper is to present the complementary elements of the German HBM system and to show its strengths and limitations on the example of plasticizers. Plasticizers have been identified by EU services and HBM4EU partners as priority substances for chemical policy at EU level. Using the complementary elements of the German HBM system, the internal exposure to classical phthalates and novel alternative plasticizers can be reliably monitored. It is shown that market changes, due to regulation of certain phthalates and the rise of substitutes, are rapidly reflected in the internal exposure of the population. It was shown that exposure to DEHP, DiBP, DnBP, and BBzP decreased considerably, whereas exposure to the novel substitutes such as DPHP, DEHTP, and Hexamoll®DINCH has increased significantly. While health-based guidance values for several phthalates (esp. DnBP, DiBP, DEHP) were exceeded quite often at the turn of the millennium, exceedances today have become rarer. Still, also the latest GerES reveals the ubiquitous and concurrent exposures to many plasticizers. Of concern is that the youngest children showed the highest exposures to most of the investigated plasticizers and in some cases their levels of DiBP and DnBP still exceeded health-based guidance values. Over the last years, mixture exposures are increasingly recognized as relevant, especially if the toxicological modes of action are similar. This is supported by a cumulative risk assessment for four endocrine active phthalates which confirms the still concerning cumulative exposure in many young children. Given the adverse health effects of some phthalates and the limited toxicological knowledge of substitutes, exposure reduction and surveillance are needed on German and EU-level. Substitutes need to be monitored, to intervene if exposures are threatening to exceed acceptable levels, or if new toxicological data question their appropriateness. It is strongly recommended to reconsider the use of plastics and plasticizers.
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Affiliation(s)
- Nora Lemke
- German Environment Agency (UBA), Berlin, Germany
| | | | - Rosa Lange
- German Environment Agency (UBA), Berlin, Germany
| | - Till Weber
- German Environment Agency (UBA), Berlin, Germany
| | - Petra Apel
- German Environment Agency (UBA), Berlin, Germany
| | | | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-University Bochum, Germany
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Hohmann A, Yuan X, Schmitt M, Zhang H, Pietzonka M, Siener M. Physical Fitness and Motor Competence in Chinese and German Elementary School Children in Relation to Different Physical Activity Settings. CHILDREN (BASEL, SWITZERLAND) 2021; 8:391. [PMID: 34068840 PMCID: PMC8153568 DOI: 10.3390/children8050391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 02/02/2023]
Abstract
(1) Background: Children with greater physical activity (PA) may show a higher physical fitness (PF) and motor competence (MC) compared to peers with less PA. The purpose of this study was to examine the relationship between moderate-to-vigorous physical activity (MVPA), PF, and MC in 8- to 9-year old children in Germany and China. MVPA was differentiated into five PA settings: family sport, club training, school sport, leisure sport, and outside play. (2) Methods: This longitudinal study comprised N = 577 children (n = 311 girls, n = 266 boys) who were studied over a one-year period. Each child's PF and MC was determined using sports motor tests. The children's PAs were measured using a questionnaire. (3) Results: The children's PA was positively associated with PF and MC. The MVPA-settings: family sport, leisure sport, outside play, school, and club sport, explained between 18 and 23 percent of the variance in selected PF and MC characteristics in a multivariate linear regression analysis. (4) Conclusions: An increase in the children's MVPA might be an appropriate aim in the school sport in Germany as well as in the club sport system in China. Furthermore, family sport should be enhanced in Germany and outside play activities in China, respectively.
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Affiliation(s)
- Andreas Hohmann
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
| | - Xinchi Yuan
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
| | - Manfred Schmitt
- Department of Psychology, University of Koblenz-Landau, Fortstraße 7, 76829 Landau in der Pfalz, Germany;
| | - Hui Zhang
- Department of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Rd, Yangpu District, Shanghai 200438, China;
- Department of Training Science, Zhejiang University, 866 Yuhangtang Rd, Xihu, Hangzhou 310028, China
| | - Micha Pietzonka
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
| | - Maximilian Siener
- Institute of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany; (A.H.); (X.Y.); (M.P.)
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Staubach P, Mann C, Peveling-Oberhag A, Lang BM, Augustin M, Hagenström K, Garbe C, Petersen J. Epidemiology of urticaria in German children. J Dtsch Dermatol Ges 2021; 19:1013-1019. [PMID: 33938627 DOI: 10.1111/ddg.14485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND To date, robust epidemiological metrics as well as data on comorbidity in pediatric urticaria are lacking. They form the basis for the design of efficient healthcare. METHODS Retrospective study to analyze epidemiological data in pediatric urticaria. The analysis is based on routine data of a health insurance company operating throughout Germany (DAK-Gesundheit). Insured people under 18 years of age who received at least one confirmed outpatient or inpatient urticaria diagnosis according to the ICD-10 classification in the years 2010 to 2015 were included in the analysis and compared to children without a corresponding diagnosis. RESULTS Of 2.3 million insured individuals, 313,581 (13.5 %) were under 18 years of age (153,214 female). Urticaria was diagnosed in 1.7 % of the 313,581 patients. The prevalence of urticaria decreased with age from 3.0 % in the 0-3-year age group to 1.0 % in the 14-18-year age group. Boys and girls were almost equally affected in all age groups. Atopic diseases as comorbidity occurred more frequently in children with urticaria than in the control group (16.0 % vs. 8.0 %). Autoimmune diseases, mental health problems, and obesity also occurred more frequently in children with urticaria than in the control group. CONCLUSIONS The increased prevalence of specific comorbidities in children with urticaria suggests an increased need for screening. Multimodal treatment strategies need to be developed and interdisciplinary collaboration promoted.
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Affiliation(s)
- Petra Staubach
- Department of Dermatology, University Medical Center, Mainz, Germany
| | - Caroline Mann
- Department of Dermatology, University Medical Center, Mainz, Germany
| | | | - Berenice M Lang
- Department of Dermatology, University Medical Center, Mainz, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kristina Hagenström
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Claudia Garbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jana Petersen
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Hanssen‐Doose A, Kunina‐Habenicht O, Oriwol D, Niessner C, Woll A, Worth A. Predictive value of physical fitness on self‐rated health: A longitudinal study. Scand J Med Sci Sports 2021; 31 Suppl 1:56-64. [DOI: 10.1111/sms.13841] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/20/2020] [Accepted: 09/07/2020] [Indexed: 12/18/2022]
Affiliation(s)
| | | | - Doris Oriwol
- University of Education Karlsruhe Karlsruhe Germany
- Karlsruhe Institute of Technology Karlsruhe Germany
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Blood pressure and resting heart rate in 3-17-year-olds in Germany in 2003-2006 and 2014-2017. J Hum Hypertens 2021; 36:544-553. [PMID: 33854175 PMCID: PMC9225953 DOI: 10.1038/s41371-021-00535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/12/2021] [Accepted: 03/29/2021] [Indexed: 11/22/2022]
Abstract
To track blood pressure (BP) and resting heart rate (RHR) in children and adolescents is important due to its associations with cardiovascular outcomes in the adulthood. Therefore, the aim of this study was to examine BP and RHR over a decade among children and adolescents living in Germany using national examination data. Cross-sectional data from 3- to 17-year-old national survey participants (KiGGS 2003–06, n = 14,701; KiGGS 2014–17, n = 3509) including standardized oscillometric BP and RHR were used for age- and sex-standardized analysis. Measurement protocols were identical with the exception of the cuff selection rule, which was accounted for in the analyses. Different BP and RHR trends were observed according to age-groups. In 3- to 6-year-olds adjusted mean SBP and DBP were significantly higher in 2014–2017 compared to 2003–2006 (+2.4 and +1.9 mm Hg, respectively), while RHR was statistically significantly lower by −3.8 bpm. No significant changes in BP or in RHR were observed in 7- to 10-year-olds over time. In 11- to 13-year-olds as well as in 14- to 17-year-olds lower BP has been observed (SBP −2.4 and −3.2 mm Hg, respectively, and DBP −1.8 and −1.7 mm Hg), while RHR was significantly higher (+2.7 and +3.7 bpm). BP trends did not parallel RHR trends. The downward BP trend in adolescents seemed to follow decreasing adult BP trends in middle and high-income countries. The increase in BP in younger children needs confirmation from other studies as well as further investigation. In school-aged children and adolescents, the increased RHR trend may indicate decreased physical fitness.
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Headache Is Associated with Low Systolic Blood Pressure and Psychosocial Problems in German Adolescents: Results from the Population-Based German KiGGS Study. J Clin Med 2021; 10:jcm10071492. [PMID: 33916726 PMCID: PMC8038357 DOI: 10.3390/jcm10071492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022] Open
Abstract
Studies have reported controversial results on the relationship between headache and blood pressure. The aim of this post hoc study was twofold: first, to further investigate this relationship and, second, to assess the impact of psychosocial factors on this association in a population-based study of German children and adolescents. The analysis was conducted on study participants aged between 11 and 17 years (n = 5221, weighted from the total study cohort) from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Health-related quality of life was assessed by self- and parent-rated German-language KINDL-R questionnaires (Children’s Quality of Life Questionnaire), while mental problems were analyzed using the Strengths and Difficulties Questionnaire (SDQ). Our findings confirmed that blood pressure was significantly lower in adolescents reporting episodes of headache than in those without headache (114.0 ± 10.2 mmHg vs. 115.5 ± 11.0 mmHg, p < 0.001). Logistic regression models adjusted to sex, age, body mass index, contraceptive use, and serum magnesium concentration demonstrated that headache was significantly associated with self-rated KINDL-R (Exp(B) = 0.96, 95% confidence interval (95% Cl) = 0.96–0.97, p < 0.001), parent-rated KINDL-R (Exp(B) = 0.97, 95% CI = 0.96–0.98, p < 0.001), as well as self-rated SDQ (Exp(B) = 1.08, 95% CI = 1.07–1.10, p < 0.001), and parent-rated SDQ (Exp(B) = 1.05, 95% CI = 1.04–1.06, p < 0.001). There was evidence that quality of life and mental problems mediated the effect of blood pressure on headache, as revealed by mediation models. Our results from the nationwide, representative KiGGS survey showed that low blood pressure is a significant predictor of headache, independent of quality of life and mental problems. However, these psychosocial factors may mediate the effect of blood pressure on headache in a still unknown manner.
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Brettschneider AK, Lage Barbosa C, Haftenberger M, Lehmann F, Mensink GBM. Adherence to food-based dietary guidelines among adolescents in Germany according to socio-economic status and region: results from Eating Study as a KiGGS Module (EsKiMo) II. Public Health Nutr 2021; 24:1216-1228. [PMID: 33427143 PMCID: PMC8025090 DOI: 10.1017/s136898002100001x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 11/23/2020] [Accepted: 01/05/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Dietary habits developed during childhood and adolescence are likely to continue into adulthood. An unbalanced diet may cause nutrient deficiencies and excessive energy intake; these enhance the risk for developing overweight and obesity and their co-morbidities. In the present analysis, food consumption of adolescents is described and evaluated against German food-based dietary guidelines with special focus on socio-economic status (SES) and region of residence. DESIGN Within the 'German Health Interview and Examination Survey for Children and Adolescents' (KiGGS Wave 2), the cross-sectional 'Eating Study as a KiGGS Module' (EsKiMo II) was conducted from 2015 until 2017 to provide data about dietary behaviour. SETTING Germany. PARTICIPANTS 1353 adolescents aged 12-17 years from a nationwide representative sample with food consumption data from computer-assisted dietary history interviews. RESULTS The median consumption of fruits, vegetables, starchy foods and milk/dairy products among adolescents in Germany was below the recommendation. The median consumption of both meat/meat products and unfavourable foods, like confectionery, which should be consumed sparingly, was about 1·5 times the recommended amount. The total amount of beverages consumed by most adolescents was above the minimum amount recommended. Soft drink consumption of adolescents with a low SES was three to five times higher than soft drink consumption of adolescents with a high SES. CONCLUSIONS The results indicate the need for an improvement of dietary habits among adolescents in Germany. Further approaches to promote healthy diets in Germany should be continued, and the focus on social inequalities should be strengthened.
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Affiliation(s)
- Anna-Kristin Brettschneider
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, Berlin 12101, Germany
| | - Clarissa Lage Barbosa
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, Berlin 12101, Germany
| | - Marjolein Haftenberger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, Berlin 12101, Germany
| | - Franziska Lehmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, Berlin 12101, Germany
| | - Gert BM Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, Berlin 12101, Germany
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Plass-Christl A, Ravens-Sieberer U, Hölling H, Otto C. Trajectories of health-related quality of life in children of parents with mental health problems: results of the BELLA study. Qual Life Res 2021; 30:1841-1852. [PMID: 33651276 DOI: 10.1007/s11136-021-02783-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Children of parents with mental health problems (CPM) have an increased risk for impaired health-related quality of life (HRQoL). This study aims at investigating the age- and gender-specific course of HRQoL and at exploring predictors of HRQoL in CPM based on longitudinal data (baseline, 1-year and 2-year follow-up) of a German population-based sample. METHODS Longitudinal data from the German BELLA study was analyzed (n = 1429; aged 11 to 17 years at baseline). The SCL-S-9 in combination with the cutoff for the General Severity Index (GSI) from the longer SCL-90-R served to identify CPM (n = 312). At first, we compared domain-specific HRQoL according to the KIDSCREEN-27 in CPM versus Non-CPM. Focusing on CPM, we used individual growth modeling to investigate the age and gender-specific course, and to explore effects of risk and (personal, familial and social) resource factors on self-reported HRQoL in CPM. RESULTS Self-reported HRQoL was reduced in CPM compared to Non-CPM in all domains, but in social support & peers. However, a minimal important difference was only reached in girls for the domain autonomy & parent relation. Internalizing and externalizing mental health problems were associated with impaired HRQoL in CPM. Self-efficacy, social support and family climate were identified as significant resources, but parental mental health problems over time were not associated with any investigated domain of HRQoL in CPM. CONCLUSIONS Adolescent female CPM may be especially at risk for reduced HRQoL. When developing support programs for CPM, self-efficacy, social support and family climate should be considered, HRQoL and mental health problems in CPM should be addressed.
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Affiliation(s)
- Angela Plass-Christl
- Evangelical Hospital Alsterdorf Hamburg, Hamburg, Germany.
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany.
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany.
| | - Heike Hölling
- Robert Koch Institute, Department of Epidemiology and Health Reporting, Berlin, Germany
| | - Christiane Otto
- University Medical Center Hamburg-Eppendorf, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Child Public Health, Hamburg, Germany
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