There is growing scientific evidence supports a link between increased childhood adiposity and early onset of puberty in girls worldwide in recent decades. However, the data from Chinese girls remain ambiguous. The aims of this study were to estimate the puberty milestones and examine attainment of puberty associated with obesity and central obesity in Chinese Han schoolgirls. The cross-sectional school-based study examined 2996 Han schoolgirls aged 9 to 19 years from 6 provinces in China. Trained clinicians assessed the girls for height, weight, waist circumference, Tanner stages of breast and pubic hair development, and menarcheal status. We classified girls as normal weight, overweight, or obese based on BMI, and as normal weight or central obese based on the waist-height ratio, then estimated and compared median age at a given Tanner stage or greater by weight class using Probit models. The median age at menarche was 12.36 years. The median ages at breast stages(B) 2 through 5 were 10.03, 11.38, 13.39, and 15.79 years, respectively, and at pubic hair stages(PH) 2 through 5 were 11.62, 12.70, 14.38, and 16.92 years, respectively. Girls from urban areas experienced menarche, B3 and B4 stages, and PH3 through PH5 stages earlier. Girls with central obesity and overweight/obesity reached puberty earlier at almost every Tanner stage of breast and pubic hair than normal girls. Girls with obesity developed PH2 and PH3 earlier than their overweight peers. However, we did not find any significant differences between girls with overweight and obesity at all stages of breast development. Childhood obesity, including both overweight/obesity and central obesity, is associated with earlier attainment of puberty in Chinese Han schoolgirls.

Background: The prevalence of being bullied traditionally among U.S. high school students is expected to reduce to 17.9%, according to Healthy People 2020 Initiatives. We examined trends in traditional victimization and cybervictimization with the latest large-scale time-series data in the United States. Methods: We analyzed the data from the 2011–2019 national Youth Risk Behavior Survey (YRBS) to access the trends in traditional victimization and cybervictimization among U.S. high school students. We identified the temporal trends using multivariate logistic regression analyses, accounting for survey design features of YRBS. Participants included 72,605 high school students. Results: The overall prevalence of victimization was 19.74% for traditional bullying and 15.38% for cyberbullying, suggesting that cyberbullying is not a low frequent phenomenon. The prevalence of victimization ranged from 20.19 to 19.04% for traditional victimization and 16.23 to 14.77% for cybervictimization, and the declined trends for the two kinds of bullying victimization were both statistically non-significant. The degree of overlap between the two kinds of bullying victimization was about 60%. Besides, female students reported more traditional victimization and cybervictimization than male peers within each survey cycle. Conclusions: No declined trends in traditional victimization and cybervictimization were observed during 2011–2019. Female students are more likely to experience school bullying. To achieve the Healthy People 2020 goal on bullying, more work is needed to explore the underlying reasons behind these unchanging trends.

China is experiencing a sizeable rural-urban flow, which may influence the health of internal migrant youth deeply. Disadvantages in the city are highly likely to contribute to health issues among the young internal migrant population. The current qualitative study is to explore how internal migrant young people view the health issues they face, and the services and opportunities they could seek in their host community. Data were collected from 90 internal migrant youth aged between 15 and 19 years old and 20 adult service providers who worked with them in a community of Shanghai, where the population of internal migrants was relatively large. Four types of qualitative research methods were used, including key informant interviews with adults, in-depth interviews with adolescents, a photovoice activity with adolescents and community mapping & focus group discussions with adolescents. Guided by the ecological systems framework and the acculturation theory, thematic analysis was conducted using ATLAS.Ti 7.0 software. While younger migrants had a limited understanding of health, elder migrant youths were more sensitive to societal and political factors related to their health. Mental health and health risk behaviors such as smoking, violence and premarital unsafe sex were thought as major health issues. Internal migrant youths rarely seek health information and services initiatively from formal sources. They believed their health concerns weren’t as pressing as the pressure coming from the high cost of living, the experience of being unfairly treated and the lack of opportunities. Participants also cited lack of family and social support, lack of awareness and supportive policies to get access to community and public services as impacting health factors. The study’s findings provide the insight to the social contexts which influence the health experience, health seeking behaviors, and city adaptation of young internal migrants in their host community. This research stresses the importance of understanding social networks and structural barriers faced by migrant youth in vulnerable environments. A multidimensional social support is essential for internal migrant youth facing present and potential health risks.

Background: Bullying is one of the most important factors associated with child abuse. However, robust tests supporting the assumption that being bullied can contribute to child sexual abuse (CSA) among left-behind children (LBC) remain sparse. This study aims to investigate the association of bullying victimization with CSA among LBC in China.Methods: A cross-sectional study was conducted in six middle schools of Sichuan and Anhui province in 2015. The bullying victimization was assessed by seven items from the Revised Olweus Bully/Victim Questionnaire. The experience of CSA was measured by ten items CSA scale with good consistency.Results: A total of 1,030 children met the sampling criteria, including 284 LBC and 746 non-LBC. The prevalence of CSA was 22.89% in LBC and 20.19% in non-LBC (p > 0.05). Bullying victimization was related to CSA among both LBC (adjusted Odds Ratio [aOR] = 2.52, 95% CI [1.34–4.73]) and non-LBC (aOR = 2.35, 95% CI [1.58–3.53]). The association between bullying victimization and CSA was much higher among left-behind girls (left-behind girls: aOR = 7.36, 95% CI [2.16–24.99]; non-left-behind girls: aOR = 2.38, 95% CI [1.08–5.27]). Also, LBC of a young age (11–15), children with siblings, living in rural areas and non-traditional family structure who were bullied were more likely to suffer CSA than their non-LBC peers.Conclusions: Bullying victimization is associated with a significant increase in CSA among both LBC and non-LBC. Anti-bullying programs should target vulnerable populations including female LBC and LBC with siblings to reduce the risk of CSA.

Non-consensual sex (NCS) among young people, an important subject with public health and human rights implications, was less studied in China. This study is to investigate the NCS awareness and victimization of university students in Shanghai, China and whether they were associated with adolescent gender-role attitudes. Gender-role attitudes, awareness and victimization of different forms of NCS were examined among 1099 undergraduates (430 males and 669 females) in four universities in Shanghai using computer-assisted self-interview approach. University students held relatively egalitarian attitude to gender roles. Gender difference existed that girls desired to be more equal in social status and resource sharing while more endorsed the submissiveness for women in sexual interaction than boys. They held low vigilance on the risk of various forms of NCS, with the mean score on perception of NCS among boys (5.67) lower than that among girls (6.37). Boys who adhered to traditional gender norms were less likely to aware the nature of NCS (β = − 0.6107, p = 0.0389). Compared with boys, higher proportion of girls had been the victims of verbal harassment, unwanted touch, fondling, and penetrative sexual intercourse. Multivariable analysis revealed that girls who held more traditional gender-role attitudes were more vulnerable to physical NCS (OR = 1.41, p = 0.0558). The weakening but still existing traditional gender norms had contributions in explaining the gender difference on the low vigilance of NCS and higher prevalence of victimization among university students in Shanghai, China. Interventions should be taken to challenge the traditional gender norms in individual and structural level, and promote the society to understand the nature of NCS better as well as enhance negotiation skills of adolescents and young people that prevent them from potentially risky situations or relationships.

Although there is much literature on adolescent suicide, combined effects of depression and anorexia nervosa on suicide were rarely investigated. The aims of this study are to examine the association between anorexia nervosa and suicidal thoughts and explore the interaction between anorexia nervosa and depression. This is a cross-sectional study, in the study, a sample of 8,746 Chinese adolescents was selected by multistage stratified method in 2012/2013 from 20 middle schools in 7 provinces across China Mainland. Multilevel logistic model was introduced to explore association between anorexia nervosa and suicidal thoughts. And subgroup analyses were conducted on participants with or without depression. Multilevel logistic model revealed that demographic variables, including academic achievement, were not the predictive risk factors of suicidal thoughts. Those who suffered from worse severity of perceived anorexia nervosa were at increased risk of thinking about suicide. The interaction between depression and anorexia nervosa was significant, however, subgroup analyses showed that the associations were significant only among the adolescents without depression. Our results indicate that all levels of anorexia nervosa serve as predictable indicators of suicidal thoughts in Chinese adolescents, and the effects of anorexia nervosa are modified by depression status.