Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic respo...Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic response and high influenza vaccination rates,offers a unique context for examining changes in vaccination trends during the pandemic.Using nationally representative data,we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups.Methods We analyzed influenza vaccination rates in South Korea between 2011-2022,focusing on pandemic-related impacts.The data of 2,426,139 adults(≥19 years)from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors.Results We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013(weighted prevalence:46.68%[95%confidence interval(CI):46.55-46.82])to 2017-2019(weighted prevalence:52.50%[95%CI:52.38-52.63]).However,a significant decline was observed in 2022,the late-COVID-19 pandemic period(weighted prevalence:55.78%[95%CI:55.56-56.01]),compared with the mid-pandemic period in 2021(weighted prevalence:59.12%[95%CI:58.91-59.32]),particularly among populations traditionally prioritized for influenza vaccination,including older adults(≥65 years)and patients with chronic diseases and low educational and income levels.Conclusion The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic,showing a notable decrease among vulnerable demographic groups.This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates,particularly among high-risk populations.展开更多
Background The patterns of cancer burden in children,adolescents and young adults are distinct from those in the general adult population,underscoring the importance of developing targeted research and interventions.T...Background The patterns of cancer burden in children,adolescents and young adults are distinct from those in the general adult population,underscoring the importance of developing targeted research and interventions.Thus,we analyzed global,regional,and national cancer mortality trends via the World Health Organization(WHO)Mortality Database among children aged 0–14 years and adolescents and young adults aged 15–34 across 77 WHO Member States.Methods Age-standardized country-specific cancer mortality rates(deaths per 100,000)and years of life lost between 1990 and 2021 were estimated via a locally weighted scatterplot smooth curve.We analyzed the associations between socioeconomic indices and mortality rates for 21 types of cancer.Furthermore,we conducted a decomposition analysis to understand the factors influencing mortality rates for these 21 types of cancer.Results Between 1990 and 2021,the age-standardized cancer mortality rate decreased from 12.35%[95%confidence interval(CI)11.81%–12.88%]to 4.83%(95%CI 4.12%–5.54%)by−3.29%per year.However,progress in reducing death rates has been heterogeneous in terms of country income,cancer site,and geography.In particular,the decrease in burden was most pronounced in North America;however,cervical and testicular cancer mortality is elevated in Africa,Latin America,and the Caribbean.While the major contributors to children’s cancer mortality(leukemia,brain,and bone tumors)have remained unchanged for the past three decades,a significant decrease in respiratory tract cancer and an increase in colorectal cancer have led to a transition in the cancer profile in adolescents and young adults.Additionally,infection-related cancers are inversely correlated with socioeconomic indices;notably,colorectal cancer appears to have no correlation with these indices.We also revealed significant changes in mortality trends during the COVID-19 pandemic,which were more pronounced in children.Finally,a decomposition analysis revealed that the decrease in the number of cancer deaths worldwide between 1990 and 2021 may be attributed primarily to age-specific mortality rather than population growth or aging.Conclusions From 1990 to 2021,a significant decreasing trend in cancer mortality in the young population,especially in high-income countries,was observed.However,progress in reducing death rates has been heterogeneous by country income,cancer site,and geography,indicating disparities in control efforts across countries.Future studies are needed to address the exposures responsible for the heterogeneity of cancer burden and the changing cancer profile in this age group.展开更多
Background Adolescent drug use poses significant public health challenges worldwide,with detrimental effects on mental and physical health.Most existing research focuses on Western countries,holding a gap in understan...Background Adolescent drug use poses significant public health challenges worldwide,with detrimental effects on mental and physical health.Most existing research focuses on Western countries,holding a gap in understanding drug use in low-and middle-income countries.Thus,we aimed to assess the prevalence of cannabis and amphetamine or methamphetamine use among school-going adolescents aged 12–15 years across 47 countries globally.Methods We used data from the Global School-based Student Health Survey from 47 countries(2009–2018)to analyze cannabis and amphetamine/methamphetamine use and age at first drug use among adolescents(n=220,362).A meta-analysis utilizing random-effects models estimated prevalence rates and weighted linear regression analyzed trends.Student’s t tests were used to compare two-subgroup categories,while one-way ANOVA was employed for analyses involving the four-subgroup category.Stratification analysis by sex,World Bank income category,region,and country-specific characteristics based on World Health Organization data were also performed.Results The study included a total of 220,362 school-going adolescents aged 12–15 years(49.96%girls)from 47 countries.The overall prevalence of cannabis use was 7.02%[95%confidence interval(CI)6.16–7.89],with higher usage among boys[9.20%(95%CI 8.05–10.36)]compared to girls[4.20%(95%CI 3.68–4.72)].Amphetamine/methamphetamine use prevalence was 4.05%(95%CI 3.51–4.60),also higher among boys[5.14%(95%CI 4.45–5.84)]than girls[2.34%(95%CI 2.00–2.69)].The region of the Americas exhibited the highest prevalence of cannabis use[11.31%(95%CI 8.44–14.17)],while the African region showed the highest prevalence of amphetamine use[4.34%(95%CI 3.14–5.53)].High-income countries reported the highest prevalence of cannabis use[9.45%(95%CI,6.06 to 12.84)],whereas low-income countries had the lowest[3.46%(95%CI 2.01–4.91)].Higher prevalence rates were associated with countries having higher homicide rates,better sanitation services,and higher health expenditures.Conclusions Cannabis use among adolescents is more prevalent than amphetamine or methamphetamine use,with significant sex differences showing higher prevalence among boys.The highest prevalence of cannabis use was observed in Latin America,while Africa exhibited the highest rates of amphetamine use.Findings from the present study indicate a need for public policies and programs targeting adolescents to effectively reduce adolescent drug use.展开更多
Background There is a paucity of research on patterns of attempts at smoking cessation,success,and influencing factors in adolescents.This study aims to analyze the prevalence of ex-smokers and current smokers with ce...Background There is a paucity of research on patterns of attempts at smoking cessation,success,and influencing factors in adolescents.This study aims to analyze the prevalence of ex-smokers and current smokers with cessation attempts in adolescents worldwide and to identify the factors that affect cessation attempts along with outcomes.Methods This study utilized the Global Youth Tobacco Survey(2010–2021)to investigate tobacco use among adolescents aged 13–15 years.Smoking status was categorized into two groups:ex-smokers,who successfully stop,and current smokers with cessation attempts.Prevalence is presented as weighted rates with 95%confidence intervals(CIs).Factors influencing smoking cessation attempts and success were assessed using adjusted odds ratios(aORs)with 95%CIs.Results Totally 9.96%of adolescents worldwide were classified as ex-smokers(95%CI 9.30%–10.63%),while 7.29%were current smokers with cessation attempts(95%CI 6.51%–8.06%).The prevalence of ex-smokers was highest in settings where primary care facilities provide tobacco-dependence treatment.The highest prevalence of current smokers with cessation attempts was observed in community-based settings.Education in schools has been shown to be associated with both smoking cessation attempts[aOR,1.44(95%CI 1.36−1.53)]and success[aOR,1.16(95%CI 1.10−1.22)].Individuals who successfully stop smoking had lower secondhand smoke exposure than current smokers,while smokers with cessation attempts experienced higher exposure than smokers without such attempts.Conclusions The prevalence of ex-smokers and current smokers with cessation attempts remains low.School-based educational programs have proven effective in promoting smoking cessation attempts and reducing exposure to secondhand smoke is essential for successful stop.展开更多
Background The coronavirus disease 2019(COVID-19)pandemic,a global health crisis,profoundly impacted all aspects of daily life.Adolescence,a pivotal stage of psychological and social development,is heavily influenced ...Background The coronavirus disease 2019(COVID-19)pandemic,a global health crisis,profoundly impacted all aspects of daily life.Adolescence,a pivotal stage of psychological and social development,is heavily influenced by the psychosocial and socio-cultural context.Hence,it is imperative to thoroughly understand the psychosocial changes adolescents experienced during the pandemic and implement effective management initiatives.Data sources We examined the incidence rates of depressive and anxiety disorders among adolescents aged 10–19 years globally and regionally.We utilized data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2021 to compare pre-pandemic(2018–2019)and pandemic(2020–2021)periods.Our investigation covered 204 countries and territories across the six World Health Organization regions.We conducted a comprehensive literature search using databases including PubMed/MEDLINE,Scopus,and Google Scholar,employing search terms such as“psychosocial”,“adolescent”,“youth”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”.Results During the pandemic,the mental health outcomes of adolescents deteriorated,particularly in terms of depressive and anxiety disorders.According to GBD 2021,the incidence rate of anxiety disorders increased from 720.26[95%uncertainty intervals(UI)=548.90–929.19]before the COVID-19 pandemic(2018–2019)to 880.87 per 100,000 people(95%UI=670.43–1132.58)during the COVID-19 pandemic(2020–2021).Similarly,the incidence rate of major depressive disorder increased from 2333.91(95%UI=1626.92–3138.55)before the COVID-19 pandemic to 3030.49 per 100,000 people(95%UI=2096.73–4077.73)during the COVID-19 pandemic.This worsening was notably pronounced in high-income countries(HICs).Rapid environmental changes,including heightened social anxiety,school closures,economic crises,and exacerbated racism,have been shown to adversely affect the mental well-being of adolescents.Conclusions The abrupt shift to remote learning and the absence of in-person social interactions heightened feelings of loneliness,anxiety,sadness,and stress among adolescents.This change magnified existing socioeconomic disparities,posing additional challenges.These complexities profoundly impact adolescents’well-being,especially vulnerable groups like those from HICs,females,and minorities.Acknowledging the underreporting bias in low-to middle-income countries highlights the importance of addressing these mental health alterations in assessments and interventions within these regions as well.Urgent interventions are crucial as the pandemic-induced mental stress may have lasting effects on adolescents’mental health.展开更多
Background Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years.Familial,social,psychological,and behav...Background Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years.Familial,social,psychological,and behavioral factors play important roles in suicide risk.As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people,there is a need to understand the current status of suicide in adolescents,including its epidemiology,associated factors,the influence of the pandemic,and management initiatives.Data sources We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019.The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization(WHO)regions.Additionally,we utilized electronic databases,including PubMed/MEDLINE and Scopus,and employed various combinations of terms such as“suicide”,“adolescents”,“youth”,“children”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”to provide a narrative review on suicide within the pediatric population in the post-pandemic era.Results Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019,it remains high.The mortality rates from suicide by firearms or any other specified means were both greater in males.Additionally,Southeast Asia had the highest suicide rate among the six WHO regions.The COVID-19 pandemic seems to contribute to suicide risk in young people;thus,there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic.Conclusions The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic,risk factors,and intervention strategies.Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era,further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era.It is necessary to identify effective prevention strategies targeting young people,particularly those at high risk,and successful treatment for individuals already manifesting suicidal behaviors.Care for suicidal children and adolescents should be improved with parental,school,community,and clinical involvement.展开更多
Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We con...Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors.PubMed/MEDLINE,Embase,EBSCO,and Google Scholar were searched from inception until January 18,2023.Data extraction,quality assessment,and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines.According to observational evidence,credibility was graded and classified by class and quality of evidence(CE;convincing,highly suggestive,suggestive,weak,or not significant).Our study protocol was registered with PROSPERO(CRD42023458696).The risk and protective factors related to SIDS are presented as equivalent odds ratios(eORs).Results We identified eight original meta-analyses,including 152 original articles,covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents.Several risk factors,including prenatal drug exposure[eOR=7.84(95%CI=4.81–12.79),CE=highly suggestive],prenatal opioid exposure[9.55(95%CI=4.87–18.72),CE=suggestive],prenatal methadone exposure[9.52(95%CI=3.34–27.10),CE=weak],prenatal cocaine exposure[4.38(95%CI=1.95–9.86),CE=weak],prenatal maternal smoking[2.25(95%CI=1.95–2.60),CE=highly suggestive],postnatal maternal smoking[1.97(95%CI=1.75–2.22),CE=weak],bed sharing[2.89(95%CI=1.81–4.60),CE=weak],and infants found with heads covered by bedclothes after last sleep[11.01(95%CI=5.40–22.45),CE=suggestive],were identified.On the other hand,three protective factors,namely,breastfeeding[0.57(95%CI=0.39–0.83),CE=non-significant],supine sleeping position[0.48(95%CI=0.37–0.63),CE=suggestive],and pacifier use[0.44(95%CI=0.30–0.65),CE=weak],were also identified.Conclusions Based on the evidence,we propose several risk and protective factors for SIDS.This study suggests the need for further studies on SIDS-related factors supported by weak credibility,no association,or a lack of adequate research.展开更多
Background Researches on the mental health of Korean adolescents during COVID-19 have largely focused on those from monocultural families,but there is limited data on sadness,suicidal ideation,and suicide attempts in ...Background Researches on the mental health of Korean adolescents during COVID-19 have largely focused on those from monocultural families,but there is limited data on sadness,suicidal ideation,and suicide attempts in multicultural adolescents.Methods This nationwide serial cross-sectional study included 688,708 adolescents aged 12–18 years who participated in the Korean Youth Risk Behavior Web-based Survey from 2011 to 2022.We compared and analyzed the prevalence of sadness,suicidal ideation,and suicide attempts among multicultural and monocultural adolescents.Multicultural adolescents were defined as those with at least one non-Korean parent.Results In 2021,the prevalence of sadness among multicultural adolescents was 31.86%[95%confidence interval(CI)30.00–33.71],suicidal ideation 17.17%(15.74–18.61),and suicide attempts 4.25%(3.51–4.99).Among monocultural adolescents,the prevalence rates were 26.09%(25.50–26.69)for sadness,12.41%(11.97–12.85)for suicidal ideation,and 1.92%(1.76–2.67)for suicide attempts.Adolescents from multicultural backgrounds were found to have higher rates of sadness,suicidal ideation,and suicide attempts.In the general population,these rates had decreased during the pre-pandemic period but increased after the onset of the pandemic then stabilized from 2020 to 2021.Female gender,smoking,alcohol use,and low school performance emerged as significant risk factors.However,no distinct risk factors specifically linked to suicide attempts were identified.Joinpoint regression analysis results aligned with the beta slope values in the main findings,reflecting a consistent pattern across both analyses.Conclusions This study revealed that sadness,suicidal ideation,and suicide attempts increased during the pandemic,reversing a pre-pandemic decline.Multicultural adolescents faced these issues more than monocultural ones,underlining the need for targeted public health measures to support at-risk adolescents during pandemics.展开更多
基金supported by the Basic Science Research Program through the National Research Foundation of Korea,funded by the Ministry of Education(RS-2024-00460379).
文摘Objective Despite the global decrease in influenza infections during the coronavirus disease 2019(COVID-19)pandemic,seasonal influenza remains a significant health issue.South Korea,known for its robust pandemic response and high influenza vaccination rates,offers a unique context for examining changes in vaccination trends during the pandemic.Using nationally representative data,we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups.Methods We analyzed influenza vaccination rates in South Korea between 2011-2022,focusing on pandemic-related impacts.The data of 2,426,139 adults(≥19 years)from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors.Results We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013(weighted prevalence:46.68%[95%confidence interval(CI):46.55-46.82])to 2017-2019(weighted prevalence:52.50%[95%CI:52.38-52.63]).However,a significant decline was observed in 2022,the late-COVID-19 pandemic period(weighted prevalence:55.78%[95%CI:55.56-56.01]),compared with the mid-pandemic period in 2021(weighted prevalence:59.12%[95%CI:58.91-59.32]),particularly among populations traditionally prioritized for influenza vaccination,including older adults(≥65 years)and patients with chronic diseases and low educational and income levels.Conclusion The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic,showing a notable decrease among vulnerable demographic groups.This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates,particularly among high-risk populations.
基金supported by the MSIT(Ministry of Science and ICT),South Korea,under the ITRC(Information Technology Research Center)support program(IITP-2024-RS-2024-00438239)supervised by the IITP(Institute for Information and Communications Technology Planning and Evaluation,RS-2024-00509257,Global AI Frontier Lab).
文摘Background The patterns of cancer burden in children,adolescents and young adults are distinct from those in the general adult population,underscoring the importance of developing targeted research and interventions.Thus,we analyzed global,regional,and national cancer mortality trends via the World Health Organization(WHO)Mortality Database among children aged 0–14 years and adolescents and young adults aged 15–34 across 77 WHO Member States.Methods Age-standardized country-specific cancer mortality rates(deaths per 100,000)and years of life lost between 1990 and 2021 were estimated via a locally weighted scatterplot smooth curve.We analyzed the associations between socioeconomic indices and mortality rates for 21 types of cancer.Furthermore,we conducted a decomposition analysis to understand the factors influencing mortality rates for these 21 types of cancer.Results Between 1990 and 2021,the age-standardized cancer mortality rate decreased from 12.35%[95%confidence interval(CI)11.81%–12.88%]to 4.83%(95%CI 4.12%–5.54%)by−3.29%per year.However,progress in reducing death rates has been heterogeneous in terms of country income,cancer site,and geography.In particular,the decrease in burden was most pronounced in North America;however,cervical and testicular cancer mortality is elevated in Africa,Latin America,and the Caribbean.While the major contributors to children’s cancer mortality(leukemia,brain,and bone tumors)have remained unchanged for the past three decades,a significant decrease in respiratory tract cancer and an increase in colorectal cancer have led to a transition in the cancer profile in adolescents and young adults.Additionally,infection-related cancers are inversely correlated with socioeconomic indices;notably,colorectal cancer appears to have no correlation with these indices.We also revealed significant changes in mortality trends during the COVID-19 pandemic,which were more pronounced in children.Finally,a decomposition analysis revealed that the decrease in the number of cancer deaths worldwide between 1990 and 2021 may be attributed primarily to age-specific mortality rather than population growth or aging.Conclusions From 1990 to 2021,a significant decreasing trend in cancer mortality in the young population,especially in high-income countries,was observed.However,progress in reducing death rates has been heterogeneous by country income,cancer site,and geography,indicating disparities in control efforts across countries.Future studies are needed to address the exposures responsible for the heterogeneity of cancer burden and the changing cancer profile in this age group.
基金supported by the MSIT(Ministry of Science and ICT),Korea,under the ITRC(Information Technology Research Center)support program(IITP-2024-RS-2024-00438239)supervised by the IITP(Institute for Information&Communications Technology Planning&Evaluation)and AI Excellence Global Innovative Leader Education Program(RS-2022-00143911).
文摘Background Adolescent drug use poses significant public health challenges worldwide,with detrimental effects on mental and physical health.Most existing research focuses on Western countries,holding a gap in understanding drug use in low-and middle-income countries.Thus,we aimed to assess the prevalence of cannabis and amphetamine or methamphetamine use among school-going adolescents aged 12–15 years across 47 countries globally.Methods We used data from the Global School-based Student Health Survey from 47 countries(2009–2018)to analyze cannabis and amphetamine/methamphetamine use and age at first drug use among adolescents(n=220,362).A meta-analysis utilizing random-effects models estimated prevalence rates and weighted linear regression analyzed trends.Student’s t tests were used to compare two-subgroup categories,while one-way ANOVA was employed for analyses involving the four-subgroup category.Stratification analysis by sex,World Bank income category,region,and country-specific characteristics based on World Health Organization data were also performed.Results The study included a total of 220,362 school-going adolescents aged 12–15 years(49.96%girls)from 47 countries.The overall prevalence of cannabis use was 7.02%[95%confidence interval(CI)6.16–7.89],with higher usage among boys[9.20%(95%CI 8.05–10.36)]compared to girls[4.20%(95%CI 3.68–4.72)].Amphetamine/methamphetamine use prevalence was 4.05%(95%CI 3.51–4.60),also higher among boys[5.14%(95%CI 4.45–5.84)]than girls[2.34%(95%CI 2.00–2.69)].The region of the Americas exhibited the highest prevalence of cannabis use[11.31%(95%CI 8.44–14.17)],while the African region showed the highest prevalence of amphetamine use[4.34%(95%CI 3.14–5.53)].High-income countries reported the highest prevalence of cannabis use[9.45%(95%CI,6.06 to 12.84)],whereas low-income countries had the lowest[3.46%(95%CI 2.01–4.91)].Higher prevalence rates were associated with countries having higher homicide rates,better sanitation services,and higher health expenditures.Conclusions Cannabis use among adolescents is more prevalent than amphetamine or methamphetamine use,with significant sex differences showing higher prevalence among boys.The highest prevalence of cannabis use was observed in Latin America,while Africa exhibited the highest rates of amphetamine use.Findings from the present study indicate a need for public policies and programs targeting adolescents to effectively reduce adolescent drug use.
基金supported by grants from the Ministry of Science and ICT(MSIT),Korea,under the Information Technology Research Center(ITRC)support program(IITP-2024-RS-2024-00438239)supervised by the Institute for Information&Communications Technology Planning&Evaluation(IITP,RS-2024-00509257,Global AI Frontier Lab).
文摘Background There is a paucity of research on patterns of attempts at smoking cessation,success,and influencing factors in adolescents.This study aims to analyze the prevalence of ex-smokers and current smokers with cessation attempts in adolescents worldwide and to identify the factors that affect cessation attempts along with outcomes.Methods This study utilized the Global Youth Tobacco Survey(2010–2021)to investigate tobacco use among adolescents aged 13–15 years.Smoking status was categorized into two groups:ex-smokers,who successfully stop,and current smokers with cessation attempts.Prevalence is presented as weighted rates with 95%confidence intervals(CIs).Factors influencing smoking cessation attempts and success were assessed using adjusted odds ratios(aORs)with 95%CIs.Results Totally 9.96%of adolescents worldwide were classified as ex-smokers(95%CI 9.30%–10.63%),while 7.29%were current smokers with cessation attempts(95%CI 6.51%–8.06%).The prevalence of ex-smokers was highest in settings where primary care facilities provide tobacco-dependence treatment.The highest prevalence of current smokers with cessation attempts was observed in community-based settings.Education in schools has been shown to be associated with both smoking cessation attempts[aOR,1.44(95%CI 1.36−1.53)]and success[aOR,1.16(95%CI 1.10−1.22)].Individuals who successfully stop smoking had lower secondhand smoke exposure than current smokers,while smokers with cessation attempts experienced higher exposure than smokers without such attempts.Conclusions The prevalence of ex-smokers and current smokers with cessation attempts remains low.School-based educational programs have proven effective in promoting smoking cessation attempts and reducing exposure to secondhand smoke is essential for successful stop.
基金supported by the National Research Foundation of Korea grant funded by the Korea government(MSIT,RS-2023-00248157)The funding agencies had no role in the design and conduct of the study+2 种基金collection,management,analysis,or interpretation of the datapreparation,review,or approval of the manuscriptor the decision to submit the manuscript for publication.
文摘Background The coronavirus disease 2019(COVID-19)pandemic,a global health crisis,profoundly impacted all aspects of daily life.Adolescence,a pivotal stage of psychological and social development,is heavily influenced by the psychosocial and socio-cultural context.Hence,it is imperative to thoroughly understand the psychosocial changes adolescents experienced during the pandemic and implement effective management initiatives.Data sources We examined the incidence rates of depressive and anxiety disorders among adolescents aged 10–19 years globally and regionally.We utilized data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2021 to compare pre-pandemic(2018–2019)and pandemic(2020–2021)periods.Our investigation covered 204 countries and territories across the six World Health Organization regions.We conducted a comprehensive literature search using databases including PubMed/MEDLINE,Scopus,and Google Scholar,employing search terms such as“psychosocial”,“adolescent”,“youth”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”.Results During the pandemic,the mental health outcomes of adolescents deteriorated,particularly in terms of depressive and anxiety disorders.According to GBD 2021,the incidence rate of anxiety disorders increased from 720.26[95%uncertainty intervals(UI)=548.90–929.19]before the COVID-19 pandemic(2018–2019)to 880.87 per 100,000 people(95%UI=670.43–1132.58)during the COVID-19 pandemic(2020–2021).Similarly,the incidence rate of major depressive disorder increased from 2333.91(95%UI=1626.92–3138.55)before the COVID-19 pandemic to 3030.49 per 100,000 people(95%UI=2096.73–4077.73)during the COVID-19 pandemic.This worsening was notably pronounced in high-income countries(HICs).Rapid environmental changes,including heightened social anxiety,school closures,economic crises,and exacerbated racism,have been shown to adversely affect the mental well-being of adolescents.Conclusions The abrupt shift to remote learning and the absence of in-person social interactions heightened feelings of loneliness,anxiety,sadness,and stress among adolescents.This change magnified existing socioeconomic disparities,posing additional challenges.These complexities profoundly impact adolescents’well-being,especially vulnerable groups like those from HICs,females,and minorities.Acknowledging the underreporting bias in low-to middle-income countries highlights the importance of addressing these mental health alterations in assessments and interventions within these regions as well.Urgent interventions are crucial as the pandemic-induced mental stress may have lasting effects on adolescents’mental health.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean government(MSIT,RS-2023-00248157).The funding agencies had no role in the design and conduct of the study,collection,management,analysis,or interpretation of the data,preparation,review,or approval of the manuscript,or the decision to submit the manuscript for publication.
文摘Background Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years.Familial,social,psychological,and behavioral factors play important roles in suicide risk.As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people,there is a need to understand the current status of suicide in adolescents,including its epidemiology,associated factors,the influence of the pandemic,and management initiatives.Data sources We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019.The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization(WHO)regions.Additionally,we utilized electronic databases,including PubMed/MEDLINE and Scopus,and employed various combinations of terms such as“suicide”,“adolescents”,“youth”,“children”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”to provide a narrative review on suicide within the pediatric population in the post-pandemic era.Results Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019,it remains high.The mortality rates from suicide by firearms or any other specified means were both greater in males.Additionally,Southeast Asia had the highest suicide rate among the six WHO regions.The COVID-19 pandemic seems to contribute to suicide risk in young people;thus,there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic.Conclusions The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic,risk factors,and intervention strategies.Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era,further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era.It is necessary to identify effective prevention strategies targeting young people,particularly those at high risk,and successful treatment for individuals already manifesting suicidal behaviors.Care for suicidal children and adolescents should be improved with parental,school,community,and clinical involvement.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT,RS-2023-00248157)。
文摘Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors.PubMed/MEDLINE,Embase,EBSCO,and Google Scholar were searched from inception until January 18,2023.Data extraction,quality assessment,and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines.According to observational evidence,credibility was graded and classified by class and quality of evidence(CE;convincing,highly suggestive,suggestive,weak,or not significant).Our study protocol was registered with PROSPERO(CRD42023458696).The risk and protective factors related to SIDS are presented as equivalent odds ratios(eORs).Results We identified eight original meta-analyses,including 152 original articles,covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents.Several risk factors,including prenatal drug exposure[eOR=7.84(95%CI=4.81–12.79),CE=highly suggestive],prenatal opioid exposure[9.55(95%CI=4.87–18.72),CE=suggestive],prenatal methadone exposure[9.52(95%CI=3.34–27.10),CE=weak],prenatal cocaine exposure[4.38(95%CI=1.95–9.86),CE=weak],prenatal maternal smoking[2.25(95%CI=1.95–2.60),CE=highly suggestive],postnatal maternal smoking[1.97(95%CI=1.75–2.22),CE=weak],bed sharing[2.89(95%CI=1.81–4.60),CE=weak],and infants found with heads covered by bedclothes after last sleep[11.01(95%CI=5.40–22.45),CE=suggestive],were identified.On the other hand,three protective factors,namely,breastfeeding[0.57(95%CI=0.39–0.83),CE=non-significant],supine sleeping position[0.48(95%CI=0.37–0.63),CE=suggestive],and pacifier use[0.44(95%CI=0.30–0.65),CE=weak],were also identified.Conclusions Based on the evidence,we propose several risk and protective factors for SIDS.This study suggests the need for further studies on SIDS-related factors supported by weak credibility,no association,or a lack of adequate research.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean Government(MSIT,RS-2023-00248157)the MSIT(Ministry of Science and ICT),Korea,under the ITRC(Information Technology Research Center)support program(IITP-2024-RS-2024-00438239)supervised by the IITP(Institute for Information&Communications Technology Planning&Evaluation).
文摘Background Researches on the mental health of Korean adolescents during COVID-19 have largely focused on those from monocultural families,but there is limited data on sadness,suicidal ideation,and suicide attempts in multicultural adolescents.Methods This nationwide serial cross-sectional study included 688,708 adolescents aged 12–18 years who participated in the Korean Youth Risk Behavior Web-based Survey from 2011 to 2022.We compared and analyzed the prevalence of sadness,suicidal ideation,and suicide attempts among multicultural and monocultural adolescents.Multicultural adolescents were defined as those with at least one non-Korean parent.Results In 2021,the prevalence of sadness among multicultural adolescents was 31.86%[95%confidence interval(CI)30.00–33.71],suicidal ideation 17.17%(15.74–18.61),and suicide attempts 4.25%(3.51–4.99).Among monocultural adolescents,the prevalence rates were 26.09%(25.50–26.69)for sadness,12.41%(11.97–12.85)for suicidal ideation,and 1.92%(1.76–2.67)for suicide attempts.Adolescents from multicultural backgrounds were found to have higher rates of sadness,suicidal ideation,and suicide attempts.In the general population,these rates had decreased during the pre-pandemic period but increased after the onset of the pandemic then stabilized from 2020 to 2021.Female gender,smoking,alcohol use,and low school performance emerged as significant risk factors.However,no distinct risk factors specifically linked to suicide attempts were identified.Joinpoint regression analysis results aligned with the beta slope values in the main findings,reflecting a consistent pattern across both analyses.Conclusions This study revealed that sadness,suicidal ideation,and suicide attempts increased during the pandemic,reversing a pre-pandemic decline.Multicultural adolescents faced these issues more than monocultural ones,underlining the need for targeted public health measures to support at-risk adolescents during pandemics.
