Association between Body Mass Index and Externalizing and Internalizing Symptoms among Chinese Adolescents: Mediating Role of Traditional Bullying and Cyberbullying Victimization.

BACKGROUND: Externalizing problems, internalizing problems, and obesity are among the greatest challenges to adolescent health. However, the moderating and mediating mechanisms that underlie this association remain predominantly unexplored. OBJECTIVES: In this study, we examined the association between body mass index (BMI) and externalizing and internalizing scores in adolescents, tested whether traditional bullying and cyberbullying mediated the association, and explored the moderated role of sex. METHODS: The data came from 1486 adolescents from grade 7, 8, and 10 living in Shantou, China. Information on BMI, traditional bullying, and cyberbullying victimization was obtained through a self-administered questionnaire. The students' externalizing and internalizing scores were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Furthermore, we built two parallel mediation models with sex as a moderating variable. RESULTS: Compared to their peers with normal weight, adolescents with increased BMI reported higher externalizing and internalizing scores. Traditional bullying and cyberbullying were both significant mediators in the two relationships. Sex moderated the pathway from BMI to cyberbullying. But sex did not moderate the relationship between BMI and traditional bullying. CONCLUSIONS: The results highlight that it is imperative for educators to identify students who are subjected to weight-based bullying and provide them with recommendations for effective coping strategies. Meanwhile, both victims of traditional bullying and those affected by cyberbullying should be the focus of prevention and intervention efforts when developing a strategy to improve levels of internalizing and externalizing symptoms among adolescents with increased BMI.

Does hip protector prevent falls and hip fractures? An umbrella review of meta-analyses.

BACKGROUND: Wearing hip protectors is a measure used to prevent hip fractures caused by falls. However, its protective effect has remained controversial in previous studies. This study provides a rationale for the use of hip protectors by pooling all the current meta-analysis evidence. METHODS: We conducted an umbrella review of all the current meta-analysis articles about the efficacy of hip protectors to reduce hip fractures and falls in communities and/or institutions. Major databases including EMBASE, Cochrane Library, PubMed and Web of Science, were searched up to June 2022. Two reviewers screened the studies, extracted the data, and conducted the methodological quality assessment independently. The primary outcome was the association statistic (odds ratio (OR), relative risk (RR), etc.) reported in the meta-analysis that quantified the influence of the intervention on hip fractures and falls compared to that of the control group. Narrative synthesis was also conducted. Forest plots and the AMSTAR score were used to describe the results and quality of the pooled literature, respectively. RESULTS: A total of six meta-analysis articles were included in the study. Hip protectors were effective at reducing hip fractures in older individuals who were in institutions (nursing or residential care settings) but not in communities (RR = 0.70, 95% CI 0.58 to 0.85, I2 = 42%, P < 0.001) (RR = 1.12, 95% CI 0.94 to 1.34, I2 = 0%, P = 0.20), and they did not reduce falls (RR = 1.01, 95% CI 0.90 to 1.13, I2 = 0%, P = 0.89). CONCLUSIONS: Hip protectors are effective at preventing hip fractures in institutionalized older adults but not in community-dwelling older adults. TRIAL REGISTRATION: This study has been registered in PROSPERO (PROSPERO ID: CRD42022351773).

Did the prevalence of traditional school bullying increase after COVID-19? Evidence from a two-stage cross-sectional study before and during COVID-19 pandemic.

BACKGROUND: COVID-19 has had a range of adverse effects on the behavior and mental health of adolescents globally, including bullying, anxiety and depression. However, there is a lack of comparative studies on the changes of school bullying before and during COVID-19 pandemic. OBJECTIVE: To examine the changes in traditional bullying before and during COVID-19 pandemic and reveal the related risk factors in Shantou, China. PARTICIPANTS AND SETTING: Two samples of secondary school students were collected in 2018 and 2021 in Shantou, respectively. METHODS: Bullying history and risk behaviors of students were measured in the past six months. The χ2 test was used to analyze differences in baseline information and bullying types. The binary logistic regression with Forward LR method was used to analyze factors that affect the risk of bullying victimization and perpetration before and during COVID-19. RESULTS: A total of 5782 secondary school students were included, 3071 before COVID-19 pandemic and 2711 during COVID-19. The prevalence of different types of victimization and perpetration all increased during COVID-19 (P < 0.001). Boarding, being a lower secondary school student (as opposed to upper secondary school), being male (as opposed to female), drinking, and playing violent video games were shared risk factors for bullying victimization and perpetration. Living in an urban (as opposed to rural and island) was a risk factor for perpetration. Smoking was a risk factor for perpetration. All differences were statistically significant (P < 0.05). CONCLUSIONS: We found that the prevalence of bullying victimization as well as perpetration increased during COVID-19. It suggests that we need to pay more attention to traditional school bullying prevention and control in China in the pandemic context.

A Cross-Sectional Survey of Different Types of School Bullying before and during COVID-19 in Shantou City, China.

BACKGROUND: Since the end of 2019, the COVID-19 pandemic has had serious wide-ranging effects on academic, occupational and other daily activities. Like other types of institutions, schools are facing unprecedented challenges. Students may face a variety of adverse consequences, including sleep disturbances and school bullying, if they are unable to adjust to the current learning and living environment. This study explored the effects of the COVID-19 pandemic on school bullying. METHODS: A total of 5782 middle school students were enrolled in this multi-stage, cross-sectional study (3071 before and 2711 during the pandemic). The pre-pandemic group had a mean age of 14.9 ± 1.73, the pandemic group of 14.75 ± 1.47. Three models were set up using binary logistic regression to adjust for confounding variables (gender, school type, alcohol consumption, smoking, playing violent video games). RESULTS: All types of bullying victimization and perpetration (physical, verbal, social and property bullying) were more common during the pandemic than before the pandemic. In terms of bullying victimization, property bullying victimization (crude odds ratio [OR]: 2.398, 95% CI: 2.014-2.854, p < 0.001; model 2 adjusted OR: 2.344, 95% CI: 1.966-2.795, p < 0.001; model 3 adjusted OR: 2.818, 95% CI: 2.292-3.464, p < 0.001) increased the most. In terms of bullying perpetration, verbal bullying perpetration (crude OR: 3.007, 95% CI: 2.448-3.693, p <0.001; model 2 adjusted OR: 2.954, 95% CI: 2.399-3.637, p < 0.001; model 3 adjusted OR:3.345, 95% CI: 2.703-4.139, p < 0.001) increased the most. CONCLUSION: This study corroborate the significance of the pandemic on traditional school bullying and suggests that we should further consider other types of bullying and establish and improve the response and prevention mechanisms during public health emergencies such as the COVID-19 pandemic.