Background: 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. Methods: 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. Results: 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. Conclusions: 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.

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.

Objective This study aimed to examine gender differences in smoking and alcohol drinking behaviors in three Asian cities of Hanoi, Shanghai, and Taipei, and to assess the magnitude of gender differences across the three cities. Methods A total of 17,016 adolescents (age: 15–19 years) and young adults (age: 20–24 years) were selected using multi-stage sampling methods and surveyed in face-to-face interviews. A total of 16,554 unmarried respondents were included in this analysis. Results Gender differences were significant for smoking only, drinking only, and both behaviors in each city. Male respondents were 30.66 times more likely to report smoking only than female respondents in Hanoi, followed by Shanghai and Taipei. This pattern was similar for drinking only and both smoking and drinking behaviors. Conclusions The magnitude of gender differences in smoking only, drinking only, and both behaviors widely varies across the three cities. Further research can examine how these differences may be used to prevent and reduce smoking and drinking in the adolescent and young adult population.

The study aims to explore gender differences in smoking and drinking in three Asian cities—Hanoi, Shanghai and Taipei, and assesses the magnitude of these gender differences across cities. A total of 17,016 adolescents and young adults, aged 15 to 24 years, residing in both urban and rural area of Hanoi, Shanghai and Taipei were selected by multistage sampling methods and surveyed by face to face interview. The gender differences are significant for smoking-only, drinking-only, and both behaviors in each city. With respect to smoking-only, males are more than 30.66 times as likely to report it compared with females in Hanoi, followed by Shanghai and Taipei. The above trend holds true when further examining drinking-only and both smoking and drinking. The magnitude of gender differences in smoking-only, drinking-only, and both behaviors widely vary across the three cities. Future research is needed to further examine the mechanisms behind these gender differences and how these differences may be utilized to prevent and reduce smoking and drinking in the adolescent and young adult population.

Objective To explore effect on family-related factors influencing premarital sex of adolescents Methods We chose unmarried adolescents aged 15 to 24 among communities in Shanghai city through multi-staged stratified cluster sam-pling. Results The prevalence of sex behavior among unmarried adolescent of Shanghai was 12. 7%,including 16. 8% for male and 8. 7% for female. According to the results of the Cox model analysis,we learn that the sex behavior of unmarried adolescent were associated with family-related factors such as sex,education,family economy,family sex-information score,children sup-port for parents score,'parents ask children to go home on time or not' and'asking for help to parents when facing difficulties or not' . Conclusion Premarital sex of adolescents was greatly influenced by family-related factors. Parents should timely and contrapuntally provide sex knowledge and sex education for their children.

Bisphenol A (BPA) is an estrogenic environmental toxin widely used in the production of plastics and ubiquitous human exposure to this chemical has been proposed to be a potential risk to human health. Exposure to BPA can negatively impact sperm quality. However, the mechanism remains largely unknown. The objectives of this study were to assess the role of BPA on sperm quality and explore the possible mechanisms. The Wistar male rats (aged 28 days) were administered BPA by oral gavage for 28 days at dose of 50, 100 and 200 mg/kg/day; meanwhile, the negative control with corn oil (0 mg/kg/day BPA) and positive control with E2 at the dose of 100 mu g/kg/day. The sperm density, sperm activity and sperm survival rate were analyzed byCASA system, and the sperm abnormality rate was analyzed by improved Papanicolaou stained. The protein expression levels of Src/p-Src, ERK1/2, p-ERK1/2 and CREB/p-CREB were detected by Western bolt. The results showed that the body weight gain, testes weight, testis coefficient, sperm density, sperm activity, sperm survival rate and protein expression levels of p-ERK1, p-ERK2 and p-CREB decreased, but the sperm abnormality rate increased with increasing BPA concentrations. There were positive correlations between sperm density, sperm activity and sperm survival rate with protein expression levels of p-ERK1, p-ERK2 and p-CREB, and negative correlations between sperm abnormality rate with the protein expression levels of p-ERK1, p-ERK2 and p-CREB. Results from the structural equation model demonstrated that BPA retained a significant negative effect to p-ERK, whereas p-ERK retained a significant positive effect to sperm quality and acted as the mediate variable. This study provides a novel insight regarding the potential role of p-ERK1 and p-ERK2 protein kinase on reproductive toxicity of BPA. The adverse effects of BPA on adult male sperm quality may be through the induction of the disruption of ERK signal pathway. However, additional research is needed to confirm our findings and to further test the suggested potential mechanisms.

We examined patterns of sexual behaviors of unmarried adolescents and youth (UAY) in three Asian cities (Shanghai, Taipei, and Hanoi) and identified factors related to the timing of initial sexual experience. From analysis of a sample of 16,554 UAY aged 15-24 years recruited from Shanghai, Taipei, and Hanoi plus data collected from face-to-face interviews complemented by computer-assisted self-interviews for intimate questions, we learned: UAY in Shanghai, Taipei, and Hanoi have different sexual behaviors. Affluent economic status increases the likelihood of early initial sexual experiences. Higher educational attainment may delay initial intercourse. Compared with Shanghai UAY, study participants from Taipei and Hanoi were 3.64 times and 0.33 times as likely to participate intercourse. These data can provide a basis for developing effective government policies and social interventions.

目的 探讨母亲妊娠期因素和围生期因素与子女青少年期血压之间的关系.方法 对1993-1995年无锡市建立的出生队列于2011-2013年(青少年期)进行随访,开展问卷调查、身高、体重和血压的测量,采用x2检验、多元线性回归分析、多因素二项式回归等统计方法进行数据分析.结果 共随访到年龄16 ～18岁之间的青少年2 256人.调整性别、青少年期年龄、青少年期超重或肥胖、青少年期生活行为因素,将母亲妊娠期和围生期相关变量纳入多因素模型,结果显示:母亲产时有妊高症的对象,青少年期的收缩压和舒张压升高,"血压升高比例"增加(RR=1.54,95％ CI: 1.26 ～ 1.90);随着出生身长的增加,青少年的收缩压升高.结论 母亲产时妊高症是子女青少年期血压升高的危险因素,应采取一定的措施,控制妊高症的发生.

Cadmium (Cd) is a heavy metal with toxicant to reproductive functions. The aim of this study was to explore the effects of environmental exposure to Cd on human semen quality. A total of 587 men from the general population, aged from 20 to 59 years old, and without occupational exposure to Cd were recruited from three provinces in China to participate in the study. The median of serum Cd was 1.9 μg/L (P25-P75:1.1-2.9). In case Cd was less than or equal to 6.3 μg/L (P95) and the semen parameters were logarithmically transformed, the inverse associations between Cd and semen volume (-0.03 ± 0.007), progressive motility (-0.01 ± 0.004), and sperm morphology (-0.04 ± 0.004) were found across the whole group, after adjusting for age group, occupation, season of semen sample collection, abstinence intervals, smoking, alcohol drinking, and body mass index. Our findings indicate that higher Cd may reduce the semen volume, progressive motility, and morphology among men without occupational exposure to Cd.

STUDY QUESTION Is it necessary to collect more than one semen sample from each individual in epidemiological studies? SUMMARY ANSWER Single semen samples can be used in model construction as long as the model adjusts for major relevant covariates. WHAT IS KNOWN ALREADY If a series of semen samples are taken from one individual at different times, significant intra-individual variation may exist. STUDY DESIGN, SIZE, DURATION A population-based cross-sectional study was conducted from 1 December 2000 to 20 November 2002. A total of 1010 volunteers, aged between 20 and 60 years old, were recruited. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 998 subjects were included for statistical analysis. Of these, 332 men provided single semen samples (group 1) and 666 men provided two samples (group 2). Semen parameters, including semen volume, sperm concentration, total sperm number, progressive motility, vitality, and sperm morphology, were analyzed with standardized methods according to the World Health Organization (WHO) laboratory manual for the examination of human semen and sperm-cervical mucus interaction (3rd edition). MAIN RESULTS AND THE ROLE OF CHANCE Rapidly progressive motility of semen from group 1 was lower than that of group 2, but other parameters were not significantly different. The differences in mean values between the double samples were small on all semen parameters. The correlations between the two ejaculates were high, but the agreements were poor except for sperm vitality and normal morphology. Model selection and validation analysis supported the premise that the regression model from the first samples was applicable for the second samples. The large sample size with extensive quality control provides robust parameter estimation and promises good applicability for model selection and validation. LIMITATIONS, REASONS FOR CAUTION The results are valid for healthy men in China, not for subfertile or infertile men. WIDER IMPLICATIONS OF THE FINDINGS The overall semen quality of a given group of healthy men will not vary significantly in the short term. Single semen samples can be used in model building as long as major relevant covariates are considered. Utilizing multiple semen donations may actually cause the samples to be less representative. STUDY FUNDING/COMPETING INTERESTS This research was supported by a grant from Shanghai Science and Technical Committee (02DJ14053) and a grant from Ministry of Science and Technology, China (9902). All authors have no competing interests.

To evaluate the knowledge level of emergency contraception, explore the determinants of the knowledge level among women seeking abortion and give sugges- tions on how to improve the quality of emergency contraception service. Method A total of 606 women requiring abortion at three MCHs in Shanghai City were interviewed face to face with structured questionnaire. Results 63. 7% of unwanted pregnancy could use EC to prevent. Subjects got their knowledge on EC mainly from books/newspapers/magazines and relatives/friends/ parents. The proportion of the awareness of EC was 28.5%. Most subjects were aware of hormonal EC pill, but only 14.9% of them knew that the pill should be taken within 72 hours after the intercourse. Among the subjects who were aware of EC, the average score of the knowledge was lower than half of the full marks. The lower the subjectu0027s educational level was, the less likely they were aware of EC and the lower score of the knowledge of EC they had. The score of the knowledge of EC was higher among subjects who learned of EC mainly from family planning publicity. Conclusion It is urgent to popularize EC in order to reduce unwanted pregnancy and induced abortion. The information, including EC can be used in which situations, itu0027s advantages and disadvantages as well as indication, should be given to women in an appropriate way and using plain language. The departments of family planning should play a leading role in improving womenu0027s knowledge of EC.

BACKGROUND:Bisphenol A (BPA) is a suspected human endocrine disruptor which is widely used. METHODS:In order to determine whether urine BPA level is associated with serum reproductive hormone levels among male adults, we carried out a cross-sectional study in China. We recruited 592 male workers and collected their urine samples for BPA measurement. We also collected blood samples and examined serum reproductive hormones. We used multiple linear regression and log-binomial model to examine associations between urine BPA level and hormone levels after controlling for age and smoking status. RESULTS:An increased urine BPA level was associated with increased prolactin (p<0.001), estradiol (p<0.001), sex hormone-binding globulin level (p=0.001), and a reduced androstenedione (p<0.001) and free androgen index level (p=0.021). Males, whose urine BPA level was in the 2nd, 3rd and highest quartiles, had respectively 1.58, 1.33 and 3.09-fold increased prevalence of having a high prolactin level (>P75 level). The highest quartile of BPA level was associated with 1.63 and 1.50-fold increased prevalence of having a high estradiol and elevated sex hormone-binding globulin level. Males with higher quartile of BPA level had a lower inhibin B level. CONCLUSION:High BPA exposure is associated with increased prolactin, estradiol and sex hormone-binding globulin level in males, and may contribute to male infertility.

Purpose: To assess the prevalence of drunkenness among adolescents in Hanoi, Shanghai, and Taipei and explore the association between heavy drinking and other health risk behaviors.Methods: The data are drawn from the Three-city Collaborative Study of Adolescent Health, conducted in Hanoi, Shanghai, and Taipei in 2006. A sample of 17,016 adolescents and young adults, aged 15-24 years, was selected by multistage sampling. Descriptive analysis was used to estimate the proportion of drunkenness and other health risk behaviors. Multivariate logistic regression was used to investigate relationships between drunkenness and risky health behaviors.Results: The proportions of the sample getting drunk during the past month were 6.36%, 4.53%, and 8.47% in Hanoi, Shanghai, and Taipei, respectively. More males than females reported drunkenness in all three cities, with the difference highest in Hanoi (11.08% vs. 1.14%) and lowest in Taipei (9.69% vs. 7.18%). Different levels of relationship between drunkenness and health risk behaviors, such as anxiety, suicidal ideation, smoking, gambling, fighting, drinking and driving, and having sexual intercourse, were found across the three cities; an exception was nonuse of contraception.Conclusion: Drunkenness was positively associated with many health risk behaviors. It may serve as an indicator of other risky behaviors. Interventions to reduce drinking and drunkenness may contribute considerably to the prevention of other risk behaviors and to adolescent safety and well-being. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

The associations between Bisphenol-A (BPA) exposure and reproductive hormone levels among women are unclear. A cross-sectional study was conducted among female workers from BPA-exposed and unexposed factories in China. Women’s blood samples were collected for assay of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β-Estradiol (E2), prolactin (PRL), and progesterone (PROG). Their urine samples were collected for BPA measurement. In the exposed group, time weighted average exposure to BPA for an 8-h shift (TWA8), a measure incorporating historic exposure level, was generated based on personal air sampling. Multiple linear regression analyses were used to examine linear associations between urine BPA concentration and reproductive hormones after controlling for potential confounders. A total of 106 exposed and 250 unexposed female workers were included in this study. A significant positive association between increased urine BPA concentration and higher PRL and PROG levels were observed. Similar associations were observed after the analysis was carried out separately among the exposed and unexposed workers. In addition, a positive association between urine BPA and E2 was observed among exposed workers with borderline significance, while a statistically significant inverse association between urine BPA and FSH was observed among unexposed group. The results suggest that BPA exposure may lead to alterations in female reproductive hormone levels.

This paper analyzes the situation of knowledge on emergency contraception among 4679 childbearing age female migrants who were involved in the project of present - residence based integrated family planning intervention in Shanghai during 1998. The project aims to getting information about the context and the influence factors of emergency contraception among female migrants and evaluating the effects of the intervention on the improvement of repondents knowledge of emergency contraception. The results indicated that the respondents knew little about emergency contraception. Before the intervention only 3.9% respondents heard about emergency contraception and 28.8% of subjects could correctly answer how to adopt emergency contraception at an appropriate time. The proportion of those who heard about something of emergency contraception in the experiment group elevated from 4.4% to 39.4% after intervention while the proportion rised from 3.4% to 7.0% in the control group. After intervention 68.5% respondents agreed with the generalization of emergency contraception. And the findings showed that 16 respondents using emergency contraception came from the experiment group. Multivariable analysis indicated that some factors such as registered permanent residence education level contraceptive knowledge resource common contraceptive knowledge marks and family planning education may affect the knowledge of emergency contraception. Consequently there is an imperative need to implement family planning education and to provide female migrants with information and service concerning family planning and reproductive health through diverse channels such as TV radio program lecture and so on so that they can take remedy after unprotected sex or failured contraception.

Objective To explore effect of Peer-related factors influencing on premarital sex behaviors among adolescents. Methods Unmarried adolescents aged 15 to 24 among communities in Shanghai City were selected through multistaged stratified cluster sampling. Results The prevalence of sex behavior among unmarried adolescent of Shanghai was12. 7%,including 16. 8% for male and 8. 7% for female. According to the results of COX model analysis,the sex behavior of unmarried adolescent were associated with peer-related factors such as peer sex information( HR = 1. 112,P 0. 01),peer having or not premarital sex behavior( HR = 2. 583,P 0. 01),peer dangerous behaviors( HR = 1. 255,P 0. 01),having sex for catering to peer( HR = 1. 804,P 0. 01),pressure of peer dangerous behaviors( HR = 1. 255,P 0. 01) and the time of lounging with friends( HR = 1. 303,P 0. 01). Conclusion Premarital sex behavior of adolescents was remarkably influenced by peer-related factors. It is important to use peer education for helping adolescents to make healthy decision on sex behavior and to establish correct value orientation.

This study explores the association of child sexual abuse (CSA) with subsequent health risk behaviors among a cross-section of 4354 adolescents and young adults surveyed in urban and rural Taipei. Descriptive analysis and logistic regressions were employed. The overall proportion of CSA was 5.15%, with more females (6.14%) than males (4.16%) likely to experience CSA. CSA was differently associated with multiple adverse health outcomes, after adjusting other factors, such as age, residence, economic status, education, employment status, and household instability. Both males and females with CSA experience were more likely to report drinking, gambling, and suicidal ideation compared with those who had no history of CSA. However, the significant association between CSA and smoking, fighting, and suicidal attempt was not observed among females. Effective interventions are needed to reduce CSA and its adverse effects on adolescent well-being.

目的 探讨母亲妊娠期和围生期因素对儿童血压的影响,为深入探讨妊娠期与围生期相关因素对儿童血压的长期影响机制提供基础数据.方法 对无锡市1993-1995年建立的出生队列于儿童期进行随访,并对其进行身高、体重和血压的测量,采用t检验、多元线性回归分析、多因素Logistic回归等方法进行统计分析.结果 共随访到2 256名年龄在10～13岁的儿童.正常出生体重组儿童的收缩压(SBP)和舒张压(DBP)分别为(100.40± 10.58)、(65.45±8.95)mm-Hg;高出生体重儿童的SBP和DBP分别为(99.81±9.96)、(65.02±8.65) mmHg,差异均无统计学意义(t值分别为1.90,1.33,P值均＞0.05).调整性别、儿童期年龄、儿童期体质量指数(BMI)和生活行为因素,将母亲妊娠期和围生期相关因素纳入多因素模型,结果显示,母亲妊娠时职业为“其他”儿童的儿童期收缩压较低;在正常出生体重组,非第1胎儿童的收缩压较高,儿童收缩压随着出生时身长的增加而增加,母亲产时有妊高症儿童的收缩压较高,且血压升高的风险增加(OR=3.13,95％CI=1.33～ 7.32);在高出生体重组,母亲产时有妊高症儿童的血压较高,血压升高风险也增加(OR=2.96,95％CI=1.44～6.08).结论 母亲产时妊高症是儿童期血压升高的重要危险因素.应采取一定的措施,预防控制孕妇妊娠期血压升高或妊高症的发生.

Cigarette smoking has been found to be more prevalent among adults and youths with a minority sexual orientation (lesbian, gay, bisexual, LGB) than among the general population, while less is known about smoking among LGB youth in low- and middle-income countries. The goal of the study was to examine cigarette smoking in relation to sexual orientation in a community-based sample of youth in Shanghai, China.

OBJECTIVE:To explore the relationship between age at menarche and infertility.STUDY DESIGN:The cross-sectional study investigated 6906 couples from the communities in Sandu Shui Autonomous County of Guizhou Province, China. Face to face interviews were conducted to collect information on age at menarche and time to first pregnancy, as well as demographic characteristics and lifestyle factors. Infertility was defined as being unable to become pregnant after attempting for ≥12 months. Poisson regression was used to assess the relationship between age at menarche and infertility of first attempt.RESULTS:The prevalence rate of infertility for the first pregnancy attempt of the study population was 11.87%. There is an obvious monotonic, almost linear, trend of prevalence rate of infertility with increasing age at menarche (P for trend: <0.001). Compared with wives with age at menarche of 13 years, the prevalence ratios of infertility were 0.71 (95%CI: 0.42, 1.20), 1.33 (95%CI: 1.05, 1.68), 1.47 (95%CI: 1.17, 1.85), 1.57 (95%CI: 1.20, 2.04), 1.41 (95%CI: 1.00, 1.99) and 1.73 (95%CI: 1.18, 2.52) for wives with age at menarche of ≤12, 14, 15, 16, 17 and ≥18 years, respectively, after adjusting for wife's year at birth, age at marriage, ethnic group, education and occupation, and husband's smoking and drinking habits before marriage.CONCLUSIONS:The present community-based study indicated that increasing age at menarche was associated with an increased risk of infertility in the study population.