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Wang Y, Mu J, Yang Y, Li X, Qin H, Mulati B, Wang Z, Gong W, Zhao Y, Gao Y. Prevalence and risk factors for astigmatism in 7 to 19-year-old students in Xinjiang, China: a cross-sectional study. BMC Ophthalmol 2024; 24:116. [PMID: 38481203 PMCID: PMC10935971 DOI: 10.1186/s12886-024-03382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND To investigate the prevalence and risk factors for astigmatism in 7-19-year-old students in Xinjiang, China. METHODS A school-based, cross-sectional study was conducted on students who underwent refraction examination in Xinjiang, China, between May and December 2019. The prevalence of astigmatism was determined. Astigmatism was defined as cylinder power (C) ≤-0.75 D, undefined astigmatism as ≤-1.50 D, and high astigmatism as C ≤-3.00 D. Astigmatism types were: against-the-rule astigmatism (maximum refraction of the main meridian in 180° ± 30°), with-the-rule astigmatism (maximum refraction of the main meridian at 90°±30°), and oblique astigmatism (all other cases). RESULTS Of the 71,838 students examined (51.0% boys, 7 - 19 years old), 25,945 (36.1%, 95%CI: 35.52-36.68%) had astigmatism and 1267 (1.8%, 95%CI: 1.07-2.53%) had high astigmatism. The prevalence of astigmatism was greater in Han individuals (39.6%) compared with the Hui (34.0%), Kazakh (34.0%), Kyrgyz (32.1%), and Uyghur (26.4%) populations. Among the 25,945 students with astigmatism, 19,947 had with-the-rule astigmatism (76.9%), 3405 had against-the-rule astigmatism (13.1%), and 2593 had oblique astigmatism (10.0%). Multivariable logistic regression analysis showed that ethnicity (Han individuals more susceptible), male gender, age, and refractive errors (myopia and hyperopia) were independently associated with astigmatism, high astigmatism, and with-the-rule astigmatism (all P < 0.05). CONCLUSIONS The prevalence of astigmatism among children and adolescents in Xinjiang was 36.1%, including 1.8% of high astigmatism. In this population, astigmatism was mainly of the with-the-rule astigmatism type (76.9%). Han ethnicity, male gender, and myopia or hyperopia were independently associated with a high risk of astigmatism.
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Affiliation(s)
- Yan Wang
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Jingyu Mu
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Yining Yang
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Xiaolong Li
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Han Qin
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Batima Mulati
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China
| | - Zhen Wang
- School of Public Health, Xinjiang Medical University, No. 393 Xinyi Road, Xinshi District, Ürümqi, Xinjiang, China
| | - Wei Gong
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Shanghai, China
| | - Yong Zhao
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China.
| | - Yunxian Gao
- Department of Ophthalmology, Traditional Chinese Medicine Hospital of Xinjiang Uyghur Autonomous Regional, No. 116 Huanghe Road, Shayibake District, 830099, Ürümqi, Xinjiang, China.
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Tu K, Shen C, Luo Y, Mo Y, Jian L, Mei X, Zhang Q, Jin L, Qin H. The relationships between screen exposure, parent-child interactions and comprehension in 8-month-old infants: The mediating role of shared viewing and parent-child conversation. PLoS One 2024; 19:e0296356. [PMID: 38165959 PMCID: PMC10760768 DOI: 10.1371/journal.pone.0296356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
OBJECTIVE To explore the relationships between screen exposure, parent-child interactions and comprehension in 8-month-old infants, and to examine whether shared viewing and parent-child conversation during screen exposure may play mediating role in that relationships. METHODS The sample included 437 infants aged 8 months from the Children's Health Department of Guiyang Maternal and Child Health Hospital during January 2022 to February 2023. The use of electronic screen devices was assessed using a screen exposure questionnaire. The Brigance Parent-child interactions Scale was used to assess parent-child interactions and the Putonghua Communicative Development Inventory (PCDI) scale was used to assess infants' word comprehension. RESULTS 48.7% of infants were found to be using screens 1-2 days per week. There was a significant difference (p < 0.05) in the PCDI-comprehension scores of screen-exposed infants compared to non-screen-exposed infants. Shared viewing and parent-child conversation during screen exposure were positively associated with parent-child interactions (p < 0.05). Mediation analysis revealed that parent-child conversation fully mediated between screen exposure and PCDI-comprehension, but partially mediated between parent-child interactions and PCDI-comprehension. CONCLUSIONS Shared viewing and parent-child conversation during screen exposure may mediate between screen exposure and comprehension development. Shared viewing, parent-child conversation and parent-child interactions may be protective factors for screen exposure in comprehension development. Suggests that parents should accompany and communicate with their children when they use electronic screen devices to reduce the negative impact of screen exposure on children's comprehension.
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Affiliation(s)
- Kexin Tu
- College of Medical Humanities, Guizhou Medical University, Guiyang, Guizhou, China
| | - Chengwei Shen
- Department of Child Health Care, Guiyang Maternal and Child Health Care Hospital, Guiyang, Guizhou, China
| | - Yan Luo
- College of Medical Humanities, Guizhou Medical University, Guiyang, Guizhou, China
- Department of Child Health Care, Guiyang Maternal and Child Health Care Hospital, Guiyang, Guizhou, China
| | - Yushi Mo
- Department of Child Health Care, Guiyang Maternal and Child Health Care Hospital, Guiyang, Guizhou, China
| | - Lanying Jian
- College of Public Health, Guizhou Medical University, Guiyang, Guizhou, China
| | - Xinjie Mei
- College of Medical Humanities, Guizhou Medical University, Guiyang, Guizhou, China
| | - Qiong Zhang
- College of Public Health, Guizhou Medical University, Guiyang, Guizhou, China
| | - Lifang Jin
- College of Medical Humanities, Guizhou Medical University, Guiyang, Guizhou, China
| | - Huiling Qin
- College of Public Health, Guizhou Medical University, Guiyang, Guizhou, China
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Rodriguez NM, Acevedo A, Torres VP, Romero AF. Refractive Error Changes Due to COVID-19 Pandemic Confinement in Children from Puerto Rico: A Retrospective Study. Optom Vis Sci 2023; 100:638-644. [PMID: 37585748 DOI: 10.1097/opx.0000000000002055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
SIGNIFICANCE The progression of myopia increased in children after the pandemic confinement. A myopic shift in the refractive error of the Hispanic population was found regardless of the refractive status of the school-aged children studied. PURPOSE This study aimed to evaluate the refractive error in Puerto Rican children before and after the COVID-19 pandemic. We were interested in whether there was a significant change in refractive error attributed to online learning during the pandemic lockdown. METHODS A retrospective record review of children aged 7 to 18 years who underwent a comprehensive visual evaluation between 2018 and 2021 at the Inter American Eye Institute in Puerto Rico was performed. The spherical equivalent pre- and post-lockdown was compared. The study excluded the best-corrected visual acuities worse than 20/40, any corneal or retinal disease, and amblyopia. RESULTS In total, 801 records were included in this study. The mean age was 12.7 ± 3.2 years, with 50.3% male and 49.7% female children. The mean spherical equivalent for the right and left eyes was similar ( r = 0.93, P ≤ .001). A significant difference in the mean spherical equivalent was found pre- and post- lockdown (0.22 ± 0.59 D, t800 = 10.44, P ≤ .001). A myopic shift post-lockdown was significant for all ages except those in the 7- (0.13 ± 0.79 D, t28 = 0.84, P = .40) and 8-year-old range (0.12 ± 0.65 D, t40 = 1.22, P = .23), respectively. No significant change was found between sexes before (0.16 ± 0.12 D; t799 = 1.38, P = .16) and after (0.15 ± 0.13 D; t799 = 1.19, P = .23) confinement. CONCLUSIONS The current study revealed a significant myopic shift in Hispanic school-aged children as a result of the pandemic confinement.
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Affiliation(s)
| | - Ariette Acevedo
- Inter American University of Puerto Rico School of Optometry, Bayamon, Puerto Rico
| | | | - Angel F Romero
- Inter American University of Puerto Rico School of Optometry, Bayamon, Puerto Rico
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Abdulla F, Hossain MM, Huq MN, Hai A, Rahman A, Kabir R, Peya FJ, Islam S, Khan HTA. Prevalence, determinants and consequences of problematic smartphone use among preschoolers (3-5 years) from Dhaka, Bangladesh: A cross-sectional investigation. J Affect Disord 2023; 329:413-427. [PMID: 36858268 DOI: 10.1016/j.jad.2023.02.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/01/2023] [Accepted: 02/20/2023] [Indexed: 03/03/2023]
Abstract
The problematic smartphone use (PSU) has been becoming a challenging health issue for preschoolers aged 3-5 years as it has severe adverse effect on their psychological, physical, and cognitive development. The scarcity of scientific research on this issue in the context of Bangladesh motivated the authors for conducting this cross-sectional study to explore the prevalence of PSU with its influential factors and adverse effects on preschooler's psychological and physical development based on primary data collected from 400 mothers. The multivariable ordinal logistic regression (OLR) was used to compute the adjusted likelihoods. The estimated prevalence of PSU was approximately 86 %, where about 29 % were severely problematic user. The likelihood of preschoolers' PSU was observed to increase with >1 h/day usage of smartphone by children (Adjusted Odds Ratio (AOR): 3.92). Other important factors were parental smartphone use, education, profession, family income, and mother's age. Both of moderate and severe PSU had adverse effect on preschoolers' health- severe PSU was found to increase the likelihood of psychological and physical problems by 6.03 and 3.29 times, respectively. The preschoolers with PSU reported to suffer from many physical and mental health problems such as attention deficit and hyperactivity disorder (ADHD), emotional instability, aggressiveness, depression, lack of control, impaired vision and hearing, obesity, body imbalance, and lack of brain development. It is now prime time to undertake strategic policies considering the findings for limiting the preschoolers' usage of smartphone, which will make Bangladesh susceptible to protect its future generation from harmful effects of PSU.
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Affiliation(s)
- Faruq Abdulla
- Department of Applied Health and Nutrition, RTM Al-Kabir Technical University, Sylhet 3100, Bangladesh.
| | - Md Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; School of Mathematics, Statistics & Physics, Newcastle University, Newcastle upon Tyne, UK.
| | - Mohammed Nazmul Huq
- Department of Statistics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh.
| | - Abdul Hai
- Department of Software Engineering, Faculty of Computer Science and Information Technology, Sichuan University, Chengdu, China.
| | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga NSW-2678, Australia.
| | - Russell Kabir
- Department for Allied and Public Health, Faculty of Medical Sciences, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ, UK.
| | - Farhana Jahan Peya
- Research, Training and Management (RTM) International, Mirpur, Dhaka 1216, Bangladesh.
| | - Sinigdha Islam
- Department of Political Science and Sociology, Faculty of Public Administration Concentration in Public and Community Health, Murray State University, Murray, KY, USA.
| | - Hafiz T A Khan
- Public Health & Statistics, College of Nursing, Midwifery and Healthcare, University of West London, Brentford, UK.
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Yang Z, Lu Z, Shen Y, Chu T, Pan X, Wang C, Wang J. Prevalence of and factors associated with astigmatism in preschool children in Wuxi City, China. BMC Ophthalmol 2022; 22:146. [PMID: 35365119 PMCID: PMC8976382 DOI: 10.1186/s12886-022-02358-2] [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: 07/26/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To investigate the status of astigmatism in preschool children in Wuxi City, and explore the risk factors related to astigmatism. The risk factors related to astigmatism development as predictors can help us identify preschool children who need vision screening at an early stage to ensure good visual quality. METHODS The cross-sectional study was conducted in 10 kindergartens randomly selected in five districts of Wuxi City in November 2018. All preschool children were measured by objective refractometry under non-cycloplegic refraction. The basic information of preschool children was collected. The relevant factors of astigmatism in the questionnaire were completed by parents. Spss 26. 0 software was used for univariate and multivariate correlation analysis. RESULTS A total of 889 preschool children participated in the study, 864 were finally included in the study. The prevalence of astigmatism was 36.0%. The risk of astigmatism in premature children was higher than that in non-premature children (adjusted odds ratio = 1.841). The prevalence of astigmatism with parents' astigmatism history was higher, compared with preschool children without parents' astigmatism history (adjusted odds ratio = 2.037). When maternal age at childbirth was older (≥ 35 years old), the risk of astigmatism increased in preschool children (adjusted odds ratio = 2.181). Compared with bottle feeding, the risk of astigmatism for mixed feeding and breastfeeding reduced in preschool children. Compared with preschool children exposed to electronic screen for less than 2 h every day, preschool children exposed to electronic screen for more than 2 h had an increased risk of astigmatism (P = 0.004). CONCLUSION The prevalence of astigmatism among preschool children in Wuxi City was high. Some risk factors such as premature birth, parents' astigmatism history, maternal age at childbirth, feeding pattern, and electronic screen exposure time were closely related to the occurrence of astigmatism among preschool children. For preschool children with significant risk factors, their eyesight should be checked regularly to ensure their visual quality.
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Affiliation(s)
- Zhihui Yang
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Zijing Lu
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Yihui Shen
- Nursing Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Ting Chu
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Xubin Pan
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Cun Wang
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Jihong Wang
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China.
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Huo L, Qi Y, Zhao S. Refractive errors and risk factors for myopia in infants aged 1-18 months in Tianjin, China. BMC Ophthalmol 2021; 21:403. [PMID: 34814873 PMCID: PMC8609796 DOI: 10.1186/s12886-021-02172-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/06/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Infancy is the of a child's visual development. Refractive errors, especially myopia, are a common vision disorder. Thus, the purpose of this study was to explore refractive errors and risk factors for myopia among infants aged 1-18 months in Tianjin, China. METHODS A total of 583 infants aged 1-18 months participated in this cross-sectional study at Tianjin Women's and Children's Health Center in China from February 2019 to November 2020. Each infant received a complete ophthalmologic examination, and myopia-related risk factors were investigated using a questionnaire. RESULTS A total of 583 eligible infants participated in this study, including 312 (53.5%) boys and 271 (46.5%) girls. There were 164 (28.1%) premature born infants. The mean age was 6.59 ± 4.84 months (range, 1-18 months). The mean spherical equivalent (MSE) for the right eye was 1.81 D ± 1.56 D, with no difference related to sex (P = 0.104). Refractive state showed an average hyperopia of +2.74 ± 1.74 D at early ages, followed by a trend toward less hyperopia, finally reaching +1.35 ± 1.44 D at the age of 18 months (P ≤0.001). The overall prevalence rates of myopia (MSE ≤ -0.50 D), emmetropia (-0.50 D<MSE<+0.50 D), hyperopia (MSE ≥ +2.00 D), and astigmatism (≥ 1.50 D) were 5.1%, 10.8%, 42.7%, and 49.9%, respectively. The chi-square tests showed that gender, gestational age ≥37 weeks, winter birth, prenatal exposure to environmental tobacco smoke, and parental history of high myopia were associated with children's myopia (P = 0.022, P = 0.023, P = 0.038, P = 0.015, P<0.001, respectively). CONCLUSIONS Among Chinese infants in Tianjin, hyperopia and astigmatism were the most frequent refractive errors, and the diopter was lower in individuals with higher age. In a small number of infants with myopia, genetic factors and the prenatal environment were associated with the early onset of myopia.
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Affiliation(s)
- Lu Huo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.,Tianjin Women's and Children's Health Center, Tianjin, China
| | - Yuanyuan Qi
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Shaozhen Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Barros VFDS, Oliveira RADSGD, Maia RB, Fernandes N, Almodin EM. Effects of the excessive use of electronic screens on vision and emotional state. REVISTA BRASILEIRA DE OFTALMOLOGIA 2021. [DOI: 10.37039/1982.8551.20210046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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Huang L, Schmid KL, Yin XN, Zhang J, Wu J, Yang G, Ruan ZL, Jiang XQ, Wu CA, Chen WQ. Combination Effect of Outdoor Activity and Screen Exposure on Risk of Preschool Myopia: Findings From Longhua Child Cohort Study. Front Public Health 2021; 9:607911. [PMID: 33748061 PMCID: PMC7973103 DOI: 10.3389/fpubh.2021.607911] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/01/2021] [Indexed: 01/12/2023] Open
Abstract
Evidence regarding screen use and outdoor activity during very early childhood (i. e., from aged 1 to 3 years) and their potential combined links to the later preschool myopia is limited. This information is needed to release effective public health messages and propose intervention strategies against preschool myopia. We collected information regarding very early childhood screen use, outdoor activity and the kindergartens vision screenings of 26,611 preschoolers from Longhua Child Cohort Study by questionnaires. Logistic regression models were used to examine the associations between reported outdoor activity, screen use from 1 to 3 years of age, and preschool myopia. Throughout very early childhood, from 1 to 3 years, the proportion of children exposed to screens increased (from 35.8 to 68.4%, p < 0.001), whereas the proportion of children who went outdoors ≥7 times/week (67.4–62.1%, p < 0.001) and who went outdoors for ≥60 min/time (53.3–38.0%, p < 0.001) declined. Exposure to fixed screen devices [adjusted odds ratio (AOR) = 2.66, 95% confidence interval (CI) = 2.09–3.44], mobile screen devices (AOR = 2.76, 95% CI = 2.15–3.58), and limited outdoor activity (AOR = 1.87, 95% CI = 1.42–2.51) during early childhood were associated with preschool myopia. Among children whose parents were myopic, the interactions between outdoor activity and fixed or mobile screen use on later preschool myopia were significant; the ORs and 95% CI were 3.34 (1.19–9.98) and 3.04 (1.06–9.21), respectively. Our findings suggest the possibility that the impact of screen exposure during early childhood on preschool myopia could be diminished by outdoor activity for children whose parents have myopia.
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Affiliation(s)
- Lihua Huang
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Katrina L Schmid
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Xiao-Na Yin
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Jingyu Zhang
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Jianbo Wu
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Guiyou Yang
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zeng-Liang Ruan
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Qin Jiang
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Chuan-An Wu
- Longhua District Maternal and Child Health Hospital, Shenzhen, China
| | - Wei-Qing Chen
- Department of Medical Statistics and Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou, China
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Chen JY, Strodl E, Huang LH, Chen YJ, Yang GY, Chen WQ. Early Electronic Screen Exposure and Autistic-Like Behaviors among Preschoolers: The Mediating Role of Caregiver-Child Interaction, Sleep Duration and Outdoor Activities. CHILDREN-BASEL 2020; 7:children7110200. [PMID: 33126543 PMCID: PMC7692375 DOI: 10.3390/children7110200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/22/2020] [Accepted: 10/24/2020] [Indexed: 12/17/2022]
Abstract
Research into early screen exposure has raised growing concerns about its impact upon children’s neuropsychological well-being. However, possible pathways remain unclear. This study therefore aimed not only to evaluate the association between screen exposure during the ages of 0–3 years and preschoolers’ autistic-like behaviors, but also the mediating roles of the frequency of caregiver-child interaction, sleep duration and level of participation in outdoor activities. Based on the 2017 survey of the Longhua Child Cohort Study, data of 29,595 child-caregiver dyads were obtained via a caregiver-reported questionnaire, with the data from 29,461 dyads included in the data analysis. Multiple linear and logistic regression models were employed to estimate the associations between screen exposure, caregiver-child interaction, sleep duration, outdoor activities, and children’s autistic-like behaviors. The results indicated that screen exposure during 0–3 years of age was associated with the presence of autistic-like behaviors at preschool age, and the strength of the association was enhanced with the increase of average daily screen time (Odds Ratios (ORs) ranging from 1.358 to 4.026). The frequency of caregiver-child interaction and sleep duration mediated 5.32% and 1.19% of the variance of the association respectively, but outdoor activities did not mediate the association. Our findings indicate that preschoolers who are exposed to screens at aged 0–3 years might have an increased risk of autistic-like behaviors, and that, the frequency of caregiver-child interaction and sleep duration might function as potential mediators of this association.
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Affiliation(s)
- Jing-Yi Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane 4059, Queensland, Australia;
| | - Li-Hua Huang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Ying-Jie Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Gui-You Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Wei-Qing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
- Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou 510080, China
- Correspondence: ; Tel.: +86-20-87332199; Fax: +86-20-87330446
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