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Bao WW, Zhao Y, Dadvand P, Jiang N, Chen G, Yang B, Huang W, Xiao X, Liang J, Chen Y, Huang S, Pu X, Huang S, Lin H, Guo Y, Dong G, Chen Y. Urban greenspace and visual acuity in schoolchildren: a large prospective cohort study in China. ENVIRONMENT INTERNATIONAL 2024; 184:108423. [PMID: 38241831 DOI: 10.1016/j.envint.2024.108423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/28/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Greenspace is known to have a positive impact on human health and well-being, but its potential effects on visual acuity have not been extensively studied. OBJECTIVES Our aim was to examine the relationship between long-term greenspace exposure and visual acuity in children, while also exploring the potential mechanisms in this association. METHODS We conducted this prospective cohort study based on the Children's growth environment, lifestyle, physical, and mental health development project (COHERENCE), which screened 286,801 schoolchildren in Guangzhou, China, starting in the 2016/17 academic year and followed them up for three academic years (2017/18-2019/20). Visual acuity was measured using a standardized logarithmic chart, and visual impairment was defined as visual acuity worse than 0.0 logarithm of the minimum angle of resolution (LogMAR) units in the better eye. We used the Normalized Difference Vegetation Index (NDVI), the Soil-Adjusted Vegetation Index (SAVI), and the Enhanced Vegetation Index (EVI) to assess the greenspace surrounding child's geocoded home and school at each visit. RESULTS Our analysis indicated that higher greenspace exposure was associated with greater visual acuity z-score at baseline and with slower decline in visual acuity z-score during the 3-year follow-up. An interquartile range increase in home-school-based NDVI 300m was associated with a 7% decrease [hazard ratios (HRs): 0.93, 95% confidence interval (CI): 0.92, 0.94] in the risk of visual impairment. We also found that air pollution, physical activity, outdoor time, and recreational screen time partially mediated the greenspace-visual acuity association. CONCLUSION Our findings suggest that increasing greenspace exposure could benefit children's visual acuity development and reduce the risk of visual impairment by reducing air pollution and recreational screen time while increasing physical activity and outdoor time. All results could have potential policy implications, given the individual and societal burdens associated with visual impairment.
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Affiliation(s)
- Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Boyi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, China
| | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yican Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xueya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shaoyi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Haotian Lin
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, 7# Jinsui Road, Guangzhou, 510623, China
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Cheng P, Zhang X, Zhou W, Xu J, Chen F, Qian D, Cao B. Prevalence and related factors of children myopia in Pudong New Area, Shanghai: a cross-sectional study. BMJ Open 2023; 13:e079330. [PMID: 38070885 PMCID: PMC10729255 DOI: 10.1136/bmjopen-2023-079330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES This study aimed to assess the prevalence and related factors of myopia among school-aged children after COVID-19 pandemic. DESIGN Cross-sectional study. SETTING Pudong New Area, Shanghai. PARTICIPANTS 1722 children aged 7-9 randomly selected from 8 primary schools were screened from 1 February 2023 to 30 April 2023. MAIN OUTCOME MEASURES Children's height, weight and eye parameters were examined. Myopia was defined as a cycloplegic spherical equivalent ≤-0.50 dioptres in either eye. A vision-related behaviour questionnaire was applied to investigate the associations between myopia and its risk factors. RESULTS Of the 1722 individuals enrolled, 25.6% (456) had myopia. After adjusting other characteristics, the following factors were associated with an increased rate of myopia: age (9 years vs 7 years, adjusted OR (AOR) 1.84, 95% CI 1.18 to 2.85, p=0.007), parental myopia status (both myopia vs none, AOR 5.66, 95% CI 3.71 to 8.63, p<0.001; one myopia vs none, AOR 2.92, 95% CI 1.93 to 4.42, p<0.001), reading books too close (yes vs no, AOR 1.58, 95% CI 1.20 to 2.08, p=0.001), writing with a tilted head (yes vs no, AOR 1.37, 95% CI 1.05 to 1.77, p=0.019), sleep patterns (early to bed late to rise vs early to bed early to rise, AOR 1.52, 95% CI 1.02 to 2.26, p=0.039). By contrast, a higher monthly household income and the habit of reading while lying down were associated with lower risk of myopia. CONCLUSIONS The prevalence of myopia is of concern among young school-aged children after COVID-19. Correcting eye use behaviour and improving sleep habits may reduce myopia. Also, gender differences should be considered in prevention strategies for children's myopia.
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Affiliation(s)
- Peng Cheng
- Eye and Dental Diseases Prevention & Treatment Center of Pudong New Area, Shanghai, China
| | - Xiaohua Zhang
- Eye and Dental Diseases Prevention & Treatment Center of Pudong New Area, Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Wei Zhou
- Eye and Dental Diseases Prevention & Treatment Center of Pudong New Area, Shanghai, China
| | - Jiawei Xu
- Eye and Dental Diseases Prevention & Treatment Center of Pudong New Area, Shanghai, China
| | - Fangrong Chen
- Eye and Dental Diseases Prevention & Treatment Center of Pudong New Area, Shanghai, China
| | - Dan Qian
- Eye and Dental Diseases Prevention & Treatment Center of Pudong New Area, Shanghai, China
| | - Bin Cao
- Eye and Dental Diseases Prevention & Treatment Center of Pudong New Area, Shanghai, China
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Duan X, Zhou YN, Chen Y. Association between body stature and prevalence of reduced visual acuity in high school graduates in Hangzhou, China. Clin Exp Optom 2023:1-5. [PMID: 37918111 DOI: 10.1080/08164622.2023.2277292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023] Open
Abstract
CLINICAL RELEVANCE The association between myopia and body stature is of great significance for understanding prevention and control of myopia. It has been extensively studied in previous studies but without consistent conclusions. BACKGROUND The aim of this study is to investigate the association between body stature and prevalence of reduced visual acuity in high school graduates in Hangzhou, China. METHODS 50,620 high school graduates who finished the physical examination of the national college entrance examination in 2020 were included. Data were derived from the database of physical examination of the national college entrance examination. Height and weight were measured, and body mass index (BMI) was calculated according to the general formula. Visual acuity was measured by the standard logarithmic visual acuity chart. RESULTS The prevalence of reduced visual acuity was 90.38% in high school graduates. Girls had a higher prevalence of reduced visual acuity than boys (93.07% vs 87.60%, P < 0.001). Boys with normal visual acuity were significantly taller (P < 0.001) and heavier (P < 0.001) than those with reduced visual acuity. Girls with normal visual acuity were significantly taller than those with reduced visual acuity (P < 0.001). The prevalence of reduced visual acuity was significantly inversely associated with height in both boys (P < 0.001) and girls (P < 0.001). The risk of reduced visual acuity was the lowest in the fourth quartile of height. The prevalence of reduced visual acuity was significantly associated with BMI only in boys (P < 0.001). The risk of reduced visual acuity was the lowest in the third quartile of BMI. CONCLUSIONS The prevalence of reduced visual acuity was inversely associated with height in both boys and girls, and there was a U-shaped association with BMI only in boys.
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Affiliation(s)
- Xu Duan
- Department of Cardiology, Hangzhou First People 's Hospital, Hangzhou, China
| | - Yi-Nan Zhou
- Department of Self-study Examination, Hangzhou Education Examination Authority, Hangzhou, China
| | - Yun Chen
- Department of National College Entrance Examination, Hangzhou Education Examination Authority, Hangzhou, China
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Zhao M, Zhang Y, Herold F, Chen J, Hou M, Zhang Z, Gao Y, Sun J, Hossain MM, Kramer AF, Müller NG, Zou L. Associations between meeting 24-hour movement guidelines and myopia among school-aged children: A cross-sectional study. Complement Ther Clin Pract 2023; 53:101792. [PMID: 37595358 DOI: 10.1016/j.ctcp.2023.101792] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/24/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND The Canadian 24-hour movement behavior (24-HMB) guidelines recommend an adequate level of physical activity (PA), a limited amount of screen time (ST), and a sufficient sleep duration (SLP) to promote the healthy development of children. Although the positive effects of adhering to the 24-HMB guidelines have been established for several health parameters, less is known about how adherence to the 24-HMB guidelines relates to the myopia risk (i.e., inability to see distant objects properly). Thus, this study investigated associations between meeting 24-HMB guidelines and myopia risk in school-aged children. METHOD Using a questionnaire survey, this cross-sectional study was conducted among parents of school-aged children (5-13 years) in China from 15th September to 15th October 2022, with a total of 1423 respondents with complete data for analysis. Parents reported their child's time spent in moderate-to-vigorous-intensity physical activity (MVPA), SLP, and ST. Multiple logistic regression analyses were performed to examine the associations between measures of PA, ST, and SLP alone and in combination, and the occurrence of myopia. RESULTS A relatively low percentage of the children being included in the current study (4.92%) met all 24-HMB guidelines, while 32.46% had myopia. Girls had a significantly higher risk of myopia compared to boys (OR = 1.3, 1.002 to 1.68, p = 0.049). Children of parents without myopia had a lower risk of myopia (OR = 0.45, 0.34-0.59, p < 0.001). Children who lived in urban areas (OR = 1.83, 95% CI 1.33 to 2.52, p < 0.001) or towns (OR = 1.60, 1.03 to 2.47, p = 0.04) had a significantly higher risk of myopia compared to those living in rural areas. Meeting SLP guidelines (OR = 0.50, 95% CI 0.31 to 0.82, p < 0.01), meeting ST + SLP guidelines (OR = 0.47, 95% CI 0.32-0.69, <0.001), and meeting all three guidelines were associated with significantly lower risk of myopia (OR = 0.40, 95% CI 0.20-0.82, p = 0.01). Meeting more 24-HMB guidelines was associated with a reduced risk of myopia. CONCLUSIONS Our data suggest that adhering to SLP, ST + SLP, and ST + SLP + PA guidelines is associated with the risk of myopia. Future research investigating dose-response associations, and potential mechanisms, is necessary to achieve a more nuanced understanding of the observed associations.
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Affiliation(s)
- Mengxian Zhao
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yanjie Zhang
- Physical Education Unit, Chinese University of Hong Kong, Shenzhen, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Jianyu Chen
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Meijun Hou
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Zhihao Zhang
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yanping Gao
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Jing Sun
- School of Medicine and Dentistry and Menzies Health Institute Queensland, Institute for Integrated Intelligence and Systems, Griffith University, Australia
| | - M Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, TX, 77204, USA; Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, TX, 77204, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, 02115, MA, United States; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, 61820, IL, United States
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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Song R, Huang W, Yang J, Tang X, Huang Y, Chen Y, Zhao M, Hu Q, Du Y. Association of aquaporin-4 antibody-seropositive optic neuritis with vision-related quality of life and depression. Front Neurol 2023; 14:1265170. [PMID: 37840923 PMCID: PMC10575616 DOI: 10.3389/fneur.2023.1265170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Aquaporin-4 (AQP4) antibody-seropositive optic neuritis (AQP4-ON) is one of the most common types of optic neuritis in China. However, the association between AQP4-ON and vision-related quality of life (QoL) and depression remains poorly understood. Methods In this cross-sectional study, 57 patients with optic neuritis were evaluated for their vision-related QoL using a Chinese version of the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) and assessed for depressive symptoms using a Chinese version of the Beck Depression Inventory-II (BDI-II). Data regarding participants' age, sex, visual acuity, and the number of recurrence events were gathered. Linear regression analysis was employed to investigate the relationships between AQP4-ON and vision-related QoL, as well as depression. Results Of the 57 included patients, 28 were AQP4-ON, and 29 were idiopathic optic neuritis (ION). AQP4-ON demonstrated a significant correlation with a decreased VFQ-25 composite score (Mean difference, -11.65 [95% CI, -21.61 to -1.69]; p = 0.023) and an increased BDI-II score (Mean difference, 6.48 [95% CI, 0.25 to 12.71]; p = 0.042) when compared to ION. The BDI-II score was correlated with the VFQ-25 composite score (Spearman ρ = -0.469; p < 0.001) but not with the visual acuity in the worse-seeing eye (Spearman ρ = 0.024; p = 0.860) or in the better-seeing eye (Spearman ρ = -0.039; p = 0.775), bilateral severe visual impairment (Spearman ρ = 0.039; p = 0.772) or the number of recurrence events (Spearman ρ = 0.184; p = 0.171). Conclusion AQP4-positive optic neuritis is associated with a decline in vision-related quality of life as well as an increased likelihood of experiencing depression. It is crucial for clinicians to assess both vision-related QoL and depression in patients with AQP4-positive optic neuritis to provide patient-centered care.
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Affiliation(s)
- Ruitong Song
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wenqiao Huang
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jun Yang
- Department of Ophthalmology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Xueshan Tang
- Department of Ophthalmology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Yihua Huang
- Department of Ophthalmology, Wuming Hospital of Guangxi Medical University, Nanning, China
| | - Yingying Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Mukun Zhao
- Jingliang Eye Hospital, Guangxi Medical University, Nanning, China
| | - Qiuming Hu
- Jingliang Eye Hospital, Guangxi Medical University, Nanning, China
| | - Yi Du
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Pirindhavellie GP, Yong AC, Mashige KP, Naidoo KS, Chan VF. The impact of spectacle correction on the well-being of children with vision impairment due to uncorrected refractive error: a systematic review. BMC Public Health 2023; 23:1575. [PMID: 37596579 PMCID: PMC10436410 DOI: 10.1186/s12889-023-16484-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/08/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Despite being easily corrected with eyeglasses, over two-thirds of the world's child population presents with vision impairment (VI) due to uncorrected refractive errors. While systematic reviews have shown that VI can significantly impact children's depression and anxiety, none have reviewed the existing literature on the association between spectacle correction and well-being. This review aims to address this knowledge gap. MAIN OUTCOME MEASURES The main outcome measures were i) cognitive and education well-being which included mathematics and english literacy, reading fluency, school function, academic performance and grades; ii) psychological and mental health well-being which included physical anxiety, learning anxiety and mental health test scores and iii) quality of life. METHODS We searched eight databases for articles published between 1999 to 2021 that assessed the associations between spectacle correction and children's (0 to 18 years) well-being. There were no restrictions on language or geographic location. Two reviewers independently screened all publications using validated quality checklists. The findings of the review were analysed using narrative synthesis. [PROSPERO CRD42020196847]. RESULTS Of 692 records found in the databases, six randomised control trials, one cohort, one cross-sectional and one qualitative study (N = 9, 1.3%) were eligible for analysis. Data were collected from 25 522 children, 20 parents and 25 teachers across the nine studies. Seven were rated as good quality (67 to 100% of quality criteria fulfilled), and two were satisfactory (33 to 66% of quality criteria fulfilled). Spectacle correction was found to improve children's educational well-being (n = 4 very strong evidence; n = 2 strong evidence), quality of life (n = 1, very strong evidence) and decrease anxiety and increase mental health scores (n = 1, strong evidence). CONCLUSION Evidence suggests that spectacle correction improves children's cognitive and educational well-being, psychological well-being, mental health, and quality of life. More research is needed, given the paucity of published literature and the focus on only three aspects of well-being.
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Affiliation(s)
| | - Ai Chee Yong
- Queens University Belfast, University Rd, Belfast, BT7 1NN, UK
| | | | - Kovin S Naidoo
- University of KwaZulu Natal, College of Health Sciences, Private Bag X54001, Durban, 4000, South Africa
| | - Ving Fai Chan
- University of KwaZulu Natal, College of Health Sciences, Private Bag X54001, Durban, 4000, South Africa.
- Queens University Belfast, University Rd, Belfast, BT7 1NN, UK.
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Peng W, Zhang Z, Wang F, Sun S, Sun Y. Association of educational environment with the prevalence of myopia: a cross-sectional study in central China. Front Public Health 2023; 11:1188198. [PMID: 37397761 PMCID: PMC10308441 DOI: 10.3389/fpubh.2023.1188198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Purposes This study was to estimate the prevalence of myopia among primary school students in Hefei, China, and evaluate the association of educational environment with myopia. Methods This study was a cross-sectional study, and recruited primary school students in grades 1-6. Children underwent a stepwise ophthalmic examination, which included visual acuity and objective cycloplegic refraction to identify children with myopia. Under the guidance of parents, children completed a questionnaire, including gender, region, grade and several indicators related to education. The study analyzed the risk factors by using a logistic regression and assessed feature importance by using a random forest algorithm. Results A total of 3,596 primary school students were involved in this analysis, and the overall prevalence of myopia was 27.1%. Gender, grade, education level of the father, education level of the mother, academic level of children, hours of homework per day on weekends, number of after-school tutoring per week and frequency of extracurricular reading were significantly associated with myopia. There was no significant association between the amount of homework per day on school days and myopia after adjusting for covariates. In terms of educational environment, the top 3 factors were academic level of children, homework on weekends and after-school tutoring. Conclusions Educational environment with high educational loads was associated with the high prevalence of myopia. Reducing the burden of studying, especially that after class, was an effective way to prevent myopia.
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Affiliation(s)
- Wei Peng
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- University of Science and Technology of China, Hefei, China
| | - Zikang Zhang
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- University of Science and Technology of China, Hefei, China
| | - Fei Wang
- The Second Hospital of Anhui Medical University, Hefei, China
| | - Shaoming Sun
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- CAS Hefei Institute of Technology Innovation, Hefei, China
| | - Yining Sun
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
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Chen L, Tang XJ, Liu Q, Zhang X. Self-directed learning: Alternative for traditional classroom learning in undergraduate ophthalmic education during the COVID-19 pandemic in China. Heliyon 2023; 9:e15632. [PMID: 37153383 PMCID: PMC10116121 DOI: 10.1016/j.heliyon.2023.e15632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/30/2023] [Accepted: 04/17/2023] [Indexed: 05/09/2023] Open
Abstract
In recent years, the COVID-19 pandemic has led to a shift in medical education from traditional face-to-face to online or remote learning, which provided challenges to faculty and students that have traditionally given face-to-face instruction. Self-directed learning (SDL) has gained popularity in undergraduate education such as nursing and adult education. Although the application of SDL in many medical teachings is practical, the application of SDL in undergraduate ophthalmology education has not been well investigated. COVID-19 pandemic led to changes in the learning style of undergraduate medical students to adapt to the shift from traditional classroom learning (TCL) to online or remote learning. Self-directed learning is a process in which individuals take the initiative in diagnosing their learning needs, formulating learning goals, identifying resources for learning, choosing and implementing appropriate learning strategies and evaluating learning outcomes. This study compared students' perspectives and study outcomes of the SDL and TCL to preliminarily investigate the effect of SDL in undergraduate ophthalmology education. The students showed equal perspectives and satisfaction with both learning models. There was no difference in learning outcomes at the end of the study. The students with different interests in ophthalmology had different perspectives on SDL and TCL. Self-directed learning is an essential alternative to traditional classroom learning in undergraduate ophthalmic education during the COVID-19 pandemic in China.
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Affiliation(s)
- Lin Chen
- Department of Ophthalmology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Xiao-Jiao Tang
- Department of Ophthalmology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Qing Liu
- Department of Ophthalmology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
| | - Xuan Zhang
- Department of Ophthalmology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, China
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Qi J, Yan Y, Yin H. Screen time among school-aged children of aged 6-14: a systematic review. Glob Health Res Policy 2023; 8:12. [PMID: 37076910 PMCID: PMC10113131 DOI: 10.1186/s41256-023-00297-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/02/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Screen time refers to the time an individual spends using electronic or digital media devices such as televisions, smart phones, tablets or computers. The purpose of this study was to conduct systematic review to analyze the relevant studies on the length and use of screen time of school-aged children, in order to provide scientific basis for designing screen time interventions and perfecting the screen use guidelines for school-aged children. METHODS Screen time related studies were searched on PubMed, EMBASE, Clinical Trials, Controlled Trials, The WHO International Clinical Trials Registry Platform, the Cochrane Central Register of Controlled Trials, CNKI, and Whipple Journal databases from January 1, 2016 to October 31, 2021. Two researchers independently screened the literature and extracted the data, and adopted a qualitative analysis method to evaluate the research status of the length and usage of screen time of school-aged students. RESULTS Fifty-three articles were included. Sixteen articles studied screen time length in the form of continuous variables. Thirty-seven articles studied screen time in the form of grouped variables. The average screen time of schoolchildren aged 6 to 14 was 2.77 h per day, and 46.4% of them had an average screen time ≥ 2 h per day. A growth trend could be roughly seen by comparing studies in the same countries and regions before and after the COVID-19 outbreak. The average rates of school-aged children who had screen time within the range of ≥ 2 h per day, were 41.3% and 59.4% respectively before and after January 2020. The main types of screen time before January 2020 were watching TV (20 literatures), using computers (16 literature), using mobile phones/tablets (4 literatures). The mainly uses of screens before January 2020 were entertainment (15 literatures), learning (5 literatures) and socializing (3 literatures). The types and mainly uses of screen time after January 2020 remained the same as the results before January 2020. CONCLUSIONS Excessive screen time has become a common behavior among children and adolescents around the world. Intervention measures to control children's screen use should be explored in combination with different uses to reduce the proportion of non-essential uses.
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Affiliation(s)
- Jingbo Qi
- School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Yujie Yan
- China-Japan Friendship Hospital, 2 East Yinghuayuan Street, Chaoyang District, Beijing, 100029, People's Republic of China
| | - Hui Yin
- School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China.
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Esteves S, Martinez-Perez C, Alvarez-Peregrina C, Sánchez-Tena MÁ. Citation Network Analysis on the Influence of Vision on Academic Performance. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10030591. [PMID: 36980150 PMCID: PMC10047661 DOI: 10.3390/children10030591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Proper vision is absolutely critical to children's academic performance, as vision problems can drastically affect learning ability. Currently, the existing literature in this field is somewhat inconsistent and carries several controversies about the influence of vision on academic performance. In this study, citation networks were utilized in order to analyze the relationship between publications and authors, the most-cited publication, and the different research areas. Additionally, the most commonly utilized publication sources along with the most common research areas were also pinpointed. METHODS The aforementioned search was executed in the Web of Science database, with a time range beginning in 1941 and ending in 2022. In order to scrutinize the publications, VOSviewer, CiteSpace software, and the Citation Network Explorer were utilized for analysis about the most-cited publication and the different research areas. RESULTS Overall, 1342 papers were found in all fields along with 2187 citation networks. Moreover, 2020 was the year with the most publications, including 127 publications and 4 citation networks. Bull et al., published in 2008, was the most-cited work, reaching a citation index of 975. The clustering function managed to identity four groups with the most engaging research topics from researchers: motor visual skills, visual memory, the influence of vision on the different learning styles, and abnormal development of the visual system. CONCLUSIONS In the end, the topic with the greatest interest was the influence of visual motor skills on academic performance. Ideally, this paper will assist fellow researchers in quickly noting which topics are of greatest interest and how research in this area has evolved.
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Affiliation(s)
- Sandrina Esteves
- ISEC LISBOA (Instituto Superior de Educação e Ciências), 1750-142 Lisbon, Portugal
| | - Clara Martinez-Perez
- ISEC LISBOA (Instituto Superior de Educação e Ciências), 1750-142 Lisbon, Portugal
| | - Cristina Alvarez-Peregrina
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Miguel Ángel Sánchez-Tena
- ISEC LISBOA (Instituto Superior de Educação e Ciências), 1750-142 Lisbon, Portugal
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
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11
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Zhang Y, Fang X, Lin Z, Xie Z, Wu H, Ou S. Histopathology-based diagnosis of Mooren’s ulcer concealed beneath the pterygium on eye. J Histotechnol 2022; 45:195-201. [DOI: 10.1080/01478885.2022.2137666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yujie Zhang
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Key Laboratory of Ocular Surface and Corneal Diseases, Xiamen University, Fujian, China
| | - Xie Fang
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Key Laboratory of Ocular Surface and Corneal Diseases, Xiamen University, Fujian, China
| | - Zhirong Lin
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Key Laboratory of Ocular Surface and Corneal Diseases, Xiamen University, Fujian, China
| | - Zhiwen Xie
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Key Laboratory of Ocular Surface and Corneal Diseases, Xiamen University, Fujian, China
| | - Huping Wu
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Key Laboratory of Ocular Surface and Corneal Diseases, Xiamen University, Fujian, China
| | - Shangkun Ou
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Key Laboratory of Ocular Surface and Corneal Diseases, Xiamen University, Fujian, China
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12
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Wang W, Peng S, Zhang F, Zhu B, Zhang L, Tan X. Progression of Vision in Chinese School-Aged Children Before and After COVID-19. Int J Public Health 2022; 67:1605028. [PMID: 36032274 PMCID: PMC9402781 DOI: 10.3389/ijph.2022.1605028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: To investigate the changes of vision, including the prevalence of myopia, hyperopia, poor vision, and the spherical equivalent refraction (SER), in school-aged children before and after the pandemic of Coronavirus Disease 2019 (COVID-19). Methods: A school-based vision screening study was performed on children in 133 primary schools in Wuhan. This study was conducted in 4 consecutive years (2018–2021). Results: A total of 468,094 children (936,188 eyes) were recruited, 255,863 (54.7%) were boys. The SER decreased in 2020 compared to other years after the age of 10. A positive myopia shift was found in younger children aged 6 (0.1 D), 7 (0.05D), and 8 (0.03 D) in 2020 compared to 2019. The progression of vision has improved slightly in 2021. Among the students included in the study, 33.7% were myopia. Conclusion: The vision of older children decreased significantly during the COVID-19. After the pandemic, there is still a high risk for them. In the future, the focus on vision prevention and control should move forward to preschool children.
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Affiliation(s)
- Wenjing Wang
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Faxue Zhang
- School of Public Health, Wuhan University, Wuhan, China
| | - Boya Zhu
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, China
- *Correspondence: Xiaodong Tan,
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13
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Comparison of Factors Associated with Myopia among Middle School Students in Urban and Rural Regions of Anhui, China. Optom Vis Sci 2022; 99:702-710. [PMID: 35914091 DOI: 10.1097/opx.0000000000001933] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE The prevention and control of myopia have become a major public health task throughout the world. The analysis of the modifiable factors associated with myopia will help in planning concrete strategies that can be widely implemented by schools and families. PURPOSE This study assessed the modifiable factors associated with myopia and compared them between rural and urban regions. METHODS Data were collected from December 2020 to March 2021. A multi-stage stratified cluster sampling method was used to select 6154 middle school students. All children underwent an eye examination, including visual acuity and cycloplegic refraction. Data on near work, sleep and outdoor activities were collected in questionnaires. RESULTS The myopia prevalence values in urban and rural regions were 68.1% and 63.7%, respectively (χ2 = 15.57, P < .001). More than 3 hours homework per day(OR in urban and rural region: 1.36, 95% CI = 1.07-1.75 vs. 1.72, 95% CI = 1.43-2.07), 36-40 core subjects per week(1.30, 95% CI = 1.04-1.57 vs. 1.42, 95% CI = 1.24-1.64) and going to sleep before 10 o'clock (0.56, 95% CI = 0.32-0.93 vs. 0.50, 95% CI = 0.28-0.90) were significantly associated with myopia in both regions. In contrast, taking breaks during near work was a significant factor in the rural region (less than 1 hour: OR = 0.57, 95% CI = 0.42-0.76; 1-2 hours: OR = 0.63, 95% CI = 0.46-0.86), but not in the urban region. More time outdoors per day was associated with a reduced prevalence of myopia only for urban children (2-3 hours: OR = 0.55, 95% CI = 0.31-0.97; more than 3 hours: OR = 0.38, 95% CI = 0.19-0.75). CONCLUSIONS Homework loads and the time of going to sleep were associated with myopia for children in both urban and rural regions. However, time outdoors was only associated with myopia in urban regions and taking breaks during near work only associated with myopia in rural regions.
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Kuzik N, da Costa BGG, Hwang Y, Verswijveren SJJM, Rollo S, Tremblay MS, Bélanger S, Carson V, Davis M, Hornby S, Huang WY, Law B, Salmon J, Tomasone JR, Wachira LJ, Wijndaele K, Saunders TJ. School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review. Int J Behav Nutr Phys Act 2022; 19:40. [PMID: 35382825 PMCID: PMC8979786 DOI: 10.1186/s12966-022-01258-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/08/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5-18 years) attending school. METHODS This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results. RESULTS Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries. CONCLUSIONS Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.
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Affiliation(s)
- Nicholas Kuzik
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada. .,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Bruno G. G. da Costa
- grid.260989.c0000 0000 8588 8547School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Yeongho Hwang
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Simone J. J. M. Verswijveren
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Scott Rollo
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mark S. Tremblay
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada ,grid.34428.390000 0004 1936 893XDepartment of Health Sciences, Carleton University, Ottawa, Canada
| | - Stacey Bélanger
- grid.14848.310000 0001 2292 3357Département de Pédiatrie, Faculté de Médicine, Université de Montréal and CHU Sainte Justine, CIRENE (Centre Intégré du Réseau en Neurodéveloppement de L’Enfant), Montréal, Quebec Canada
| | - Valerie Carson
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Melanie Davis
- Physical and Health Education (PHE) Canada, Ottawa, Canada
| | - Susan Hornby
- Pan-Canadian Joint Consortium for School Health (JCSH), Summerside, Canada
| | - Wendy Yajun Huang
- grid.221309.b0000 0004 1764 5980Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Barbi Law
- grid.260989.c0000 0000 8588 8547School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Jo Salmon
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jennifer R. Tomasone
- grid.410356.50000 0004 1936 8331School of Kinesiology and Health Studies, Queen’s University, Kingston, Canada
| | - Lucy-Joy Wachira
- grid.9762.a0000 0000 8732 4964Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Katrien Wijndaele
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Travis J. Saunders
- grid.139596.10000 0001 2167 8433Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
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