Application of two different methods of visual acuity assessment for myopia screening among lower grade elementary school students / 中国学校卫生

Objective@#To explore two visual acuity standards for examining uncorrected visual acuity (UCVA) to define poor vision in lower grade elementary school students, and to compare the difference of screening myopia rates when combined with non cycloplegic auto refraction (NCAR), so as to provide a scientific basis for standardizing UCVA examination methods using CAR as the gold standard of authenticity and reliability.@*Methods@#From March 22nd to April 9th, 2023, a total of 549 first and second grade students aged 7-8 years from a primary school in Hefei City were selected for the study by convenient cluster sampling method. Two methods were employed for UCVA examination:the first method involved charts where the student could not make mistakes in identifying at least half of the characters per line (V1), and the second method used charts with character sizes ranging from 4.0 -4.5, 4.6-5.0 and 5.1-5.3, without allowing 1, 2 and 3 errors per line (V2). While NCAR was performed, then 187 students underwent CAR examination. Paired Wilcoxon rank-sum test and McNemar test were used to compare the differences between V1 and V2 methods in defining poor vision and screening myopia rates. Using CAR as the gold standard, the authenticity and reliability of defining screening myopia rates through the combination of V1 and V2 methods along with NCAR were evaluated.@*Results@#The UCVA examination results for V1 and V2 showed statistically significant differences in both the right eye [5.0(4.9,5.0), 4.9(4.8,5.0)] and the left eye [ 5.0 (4.9,5.0), 4.9(4.8,5.0)] ( Z=-13.95, -13.34, P <0.01). The detection rates of poor vision for the right eye were 43.53% for V1 and 63.21% for V2, and the left eye with 44.08% for V1 and 62.11% for V2, with statistically significant differences ( χ 2= 106.01 , 95.09, P <0.01). When screening myopia rates were assessed for UCNA methods combined with NCAR, the right eye rates were 21.49% for V1 and 24.59% for V2, and the left eye rates were 21.31% for V1 and 23.13% for V2, with statistically significant differences ( χ 2=15.06, 8.10, P <0.01). Using CAR as the gold standard, the detection rates in the right eye and left eye were 16.58 % and 17.11%, respectively. The Youden indices for defining screening myopia in the right eye were 0.80 for V1 and 0.79 for V2, and the left eye with 0.85 for V1 and 0.83 for V2. The agreement rates for the right eye were 91.98 % for V1 and 89.30% for V2, and the left eye with 94.12% for V1 and 91.98% for V2. The Kappa values for the right eye were 0.73 for V1 and 0.67 for V2, and the left eye with 0.81 for V1 and 0.75 for V2.@*Conclusions@#Authenticity and reliability of two UCVA examination methods combined with NCAR in defining screening myopia are higher in V1 than V2 methods. It is recommended to unify the visual acuity examination methods by requiring the correct identification of more than half of the total number of visual markers in a row.

Focus on the dietary behaviors and mental health among multi ethnic adolescents / 中国学校卫生

Abstract@#Unhealthy eating behaviors among adolescents are common, and psychological behavior problems are prominent. The paper examines the status and associations underlying unhealthy eating behaviors and psychological behavior problems in adolescents from border multi ethnic areas, and further discusses the importance of research in border area involving multi ethnic adolescents, and highlights its significance in the context of constructing healthy schools in border areas,so as to provide a basis for promoting effectively healthy school environments in border areas of China.

Application of a polygenic risk score in the early prediction of myopia in children and adolescents / 中国学校卫生

Abstract@#Myopia has become a major public health issue of global concern. Scientific and effective myopia prediction models can help identify high risk groups for myopia, thereby achieving precise prevention. With the rapid development of genome wide association studies and the establishment of large scale prospective population cohorts, the polygenic risk score (PRS) model has been used to predict myopia phenotypes, advancing the myopia prediction window and thus predicting high myopia risk for early screening and intervention for at risk groups. The review aims to systematically elaborate the identification and verification of myopia genes in recent years, briefly describe the practice and effectiveness evaluation of the PRS model in myopia prevention research at home and abroad, reveal the application value in myopia prediction research, and emphasize the relationship between the PRS prediction model and outdoor activities. Close eye use and other preventive measures are of great significance to promote the precise prevention of myopia in children and adolescents.

Association of different sleep characteristics and cardiometabolic risk in college students / 中国学校卫生

Objective@#To describe the association of different sleep characteristics and cardiometabolic risk among college students, so as to provide reference for health promotion of college students.@*Methods@#By random cluster sampling method, a questionnaire survey and physical examination including blood pressure, waist circumference and blood lipid indicators, which were conducted in April and May of 2019 among a total of 1 179 college students from the first grade in two universities in Hefei City of Anhui Province and Shangrao City of Jiangxi Province. A total of 729 college students with valid questionnaires were included into analysis. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to investigate sleep behavior, and the Morning And Evening Questionnaire-5 (MEQ-5) was used to investigate sleep characteristics. The cardiometabolic risk score was derived using the sum of the standardized sex specific Z scores of waist circumference, mean arterial pressure, HDL cholesterol (multiplied by -1), triglycerides, and insulin resistance index. The rank sum tests were used to compare differences in cardiometabolic risk scores across demographic characteristics. Generalized linear models were used to compare the association of different sleep characteristics with cardiometabolic risk scores among college students.@*Results@#The average cardiovascular metabolic risk score of college students was -0.32(-2.03, 1.58). There were statistically significant differences in cardiovascular metabolic risk scores among college students in variables such as smoking, health status, and physical activity levels ( t/F=-3.41, 12.88, 51.07, P <0.01). The results of the generalized linear model showed that nighttime preference ( B=1.89, 95%CI =1.02-3.49), insomnia symptoms ( B=3.25, 95%CI =1.79-5.90), and short or long sleep duration ( B=1.92, 95%CI =1.21-3.05) were positively correlated with the cardiovascular metabolic risk score of college students ( P <0.05).@*Conclusions@#Poor sleep patterns among college students are positively correlated with the risk of cardiovascular metabolism. The sleep behavior of college students should be actively changed to reduce the risk of cardiovascular disease.

Science driven application and transformation for telling better stories of school health research / 中国学校卫生

Abstract@#The global disease burden of health problems among children and adolescents is becoming increasingly serious and more prominent worldwide, this calls for a more intergrated and effective school health education, and services and system education should be strengthened. This editorial highlights the importance of problem oriented school health research by telling two stories of school health, including identification of risk factors for health problems and evidence based interventions. Using highquality scientific evidence to promote best practices in school health, improve science driven application and transformation, enhance capacity for comprehensive school health services, and empower child and adolescent health and wellbeing across China.

Research progress on the association between violet light and myopia / 中国学校卫生

Abstract@#Myopia has become a major global public health problem. Exposure to outdoor light may explain the protective effect of outdoor activities on myopia. Currently, a growing number of studies focus on the effects of the spectrum on eye health. Recent studies have found that violet light may have a protective effect on myopia, but the mechanism of action between violet light and myopia is not yet fully understood. The paper reviews the association between violet light and myopia prevention and control, and the possible mechanisms of violet light and myopia to provide a reference value for further exploration of the role of violet light on myo pia .

Prevalence of myopia and consistency evaluation of three myopia assessment methods among children and adolescents / 中国学校卫生

Objective@#To evaluate the prevalence and consistency of screening myopia, non-cycloplegic myopia and cycloplegic myopia in children and adolescents, and to provide references for exploring the factors affecting the consistency of different definition methods.@*Methods@#A total of 3 868 children and adolescents aged 6 to 17 years from seven schools were included in a school based cross sectional study in Shandong Province in September 2020. The prevalence of screening myopia, non cycloplegic refraction, and cycloplegic refraction at different ages and all children and adolescents were analyzed. With cycloplegic spherical equivalent ≤-0.50 D as the gold standard for myopia, and Kappa test and area under the ROC curve were used to evaluate the consistency.@*Results@#The prevalence of cycloplegic myopia and screening myopia were 36.7% and 38.3% among children and adolescents. The prevalence of non cycloplegic myopia was 62.4%, which was significantly higher than screening myopia and cycloplegic myopia two methods in primary and junior high schools. Among 3 868 subjects, there were 3 628 (93.8%) subjects with screening myopia and 2 862 (74.0%) subjects with non cycloplegic myopia who were consistent with the gold standard for myopia. The Kappa values of screening myopia and non cycloplegic myopia were 0.87 and 0.51, and the area under the ROC curve was 0.94 (95% CI =0.93-0.95) and 0.79 (95% CI =0.78-0.81). Compared with other groups, children and adolescents aged 8 to 17 years, in junior or high school, urban residence, better presenting distance visual acuity, and astigmatism ≤1.50 D had a higher consistency in the application of screening myopia ( P <0.05).@*Conclusion@#The consistency between screening myopia and cycloplegic myopia is high, and the consistency between non cycloplegic objective myopia is low.

Establishment of a concise health index synthetic evaluation method for adolescents / 中国学校卫生

Objective@#The aim of this study was to establish a comprehensive concise health index (CHI) for evaluating adolescents, so as to provide a basis for determining the overall health status of adolescents in China.@*Methods@#On the basis of a literature review and consensus among core researchers, adolescent CHI indicators in the following five dimensions were assessed:physical growth, physical fitness, common diseases, mental health and behavioral health. A total of 24 experts used an analysis hierarcgy process (AHP) to calculate the indicators subjective weights. In addition, from October to December of 2021, two regions, A and B were selected to conduct empirical research, and the CRITIC method was used to calculate the objective weights of the indicators. Finally, the weight coefficients were determined through the AHP-CRITIC combination weight method, and comprehensive evaluation was performed with the TOPSIS method.@*Results@#Across academic period and genders, the combined weighted coefficients of the health indicators were as follows:BMI, 0.081-0.095; waist circumference, 0.070-0.081; relative grip strength, 0.101-0.108; myopia, 0.110-0.128; dental caries, 0.055-0.070; psychological symptoms, 0.240-0.262; physical exercise, 0.085-0.115; screen time, 0.097-0.111; and sleep duration, 0.086-0.103. The health index of middle school students in city A (0.626±0.065) was significantly higher than that in city B(0.613±0.066)( t=6.34, P <0.01).@*Conclusion@#The comprehensive adolescent CHI evaluation method has good consistency and application value, and may serve as a reference for adolescent health monitoring.

Association between eye use behaviors and self reported myopia in middle and high school students / 中国学校卫生

Objective@#To analyze the association between eye use behavior and self reported myopia in middle and high school students, and provide the scientific basis for the prevention and control of myopia.@*Methods@#A total of 14 872 middle and high school students was selected from four provinces and cities from December 2015 to March 2016, including Jiangxi(Nanchang,Yintan,Dexing), Liaoning(Shenyang), Guangdong(Shenzhen), Henan(Zhengzhou) provinces. A self administrated questionnaire was used to collect the basic information, self reported myopia and eye use behaviors among middle and high school students. The Chi square tests were applied to compare the differences in self reported myopia among middle and high school students with different characteristics. Multivariate binary Logistic regression models were used to analyze the association between eye use behavior and self reported myopia in middle and high school students.@*Results@#The self reported myopia rate of middle and high school students was 68.5%, with 59.7% and 78.6% for junior high school students and senior high school students, respectively. After adjusting for the potential confounders, the Logistic regression models showed that middle and high school students who read and write with their heads down ( OR =1.94, 2.32),middle and high school students who lie down or lie on stomach when using their eyes ( OR =1.27, 1.28) had a higher risk of self reported myopia ( P <0.01). There was a negative correlation between eye use distance (reading and writing distance, distance from eyes to TV, mobile phone, or tablet) and self reported myopia ( OR =0.73, 0.70, 0.81; 0.61, 0.66 , 0.76) in middle and high school students ( P <0.01). In addition, the risk of self reported myopia was lower in middle school students with longer eye to computer distance ( OR=0.77, P <0.01).@*Conclusion@#There is a significant association between eye use postures, eye use distance and self reported myopia in middle and high school students. Health education for the risk and behavior factors of myopia should be actively promoted to ensure the visual health of children and adolescents.

Association between sleep quality and anxiety-depression co-morbid symptoms among nursing students of medical college in Hefei City / 中国学校卫生

Objective@#To describe the prevalence and association of sleep quality and anxiety-depression co-morbid symptoms among nursing students, in order to provide a reference basis for promoting the development of nursing students mental health.@*Methods@#Using a prospective study design, baseline survey was conducted in January 2019 among a random cluster sample of 1 716 individuals in three medical universities in Hefei, Anhui Province, and a follow-up survey was conducted in October 2019, with a valid number of 1 573 individuals after matching with the baseline survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess nursing students sleep quality, and the Depression Anxiety Stress Scale (DASS-21) to assess the anxiety-depression comorbid symptoms.@*Results@#The detection rates of anxiety-depression co-morbidities among nursing students at baseline and follow-up survey were 16.9% and 18.2%, respectively, and the detection rates of poor sleep quality among nursing students at baseline and follow-up survey were 10.1% and 10.3%, respectively. The results of the binary Logistic regression model showed that baseline PSQI score were positively associated with the risk of anxiety-depression co-morbid symptoms among nursing students at baseline ( OR=1.49, 95%CI =1.40-1.59) and after nine months of follow-up ( OR=1.22, 95%CI =1.16-1.28). Furthermore, the influence of baseline sleep quality on the risk of anxiety-depression co-morbid symptoms were mainly concentrated in the five dimensions of sleep time, sleep efficiency, sleep disorders, hypnotic drugs and daytime dysfunction, and such effects of sleep time, sleep disorders and daytime dysfunction still existed in the follow-up investigation.@*Conclusion@#Poor sleep quality of nursing students can increase the risk of anxiety-depression co-morbidities. Improving sleep quality of nursing students has a positive effect on improving their mental health.

Application and implications of implementation science framework in school health / 中国学校卫生

Abstract@#As an emerging discipline, implementation research has been widely used in many health fields, such as the prevention and control of chronic noncommunicable diseases and mental health promotion. However, school based implementation research in China is still in its infancy. The paper introduces the implementation science framework applied in the field of school health in foreign countries, and reviews its application in nutrition intervention, physical activity and mental health promotion, and prevention of health risk behaviors in school settings, in order to provide theoretical basis and practical guidance for the application of implementation research in school health in China.

Association between non school sedentary time and myopia among primary and secondary school students with different levels of physical activity / 中国学校卫生

Objective@#To analyze the association between non-school sedentary time and myopia among primary and secondary school students with different levels of physical activity, so as to provide data for precise measures to prevent and control myopia.@*Methods@#From September to December 2019, stratified cluster sampling was used to select 7 872 primary and secondary students in grades 4 to 12, middle and high school students from Hefei, Suzhou, Chizhou and Wuhu Cities in Anhui Province. Face-to-face questionnaires and vision examinations were conducted to collect demographic information, physical activity time, sedentary study time and visual health status. Potential categories were analyzed for different types of physical activity time, and Logistic regression was used to assess the relationship between non-school sedentary time and myopia at different levels of physical activity.@*Results@#A total of 2 976 primary and secondary school students were found with high physical activity levels and 4 896 primary and secondary school students with low physical activity levels. The proportion of low physical activity was higher in girls than in boys (68.7% vs . 55.6%), and the differences were statistically significant ( χ 2=143.97, P <0.01). The overall screening myopia rate was 48.2%, with statistically significant differences among female students (53.0%) compared with male students (43.3%), urban students ( 51.8 %) compared with rural students (44.5%), and longer non-school sedentary time students (60.6%) compared with average (45.1%) and shorter (42.1%) non-school sedentary time students, and the differences were statistically significant ( χ 2=73.15, 41.96 , 161.74, P <0.01). Adjusting for confounders such as residence, grade, gender, age, father s education, mother s education, and body mass index (BMI), multivariate Logistic regression analysis revealed that prolonged after-school sedentary study was positivety correlated with myopia among primary and secondary school students of low physical activity levels ( OR=1.52, 95%CI=1.27-1.83, P <0.01), and there was no statistical association between after-school sedentary time and myopia in primary and secondary school students with high physical activity levels ( P >0.05).@*Conclusion@#Attention should be paid to non-school sedentary time for primary and secondary school students with low physical activity levels. And students who spend a lot of time sitting outside of school should be encouraged to maintain high physical activity levels to reduce the risk of myopia.

Association of vitamin D deficiency with anxiety and depressive symptoms among middle school students in Shenzhen / 中国学校卫生

Objective@#To explore the association of vitamin D deficiency with anxiety and depressive symptoms as well as their comorbidity, so as to provide references for improving the mental health of children and adolescents.@*Methods@#From October to December 2021, a total of 1 323 students from four middle schools in Shenzhen were selected by using convenience sampling method for a questionnaire survey and physical examination. Fasting blood samples were collected to detect vitamin D levels. The Chi square test and multiple Logistic regression model were used to analyze the association of vitamin D deficiency with anxiety and depressive symptoms and their comorbidity among middle school students.@*Results@#The detection rates of anxiety, depressive, and thier comorbidities in middle school students were 33.0%, 21.5% and 16.3%, respectively. After adjusting for confounding factors, vitamin D deficiency was positively associated with the risk of anxiety symptoms ( OR=1.59, 95%CI =1.02-2.46), depressive symptoms ( OR=1.94, 95%CI =1.22-3.09) and anxiety depressive comorbid symptoms ( OR=1.75, 95%CI =1.06-2.90) in secondary school students ( P ＜0.05).@*Conclusion@#Vitamin D deficiency is associated with an increased risk of anxiety, depressive and their co morbidity symptoms in middle school students, and the directionality of the association should be further studied.

Promoting digital technology to enable new opportunities for universal mental health services in schools / 中国学校卫生

Abstract@#In rescent years, schools are confronting continued mental health needs of children and adolescents. The person centered school mental health service model is impossible to meet current and future increasingly public health problems. Under the framework of the "whole School, whole Community, whole Child" (WSCC) theory and the concept of health promoting schools proposed by the World Health Organization, the editorial proposes to integrate universal mental health services into essential public health services in school, as well as to build a digital school mental health service platform to enable new opportunities for universal mental health services in schools.

Expert interpretation of Comprehensive Public Health Intervention Technical Guidelines for Prevention and Control of Myopia among Children and Adolescents / 中国学校卫生

Abstract@#The National Bureau of Disease Control and Prevention has issued the Guidelines for Comprehensive Public Health Intervention Techniques for Prevention and Control of Myopia in Children and Adolescents, which summarizes and evaluates the practical experience of the Comprehensive National Children s Myopia Management Plan in the past 5 years, examines the causes and develops evidence based interventions for myopia. The Guidelines recommend eight public health intervention techniques based on a three tier prevention strategy, and propose three practical measures. The article interprets the Guidelines in terms of their background, theoretical basis, practical significance, content, and further examines their organization and implementation, so as to enhance understanding among professionals in public health institutions and related departments involved in the prevention and control of myopia in youth, while facilitating their application and promotion.

Comparative application of three methods for testing distance visual acuity among children / 中国学校卫生

Objective@#To understand the differences in the application of three distant vision examination methods in children, so as to provide a reference for developing a unified distant vision examination for this population.@*Methods@#The study involved 98 children aged 4 to 16 years who visited the ophthalmology department of a children s hospital in Anhui Province between August 15 and 25, 2022. Vision was measured using the distant vision test method specified in the 2014 National Student Physical Fitness and Health Survey (V1), the 2019 National Student Physical Fitness and Health Survey (V2), and Specification for Screening of Refractive Error in Primary and Secondary School Students (WS/T 663-2020) (V3). The paired samples McNemar s test and Wilcoxon test were performed to compare the detection rate of poor vision and the difference between the visual acuity test results of the three methods.@*Results@#The results of the 98 children examined according to V1, V2, and V3 showed that the M (P25, P 75 ) of the right eye were 4.8（4.6，5.0），4.8（4.7，5.0），and 4.8（4.7，5.0）while the left eye visual acuity M ( P 25 , P 75 ) were 4.8 （4.6，5.0），4.9（ 4.7 ，5.0），and 4.9（4.7，5.0），respectively. The rates of poor visual acuity detection for the right eye were 63.3%, 58.2% and 58.2 % for V1, V2, and V3, respectively, while for the left eye, they were 58.2%, 54.1% and 53.1%, respectively. McNemar test results showed that there were no statistically significant differences in the rates of poor visual acuity detection between the right and left eyes for V1 vs. V2, V1 vs. V3, and V2 vs. V3 (left eyes： χ 2=2.25，2.29，0.00，right eyes： χ 2=3.20，3.20，0.00， P >0.05).Wilcoxon test results indicated that there were statistically significant differences between the right and left eye visual acuity groups for V1 vs. V2 and V1 vs. V3 (left eyes： Z =-4.15，-4.60, right eyes： Z = -4.70，-4.99, P <0.01).@*Conclusion@#Irrespective of whether the starting visual standard starts at row 4.0 or 5.0, different standards of visual standard passage have an impact on the visual acuity results. It is recommended that existing methods of screening for distance vision are standardized.

Development and evaluation of the reliability and validity of the Assessment of Smartphone Multitasking for Adolescents / 中国学校卫生

Objective@#To develop the Assessment of Smartphone Multitasking for Adolescents (ASMA) and evaluate its reliability and construct validity, so that to provide an evaluation tool for relevant epidemiological studies.@*Methods@#Based on literature review, expert based judgement, and group discussion, the self administered ASMA identified 3 dimensions named smartphone activities and non-media activities multitasking, smartphone activities and other media activities multitasking, and smartphone functional use multitasking, which initially included 27 items. From October to December 2021, 5 566 college students were selected from 7 regions, including Liaoning, Shanxi, Henan, Shanghai, Chongqing, Shenzhen, and Yunnan by multi stage cluster sampling method, and item analysis, factor analysis, and reliability evaluation were used to screen items and evaluate reliability and validity.@*Results@#The final version of AMSA contained 3 dimensions covering 26 items. The variance cumulative contribution rate was 59.63 %. The internal consistency test showed that Cronbach s alpha coefficient for the questionnaire was 0.944, and ranged from 0.838 to 0.928 for each dimension. The split half coefficient of the questionnaire was 0.849 and ranging from 0.781 to 0.874 for each dimension. The results of confirmatory factor analysis showed that the root mean square error of approximation (RMSEA), comparative fit index (CFI), and Tucker Lewis index (TLI) of the questionnaire were 0.068, 0.901, and 0.891, respectively, which had which had a good fitting degree. The results of Pearson correlation analysis showed that the criterion validity of the questionnaire was good ( r=0.206-0.351, P <0.01).@*Conclusion@#The ASMA is consistent with the evaluation standard of psychometrics and can be used as an assessment tool to evaluate smartphone multitasking behaviors in adolescents.

Research progress on the association between built environment and myopia in children and adolescents / 中国学校卫生

Abstract@#Myopia is the most common visual impairment among children and adolescents. With the acceleration of urbanization, the relationship between myopia and factors of the built environment, such as building density, living space, green environment, etc, has attracted widespread attention in society. A growing number of studies have shown that the factors of the built environment play an important role in the onset and progression of myopia. This current review focuses on the effects of the built environment on myopia in children and adolescents, summarizes the association between the built environment and myopia in children and adolescents from the aspects of environmental density, living space and green space environment, and discusses the potential paths of the association, including affecting the light environment and restricting the outdoor activities of children and adolescents, which could provide environmental etiological clues for the prevention and control of myopia in children and adolescents and reduce the burden of public health caused by myopia.

Bidirectional associations between cellular phone use behaviors and depressive symptoms in college students: a follow up study / 中国学校卫生

Objective@#The study aimed to describe the prevalence of mobile phone use and depressive symptoms and to examine the bidirectional associations between the two among college students, providinb evidence for mental health promotion among college students.@*Methods@#A longitudinal study with follow up at 6 month intervals was conducted in 1 135 students from 2 universities in Hefei, Anhui Province and Shangrao, Jiangxi Province who were selected between April and May 2019. The last follow up was conducted between April and May 2021 based on questionnaire survey, and 999 valid participants were obtained after matching. The self designed questionnaire was used to investigate the duration of cellular phone use and use of cellular phone functions among college students. The Self rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and the Patient Health Questionnaire-9 (PHQ-9) were used to assess cellular phone dependence and depressive symptoms among college students. Pearson correlation analysis was used to examine the correlation between cellular phone use behavior and depressive symptoms at baseline and 2 years later; linear regression model was used to analyze the linear association between cellular phone use behavior and depressive symptoms scores; autoregressive cross lagged model was used to analyze the bidirectional associations between cellular phone use behaviors and depressive symptoms among college students over time.@*Results@#The prevalence of mobile phone dependence and depressive symptoms among college students at baseline were 24.3% and 42.4%, respectively. The mean duration of mobile phone use among college students at baseline and the 2 year follow up were (2.84±0.90)h/d and (2.02±1.05)h/d, respectively; the mean scores of mobile phone dependence were (23.30±9.00) and (23.29±10.45), respectively; the mean scores of mobile phone function use were (30.12±6.66) and (29.12±7.27), respectively; and the mean scores of depressive symptoms were (4.51±4.76) and (2.61±4.40), respectively. Pearson correlation analysis showed there were significant positive correlations between duration of cellular phone use, cellular phone dependence, use of cellular phone functions at baseline or 2 years later and depressive symptoms 2 years later( r =0.08-0.50, P <0.05). Linear regression models showed a significant positive association between cellular phone dependence at baseline and depressive symptoms ( β=0.26, 95%CI =0.23-0.29) at baseline and 2 years later ( β=0.12, 95%CI =0.09-0.15). Autoregressive cross lagged models showed that cellular phone dependence at baseline positively predicted depressive symptoms 2 years later ( β =0.04) and depressive symptoms at baseline positively predicted cellular phone dependence 2 years later( β =0.23)( P <0.05).@*Conclusion@#There was a bidirectional association between cellular phone dependence and depressive symptoms among college students. Reducing cellular phone dependence is of positive significance for improving college students mental health.

Research progress of association between the built environment in community and the obesity of children and adolescents / 中国学校卫生

Abstract@#With the socio economic development and urbanization, obesity increased dramatically worldwide among children and adolescents over the past years. The determinants of obesity are complicated, and its association with built environment in community has received great concern in recent years. To provide theoretical basis for building supportive environment beneficial for obesity prevention, the review summarizes obesity related built environment, including food environment, physical activity environment, road traffic environment, lighting at night.