Reduced Health-Related Quality of Life Due to Mobile Phone Dependence in a Sample of Chinese College Students: The Mediating Role of Chronotype and Sleep Quality.

PURPOSE: Presenting a chain mediation model to investigate whether mobile phone dependence results in a reduction in health-related quality of life (HRQoL) among Chinese college students, through the mediating effect of chronotype and sleep quality. DESIGN AND SETTING: A cross-sectional survey was conducted on students from a Chinese university using a validated structured questionnaire. SAMPLE: 2014 freshmen. MEASURES: The study measured the students' level of mobile phone dependence using the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use. Chronotype and sleep quality were measured by the Chinese version of the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI), respectively. HRQoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L), including a descriptive system and a visual analog scale (VAS). ANALYSIS: Descriptive statistical analysis, correlation analysis, and mediation analysis. RESULTS: Mobile phone dependence had a significant negative effect on HRQoL as indicated by both the EQ-5D-5L index score and EQ-VAS score (P < .001 for both). Additionally, it was found to significantly predict chronotype (MEQ score) (ß = -.546, P < .001) and sleep quality (PSQI score) (ß = .163, P < .001). Chronotype negatively predict sleep quality (ß = -.058, P < .001), and sleep quality was a significant negative predictor of HRQoL (EQ-5D-5L index score, ß = -.008, P < .001; EQ-VAS score, ß = -1.576, P < .001). CONCLUSION: Mobile phone dependence negatively impacts students' HRQoL through chronotype and sleep quality, and there is a chain mediating effect. Students should consider making lifestyle changes to improve their HRQoL and promote health.

Risk factors for myopia among children and adolescents: an umbrella review of published meta-analyses and systematic reviews.

AIMS: To identify potential risk factors for myopia in children and adolescents and assess the credibility of each evidence, providing reference for the development of myopia prevention strategies. METHODS: We searched PubMed, Web of Science and Embase databases from inception to April 2022 to find systematic reviews or meta-analyses investigating the relationship between potential risk factors and myopia, and conducted an umbrella review. We recalculated the pooled effect sizes and 95% CIs of each potential risk factor through random-effects model, and reported its 95% prediction interval and between-study heterogeneity. Small-study effect and excess of significance bias were assessed to reveal potential publication bias. RESULTS: Twelve publications were included in this umbrella review, including eight meta-analyses and four qualitative systematic reviews. Twenty-two factors were identified, of which 16 were analysed quantitatively. Ten factors showed statistically significant association with myopia. Myopia in one or two parents and per additional hour of time spend outdoors per week were rated as highly suggestive evidence. Near work and gender were evaluated as suggestive evidence. The other five factors are weak evidence. CONCLUSIONS: We found several risk factors for myopia with different levels of evidence, of which parental myopia presented the strongest association with myopia in children and adolescents. Our findings contribute to a better understanding of the association between potential risk factors and myopia among children and adolescents and are important for informing parenting, education, clinical practice guidelines and public health policy. PROSPERO TRIAL REGISTRATION NUMBER: CRD42022333053.