Abstract Myopia is the most common vision disorder in children and adolescents, and the incidence of myopia among children and adolescents in China ranks among the highest in the world. Existing research results show that lack of outdoor activities is a risk factor for myopia in children and adolescents. The underlying mechanism is closely related to the difference in duration, intensity and spectrum between outdoor and indoor lighting. Illumination is an important environmental factor affecting the occurrence and development of myopia in children and adolescents. Different illumination parameters, such as the intensity, time and spectrum composition of illumination, can affect the occurrence and development of myopia. In this paper, we reviewed the epidemiological studies and animal experiments on the relationship between exposure duration, intensity and spectrum of daylight and night light and myopia in children and adolescents, in an attempt to provide new clues for the prevention and control of myopia in children and adolescents.

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.

Objective: To describe digital media use in college students during the coronavirus disease 2019(COVID-19) outbreak. Methods: A structured self-administered electronic questionnaire was designed and admin istered during February 4 to 12, 2020, collecting information on the use time of digital media and anxiety symptoms of college students in China during the COVID-19 outbreak. Data was analyzed by Chi-square test, univariate and multivariate Logistic regression models. Results: A total of 11 787 university students were recruited. The detection rate of anxiety symptoms was 17.8%. The percentages of screen time ≤2, >2-4 and >4 h/d were 21.3%, 31.4% and 47.3%. The proportions of mobile phone use time ≤2, >2-4 and >4 h/d were 14.6%, 33.2% and 52.3%. The proportion of browsing information regarding COVID-19 ≤1, 1-2 and >2 h/d were 66.6%, 19.4% and 13.9%. The results of Logistic regression analysis revealed that the detection rate of anxiety symptoms was lower among the students having 2-4 h/d of screen time(OR=0.70, 95%CI=0.61-0.81), but higher among the students having more than 4 h/d of screen time(OR=1.13, 95%CI=1.00-1.28) compared with those having ≤2 h/d of video usage time. Compared with the mobile phone usage ≤2 h/d group, the detection rate was lower among >2-4 h/d group(OR=0.78, 95%CI=0.66-0.91). However, anxiety symptoms were more likely to occur in the group of > 4 h/d(OR=1.20, 95%CI=1.04-1.39). The detection of anxiety symptoms was higher in the group with more browsing time. The OR for anxiety symptoms detection rate was 1.55(1.38-1.75) among the students with >1-2 h/d of browsing information regarding COVID-19 and 2.15(1.89-2.44) among the students with >2 h/d of browsing information regarding COVID-19 compared with those with ≤1 h/d of browsing information regarding COVID-19. Conclusion During the epidemic period, the use of >2-4 h/d digital media helps to reduce the occurrence of anxiety symptoms. But the use of computers and mobile phones for more than 4 h/d is associated with higher level of anxiety symptoms among college students. Less screen time spent on fact-checking on COVID-19 might help reduce anxiety sympotoms among college students.

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.

Objective: To study the consumption status of sports drinks in colleges and universitiesand its influencing factors,so as to provide the scientific basis for conducting nutrition education and making interventional measures. Methods: 2 610 college students from arts school, PE school and Chemistry and Environmental Science Institute of a university in Shangrao city, Jiangxi Province were randomly selected by random cluster sampling method to investigate the frequency and types of drinking beverages. Results: In terms of gender, apart from lactic acid drinks, there was significant statistical significance in whether men and women regularly consumed beverages (fruit and vegetable juice drinks, χ2=24.20;Tea beverage, χ2=45.58;Carbonated beverage, χ2=57.27;Energy drink χ2=86.68, P<0.01).In addition to lactic acid drinks, there was statistically significant difference in whether the college regularly consumed beverages (fruit and vegetable juice drinks, χ2=54.72;Tea beverage, χ2=25.97;Carbonated beverages, χ2=46.64;Energy drinks χ2=74.81, P<0.01).In terms of family residence, only tea beverage (χ2=25.97) and carbonated beverage (χ2=46.64) had statistical significance（P<0.01）. In terms of monthly living expenses, all beverage types had statistical significance (milk beverage, χ2=11.69;Fruit and vegetable juice beverage, χ2=18.92;Tea beverage, χ2=20.09;Carbonated beverages,χ2=29.98;Energy drink χ2=17.71, P<0.01). Logistic regression analysis showed that apart from lactic beverages, male students were more likely to consume fruit and vegetable juice, tea beverage, carbonated drinks and functional drinks than female students(OR=1.60, 2.38, 2.50, 4.95, P<0.01); The students in PE school were more likely to consume lactic beverages and functional drinks than those in Arts school, while the students in Chemistry and environmental science institute were less likely to consume fruit and vegetable juice, tea beverage, carbonated drinks and functional drinks than those in Art school (OR=1.29, 2.19, 0.43, 0.50, 0.42, 0.42, P<0.05); The students who spent >1 500 yuan monthly were more likely to consume lactic beverages, fruit and vegetable juice, tea beverage, carbonated drinks than those spent <1000 yuan monthly, and they consumed more functional than those spent<1 000 yuan monthly(OR=1.68, 1.75, 1.73, 2.15, 1.69, P<0.05). Conclusion The students of different characters have different kinds of beverages. Therefore, health education should focus on male students who spend <1 500 monthly, and targeted measures should be taken to help college students build up a reasonable concept of beverage consumption so as to promote the formation of a scientific behavior of beverage consumption.

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.

Objective: To analyze the association between sleep chronotype and suicidal psychological behaviors among middle school students, so as to provide a scientific basis for the prevention and control of middle school students suicide. Methods: In October 2021 and November 2022, a multistage cluster sampling method was used to conduct baseline and followup surveys in Shenyang, Zhengzhou, Nanchang, and Taiyuan cities in China, and a total of 6 656 middle and high school students were included as the research subjects. The Chisquare test was used to analyze the groups differences, and generalized estimating equation was used to analyze the associations between middle school students sleep chronotype and suicide ideation, suicide plan and suicide attempt, and the grade stratification was carried out. Results: Baseline detection of suicide ideation, suicide plan, and suicide attempt were 26.3%, 12.6%, and 5.3%, respectively, with followup rates of 21.0%, 10.0%, and 4.8% for each, and varied significantly by gender, academic stress, smoking or alcohol use, and anxiety or depressive symptoms among middle school students (χ2=11.93-880.20, P<0.05). After adjusting for gender, academic stress, physical activity, smoking, alcohol use, anxiety and depressive symptoms, generalized estimating equations showed that compared with the morning sleep chronotype, the OR(95%CI) for suicide ideation, suicide plan and suicide attempt were 1.61(1.36-1.89), 1.66(1.35-2.05) and 1.41(1.06-1.88) among evening chronotype students, and were higher among junior 1.78(1.39-2.27), 2.00(1.48-2.69) and senior middle school students 1.84(1.44-2.35), 1.67(1.20-2.33) (P<0.05). Conclusion There is a positive association between evening sleep chronotype and middle school students suicidal psychological behavior, and improving sleep chronotype may be one of the effective measures to prevent middle school students suicide.

Abstract Myopia is becoming a global public health problem, the prevalence of myopia among Chinese children and adolescents is high. The nature and nurture etiologies of myopia have been debated for a long time, and current evidence suggests that behavioral and environmental factors are the main causes of myopia in children and adolescents. Challenges in research on behavioral risk factors include cross sectional design, as well as limited longitudinal and intervention. Therefore, future studies need to highlight cohorts study and intervention study, and bring in implementation research to evaluate the significance of application, so as to bridge gaps between research evidence and practice for prevention and control of myopia.

Abstract China has one of the world’s highest prevalence of myopia in children and adolescents, and children are developing myopia earlier. Myopia has become a important issues affecting children and adolescents health, as well as a significant public health concern. There has been continuing debate over the role of nature and nurture in the aetiology of myopia, growing evidence showed that environmental factors has a determine effect on myopia.The randomized controlled trials has assured the relationship between time outdoors and myopia. Based on reviewed published articles, survey and intervention studies and school health practices, according to the principle of school organization, student participation and family cooperation, the authors proposed outdoors activities as initiative for myopia prevention and control in children and adolescents. The detail recommendation contents, levels were list out.

Cardiometabolic disease is one of the leading causes of morbidity and mortality in adults. In recent years, the prevalence of cardiometabolic disease has increased year by year, becoming a major problem in the global disease burden. The occurrence and development of cardiometabolic risk are affected by many factors. Shift work as an occupational hazard has been widely concerned. Nurses are a typical population for shift work, but few studies have looked at the association between their shift work and cardiometabolic risk. This article reviewed the current situation of cardiometabolic risk and the research progress on the association between shift work and cardiometabolic risk among nurses. The results showed that cardiometabolic risk is prevalent in the nurse population. Shift work is associated with cardiometabolic risks such as metabolic syndrome, cardiovascular disease, diabetes, and dyslipidemia, and is mediated by circadian rhythm disorder, hormone secretion disorder, and stress response. However, the causal relationship between shift work and cardiometabolic risk is still unclear, and further prospective cohort studies should be conducted to improve the understanding of the impact of shift work on cardiometabolic risk in order to improve the cardiometabolic health status of nurses.