The aim of this study was to investigate the association between maternal blood lipid trajectories during pregnancy and myopia in preschool offspring as well as the combined effects of maternal blood lipid trajectories and gestational diabetes mellitus (GDM) on myopia in offspring. A prospective cohort design with a nested case‒control component was employed in this study. Visual outcomes in children aged 3–6 years, including both noncycloplegic refraction screening results and clinically validated diagnoses from medical records, were obtained. Maternal blood lipid trajectories were classified using group-based multi-trajectory modelling from repeat measurements of total cholesterol (TC) and triglycerides (TGs) during pregnancy in mothers with and without GDM as a complication. Modified Poisson regression models and generalized linear models were used to assess the associations between the maternal lipid trajectory and offspring myopia. Among the 4043 included mother‒child pairs, four distinct maternal lipid trajectories were identified: Group 1, “consistently normal TC and TG”; Group 2, “keeping normal TC but high TG”; Group 3, “moderately increasing TC and TG”; and Group 4, “highly increasing TC and TG”, accounting for 50.0

Little is known about the epidemiology of myopia-related behavior patterns among adolescents in economically developed regions of China, and their associations with myopia.This prospective cohort study included 1945 adolescents aged 12 to 17 years from 2019 to 2023. Lifestyle indicators (sleep time, moderate to vigorous physical activity (MVPA), outdoor time, screen time, extra-study time) were investigated by self-reported questionnaire annually, and trajectory groups were generated using group-based multi-trajectory models. The main outcome measures were noncycloplegic refractions and axial length (AL), corneal radius (CR).In the cohort of‌ 1945 participants, we identified three lifestyle trajectory groups based on the distribution of lifestyle indicators. The "General" group accounted for 38.2%, exhibiting a longer sleep duration of about 8 h, approximately 3 days of MVPA ≥ 1 h weekly, daily outdoor time of at least 2 h, around 2 h of daily screen time, and weekly extra-study time of 0.5 h. The "Rapidly declining sleep time and prolonged extra-study time" (52.2%) group was characterized by a rapidly declining sleep duration and 2.5 h of weekly extra-study time. The "Persistently low MVPA and prolonged extra-study time" group (8.8%) demonstrated minimal physical activity, averaging only 0.6 days of MVPA ≥ 1 h weekly and 2 h of weekly extra-study time. Compared to "General", the "Rapidly declining sleep time and prolonged extra-study time" lifestyle was associated with myopia(OR:1.30; 95%CI = 1.01 to 1.67), rapid SE progression(OR = 1.35; 95%CI = 1.06 to 1.72), and higher myopia degree(OR = 1.10; 95%CI = 1.01 to 1.20); longer AL(β coefficient: 0.17; 95%CI = 0.05 to 0.29) and positive AL/CR ratio(β coefficient: 0.02; 95%CI = 0.01 to 0.03), but not associated with AL progression or AL/CR ratio progression. For middle school students in China, there were 3 different patterns of myopia-related behaviors. The lifestyle characterized by prolonged extra-study time and rapidly declining sleep time was associated with an elevated risk for myopia.

To evaluate the stability and predictive ability of uncorrected visual acuity (UCVA), non-cycloplegic refraction (NCR), and axial length (AL) as indicators in non-cycloplegic school vision screening for myopia. This retrospective cohort study is based on the Shanghai Child and Adolescent Large-scale Eye Study (SCALE). Participants included students who failed school screenings and were referred for follow-up cycloplegic refractions at eye hospitals within three months. We evaluated the differences in UCVA, spherical equivalent (SE), and AL between school screenings and hospital re-evaluations. Furthermore, we assessed the validity of using UCVA in combination with NCR as predictive metrics for myopia referral. Among the 8,492 children, 4,357 (51.3

Objective To identify determinants of the utilisation of ophthalmic clinical health services among students who failed school vision screening.Methods This study employed a sequential explanatory mixed methods design, underpinned by Andersen’s Behavioural Model of Health Service Utilisation. Data were initially gathered through interviews with 27 stakeholders—comprising 5 ophthalmologists, 7 community doctors, 7 public health professionals and 8 teachers. The qualitative insights informed the construction of a questionnaire, which subsequently garnered responses from 6215 participants. Qualitative data underwent thematic analysis with NVivo V.12, while quantitative data were analysed using multivariable multinomial logistic regression in SAS V.9.4. Data integration was performed using the Pillar Integration Process for a deductive, evidence-based synthesis of findings.Results The research revealed that students attending vision demonstration schools and receiving encouragement from schools or communities to access clinical ophthalmic services demonstrated higher adherence to referral (OR=1.66, 95% CI 1.30 to 2.12; OR=1.54, 95% CI 1.33 to 1.80). Conversely, older students and those from higher-income families exhibited lower adherence rates (OR=0.31, 95% CI 0.23 to 0.44; OR=0.34, 95% CI 0.25 to 0.46). Moreover, students with less urgent medical needs were more likely to adhere to referrals compared with those needing immediate referrals (OR=1.24, 95% CI 1.06 to 1.45).Four pillars emerged: (a) adherence decreased with age, (b) financial constraints did not pose an obstacle, (c) public health services played a critical role, (d) referral urgency did not linearly correlate with adherence.Conclusion The utilisation of ophthalmic clinical health services following vision screening failure in students is significantly influenced by public health services provided by schools or communities, such as prompting those with abnormal screening results to access ophthalmic clinical health services.

Abstract Background Schools play an organizational role in managing myopia-related behavioral habits among students. We evaluated the effects of school myopia management measures on myopia onset and progression in a school-based prospective 1-year observational study. Methods In total, 8319 children from 26 elementary schools were included. Online questionnaire completed by a parent, in which school myopia management experience including outdoor activities in recess or physical education class, teachers’ supervision, and teaching facilities. Variables were defined as implemented well or poorly, according to the Comprehensive Plan to Prevent Myopia among Children and Teenagers. Children underwent ophthalmic examinations, and the incidence and progression of myopia from 2019 to 2020 were estimated. Multilevel logistic regression models were constructed to analyze the association between school management measures and myopia development in 8,9 years and 10,11 years students. Results From 2019 to 2020, the incidence of myopia among primary school students was 36.49%; the mean difference of spherical equivalent in myopic children was − 0.29 ± 1.22 diopters. The risk of incident myopia was reduced by 20% in 8,9 years participants with well-implemented class recess compared with those with poorly implemented class recess (adjusted odds ratio [aOR]: 0.80, p = 0.032). PE outdoor time was significantly associated with myopia incidence in 10,11 years students (aOR: 0.76, p = 0.043). Compared with poorly implemented reading and writing posture, desk and chair height, 10,11 participants with well-implemented desk and chair height were less likely to have rapid myopic progression (p = 0.029, p = 0.022). Conclusion In Shanghai, children’s myopia is associated with better implementation of school myopia management measures. The present findings suggest that outdoor activities during class recess or PE class, providing suitable desks and chairs, and adequate instruction in reading and writing postures might protect against pathological eye growth. An age-specific myopia prevention and control programs in school is of primary importance.

目的 研制针对中小学生电子屏幕使用行为的评价问卷,为综合评价中小学生屏幕使用行为提供依据.方法 于2022年8-9月邀请19名专家,在查阅文献的基础上,以国家教育和卫生主管部门颁布的一系列指南和标准以及国内外相关指南为依据,结合现有的有关儿童青少年屏幕使用行为的评价工具,形成中小学生电子屏幕使用行为评价问卷的初始框架和条目池,通过德尔菲专家咨询后确定评价问卷的维度、评价条目及权重.结果 两轮专家咨询的问卷回收率分别为95.0％和100.0％,问卷意见提出率分别为89.5％和63.2％,专家权威系数(Cr)为0.87.最终形成包含屏幕使用类型和时间控制、屏幕使用相关卫生行为、屏幕使用中的安全与文明、合理安排屏幕与非屏幕使用活动4个维度,共44个具体条目的评价问卷.各条目变异系数(CV)范围为0.00～0.19,肯德尔协调系数(W)由0.22上升至0.34(P值均＜0.01),专家意见一致可信.结论 编制的中小学生电子屏幕使用行为评价问卷,可用于综合评价中小学生电子屏幕使用行为,为后续采取干预措施改善中小学生电子屏幕使用相关行为提供依据.

目的 研制面向幼儿园、中小学教师的学生视力保护相关健康素养评价问卷,为量化评估学校教师近视防控能力提供依据.方法 依照教育部和国家卫生健康委等部门颁布的近视防控相关要求和文件、参考世界卫生组织提出的健康素养整合定义,形成学生视力保护相关学校教师健康素养评价体系和问题条目库,选择24名相关领域专家进行两轮德尔菲专家咨询后确定适用幼儿园和中小学校的评价指标条目、评价问题和权重.结果 两轮德尔菲专家咨询,专家回复率分别为83.3％和79.2％,专家权威系数为0.91.最终形成含近视核心知识掌握、日常教学行为、学生用眼行为指导、户外活动促进、教学用光环境营造5个维度,分别包含30和23个条目的 中小学教师和幼儿园教师评价问卷,各维度及各问题条目评分的变异系数范围分别为0.07～0.15,0.08～0.29,专家意见一致可信.结论 研究形成了学生视力保护相关的幼儿园教师和中小学校教师健康素养评价问卷,可作为基于学校的近视综合防控项目的 干预切入点和效果评估依据.

目的 了解新冠肺炎疫情前及期间城市学龄前儿童各类电子屏幕使用时间及影响因素,为控制学龄前儿童电子屏幕使用和预防近视提供科学依据.方法 运用多阶段整群随机抽样法,于2020年6-7月,横断面调查上海市闵行区幼儿园8 244名儿童,通过家长问卷收集学龄前儿童在新冠肺炎疫情暴发前后各类电子屏幕的使用时长,估算加权屏幕屈光时间,分析家庭电子屏幕督导行为与学龄前儿童加权屏幕屈光时间的关联.结果 被调查学龄前儿童新冠肺炎疫情期间每日手机、电脑/平板、电视/投影视屏时长过度检出率分别为30.52％,51.40％,56.82％,而疫情前上学日三者检出率分别为21.94％,41.80％,47.51％.控制重要混杂因素后,家长控制孩子使用电子屏幕的频率高、家长对孩子使用电子屏幕时间有规定并严格实施与疫情前加权屏幕屈光时间负向关联(调整OR=0.60～0.77,P值均＜0.05);家长陪伴孩子时使用电子屏幕的频率高、家长对孩子使用电子屏幕时间有规定但实施不严格与加权屏幕屈光时间和疫情期间加权屏幕屈光时间增加正向关联(调整OR=1.18～1.80,P值均＜0.05).结论 城市学前儿童疫情前后电子屏幕用眼时长均过长.学龄前儿童视屏行为的控制措施中,应注重家庭内部的电子屏幕使用管理和父母自身的榜样作用.

目的 评估上海市《闵行区儿童青少年近视防控三年行动计划(2019-2021年)》实施1年后家长对学生用眼卫生健康服务的态度,为优化干预措施提供科学依据和决策参考.方法 采用多阶段分层整群抽样的方法进行样本选择,最终完成20 176份有效学生家长问卷,进行对学生眼卫生健康服务态度评估.结果 家长对学生用眼卫生健康服务满意率前3位分别是定点医疗机构提供的服务6 849名(84.65％)、提供视力筛查结果反馈方式16 915名(83.84％)、定点医疗机构检查流程6 704名(82.91％).认为需要改善的环节前3位分别是用眼行为和用眼环境干预8 476名(42.01％)、家长告知7 850名(38.91％)、定期随访管理7 222名(33.67％).不同学段、既往眼部疾病诊断史对学生用眼卫生服务的满意率和改善环节需求有影响,差异均有统计学意义(P值均＜0.05).结论 干预实施1年后,家长对学生用眼卫生健康服务整体较满意,不同特征学生家长对卫生健康服务需求有所侧重,建议进一步提供精细化、个性化的用眼卫生健康服务.

在健康中国建设背景下,研究生作为高层次人才的重要来源,面临着科研、婚恋和就业的三重压力,心理健康问题频发、心理健康现状不容乐观.分析研究生心理健康状态的现状及影响因素,了解各高校心理健康教育的模式,提出要创新体制机制,构建符合研究生特点的心理健康教育服务新模式,即转变医学倾向、丰富心理教育内涵;坚持全员参与、拓展服务管理层级;整合多样途径,构建特色心理课程;注重专业实践,提升专业人员素质.