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BackgroundSmartphone overuse has been cited as a potentially modifiable risk factor that can result in visual impairment. However, reported associations between smartphone overuse and visual impairment have been inconsistent. ObjectiveThe aim of this systematic review was to determine the association between smartphone overuse and visual impairment, including myopia, blurred vision, and poor vision, in children and young adults. MethodsWe conducted a systematic search in the Cochrane Library, PubMed, EMBASE, Web of Science Core Collection, and ScienceDirect databases since the beginning of the databases up to June 2020. Fourteen eligible studies (10 cross-sectional studies and 4 controlled trials) were identified, which included a total of 27,110 subjects with a mean age ranging from 9.5 to 26.0 years. We used a random-effects model for meta-analysis of the 10 cross-sectional studies (26,962 subjects) and a fixed-effects model for meta-analysis of the 4 controlled trials (148 subjects) to combine odds ratios (ORs) and effect sizes (ES). The I2 statistic was used to assess heterogeneity. ResultsA pooled OR of 1.05 (95% CI 0.98-1.13, P=.16) was obtained from the cross-sectional studies, suggesting that smartphone overuse is not significantly associated with myopia, poor vision, or blurred vision; however, these visual impairments together were more apparent in children (OR 1.06, 95% CI 0.99-1.14, P=.09) than in young adults (OR 0.91, 95% CI 0.57-1.46,P=.71). For the 4 controlled trials, the smartphone overuse groups showed worse visual function scores compared with the reduced-use groups. The pooled ES was 0.76 (95% CI 0.53-0.99), which was statistically significant (P

Background: Child eating behaviors (CEBs) and parental feeding practices (PFPs) play critical roles in childhood obesity. However, the bidirectional relationships between CEBs and PFPs remain equivocal. This longitudinal study aimed to explore their bidirectional relationships. Methods: A convenience sample of 870 parents with preschoolers was recruited in this longitudinal study (Shanghai, China). Three non-responsive feeding practices (NFPs), three responsive feeding practices (RFPs), five CEBs, and covariates were collected using validated questionnaires at baseline and the 6-month follow-up. Cross-lagged analyses using structural equation modeling (SEM) were performed to examine their bidirectional relationships. Results: Eight hundred and fifty-three parents completed questionnaires, with a response rate of 98%. The mean age of their children at baseline was 4.39 years (standard deviation = 0.72 years). Eighteen out of sixty longitudinal cross-lagged paths were statistically significant. Parental encouragement of healthy eating and content-restricted feeding were found to be bidirectionally associated with child food fussiness. Four parent-driven associations and one child-driven association were identified between RFPs and CEBs. For example, monitoring was negatively associated with children's unhealthy eating habits (β = −0.066, standard error (SE) = 0.025, p < 0.01). Eight child-driven associations and one parent-driven association were observed between NFPs and CEBs. For example, higher child satiety responsiveness predicted a higher pressure to eat (β = 0.057, SE = 0.029, p < 0.01) and the use of food as a reward (β = 0.083, SE = 0.031, p < 0.01). Conclusions: There were bidirectional, parent-driven, and child-driven associations. Parents should be encouraged to adopt RFPs to shape CEBs. Increasing parents' understanding of CEBs and providing them with reasonable coping strategies would help optimize PFPs. [ABSTRACT FROM AUTHOR]

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Objectives:To assess the reliability and validity of the Chinese version of Aging Perceptions Questionnaire (C-APQ). Method:Participants aged 65 years and over were recruited from February 2012 to November 2012. The Aging Perceptions Questionnaire was translated into Chinese version professionally. Content validity was examined by a panel of seven experts; item reliabilities were assessed by test–retest; internal consistency was assessed by Cronbach's α coefficient; half of the sample (N= 379) was selected to explore factorial structure of the C-APQ by exploratory factor analysis (EFA) and another half of the sample (N= 379) was selected to confirm the findings from the EFA by confirmatory factor analysis (CFA). Statistical package SPSS version 18.0 and Amos 17.0 were used for the analysis. Results:The Cronbach's α coefficient of the C-APQ was 0.884. The test–retest reliability was satisfactory, with all intraclass correlation coefficients greater than 0.4. The overall content validity index was greater than 0.99. Seven factors (timeline acute/chronic, timeline cyclical, emotional representations, control positive, control negative, consequences positive and consequences negative) were identified in EFA and confirmed in CFA. Conclusion:The C-APQ could be a reliable and a valid measure of the self-perceptions of aging in the elderly in China, which may help to improve the life quality and extend longevity of the elderly. [ABSTRACT FROM AUTHOR]