Exploring Associations between Problematic Internet Use, Depressive Symptoms and Sleep Disturbance among Southern Chinese Adolescents

The primary aim of this study was to examine associations between problematic Internet use, depression and sleep disturbance, and explore whether there were differential effects of problematic Internet use and depression on sleep disturbance. A total of 1772 adolescents who participated in the Shantou Adolescent Mental Health Survey were recruited in 2012 in Shantou, China. The Chinese version of the Internet Addiction Test (IAT) was used to evaluate the prevalence and severity of Internet addiction. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI), a 10-item version of the Center for Epidemiologic Studies Depression Scale (CESD-10), and other socio-demographic measures were also completed. Multiple regression analysis was used to test the mediating effect of problematic Internet use and depression on sleep disturbance. Among the participants, 17.2% of adolescents met the criteria for problematic Internet use, 40.0% were also classified as suffering from sleep disturbance, and 54.4% of students had depressive symptoms. Problematic Internet use was significantly associated with depressive symptoms and sleep disturbance. The correlation between depressive symptoms and sleep disturbance was highly significant. Both problematic Internet use (β = 0.014; Sobel test Z = 12.7, p < 0.001) and depression (β = 0.232; Sobel test Z = 3.39, p < 0.001) had partially mediating effects on sleep disturbance and depression was of greater importance for sleep disturbance than problematic Internet use. There is a high prevalence of problematic Internet use, depression and sleep disturbance among high school students in southern China, and problematic Internet use and depressive symptoms are strongly associated with sleep disturbance. This study provides evidence that problematic Internet use and depression have partially mediating effects on sleep disturbance. These results are important for clinicians and policy makers with useful information for prevention and intervention efforts

Characteristics of included studies about ambient humidity and children's health (n = 37).

<p><b>Abbreviations</b>: GAM, generalized additive model; GLM, generalized linear models; ARIMA models, autoregressive integrated moving average modeling; r, correlation coefficient; β, regression coefficient; R²/r², coefficient of determination; RR, relative risk; OR, odds ratio; IRR, incident rate ratio; CI, 95% confidence interval; RSV, human respiratory syncytial virus; IA, influenza virus A.</p>a<p>These included articles are ordered by the date of publication and the first word of their titles.</p>b<p>In these studies there is more than one meteorological factor that was investigated and analyzed, respectively or simultaneously.</p><p>[N]: N is the specific citation number of the related study included in the present review.</p><p>Characteristics of included studies about ambient humidity and children's health (n = 37).</p

Impact of Ambient Humidity on Child Health: A Systematic Review

<div><p>Background and Objectives</p><p>Changes in relative humidity, along with other meteorological factors, accompany ongoing climate change and play a significant role in weather-related health outcomes, particularly among children. The purpose of this review is to improve our understanding of the relationship between ambient humidity and child health, and to propose directions for future research.</p><p>Methods</p><p>A comprehensive search of electronic databases (PubMed, Medline, Web of Science, ScienceDirect, OvidSP and EBSCO host) and review of reference lists, to supplement relevant studies, were conducted in March 2013. All identified records were selected based on explicit inclusion criteria. We extracted data from the included studies using a pre-designed data extraction form, and then performed a quality assessment. Various heterogeneities precluded a formal quantitative meta-analysis, therefore, evidence was compiled using descriptive summaries.</p><p>Results</p><p>Out of a total of 3797 identified records, 37 papers were selected for inclusion in this review. Among the 37 studies, 35% were focused on allergic diseases and 32% on respiratory system diseases. Quality assessment revealed 78% of the studies had reporting quality scores above 70%, and all findings demonstrated that ambient humidity generally plays an important role in the incidence and prevalence of climate-sensitive diseases among children.</p><p>Conclusions</p><p>With climate change, there is a significant impact of ambient humidity on child health, especially for climate-sensitive infectious diseases, diarrhoeal diseases, respiratory system diseases, and pediatric allergic diseases. However, some inconsistencies in the direction and magnitude of the effects are observed.</p></div

Flow chart of the screening and selection process of the study articles.

<p>Flow chart of the screening and selection process of the study articles.</p

Adapted STROBE Statement—checklist of items that should be included in reports of observational studies (including additions/adaptations for accommodating meteorological data).

<p>*Give information separately for cases and controls in case-control studies and, if applicable, for exposed and unexposed groups in cohort and cross-sectional studies.</p><p>Adapted STROBE Statement—checklist of items that should be included in reports of observational studies (including additions/adaptations for accommodating meteorological data).</p