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The construct of Morning Affect (MA; alertness upon awakening/time required to feel fully awake) emerged from exploratory factor analysis of morningness-eveningness questionnaires, and while it has been equated with morningness-eveningness preference it has much conceptual overlap with sleep inertia (SI; the transitional state between sleep and being fully awake). The current study compared questionnaire measures of these constructs to help clarify their inter-relationships. A volunteer sample of 453 students at an English-medium university in China completed an online survey including the Sleep Inertia Questionnaire (SIQ), the Morningness-Eveningness-Stability-Scale-improved (MESSi), with subscales for MA, Eveningness, and Distinctness (amplitude of diurnal variation), and the reduced Morningness-Eveningness Questionnaire (rMEQ). Measures of depression, sleep quality, mindfulness, and personality were also included. Exploratory factor analysis of the SIQ, MESSi, and rMEQ items revealed seven factors: Cognitive, Emotional, and Physiological SI, Responses to SI (including one MA item), and Duration of SI (one SIQ item, 3/5 MA items, and one rMEQ item); Morningness-Eveningness (MESSi Eveningness items, plus 3/5 rMEQ items); Distinctness (3/5 MESSi items). These results suggest that Morning Affect may be better characterised as a general measure of sleep inertia, and may contribute to ongoing development/refinement of questionnaire measures of circadian functioning. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the relationship between chronotypes and aggression in adolescents. Methods: A cross-sectional study was conducted on 755 primary and secondary school students aged 11–16 years in rural areas of Ningxia Province, China. The Chinese version of the Buss-Perry Aggression Questionnaire (AQ-CV) and the Chinese version Morningness-Eveningness Questionnaire (MEQ-CV) were used to assess the aggressive behavior and chronotypes of the study subjects. The Kruskal-Wallis test was then used to compare the differences in aggression among adolescents with different chronotypes, and Spearman correlation analysis to determine the relationship between chronotypes and aggression. Further linear regression analysis was used to investigate the effects of chronotype, personality traits, family environment, and class environment on adolescent aggression. Results: There were significant differences in chronotypes between different age groups and different sexes. Spearman correlation analysis showed that the MEQ-CV total score was negatively correlated with the AQ-CV total score (r = -0.263) and score of each AQ-CV subscale. In Model 1, chronotypes were negatively associated with aggression when controlling for age and sex, and evening-type adolescents might be more likely to exhibit aggressive behavior (b = -0.513, 95% CI: [-0.712, -0.315], P < 0.001); in Model 2, the negative association remained after controlling for family and class environment on the basis of Model 1 (b = -0.404, 95% CI: [-0.601, -0.208], P < 0.001); and in Model 3, the negative association still existed after controlling for personality traits on the basis of Model 2 (b = -0.383, 95% CI: [-0.577, -0.190], P < 0.001). Conclusion: Compared to morning-type adolescents, evening-type adolescents were more likely to exhibit aggressive behavior. Given social expectations for MT adolescents, adolescents should be actively guided to develop a good circadian rhythm that may be more conducive to their physical and mental development. [ABSTRACT FROM AUTHOR]

Background: In China, diabetes has become a serious healthcare problem that plagues individuals and the government because of its high mortality rate and social burden, with type 2 diabetes mellitus (T2DM) accounting for the vast majority (about 90%) of cases. T2DM patients face a huge medication burden and it is imperative to find appropriate tools to assess the medication burden for patients. This study aimed to translate the original Diabetes Treatment Burden Questionnaire (DTBQ) into Chinese and assessed the reliability and validity of the DTBQ concerning the burden of medication treatment in patients with type 2 diabetes. Methods: A total of 329 T2DM patients were recruited to participate in the survey. The original version scale was first translated into Chinese using the backward and forward translation procedures. The internal consistency reliability of the scale was measured by the Cronbach alpha coefficient, the test-retest reliability, and the item-total correlation. The validity of the scale was assessed by the content validity index, exploratory factor analysis and confirmatory factor analysis. Results: The content validity index of the scale was 0.920. Cronbach alpha coefficient for the scale was 0.831. Exploratory factor analysis (EFA) supported a 15-item and 3-factor structure of the translated questionnaire. Confirmatory factor analysis (CFA) showed in the model fitness index, the chi-square degree of freedom was 3.575, the incremental fit index (IFI) was 0.917, the comparative fit index(CFI) was 0.916, the Tucker Lewis Index(TLI) was 0.900, all within acceptable limits. The retest reliability was 0.892, and the corrected item-total correlations for the items ranged from 0.293 to 0.729. Conclusion: Verification results showed that the Chinese version of the 15-item DTBQ had reliable reliability and validity. Therefore, it can be considered as an appropriate tool to assess the burden of drug treatment for patients with type 2 diabetes in China. [ABSTRACT FROM AUTHOR]

Background: College freshmen tend to have more psychological and behavioral problems compared with other populations, especially depressive symptoms. Perceived parental control has been proved to play a significant role in mental health among children and adolescents. Based on the theoretical and empirical research of chronotype and sleep quality, this study constructed a chain mediating model to examine whether they mediated the relationship between parental control and depressive symptoms among Chinese college freshmen.Methods: A total of 2014 college freshmen from Dali University were recruited to participate in this study and completed self-report Parental Bonding Instrument (PBI), Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI) and Self-Rating Depression Scale (SDS). PROCESS 3.5 for SPSS was applied to determine the chain mediating effect of chronotype and sleep quality between parental control and depressive symptoms.Results: College freshmen with depressive symptoms have higher levels of parental control and worse subjective sleep quality than normal population (all p < 0.001). All study variables are correlated with each other, while chronotype has no significant association with depressive symptoms (r = -0.03, p > 0.05). Both maternal and paternal control have a direct link with depressive symptoms (β = 0.86, p < 0.001; β = 0.88, p < 0.001). Parental control could affect depressive symptoms via the independent mediating effect of sleep quality and the chain mediating effect of chronotype and sleep quality. The total indirect effects of maternal and paternal control on depressive symptoms are 0.93 and 0.94, respectively.Conclusions: Chronotype and sleep quality could mediate the association between parental control and depressive symptoms. [ABSTRACT FROM AUTHOR]

Correlates of academic achievement can vary by subject and by assessment type, although consistent associations have been found with some variables, including morningness-eveningness. In the present study, 153 second-year undergraduate Business School students at an English-medium university in China completed questionnaire measures of morningness-eveningness, mind wandering, sleep quality, conscientiousness, affect and metacognitive beliefs. Positive correlates of grades in three English for Academic Purposes assessments (coursework, speaking, and exam) included English level, morningness and self-discipline. Negative correlates of achievement included mind wandering, negative affect, rise time and poor sleep quality, and also maladaptive metacognitive beliefs, which were most strongly associated with exam performance. Significant predictors of achievement included English level and aspects of sleep quality. Exploratory mediation analysis investigated potential mediators between morningness-eveningness and achievement. Morningness-eveningness was found to have indirect effects on achievement through sleep-related factors, mind wandering, conscientiousness, negative affect, and metacognitive beliefs. These results contribute to the understanding of academic achievement in different subjects and assessment types, and identify possible indirect effects in the association between morningness-eveningness and academic achievement. [ABSTRACT FROM AUTHOR]

Objective: To evaluate reliability and validity of the Chinese version of Narcolepsy Severity Scale (NSS) in adult patients with narcolepsy type 1 (NT1).Methods: One hundred and fifty-one adult patients (≥18 years) with NT1 were recruited. All filled out the 15-item Chinese version of NSS. Item analysis included critical ratio and correlation analysis. The validity of NSS was assessed by exploratory factor analysis, discriminant validity and convergent validity. Reliability of NSS was assessed by Cronbach's α coefficient, spilt-half reliability and test-retest reliability.Results: Critical value of all 15 items ranged from 3.01 to 13.36. Each item was significantly correlated with the total score by a correlation coefficient (r) ranging from 0.219 to 0.700. Three common domains were extracted and 15 items explained 54.86% of the total variance. There was a shift in domains compared to the English version likely due to cultural differences. Cronbach's α coefficient for the total scale of 15 items was 0.821 and for three factors was 0.726, 0.748 and 0.760 respectively. The NSS had good correlation with Epworth sleepiness scale scores, Insomnia severity index scores and moderate correlation with mean the sleep latency of polysomnographic recording, and European Quality of Life-5 Dimensions Questionnaire. The Chinese version of NSS showed good spilt-half reliability and test-retest reliability.Conclusion: The Chinese version of NSS shows satisfactory psychometric properties with good validity and reliability. It is applicable to evaluate the severity and consequences of symptoms in Chinese adult patients with NT1. [ABSTRACT FROM AUTHOR]

Objective: To assess sleep disturbances and associated factors among front-line healthcare providers who have been called upon for, dispatched (HPCD) and exposed to COVID-19 in China.Methods: This cross-sectional, survey-based, isolation area-stratified study collected demographic data, sleep status and emotional measurements from 1036 HPCD in nine medical institutions from March 5 to 9, 2020 in Wuhan, China, which was the epicenter of the epidemic. HPCD who worked in isolation areas with COVID-19 were eligible for inclusion. The severity of symptoms of sleep disorders, insomnia and emotional self-efficacy were assessed by the Chinese versions of the 10-item Self-rating sleeping situation scale, the seven-item Insomnia Severity Index and the 12-item Regulatory emotional self-efficacy questionnaire, respectively. Univariate analysis was performed to identify factors associated with sleep disturbances. A structural equation model (SEM) was constructed via AMOS to explore the relationship among the four components.Results: A total of 1036 out of 1075 contacted individuals completed the survey, with a participation rate of 96.4%. A total of 925 (89.3%) were aged 20-39 years, and 755 (72.9%) were women. Among all participants, 874 (84.4%) were nurses, and 162 (15.6%) were physicians; 538 (51.9%) worked in intensive care isolation units; 843 (81.4%) worked in isolation areas for 4 h straight, and 395 (38.1%) perceived COVID-19 peer exposure. A considerable proportion of participants reported symptoms of sleep disorders (543, 52.4%). Exposure status and length of work were the main factors affecting sleep status, which had indirect effects on sleep status by mediating regulatory emotional self-efficacy.Conclusions: In this survey of HPCD for patients with COVID-19 in China, participants reported experiencing sleep disturbance burdens, especially those having exposure experience and working long shifts. Regulatory emotional self-efficacy (RESE) is an important resource for alleviating sleep disturbances and improving sleep quality. These findings emphasize the importance of being prepared to support HPCD through psychological interventions. [ABSTRACT FROM AUTHOR]

Objectives: The 2019 novel coronavirus (COVID-19) pandemic is a severe global crisis which has resulted in many public health problems. This study aimed to investigate the prevalence of poor sleep quality and its related factors among employees who returned to work during the COVID-19 pandemic.Methods: Our online cross-sectional study included 2,410 participants aged ≥17 years in Deqing and Taizhou, Zhejiang Province, China from 5th to 14th March 2020. The questionnaire covered information on demographic characteristics, health status, workplace, lifestyle, attitude towards COVID-19, assessment of anxiety, depression and sleep quality. The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) was administered to measure the poor sleep quality. Poor sleep quality was defined as a global PSQI score>5. Factors associated with sleep quality were analyzed by logistic regression models.Results: In sum near half (49.2%) of 2,410 returning workers were females and the average year of subjects was 36.3 ± 9.1 years. The overall prevalence of poor sleep quality was 14.9% (95%CI: 13.5%-16.3%). The average score of PSQI was 3.0 ± 2.5 and average sleep duration was 7.6 ± 1.2 h. Independent related factors of poor sleep quality included age older than 24 years, higher education level, negative attitude towards COVID-19 control measures, anxiety and depression.Conclusions: Poor sleep quality was common and there was a shorter sleep duration among returning workers during the COVID-19 pandemic. Possible risk factors identified from this study may be of great importance in developing proper intervention for the targeted population to improve the sleep health during the COVID-19 public health emergency. [ABSTRACT FROM AUTHOR]

Aim: Individual vulnerability to shift work disorder (SWD) varies. The aim of the present study was to verify the individual characteristics that predicted SWD onset by following Chinese intern nurses who at baseline had not worked rotating or night shifts.Methods: A total of 706 Chinese first-year intern female nurses aged 16-24 years were recruited. At baseline (T0), they reported demographic characteristics, insomnia symptoms and excessive sleepiness, trait neuroticism, sleep reactivity, morningness, and circadian flexibility and languidity. At the three-month (T1) and six-month (T2) follow-up, the SWD status was determined based on significant sleep disturbance and/or excessive sleepiness in the context of working a rotating shift schedule.Results and Conclusions: The prevalence rates of SWD were 35.2% at T1 and 37.7% at T2. Two bivariate logistics regressions revealed that morningness (odds ratio [OR] = 1.31, 95% confidence interval [CI] = 1.09-1.58, T1; OR = 1.36, 95% CI = 1.12-1.65, T2), languidity (OR = 1.56, 95% CI = 1.28-1.90, T1), and sleep reactivity (OR = 1.29, 95% CI = 1.07-1.57, T1; OR = 1.31, 95% CI = 1.07-1.61, T2) predicted the onset of SWD, while flexibility (OR = 0.75, 95% CI = 0.62-0.90, T1) decreased the odds of SWD onset. By comparing nurses with SWD and nurses without SWD across all six months, morningness (OR = 1.58, 95% CI = 1.20-2.07), sleep reactivity (OR = 1.54, 95% CI = 1.16-2.04), languidity (OR = 1.70, 95% CI = 1.30-2.22), and flexibility (OR = 0.70, 95% CI = 0.54-0.90) showed significant effects on persistent SWD. [ABSTRACT FROM AUTHOR]

Objectives: To explore the relationship between sleep pattern (morningness–eveningness) and depression in Chinese shift workers ("Three Shifts" workers), and to examine whether emotional exhaustion plays a mediating role in this relationship. Study Design: We examined the impact of sleep pattern on the depression of three shifts workers, focusing on the mediating effect of emotional exhaustion. Methods: A total of 1303 shift workers in the north and south of China were invited to participate in this study using convenience sampling. They completed a questionnaire which collected information on socio‐demographic variables, along with measures of sleep pattern, depression, and emotional exhaustion. Using structural equation modelling, the mediating role of emotional exhaustion in sleep pattern and depression was explored. Results: Of the three shifts workers 46.43% reported symptoms of depression; 27.84% identified as morning types while only 6.56% were evening types, with the remaining 65.60% falling into the intermediate category. There was a negative correlation between sleep pattern and depression, and between sleep pattern and emotional exhaustion, but a positive correlation between emotional exhaustion and depression. As predicted, emotional exhaustion played a mediating role in the relationship between sleep pattern and depression. Conclusions: Having an evening sleep pattern was a risk factor for depression in three shifts workers; however, emotional exhaustion mediated the relationship between sleep pattern and depression. This finding may inform interventions aimed at reducing the level of depression within three shifts staff. [ABSTRACT FROM AUTHOR]

Background: People undergoing mass home- and community-based quarantine are vulnerable to mental health disorders during outbreaks of coronavirus disease (COVID-19), but few studies have evaluated the associated psychosocial factors.Objective: This study aimed to estimate the prevalence of anxiety and depressive symptoms and identify associated demographic and psychosocial factors in the general Chinese population during the COVID-19 pandemic quarantine period.Methods: Participants aged 18 years or above were recruited in a cross-sectional online survey using snowball sampling from February 26-29, 2020. The survey included questions on demographics, family relationships, chronic diseases, quarantine conditions, lifestyle, COVID-19 infection, and anxiety and depressive symptoms. Logistic regression analyses were conducted to identify factors associated with elevated anxiety or depressive symptoms.Results: Out of 2331 participants, 762 (32.7%) experienced elevated anxiety or depressive symptoms. Nine risk factors associated with anxiety or depressive symptoms included younger age, reduced income, having cancer or other chronic diseases, having family members living with cancer, concerns related to COVID-19 infection for themselves or family members, living alone, having family conflicts, having <3 or >8 hours of sedentary time per day, and worsened sleep quality.Conclusions: The findings highlight an urgent need for psychological support for populations at high risk for elevated anxiety or depressive symptoms during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

• The evening-type drivers showed different direction in self-reported driving behavior and simulated driving behavior. • The evening-type drivers self-reported more dangerous driving behaviors but had better lateral control on the simulated driving task than morning-type drivers. • The evening-type drivers had greater accuracy in the visual-spatial working memory task than morning-type drivers. • The ability of visual-spatial working memory could predicted the simulated driving behavior. Circadian rhythms are changes in life activities over a cycle of approximately 24 hours. Studies on chronotypes have found that there are significant differences in physiology, personality, cognitive ability and driving behavior between morning-type and evening-type people. The purpose of this study is to explore the relationship between visual-spatial working memory and driving behavior between morning-type and evening-type drivers in China. A total of 42 Chinese drivers were selected to participate in this study according to their score on the Morningness-Eveningness Questionnaire, including 22 morning-type drivers and 20 evening-type drivers. During the experiment, the participants completed one cognitive task (visual-spatial working memory), two simulated driving tasks (car-following task and pedestrian-crossing task), and the Dula Dangerous Driving Index (DDDI). The results showed that evening-type drivers self-reported more dangerous driving behaviors but had better lateral control on the simulated driving task than morning-type drivers. In addition, evening-type drivers had greater accuracy when performing the visual-spatial working memory task. Moreover, the accuracy on the visual-spatial working memory task positively predicted the percentage of time over the speed limit by 10 mph (POS10) and negatively correlated with the reaction time measure (time to meet pedestrians) in the pedestrian-crossing task. The relationships among chronotype, cognitive ability and driving behavior are also discussed. Understanding the underlying mechanisms could help explain why evening-type drivers perform dangerous driving behaviors more often. [ABSTRACT FROM AUTHOR]

Despite the fact that urban green spaces provide multiple benefits to urban residents, they have some negative effects on people, such as mosquito bites which not only cause major nuisance and debase visitors' experiences, but also transmit infectious diseases, discouraging people access to urban green spaces. In order to find the effects of landscape composition on mosquito population and provide practical methods of design to control mosquitoes, ten sample sites of urban green spaces in Xuzhou, eastern China were selected and their mosquito densities were measured using the light traps during the evening in summer 2019. And, the satellite image with a radius of 300 m centered by the light trap on each site was used to quantify the landscape composition of the ten sites studied. The results indicate that (1) more aquatic plants can predicate a higher mosquito density, and more water implies an environment with more mosquitoes; (2) in general, the higher the wood plant coverage is, the fewer mosquitoes are. These results provide valuable guidance and reference for anti-mosquito landscape design and management. [ABSTRACT FROM AUTHOR]