International Journal of Environmental Research and Public Health — Open Access Journal

Background: Perfectionism has been linked to suicide. According to the Narrative-Crisis Model of suicide, individuals with trait vulnerabilities are prone to develop a certain mindset, known as a Suicidal Narrative, which may precipitate the Suicide Crisis Syndrome (SCS), culminating in suicide. The purpose of this study was to investigate the association between perfectionism (trait vulnerability), fear of humiliation (component of the Suicidal Narrative), SCS, and prospective near-term suicidal thoughts and behaviors (STB). Methods: Adult psychiatric outpatient participants (N = 336) were assessed at baseline with the Suicidal Narrative Inventory for perfectionism and fear of humiliation. The questions used to assess perfectionism were adapted from the Multidimensional Perfectionism Scale. The severity of the SCS was calculated using the Suicide Crisis Inventory. STB were assessed at baseline and after one month using the Columbia Suicide Severity Rating Scale. Serial mediation analyses were conducted using PROCESS version 3.3 in SPSS. Results: While the direct effect of perfectionism on prospective STB was not significant (b = 0.01, p = 0.19), the indirect effect of perfectionism on STB, through serial mediation by fear of humiliation and the SCS, was significant (indirect effect p = 0.007, 95% CI [0.003,0.013]). The indirect effect was not significant for models that did not include both mediators. Limitations: Variables were assessed at one time only. Conclusion: Perfectionism did not directly modulate STB. Perfectionism may be related to suicidal behavior through fear of humiliation, leading to the SCS. These results support the Narrative-Crisis Model of suicide and clarify the role of perfectionism in the etiology of suicide. Full article

This paper presented a new approach to the calculation of quality-adjusted life years (QALY) based on multi-criteria decision-making (MCDM) methods and using the EQ-5D-5L questionnaire. The health status utility values were calculated through a hybrid methodology. We combined the analytic hierarchy process (AHP), the AHP with a D-number extended fuzzy preference relation (D-AHP), the fuzzy analytic hierarchy process (F-AHP), and the technique for order preference by similarity to the ideal solution (TOPSIS) to obtain individual and aggregated utility values. The preference data were elicited using a sample of individuals from a Colombian university. In all tested methods, the ordinal preferences were consistent, and the weights were compared using the Euclidean distance criterion (EDC). We identified F-AHP-TOPSIS as the optimal method; its benefits were associated with modeling the response options of the EQ-5D in linguistic terms, it gave the best approximation to the initial preferences according to EDC, and it could be used as an alternative to the known prioritization method. This hybrid methodology was particularly useful in certain medical decisions concerned with understanding how a specific person values his or her current health or possible health outcomes from different interventions in small population samples and studies carried out in low- and middle-low-income countries. Full article

A smart glasses-based wearable personnel proximity warning system (PWS) was developed for pedestrian safety in construction and mining sites. The smart glasses receive signals transmitted by Bluetooth beacons attached to heavy equipment or vehicles, with the proximity determined by the signal strength. A visual alert is displayed to the wearer when in close proximity. The media access control address of the Bluetooth beacon provides information on the approaching equipment or vehicle, which is displayed to the wearer so that they can respond appropriately. There was a detection distance of at least 10 m regardless of the direction the pedestrian was looking and the alert was successful in all 40 trials at ≥10 meters. The subjective workload was evaluated using the NASA task load index on ten subjects, either without a personal PWS, with a smartphone-based PWS, or with the smart glasses-based PWS. The mental, temporal, and physical stresses were lowest when using the smart glasses-based PWS. Smart glasses-based PWSs can improve work efficiency by freeing both hands of the pedestrians, and various functions can be supported through application development. Therefore, they are particularly useful for pedestrian safety in construction and mining sites. Full article

The aim of this study was to evaluate the risk factors associated with the occurrence of caries in permanent teeth (PT) and in the permanent first molar (PFM) seven years after their eruption. Children born in 2005 who were enrolled in a Community Dental Program were included. A total of 278 children were enrolled. Evaluated risk factors were parental caries experience, educational level of the mother, routine medications, systemic diseases, dietary habits, toothbrushing frequency, existence of molar incisor hypomineralization (MIH) in the PT, and caries in the temporary teeth (TT). Associations between independent variables and the DMF-T (decayed, missing, and filled teeth in PT) and DMF-M (DMF in PFM) indices, only considering cavitated and non-cavitated carious lesions or cavitated carious lesions as outcomes, were evaluated by Poisson regression with robust variance analysis. A cariogenic diet (sweets and soft drinks), toothbrushing frequency of <1 a day, a presence of df-t (decayed and filled temporary teeth) score of >0, low educational level of the mother, and existence of MIH were associated with high DMF-T or DMF-M values (p < 0.05). We can conclude that the intake of sweets and soft drinks, toothbrushing frequency, the presence of caries in TT, and MIH in PT were the best predictors of the occurrence of caries in PT and PFM. Full article

This paper describes efforts by public health practitioners to address a health crisis caused by economic development policies that are unrestrained by either environmental, public health, or human rights mandates. Economic development projects funded by international funding institutions like the Inter-American Development Bank that reduce poverty when measured in terms of Gross Domestic Product (GDP) per capita in the transborder region between Suriname and French Guiana harm minority populations where commercial activities destroy, alter, and remove the resources upon which local communities depend. In this study, the structural causes of a community health crisis affecting Indigenous people in the transborder region between Suriname and French Guiana was addressed by seeking gatekeepers in government who have access to policy-making processes. We found that deeply rooted economic development policies structured social, economic, and political alliances and made them resistant to feedback and reform. We concluded that work must be focused beyond the simple exchange of public health information. Public health practitioners must become politically active to create new policy commitments and new patterns of governance that advance development as well as improve health outcomes. Failure to do so may result in public health practitioners becoming ‘engaged followers’ that are complicit in the inhumanity that springs from their acquiescence to the authority of government officials when their policies are the cause of preventable death, disease, and disability. Full article

Poor air quality usually leads to PM_2.5 warnings and affects human health. The impact of frequency and duration of extreme air quality has received considerable attention. The extreme concentration of air pollution is related to its duration and annual frequency of occurrence known as concentration–duration–frequency (CDF) relationships. However, the CDF formulas are empirical equations representing the relationship between the maximum concentration as a dependent variable and other parameters of interest, i.e., duration and annual frequency of occurrence. As a basis for deducing the extreme CDF relationship of PM_2.5, the function assumes that the extreme concentration is related to the duration and frequency. In addition, the spatial pattern estimation of extreme PM_2.5 is identified. The regional CDF identifies the regional extreme concentration with a specified duration and return period. The spatial pattern of extreme air pollution over 8 h duration shows the hotspots of air quality in the central and southwestern areas. Central and southwestern Taiwan is at high risk of exposure to air pollution. Use of the regional CDF analysis is highly recommended for efficient design of air quality management and control. Full article

Flexible work arrangements permitting workers to work anytime and anywhere are increasingly common. This flexibility can introduce both challenges and opportunities for the organisation, as well as for worker work-life balance (WLB). This cross-sectional study aimed to examine the extent to which occupational factors (organizational, leadership and psychosocial) and individual work-related behaviours (over-commitment, overtime work and boundary management) are associated with WLB, and whether these associations are modified by the perceived level of flexibility at work (i.e., control over when, where, and how to do the work). In total, 2960 full-time office workers with flexible work arrangements at the Swedish Transport Administration participated. Associations were determined using linear regression analyses with adjustment for covariates. The strongest negative associations with WLB were found for over-commitment, quantitative job demands, expectations of availability, and overtime work. Strongest positive associations were found for boundary management, information about organizing work, social support, and relation-oriented leadership. Perceived flexibility was positively associated with WLB, and interacted with several of the examined factors, buffering their negative associations with WLB. Results suggest that WLB can be promoted by organizational initiatives focusing on minimizing excessive job demands, increasing psychosocial resources, supporting boundary management, and enhancing perceived flexibility. Full article

The aim of this study was to examine the quality of life and to report on the utility and QALY measures in patients before and after coronary artery bypass grafting (CABG); to investigate whether the SF-12 is comparable with the SF-36 for measuring health-related quality of life of patients with CABG; and to determine the impact of individual predictors on poor quality of life assessment after rehabilitation. This prospective study was conducted between January 2017 and December 2018 at the University Hospital Center Osijek, at three time points: pre-operation, 1 month after surgery, and after rehabilitation. The study was conducted with the SF-36 and SF-12 health questionnaires on 47 participants. After rehabilitation, there was a significant improvement in all domains of quality of life. The highest score was given to the change in pain (BP); mean scores were 63.8 (95% CI 56.9 to 70.6) (p = 0.001). The lowest grade (the lowest quality) after rehabilitation was in the domain of limitations due to physical difficulties (RP); arithmetic mean was 48.5 (95% CI 41 to 55.9) (p < 0.001). Quality-adjusted life-year was 0.41 (95% CI 0.38–0.44) after the CABG. The results of this study show that patients with coronary heart disease have poor quality of life before surgery. One month after the surgery, the quality of life improved, but was still inadequate. One year after surgery, satisfactory results were obtained in almost all subscales. The SF-36, SF-12, and its components, can be used effectively in patients with CABG. Age, gender, lifestyle, and risk factors in our sample of participants are not predictors of poor quality of life assessment after rehabilitation. Full article

Perfectionism is a multidimensional personality trait characterized by effort and rigidity in setting high personal standards, accompanied by an excessive tendency toward critical assessments, which plays an important role in cognitive, behavioral, and emotional functioning. During adolescence, personality is built on a fundamental pillar—self-esteem—which plays an important role in sports practice when it comes to achieving the best possible performance. Anger has an emotional component that, interpreted in an unadaptive way, interferes with sports performance. The aim of this study is to assess differences according to self-esteem and perfectionism indicators and anger expression and management in young athletes. The sample included 229 male athletes to the quarries of professional sports with ages between 13 and 17 years. They were administered the Multidimensional Perfectionism Scale, the State-Trait Anger Expression Inventory for Children and Adolescents, the Rosenberg Self-esteem Scale, and a socio-demographic questionnaire. Predictive analysis showed that low personal standards and high levels of organization (indicators of adaptive perfectionism) acted as predictors of state anger, while those showing high personal standards predicted high anger management in athletes with high self-esteem. High personal standards predicted lower indicators of trait anger in athletes with low self-esteem. The results revealed the influence of high self-esteem as a protective factor in the predictive relationship among anger traits and personal standards. The study describes the relationship of these variables in the belongings of young male footballers (under high sport pressure), showing the need to take care of the athletes’ self-esteem in sport environments through prevention programs that include psychological and social resources training systems. Full article

Dyslexia is one of the most common neurobehavioral disorders. Children with dyslexia usually suffer from negative, behavior personality problems, and impacted life quality. We aimed to identify family environment factors for dyslexia, and to evaluate the personality, behavior characteristics and life quality of children with dyslexia. A total of 60 children diagnosed with dyslexia and 180 normal children that were aged 7–12 who speak Chinese were recruited from four primary schools in Shantou City, China. Self-designed questionnaire, children’s edition of the Eysenck Personality Questionnaire (EPQ), Conners’ Parent Rating Scale (CPRS), and Quality of Life scale for children and adolescents (QLSCA) were employed for investigation. Multiple logistic regressions show that antenatal training (OR = 0.36), higher household income, higher parents’ educational levels, and parents engaging in white-collar jobs were negatively associated with dyslexia; while, family members also suffering from dyslexia (OR = 12.17), lower frequency of communication between parents and children, and worse parent-child relationship were positively associated with dyslexia. Children with dyslexia scored higher in psychoticism and neuroticism (p = 0.040, 0.008), but lower in extroversion and dissimulation than normal children (p = 0.025, 0.007) in the EPQ test. They tended to be more introversion (68.3% vs. 43.0%), psychoticism (25.0% vs. 13.3%), and neuroticism (46.7% vs. 18.8%) than the controls. In addition, children with dyslexia had higher scores in conduct problem, learning problem, hyperactivity, and Conners’ index of hyperactivity (CIH) in CPRS test; and, lower scores of psychosocial function, physical and mental health, and satisfaction of living quality in QLSCA test (all p < 0.05). Several family environment and parenting factors were associated with children’s dyslexia significantly. Children with dyslexia had the personality of psychoticism, neuroticism, introversion, and more behavioral problems. Dyslexia significantly impacted the children’s quality of life. Our findings provide multiple perspectives for early intervention of dyslexia in children, particularly in family factors and the parenting environment. Full article

Propane-1,3-sultone (PS) is an alkylating substance used in the production of polymers, fungicides, insecticides, dyes, and detergents. It is absorbed into the human body by inhalation, digestion, and through the skin; it is also a possible carcinogen. Occupational exposure to this substance may occur on industrial or laboratory contact. In Poland, the maximum allowable concentration (MAC) for PS in workplace air is 7 µg/m³. The paper presents a method for determination of PS in workplace air using a gas chromatograph coupled with a mass spectrometer (GC-MS). Air containing PS is passed through a glass tube containing a glass fiber filter and two layers of silica gel. The substance is washed with acetonitrile and the solution obtained analysed using GC-MS. The measuring range for an air sample of 360 L is 0.7 14 µg/m³. The limit of detection (LOD) is 13 ng/m³, limit of quantification (LOQ) is 40 ng/m³. Full article

The number of tuberculosis (TB) cases in Pakistan ranks fifth in the world. The National TB Control Program (NTP) has recently reported more than 462,920 TB patients in Khyber Pakhtunkhwa province, Pakistan from 2002 to 2017. This study aims to identify spatial and space-time clusters of TB cases in Khyber Pakhtunkhwa province Pakistan during 2015–2019 to design effective interventions. The spatial and space-time cluster analyses were conducted at the district-level based on the reported TB cases from January 2015 to April 2019 using space-time scan statistics (SaTScan). The most likely spatial and space-time clusters were detected in the northern rural part of the province. Additionally, two districts in the west were detected as the secondary space-time clusters. The most likely space-time cluster shows a tendency of spread toward the neighboring districts in the central part, and the most likely spatial cluster shows a tendency of spread toward the neighboring districts in the south. Most of the space-time clusters were detected at the start of the study period 2015–2016. The potential TB clusters in the remote rural part might be associated to the dry–cool climate and lack of access to the healthcare centers in the remote areas. Full article

Bovine brucellosis remains a persistent infection in ruminants in Pakistan. A total of 828 (409 buffaloes and 419 cattle) sera were collected from 11 institutional-owned livestock farms in Punjab, Pakistan. The samples were tested by rose bengal plate agglutination test (RBPT) and indirect enzyme-linked immunosorbent assay (iELISA). The seroprevalence along with 95% confidence interval (CI) was determined. Univariable and multivariable analysis of the epidemiological background data was conducted and odds ratio (OR) was calculated to understand any association between the risk factors and the seroprevalence. An overall seroprevalence of 3.9% (Positive/Tested = 32/828) and 3.3% (27/828) was detected by RBPT and iELISA, respectively. The seroprevalence of 5.6% (CI 3.6–8.3) and 4.7%, (CI 2.8–7.2) and the odds ratio of 2.63 (CI 1.20–5.77) and 2.50 (CI 1.08–5.78) for testing positive by RBPT and iELISA, respectively were significantly higher (p < 0.05) in buffaloes than in cattle. Breed, sex, history of abortion and retention of fetal membranes (RFM) in the animals were not found statistically significantly associated with the infection. RBPT and iELISA based results agreed almost perfect (k = 0.877). In total, Brucella abortus-DNA (9/27) was amplified from seropositive samples by real-time polymerase chain reaction. This study identified for the first time the etiological agents of brucellosis at a molecular level at institutional-owned livestock farms in Pakistan. Full article

The problem of early motherhood is still a serious medical and social problem in many countries around the world. The aim of this study was to analyze the attitudes of teenage mothers towards pregnancy and childbirth. A retrospective cross-sectional study was conducted with the use of an original questionnaire containing a test to measure attitudes on a five-point Likert scale and a Life Orientation Test-Revised (LOT-R) to assess dispositional optimism. The study involved 308 teenage mothers between 13 and 19 years of age. Attitudes of teenage mothers towards pregnancy and childbirth were more often positive (90.6%) than negative (9.4%). Sociodemographic features determining the attitudes of teenage mothers towards both their pregnancy and childbirth included their age, marital status, current occupation, and main source of income. The type of attitude adopted by teenage mothers towards pregnancy and childbirth was significantly related to the level of their dispositional optimism. Full article

Land consolidation is essential in China for improving land use efficiency and supporting rural public space governance. Previously, the implementation of land consolidation projects (LCPs) had been mainly led by governments in China. In recent years, the Chinese government vigorously promoted land consolidation, and land consolidation in the corporation-leading mode (CLM) has emerged. This study focused on investigating the performance of CLM projects and the difference in performance levels between the CLM projects and the government-leading mode (GLM) projects. Based on the improved extensible matter–element model, the performance levels of 14 LCPs in GLM and CLM of Jianghan Plain, Hubei Province and related impact factors were analyzed. A set of evaluation indices was selected based on the “process-based thinking and logic”. Results showed that: (1) performance levels of the 14 LCPs are different, most of the projects in the GLM have ordinary or poor performance, while most of the projects in the CLM have excellent or good performance; (2) factors affecting the performance levels of LCPs are also different in the two modes. The main influencing factors in the CLM were the poor access to field roads, insufficient shelterbelt planting, and low land reclamation efficiency, while the insufficient shelterbelt planting, low annual output value of farmland and grain production capacity, low increase rate of agricultural labor production, and low land reclamation efficiency were the main influencing factors in the GLM; (3) comparative analysis of the two modes revealed that LCPs in the CLM have clear investment directions, high output benefits, and obvious advantages in the development of modern agriculture when compared with the GLM. To achieve improving the performance levels of LCPs, policy makers should actively innovate the implementation mode of LCPs and encourage all kinds of agricultural corporations to participate in land consolidation. Full article

Current trends in the analysis of the physical fitness of athletes are based on subjecting the athlete to requirements similar to those found in competition. Regarding physical fitness, a thorough study of the capacities that affect the development of team sports in different ages and gender is required since the demands are not equivalent. The objective of this paper was to characterize the physical-physiological demands of athletes in an aerobic and anaerobic test specific to basketball players, as well as the evolution of the variables according to age and gender. The research was carried out in 149 players from different training categories (n = 103 male; n = 46 female). The athletes performed two field tests that evaluated both aerobic capacity and lactic anaerobic capacity. Each athlete was equipped with an inertial device during the tests. Sixteen variables (equal in both tests) were analyzed. Three of them evaluated technical-tactical aspects, four variables of objective internal load, six kinematic variables of objective external load (two related to distance and four related to accelerometry) and three neuromuscular variables of objective external load. The obtained results show significant differences in the variables analyzed according to the age and gender of the athletes. They are mainly due to factors related to the anthropometric maturation and development inherent in age and have an impact on the efficiency and technical and tactical requirements of the tests carried out and, therefore, on the obtained results in the tests. Full article

Effective risk communication in public health requires the development of social skills such as active listening and empathy. Communicative and social skills were evaluated in third-year medical students (n = 917) using the Active Listening Test and the Test of Cognitive and Affective Empathy. The results obtained revealed that our participants had equal or better-than-norm communication skills. Women scored higher in active listening whereas men scored higher on the General Empathy Scale. The students who preferred a clinical specialty obtained higher scores in active listening and empathetic abilities, as compared to students who chose a surgical specialty. In conclusion, the medical students who participated in the study exhibited good communicative and social skills. An association was observed between gender and specialty preference, and empathy and active listening skills. Full article

Extensive research underscores that we interpret the world through metaphors; moreover, common metaphors are a useful means to enhance the pursuit of personal and collective goals. In the context of planetary health—defined as the interdependent vitality of all natural and anthropogenic ecosystems (social, political and otherwise)—one enduring metaphor can be found in the concept of “Spaceship Earth”. Although not without criticism, the term “Spaceship Earth” has been useful to highlight both resource limitations and the beauty and fragility of delicate ecosystems that sustain life. Rene Dubos, who helped popularize the term, underscored the need for an exposome perspective, one that examines the total accumulated environmental exposures (both detrimental and beneficial) that predict the biological responses of the “total organism to the total environment” over time. In other words, how large-scale environmental changes affect us all personally, albeit in individualized ways. This commentary focuses the ways in which microbes, as an essential part of all ecosystems, provide a vital link between personal and planetary systems, and mediate the biopsychosocial aspects of our individualized experience—and thus health—over our life course journey. A more fine-grained understanding of these dynamics and our power to change them, personally and collectively, lies at the core of restoring “ecosystems balance” for person, place and planet. In particular, restoring human connectedness to the natural world, sense of community and shared purpose must occur in tandem with technological solutions, and will enhance individual empowerment for personal well-being, as well as our collective potential to overcome our grand challenges. Such knowledge can help shape the use of metaphor and re-imagine solutions and novel ways for restoration or rewilding of ecosystems, and the values, behaviors and attitudes to light the path toward exiting the Anthropocene. Full article

Introduction: Many studies have reported that regular physical activity is positively associated with cognitive performance and more selectively with executive functions. However, some studies reported that the association of physical activity on executive performance in younger adults was not as clearly established when compared to studies with older adults. Among the many physiological mechanisms that may influence cognitive functioning, prefrontal (PFC) oxygenation seems to play a major role. The aim of the current study was to assess whether executive function and prefrontal oxygenation are dependent on physical activity levels (active versus inactive) in healthy young males. Methods: Fifty-six healthy young males (22.1 ± 2.4 years) were classified as active (n = 26) or inactive (n = 30) according to the recommendations made by the World Health Organization (WHO) and using the Global Physical Activity Questionnaire (GPAQ). Bilateral PFC oxygenation was assessed using functional near-infrared spectroscopy (fNIRS) during a computerized Stroop task (which included naming, inhibition, and switching conditions). Accuracy (% of correct responses) and reaction times (ms) were used as behavioural indicators of cognitive performances. Changes in oxygenated (∆HbO₂) and deoxygenated (∆HHb) hemoglobin were measured to capture neural changes. Several two-way repeated measures ANOVAs (Physical activity level x Stroop conditions) were performed to test the null hypothesis of an absence of interaction between physical activity level and executive performance in prefrontal oxygenation. Results: The analysis revealed an interaction between physical activity level and Stroop conditions on reaction time (p = 0.04; ES = 0.7) in which physical activity level had a moderate effect on reaction time in the switching condition (p = 0.02; ES = 0.8) but not in naming and inhibition conditions. At the neural level, a significant interaction between physical activity level and prefrontal oxygenation was found. Physical activity level had a large effect on ΔHbO₂ in the switching condition in the right PFC (p = 0.04; ES = 0.8) and left PFC (p = 0.02; ES = 0.96), but not in other conditions. A large physical activity level effect was also found on ΔHHb in the inhibition condition in the right PFC (p < 0.01; ES = 0.9), but not in the left PFC or other conditions. Conclusion: The results of this cross-sectional study indicate that active young males performed better in executive tasks than their inactive counterparts and had a larger change in oxygenation in the PFC during these most complex conditions. Full article