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

Social support before and after childbirth is a possible protective factor for perinatal depression. Currently, there is a lack of longitudinal studies beyond the first year postpartum exploring the relationship of social support with depression and anxiety. Social support is also a possible protective factor for adverse child development, which is a known consequence of perinatal depression. The present study followed up a cohort of depressed women (n = 54) from a randomised controlled trial of psychological treatment for antenatal depression. We examined the trajectory of the relationships between perceived social support (Social Provisions Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory) twice in pregnancy and twice postpartum up to two years. The influence of social support on child development and parenting-related stress was also explored. Two aspects of social support, Reassurance of Worth and Reliable Alliance, were strongly related to perinatal depression and anxiety, particularly when predicting symptoms in late pregnancy. However, the effect of postnatal depression on child development at 9 and 24 months post-birth was not mediated by social support. These results suggest the importance of adjusting current interventions for depressed perinatal women to focus on social support in late pregnancy and the first six months postpartum. Full article

Although some previous studies have examined the impact of transformational leadership on safety behavior, those works have paid relatively less attention to the intermediating role of employees’ job strain in the link as well as contingent variables that moderate the relationship. Considering that not only job strain substantially affects employees’ perceptions, attitudes, and behaviors in an organization, but also there are some contextual factors that moderate the relationships, we investigated intermediating mechanisms (i.e., mediator and moderator) in the relationship between transformational leadership and safety behavior. Relying on the context-attitude-behavior framework, we conducted a structural equation modeling analysis with a moderated mediation model. Specifically, we hypothesized that the level of an employee’s job strain would mediate the transformational leadership–safety behavior link. We also hypothesized that an employee’s self-efficacy regarding safety would moderate the association between job strain and safety behavior. Using survey data from 997 South Korean employees, we found that all of our hypotheses were supported. The findings suggest that the level of an employee’s job strain mediates and elaborately explains the transformational leadership–safety behavior link. Moreover, an employee’s self-efficacy regarding safety is a buffering factor which decreases the harmful effects of job strain on safety behavior. Full article

Athletes possibly experience a great deal of stress which may cause anxiety and burnout. Athletes’ perceptions of their coaches’ behaviors influence their performance and psychological well-being. The purpose of this study is to investigate the relationship between athletes’ perception of their coaches’ coaching behaviors and burnout, and also to examine the medication effects of competitive trait anxiety on the relationship. A total of 368 collegiate athletes participated in the study, and their ages ranged from 20 to 26 years old (M_age = 21.21 years, SD = 1.07 years). A cross-sectional research design was employed to collect the data. Descriptive statistics and structural equation modeling are utilized to analyze the data. Trait anxiety in athletes had a significant correlation with athlete burnout as well as significant pathways. Controlling coaching behaviors were significantly related to athletes’ competitive trait anxiety, whereas autonomy-supportive coaching behaviors were not significantly related to trait anxiety. A significant positive pathway from controlling coaching to trait anxiety was observed. The bootstrapping results indicated a significant and indirect pathway from controlling coaching to athlete burnout via competitive trait anxiety. Given that controlling coaching behaviors affected trait anxiety and, in turn, burnout, it is concluded that coaches should provide less controlling coaching to reduce anxiety and burnout in athletes. Full article

The psychometric properties of the Parental Smartphone Use Management Scale (PSUMS) and its prospective relationships with symptoms of smartphone addiction and attention deficit hyperactivity disorder (ADHD) were studies in a sample of parents of adolescents with ADHD. This is a scale to measure parents’ perceived self-efficacy on managing their children’s smartphone use. Construct validity (exploratory factor analysis and confirmatory factor analysis), criterion-related validity (known-group validity and concurrent validity), and reliability (Cronbach’s alpha) were performed for data analyses. The results showed that the PSUMS had good factorials validity and high reliabilities, with Cronbach’s alphas ranging between 0.93 and 0.95. The 17-item PSUMS accounted for 78.58% of the total variance and contains three theoretically and statistically appropriate subscales: reactive management, proactive management, and monitoring. Strong relationships were found between parental smartphone use management and symptoms of smartphone addiction and ADHD in expected directions. Moreover, parents of children with smartphone addiction yielded lower scores on all three PSUMS subscales than parents of children without smartphone addiction. The PSUMS is considered a valuable and reliable tool in the study of parental management on their adolescent children’s smartphone use, while providing us with important targets for intervention. Full article

The aim of this investigation was to assess the association of sedentary behaviour with 12 different sleep problem indicators among rural middle-aged and elderly adults in South Africa. Cross-sectional data were analysed from the “Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa” (HAALSI) baseline survey. Participants responded to a questionnaire, including sociodemographic, health, anthropometric measures, sedentary behaviour and 12 different sleep problem indicators. The sample included 4782 individuals 40 years and older (median 61 years, interquartile range = 20 years). Overall, participants engaged <4 h (55.9%), 4–<8 h (34.1%), 8 or more hours a day (9.9%) sedentary time a day. In adjusted multinomial logistic regression, 8 h of more sedentary time was associated with short and long sleep. In adjusted logistic regression analysis, high sedentary time was positively associated with snoring, gasping, breathing stops and restless sleep and negatively associated with insufficient sleep and sleep problems due to a traumatic event. In combined analysis, compared to persons with low or moderate sedentary behaviour and moderate or high physical activity, persons with high sedentary behaviour and low physical activity were more likely to have long sleep, insufficient sleep, snoring, gasping, breathing stops, and restless sleep and less likely to have sleep problems due to traumatic events. Findings show an association between sedentary behaviour and/or combined sedentary behaviour and low physical activity with seven of 12 sleep problem indicators (short sleep, long sleep, insufficient sleep, snoring, gasping, breathing stops, and restless sleep). Full article

The evolution of lung function, including assessment of small airways, was assessed in individuals enrolled in the World Trade Center Environmental Health Center (WTC-EHC). We hypothesized that a bronchodilator response at initial evaluation shown by spirometry or in small airways, as measured by forced oscillation technique (FOT), would be associated with improvement in large and small airway function over time. Standardized longitudinal assessment included pre and post bronchodilator (BD) spirometry (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV₁) and FOT (resistance at 5 Hz, R₅; resistance at 5 minus 20 Hz, R_5–20). Longitudinal changes were assessed using linear mixed-effects modelling with adjustment for potential confounders (median follow-up 2.86 years; 95% measurements within 4.9 years). Data demonstrated: (1) parallel improvement in airflow and volume measured by spirometry and small airway function (R₅ and R_5–20) measured by FOT; (2) the magnitude of longitudinal improvement was tightly linked to the initial BD response; and (3) longitudinal values for small airway function on FOT were similar to residual abnormality observed post BD at initial visit. These findings suggest presence of reversible and irreversible components of small airway injury that are identifiable at initial presentation. These results have implications for treatment of isolated small airway abnormalities that can be identified by non-invasive effort independent FOT particularly in symptomatic individuals with normal spirometry indices. This study underscores the need to study small airway function to understand physiologic changes over time following environmental and occupational lung injury. Full article

To investigate the role and microorganism-related mechanisms of macrophytes and assess the feasibility of Oenanthe javanica (Blume) DC. in promoting nitrogen removal in free-water surface constructed wetlands (FWS-CWS) under low temperatures (<10 °C), pilot-scale FWS-CWS, planted with O. javanica, were set up and run for batch wastewater treatment in eastern China during winter. The presence of macrophytes observably improved the removal rates of ammonia nitrogen (65%–71%) and total nitrogen (41%–48%) (p < 0.05), with a sharp increase in chemical oxygen demand concentrations (about 3–4 times). Compared to the unplanted systems, the planted systems not only exhibited higher richness and diversity of microorganisms, but also significantly higher abundances of bacteria, ammonia monooxygenase gene (amoA), nitrous oxide reductase gene (nosZ), dissimilatory cd1-containing nitrite reductase gene (nirS), and dissimilatory copper-containing nitrite reductase gene (nirK) in the substrate. Meanwhile, the analysis of the microbial community composition further revealed significant differences. The results indicate that enhanced abundances of microorganisms, and the key functional genes involved with nitrogen metabolism in the planted systems played critical roles in nitrogen removal from wastewater in FWS-CWS. Furthermore, abundant carbon release from the wetland macrophytes could potentially aid nitrogen removal in FWS-CWS during winter. Full article

Nitrate and bromide ions are generally considered indicators of anthropogenic pollution and seawater intrusion, respectively, in the groundwater of coastal territories. The analysis of these species is generally carried out with routine chromatographic analyses which generally afford partially merged or poorly resolved peaks. In the present paper a simple method for the correct evaluation of their concentration in water is reported. This method does not imply utilization of other instruments or technologies, only the mathematical elaboration of the data obtained from routine analysis of standard solutions containing the two species. Standard binary solutions of nitrate and bromide ions at different concentrations, ranging between 0.1 and 2 mM, were analyzed by means of ion chromatography. Splitting two partially merged chromatographic peaks and considering each resulting area as originating from a single species produces “measured” concentration values which differ from the nominal ones. Such a procedure generates errors (one per species) which can be written as a function of the above mentioned “measured” concentrations and which can be graphically represented by means of a surface in a three-dimensional (3D) space. In this way, “measured” concentrations of bromide and nitrate ions can be corrected by calculating the errors generated under the experimental conditions at which the chromatographic separation is performed. Notably, this is analogous with the two-dimensional (2D) calibration normally carried out for analytical purposes. Indeed, both methods allow estimation of the unknown concentration of species in solution by correlating the instrumental response with the concentration of standard solutions. Full article

Sufficient and accurate air pollutant data are essential to analyze and control air contamination problems. An orthogonal polynomial fitting (OPF) method using Chebyshev basis functions is introduced to produce spatial distributions of fine particle (PM_2.5) concentrations in central and southern regions of China. Idealized twin experiments (IE1 and IE2) are designed to validate the feasibility of the OPF method. IE1 is designed in accordance with the most common distribution of PM_2.5 concentrations in China, whereas IE2 represents a common distribution in spring and autumn. In both idealized experiments, prescribed distributions are successfully estimated by the OPF method with smaller errors than kriging or Cressman interpolations. In practical experiments, cross-validation is employed to assess the interpolation results. Distributions of PM_2.5 concentrations are well improved when OPF is applied. This suggests that errors decrease when the fitting order increases and arrives at the minimum when both orders reach 6. Results calculated by the OPF method are more accurate than kriging and Cressman interpolations if appropriate fitting orders are selected in practical experiments. Full article

Lead exposure is associated with a wide range of adverse effects on human health. The principal exposure route in the general population is through the diet. In this study, we estimate the dietary lead intake and associated health risks among the residents of Guangzhou, China. Data on lead concentrations were derived from the food safety risk monitoring system, which included 6339 samples from 27 food categories collected in 2014–2017. Food consumption data were taken from a 2011 dietary survey of 2960 Guangzhou residents from 998 households. Dietary lead intake was estimated by age group (3–6, 7–17, 18–59, and ≥60 years), and relevant health risks were assessed using the margin of exposure (MOE) method. The mean and 95th percentiles (P95) of dietary lead intake were respectively 0.7466 and 2.4525 μg/kg body weight per day for preschool children aged 3–6 years; 0.4739 and 1.5522 μg/kg bw/day for school children aged 7–17 years; 0.3759 and 1.1832 μg/kg bw/day for adults aged 18–59 years; and 0.4031 and 1.3589 μg/kg bw/day for adults aged ≥60 years. The MOE value was less than 1 for preschool children at the mean exposure level and for all age groups at the P95 exposure level. Rice and its products, leafy vegetables, and wheat flour and its products were found to be the primary food sources of lead exposure. Our findings suggest that the health risk from dietary lead exposure is low for Guangzhou residents overall, but that young children and consumers of certain foods may be at increased risk. Continued efforts are needed to reduce the dietary lead exposure in Guangzhou. Full article

In this study, we assessed the hemoglobin levels and anemia status of Chinese children and adolescents from the Chinese National Nutrition and Health Survey (CNNHS) in 2010–2012 and analyzed the factors associated with anemia. The hemoglobin concentration and prevalence of anemia for children and adolescents aged 6–17 years from both CNNHS 2010–2012 and CNNHS 2002 were analyzed. Multi-variable logistic regression analysis was used to assess the factors associated with anemia. The mean hemoglobin concentration increased among Chinese children and adolescents, from 135.2 ± 13.9g/L in CNNHS 2002 to 141.2 ± 15.8 g/L in CNNHS 2010–2012, with the prevalence of anemia decreasing from 12.6% to 6.6% (p<0.0001). Anemia was specifically related to girls (p < 0.0001);children aged 6–8 years (p = 0.0175), 12–14 years (p = 0.0007), and 15–17 years (p < 0.0001);ordinary rural areas (p = 0.0009) and poor rural areas (p < 0.0001);spring (p < 0.0001), autumn (p < 0.0001), and winter (p < 0.0001);underweight individuals (p < 0.0001); and an annual average income per capita of less than 20,000 RMB (p < 0.0001).The prevalence of anemia in Chinese children and adolescents has improved significantly in comparison to 10 years prior; however, it remains a public health problem in this population. Further research is required to understand the determinants of iron status, which could then lead to strategies to alleviate iron deficiency for Chinese children and adolescents, especially for girls, those living in rural areas, underweight individuals, and those with a low family income. Full article

This study aims to investigate the association between surrounding greenness and schizophrenia incidence in Taiwan. Data of 869,484 individuals without a history of schizophrenia were included from the Longitudinal Health Insurance Database from 2000 through 2010 for analysis. The diagnoses of schizophrenia were based on ICD-9 codes. Greenness exposure was assessed using the satellite-based normalized difference vegetation index, assuming individuals lived near the hospital they most often visited for common cold during the study period. Cox proportional hazards models were applied to assess the association between greenness exposure and schizophrenia incidence after adjustments were made for the potential confounders. A total of 5,069 schizophrenia cases were newly diagnosed during the study period. A negative significant (P < 0.05) association found using 2,000-m buffer distances (distance of a moderately paced 20-min walk) in the whole Taiwan island, cities, and metropolitan areas. The results of the stratified analysis based on sex and health insurance rate suggested surrounding greenness has approximately equal effects of reducing the risk of schizophrenia, regardless of sex or financial status. In conclusion, our findings suggest that more surrounding greenness may reduce the risk of schizophrenia. Full article

The rise in obesity prevalence has increased research interest in the obesogenic environment and its influence on excess weight. The aim of the present study was to review and map data collection instruments for obesogenic environments in adults in order to provide an overview of the existing evidence and enable comparisons. Through the scoping review method, different databases and webpages were searched between January 1997 and May 2018. Instruments were included if they targeted adults. The documents were categorised as food environment or built environment. In terms of results, 92 instruments were found: 46 instruments measuring the food environment, 42 measuring the built environment, and 4 that characterised both environments. Numerous diverse instruments have been developed to characterise the obesogenic environment, and some of them have been developed based on existing ones; however, most of them have not been validated and there is very little similarity between them, hindering comparison of the results obtained. In addition, most of them were developed and used in the United States and were written in English. In conclusion, there is a need for a robust instrument, improving or combining existing ones, for use within and across countries, and more sophisticated study designs where the environment is contemplated in an interdisciplinary approach. Full article

The study aimed to investigate the association between sedentary behavior and depression among rural South Africans. Data were analyzed from the cross-sectional baseline survey of the “Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa (HAALSI)”. Participants responded to various measures, including sociodemographic information, health status, anthropometric measures, and sedentary behavior. The sample included 4782 persons (40 years and above). Overall, participants engaged in <4 h (55.9%), 4–<8 h (34.1%), 8–<11 h (6.4%), or 11 or more h a day (3.5%) of sedentary behavior, and 17.0% screened positive for depression. In multivariable logistic regression, which was adjusted for sociodemographic variables (Model 1) (Odds Ratio, or OR: 2.45, Confidence Interval, or CI: 1.74, 3.46) and adjusted for sociodemographic and health variables, including physical activity (Model 2) (OR: 3.00, CI: 2.00, 4.51), high sedentary time (≥11 h) was independently associated with depression. In combined analysis, compared to persons with low or moderate sedentary behavior (<8 h) and moderate or high physical activity, persons with high sedentary behavior (≥8 h) and low physical activity were more likely to have depression in Model 1 (OR: 1.60, CI: 1.65, 3.13) and Model 2 (OR: 1.60, CI: 1.05, 2.44). Findings support that sedentary behavior and combined sedentary behavior and low physical activity may be a modifiable target factor for strategies to reduce depression symptoms in this rural population in South Africa. Full article

This study examines whether having health conditions or concerns related to smoking is associated with use of vaping products. Data came from the 2016 wave of the International Tobacco Control Four Country Smoking and Vaping Survey. Smokers and recent quitters (n = 11,344) were asked whether they had a medical diagnosis for nine health conditions (i.e., depression, anxiety, alcohol problems, severe obesity, chronic pain, diabetes, heart disease, cancer, and chronic lung disease) and concerns about past and future health effects of smoking, and their vaping activities. Respondents with depression and alcohol problems were more likely to be current vapers both daily (Adjusted odds ratio, AOR = 1.42, 95% confidence interval, CI 1.09–1.85, p < 0.05 for depression; and AOR = 1.52, 95% CI 1.02–2.27, p < 0.05 for alcohol) and monthly (AOR = 1.32, 95% CI 1.11–1.57 for depression, p < 0.01; and AOR = 1.43, 95% CI 1.06–1.90, p < 0.05 for alcohol). Vaping was more likely at monthly level for those with severe obesity (AOR = 1.77, 95% CI 1.29–2.43, p < 0.001), cancer (AOR = 5.19, 95% CI 2.20–12.24, p < 0.001), and concerns about future effects of smoking (AOR = 1.83, 95% CI 1.47–2.28, p < 0.001). Positive associations were also found between chronic pain and concerns about past health effects of smoking and daily vaping. Only having heart disease was, in this case negatively, associated with use of vaping products on their last quit attempt (AOR = 0.72, 95% CI 0.43–0.91, p < 0.05). Self-reported health condition or reduced health associated with smoking is not systematically leading to increased vaping or increased likelihood of using vaping as a quitting strategy. Full article

China’s construction industry has experienced a long period of development and reform but compared to developed countries, safety on construction sites in China continues to present serious problems. Safety consciousness and safety citizenship behaviour are influential factors related to safety issues in the construction industry and may play a direct role in improving the safety of personnel on construction sites. However, recently no research has been focused on the relationship between safety consciousness and safety citizenship behaviour. Therefore, this paper aimed to investigate the relationship between safety consciousness and safety citizenship behaviour for personnel working on construction sites in China by using a questionnaire survey and statistical analysis, so that correlation between safety consciousness and safety citizenship can be demonstrated and effective measures suggested to improve the safety of construction workers in China, and perhaps in other countries as well. Full article

This study aimed to evaluate the effects of the differences between two typical payment methods for the new rural cooperative medical scheme (NRCMS) in China on the utilisation of inpatient services. Interrupted time-series analysis (ITSA) and propensity score matching (PSM) were used to measure the difference between two typical payment methods for the NRCMS with regard to the utilisation of inpatient services. After the reform was formally implemented, the level and slope difference after reform compared with pre-intervention (distribution of inpatients in county hospitals (DIC), distribution of inpatients in township hospitals (DIT) and the actual compensation ratio of inpatients (ARCI)) were not statistically significant. Kernel matching obtained better results in reducing the mean and median of the absolute standardised bias of covariates of appropriateness of admission (AA), appropriateness of disease (AD). The difference in AA and AD of the matched inpatients between two groups was −0.03 (p-value = 0.042, 95% CI: −0.08 to 0.02) and 0.21 (p-value < 0.001, 95% CI: −0.17 to 0.25), respectively. The differences in the utilisation of inpatient services may arise owing to the system designs of different payment methods for NRCMS in China. The causes of these differences can be used to guide inpatients to better use medical services, through the transformation and integration of payment systems. Full article

Secondhand smoke (SHS), a common environmental exposure factor, has become a serious public health problem. Metabolic syndrome is another worldwide clinical challenge. Our study tried to determine the age differences in the relationship between SHS and the risk of metabolic syndrome. Studies were searched in PubMed and Web of Science from 11 November to 30 November 2018. Eighteen studies were finally included based on inclusion and exclusion criteria. The relationship between SHS and the risk indicators of metabolic syndrome was analyzed. The weighted mean difference (WMD) of fasting plasma glucose (FPG), insulin, body mass index (BMI), and waist circumference (WC), and the standard mean difference (SMD) of total cholesterol, triglycerides, and low- and high-density lipoprotein-cholesterol (LDL-C, HDL-C) were calculated in a meta-analysis. SHS was positively associated with the level of insulin and WC. According to the subgroup analysis based on age difference, SHS was positively associated with FPG in the upper age group, and positively associated with LDL-C and negatively associated with HDL-C in the lower age group. BMI showed a more obvious positive correlation in the adults group than in the children and the teenagers group. In conclusion, the association of metabolic syndrome with SHS varies with age. When exposed to SHS, older people may be more susceptible to glucose metabolic disorder, but younger people may be more susceptible to lipid metabolic disorder. Full article

Background: Studies have found that exposure to fine particulate matter with sizes below 2.5 µm (PM_2.5) might cause inflammation response via the NF-κB pathway. To date, only a few studies have focused on the toxicity of different components of PM_2.5. We aimed to explore the effects of PM_2.5 with different components on the expression levels of NF-κB family gene mRNA and inflammatory molecules in human macrophages. Methods: Human monocytic cell line THP-1-derived macrophages were exposed to water-soluble (W-PM_2.5), fat-soluble (F-PM_2.5), and insoluble (I-PM_2.5) PM_2.5. The cell survival rate was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The levels of inflammatory molecules were determined by enzyme-linked immunosorbent assay (ELISA), and the relative mRNA levels of the NF-κB family gene were determined by real time PCR. Results: PM_2.5 could decrease the cell viability. After exposure to W-PM_2.5, the levels of interleukins (IL)-1β and IL-12 p70 significantly increased. After exposure to F-PM_2.5, the levels of IL-12 p70 significantly increased. The levels of IL-12 p70 and TNF-α after exposure to I-PM_2.5 were significantly higher than that in W- and F-PM_2.5 treatment groups. The levels of IL-8, C reactive protein (CRP), and cyclooxygenase (COX)-2 increased only after exposure to I-PM_2.5. F-PM_2.5 increased the mRNA levels of NF-κB genes, especially NF-κB₁ and RelA. Conclusions: PM_2.5 can decrease the cell survival rate and up-regulate the expression of NF-κB family gene mRNA and inflammatory molecules. The main toxic components of PM_2.5 related to inflammatory response in macrophages were the I-PM_2.5. Full article