Mental Health and Asthma in China: the Guangzhou Biobank Cohort Study

Background

There is consistent evidence of the co-occurrence of poor mental health and asthma in Western populations. Since the experience and expression of mental health is partly culturally determined, it is of interest to examine if similar associations are found in other cultural settings. In that regard, very little is known about the association between mental health and asthma in Asian countries, such as China.

Purpose

The aim of this study was to investigate the relationship between mental health and asthma in a large sample from China.

Method

We used data from the Guangzhou Biobank Cohort Study phase 3 (n?=?9,280). Participants reported physician-diagnosed asthma. Mental health measures included the 15-item Chinese version of the Geriatric Depression Scale (GDS-C) and the SF-12 Mental Component Summary (MCS) score. We compared the prevalence of asthma by GDS-C and MCS scores by estimating prevalence ratios (PRs) and their corresponding 95% confidence intervals (95% CI), using Poisson regression.

Results

Compared to those without depression, the prevalence of asthma was higher in those with moderate or severe depression levels (PR?=?2.63, 95% CI?=?1.58–4.40 and PR?=?4.43, 95% CI?=?1.62–12.09, p for trend ≤0.0001). The prevalence of asthma increased by 46% with every 1 standard deviation increase of the GDS-C score (PR?=?1.46, 95% CI?=?1.24–1.73). The MCS score was not associated with asthma.

Conclusion

Depressive symptoms were associated with asthma prevalence in a Chinese population. Further research into the mechanism and potential directions of causality is warranted.     

Subjective Social Status: Construct Validity and Associations with Psychosocial Vulnerability and Self-Rated Health

Background

Subjective social status (SSS) predicts health outcomes independently of traditional, objective indicators of socioeconomic status (SES). However, the potential confounding and mediating effects of negative affect and similar psychosocial risk and resilience factors have not been adequately addressed through formal studies of convergent and discriminant validity of SSS measures.

Purpose

The current study provides such a test of construct validity and subsequently examines whether psychosocial factors mediate the relationship between SSS and self-rated health.

Methods

We examined the convergent and discriminant validity of the MacArthur scales of SSS relative to measures of psychosocial risk and resilience (i.e., neuroticism, depressive symptoms, optimism, and marital quality) as well as SES (i.e., income) in 300 middle-aged and older married US couples. We also tested a factor of psychosocial vulnerability as a mediator of the relationship between SSS and self-rated health.

Results

Findings indicated clear convergent and discriminant validity of the MacArthur scales. Further, controlling age and income, both the US and community measures of SSS predicted psychosocial factors for men, however, only the community measure was independently predictive for women. Psychosocial vulnerability significantly mediated the pathway between SSS and self-rated health for men and women after controlling age and income.

Conclusions

These results provide strong support for the construct validity of the MacArthur scales and provide additional evidence of the role of psychosocial risk and resilience factors as mediators of the effects of SSS on health.     

Modern Health Worries, Subjective Health Complaints, Health Care Utilization, and Sick Leave in the Norwegian Working Population

Background

Modern health worries (concerns about aspects of modern life affecting health) heve been associated with subjective health complaints and health care utilization.

Purpose

The aim of this study was to investigate the association between modern health worries (MHW) and subjective health complaints (SHC), health care utilization, and sick leave related to such complaints in the Norwegian working population.

Methods

A sample of the Norwegian working population (N?=?569) answered a questionnaire which included the Subjective Health Complaints Inventory and a Norwegian version of the Modern Health Worries Scale.

Results

Ninety-one percent of the participants reported at least one complaint in the past 30 days, and 96 % of the participants reported concerns for at least one of the items in the MHW scale. Women reported significantly more and more severe complaints compared to men and significantly more concern about aspects of modern life affecting health. Participants who reported a high level of MHW showed nearly twice the risk of reporting a high level of SHC (odds ratio (OR)?=?1.83; 95 % confidence interval (CI)?=?1.30–2.71; p?=?0.001), and they showed twice the risk for self-certified sick leave related to SHC (OR?=?2.04; 95 % CI?=?1.01–3.92; p?=?0.048). High levels of MHW showed no significant association with health care utilization or doctor-certified sick leave.

Conclusions

Subjective health complaints and concerns about aspects of modern life affecting health are very common, even among healthy workers. Women have more complaints and more concerns compared to men. Within the health care system, it may be advantageous to pay close attention to the association between high levels of MHW and high levels of SHC.     

Youth, Sexual Risk-Taking Behavior, and Mental Health: a Study of University Students in Uganda

Background

Little focus has been paid to the role of mental health among young people with regard to risky sexual behavior and HIV prevention in sub-Saharan Africa. The aim of this study was to investigate the relationship between poor mental health and risky sexual behavior (HIV/AIDS) among a population of university students in Uganda.

Methods

In 2005, 980 Ugandan university students completed a self-administered questionnaire (response rate 80%) assessing sociodemographic and religious background factors, mental health, alcohol use, and sexual behavior. Mental health was assessed using items from the Hopkins Symptoms Checklist-25 and the Symptom Checklist-90.

Results

High scores on depression and high numbers of sexual partners among both males (odds ratio (OR) 2.0, 95% confidence interval (CI) 1.2?C3.3) and females (OR 3.3, 95% CI 1.3?C8.6) were significantly associated. Elevated anxiety scores among men were associated with high numbers of sexual partners (OR 1.9, 95% CI 1.1?C3.3) and inconsistent condom use (OR 1.9, 95% CI 1.1?C3.6). Psychoticism was also significantly associated with high numbers of sexual partners among men. The associations remained statistically significant after controlling for sociodemographic factors and level of alcohol consumption.

Conclusion

These findings indicate that previous conclusions on the association between sexual behavior and mental health from high- and middle-income countries also are valid in a low-income setting, such as in Uganda. This knowledge has implications for policy formation and HIV/AIDS preventive strategies. Coordinated youth-friendly mental health and sexual and reproductive health services to meet the needs of young people would be desirable.     

Associations Between Supportive Leadership and Employees Self-Rated Health in an Occupational Sample

Background

Protecting the health of the work force has become an important issue in public health research.

Purpose

This study aims to explore potential associations between supportive leadership style (SLS), an aspect of leadership behavior, and self-rated health (SRH) among employees.

Method

We drew on cross-sectional data from a cohort of industrial workers (n?=?3,331), collected in 2009. We assessed employees' ratings of supportive, employee-oriented leadership behavior at their job, their SRH, and work stress as measured by the effort–reward model and scales measuring demands, control, and social support. Logistic regression estimated odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) for the association between the perception of poor SLS and poor SRH controlling for work-related stress and other confounders. Sensitivity analyses stratified models by sex, age, and managerial position to test the robustness of associations.

Results

Perception of poor SLS was associated with poor SRH [OR 2.39 (95 % CI 1.95–2.92)]. Although attenuated following adjustment for measures of work-related stress and other confounders [OR 1.60 (95 % CI 1.26–2.04)], the magnitude, direction, and significance of this association remained robust in stratified models in most subgroups.

Conclusion

SLS appears to be relevant to health in the workplace. Leadership behavior may represent a promising area for future research with potential for promoting better health in a large segment of the adult population.     

Sleep problems and poor academic performance in primary school children

Objective

Sleep problems may affect daytime performance. Thus, the prevalence of sleep problems and their associations with poor academic performance in a cross-sectional study performed in 27 primary schools in Hannover, Germany, were investigated.

Methods

Sleep problems (e.g., sleep onset delays, night awakenings, sleepwalking, nightmares, and bedwetting) were examined by parental and children’s questionnaires. Poor academic performance, defined as grade 4 or more on a 6-point scale, or requirement for additional lessons in mathematics, science, reading, spelling, or handwriting was assessed using grades from the last term’s school report forms.

Results

Of 1,144 children enrolled (mean age 9.6 years, 51% males), 760 (66.4%) had sleep problems reported by their parents, with sleep onset delays having the highest prevalence (prevalence 49.1%, 95% confidence interval (CI) 46.1–51.9). Children reported sleep problems more frequently than their parents. Significant associations with academic performance were found for night awakenings and nightmares; however, clear dose–response relationships were only found for nightmares. Children who “often” had nightmares (n?=?24) were more likely to have poor academic performance in mathematics (odds ratio 5.2, 95% CI 1.6–17.1), science (6.8, 95% CI 1.4–32.1), and spelling (7.5, 95% CI 2.3–24.9).

Conclusion

Sleep problems are common in primary school children. Among these, nightmares may have a negative impact on academic performance.     

Psychological Resources as Mediators of the Association Between Social Class and Health: Comparative Findings from Japan and the USA

Background

Recently, researchers have proposed that psychological resources might be key concept in explaining the association between social class and health. However, empirical examinations of the extent to which psychological resources to social class in health are still few.

Purpose

This study investigated mediating effects of selected psychological resources (sense of control, self-esteem, optimism, and neuroticism) on the association of social class [education and subjective social status (SSS)] with current health status (self-rated health and the number of chronic conditions).

Method

This sample consisted of 1,805 Americans (818 males and 987 females) from the Midlife in the United States (MIDUS) survey, 2004–2006 and 1,027 Japanese (505 males and 522 females) from the Midlife in Japan (MIDJA) survey in Tokyo, Japan, 2008–2010. Information on social class, psychological resources, and health status was obtained using telephone interviews or written questionnaires.

Results

A mediation analysis was conducted separately for males and females in Japan and the USA. Neuroticism significantly mediated the association of education and SSS with self-rated health and chronic conditions among males and females in both countries, with one exception (not for chronic conditions among Japanese females). Sense of control significantly mediated the association of education and SSS with self-rated health among males and females in both countries. As hypothesized, self-esteem significantly mediated almost all of the associations of education and SSS with self-rated health and chronic conditions among men and women in the USA, but very few such associations in Japan. Optimism significantly mediated most associations of social class and health status in both countries, but only among females.

Conclusions

Overall, the findings underscore important culture- and gender specificity in the ways in which psychosocial resources mediate the links between social class and health.     

Impact of an Educational Programme on Reproductive Health Among Young Migrant Female Workers in Shenzhen,China: an Intervention Study

Background

Reproductive health and sexually transmitted diseases (STD) account for a high proportion of health problems in the rural-to-urban young female migrant workers in China. Improving these conditions remains highly challenging.

Purpose

To developed an educational programme to advance the reproductive health of the female workers.

Method

An intervention study was conducted between July 2010 and April 2011 in Shenzhen. Two commune factories were selected to participate and provided a control cluster receiving routine local government health services and a second cluster receiving an educational intervention in addition to the routine services. The intervention included distribution and free access to educational study materials. The factory workers’ knowledge, attitudes and behaviour in the area of reproductive health and STD were the main study outcomes.

Results

Compared with the control cluster, at the 6-month follow-up assessment, the intervention cluster had a significantly higher proportion of correct answers to queries about human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (standardised coefficients of multiple linear regression (B) 0.047; P?=?0.020) and awareness of places providing free contraceptives (odds ratio [OR] 2.011, 95 % confidence interval [CI] 1.635–2.472; P?<?0.001), and a significantly lower proportion accepting premarital sex (OR 0.492, 95 % CI 0.416–0.582; P?<?0.001), practising premarital sex (OR 0.539, 95 % CI 0.478–0.608; P?<?0.001) or suffering from gynaecological disorders (OR 0.801, 95 % CI 0.697–0.921; P?=?0.002).

Conclusion

A community-based educational intervention targeting unmarried female migrant workers appears to be effective in substantially improving their knowledge of reproductive health and their attitudes and behaviour towards health, and in reducing prevalence of STD.     

Stress Underestimation and Mental Health Outcomes in Male Japanese Workers: a 1-Year Prospective Study

Purpose

Being appropriately aware of the extent of stress experienced in daily life is essential in motivating stress management behaviours. Excessive stress underestimation obstructs this process, which is expected to exert adverse effects on health. We prospectively examined associations between stress underestimation and mental health outcomes in Japanese workers.

Methods

Web-based surveys were conducted twice with an interval of 1 year on 2359 Japanese male workers. Participants were asked to complete survey items concerning stress underestimation, depressive symptoms, sickness absence, and antidepressant use.

Results

Multiple logistic regression analysis revealed that high baseline levels of ‘overgeneralization of stress’ and ‘insensitivity to stress’ were significantly associated with new-onset depressive symptoms (OR?=?2.66 [95 % CI, 1.54–4.59], p?<?.01) and antidepressant use (OR?=?4.91 [95 % CI, 1.22–19.74], p?<?.05), respectively, during the 1-year follow-up period.

Conclusions

This study clearly demonstrated that stress underestimation, including stress insensitivity and the overgeneralization of stress, could exert adverse effects on mental health.

     

Workplace Psychosocial Factors Associated with Work-Related Injury Absence: A Study from a Nationally Representative Sample of Korean Workers

Background

Little is known about the association between psychosocial factors and injury absence in the workplace.

Purpose

This study aims to assess the association of comprehensive workplace psychosocial factors with work-related injury absence among Korean workers.

Methods

The data (n?=?7,856) were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample (n?=?10,043) of the Korean working population. The survey instrument contained questions about hours of work, physical risk factors, work organization, and the effect of work on health/injury. Work-related injury absence was indicated by a dichotomous variable with at least 1 day absence during the preceding 12 months. Logistic regression models were used to calculate odds ratio and confidence interval (CI). Incremental adjustments for sociodemographic, health behavior, and occupational confounding variables were employed in the models.

Results

The overall 1-year prevalence of work-related injury absence in this study was 1.37 % (95 % CI, 1.11–1.63 %). Those who experienced violence at work (adjusted odds ratio (aOR), 7.05 (95 % CI, 2.69-18.5)), threat of violence at work (aOR, 4.25 (95 % CI, 1.32–13.64)), low job autonomy (aOR, 1.79 (95 % CI, 1.17–2.74)), and high job strain (aOR, 2.38 (95 % CI, 1.29–4.42) had an increased risk of injury absence, compared with their respective counterparts (p?<?0.05). Among all job types, skilled workers in Korea were at a near fourfold risk of work absence due to occupational injuries, compared with managers in low-risk jobs.

Conclusion

Workplace violence and increased job strain were two key workplace psychosocial factors associated with work-related injury absence.     

Suicidal behaviours in South East London: Prevalence,risk factors and the role of socio-economic status

Background

Low socio-economic status (SES) is an established risk factor of suicidal behaviours, but it is unknown to what extent its association is direct, indirect or confounded, given its strong association to mental health. We aimed to (I) estimate the prevalence of suicidal behaviours; (II) describe relevant risk factors; and (III) investigate direct and indirect effects of SES on suicidal behaviours.

Methods

We used cross-sectional community survey data of adults from randomly selected South East London households (SELCoH). Suicidal outcome measures replicated the 2007 Adult Psychiatric Morbidity Survey in England (APMS). Lifetime prevalence was described by socio-demographics, SES, mental health indicators, and life events. Structured symptom screens and a drug use questionnaire measured mental health. Structural equation models estimated direct and indirect effects of a latent SES variable on suicidal ideation and suicide attempts, adjusting for covariates.

Results

20.5% (95% CI: 18.4–22.7) reported suicidal ideation and 8.1% (95% CI: 6.8–9.7) reported suicide attempts (higher than APMS estimates: 13.7%, 4.8%, respectively). Unadjusted risk factors included poor mental health, low SES, and non-married/non-cohabitating relationship status. Black African ethnicity was protective, and women reported more suicide attempts. SES was directly associated to suicide attempts, but not suicidal ideation. SES had indirect effects on suicidal outcomes via mental health and life events.

Limitations

The cross-sectional design and application of measures for different time periods did not allow for causal inferences.

Conclusions

Suicidal behaviours were more prevalent than in the general UK population. Interventions targeting low SES individuals may prove effective in preventing suicide attempts.     

Socioeconomic Disparities in Health Risk Behavior Clusterings Among Korean Adolescents

Purpose

This study aims to investigate the socioeconomic disparities in health risk behavior clusterings among Korean adolescents and to assess the mediating role of stress on this association.

Method

We analyzed the 2015 Korean Youth Risk Behavior Survey, a nationally representative sample of Korean middle and high school students aged 12–18 years (N?=?68,043). The co-occurrence of multiple health risk behaviors (i.e., cigarette smoking, drinking, and unprotected sex) was used to operationalize health risk behavior clusterings that ranged from zero to three. Ordinal and multinomial logistic regressions were conducted to examine socioeconomic disparities in health risk behavior clusterings and mediating effect of perceived stress between socioeconomic status (SES) and health risk behaviors.

Results

When SES was grouped into five groups, adolescents in the lowest SES [adjusted odds ratio (AOR)?=?2.15, 95% confidence interval (CI)?=?1.90–2.44] and the highest SES (AOR?=?1.29, 95% CI?=?1.18–1.40) showed a higher likelihood of risk behavior clusterings than any other SES groups. Stress partially mediated the relationship between SES and co-occurrence of multiple health risk behaviors while accounting for their demographic characteristics. Adolescents in the lowest and highest SES reported higher stress than other SES groups, which, in turn, was associated with the co-occurrence of multiple health risk behaviors.

Conclusion

The results suggest that perceived stress level partly explains why affluent as well as low-SES adolescents engage in multiple risk behaviors. The findings also discourage use of a linear approach in socioeconomic disparity investigation in relation to adolescent health behaviors.

     

Severe and Differential Underestimation of Self-reported Smoking Prevalence in Chinese Adolescents

Background

Evaluating the progress of tobacco control across the world heavily relies on smoking prevalence estimates. Those estimates are often based on surveys of self-reported cigarette smoking status. The accuracy varies among populations with different social and cultural backgrounds.

Purpose

The objective of this study was to estimate the prevalence of smoking and assess the accuracy of self-report smoking status in Chinese adolescents.

Method

This population-based cross-sectional survey included 10,934 adolescents aged 12 to 18 years from 17 schools in Shanghai, China. Data on adolescents’ smoking status were collected from adolescents’ self-reporting and from parents’ questionnaires, separately. Based on the data of two sources, the total number of smokers among the study participants was estimated using a capture–recapture method.

Results

Among 5,452 girls and 5,482 boys, the prevalence estimates of self-reported smoking were 13.6 % (748) and 5.2 % (284) for boys and girls, respectively. Parents only identified smaller proportions of smoking adolescents: 2.9 % (160) boys and 0.6 % (30) girls. Using the capture–recapture method, we estimated the prevalence of smoking as 18.3 % (95 % CI 16.4, 20.3) for boys and 14.2 % (95 % CI 7.6, 20.8) for girls.

Conclusion

Reliance on self-reporting to identify smokers among Chinese adolescents significantly underestimates the number of smokers, particularly among Chinese girls. Self-reported smokers only represent less than half of actual smokers in girls. Our findings are important for monitoring smoking trends and evaluating tobacco control interventions among Chinese adolescents.     

Factors Related to Non-recovery from Whiplash. The Nord-Trøndelag Health Study (HUNT)

Background

Whiplash injuries show a variable prognosis which is difficult to predict. Most individuals experiencing whiplash injuries rapidly recover but a significant proportion develop chronic symptoms and ongoing disability.

Purpose

By employing longitudinal data, we investigated how psychological and physical symptoms, self-rated health, use of health services and medications, health behavior and demographic factors predict recovery from whiplash.

Method

Data from two waves of a large, Norwegian, population-based study (The Nord-Trøndelag Health Study: HUNT2 and HUNT3) were used. Individuals reporting whiplash in HUNT2 (baseline) were identified in HUNT3 11 years later. The characteristics of individuals still suffering from whiplash in HUNT3 were compared with the characteristics of individuals who had recovered using Pearson’s chi-squared test, independent sample t-tests and logistic regression.

Results

At follow-up, 31.6 % of those reporting whiplash at baseline had not recovered. These individuals (n?=?199) reported worse health at baseline than recovered individuals (n?=?431); they reported poorer self-rated health (odds ratio [OR]?=?3.12; 95 % confidence interval [CI], 2.20–4.43), more symptoms of anxiety (OR?=?1.70; 95 % CI, 1.15–2.50), more diffuse somatic symptoms (OR?=?2.38; 95 % CI, 1.61–3.51) and more musculoskeletal symptoms (OR?=?1.21; 95 % CI, 1.13–1.29). Individuals still suffering from whiplash also visited more health practitioners at baseline (OR?=?1.18; 95 % CI, 1.06–1.32) and used more medications (OR?=?1.24; 95 % CI, 1.09–1.40).

Conclusion

Poor self-rated health seems to be a strong risk factor for whiplash injuries becoming chronic. Diffuse somatic symptoms, musculoskeletal symptoms and symptoms of anxiety at baseline are important prognostic risk factors. Knowledge of these maintaining risk factors enables identification of individuals at risk of non-recovery, facilitating adequate treatment for this vulnerable group.     

Interest and Use of Mental Health and Specialty Behavioral Medicine Counseling in US Primary Care Patients

Background

Counseling interventions have the potential to improve health and quality of life for primary care patients, but there are few studies describing the interest in and utilization of counseling among this patient population in the USA.

Purpose

The purpose of the study was to evaluate interest in mental health and specialty behavioral medicine counseling and predictors of utilization over 1 year among US primary care patients.

Method

Participants in this two-survey longitudinal study included 658 primary care patients in an urban US academic medical center (461 females, age M?=?51.05, SD?=?15.46 years). Retention rate was 61.2% at survey 2. Patient demographics, depression, anxiety, and interest in counseling services were assessed through a survey mailed 1 week following an outpatient appointment. Respondents to survey 1 were re-contacted 1 year later to assess. Interest and use of the following counseling services were evaluated in the relevant subgroups: mental health (the entire sample and patients with elevated anxiety and/or depression), health/lifestyle (overweight and obese participants), smoking cessation (current and occasional smokers), and pain management (participants with elevated daily pain ratings).

Results

At survey 1, 45.7% of the sample reported interest in mental health counseling, and 58.9% of the sample reported interest in behavioral medicine counseling. Among overweight or obese participants, 59.9% were interested in health/lifestyle counseling. Among smokers, 55.3% were interested in smoking cessation, and among participants with chronic pain, 33.8% were interest in pain management. Rates of utilization of services at survey 2 were 21.3% for mental health, 7.7% for health/lifestyle, 6.7% for smoking cessation, and 6.6% for pain management. Interest in receiving services at survey 1 was the strongest predictor of utilization.

Conclusion

Results demonstrate high interest but low utilization over 1 year among US primary care patients. Identifying patients interested in counseling services and reducing barriers may help facilitate receipt of services for those with interest and need for behavioral treatments.     

Intimate Partner Violence and Mental Health Effects: A Population-Based Study among Married Women in Karachi, Pakistan

Background

Intimate partner violence (IPV) is recognized all over the world for its association with mental health problems in women. In Pakistan, such violence occurs commonly, but detailed information on mental health effects is scarce. The purpose of this study is to focused on married couples in urban Karachi to investigate mental health effects associated with physical, sexual and psychological violence perpetrated by husbands towards wives. Disclosure rates and health care-seeking behaviour were also investigated.

Method

This cross-sectional study involved 759 women between the ages of 25 and 60 years, selected using a multi-stage random sampling technique. The women were interviewed by trained community midwives using a structured questionnaire.

Results

In the total population of women, mental symptoms were prevalent. Women subjected to any form of violence reported, however, considerably poorer mental health than unexposed women. A statistically significant difference for almost all of the studied health parameters persisted even after controlling for socio-demographic factors. The strongest associations were found for suicidal thoughts and physical violence (OR 4.41; 3.18–6.12), sexual abuse (OR 4.39; 3.17–6.07) and psychological abuse (OR 5.17; 3.28–8.15). The interviews revealed that only 27% of the women subjected to violence had disclosed this to anyone, in most cases to their parents.

Conclusion

The findings in this study highlight that the violence women have to face contributes to the development of multiple forms of psychological stress and serious mental health problems. Women’s restrictive life circumstances seriously hamper women’s empowerment. Reliable health surveillance system and health care services are needed to serve abused women. Policy initiatives focused on IPV and gender inequality in Pakistan should be initiated.     

Family and Neighborhood Correlates of Overweight and Obesogenic Behaviors Among Chinese Children

Background

The prevalence of childhood obesity is increasing rapidly in China. However, research on its modifiable environmental determinants to inform preventive interventions is limited.

Purpose

This paper reports a cross-sectional study that aimed to identify family and neighborhood environmental correlates of overweight and related health behavior among Chinese primary school-aged children in urban areas.

Methods

Routinely collected height and weight data of third year students (8–10 years) from four primary schools in socioeconomically distinct districts of two southern cities of China was obtained. Using the WHO 2007 reference values, children were categorized into overweight/obese or non-overweight. Parents of the same children completed a questionnaire, comprising mainly validated questions, about family and perceived neighborhood environments, parental physical activity habits, and the child's dietary and physical activity patterns. Multiple logistic regression analysis was performed to examine the association between these environmental factors and childhood overweight or whether or not the child engages in at least 1 h daily moderate to vigorous physical activity. Multiple linear regression analysis was undertaken to examine the association between environmental factors and the frequency of consumption of unhealthy snacks, fruit, and vegetables in children.

Results

Data on 497 children were available. Children who were mainly cared for by their grandparents were over twice as likely to be overweight/obese (adjusted OR 2.03; 95 % CI 1.19–3.47) and to have higher consumption of unhealthy snacks and sugar-added drinks (B?=?2.13, 95 % CI 0.87–3.40), compared with children who were mainly cared for by their parents or other adult. Children who lived with at least two grandparents in the household were at higher risk for being overweight/obese than children who lived without any grandparent (adjusted OR 1.72; 95 % CI 1.00–2.94). No evidence was found for associations between perceived neighborhood environmental characteristics and child's weight status and obesogenic behaviors in this study.

Conclusions

Children's family environment, particularly the living-in grandparents, should be targeted in future preventive interventions among China's southern urban populations.     

Work Stress is Associated with Diabetes and Prediabetes: Cross-Sectional Results from the MIPH Industrial Cohort Studies

Background

Diabetes is rapidly rising globally, and the relation of psychosocial stress in workplace to diabetes and prediabetes is not well investigated.

Purpose

The aim of the study was to examine the association of work stress with diabetes and prediabetes in a sample of German industrial workers.

Method

In this cross-sectional survey of an occupational cohort (n?=?2,674, 77 % male), work stress was measured by the Effort–Reward Imbalance (ERI) Questionnaire. Diabetic status, i.e., diabetes and prediabetes, were diagnosed by glycated hemoglobin A1c criterion or fasting plasma glucose criterion supplemented by self-reports.

Results

The overall prevalence rates of diabetes and prediabetes were 3.5 and 42.2 %, respectively. Using ordinal logistic regression with adjustment for potential confounding factors, high ERI at work was associated with diabetes-related ordinal variable (odds ratio [OR], 1.27; 95 % confidence interval [95 % CI], 1.02–1.58) and prediabetes-related ordinal variable (OR, 1.26; 95 % CI, 1.01–1.58) in men, whereas the associations in women were somewhat less pronounced and did not reach statistical significance.

Conclusion

The findings indicate that work stress in terms of ERI is associated with diabetes and prediabetes in German industrial male workers. If supported by prospective evidence, results point to a new approach towards primary prevention of diabetes.     

Personal Factors Associated with Smoking Among Marginalized and Disadvantaged Youth in Japan

Background

A national survey in Japan reported that the prevalence of smoking among high school students has sharply decreased in recent years. However, the survey only considered students who attended regular high schools (RHSs), and Japan offers part-time high schools (PHSs) that are often attended by academically and socioeconomically disadvantaged youth.

Purpose

Therefore, we examined the smoking prevalence and smoking-related factors among PHS students.

Method

A self-administered questionnaire-based survey was conducted at six PHSs. The subjects included 540 enrolled students aged 15 to 18 years. The questionnaire included items on smoking status, smokers in the family, frequency of convenience store use, lifestyle behaviors, and health awareness. Logistic regression analysis was used to identify factors that were significantly associated with smoking.

Results

A total of 45.6 % of students had smoking experience, and 29.3 % were smokers. For males and females, the smoking prevalence was about 3 and 7–12 times higher, respectively, than that reported in the national survey. The factors found to be significantly associated with smoking included having a smoker in the family, experience with drinking alcohol, and using convenience store daily (odds ratio [OR]?=?12.5) or sometimes (OR?=?3.63). There was a significant dose–response relationship between smoking and convenience store use.

Conclusion

The smoking prevalence among PHS students was remarkably higher than that among RHS students. These findings suggest that marginalized and disadvantaged youth should be targeted for tobacco control, and intervention is needed to protect youth from tobacco sales and advertising at convenience stores.