Prospective longitudinal associations between household smoke exposure in early childhood and antisocial behavior at age 12

Schizophrenia mediating the effect of smoking phenotypes on antisocial behavior: A Mendelian randomization analysis

AIMS

Previous studies have indicated that smoking is linked to an increased risk of developing schizophrenia, and that individuals with schizophrenia are more prone to engaging in antisocial behavior. However, the causal effects of smoking behaviors on antisocial behavior and the potential mediating role of schizophrenia remains largely unclear.

METHODS

In the present study, using the summary data from genome wide association studies of smoking phenotypes (N = 323,386-805,431), schizophrenia (Ncases = 53,386, Ncontrols = 77,258), and antisocial behavior (N = 85,359), we assessed bidirectional causality between smoking phenotypes and schizophrenia by the Mendelian randomization (MR) approach. Using a two-step MR approach, we further examined whether causal effects of smoking phenotypes/schizophrenia on antisocial behavior were mediated by schizophrenia/smoking phenotypes.

RESULTS

The results showed that smoking initiation (SmkInit) and age of smoking initiation (AgeSmk) causally increase the risk of schizophrenia (SmkInit: OR = 2.06, 95% CI = 1.77-2.39, p = 4.36 × 10-21 ; AgeSmk: OR = 0.32, 95% CI = 0.16-0.62, p = 8.11 × 10-4 , Bonferroni corrected). However, there was no causal effect that liability to schizophrenia leads to smoking phenotypes. MR evidence also revealed causal influences of SmkInit and the amount smoked (CigDay) on antisocial behavior (SmkInit: OR = 1.28, 95% CI = 1.17-1.41, p = 2.53 × 10-7 ; CigDay: OR = 1.16, 95% CI = 1.06-1.27, p = 1.60 × 10-3 , Bonferroni corrected). Furthermore, the mediation analysis indicated that the relationship between SmkInit and antisocial behavior was partly mediated by schizophrenia (mediated proportion = 6.92%, 95% CI = 0.004-0.03, p = 9.66 × 10-3 ).

CONCLUSIONS

These results provide compelling evidence for taking smoking interventions as a prevention strategy for schizophrenia and its related antisocial behavior.

Association between postnatal environmental tobacco smoke exposure controlling for prenatal exposure and conduct problems in children: A systematic review

Prenatal exposure to environmental tobacco smoke (ETS) is commonly associated with conduct problems in children. However, there is limited research on the effects of postnatal ETS exposure on the development of conduct problems, and many studies focusing on the postnatal period fail to control for the effects of prenatal ETS. This systematic review explores the association between postnatal ETS exposure and child conduct problems in studies that control for prenatal ETS exposure. Of the thirteen studies identified, nine reported a significant positive association of postnatal ETS exposure and child conduct-related behavior problems when controlling for prenatal ETS exposure. Results from tests of dose-response relationships were mixed. These findings highlight the significance of postnatal ETS exposure in conferring risk for conduct problems over and above prenatal ETS, and thus provide important information for guiding public health recommendations.

The development of youth antisocial behavior across time and context: A systematic review and integration of person-centered and variable-centered research

BACKGROUND

Trajectories of youth antisocial behavior (ASB) are characterized by continuity and change. Although numerous longitudinal studies have examined ASB, findings from person-centered and variable-centered research have not yet been integrated. The present paper integrates findings across statistical methods for a more comprehensive understanding of the development of ASB. Neighborhood disadvantage is considered as a core moderator.

METHODS

The study protocol was registered in the PROSPERO database of systematic reviews (registration number CRD42021255820). The PsycINFO and PubMed databases were examined (September 2022) to identify longitudinal studies of youth aggression and/or rule-breaking. Results from person-centered and variable-centered studies were integrated via narrative synthesis, and a systematic quality assessment was conducted.

RESULTS

Of 8227 studies identified, 136 met inclusion criteria. Our review indicated that rule-breaking trajectories were largely distinguished by differences in rate of change (i.e., slope), whereas aggression trajectories differed more by baseline level (i.e., intercept), particularly in childhood. For adolescents in disadvantaged neighborhoods, however, aggression trajectories differed by both intercept and slope.

CONCLUSIONS

The respective importance of the intercept and slope differed across dimensions of ASB, developmental stage, and neighborhood residence. Neighborhood disadvantage was associated with trajectories of aggression, consistent with developmental theories emphasizing the role of person-environment interactions.

The Association between Physical Environment and Externalising Problems in Typically Developing and Neurodiverse Children and Young People: A Narrative Review

The physical environment is of critical importance to child development. Understanding how exposure to physical environmental domains such as greenspace, urbanicity, air pollution or noise affects aggressive behaviours in typical and neurodiverse children is of particular importance given the significant long-term impact of those problems. In this narrative review, we investigated the evidence for domains of the physical environment that may ameliorate or contribute to the display of aggressive behaviours. We have considered a broad range of study designs that include typically developing and neurodiverse children and young people aged 0-18 years. We used the GRADE system to appraise the evidence. Searches were performed in eight databases in July 2020 and updated in June 2022. Additional articles were further identified by hand-searching reference lists of included papers. The protocol for the review was preregistered with PROSPERO. Results: We retrieved 7174 studies of which 67 are included in this review. The studies reported on green space, environmental noise and music, air pollution, meteorological effects, spatial density, urban or rural setting, and interior home elements (e.g., damp/sensory aspects/colour). They all used well validated parent and child reported measures of aggressive behaviour. Most of the studies were rated as having low or unclear risk of bias. As expected, noise, air pollution, urbanicity, spatial density, colour and humidity appeared to increase the display of aggressive behaviours. There was a dearth of studies on the role of the physical environment in neurodiverse children. The studies were heterogeneous and measured a range of aggressive behaviours from symptoms to full syndromes. Greenspace exposure was the most common domain studied but certainty of evidence for the association between environmental exposures and aggression problems in the child or young person was low across all domains. We found a large knowledge gap in the literature concerning neurodiverse children, which suggests that future studies should focus on these children, who are also more likely to experience adverse early life experiences including living in more deprived environments as well as being highly vulnerable to the onset of mental ill health. Such research should also aim to dis-aggregate the underlying aetiological mechanisms for environmental influences on aggression, the results of which may point to pathways for public health interventions and policy development to address inequities that can be relevant to ill health in neurodiverse young people.

Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children

BACKGROUND

Tobacco smoke exposure (TSE), defined as secondhand smoke (SHS) and thirdhand smoke (THS), is associated with negative health consequences. This study's objective was to assess the associations between home TSE status and school engagement, school success, and afterschool activity participation among school-aged children.

METHODS

We conducted a secondary analysis of 2018-2019 National Survey of Children's Health cross-sectional data. Children ages 6-11 years (N = 17,466) were categorized into home TSE groups: no home TSE; THS exposure only; and SHS and THS exposure. Weighted logistic and Poisson regression models were built.

RESULTS

Compared to children with no home TSE, children with home THS exposure only and SHS and THS exposure were at decreased odds of being engaged in school (AOR = 0.69, 95%CI = 0.57, 0.83; AOR = 0.63, 95%CI = 0.41, 0.97, respectively), and at increased odds of having ≥1 school-to-home contact about child problems in school (AOR = 1.83, 95%CI = 1.50, 2.23; AOR = 1.58, 95%CI = 1.05, 2.37, respectively). Children with THS exposure only were at increased odds of missing ≥1 school day (AOR = 1.43, 95%CI = 1.13, 1.81). Children with THS exposure only (ARR = 0.90, 95%CI = 0.83, 0.96) and SHS and THS exposure (ARR = 0.74, 95%CI = 0.61, 0.89) were at reduced likelihood of participating in a higher number of afterschool activities.

CONCLUSIONS

Children exposed to home tobacco smoke are at unique risk for poorer school engagement and success.

Associated Factors for Dropout of First Vs Third Doses of Diphtheria Tetanus Pertussis (DPT) Vaccination in Nepal

Background

Immunization acts as a key intervention to reduce under-five mortality and morbidity. Despite global progress on vaccination, difficulties in the utilization of this service in developing countries have been observed. According to Nepal Demographic and Health Survey (NDHS) 2016, only 78% of children received a complete dose of vaccine among which the first-dose receiver of DPT is 98%, whereas only 83% received a third dose. This study aims to explore the influencing factors of DPT vaccination dropout in Nepal.

Methods

The explorative study was done through secondary data analysis of NDHS 2016. The KR file was used for the analysis of information for 2883 children. Factors influencing dropout of DPT vaccination were explored against the independent variables such as external environment, predisposing factors, and enabling resources. All the analyses were weighted before the analysis. The descriptive, bivariate, and multivariate analyses were performed. The variables showing collinearity have been removed in the final model.

Results

A higher dropout was reported in Terai (18.9%) and province 2 (22.0%), among uneducated mothers (18.1%) and uneducated fathers (19.4%), less than once a week internet users (22.2%), the nonradio listener (17.4%), who had <4 ANC visits (22.7%), home delivery (19.2%), no advised SBA (19.1%), long distance to health facility (17.9%), no iron supplementation in pregnancy (24.3%), and PNC by TBA/others (21.1%). All these tested relationships were found statistically significant (P value <0.05). The aOR for dropout was found to be 7.94 (4.07–15.51) for mothers with less than 4 or no ANC visit, long distance to health facility 4.68 (1.98–10.67), province 2 3.53 (1.13–11.03), and mother without formal employment 2.33 (1.52–3.55).

Conclusion

Factors related to health services, distance, provinces, and socioeconomic status of the family were influencers for vaccine dropout. Targeted intervention towards disadvantaged regions, counseling the mother during ANC, improving the education status of parents, access to the health facility, and use of mass media for advocacy are hereby recommended.

Association of the Built Environment With Childhood Psychosocial Stress

IMPORTANCE

Emerging research suggests that factors associated with the built environment, including artificial light, air pollution, and noise, may adversely affect children's mental health, while living near green space may reduce stress. Little is known about the combined roles of these factors on children's stress.

OBJECTIVE

To investigate associations between components of the built environment with personal and home characteristics in a large cohort of children who were assessed for perceived stress.

DESIGN, SETTING, AND PARTICIPANTS

In this cohort study, a total of 2290 Southern California Children's Health Study participants residing in 8 densely populated urban communities responded to detailed questionnaires. Exposures of artificial light at night (ALAN) derived from satellite observations, near-roadway air pollution (NRP) determined from a dispersion model, noise estimated from the US Traffic Noise Model, and green space from satellite observations of the enhanced vegetation index were linked to each participant's geocoded residence.

MAIN OUTCOMES AND MEASURES

Children's stress was assessed at ages 13 to 14 years and 15 to 16 years using the 4-item Perceived Stress Scale (PSS-4), scaled from 0 to 16, with higher scores indicating greater perceived stress. Measurements were conducted in 2010 and 2012, and data were analyzed from February 6 to August 24, 2019. Multivariate mixed-effects models were used to examine multiple exposures; modification and mediation analyses were also conducted.

RESULTS

Among the 2290 children in this study, 1149 were girls (50%); mean (SD) age was 13.5 (0.6) years. Girls had significantly higher perceived stress measured by PSS-4 (mean [SD] score, 5.7 [3.4]) than boys (4.9 [3.2]). With increasing age (from 13.5 [0.6] to 15.3 [0.6] years), the mean PSS-4 score rose from 5.6 (3.3) to 6.0 (3.4) in girls but decreased for boys from 5.0 (3.2) to 4.7 (3.1). Multivariate mixed-effects models examining multiple exposures indicated that exposure to secondhand smoke in the home was associated with a 0.85 (95% CI, 0.46-1.24) increase in the PSS-4 score. Of the factors related to the physical environment, an interquartile range (IQR) increase in ALAN was associated with a 0.57 (95% CI, 0.05-1.09) unit increase in the PSS-4 score together with a 0.16 score increase per IQR increase of near-roadway air pollution (95% CI, 0.02-0.30) and a -0.24 score decrease per IQR increase of the enhanced vegetation index (95% CI, -0.45 to -0.04). Income modified the ALAN effect size estimate; participants in households earning less than $48 000 per year had significantly greater stress per IQR increase in ALAN. Sleep duration partially mediated the associations between stress and both enhanced vegetation index (17%) and ALAN (18%).

CONCLUSIONS AND RELEVANCE

In this cohort study, children's exposure to smoke at home in addition to residential exposure to ALAN and near-roadway air pollution were associated with increased perceived stress among young adolescent children. These associations appeared to be partially mitigated by more residential green space. The findings may support the promotion of increased residential green spaces to reduce pollution associated with the built environment, with possible mental health benefits for children.

The Effects of Satisfaction of Basic Psychological Needs at School on Children's Prosocial Behavior and Antisocial Behavior: The Mediating Role of School Satisfaction

Grounded in Basic Psychological Need Theory, we examined the direct effects of the satisfaction of three basic psychological needs at school (i.e., satisfaction of autonomy needs at school, satisfaction of relatedness needs at school, and satisfaction of competence needs at school) on prosocial behavior and antisocial behavior as well as the mediation effects of school satisfaction on the relations between the satisfaction of three basic psychological needs at school and prosocial behavior as well as antisocial behavior. We employed a sample of 801 Chinese children (429 males; Mage = 9.47) in a three-wave longitudinal study, with each wave occurring 6 months apart. Direct and indirect effects were estimated by Structural Equation Modeling. Results indicated that: (1) Satisfaction of relatedness needs at school and competence needs at school, but not satisfaction of autonomy needs at school, displayed direct effects on prosocial behavior. Also, satisfaction of relatedness needs at school, but not satisfaction of autonomy needs at school or competence needs at school, displayed direct effects on antisocial behavior. (2) Both satisfaction of relatedness needs at school and competence needs at school displayed indirect effects on prosocial behavior and antisocial behavior via school satisfaction as a mediator. However, satisfaction of autonomy needs at school failed to have indirect effects on prosocial behavior or antisocial behavior via school satisfaction. These findings suggest differential predictors of children's prosocial and antisocial behavior, supporting the separability of the two constructs. The findings also suggest developmental differences in need satisfaction, with the satisfaction of autonomy needs playing a relatively less important role in school-age children. We also discussed limitations and practical applications of the study.

Aromatic hydrocarbons in a controlled ecological life support system during a 4-person-180-day integrated experiment

Indoor air quality is vital to the health and comfort of people who live inside a controlled ecological life support system (CELSS) built for long-term space explorations. Here we measured aromatic hydrocarbons to assess their sources and health risks during a 4-person-180-day integrated experiment inside a CELSS with four cabins for growing crops, vegetables and fruits and other two cabins for working, accommodations and resources management. During the experiment, the average concentrations of benzene, ethylbenzene, m,p-xylenes and o-xylene were found to decrease exponentially from 7.91±3.72, 37.2±35.2, 100.8±111.7 and 46.8±44.1μg/m³ to 0.39±0.34, 1.4±0.5, 2.8±0.7 and 2.1±0.9μg/m³, with half-lives of 25.3, 44.8, 44.7 and 69.3days, respectively. Toluene to benzene ratios indicated emission from construction materials or furniture to be a dominant source for toluene, and concentrations of toluene fluctuated during the experiment largely due to the changing sorption by growing plants. The cancer and no-cancer risks based on exposure pattern of the crews were insignificant in the end of the experiment. This study also suggested that using low-emitting materials/furniture, growing plants and purifying air actively would all help to lower hazardous air pollutants inside CELSS. Broadly, the results would benefit not only the development of safe and comfort life support systems for space exploration but also the understanding of interactions between human and the total environment in closed systems.