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Int. J. Environ. Res. Public Health, Volume 11, Issue 10 (October 2014), Pages 9938-11027

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Open AccessArticle Acoustic Noise Alters Selective Attention Processes as Indicated by Direct Current (DC) Brain Potential Changes
Int. J. Environ. Res. Public Health 2014, 11(10), 9938-9953; doi:10.3390/ijerph111009938
Received: 23 June 2014 / Revised: 2 September 2014 / Accepted: 16 September 2014 / Published: 26 September 2014
Cited by 2 | PDF Full-text (1480 KB) | HTML Full-text | XML Full-text
Abstract
Acoustic environmental noise, even of low to moderate intensity, is known to adversely affect information processing in animals and humans via attention mechanisms. In particular, facilitation and inhibition of information processing are basic functions of selective attention. Such mechanisms can be investigated by
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Acoustic environmental noise, even of low to moderate intensity, is known to adversely affect information processing in animals and humans via attention mechanisms. In particular, facilitation and inhibition of information processing are basic functions of selective attention. Such mechanisms can be investigated by analyzing brain potentials under conditions of externally directed attention (intake of environmental information) versus internally directed attention (rejection of environmental stimuli and focusing on memory/planning processes). This study investigated brain direct current (DC) potential shifts—which are discussed to represent different states of cortical activation—of tasks that require intake and rejection of environmental information under noise. It was hypothesized that without background noise rejection tasks would show more positive DC potential changes compared to intake tasks and that under noise both kinds of tasks would show positive DC shifts as an expression of cortical inhibition caused by noise. DC potential shifts during intake and rejection tasks were analyzed at 16 standard locations in 45 persons during irrelevant speech or white noise vs. control condition. Without noise, rejection tasks were associated with more positive DC potential changes compared to intake tasks. During background noise, however, this difference disappeared and both kinds of tasks led to positive DC shifts. Results suggest—besides some limitations—that noise modulates selective attention mechanisms by switching to an environmental information processing and noise rejection mode, which could represent a suggested “attention shift”. Implications for fMRI studies as well as for public health in learning and performance environments including susceptible persons are discussed. Full article
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Open AccessCommunication Can Migration Health Assessments Become a Mechanism for Global Public Health Good?
Int. J. Environ. Res. Public Health 2014, 11(10), 9954-9963; doi:10.3390/ijerph111009954
Received: 1 July 2014 / Revised: 9 September 2014 / Accepted: 18 September 2014 / Published: 26 September 2014
Cited by 9 | PDF Full-text (498 KB) | HTML Full-text | XML Full-text
Abstract
Migrant health assessments (HAs) consist of a medical examination to assess a migrant’s health status and to provide medical clearance for work or residency based on conditions defined by the destination country and/or employer. We argue that better linkages between health systems and
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Migrant health assessments (HAs) consist of a medical examination to assess a migrant’s health status and to provide medical clearance for work or residency based on conditions defined by the destination country and/or employer. We argue that better linkages between health systems and migrant HA processors at the country level are needed to shift these from being limited as an instrument of determining non-admissibility for purposes of visa issuance, to a process that may enhance public health. The importance of providing appropriate care and follow-up of migrants who “fail” their HA and the need for global efforts to enable data-collection and research on HAs are also highlighted. Full article
(This article belongs to the Special Issue Migrant Health)
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Open AccessArticle Evaluation of Resident Evacuations in Urban Rainstorm Waterlogging Disasters Based on Scenario Simulation: Daoli District (Harbin, China) as an Example
Int. J. Environ. Res. Public Health 2014, 11(10), 9964-9980; doi:10.3390/ijerph111009964
Received: 2 July 2014 / Revised: 3 September 2014 / Accepted: 9 September 2014 / Published: 26 September 2014
Cited by 3 | PDF Full-text (919 KB) | HTML Full-text | XML Full-text
Abstract
With the acceleration of urbanization, waterlogging has become an increasingly serious issue. Road waterlogging has a great influence on residents’ travel and traffic safety. Thus, evaluation of residents’ travel difficulties caused by rainstorm waterlogging disasters is of great significance for their travel safety
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With the acceleration of urbanization, waterlogging has become an increasingly serious issue. Road waterlogging has a great influence on residents’ travel and traffic safety. Thus, evaluation of residents’ travel difficulties caused by rainstorm waterlogging disasters is of great significance for their travel safety and emergency shelter needs. This study investigated urban rainstorm waterlogging disasters, evaluating the impact of the evolution of such disasters’ evolution on residents’ evacuation, using Daoli District (Harbin, China) as the research demonstration area to perform empirical research using a combination of scenario simulations, questionnaires, GIS spatial technology analysis and a hydrodynamics method to establish an urban rainstorm waterlogging numerical simulation model. The results show that under the conditions of a 10-year frequency rainstorm, there are three street sections in the study area with a high difficulty index, five street sections with medium difficulty index and the index is low at other districts, while under the conditions of a 50-year frequency rainstorm, there are five street sections with a high difficulty index, nine street sections with a medium difficulty index and the other districts all have a low index. These research results can help set the foundation for further small-scale urban rainstorm waterlogging disaster scenario simulations and emergency shelter planning as well as forecasting and warning, and provide a brand-new thought and research method for research on residents’ safe travel. Full article
(This article belongs to the Special Issue Preparedness and Emergency Response)
Open AccessArticle Are Students’ Symptoms and Health Complaints Associated with Perceived Stress at University? Perspectives from the United Kingdom and Egypt
Int. J. Environ. Res. Public Health 2014, 11(10), 9981-10002; doi:10.3390/ijerph111009981
Received: 5 August 2014 / Revised: 10 September 2014 / Accepted: 12 September 2014 / Published: 26 September 2014
Cited by 12 | PDF Full-text (438 KB) | HTML Full-text | XML Full-text
Abstract
This cross-sectional survey assessed and compared by country, the levels and correlates of 21 self-reported symptoms/health complaints. We examined the associations between self-reported symptoms and perceived stress. Data was collected from universities in the United Kingdom and Egypt (N = 3706 and 3271
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This cross-sectional survey assessed and compared by country, the levels and correlates of 21 self-reported symptoms/health complaints. We examined the associations between self-reported symptoms and perceived stress. Data was collected from universities in the United Kingdom and Egypt (N = 3706 and 3271 undergraduates, respectively). A self-administered questionnaire assessed a range of self-reported symptoms, perceived stress, sociodemographic (gender, age, marital status, year of study, living arrangements during semester, income sufficiency), lifestyle (tobacco smoking, illicit drug/s use, alcohol consumption frequency), and health variables (subjective health status, health awareness, BMI), along with religiosity, and quality of life. Factor analysis categorized the 21 self-reported symptoms into four components. Correlation analysis and linear regression tested the associations between the self-reported symptoms and stress. Factor analysis of the health symptoms generated four symptom groups for each of the UK and Egypt (psychological; circulatory/breathing; gastrointestinal; and, pains/aches), and factor loadings were quite similar for both countries. Whilst the two samples showed similarities as to the kind of symptoms most frequently reported by students, the Egyptian sample had significantly higher frequency than the UK for every symptom. Frequent complaints (both countries) included difficulties to concentrate, fatigue, headaches, nervousness/anxiety, and back pain (UK) and mood swings (Egypt). Significantly more Egyptian students reported ≥4 symptoms over the past year than the UK. For each of the UK and Egypt, across each of the four symptom groups, there was a stepladder appearance whereby the frequency of symptoms increased with increasing quartiles of perceived stress. Not controlling for other variables, for both countries, there were significant positive correlations between each of the four symptom groups and stress; the highest correlation was for psychological symptoms. After controlling for sex, age country, and other symptom groups, stress was highly and significantly associated with psychological symptoms and also with pain & aches symptoms in both countries. UK students were generally less stressed than their counterparts in Egypt. Age and female gender were also associated with stress; the younger the student was the more likely to suffer from stress. Interactions were not significant. Across both countries, the levels of stress among students and the associations between perceived stress and health complaints suggest the need for a multiple approaches in order to understand the sources of stress; how college students experience stress; and, the coping mechanisms that different students employ to mitigate stress. Interventions aimed at both preventing, treating and caring for students’ distress, and also preventive strategies to help minimize the impact of stressful situations are required. Strategies that address both physical and psychological complaints may be beneficial for this population. Full article
Open AccessArticle Genomic Instability in Human Lymphocytes from Male Users of Crack Cocaine
Int. J. Environ. Res. Public Health 2014, 11(10), 10003-10015; doi:10.3390/ijerph111010003
Received: 22 July 2014 / Revised: 25 August 2014 / Accepted: 28 August 2014 / Published: 26 September 2014
Cited by 5 | PDF Full-text (470 KB) | HTML Full-text | XML Full-text
Abstract
Recent research suggests that crack cocaine use alters systemic biochemical markers, like oxidative damage and inflammation markers, but very few studies have assessed the potential effects of crack cocaine at the cellular level. We assessed genome instability by means of the comet assay
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Recent research suggests that crack cocaine use alters systemic biochemical markers, like oxidative damage and inflammation markers, but very few studies have assessed the potential effects of crack cocaine at the cellular level. We assessed genome instability by means of the comet assay and the cytokinesis-block micronucleus technique in crack cocaine users at the time of admission to a rehabilitation clinic and at two times after the beginning of withdrawal. Thirty one active users of crack cocaine and forty control subjects were evaluated. Comparison between controls and crack cocaine users at the first analysis showed significant differences in the rates of DNA damage (p = 0.037). The frequency of micronuclei (MN) (p < 0.001) and nuclear buds (NBUDs) (p < 0.001) was increased, but not the frequency of nucleoplasmic bridges (NPBs) (p = 0.089). DNA damage decreased only after the end of treatment (p < 0.001). Micronuclei frequency did not decrease after treatment, and nuclear buds increased substantially. The results of this study reveal the genotoxic and mutagenic effects of crack cocaine use in human lymphocytes and pave the way for further research on cellular responses and the possible consequences of DNA damage, such as induction of irreversible neurological disease and cancer. Full article
Open AccessArticle In vitro and in vivo Effects of Free and Chalcones-Loaded Nanoemulsions: Insights and Challenges in Targeted Cancer Chemotherapies
Int. J. Environ. Res. Public Health 2014, 11(10), 10016-10035; doi:10.3390/ijerph111010016
Received: 15 July 2014 / Revised: 29 August 2014 / Accepted: 4 September 2014 / Published: 26 September 2014
Cited by 3 | PDF Full-text (1247 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Several obstacles are encountered in conventional chemotherapy, such as drug toxicity and poor stability. Nanotechnology is envisioned as a strategy to overcome these effects and to improve anticancer therapy. Nanoemulsions comprise submicron emulsions composed of biocompatible lipids, and present a large surface area
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Several obstacles are encountered in conventional chemotherapy, such as drug toxicity and poor stability. Nanotechnology is envisioned as a strategy to overcome these effects and to improve anticancer therapy. Nanoemulsions comprise submicron emulsions composed of biocompatible lipids, and present a large surface area revealing interesting physical properties. Chalcones are flavonoid precursors, and have been studied as cytotoxic drugs for leukemia cells that induce cell death by different apoptosis pathways. In this study, we encapsulated chalcones in a nanoemulsion and compared their effect with the respective free compounds in leukemia and in non-tumoral cell lines, as well as in an in vivo model. Free and loaded-nanoemulsion chalcones induced a similar anti-leukemic effect. Free chalcones induced higher toxicity in VERO cells than chalcones-loaded nanoemulsions. Similar results were observed in vivo. Free chalcones induced a reduction in weight gain and liver injuries, evidenced by oxidative stress, as well as an inflammatory response. Considering the high toxicity and the side effects induced generally by all cancer chemotherapies, nanotechnology provides some options for improving patients’ life quality and/or increasing survival rates. Full article
Open AccessArticle Aberrant Production of Th1/Th2/Th17-Related Cytokines in Serum of C57BL/6 Mice after Short-Term Formaldehyde Exposure
Int. J. Environ. Res. Public Health 2014, 11(10), 10036-10050; doi:10.3390/ijerph111010036
Received: 25 July 2014 / Revised: 15 September 2014 / Accepted: 16 September 2014 / Published: 26 September 2014
Cited by 3 | PDF Full-text (581 KB) | HTML Full-text | XML Full-text
Abstract
Previous studies have shown that formaldehyde (FA) could cause immunotoxicity by changing the number of T lymphocytes and that cytokines play a pivotal role in the regulation of T lymphocytes. However, the previously used cytokine detection methods are difficult to use in the
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Previous studies have shown that formaldehyde (FA) could cause immunotoxicity by changing the number of T lymphocytes and that cytokines play a pivotal role in the regulation of T lymphocytes. However, the previously used cytokine detection methods are difficult to use in the measurement of several cytokines in a small amount of sample for one test. Therefore, the cytometric bead array (CBA) technique was used. CBA showed better analytical efficiency and sensitivity than the previous methods. C57BL/6 mice were exposed to the control (normal saline), low FA concentration (0.5 mg/kg), and high FA concentration (2 mg/kg) for 1 week or 1 month. The contents of cytokines, including Th1-related cytokines (IL-2, IFN-γ, and tumor necrosis factor), Th2-related cytokines (IL-4, IL-6, and IL-10), and Th17-related cytokines (IL-17A), were measured by using the BD FACS Canto II Flow Cytometer and analyzed by FCAP ArrayTM Software. Th1/Th2/Th17-related cytokines showed a slightly decreasing trend after low FA exposure. Conversely, a significantly increasing trend was found after high FA exposure. Th1/Th2/Th17-related cytokines all serve important functions in the immune reactions in mice after FA exposure. Full article
Open AccessArticle Work Hard, Party Harder: Drug Use and Sexual Behaviour in Young British Casual Workers in Ibiza, Spain
Int. J. Environ. Res. Public Health 2014, 11(10), 10051-10061; doi:10.3390/ijerph111010051
Received: 12 August 2014 / Revised: 19 September 2014 / Accepted: 19 September 2014 / Published: 26 September 2014
Cited by 10 | PDF Full-text (295 KB) | HTML Full-text | XML Full-text
Abstract
Background: Every summer, young people flock to nightlife-focused holiday resorts around the world to find casual work. Despite being exposed to hedonistic environments, often for several months, little is known about their substance use, sexual activity and health service needs over this
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Background: Every summer, young people flock to nightlife-focused holiday resorts around the world to find casual work. Despite being exposed to hedonistic environments, often for several months, little is known about their substance use, sexual activity and health service needs over this extended amount of time abroad. Methods: A short anonymous questionnaire examining alcohol and drug use, sexual behaviour and use of health services was administered to young British casual workers aged 16–35 in San Antonio, Ibiza (n = 171). Results: 97.7% of casual workers used alcohol in Ibiza, and the majority (85.3%) used drugs. Almost half (43.5%) of all participants used a drug in Ibiza that they had never used in the UK. Most casual workers arrived in Ibiza without a partner or spouse (86.5%). Of these, 86.9% had sex during their stay and 50.0% had unprotected sex; often while under the influence of alcohol. Only 14.3% of those having unprotected sex with a new partner sought a sexual health check-up in Ibiza, although 84.1% intended to do this on their return to the UK. Conclusion: Substance use and sexual risk taking is widespread among young British casual workers in Ibiza. Such international nightlife resorts represent key settings for substance-related health and social problems, and for the international spread of sexually transmitted infections. Addressing the health needs of casual workers and the environments that permit and promote their excessive behaviour requires collaboration between authorities in home and destination countries and the tourism industry. Full article
(This article belongs to the Special Issue Substance and Drug Abuse Prevention)
Open AccessArticle The Role of Cities in Reducing Smoking in China
Int. J. Environ. Res. Public Health 2014, 11(10), 10062-10075; doi:10.3390/ijerph111010062
Received: 3 June 2014 / Revised: 19 September 2014 / Accepted: 22 September 2014 / Published: 26 September 2014
Cited by 2 | PDF Full-text (343 KB) | HTML Full-text | XML Full-text
Abstract
China is the epicenter of the global tobacco epidemic. China grows more tobacco, produces more cigarettes, makes more profits from tobacco and has more smokers than any other nation in the world. Approximately one million smokers in China die annually from diseases caused
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China is the epicenter of the global tobacco epidemic. China grows more tobacco, produces more cigarettes, makes more profits from tobacco and has more smokers than any other nation in the world. Approximately one million smokers in China die annually from diseases caused by smoking, and this estimate is expected to reach over two million by 2020. China cities have a unique opportunity and role to play in leading the tobacco control charge from the “bottom up”. The Emory Global Health Institute—China Tobacco Control Partnership supported 17 cities to establish tobacco control programs aimed at changing social norms for tobacco use. Program assessments showed the Tobacco Free Cities grantees’ progress in establishing tobacco control policies and raising public awareness through policies, programs and education activities have varied from modest to substantial. Lessons learned included the need for training and tailored technical support to build staff capacity and the importance of government and organizational support for tobacco control. Tobacco control, particularly in China, is complex, but the potential for significant public health impact is unparalleled. Cities have a critical role to play in changing social norms of tobacco use, and may be the driving force for social norm change related to tobacco use in China. Full article
(This article belongs to the Special Issue Tobacco Control)
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Open AccessArticle The Value of Mainstreaming Human Rights into Health Impact Assessment
Int. J. Environ. Res. Public Health 2014, 11(10), 10076-10090; doi:10.3390/ijerph111010076
Received: 1 September 2014 / Revised: 18 September 2014 / Accepted: 18 September 2014 / Published: 26 September 2014
Cited by 2 | PDF Full-text (230 KB) | HTML Full-text | XML Full-text
Abstract
Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice,
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Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well. Full article
(This article belongs to the Special Issue Health Impact Assessment: Realizing Its Potential)
Open AccessArticle Ilex paraguariensis Extract Increases Lifespan and Protects Against the Toxic Effects Caused by Paraquat in Caenorhabditis elegans
Int. J. Environ. Res. Public Health 2014, 11(10), 10091-10104; doi:10.3390/ijerph111010091
Received: 21 July 2014 / Revised: 16 September 2014 / Accepted: 22 September 2014 / Published: 26 September 2014
Cited by 5 | PDF Full-text (694 KB) | HTML Full-text | XML Full-text
Abstract
Recent studies have shown that phenolic compounds present in yerba mate have antioxidant defense properties. To verify whether Ilex paraguariensis extracts are capable of increasing the lifespan of an organism, we have used the free-living nematode Caenorhabditis elegans. Notably, this is the
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Recent studies have shown that phenolic compounds present in yerba mate have antioxidant defense properties. To verify whether Ilex paraguariensis extracts are capable of increasing the lifespan of an organism, we have used the free-living nematode Caenorhabditis elegans. Notably, this is the first study that analyzes the effects of the extracts of yerba mate obtained from an extraction method that mimics the manner that the plant is consumed by the population by using a live organism. Yerba mate was purchased from commercial markets from Argentina, Brazil, and Uruguay. Ilex paraguariensis extracts significantly increased the life span of C. elegans. Moreover, the extracts reduced the ROS levels per se, and protected from the reduced survival and reproduction rate induced by paraquat exposure. Considering molecular aspects, we observed that the worms pretreated with the extracts depicted higher translocation of the transcription factor DAF-16::GFP to the nucleus. However, there was no increase in the levels of the DAF-16 target genes, SOD-3 and catalase. Our results suggest that the increase of lifespan caused by the different extracts is associated to the antioxidant potential of yerba mate, however this effect is not completely mediated by daf-16. Full article
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Open AccessArticle Enteric Pathogen Survival Varies Substantially in Irrigation Water from Belgian Lettuce Producers
Int. J. Environ. Res. Public Health 2014, 11(10), 10105-10124; doi:10.3390/ijerph111010105
Received: 2 July 2014 / Revised: 18 September 2014 / Accepted: 19 September 2014 / Published: 29 September 2014
Cited by 2 | PDF Full-text (1294 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
It is accepted that irrigation water is a potential carrier of enteric pathogens, such as Salmonella and E. coli O157:H7 and, therefore, a source for contamination of fresh produce. We tested this by comparing irrigation water samples taken from five different greenhouses in
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It is accepted that irrigation water is a potential carrier of enteric pathogens, such as Salmonella and E. coli O157:H7 and, therefore, a source for contamination of fresh produce. We tested this by comparing irrigation water samples taken from five different greenhouses in Belgium. The water samples were inoculated with four zoonotic strains, two Salmonella and two E. coli O157:H7 strains, and pathogen survival and growth in the water were monitored up till 14 days. The influence of water temperature and chemical water quality was evaluated, and the survival tests were also performed in water samples from which the resident aquatic microbiota had previously been eliminated by filter sterilization. The pathogen’s survival differed greatly in the different irrigation waters. Three water samples contained nutrients to support important growth of the pathogens, and another enabled weaker growth. However, for all, growth was only observed in the samples that did not contain the resident aquatic microbiota. In the original waters with their specific water biota, pathogen levels declined. The same survival tendencies existed in water of 4 °C and 20 °C, although always more expressed at 20 °C. Low water temperatures resulted in longer pathogen survival. Remarkably, the survival capacity of two E. coli 0157:H7 strains differed, while Salmonella Thompson and Salmonella Typhimurium behaved similarly. The pathogens were also transferred to detached lettuce leaves, while suspended in two of the water samples or in a buffer. The effect of the water sample on the pathogen’s fitness was also reproduced on the leaves when stored at 100% relative humidity. Inoculation of the suspension in buffer or in one of the water samples enabled epiphytic growth and survival, while the pathogen level in the other water sample decreased once loaded on the leaves. Our results show that irrigation waters from different origin may have a different capacity to transmit enteric pathogens and an important impact on the fitness of the pathogens to sustain and even grow on the leaf surface. Full article
Open AccessArticle Chromium in Drinking Water: Association with Biomarkers of Exposure and Effect
Int. J. Environ. Res. Public Health 2014, 11(10), 10125-10145; doi:10.3390/ijerph111010125
Received: 2 August 2014 / Revised: 16 September 2014 / Accepted: 16 September 2014 / Published: 29 September 2014
Cited by 5 | PDF Full-text (796 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
An epidemiological cross-sectional study was conducted in Greece to investigate health outcomes associated with long-term exposure to chromium via drinking water. The study population consisted of 304 participants. Socio-demographics, lifestyle, drinking water intake, dietary habits, occupational and medical history data were recorded through
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An epidemiological cross-sectional study was conducted in Greece to investigate health outcomes associated with long-term exposure to chromium via drinking water. The study population consisted of 304 participants. Socio-demographics, lifestyle, drinking water intake, dietary habits, occupational and medical history data were recorded through a personal interview. Physical examination and a motor test were carried out on the individuals. Total chromium concentrations were measured in blood and hair of the study subjects. Hematological, biochemical and inflammatory parameters were determined in blood. Chromium in drinking water ranged from <0.5 to 90 μg·L−1 in all samples but one (220 μg·L−1), with a median concentration of 21.2 μg·L−1. Chromium levels in blood (median 0.32 μg·L−1, range <0.18–0.92 μg·L−1) and hair (median 0.22 μg·g−1, range 0.03–1.26 μg·g−1) were found within “normal range” according to the literature. Personal lifetime chromium exposure dose via drinking water, calculated from the results of the water analyses and the questionnaire data, showed associations with blood and hair chromium levels and certain hematological and biochemical parameters. Groups of subjects whose hematological or biochemical parameters were outside the normal range were not correlated with chromium exposure dose, except for groups of subjects with high triglycerides or low sodium. Motor impairment score was not associated with exposure to chromium. Full article
Open AccessArticle Exposure to Endocrine Disrupters and Nuclear Receptor Gene Expression in Infertile and Fertile Women from Different Italian Areas
Int. J. Environ. Res. Public Health 2014, 11(10), 10146-10164; doi:10.3390/ijerph111010146
Received: 11 July 2014 / Revised: 15 September 2014 / Accepted: 22 September 2014 / Published: 29 September 2014
Cited by 6 | PDF Full-text (733 KB) | HTML Full-text | XML Full-text
Abstract
Within the PREVIENI project, infertile and fertile women were enrolled from metropolitan, urban and rural Italian areas. Blood/serum levels of several endocrine disrupters (EDs) (perfluorooctane sulfonate, PFOS; perfluorooctanoic acid, PFOA; di-2-ethylhexyl-phthalate, DEHP; mono-(2-ethylhexyl)-phthalate, MEHP; bisphenol A, BPA) were evaluated concurrently with nuclear receptors
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Within the PREVIENI project, infertile and fertile women were enrolled from metropolitan, urban and rural Italian areas. Blood/serum levels of several endocrine disrupters (EDs) (perfluorooctane sulfonate, PFOS; perfluorooctanoic acid, PFOA; di-2-ethylhexyl-phthalate, DEHP; mono-(2-ethylhexyl)-phthalate, MEHP; bisphenol A, BPA) were evaluated concurrently with nuclear receptors (NRs) gene expression levels (ERa, ERb, AR, AhR, PPARg, PXR) in peripheral blood mononuclear cells (PBMCs). Infertile women from the metropolitan area displayed significantly higher levels of: BPA compared to fertile women (14.9 vs. 0.5 ng/mL serum); BPA and MEHP compared to infertile women from urban and rural areas; enhanced expression levels of NRs, except PPARg. Infertile women from urban and rural areas had PFOA levels significantly higher than those from metropolitan areas. Our study indicates the relevance of the living environment when investigating the exposure to EDs and the modulation of the NR panel in PBMC as a suitable biomarker of the effect, to assess the EDs impact on reproductive health. Full article
Open AccessArticle Concurrent Fetal Exposure to Multiple Environmental Chemicals along the U.S.—Mexico Border: An Exploratory Study in Brownsville, Texas
Int. J. Environ. Res. Public Health 2014, 11(10), 10165-10181; doi:10.3390/ijerph111010165
Received: 20 June 2014 / Revised: 26 August 2014 / Accepted: 24 September 2014 / Published: 29 September 2014
Cited by 5 | PDF Full-text (310 KB) | HTML Full-text | XML Full-text
Abstract
There is mounting concern that cumulative exposure to diverse chemicals in the environment may contribute to observed adverse health outcomes in the Lower Rio Grande Valley of Texas. To investigate this situation, biomarker concentrations of organochlorine (OC) pesticides/metabolites, polychlorinated biphenyls (PCBs), and polycyclic
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There is mounting concern that cumulative exposure to diverse chemicals in the environment may contribute to observed adverse health outcomes in the Lower Rio Grande Valley of Texas. To investigate this situation, biomarker concentrations of organochlorine (OC) pesticides/metabolites, polychlorinated biphenyls (PCBs), and polycyclic aromatic hydrocarbons (PAHs) were measured in maternal and umbilical cord blood from pregnant Hispanic women in Brownsville, TX. Results show that both mothers and fetuses were exposed concurrently to a variety of relatively low-level, hazardous environmental chemicals. Approximately 10% of the blood specimens had comparatively high concentrations of specific OC pesticides, PCBs and PAHs. Because many pregnant women in Brownsville live in socioeconomically-disadvantaged and environmentally-challenging circumstances, there is appropriate concern that exposure to these exogenous substances, either individually or in combination, may contribute to endemic health problems in this population, including cardiovascular disease, obesity, and diabetes. The challenge is to identify individuals at highest comparative risk and then implement effective programs to either prevent or reduce cumulative exposures that pose significant health-related threats. Full article
(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)
Open AccessArticle Changes in Access to Health Services of the Immigrant and Native-Born Population in Spain in the Context of Economic Crisis
Int. J. Environ. Res. Public Health 2014, 11(10), 10182-10201; doi:10.3390/ijerph111010182
Received: 13 August 2014 / Revised: 17 September 2014 / Accepted: 18 September 2014 / Published: 30 September 2014
Cited by 12 | PDF Full-text (686 KB) | HTML Full-text | XML Full-text
Abstract
Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables
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Aim: To analyze changes in access to health care and its determinants in the immigrant and native-born populations in Spain, before and during the economic crisis. Methods: Comparative analysis of two iterations of the Spanish National Health Survey (2006 and 2012). Outcome variables were: unmet need and use of different healthcare levels; explanatory variables: need, predisposing and enabling factors. Multivariate models were performed (1) to compare outcome variables in each group between years, (2) to compare outcome variables between both groups within each year, and (3) to determine the factors associated with health service use for each group and year. Results: unmet healthcare needs decreased in 2012 compared to 2006; the use of health services remained constant, with some changes worth highlighting, such as the decline in general practitioner visits among autochthons and a narrowed gap in specialist visits between the two populations. The factors associated with health service use in 2006 remained constant in 2012. Conclusion: Access to healthcare did not worsen, possibly due to the fact that, until 2012, the national health system may have cushioned the deterioration of social determinants as a consequence of the financial crisis. Further studies are necessary to evaluate the effects of health policy responses to the crisis after 2012. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Bacterial Meningitis: A Density-Equalizing Mapping Analysis of the Global Research Architecture
Int. J. Environ. Res. Public Health 2014, 11(10), 10202-10214; doi:10.3390/ijerph111010202
Received: 5 August 2014 / Revised: 24 September 2014 / Accepted: 25 September 2014 / Published: 30 September 2014
Cited by 6 | PDF Full-text (3745 KB) | HTML Full-text | XML Full-text
Abstract
Bacterial meningitis is caused by a variety of pathogens and displays an important public health threat all over the world. Despite the necessity to develop customized public health-related research projects, a thorough study of global meningitis research is not present, so far. Therefore,
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Bacterial meningitis is caused by a variety of pathogens and displays an important public health threat all over the world. Despite the necessity to develop customized public health-related research projects, a thorough study of global meningitis research is not present, so far. Therefore, the aim of this study was a combined density-equalizing and scientometric study. To evaluate the scientific efforts of bibliometric methods, density-equalizing algorithms and large-scale data analysis of the Web of Science were applied in the period between 1900 and 2007. From this, 7998 publications on bacterial meningitis have been found. With a number of 2698, most publications have been written by U.S. authors, followed by the UK (912), Germany (749) and France (620). This dominance can also be shown in the international cooperation. The specific citation analyses reveal that the nation with the highest average citation rate (citations per publications) was Norway (26.36), followed by Finland (24.16) and the U.S. (24.06). This study illustrates the architecture of global research on bacterial meningitis and points to the need for customized research programs with a focus on local public health issues in countries with a low development index, but high incidences, to target this global public health problem. Full article
Open AccessArticle MRSA: A Density-Equalizing Mapping Analysis of the Global Research Architecture
Int. J. Environ. Res. Public Health 2014, 11(10), 10215-10225; doi:10.3390/ijerph111010215
Received: 17 July 2014 / Revised: 22 September 2014 / Accepted: 23 September 2014 / Published: 30 September 2014
Cited by 7 | PDF Full-text (363 KB) | HTML Full-text | XML Full-text
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has evolved as an alarming public health thread due to its global spread as hospital and community pathogen. Despite this role, a scientometric analysis has not been performed yet. Therefore, the NewQIS platform was used to conduct a combined
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Methicillin-resistant Staphylococcus aureus (MRSA) has evolved as an alarming public health thread due to its global spread as hospital and community pathogen. Despite this role, a scientometric analysis has not been performed yet. Therefore, the NewQIS platform was used to conduct a combined density-equalizing mapping and scientometric study. As database, the Web of Science was used, and all entries between 1961 and 2007 were analyzed. In total, 7671 entries were identified. Density equalizing mapping demonstrated a distortion of the world map for the benefit of the USA as leading country with a total output of 2374 publications, followed by the UK (1030) and Japan (862). Citation rate analysis revealed Portugal as leading country with a rate of 35.47 citations per article, followed by New Zealand and Denmark. Country cooperation network analyses showed 743 collaborations with US-UK being most frequent. Network citation analyses indicated the publications that arose from the cooperation of USA and France as well as USA and Japan as the most cited (75.36 and 74.55 citations per collaboration article, respectively). The present study provides the first combined density-equalizing mapping and scientometric analysis of MRSA research. It illustrates the global MRSA research architecture. It can be assumed that this highly relevant topic for public health will achieve even greater dimensions in the future. Full article
Open AccessArticle A Health Impact Assessment of a Proposed Bill to Decrease Speed Limits on Local Roads in Massachusetts (U.S.A.)
Int. J. Environ. Res. Public Health 2014, 11(10), 10269-10291; doi:10.3390/ijerph111010269
Received: 29 August 2014 / Revised: 19 September 2014 / Accepted: 23 September 2014 / Published: 2 October 2014
Cited by 3 | PDF Full-text (902 KB) | HTML Full-text | XML Full-text
Abstract
Decreasing traffic speeds increases the amount of time drivers have to react to road hazards, potentially averting collisions, and makes crashes that do happen less severe. Boston’s regional planning agency, the Metropolitan Area Planning Council (MAPC), in partnership with the Massachusetts Department of
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Decreasing traffic speeds increases the amount of time drivers have to react to road hazards, potentially averting collisions, and makes crashes that do happen less severe. Boston’s regional planning agency, the Metropolitan Area Planning Council (MAPC), in partnership with the Massachusetts Department of Public Health (MDPH), conducted a Health Impact Assessment (HIA) that examined the potential health impacts of a proposed bill in the state legislature to lower the default speed limits on local roads from 30 miles per hour (mph) to 25 mph. The aim was to reduce vehicle speeds on local roads to a limit that is safer for pedestrians, cyclists, and children. The passage of this proposed legislation could have had far-reaching and potentially important public health impacts. Lower default speed limits may prevent around 18 fatalities and 1200 serious injuries to motorists, cyclists and pedestrians each year, as well as promote active transportation by making local roads feel more hospitable to cyclists and pedestrians. While a lower speed limit would increase congestion and slightly worsen air quality, the benefits outweigh the costs from both a health and economic perspective and would save the state approximately $62 million annually from prevented fatalities and injuries. Full article
(This article belongs to the Special Issue Health Impact Assessment: Realizing Its Potential)
Open AccessArticle Ecohealth Approach to Urban Waste Management: Exposure to Environmental Pollutants and Health Risks in Yamoussoukro, Côte d’Ivoire
Int. J. Environ. Res. Public Health 2014, 11(10), 10292-10309; doi:10.3390/ijerph111010292
Received: 29 June 2014 / Revised: 18 September 2014 / Accepted: 19 September 2014 / Published: 2 October 2014
Cited by 1 | PDF Full-text (1282 KB) | HTML Full-text | XML Full-text
Abstract
Poor waste management is a key driver of ill-health in urban settlements of developing countries. The current study aimed at assessing environmental and human health risks related to urban waste management in Yamoussoukro, the political capital of Côte d’Ivoire. We undertook trans-disciplinary research
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Poor waste management is a key driver of ill-health in urban settlements of developing countries. The current study aimed at assessing environmental and human health risks related to urban waste management in Yamoussoukro, the political capital of Côte d’Ivoire. We undertook trans-disciplinary research within an Ecohealth approach, comprised of a participatory workshop with stakeholders and mapping of exposure patterns. A total of 492 randomly selected households participated in a cross-sectional survey. Waste deposit sites were characterised and 108 wastewater samples were subjected to laboratory examinations. The physico-chemical parameters of the surface water (temperature, pH, conductivity, potential oxidise reduction, BOD5, COD, dissolved oxygen, nitrates, ammonia and total Kendal nitrogen) did not comply with World Health Organization standards of surface water quality. Questionnaire results showed that malaria was the most commonly reported disease. Diarrhoea and malaria were associated with poor sanitation. Households having dry latrines had a higher risk of diarrhoea (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.2–2.7) compared to latrines with septic tanks and also a higher risk for malaria (OR = 1.9, 95% (CI) 1.1–3.3). Our research showed that combining health and environmental assessments enables a deeper understanding of environmental threats and disease burdens linked to poor waste management. Further study should investigate the sanitation strategy aspects that could reduce the environmental and health risks in the study area. Full article
Open AccessArticle Behavioral Attitudes and Preferences in Cooking Practices with Traditional Open-Fire Stoves in Peru, Nepal, and Kenya: Implications for Improved Cookstove Interventions
Int. J. Environ. Res. Public Health 2014, 11(10), 10310-10326; doi:10.3390/ijerph111010310
Received: 30 July 2014 / Revised: 28 September 2014 / Accepted: 28 September 2014 / Published: 3 October 2014
Cited by 10 | PDF Full-text (1128 KB) | HTML Full-text | XML Full-text
Abstract
Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation
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Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation of cookstove projects; however, these studies have not examined the implications of the traditional stove use and design across multiple resource-poor settings in the implementation and promotion of improved cookstove projects that utilize a single, standardized stove design. We conducted in-depth interviews and direct observations of meal preparation and traditional, open-fire stove use of 137 women aged 20–49 years in Kenya, Peru and Nepal prior in the four-month period preceding installation of an improved cookstove as part of a field intervention trial. Despite general similarities in cooking practices across sites, we identified locally distinct practices and norms regarding traditional stove use and desired stove improvements. Traditional stoves are designed to accommodate specific cooking styles, types of fuel, and available resources for maintenance and renovation. The tailored stoves allow users to cook and repair their stoves easily. Women in each setting expressed their desire for a new stove, but they articulated distinct specific alterations that would meet their needs and preferences. Improved cookstove designs need to consider the diversity of values and needs held by potential users, presenting a significant challenge in identifying a “one size fits all” improved cookstove design. Our data show that a single stove design for use with locally available biomass fuels will not meet the cooking demands and resources available across the three sites. Moreover, locally produced or adapted improved cookstoves may be needed to meet the cooking needs of diverse populations while addressing health and environmental concerns of traditional stoves. Full article
Open AccessArticle Telephone-Based Adiposity Prevention for Families with Overweight Children (T.A.F.F.-Study): One Year Outcome of a Randomized, Controlled Trial
Int. J. Environ. Res. Public Health 2014, 11(10), 10327-10344; doi:10.3390/ijerph111010327
Received: 25 June 2014 / Revised: 23 September 2014 / Accepted: 29 September 2014 / Published: 3 October 2014
Cited by 2 | PDF Full-text (815 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The one-year outcome of the randomized controlled T.A.F.F. (Telephone based Adiposity prevention For Families) study is presented. Screening of overweight (BMI-SDS > 90th centile) children 3.5–17.4 years was performed via the German CrescNet database, and candidates were randomized
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The one-year outcome of the randomized controlled T.A.F.F. (Telephone based Adiposity prevention For Families) study is presented. Screening of overweight (BMI-SDS > 90th centile) children 3.5–17.4 years was performed via the German CrescNet database, and candidates were randomized to an intervention group (IG) and control group (CG). The intervention consisted of computer-aided telephone counselling for one year, supported by mailed newsletters. The primary endpoint was change in BMI-SDS; secondary endpoints were eating behavior, physical activity, media consumption, quality of life. Data from 289 families (145 IG (51% females); 144 CG (50% females)) were analyzed (Full Analysis Set: FAS; Per Protocol Set: PPS). Successful intervention was defined as decrease in BMI-SDS ≥ 0.2. In the FAS, 21% of the IG was successful as compared to 16% from the CG (95% CI for this difference: (−4, 14), p = 0.3, mean change in BMI-SDS: −0.02 for IG vs. 0.02 for CG; p = 0.4). According to the PPS, however, the success rate was 35% in the IG compared to 19% in the CG (mean change in BMI-SDS: −0.09 for IG vs. 0.02 for CG; p = 0.03). Scores for eating patterns (p = 0.01), media consumption (p = 0.007), physical activity (p = 9 × 10−9), quality of life (p = 5 × 10−8) decreased with age, independent of group or change in BMI-SDS. We conclude that a telephone-based obesity prevention program suffers from well-known high attrition rates so that its effectiveness could only be shown in those who adhered to completion. The connection between lifestyle and weight status is not simple and requires further research to better understand. Full article
(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)
Open AccessArticle Reasons for Starting and Stopping Electronic Cigarette Use
Int. J. Environ. Res. Public Health 2014, 11(10), 10345-10361; doi:10.3390/ijerph111010345
Received: 29 June 2014 / Revised: 28 September 2014 / Accepted: 28 September 2014 / Published: 3 October 2014
Cited by 44 | PDF Full-text (694 KB) | HTML Full-text | XML Full-text
Abstract
The aim of our study was to explore reasons for starting and then stopping electronic cigarette (e-cigarette) use. Among a national sample of 3878 U.S. adults who reported ever trying e-cigarettes, the most common reasons for trying were curiosity (53%); because a friend
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The aim of our study was to explore reasons for starting and then stopping electronic cigarette (e-cigarette) use. Among a national sample of 3878 U.S. adults who reported ever trying e-cigarettes, the most common reasons for trying were curiosity (53%); because a friend or family member used, gave, or offered e-cigarettes (34%); and quitting or reducing smoking (30%). Nearly two-thirds (65%) of people who started using e-cigarettes later stopped using them. Discontinuation was more common among those whose main reason for trying was not goal-oriented (e.g., curiosity) than goal-oriented (e.g., quitting smoking) (81% vs. 45%, p < 0.001). The most common reasons for stopping e-cigarette use were that respondents were just experimenting (49%), using e-cigarettes did not feel like smoking cigarettes (15%), and users did not like the taste (14%). Our results suggest there are two categories of e-cigarette users: those who try for goal-oriented reasons and typically continue using and those who try for non-goal-oriented reasons and then typically stop using. Research should distinguish e-cigarette experimenters from motivated users whose decisions to discontinue relate to the utility or experience of use. Depending on whether e-cigarettes prove to be effective smoking cessation tools or whether they deter cessation, public health programs may need distinct strategies to reach and influence different types of users. Full article
(This article belongs to the Special Issue Electronic Cigarettes as a Tool in Tobacco Harm Reduction)
Open AccessArticle Geographical Scale Effects on the Analysis of Leptospirosis Determinants
Int. J. Environ. Res. Public Health 2014, 11(10), 10366-10383; doi:10.3390/ijerph111010366
Received: 30 May 2014 / Revised: 3 September 2014 / Accepted: 10 September 2014 / Published: 10 October 2014
Cited by 4 | PDF Full-text (910 KB) | HTML Full-text | XML Full-text
Abstract
Leptospirosis displays a great diversity of routes of exposure, reservoirs, etiologic agents, and clinical symptoms. It occurs almost worldwide but its pattern of transmission varies depending where it happens. Climate change may increase the number of cases, especially in developing countries, like Brazil.
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Leptospirosis displays a great diversity of routes of exposure, reservoirs, etiologic agents, and clinical symptoms. It occurs almost worldwide but its pattern of transmission varies depending where it happens. Climate change may increase the number of cases, especially in developing countries, like Brazil. Spatial analysis studies of leptospirosis have highlighted the importance of socioeconomic and environmental context. Hence, the choice of the geographical scale and unit of analysis used in the studies is pivotal, because it restricts the indicators available for the analysis and may bias the results. In this study, we evaluated which environmental and socioeconomic factors, typically used to characterize the risks of leptospirosis transmission, are more relevant at different geographical scales (i.e., regional, municipal, and local). Geographic Information Systems were used for data analysis. Correlations between leptospirosis incidence and several socioeconomic and environmental indicators were calculated at different geographical scales. At the regional scale, the strongest correlations were observed between leptospirosis incidence and the amount of people living in slums, or the percent of the area densely urbanized. At the municipal scale, there were no significant correlations. At the local level, the percent of the area prone to flooding best correlated with leptospirosis incidence. Full article
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
Open AccessArticle The Impact of Different Proportions of a Treated Effluent on the Biotransformation of Selected Micro-Contaminants in River Water Microcosms
Int. J. Environ. Res. Public Health 2014, 11(10), 10390-10405; doi:10.3390/ijerph111010390
Received: 19 August 2014 / Revised: 24 September 2014 / Accepted: 29 September 2014 / Published: 10 October 2014
Cited by 4 | PDF Full-text (617 KB) | HTML Full-text | XML Full-text
Abstract
Attenuation of micro-contaminants is a very complex field in environmental science and evidence suggests that biodegradation rates of micro-contaminants in the aqueous environment depend on the water matrix. The focus of the study presented here is the systematic comparison of biotransformation rates of
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Attenuation of micro-contaminants is a very complex field in environmental science and evidence suggests that biodegradation rates of micro-contaminants in the aqueous environment depend on the water matrix. The focus of the study presented here is the systematic comparison of biotransformation rates of caffeine, carbamazepine, metoprolol, paracetamol and valsartan in river water microcosms spiked with different proportions of treated effluent (0%, 0.1%, 1%, and 10%). Biotransformation was identified as the dominating attenuation process by the evolution of biotransformation products such as atenolol acid and valsartan acid. Significantly decreasing biotransformation rates of metoprolol were observed at treated effluent proportions ≥0.1% whereas significantly increasing biotransformation rates of caffeine and valsartan were observed in the presence of 10% treated effluent. Potential reasons for the observations are discussed and the addition of adapted microorganisms via the treated effluent was suggested as the most probable reason. The impact of additional phosphorus on the biodegradation rates was tested and the experiments revealed that phosphorus-limitation was not responsible. Full article
(This article belongs to the Special Issue Emerging Contaminants in the Environment)
Open AccessArticle Evaluating the Effect of a Novel Molluscicide in the Endemic Schistosomiasis Japonica Area of China
Int. J. Environ. Res. Public Health 2014, 11(10), 10406-10418; doi:10.3390/ijerph111010406
Received: 18 July 2014 / Revised: 15 September 2014 / Accepted: 19 September 2014 / Published: 10 October 2014
Cited by 7 | PDF Full-text (421 KB) | HTML Full-text | XML Full-text
Abstract
Oncomelania hupensis is the sole intermediate host snail of Schistosoma japonicum in China. Snail control by molluscicide remains one of the most effective measures of schistosomiasis japonica control. A 50% wettable powder of niclosamide ethanolamine salt (WPN) is widely used for snail
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Oncomelania hupensis is the sole intermediate host snail of Schistosoma japonicum in China. Snail control by molluscicide remains one of the most effective measures of schistosomiasis japonica control. A 50% wettable powder of niclosamide ethanolamine salt (WPN) is widely used for snail control in China. However, WPN is costly and toxic to fish. A novel molluscicide named LDS, the salt of quinoid-2′, 5-dichloro-4′-nitrosalicylanilide from niclosamide, has been developed. To evaluate the effects of large-scale field application of LDS on field snail control, tests were conducted in 15 counties of Hubei Province, China. Active adult snails, were immersed in 0.2, 0.4, and 0.6 g/m3 of 10% LDS, 1.0 g/m3 of 50% WPN was used as the molluscicide control, and then the mortality rates of snails were investigated after 1, 2, and 3 days. In addition, four active concentrations of 10% LDS (0.4, 0.6, 0.8 and 1.0 g/m2) were applied by spraying and powdering in the field. 1.0 g/m2 of 50% WPN was used as the molluscicide control, and then the mortality rates of snails were observed after 1, 3, and 7 days. The results indicated that 0.4 g/m3 LDS applied by the immersion or 0.6 g/m2 LDS applied by spraying and powdering achieved the same molluscicidal effect as that of WPN, regardless of exposure time. By using different methods, the snail mortality rates in the molluscicide groups were related to exposure time and concentration, respectively. LDS costs less than WPN; thus, LDS is suitable and applicable for use as a molluscicide in schistosomiasis japonica epidemic areas. Full article
Open AccessArticle Scalable Combinatorial Tools for Health Disparities Research
Int. J. Environ. Res. Public Health 2014, 11(10), 10419-10443; doi:10.3390/ijerph111010419
Received: 1 August 2014 / Revised: 30 September 2014 / Accepted: 1 October 2014 / Published: 10 October 2014
Cited by 5 | PDF Full-text (895 KB) | HTML Full-text | XML Full-text
Abstract
Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual’s genetic endowment, particularly to environmental exposures experienced across his or
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Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual’s genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size and heterogeneity of available data needed to illuminate latent gene x environment interactions. This has prompted the adaptation and application of scalable combinatorial methods, many from genome science research, to the study of population health. Most of these powerful tools are algorithmically sophisticated, highly automated and mathematically abstract. Their utility motivates the main theme of this paper, which is to describe real applications of innovative transdisciplinary models and analyses in an effort to help move the research community closer toward identifying the causal mechanisms and associated environmental contexts underlying health disparities. The public health exposome is used as a contemporary focus for addressing the complex nature of this subject. Full article
(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)
Open AccessArticle Levels of Organochlorine Pesticides in Blood Plasma from Residents of Malaria-Endemic Communities in Chiapas, Mexico
Int. J. Environ. Res. Public Health 2014, 11(10), 10444-10460; doi:10.3390/ijerph111010444
Received: 25 July 2014 / Revised: 22 September 2014 / Accepted: 25 September 2014 / Published: 10 October 2014
Cited by 9 | PDF Full-text (630 KB) | HTML Full-text | XML Full-text
Abstract
Organochlorine (OC) pesticides have been extensively used for pest control in agriculture and against malaria vectors in the region of Soconusco, Chiapas, in southern Mexico. Our study aimed to identify whether the inhabitants of four Soconusco communities at different locations (i.e.,
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Organochlorine (OC) pesticides have been extensively used for pest control in agriculture and against malaria vectors in the region of Soconusco, Chiapas, in southern Mexico. Our study aimed to identify whether the inhabitants of four Soconusco communities at different locations (i.e., altitudes) and with different history of use of OC pesticides, have been similarly exposed to residues of these pesticides. In particular, we analyzed the potential relationship between levels of OC pesticides in plasma and the age, gender, and residence of the study population (n = 60). We detected seven pesticides in total (γ-HCH, β-HCH, heptachlor, p,pʹ-DDE, p,p'-DDT, β-endosulfan, endrin aldehyde). Of these, p,pʹ-DDE and β-endosulfan were the most frequently found (in 98% and 38% of the samples, respectively). The low-altitude (<20 m above sea level; masl) and mid-altitude (520 masl) locations had the highest levels of p,pʹ-DDE, with geometric means of 50.6 µg/L and 44.46 µg/L, respectively. The oldest subjects (>60 years) had the highest p,pʹ-DDE level (56.94 ± 57.81 µg/L) of all age groups, while men had higher p,pʹ-DDE (34.00 ± 46.76 µg/L) than women. Our results demonstrate that residents of the Soconusco region are exposed to p,pʹ-DDE because of high exposure to DDT in the past and current environmental exposure to this DDT-breakdown product. Full article
Open AccessArticle Alcohol Misuse and Associations with Childhood Maltreatment and Out-of-Home Placement among Urban Two-Spirit American Indian and Alaska Native People
Int. J. Environ. Res. Public Health 2014, 11(10), 10461-10479; doi:10.3390/ijerph111010461
Received: 4 July 2014 / Revised: 30 September 2014 / Accepted: 2 October 2014 / Published: 14 October 2014
Cited by 3 | PDF Full-text (675 KB) | HTML Full-text | XML Full-text
Abstract
This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during
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This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7%) and emotional abuse (71.8%) among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, respectively). Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals. Full article
(This article belongs to the Special Issue Substance and Drug Abuse Prevention)
Open AccessArticle Cryptosporidium and Giardia in Surface Water: A Case Study from Michigan, USA to Inform Management of Rural Water Systems
Int. J. Environ. Res. Public Health 2014, 11(10), 10480-10503; doi:10.3390/ijerph111010480
Received: 31 July 2014 / Revised: 22 September 2014 / Accepted: 29 September 2014 / Published: 14 October 2014
Cited by 5 | PDF Full-text (1578 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Cryptosporidium and Giardia pose a threat to human health in rural environments where water supplies are commonly untreated and susceptible to contamination from agricultural animal waste/manure, animal wastewater, septic tank effluents and septage. Our goals for this paper are to: (1) explore the
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Cryptosporidium and Giardia pose a threat to human health in rural environments where water supplies are commonly untreated and susceptible to contamination from agricultural animal waste/manure, animal wastewater, septic tank effluents and septage. Our goals for this paper are to: (1) explore the prevalence of these protozoan parasites, where they are found, in what quantities, and which genotypes are present; (2) examine relationships between disease and land use comparing human health risks between rural and urban environments; and (3) synthesize available information to gain a better understanding of risk and risk management for rural water supplies. Our results indicate that Cryptosporidium and Giardia were more prevalent in rural versus urban environments based on the number of positive samples. Genotyping showed that both the human and animal types of the parasites are found in rural and urban environments. Rural areas had a higher incidence of disease compared to urban areas based on the total number of disease cases. Cryptosporidiosis and giardiasis were both positively correlated (p < 0.001) with urban area, population size, and population density. Finally, a comprehensive strategy that creates knowledge pathways for data sharing among multiple levels of management may improve decision-making for protecting rural water supplies. Full article
(This article belongs to the Special Issue Evaluation of Rural Water Systems and Public Health)
Open AccessArticle Creating an eLearning Resource to Improve Knowledge and Understanding of Pregnancy in the Context of HIV Infection
Int. J. Environ. Res. Public Health 2014, 11(10), 10504-10517; doi:10.3390/ijerph111010504
Received: 3 July 2014 / Revised: 30 September 2014 / Accepted: 30 September 2014 / Published: 14 October 2014
PDF Full-text (669 KB) | HTML Full-text | XML Full-text
Abstract
Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma.
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Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. This paper presents how we sought to translate the evidence from a qualitative study of the perspectives of HIV affected pregnant women and expectant fathers on the care they received, from the pre conception to post natal period, into educational material for maternity care practice. Narrative scripts were written based on the original research interviews, with care taken to reflect the key themes from the research. We explore the way in which the qualitative findings bring to life patient and partner experiences and what it means for nurses, midwives and doctors to be prepared to care for couples affected by HIV. In so doing, we challenge the inequity between the dominance of biomedical knowledge over understanding the patient experience in the preparation of health professionals to care for HIV affected women and men who are having a baby or seeking to have a baby. Full article
Open AccessArticle A Method for Estimating Urban Background Concentrations in Support of Hybrid Air Pollution Modeling for Environmental Health Studies
Int. J. Environ. Res. Public Health 2014, 11(10), 10518-10536; doi:10.3390/ijerph111010518
Received: 29 July 2014 / Revised: 29 September 2014 / Accepted: 30 September 2014 / Published: 15 October 2014
Cited by 5 | PDF Full-text (6219 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Exposure studies rely on detailed characterization of air quality, either from sparsely located routine ambient monitors or from central monitoring sites that may lack spatial representativeness. Alternatively, some studies use models of various complexities to characterize local-scale air quality, but often with poor
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Exposure studies rely on detailed characterization of air quality, either from sparsely located routine ambient monitors or from central monitoring sites that may lack spatial representativeness. Alternatively, some studies use models of various complexities to characterize local-scale air quality, but often with poor representation of background concentrations. A hybrid approach that addresses this drawback combines a regional-scale model to provide background concentrations and a local-scale model to assess impacts of local sources. However, this approach may double-count sources in the study regions. To address these limitations, we carefully define the background concentration as the concentration that would be measured if local sources were not present, and to estimate these background concentrations we developed a novel technique that combines space-time ordinary kriging (STOK) of observations with outputs from a detailed chemistry-transport model with local sources zeroed out. We applied this technique to support an exposure study in Detroit, Michigan, for several pollutants (including NOx and PM2.5), and evaluated the estimated hybrid concentrations (calculated by combining the background estimates that addresses this issue of double counting with local-scale dispersion model estimates) using observations. Our results demonstrate the strength of this approach specifically by eliminating the problem of double-counting reported in previous hybrid modeling approaches leading to improved estimates of background concentrations, and further highlight the relative importance of NOx vs. PM2.5 in their relative contributions to total concentrations. While a key limitation of this approach is the requirement for another detailed model simulation to avoid double-counting, STOK improves the overall characterization of background concentrations at very fine spatial scales. Full article
(This article belongs to the Special Issue Air Pollution Modeling)
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Open AccessArticle Land Ecological Security Evaluation of Guangzhou, China
Int. J. Environ. Res. Public Health 2014, 11(10), 10537-10558; doi:10.3390/ijerph111010537
Received: 6 March 2014 / Revised: 23 September 2014 / Accepted: 28 September 2014 / Published: 15 October 2014
Cited by 5 | PDF Full-text (1182 KB) | HTML Full-text | XML Full-text
Abstract
As the land ecosystem provides the necessary basic material resources for human development, land ecological security (LES) plays an increasingly important role in sustainable development. Given the degradation of land ecological security under rapid urbanization and the urgent LES requirements of urban populations,
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As the land ecosystem provides the necessary basic material resources for human development, land ecological security (LES) plays an increasingly important role in sustainable development. Given the degradation of land ecological security under rapid urbanization and the urgent LES requirements of urban populations, a comprehensive evaluation method, named Double Land Ecological Security (DLES), has been introduced with the city of Guangzhou, China, as a case study, which evaluates the LES in regional and unit scales for reasonable and specific urban planning. In the evaluation process with this method, we have combined the material security with the spiritual security that is inevitably associated with LES. Some new coefficients of land-security supply/demand distribution and technology contribution for LES evaluation have also been introduced for different spatial scales, including the regional and the unit scales. The results for Guangzhou indicated that, temporally, the LES supply indices were 0.77, 0.84 and 0.77 in 2000, 2006 and 2009 respectively, while LES demand indices for the city increased in 2000, 2006 and 2009 from 0.57 to 0.95, which made the LES level decreased slowly in this period. Spatially, at the regional scale, the urban land ecological security (ULES) level decreased from 0.2 (marginal security) to −0.18 (marginal insecurity) as a whole; in unit scale, areas in the north and in parts of the east were relatively secure and the security area was shrinking with time, but the central and southern areas turned to be marginal insecurity, especially in 2006 and 2009. This study proposes that DLES evaluation should be conducted for targeted and efficient urban planning and management, which can reflect the LES level of study area in general and in detail. Full article
Open AccessArticle Predictors of Healthcare Service Utilization for Mental Health Reasons
Int. J. Environ. Res. Public Health 2014, 11(10), 10559-10586; doi:10.3390/ijerph111010559
Received: 6 June 2014 / Revised: 24 September 2014 / Accepted: 25 September 2014 / Published: 15 October 2014
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Abstract
This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons
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This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior) and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care. Full article
(This article belongs to the Special Issue Mental Health Care)
Open AccessArticle Future Climate Data from RCP 4.5 and Occurrence of Malaria in Korea
Int. J. Environ. Res. Public Health 2014, 11(10), 10587-10605; doi:10.3390/ijerph111010587
Received: 14 August 2014 / Revised: 18 September 2014 / Accepted: 6 October 2014 / Published: 15 October 2014
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Abstract
Since its reappearance at the Military Demarcation Line in 1993, malaria has been occurring annually in Korea. Malaria is regarded as a third grade nationally notifiable disease susceptible to climate change. The objective of this study is to quantify the effect of climatic
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Since its reappearance at the Military Demarcation Line in 1993, malaria has been occurring annually in Korea. Malaria is regarded as a third grade nationally notifiable disease susceptible to climate change. The objective of this study is to quantify the effect of climatic factors on the occurrence of malaria in Korea and construct a malaria occurrence model for predicting the future trend of malaria under the influence of climate change. Using data from 2001–2011, the effect of time lag between malaria occurrence and mean temperature, relative humidity and total precipitation was investigated using spectral analysis. Also, a principal component regression model was constructed, considering multicollinearity. Future climate data, generated from RCP 4.5 climate change scenario and CNCM3 climate model, was applied to the constructed regression model to simulate future malaria occurrence and analyze the trend of occurrence. Results show an increase in the occurrence of malaria and the shortening of annual time of occurrence in the future. Full article
Open AccessArticle Lifestyle Course as an Investment in Perceived Improved Health among Newly Arrived Women from Countries outside Europe
Int. J. Environ. Res. Public Health 2014, 11(10), 10622-10640; doi:10.3390/ijerph111010622
Received: 15 July 2014 / Revised: 23 September 2014 / Accepted: 10 October 2014 / Published: 15 October 2014
Cited by 2 | PDF Full-text (704 KB) | HTML Full-text | XML Full-text
Abstract
Family reunification was the most common reason (34%) for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a
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Family reunification was the most common reason (34%) for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a local coordinator. Sessions were five-weeks long, two hours a week. The quantitative data cover results from 54 participants, mainly Arabic and Somali-speaking, who participated in 10 groups. The participants’ perceived health improved significantly over the three measures. They also shared that their health significantly improved according to moderate effect size. The qualitative data, analyzed using revised content analysis, reflected one general theme: “the intervention is an investment in perceived improved health”, and four categories: “perceived increased health literacy”, “strength, empowerment and security”, “finding a new lifestyle”, and “the key to entry into Swedish society is language”. An intervention focusing on the prevention of ill-health, on health as a human right, and on empowerment, and aimed at female newcomers, has practical implications. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Modeling Population Exposure to Ultrafine Particles in a Major Italian Urban Area
Int. J. Environ. Res. Public Health 2014, 11(10), 10641-10662; doi:10.3390/ijerph111010641
Received: 30 July 2014 / Revised: 24 September 2014 / Accepted: 8 October 2014 / Published: 15 October 2014
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Abstract
Average daily ultrafine particles (UFP) exposure of adult Milan subpopulations (defined on the basis of gender, and then for age, employment or educational status), in different exposure scenarios (typical working day in summer and winter) were simulated using a microenvironmental stochastic simulation model.
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Average daily ultrafine particles (UFP) exposure of adult Milan subpopulations (defined on the basis of gender, and then for age, employment or educational status), in different exposure scenarios (typical working day in summer and winter) were simulated using a microenvironmental stochastic simulation model. The basic concept of this kind of model is that time-weighted average exposure is defined as the sum of partial microenvironmental exposures, which are determined by the product of UFP concentration and time spent in each microenvironment. In this work, environmental concentrations were derived from previous experimental studies that were based on microenvironmental measurements in the city of Milan by means of personal or individual monitoring, while time-activity patterns were derived from the EXPOLIS study. A significant difference was observed between the exposures experienced in winter (W: 28,415 pt/cm3) and summer (S: 19,558 pt/cm3). Furthermore, simulations showed a moderate difference between the total exposures experienced by women (S: 19,363 pt/cm3; W: 27,623 pt/cm3) and men (S: 18,806 pt/cm3; W: 27,897 pt/cm3). In addition, differences were found as a function of (I) age, (II) employment status and (III) educational level; accordingly, the highest total exposures resulted for (I) 55–59 years old people, (II) housewives and students and (III) people with higher educational level (more than 10 years of scholarity). Finally, significant differences were found between microenvironment-specific exposures. Full article
(This article belongs to the Special Issue Ultrafine Particles and Potential Health Effects)
Open AccessArticle Longitudinal Trajectories of Cholesterol from Midlife through Late Life according to Apolipoprotein E Allele Status
Int. J. Environ. Res. Public Health 2014, 11(10), 10663-10693; doi:10.3390/ijerph111010663
Received: 1 August 2014 / Revised: 23 September 2014 / Accepted: 26 September 2014 / Published: 16 October 2014
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Abstract
Background: Previous research indicates that total cholesterol levels increase with age during young adulthood and middle age and decline with age later in life. This is attributed to changes in diet, body composition, medication use, physical activity, and hormone levels. In the current
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Background: Previous research indicates that total cholesterol levels increase with age during young adulthood and middle age and decline with age later in life. This is attributed to changes in diet, body composition, medication use, physical activity, and hormone levels. In the current study we utilized data from the Framingham Heart Study Original Cohort to determine if variations in apolipoprotein E (APOE), a gene involved in regulating cholesterol homeostasis, influence trajectories of total cholesterol, HDL cholesterol, and total: HDL cholesterol ratio from midlife through late life. Methods: Cholesterol trajectories from midlife through late life were modeled using generalized additive mixed models and mixed-effects regression models. Results: APOE e2+ subjects had lower total cholesterol levels, higher HDL cholesterol levels, and lower total: HDL cholesterol ratios from midlife to late life compared to APOE e3 and APOE e4+ subjects. Statistically significant differences in life span cholesterol trajectories according to gender and use of cholesterol-lowering medications were also detected. Conclusion: The findings from this research provide evidence that variations in APOE modify trajectories of serum cholesterol from midlife to late life. In order to efficiently modify cholesterol through the life span, it is important to take into account APOE allele status. Full article
(This article belongs to the Special Issue Genetic Epidemiology)
Open AccessArticle Predictiveness of Disease Risk in a Global Outreach Tourist Setting in Thailand Using Meteorological Data and Vector-Borne Disease Incidences
Int. J. Environ. Res. Public Health 2014, 11(10), 10694-10709; doi:10.3390/ijerph111010694
Received: 12 March 2014 / Revised: 30 September 2014 / Accepted: 7 October 2014 / Published: 16 October 2014
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Abstract
Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease
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Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease risk in a global outreach tourist setting. The retrospective data of dengue and malaria incidences together with local meteorological factors (temperature, rainfall, humidity) registered from 2001 to 2011 on Koh Chang, Thailand were used in this study. Seasonal distribution of disease incidences and its correlation with local climatic factors were analyzed. Seasonal patterns in disease transmission differed between dengue and malaria. Monthly meteorological data and reported disease incidences showed good predictive ability of disease transmission patterns. These findings provide a rational basis for identifying the predictive ability of local meteorological factors on disease incidence that may be useful for the implementation of disease prevention and vector control programs on the tourism island, where climatic factors fluctuate. Full article
Open AccessArticle Effect of Humic Acid on As Redox Transformation and Kinetic Adsorption onto Iron Oxide Based Adsorbent (IBA)
Int. J. Environ. Res. Public Health 2014, 11(10), 10710-10736; doi:10.3390/ijerph111010710
Received: 9 July 2014 / Revised: 25 September 2014 / Accepted: 8 October 2014 / Published: 16 October 2014
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Abstract
Due to the importance of adsorption kinetics and redox transformation of arsenic (As) during the adsorption process, the present study elucidated natural organic matter (NOM) effects on As adsorption-desorption kinetics and speciation transformation. The experimental procedures were conducted by examining interactions of arsenate
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Due to the importance of adsorption kinetics and redox transformation of arsenic (As) during the adsorption process, the present study elucidated natural organic matter (NOM) effects on As adsorption-desorption kinetics and speciation transformation. The experimental procedures were conducted by examining interactions of arsenate and arsenite with different concentrations of humic acid (HA) as a model representative of NOM, in the presence of iron oxide based adsorbent (IBA), as a model solid surface in three environmentally relevant conditions, including the simultaneous adsorption of both As and HA onto IBA, HA adsorption onto As-presorbed IBA, and As adsorption onto HA-presorbed IBA. Experimental adsorption-desorption data were all fitted by original and modified Lagergren pseudo-first and -second order adsorption kinetic models, respectively. Weber’s intraparticle diffusion was also used to gain insight into the mechanisms and rate controlling steps, which the results suggested that intraparticle diffusion of As species onto IBA is the main rate-controlling step. Different concentrations of HA mediated the redox transformation of As species, with a higher oxidation ability than reduction. The overall results indicated the significant effect of organic matter on the adsorption kinetics and redox transformation of As species, and consequently, the fate, transport and mobility of As in different environmentally relevant conditions. Full article
Open AccessArticle Managing the Health Impacts of Drought in Brazil
Int. J. Environ. Res. Public Health 2014, 11(10), 10737-10751; doi:10.3390/ijerph111010737
Received: 6 August 2014 / Revised: 1 October 2014 / Accepted: 7 October 2014 / Published: 16 October 2014
Cited by 8 | PDF Full-text (1228 KB) | HTML Full-text | XML Full-text
Abstract
Drought is often a hidden risk with the potential to become a silent public health disaster. It is difficult to define precisely when it starts or when it is over, and although it is a climatological event, its impacts depend on other human
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Drought is often a hidden risk with the potential to become a silent public health disaster. It is difficult to define precisely when it starts or when it is over, and although it is a climatological event, its impacts depend on other human activities, and are intensified by social vulnerability. In Brazil, half of all natural disaster events are drought related, and they cause half of the impacts in number of affected persons. One large affected area is the semiarid region of Brazil’s Northeast, which has historically been affected by drought. Many health and well-being indicators in this region are worse than the rest of the country, based on an analysis of 5565 municipalities using available census data for 1991, 2000 and 2010, which allowed separating the 1133 municipalities affected by drought in order to compare them with the rest of the country. Although great progress has been made in reducing social and economic vulnerability, climate change and the expected changes in the semiarid region in the next few decades call for a review of current programs, particularly in public health, and the planning of new interventions with local communities. This study reviews the literature, analyzes available data and identifies possible actions and actors. The aim is to ensure there will be sufficient and sustainable local adaptive capacity and resilience, for a population already living within the limits of environmental vulnerability. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
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Open AccessArticle Staying the Course? Challenges in Implementing Evidence-Based Programs in Community Mental Health Services
Int. J. Environ. Res. Public Health 2014, 11(10), 10752-10769; doi:10.3390/ijerph111010752
Received: 18 August 2014 / Revised: 8 October 2014 / Accepted: 10 October 2014 / Published: 16 October 2014
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Abstract
This paper focuses on the second phase of the deinstitutionalisation of mental health care in which the development of community-based interventions are supposed to be implemented in local community mental health care systems. The challenge to sustainable implementation is illustrated by the Swedish
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This paper focuses on the second phase of the deinstitutionalisation of mental health care in which the development of community-based interventions are supposed to be implemented in local community mental health care systems. The challenge to sustainable implementation is illustrated by the Swedish case where the government put forward a national training program that sought to introduce Assertive Community Treatment (ACT) for people with severe mental illness. This study is based on document analysis and qualitative interviews with actors at the national, regional, and local levels covering a total of five regions and 15 municipalities that participated in the program. The analysis of the national experiences is put in relation to both research on public administration and policy analysis as well as to current research on implementation of evidence-based programs. The results showed a “drift” of the original model, which had already begun at the policy formulation stage and ended up in a large number of different local arrangements where only a few of the original components of ACT remained. We conclude that issues with implementation can only be fully understood by considering factors at different analytical levels. Full article
(This article belongs to the Special Issue Mental Health Care)
Open AccessArticle Decreased Survival of Glioma Patients with Astrocytoma Grade IV (Glioblastoma Multiforme) Associated with Long-Term Use of Mobile and Cordless Phones
Int. J. Environ. Res. Public Health 2014, 11(10), 10790-10805; doi:10.3390/ijerph111010790
Received: 11 September 2014 / Revised: 8 October 2014 / Accepted: 11 October 2014 / Published: 16 October 2014
Cited by 15 | PDF Full-text (819 KB) | HTML Full-text | XML Full-text
Abstract
On 31 May 2011 the WHO International Agency for Research on Cancer (IARC) categorised radiofrequency electromagnetic fields (RF-EMFs) from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields, as a Group 2B, i.e., a “possible”, human carcinogen. A causal
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On 31 May 2011 the WHO International Agency for Research on Cancer (IARC) categorised radiofrequency electromagnetic fields (RF-EMFs) from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields, as a Group 2B, i.e., a “possible”, human carcinogen. A causal association would be strengthened if it could be shown that the use of wireless phones has an impact on the survival of glioma patients. We analysed survival of 1678 glioma patients in our 1997–2003 and 2007–2009 case-control studies. Use of wireless phones in the >20 years latency group (time since first use) yielded an increased hazard ratio (HR) = 1.7, 95% confidence interval (CI) = 1.2–2.3 for glioma. For astrocytoma grade IV (glioblastoma multiforme; n = 926) mobile phone use yielded HR = 2.0, 95% CI = 1.4–2.9 and cordless phone use HR = 3.4, 95% CI = 1.04–11 in the same latency category. The hazard ratio for astrocytoma grade IV increased statistically significant per year of latency for wireless phones, HR = 1.020, 95% CI = 1.007–1.033, but not per 100 h cumulative use, HR = 1.002, 95% CI = 0.999–1.005. HR was not statistically significant increased for other types of glioma. Due to the relationship with survival the classification of IARC is strengthened and RF-EMF should be regarded as human carcinogen requiring urgent revision of current exposure guidelines. Full article
Open AccessArticle Evaluation of Toxic Metals and Essential Elements in Children with Learning Disabilities from a Rural Area of Southern Brazil
Int. J. Environ. Res. Public Health 2014, 11(10), 10806-10823; doi:10.3390/ijerph111010806
Received: 17 July 2014 / Revised: 9 October 2014 / Accepted: 10 October 2014 / Published: 17 October 2014
Cited by 5 | PDF Full-text (800 KB) | HTML Full-text | XML Full-text
Abstract
Children’s exposure to metals can result in adverse effects such as cognitive function impairments. This study aimed to evaluate some toxic metals and levels of essential trace elements in blood, hair, and drinking water in children from a rural area of Southern Brazil.
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Children’s exposure to metals can result in adverse effects such as cognitive function impairments. This study aimed to evaluate some toxic metals and levels of essential trace elements in blood, hair, and drinking water in children from a rural area of Southern Brazil. Cognitive ability and δ-aminolevulinate dehydratase (ALA-D) activity were evaluated. Oxidative stress was evaluated as a main mechanism of metal toxicity, through the quantification of malondialdehyde (MDA) levels. This study included 20 children from a rural area and 20 children from an urban area. Our findings demonstrated increase in blood lead (Pb) levels (BLLs). Also, increased levels of nickel (Ni) in blood and increase of aluminum (Al) levels in hair and drinking water in rural children were found. Deficiency in selenium (Se) levels was observed in rural children as well. Rural children with visual-motor immaturity presented Pb levels in hair significantly increased in relation to rural children without visual-motor immaturity (p < 0.05). Negative correlations between BLLs and ALA-D activity and positive correlations between BLLs and ALA-RE activity were observed. MDA was significantly higher in rural compared to urban children (p < 0.05). Our findings suggest that rural children were co-exposed to toxic metals, especially Al, Pb and Ni. Moreover, a slight deficiency of Se was observed. Low performance on cognitive ability tests and ALA-D inhibition can be related to metal exposure in rural children. Oxidative stress was suggested as a main toxicological mechanism involved in metal exposure. Full article
Open AccessArticle Bioluminescence ATP Monitoring for the Routine Assessment of Food Contact Surface Cleanliness in a University Canteen
Int. J. Environ. Res. Public Health 2014, 11(10), 10824-10837; doi:10.3390/ijerph111010824
Received: 21 July 2014 / Revised: 29 September 2014 / Accepted: 13 October 2014 / Published: 17 October 2014
Cited by 10 | PDF Full-text (704 KB) | HTML Full-text | XML Full-text
Abstract
ATP bioluminescence monitoring and traditional microbiological analyses (viable counting of total mesophilic aerobes, coliforms and Escherichia coli) were used to evaluate the effectiveness of Sanitation Standard Operating Procedures (SSOP) at a university canteen which uses a HACCP-based approach. To that end, 10
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ATP bioluminescence monitoring and traditional microbiological analyses (viable counting of total mesophilic aerobes, coliforms and Escherichia coli) were used to evaluate the effectiveness of Sanitation Standard Operating Procedures (SSOP) at a university canteen which uses a HACCP-based approach. To that end, 10 cleaning control points (CPs), including food contact surfaces at risk of contamination from product residues or microbial growth, were analysed during an 8-month monitoring period. Arbitrary acceptability limits were set for both microbial loads and ATP bioluminescence readings. A highly significant correlation (r = 0.99) between the means of ATP bioluminescence readings and the viable counts of total mesophilic aerobes was seen, thus revealing a strong association of these parameters with the level of surface contamination. Among CPs, the raw meat and multi-purpose chopping boards showed the highest criticalities. Although ATP bioluminescence technology cannot substitute traditional microbiological analyses for the determination of microbial load on food contact surfaces, it has proved to be a powerful tool for the real time monitoring of surface cleanliness at mass catering plants, for verify the correct application of SSOP, and hence for their implementation/revision in the case of poor hygiene. Full article
Open AccessArticle Sociobehavioral Factors Associated with Caries Increment: A Longitudinal Study from 24 to 36 Months Old Children in Thailand
Int. J. Environ. Res. Public Health 2014, 11(10), 10838-10850; doi:10.3390/ijerph111010838
Received: 12 August 2014 / Revised: 11 October 2014 / Accepted: 14 October 2014 / Published: 17 October 2014
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Abstract
The aim of this study is to investigate sociobehavioral risk factors from the prenatal period until 36 months of age, and the caries increment from 24 to 36 months of the child in Thailand. The data utilized in this study come from the
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The aim of this study is to investigate sociobehavioral risk factors from the prenatal period until 36 months of age, and the caries increment from 24 to 36 months of the child in Thailand. The data utilized in this study come from the prospective cohort study of Thai children (PCTC) from prenatal to 36 months of the child in Mueang Nan district, Northern Thailand. The total sample size recruited was 783 infants. The sample size with dental caries data was 603 and 597, at 24 months and at 36 months, respectively. The sample size of having two assessment points with a dental examination (at 24 months and at 36 months) was 597. Results indicate that the caries increment was 52.9%, meaning from 365 caries free children at 24 months 193 had developed dental caries at 36 months. The prevalence of dental caries was 34.2% at 24 months (n = 206) and 68.5% at 36 months of age (n = 409). In bivariate analysis, higher education of the mother, lower household income, bottle feeding of the infant, frequent sweet candy consumptions, and using rain or well water as drinking water were associated with dental caries increment, while in multivariate conditional logistic regression analysis lower household income, higher education of the mother, and using rain or well water as drinking water remained associated with dental caries increment. In conclusion, a very significant increase in caries development was observed, and oral health may be influenced by sociobehavioural risk factors. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Are Delta-Aminolevulinate Dehydratase Inhibition and Metal Concentrations Additional Factors for the Age-Related Cognitive Decline?
Int. J. Environ. Res. Public Health 2014, 11(10), 10851-10867; doi:10.3390/ijerph111010851
Received: 16 June 2014 / Revised: 16 September 2014 / Accepted: 25 September 2014 / Published: 17 October 2014
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Abstract
Aging is often accompanied by cognitive impairments and influenced by oxidative status and chemical imbalances. Thus, this study was conducted to examine whether age-related cognitive deficit is associated with oxidative damage, especially with inhibition of the enzyme delta-aminolevulinate dehydratase (ALA-D), as well as
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Aging is often accompanied by cognitive impairments and influenced by oxidative status and chemical imbalances. Thus, this study was conducted to examine whether age-related cognitive deficit is associated with oxidative damage, especially with inhibition of the enzyme delta-aminolevulinate dehydratase (ALA-D), as well as to verify the influence of some metals in the enzyme activity and cognitive performance. Blood ALA-D activity, essential (Fe, Zn, Cu, Se) and non-essential metals (Pb, Cd, Hg, As, Cr, Ni, V) were measured in 50 elderly and 20 healthy young subjects. Cognitive function was assessed by tests from Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) battery and other. The elderly group presented decreased ALA-D activity compared to the young group. The index of ALA-D reactivation was similar to both study groups, but negatively associated with metals. The mean levels of essential metals were within the reference values, while the most toxic metals were above them in both groups. Cognitive function impairments were observed in elderly group and were associated with decreased ALA-D activity, with lower levels of Se and higher levels of toxic metals (Hg and V). Results suggest that the reduced ALA-D activity in elderly can be an additional factor involved in cognitive decline, since its inhibition throughout life could lead to accumulation of the neurotoxic compound ALA. Toxic metals were found to contribute to cognitive decline and also to influence ALA-D reactivation. Full article
Open AccessArticle Functional Validity of a Judgment Skills Measure within the Concept of Health Literacy for Sleeping Disorder Patients
Int. J. Environ. Res. Public Health 2014, 11(10), 10868-10882; doi:10.3390/ijerph111010868
Received: 14 July 2014 / Revised: 25 September 2014 / Accepted: 13 October 2014 / Published: 17 October 2014
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Abstract
The concept of health literacy has been widened to include higher order aspects such as patient decision-making skills while its measurement continued to rely narrowly on reading and numeracy skills, known as functional health literacy. We developed a Judgment Skills measure, designed to
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The concept of health literacy has been widened to include higher order aspects such as patient decision-making skills while its measurement continued to rely narrowly on reading and numeracy skills, known as functional health literacy. We developed a Judgment Skills measure, designed to assess patients’ ability to make appropriate decisions with regard to their condition. The measure offers scenarios with answer options ranked for biomedical adequacy. This study aims to examine the psychometric properties and the functional validity of the Judgment Skills measure. A self-administered survey among 87 primary insomnia patients in the Italian-speaking part of Switzerland was conducted. The extensive path model included variables such as functional health literacy, coping with the medical condition, experience of the scenario, sleep quality, duration suffering, education, and age. Correlation analyses were conducted to link the variables. The Judgment Skills measure showed the expected significant correlations. In general, higher Judgment Skills were related to coping strategies leading to better health outcomes. Functional health literacy correlated highly with education, while Judgment Skills did not, which confirmed the conceptual difference of these skills. The findings propose a model for conducting research that does embrace the broader conceptualization of health literacy. Full article
Open AccessArticle Impact of Viewing vs. Not Viewing a Real Forest on Physiological and Psychological Responses in the Same Setting
Int. J. Environ. Res. Public Health 2014, 11(10), 10883-10901; doi:10.3390/ijerph111010883
Received: 24 July 2014 / Revised: 8 October 2014 / Accepted: 14 October 2014 / Published: 20 October 2014
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Abstract
We investigated the impact of viewing versus not viewing a real forest on human subjects’ physiological and psychological responses in the same setting. Fifteen healthy volunteers (11 males, four females, mean age 36 years) participated. Each participant was asked to view a forest
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We investigated the impact of viewing versus not viewing a real forest on human subjects’ physiological and psychological responses in the same setting. Fifteen healthy volunteers (11 males, four females, mean age 36 years) participated. Each participant was asked to view a forest while seated in a comfortable chair for 15 min (Forest condition) vs. sitting the same length of time with a curtain obscuring the forest view (Enclosed condition). Both conditions significantly decreased blood pressure (BP) variables, i.e., systolic BP, diastolic BP, and mean arterial pressure between pre and post experimental stimuli, but these reductions showed no difference between conditions. Interestingly, the Forest viewing reduced cerebral oxygenated hemoglobin (HbO2) assessed by near-infrared spectroscopy (NIRS) and improved the subjects’ Profile of Mood States (POMS) scores, whereas the Enclosed condition increased the HbO2 and did not affect the POMS scores. There were no significant differences in saliva amylase or heart rate variability (HRV) between the two conditions. Collectively, these results suggest that viewing a real forest may have a positive effect on cerebral activity and psychological responses. However, both viewing and not viewing the forest had similar effects on cardiovascular responses such as BP variables and HRV. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
Open AccessArticle Ultrasensitive UPLC-MS-MS Method for the Quantitation of Etheno-DNA Adducts in Human Urine
Int. J. Environ. Res. Public Health 2014, 11(10), 10902-10914; doi:10.3390/ijerph111010902
Received: 15 July 2014 / Revised: 30 September 2014 / Accepted: 7 October 2014 / Published: 21 October 2014
Cited by 2 | PDF Full-text (534 KB) | HTML Full-text | XML Full-text
Abstract
Etheno-DNA adducts are generated from the metabolism of exogenous carcinogens and endogenous lipid peroxidation. We and others have previously reported that 1,N6-ethenodeoxyadenosine (εdA) and 3,N4-ethenodeoxycytidine (εdC) are present in human urine and can be utilized as biomarkers
[...] Read more.
Etheno-DNA adducts are generated from the metabolism of exogenous carcinogens and endogenous lipid peroxidation. We and others have previously reported that 1,N6-ethenodeoxyadenosine (εdA) and 3,N4-ethenodeoxycytidine (εdC) are present in human urine and can be utilized as biomarkers of oxidative stress. In this study, we report a new ultrasensitive UPLC-ESI-MS/MS method for the analysis of εdA and edC in human urine, capable of detecting 0.5 fmol εdA and 0.3 fmol εdC in 1.0 mL of human urine, respectively. For validation of the method, 20 human urine samples were analyzed, and the results revealed that the mean levels of εdA and εdC (SD) fmol/µmol creatinine are 5.82 ± 2.11 (range 3.0–9.5) for εdA and 791.4 ± 328.8 (range 116.7–1264.9) for εdC in occupational benzene-exposed workers and 2.10 ± 1.32 (range 0.6–4.7) for εdA and 161.8 ± 200.9 (range 1.8–557.5) for εdC in non-benzene-exposed workers, respectively. The ultrasensitive detection method is thus suitable for applications in human biomonitoring and molecular epidemiology studies. Full article
Open AccessArticle Horizon 2020 Priorities in Clinical Mental Health Research: Results of a Consensus-Based ROAMER Expert Survey
Int. J. Environ. Res. Public Health 2014, 11(10), 10915-10939; doi:10.3390/ijerph111010915
Received: 15 July 2014 / Revised: 19 September 2014 / Accepted: 30 September 2014 / Published: 21 October 2014
Cited by 4 | PDF Full-text (728 KB) | HTML Full-text | XML Full-text
Abstract
Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to
[...] Read more.
Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to the importance of three challenges in the field of clinical mental health research: (1) the development of new, safe and effective interventions for mental disorders; (2) understanding the mechanisms of disease in order to be able to develop such new interventions; and (3) defining outcomes (an improved set of outcomes, including alternative outcomes) to use for clinical mental health research evaluation. Proposed actions involved increasing the utilization of tailored approaches (personalized medicine), developing blended eHealth/mHealth decision aids/guidance tools that help the clinician to choose between various treatment modalities, developing specific treatments in order to better target comorbidity and (further) development of biological, psychological and psychopharmacological interventions. The experts indicated that addressing these priorities will result in increased efficacy and impact across Europe; with a high probability of success, given that Europe has important strengths, such as skilled academics and a long research history. Finally, the experts stressed the importance of creating funding and coordinated networking as essential action needed in order to target the variety of challenges in clinical mental health research. Full article
(This article belongs to the Special Issue Mental Health Care)
Open AccessArticle Secular Trends in Habitual Physical Activities of Mozambican Children and Adolescents from Maputo City
Int. J. Environ. Res. Public Health 2014, 11(10), 10940-10950; doi:10.3390/ijerph111010940
Received: 25 August 2014 / Revised: 10 October 2014 / Accepted: 16 October 2014 / Published: 21 October 2014
Cited by 7 | PDF Full-text (678 KB) | HTML Full-text | XML Full-text
Abstract
Social and economic changes occurring in the last two decades in Mozambique may have induced lifestyle changes among youth. This study aimed to document secular changes in habitual physical activities of Mozambican youth between 1992, 1999 and 2012. A total of 3393 youth
[...] Read more.
Social and economic changes occurring in the last two decades in Mozambique may have induced lifestyle changes among youth. This study aimed to document secular changes in habitual physical activities of Mozambican youth between 1992, 1999 and 2012. A total of 3393 youth (eight–15 years), were measured in three different time periods (1992, 1999, 2012). Habitual physical activity (PA) was estimated with a questionnaire, including items related to household chores, sport participation, traditional games and walking activities. Biological maturation was assessed. Analysis of Covariance (ANCOVA) was used to compare mean differences in PA across the years. Significant decreases between 1992–1999 and 1992–2012 were observed for boys in household chores, games and walking, and a significant decline between 1999 and 2012 was found in sport participation. Among girls, a significant and consistent decline (1992 > 1999 > 2012) was observed for household chores, a decline between 1992–1999 and 1992–2012 for games and walking, and a significant increase between 1992 and 1999 in sport participation. In general, a negative secular trend was found in habitual PA among Mozambican youth. Interventions aimed at increasing PA represent important educational and public health opportunities. Full article
Open AccessArticle The Study of External Dose Rate and Retained Body Activity of Patients Receiving 131I Therapy for Differentiated Thyroid Carcinoma
Int. J. Environ. Res. Public Health 2014, 11(10), 10991-11003; doi:10.3390/ijerph111010991
Received: 13 August 2014 / Revised: 9 October 2014 / Accepted: 10 October 2014 / Published: 21 October 2014
PDF Full-text (953 KB) | HTML Full-text | XML Full-text
Abstract
Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving 131I therapy. Seventy patients were stratified
[...] Read more.
Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving 131I therapy. Seventy patients were stratified into two groups: the ablation group (A) and the follow-up group (FU). The patients’ external dose rate was measured, and simultaneously, their retained body radiation activity was monitored at various time points. The equations of the external dose rate and the retained body activity, described as a function of hours post administration, were fitted. Additionally, the release time for patients was calculated. The reduction in activity in the group receiving a second or subsequent treatment was more rapid than the group receiving only the initial treatment. Most important, an expeditious method was established to indirectly evaluate the retained body activity of patients by measuring the external dose rate with a portable radiation survey meter. By this method, the calculated external dose rate limits are 19.2, 8.85, 5.08 and 2.32 μSv·h1 at 1, 1.5, 2 and 3 m, respectively, according to a patient’s released threshold level of retained body activity <400 MBq. This study is beneficial for radiation safety decision-making. Full article
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Open AccessArticle Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening
Int. J. Environ. Res. Public Health 2014, 11(10), 11004-11014; doi:10.3390/ijerph111011004
Received: 2 September 2014 / Revised: 29 September 2014 / Accepted: 15 October 2014 / Published: 21 October 2014
Cited by 14 | PDF Full-text (363 KB) | HTML Full-text | XML Full-text
Abstract
Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a
[...] Read more.
Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries. Full article
(This article belongs to the Special Issue Migrant Health)
Open AccessArticle Impact of Oral Health Behaviors on Dental Caries in Children with Intellectual Disabilities in Guangzhou, China
Int. J. Environ. Res. Public Health 2014, 11(10), 11015-11027; doi:10.3390/ijerph111011015
Received: 6 August 2014 / Revised: 15 October 2014 / Accepted: 16 October 2014 / Published: 22 October 2014
Cited by 3 | PDF Full-text (290 KB) | HTML Full-text | XML Full-text
Abstract
Dental care is consistently reported as one of the primary medical needs of children with disabilities (IDC). The aim of the present study was to explore the influence of oral health behaviors on the caries experience in children with intellectual disabilities in Guangzhou,
[...] Read more.
Dental care is consistently reported as one of the primary medical needs of children with disabilities (IDC). The aim of the present study was to explore the influence of oral health behaviors on the caries experience in children with intellectual disabilities in Guangzhou, China. A cross-sectional study was carried out in 477 intellectually disabled children, 12 to 17 years old, who were randomly selected from special educational schools in Guangzhou. A self-administered parental questionnaire was used to collect data on socio-demographic characteristics and oral health behavior variables, and 450 valid questionnaires were returned. Multiple regression analysis was used to examine the factors associated with dental caries. The average age of those in the sample was 14.6 years (SD = 1.3), 68.4% of whom were male, and the caries prevalence rate was 53.5% (DMFT = 1.5 ± 2.0). The factors significantly affecting the development of dental caries in IDC included gender, the presence or absence of cerebral palsy, and the frequency of dental visits and toothbrushing. In conclusion, the presence of cerebral palsy contributed to an increase risk of caries experience in intellectually disabled children, while toothbrushing more than twice a day and routine dental visits were caries-protective factors. Oral health promotion action may lead to a reduction in dental caries levels in IDC. Full article

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Open AccessReview Understanding How Organized Youth Sport May Be Harming Individual Players within the Family Unit: A Literature Review
Int. J. Environ. Res. Public Health 2014, 11(10), 10226-10268; doi:10.3390/ijerph111010226
Received: 26 June 2014 / Revised: 17 September 2014 / Accepted: 24 September 2014 / Published: 1 October 2014
Cited by 11 | PDF Full-text (740 KB) | HTML Full-text | XML Full-text
Abstract
Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative
[...] Read more.
Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little thus far has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of studies on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest), SPORTDiscus and Health, History, Management databases (EBSCOhost), Science, Social Science, Arts and Humanities on Web of Science (ISI), SCOPUS and Scirus (Elsevier). Results show the darker side of organized sport for actors within the family unit. A model is proposed to explain under which circumstances sport leads to positive versus negative outcomes, ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health. Full article
(This article belongs to the Special Issue IJERPH: 10th Anniversary)
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Open AccessReview Potential Transferability of Economic Evaluations of Programs Encouraging Physical Activity in Children and Adolescents across Different Countries—A Systematic Review of the Literature
Int. J. Environ. Res. Public Health 2014, 11(10), 10606-10621; doi:10.3390/ijerph111010606
Received: 11 August 2014 / Revised: 22 September 2014 / Accepted: 28 September 2014 / Published: 15 October 2014
Cited by 4 | PDF Full-text (689 KB) | HTML Full-text | XML Full-text
Abstract
Physical inactivity is an increasing problem. Owing to limited financial resources, one method of getting information on the cost-effectiveness of different types of prevention programs is to examine existing programs and their results. The aim of this paper is to give an overview
[...] Read more.
Physical inactivity is an increasing problem. Owing to limited financial resources, one method of getting information on the cost-effectiveness of different types of prevention programs is to examine existing programs and their results. The aim of this paper is to give an overview of the transferability of cost-effectiveness results of physical activity programs for children and adolescents to other contexts. Based on a systematic review of the literature, the transferability of the studies found was assessed using a sub-checklist of the European Network of Health Economic Evaluation Databases (EURONHEED). Thirteen studies of different physical activity interventions were found and analyzed. The results for transferability ranged from “low” to “very high”. A number of different factors influence a program’s cost-effectiveness (i.e., discount rate, time horizon, etc.). Therefore, transparency with regard to these factors is one fundamental element in the transferability of the results. A major point of criticism is that transferability is often limited because of lack of transparency. This paper is the first to provide both an overview and an assessment of transferability of economic evaluations of existing programs encouraging physical activity in children and adolescents. This allows decision makers to gain an impression on whether the findings are transferable to their decision contexts, which may lead to time and cost savings. Full article
(This article belongs to the Special Issue Health Economics)
Open AccessReview Animal Leptospirosis in Latin America and the Caribbean Countries: Reported Outbreaks and Literature Review (2002–2014)
Int. J. Environ. Res. Public Health 2014, 11(10), 10770-10789; doi:10.3390/ijerph111010770
Received: 28 May 2014 / Revised: 15 September 2014 / Accepted: 30 September 2014 / Published: 16 October 2014
Cited by 8 | PDF Full-text (1941 KB) | HTML Full-text | XML Full-text
Abstract
Leptospirosis is a worldwide zoonotic disease whose transmission is linked through multiple factors in the animal-human-ecosystem interface. The data on leptospirosis reported to the World Organization for Animal Health (OIE) for Latin America and Caribbean (LAC) countries/sovereign territories from 2005–2011 were mapped, showing
[...] Read more.
Leptospirosis is a worldwide zoonotic disease whose transmission is linked through multiple factors in the animal-human-ecosystem interface. The data on leptospirosis reported to the World Organization for Animal Health (OIE) for Latin America and Caribbean (LAC) countries/sovereign territories from 2005–2011 were mapped, showing a wide distribution of outbreaks in the region. Tropical terrestrial biomes are the predominate ecosystems showing reports of outbreaks. Climatic and ecological factors were relevant to the occurrence of epidemic outbreaks. The available scientific information from 2002–2014 was summarized to obtain a general overview and identify key issues related to the One Health approach. The primary serological test used for diagnosis and for conducting surveys was the microscopic agglutination test (MAT). Reports regarding the isolation and typing of leptospires were scattered and limited to data from a few countries, but their results revealed considerable biodiversity at the species and serovar levels. A total of six out of 11 currently named pathogenic species were found in the region. There was also high diversity of animal species showing evidence of infection by leptospires, including rodents, pets, livestock and wild animals. Prevention and control measures for leptospirosis should consider issues of animal and human health in the context of ecosystems, the territorial land borders of countries and trade. Full article
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
Open AccessReview New Roles for Pharmacists in Community Mental Health Care: A Narrative Review
Int. J. Environ. Res. Public Health 2014, 11(10), 10967-10990; doi:10.3390/ijerph111010967
Received: 16 July 2014 / Revised: 30 September 2014 / Accepted: 7 October 2014 / Published: 21 October 2014
Cited by 15 | PDF Full-text (376 KB) | HTML Full-text | XML Full-text
Abstract
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence
[...] Read more.
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists’ role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists’ attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma. Full article
(This article belongs to the Special Issue Mental Health Care)

Other

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Open AccessCorrection Correction: Soppa, V.J., et al. Respiratory Effects of Fine and Ultrafine Particles from Indoor Sources—A Randomized Sham-Controlled Exposure Study of Healthy Volunteers Int. J. Environ. Res. Public Health 2014, 11, 6871–6889
Int. J. Environ. Res. Public Health 2014, 11(10), 10362-10365; doi:10.3390/ijerph111010362
Received: 29 August 2014 / Accepted: 1 September 2014 / Published: 7 October 2014
Cited by 1 | PDF Full-text (198 KB) | HTML Full-text | XML Full-text
Abstract The authors wish to make the following amendments to their paper published in International Journal of Environmental Research and Public Health [1][...] Full article
Open AccessProject Report Measuring Quality of Mental Health Care: An International Comparison
Int. J. Environ. Res. Public Health 2014, 11(10), 10384-10389; doi:10.3390/ijerph111010384
Received: 30 June 2014 / Revised: 26 September 2014 / Accepted: 30 September 2014 / Published: 10 October 2014
Cited by 3 | PDF Full-text (98 KB) | HTML Full-text | XML Full-text
Abstract
The International Initiative for Mental Health Leadership (IIMHL) (www.iimhl.com) is a unique international collaborative that focuses on improving mental health and addiction services. IIMHL is a collaboration of eight countries including Australia, England, Canada, New Zealand, Republic of Ireland, Scotland, Sweden and USA.[...]
[...] Read more.
The International Initiative for Mental Health Leadership (IIMHL) (www.iimhl.com) is a unique international collaborative that focuses on improving mental health and addiction services. IIMHL is a collaboration of eight countries including Australia, England, Canada, New Zealand, Republic of Ireland, Scotland, Sweden and USA.[...] Full article
(This article belongs to the Special Issue Mental Health Care)
Open AccessConcept Paper Effects of Non-Differential Exposure Misclassification on False Conclusions in Hypothesis-Generating Studies
Int. J. Environ. Res. Public Health 2014, 11(10), 10951-10966; doi:10.3390/ijerph111010951
Received: 11 June 2014 / Revised: 11 October 2014 / Accepted: 14 October 2014 / Published: 21 October 2014
Cited by 3 | PDF Full-text (2205 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Despite the theoretical success of obviating the need for hypothesis-generating studies, they live on in epidemiological practice. Cole asserted that “… there is boundless number of hypotheses that could be generated, nearly all of them wrong” and urged us to focus on evaluating
[...] Read more.
Despite the theoretical success of obviating the need for hypothesis-generating studies, they live on in epidemiological practice. Cole asserted that “… there is boundless number of hypotheses that could be generated, nearly all of them wrong” and urged us to focus on evaluating “credibility of hypothesis”. Adopting a Bayesian approach, we put this elegant logic into quantitative terms at the study planning stage for studies where the prior belief in the null hypothesis is high (i.e., “hypothesis-generating” studies). We consider not only type I and II errors (as is customary) but also the probabilities of false positive and negative results, taking into account typical imperfections in the data. We concentrate on a common source of imperfection in the data: non-differential misclassification of binary exposure classifier. In context of an unmatched case-control study, we demonstrate—both theoretically and via simulations—that although non-differential exposure misclassification is expected to attenuate real effect estimates, leading to the loss of ability to detect true effects, there is also a concurrent increase in false positives. Unfortunately, most investigators interpret their findings from such work as being biased towards the null rather than considering that they are no less likely to be false signals. The likelihood of false positives dwarfed the false negative rate under a wide range of studied settings. We suggest that instead of investing energy into understanding credibility of dubious hypotheses, applied disciplines such as epidemiology, should instead focus attention on understanding consequences of pursuing specific hypotheses, while accounting for the probability that the observed “statistically significant” association may be qualitatively spurious. Full article
(This article belongs to the Special Issue Methodological Innovations and Reflections)

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