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Int. J. Environ. Res. Public Health, Volume 11, Issue 5 (May 2014), Pages 4555-5566

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Open AccessArticle Public Health Workers and Vaccination Coverage in Eastern China: A Health Economic Analysis
Int. J. Environ. Res. Public Health 2014, 11(5), 5555-5566; https://doi.org/10.3390/ijerph110505555
Received: 21 April 2014 / Revised: 16 May 2014 / Accepted: 16 May 2014 / Published: 22 May 2014
Cited by 1 | PDF Full-text (232 KB) | HTML Full-text | XML Full-text
Abstract
Background: Vaccine-preventable diseases cause more than one million deaths among children under 5 years of age every year. Public Health Workers (PHWs) are needed to provide immunization services, but the role of human resources for public health as a determinant of vaccination
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Background: Vaccine-preventable diseases cause more than one million deaths among children under 5 years of age every year. Public Health Workers (PHWs) are needed to provide immunization services, but the role of human resources for public health as a determinant of vaccination coverage at the population level has not been assessed in China. The objective of this study was to test whether PHW density was positively associated with childhood vaccination coverage in Zhejiang Province, East China. Methods: The vaccination coverage rates of Measles Containing Vaccine (MCV), Diphtheria, Tetanus and Pertussis combined vaccine (DTP), and Poliomyelitis Vaccine (PV) were chosen as the dependent variables. Vaccination coverage data of children aged 13–24 months for each county in Zhejiang Province were taken from the Zhejiang Immunization Information System (ZJIIS). Aggregate PHW density was an independent variable in one set of regressions, and Vaccine Personnel (VP) and other PHW densities were used separately in another set. Data on densities of PHW and VP were taken from a national investigation on EPI launched by Ministry of Health of China in 2013. We controlled other determinants that may influence the vaccination coverage like Gross Domestic Product (GDP) per person, proportion of migrant children aged <7 years, and land area. These data were taken from Zhejiang Provincial Bureau of Statistics and ZJIIS. Results: PHW density was significantly influence the coverage rates of MCV [Adjusted Odds Ratio(AOR) = 4.29], DTP3(AOR = 2.16), and PV3 (AOR = 3.30). However, when the effects of VPs and other PHWs were assessed separately, we found that VP density was significantly associated with coverage of all three vaccinations (MCV AOR = 7.05; DTP3 AOR = 1.82; PV3 AOR = 4.83), while other PHW density was not. Proportion of migrant children < 7 years and Land area were found as negative and significant determinants for vaccination coverage, while GDP per person had no effect on vaccination coverage. Conclusions: A higher density of PHWs (VP) would improve the availability of immunization services over time and space, which may increase the possibility of achieving a higher childhood vaccination coverage rate. It was indicated that the level of GDP per person had no association with the improved vaccination coverage after controlling for other potential factors. Our findings implicated that PHW density was a major constraint on immunization coverage in Zhejiang Province. Full article
Open AccessArticle A Qualitative Investigation of Adolescents’ Perceived Mechanisms of Change from a Universal School-Based Depression Prevention Program
Int. J. Environ. Res. Public Health 2014, 11(5), 5541-5554; https://doi.org/10.3390/ijerph110505541
Received: 24 March 2014 / Revised: 14 May 2014 / Accepted: 15 May 2014 / Published: 22 May 2014
Cited by 12 | PDF Full-text (243 KB) | HTML Full-text | XML Full-text
Abstract
A recent meta-analysis provides evidence supporting the universal application of school-based prevention programs for adolescent depression. The mechanisms underlying such successful interventions, however, are largely unknown. We report on a qualitative analysis of 109 Grade 9 students’ beliefs about what they gained from
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A recent meta-analysis provides evidence supporting the universal application of school-based prevention programs for adolescent depression. The mechanisms underlying such successful interventions, however, are largely unknown. We report on a qualitative analysis of 109 Grade 9 students’ beliefs about what they gained from an evidence-based depression prevention intervention, the Resourceful Adolescent Program (RAP-A). Fifty-four percent of interviewees articulated at least one specific example of program benefit. A thematic analysis of responses revealed two major themes, improved interpersonal relationships and improved self-regulation, both stronger than originally assumed. A more minor theme also emerged—more helpful cognitions. It is postulated that both improved interpersonal relationships and improved self-regulation are likely to enhance one another, and more helpful cognitions may express its contribution through enhanced self-regulation. These findings broaden our understanding of the impact of depression prevention programs, beginning to illuminate how such programs benefit participants. Full article
(This article belongs to the Special Issue Adolescent Depression Prevention)
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Open AccessArticle Assessment of the Microbiological Quality of Groundwater in Three Regions of the Valencian Community (Spain)
Int. J. Environ. Res. Public Health 2014, 11(5), 5527-5540; https://doi.org/10.3390/ijerph110505527
Received: 6 February 2014 / Revised: 16 April 2014 / Accepted: 12 May 2014 / Published: 22 May 2014
Cited by 3 | PDF Full-text (925 KB) | HTML Full-text | XML Full-text
Abstract
Urban groundwater development was traditionally constrained by concerns about its quality. This study was conducted in the regions of La Ribera Alta and Ribera Baja and La Plana de Requena-Utiel of the Valencian Community (Valencia, Spain) where population density, demand for drinking water
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Urban groundwater development was traditionally constrained by concerns about its quality. This study was conducted in the regions of La Ribera Alta and Ribera Baja and La Plana de Requena-Utiel of the Valencian Community (Valencia, Spain) where population density, demand for drinking water and agricultural activities are high. Groundwater bodies (GWBs) are regarded as management areas within each territory, and were used to establish protection policies. This study analyzed eleven GWBs. We used two databases with microbiological measurements from 154 wells over a 7-year period (2004–2011), risk factors and groundwater information. Wells were grouped according to frequency of microbiological contamination using E. coli measurements, category <1, or wells with low-frequency microbiological contamination and high-frequency wells or category 1–100, according to World Health Organization (WHO) quality criteria of drinking water. Of all wells, 18.12% showed high-frequency microbiological contamination with a majority distribution in the Ribera Alta region (26.98%, p < 0.001). No significant differences were found between the two risk categories for flow, static level, well depth and distance from population centres. This paper reveals that the vulnerability classes established by the Geological and Mining Institute of Spain (IGME) do not match the microbiological results, and that only eight wells with high-frequency contamination coincide with the high vulnerability areas. Full article
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Open AccessArticle Use of Segregation Indices, Townsend Index, and Air Toxics Data to Assess Lifetime Cancer Risk Disparities in Metropolitan Charleston, South Carolina, USA
Int. J. Environ. Res. Public Health 2014, 11(5), 5510-5526; https://doi.org/10.3390/ijerph110505510
Received: 4 March 2014 / Revised: 25 April 2014 / Accepted: 12 May 2014 / Published: 21 May 2014
Cited by 14 | PDF Full-text (550 KB) | HTML Full-text | XML Full-text
Abstract
Background: Studies have demonstrated a relationship between segregation and level of education, occupational opportunities, and risk behaviors, yet a paucity of research has elucidated the association between racial residential segregation, socioeconomic deprivation, and lifetime cancer risk. Objectives: We examined estimated lifetime
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Background: Studies have demonstrated a relationship between segregation and level of education, occupational opportunities, and risk behaviors, yet a paucity of research has elucidated the association between racial residential segregation, socioeconomic deprivation, and lifetime cancer risk. Objectives: We examined estimated lifetime cancer risk from air toxics by racial composition, segregation, and deprivation in census tracts in Metropolitan Charleston. Methods: Segregation indices were used to measure the distribution of groups of people from different races within neighborhoods. The Townsend Index was used to measure economic deprivation in the study area. Poisson multivariate regressions were applied to assess the association of lifetime cancer risk with segregation indices and Townsend Index along with several sociodemographic measures. Results: Lifetime cancer risk from all pollution sources was 28 persons/million for half of the census tracts in Metropolitan Charleston. Isolation Index and Townsend Index both showed significant correlation with lifetime cancer risk from different sources. This significance still holds after adjusting for other sociodemographic measures in a Poisson regression, and these two indices have stronger effect on lifetime cancer risk compared to the effects of sociodemographic measures. Conclusions: We found that material deprivation, measured by the Townsend Index and segregation measured by the Isolation index, introduced high impact on lifetime cancer risk by air toxics at the census tract level. Full article
(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)
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Open AccessArticle Elevated White Blood Cell Count Is Associated with Higher Risk of Glucose Metabolism Disorders in Middle-Aged and Elderly Chinese People
Int. J. Environ. Res. Public Health 2014, 11(5), 5497-5509; https://doi.org/10.3390/ijerph110505497
Received: 4 April 2014 / Revised: 12 May 2014 / Accepted: 13 May 2014 / Published: 20 May 2014
Cited by 9 | PDF Full-text (265 KB) | HTML Full-text | XML Full-text
Abstract
White blood cell (WBC) count has been associated with diabetic risk, but whether the correlation is independent of other risk factors has hardly been studied. Moreover, very few such studies with large sample sizes have been conducted in Chinese. Therefore, we investigated the
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White blood cell (WBC) count has been associated with diabetic risk, but whether the correlation is independent of other risk factors has hardly been studied. Moreover, very few such studies with large sample sizes have been conducted in Chinese. Therefore, we investigated the relationship between WBC count and glucose metabolism in china. We also examined the relevant variables of WBC count. A total of 9,697 subjects (mean age, 58.0 ± 9.1 years) were recruited. The subjects were classified into four groups, including subjects with normal glucose tolerance, isolated impaired fasting glucose, impaired glucose tolerance and type 2 diabetes mellitus (T2DM). We found that WBC count increased as glucose metabolism disorders exacerbated. WBC count was also positively correlated with waist hip ratio, body mass index, smoking, triglycerides, glycosylated haemoglobin A1c (HbA1c) and 2-h postprandial glucose. In addition, high density lipoprotein and the female gender were inversely correlated with WBC count. In patients with previously diagnosed T2DM, the course of T2DM was not correlated with WBC count. Our findings indicate that elevated WBC count is independently associated with worsening of glucose metabolism in middle-aged and elderly Chinese. In addition, loss of weight, smoking cessation, lipid-modifying therapies, and control of postprandial plasma glucose and HbA1c may ameliorate the chronic low-grade inflammation. Full article
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Open AccessArticle Physical Activity Levels in Women Attending Breast Screening, Receiving Chemotherapy and Post-Breast Cancer Treatment; A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2014, 11(5), 5487-5496; https://doi.org/10.3390/ijerph110505487
Received: 11 March 2014 / Revised: 24 April 2014 / Accepted: 9 May 2014 / Published: 20 May 2014
Cited by 5 | PDF Full-text (425 KB) | HTML Full-text | XML Full-text
Abstract
Background: A lack of physical activity (PA) is a well-recognised risk factor in the development of breast cancer (BC) and evidence-base research on the impact of PA on BC survival is consolidating. However, evidence reveals that BC survivors have low levels of
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Background: A lack of physical activity (PA) is a well-recognised risk factor in the development of breast cancer (BC) and evidence-base research on the impact of PA on BC survival is consolidating. However, evidence reveals that BC survivors have low levels of PA, suggesting the need of targeted interventions to enhance the PA behaviour of BC survivors. Unfortunately, there is lack of data from the UK about the PA behaviours of women at various stages of diagnosis and treatment of BC. Therefore, the aim of the present study was to assess PA levels in women at different stages of BC pathway. Patients and Methods: A convenient sample of patients was selected at various stages of presentation and treatment of BC. Patients attending for breast screening for NHSBSP (n = 188), post-operative patients attending for chemotherapy (n = 41) and BC patients within one year’s post-treatment (n = 80) were invited to take part in this cross-sectional study. Results: Based on the odds ratio, the likelihood of a chemotherapy participant not meeting PA guidelines (i.e., being in the low activity category) were three times higher than the odds of a NHSBPS attendee not meeting PA guidelines, and compared to post-treatment participants, the chemotherapy patient’s odds of not meeting PA guidelines was four times higher. The odds of NHSBPS attendees being in the high activity category compared to the moderate category were three times higher than that of a post-treatment participant. Conclusions: The current study suggests the need to establish robust PA interventions to enhance the PA behaviour of breast cancer survivors. Full article
(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)
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Open AccessArticle Diabetes Prevention in the New York City Sikh Asian Indian Community: A Pilot Study
Int. J. Environ. Res. Public Health 2014, 11(5), 5462-5486; https://doi.org/10.3390/ijerph110505462
Received: 31 January 2014 / Revised: 6 May 2014 / Accepted: 9 May 2014 / Published: 19 May 2014
Cited by 25 | PDF Full-text (267 KB) | HTML Full-text | XML Full-text
Abstract
India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs
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India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI), waist circumference, blood pressure, glucose, and cholesterol) and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge). Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious. Full article
(This article belongs to the Special Issue Diabetes Prevention: Challenges and Opportunities)
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Open AccessArticle Green Perspectives for Public Health: A Narrative Review on the Physiological Effects of Experiencing Outdoor Nature
Int. J. Environ. Res. Public Health 2014, 11(5), 5445-5461; https://doi.org/10.3390/ijerph110505445
Received: 1 April 2014 / Revised: 12 May 2014 / Accepted: 14 May 2014 / Published: 19 May 2014
Cited by 46 | PDF Full-text (446 KB) | HTML Full-text | XML Full-text
Abstract
Natural environments offer a high potential for human well-being, restoration and stress recovery in terms of allostatic load. A growing body of literature is investigating psychological and physiological health benefits of contact with Nature. So far, a synthesis of physiological health outcomes of
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Natural environments offer a high potential for human well-being, restoration and stress recovery in terms of allostatic load. A growing body of literature is investigating psychological and physiological health benefits of contact with Nature. So far, a synthesis of physiological health outcomes of direct outdoor nature experiences and its potential for improving Public Health is missing. We were interested in summarizing the outcomes of studies that investigated physiological outcomes of experiencing Nature measuring at least one physiological parameter during the last two decades. Studies on effects of indoor or simulated Nature exposure via videos or photos, animal contact, and wood as building material were excluded from further analysis. As an online literature research delivered heterogeneous data inappropriate for quantitative synthesis approaches, we descriptively summarized and narratively synthesized studies. The procedure started with 1,187 titles. Research articles in English language published in international peer-reviewed journals that investigated the effects of natural outdoor environments on humans by were included. We identified 17 relevant articles reporting on effects of Nature by measuring 20 different physiological parameters. We assigned these parameters to one of the four body systems brain activity, cardiovascular system, endocrine system, and immune function. These studies reported mainly direct and positive effects, however, our analyses revealed heterogeneous outcomes regarding significance of results. Most of the studies were conducted in Japan, based on quite small samples, predominantly with male students as participants in a cross-sectional design. In general, our narrative review provided an ambiguous illustration of the effects outdoor nature exerted on physiological parameters. However, the majority of studies reported significant positive effects. A harmonizing effect of Nature, especially on physiological stress reactions, was found across all body systems. From a Public Health perspective, interdisciplinary work on utilizing benefits of Nature regarding health promotion, disease prevention, and nature-based therapy should be optimized in order to eventually diminish given methodological limitations from mono-disciplinary studies. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
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Open AccessArticle Geographical Distribution Patterns of Iodine in Drinking-Water and Its Associations with Geological Factors in Shandong Province, China
Int. J. Environ. Res. Public Health 2014, 11(5), 5431-5444; https://doi.org/10.3390/ijerph110505431
Received: 7 March 2014 / Revised: 29 April 2014 / Accepted: 4 May 2014 / Published: 19 May 2014
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Abstract
County-based spatial distribution characteristics and the related geological factors for iodine in drinking-water were studied in Shandong Province (China). Spatial autocorrelation analysis and spatial scan statistic were applied to analyze the spatial characteristics. Generalized linear models (GLMs) and geographically weighted regression (GWR) studies
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County-based spatial distribution characteristics and the related geological factors for iodine in drinking-water were studied in Shandong Province (China). Spatial autocorrelation analysis and spatial scan statistic were applied to analyze the spatial characteristics. Generalized linear models (GLMs) and geographically weighted regression (GWR) studies were conducted to explore the relationship between water iodine level and its related geological factors. The spatial distribution of iodine in drinking-water was significantly heterogeneous in Shandong Province (Moran’s I = 0.52, Z = 7.4, p < 0.001). Two clusters for high iodine in drinking-water were identified in the south-western and north-western parts of Shandong Province by the purely spatial scan statistic approach. Both GLMs and GWR indicated a significantly global association between iodine in drinking-water and geological factors. Furthermore, GWR showed obviously spatial variability across the study region. Soil type and distance to Yellow River were statistically significant at most areas of Shandong Province, confirming the hypothesis that the Yellow River causes iodine deposits in Shandong Province. Our results suggested that the more effective regional monitoring plan and water improvement strategies should be strengthened targeting at the cluster areas based on the characteristics of geological factors and the spatial variability of local relationships between iodine in drinking-water and geological factors. Full article
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Open AccessArticle Funding Decisions for Newborn Screening: A Comparative Review of 22 Decision Processes in Europe
Int. J. Environ. Res. Public Health 2014, 11(5), 5403-5430; https://doi.org/10.3390/ijerph110505403
Received: 15 January 2014 / Revised: 29 April 2014 / Accepted: 9 May 2014 / Published: 19 May 2014
Cited by 5 | PDF Full-text (255 KB) | HTML Full-text | XML Full-text
Abstract
Decision-makers need to make choices to improve public health. Population-based newborn screening (NBS) is considered as one strategy to prevent adverse health outcomes and address rare disease patients’ needs. The aim of this study was to describe key characteristics of decisions for funding
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Decision-makers need to make choices to improve public health. Population-based newborn screening (NBS) is considered as one strategy to prevent adverse health outcomes and address rare disease patients’ needs. The aim of this study was to describe key characteristics of decisions for funding new NBS programmes in Europe. We analysed past decisions using a conceptual framework. It incorporates indicators that capture the steps of decision processes by health care payers. Based on an internet survey, we compared 22 decisions for which answers among two respondents were validated for each observation. The frequencies of indicators were calculated to elicit key characteristics. All decisions resulted in positive, mostly unrestricted funding. Stakeholder participation was diverse focusing on information provision or voting. Often, decisions were not fully transparent. Assessment of NBS technologies concentrated on expert opinion, literature review and rough cost estimates. Most important appraisal criteria were effectiveness (i.e., health gain from testing for the children being screened), disease severity and availability of treatments. Some common and diverging key characteristics were identified. Although no evidence of explicit healthcare rationing was found, processes may be improved in respect of transparency and scientific rigour of assessment. Full article
Open AccessArticle Range-Finding Risk Assessment of Inhalation Exposure to Nanodiamonds in a Laboratory Environment
Int. J. Environ. Res. Public Health 2014, 11(5), 5382-5402; https://doi.org/10.3390/ijerph110505382
Received: 13 March 2014 / Revised: 4 May 2014 / Accepted: 8 May 2014 / Published: 16 May 2014
Cited by 15 | PDF Full-text (1096 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This study considers fundamental methods in occupational risk assessment of exposure to airborne engineered nanomaterials. We discuss characterization of particle emissions, exposure assessment, hazard assessment with in vitro studies, and risk range characterization using calculated inhaled doses and dose-response translated to humans from
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This study considers fundamental methods in occupational risk assessment of exposure to airborne engineered nanomaterials. We discuss characterization of particle emissions, exposure assessment, hazard assessment with in vitro studies, and risk range characterization using calculated inhaled doses and dose-response translated to humans from in vitro studies. Here, the methods were utilized to assess workers’ risk range of inhalation exposure to nanodiamonds (NDs) during handling and sieving of ND powder. NDs were agglomerated to over 500 nm particles, and mean exposure levels of different work tasks varied from 0.24 to 4.96 µg·m−3 (0.08 to 0.74 cm−3). In vitro-experiments suggested that ND exposure may cause a risk for activation of inflammatory cascade. However, risk range characterization based on in vitro dose-response was not performed because accurate assessment of delivered (settled) dose on the cells was not possible. Comparison of ND exposure with common pollutants revealed that ND exposure was below 5 μg·m−3, which is one of the proposed exposure limits for diesel particulate matter, and the workers’ calculated dose of NDs during the measurement day was 74 ng which corresponded to 0.02% of the modeled daily (24 h) dose of submicrometer urban air particles. Full article
(This article belongs to the Special Issue Ultrafine Particles and Potential Health Effects)
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Open AccessArticle Decrease of Pirimiphos-Methyl and Deltamethrin Residues in Stored Rice with Post-Harvest Treatment
Int. J. Environ. Res. Public Health 2014, 11(5), 5372-5381; https://doi.org/10.3390/ijerph110505372
Received: 17 March 2014 / Revised: 6 May 2014 / Accepted: 9 May 2014 / Published: 16 May 2014
Cited by 5 | PDF Full-text (394 KB) | HTML Full-text | XML Full-text
Abstract
A modified quick, easy, cheap, effective, rugged (QuEChERS) method with multi-walled carbon nanotubes (MWCNTs) as reversed-dispersive solid phase extraction (r-DSPE) material was applied to the analysis of pirimiphos-methyl and deltamethrin residues in stored rice. Two dustable powder (DP) formulations (2% pirimiphos-methyl and deltamethrin
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A modified quick, easy, cheap, effective, rugged (QuEChERS) method with multi-walled carbon nanotubes (MWCNTs) as reversed-dispersive solid phase extraction (r-DSPE) material was applied to the analysis of pirimiphos-methyl and deltamethrin residues in stored rice. Two dustable powder (DP) formulations (2% pirimiphos-methyl and deltamethrin DP; 5% pirimiphos-methyl DP) were applied in simulated storehouse trials in the lab. The residues and dissipation of the two pesticides in stored rice were investigated. Slow dissipation of both pesticides was observed in stored rice. The half-lives of pirimiphos-methyl were 23.9–28.9 days, and those of deltamethrin were 23.9–24.8 days. Residues of pirimiphos-methyl from application rates of 4.5–6.75 a.i. mg/kg (active ingredient milligram per kilogram) and 10–15 a.i. mg/kg were 1.6–3.8 mg/kg and 3.0–4.5 mg/kg at 60 days Pre-harvest Interval (PHI). Residues of deltamethrin from an application rate of 0.5–0.75 a.i. mg/kg were 0.13–0.14 mg/kg at 60 days PHI. Both pesticides residues were below the Maximum Residue Limits (MRLs) established by the Codex Alimentarius Commission (CAC). Therefore, at the recommended dosages they are safe for use on stored rice. Full article
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Open AccessArticle The Next Generation of Interoperability Agents in Healthcare
Int. J. Environ. Res. Public Health 2014, 11(5), 5349-5371; https://doi.org/10.3390/ijerph110505349
Received: 3 March 2014 / Revised: 24 April 2014 / Accepted: 28 April 2014 / Published: 16 May 2014
Cited by 23 | PDF Full-text (4480 KB) | HTML Full-text | XML Full-text
Abstract
Interoperability in health information systems is increasingly a requirement rather than an option. Standards and technologies, such as multi-agent systems, have proven to be powerful tools in interoperability issues. In the last few years, the authors have worked on developing the Agency for
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Interoperability in health information systems is increasingly a requirement rather than an option. Standards and technologies, such as multi-agent systems, have proven to be powerful tools in interoperability issues. In the last few years, the authors have worked on developing the Agency for Integration, Diffusion and Archive of Medical Information (AIDA), which is an intelligent, agent-based platform to ensure interoperability in healthcare units. It is increasingly important to ensure the high availability and reliability of systems. The functions provided by the systems that treat interoperability cannot fail. This paper shows the importance of monitoring and controlling intelligent agents as a tool to anticipate problems in health information systems. The interaction between humans and agents through an interface that allows the user to create new agents easily and to monitor their activities in real time is also an important feature, as health systems evolve by adopting more features and solving new problems. A module was installed in Centro Hospitalar do Porto, increasing the functionality and the overall usability of AIDA. Full article
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Open AccessArticle Face Validity of the Single Work Ability Item: Comparison with Objectively Measured Heart Rate Reserve over Several Days
Int. J. Environ. Res. Public Health 2014, 11(5), 5333-5348; https://doi.org/10.3390/ijerph110505333
Received: 13 February 2014 / Revised: 14 April 2014 / Accepted: 8 May 2014 / Published: 16 May 2014
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Abstract
Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR) among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male
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Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR) among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male = 74) aged 18–65 years from the cross-sectional “New method for Objective Measurements of physical Activity in Daily living (NOMAD)” study. The workers reported their single item work ability and completed an aerobic capacity cycling test and objective measurements of heart rate reserve monitored with Actiheart for 3–4 days with a total of 5,810 h, including 2,640 working hours. Results: A significant moderate correlation between work ability and %HRR was observed among males (R = −0.33, P = 0.005), but not among females (R = 0.11, P = 0.431). In a gender-stratified multi-adjusted logistic regression analysis, males with high %HRR were more likely to report a reduced work ability compared to males with low %HRR [OR = 4.75, 95% confidence interval (95% CI) = 1.31 to 17.25]. However, this association was not found among females (OR = 0.26, 95% CI 0.03 to 2.16), and a significant interaction between work ability, %HRR and gender was observed (P = 0.03). Conclusions: The observed association between work ability and objectively measured %HRR over several days among male blue-collar workers supports the face validity of the single work ability item. It is a useful and valid measure of the relation between physical work demands and resources among male blue-collar workers. The contrasting association among females needs to be further investigated. Full article
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Open AccessArticle A Randomized Longitudinal Factorial Design to Assess Malaria Vector Control and Disease Management Interventions in Rural Tanzania
Int. J. Environ. Res. Public Health 2014, 11(5), 5317-5332; https://doi.org/10.3390/ijerph110505317
Received: 14 March 2014 / Revised: 9 May 2014 / Accepted: 9 May 2014 / Published: 16 May 2014
Cited by 5 | PDF Full-text (540 KB) | HTML Full-text | XML Full-text | Correction
Abstract
The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed
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The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1) a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2) vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding). The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials. Full article
(This article belongs to the Special Issue Epidemiology, Prevention and Control of Malaria)
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