Next Issue
Previous Issue

E-Mail Alert

Add your e-mail address to receive forthcoming issues of this journal:

Journal Browser

Journal Browser

Table of Contents

Int. J. Environ. Res. Public Health, Volume 11, Issue 6 (June 2014), Pages 5567-6611

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
View options order results:
result details:
Displaying articles 1-65
Export citation of selected articles as:

Research

Jump to: Review, Other

Open AccessArticle Community-Based Recreational Football: A Novel Approach to Promote Physical Activity and Quality of Life in Prostate Cancer Survivors
Int. J. Environ. Res. Public Health 2014, 11(6), 5567-5585; doi:10.3390/ijerph110605567
Received: 10 March 2014 / Revised: 8 May 2014 / Accepted: 8 May 2014 / Published: 26 May 2014
Cited by 8 | PDF Full-text (219 KB) | HTML Full-text | XML Full-text
Abstract
As the number of cancer survivors continues to increase, there is an increasing focus on management of the long-term consequences of cancer including health promotion and prevention of co-morbidity. Prostate cancer is the most frequent type of cancer type in men and causes
[...] Read more.
As the number of cancer survivors continues to increase, there is an increasing focus on management of the long-term consequences of cancer including health promotion and prevention of co-morbidity. Prostate cancer is the most frequent type of cancer type in men and causes increased risk of heart disease, diabetes and osteoporosis. Epidemiological evidence points to a positive effect of regular physical activity on all-cause and prostate cancer mortality and current clinical evidence supports the use of exercise in cancer rehabilitation. However, the external validity of existing exercise studies is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport environments, the study offers a novel approach in the strive towards sustained physical activity adherence and accessibility in prostate cancer survivors. Full article
(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)
Open AccessArticle Oxidative Stress of Office Workers Relevant to Tobacco Smoking and Inner Air Quality
Int. J. Environ. Res. Public Health 2014, 11(6), 5586-5597; doi:10.3390/ijerph110605586
Received: 27 March 2014 / Revised: 16 May 2014 / Accepted: 20 May 2014 / Published: 26 May 2014
Cited by 7 | PDF Full-text (789 KB) | HTML Full-text | XML Full-text
Abstract
Studies have used 8-hydroxydeoxyguanosine (8-OHdG) as a biomarker to detect systemic oxidative DNA damage associated with oxidative stress. However, studies on the association between exposure to tobacco smoking and urinary 8-OHdgG give inconsistent results. Limited studies have estimated the oxidative stress among office
[...] Read more.
Studies have used 8-hydroxydeoxyguanosine (8-OHdG) as a biomarker to detect systemic oxidative DNA damage associated with oxidative stress. However, studies on the association between exposure to tobacco smoking and urinary 8-OHdgG give inconsistent results. Limited studies have estimated the oxidative stress among office workers. This study assessed the association between urinary 8-OHdG and cotinine for office workers.  Workers (389) including smokers, ex-smokers and non-smokers from 87 offices at high-rise buildings in Taipei participated in this study with informed consent. Each participant completed a questionnaire and provided a spot urine specimen at the end of work day for measuring urinary 8-OHdG and cotinine. The carbon dioxide (CO2) levels in workers’ offices were also measured. The questionnaire reported socio-demographic characteristics, life styles and allergic history. The urinary 8-OHdG level increased with the cotinine level among participants (Spearmans’ rho = 0.543, p < 0.001). The mean of urinary 8-OHdG and cotinine was 5.81 ± 3.53 μg/g creatinine and 3.76 ± 4.06 μg/g creatinine, respectively. Comparing with non-smokers, the adjusted odds ratio (OR) of having urinary 8-OHdG greater than the median level of 4.99 μg/g creatinine was 5.30 (95% confidence intervals (CI) = 1.30–21.5) for current smokers and 0.91 (95% CI = 0.34–2.43) for former smokers. We also found workers exposed to 1,000 ppm of CO2 at offices had an adjusted OR of 4.28 (95% CI = 1.12–16.4) to have urinary 8-OHdG greater than 4.99 μg/g creatinine, compared to those exposed to indoor CO2 under 600 ppm. In conclusion, urinary 8-OHdG could represent a suitable marker for measuring smoking and CO2 exposure for office workers. Full article
Open AccessArticle Differences of Soil Fertility in Farmland Occupation and Supplement Areas in the Taihu Lake Watershed during 1985–2010
Int. J. Environ. Res. Public Health 2014, 11(6), 5598-5612; doi:10.3390/ijerph110605598
Received: 3 March 2014 / Revised: 6 May 2014 / Accepted: 19 May 2014 / Published: 26 May 2014
PDF Full-text (1233 KB) | HTML Full-text | XML Full-text
Abstract
Since the 1980s a series of farmland policies have been implemented in China to stabilize the balance of farmland quantity and quality against accelerating urbanization and industrialization processes. This paper aims to reveal differences of soil fertility in the farmland occupation area (FOA)
[...] Read more.
Since the 1980s a series of farmland policies have been implemented in China to stabilize the balance of farmland quantity and quality against accelerating urbanization and industrialization processes. This paper aims to reveal differences of soil fertility in the farmland occupation area (FOA) and farmland supplement area (FSA). In 1985–2000 the decline of the FOA area was 181,000 ha, but the FSA rarely increased. In 2000–2010 the decline of the FOA area was 824,800 ha, but the FSA increased dramatically. The accelerating loss process is closely related to urbanization and industrialization of the locations. Most occupied farmland was still located in the areas with higher soil fertility. The FOA in 1985–2000 had higher soil fertility than the FSA, but the FSA in 2000–2010 significantly raised its soil fertility to close to the FOAs’ level. The rate of excellent-good levels of the FOA in 2000–2010 decreased from 46.13% to 37.61%; The development model shifts and farmland policies implementation are the chief driving factors behind AFOS changes. The TDBF policy and the main function zoning project should continue to play an effective role in balancing the farmland system. Full article
Open AccessArticle Geospatial Disparities and the Underlying Causes of Major Cancers for Women in Taiwan
Int. J. Environ. Res. Public Health 2014, 11(6), 5613-5627; doi:10.3390/ijerph110605613
Received: 28 March 2014 / Revised: 16 May 2014 / Accepted: 16 May 2014 / Published: 26 May 2014
PDF Full-text (1120 KB) | HTML Full-text | XML Full-text
Abstract
Some specific types of cancer still pose a severe threat to the health of Taiwanese women. This study focuses on determining the geographical locations of hot spots and causal factors related to the major categories of cancers in Taiwanese women. Cancer mortality data
[...] Read more.
Some specific types of cancer still pose a severe threat to the health of Taiwanese women. This study focuses on determining the geographical locations of hot spots and causal factors related to the major categories of cancers in Taiwanese women. Cancer mortality data from 1972 to 2001 of 346 townships in Taiwan were obtained from the Atlas of Cancer Mortality. Principal component analysis was conducted to determine the primary categories of female cancers. The spatial patterns of hot spots and cold spots for each major cancer category were identified using the local indicator of spatial association. Finally, the regional differences between the hot spots and cold spots were compared to confirm the possible factors causing cancer throughout Taiwan. A total of 21 cancer types in women were divided into seven major categories, which accounted for 68.0% of the total variance. The results from the spatial autocorrelation analysis showed significant spatial clusters of the cancer categories. Based on the overall consistency of results between this study and those of previous research, this study further identified the high-risk locations and some specific risk factors for major cancer types among Taiwanese women. Full article
Open AccessArticle Phthalate Exposure and Health-Related Outcomes in Specific Types of Work Environment
Int. J. Environ. Res. Public Health 2014, 11(6), 5628-5639; doi:10.3390/ijerph110605628
Received: 28 March 2014 / Revised: 15 May 2014 / Accepted: 16 May 2014 / Published: 26 May 2014
Cited by 5 | PDF Full-text (198 KB) | HTML Full-text | XML Full-text
Abstract
Many toxic substances in the workplace can modify human health and quality of life and there is still insufficient data on respiratory outcomes in adults exposed to phthalates. The aim of this work was to assess in waste management workers from the Nitra
[...] Read more.
Many toxic substances in the workplace can modify human health and quality of life and there is still insufficient data on respiratory outcomes in adults exposed to phthalates. The aim of this work was to assess in waste management workers from the Nitra region of Slovakia (n = 30) the extent of exposure to phthalates and health-related outcomes. Four urinary phthalate metabolites mono(2-ethylhexyl) phthalate (MEHP), monobutyl phthalate (MnBP), monoethyl phthalate (MEP) and monoisononyl phthalate (MiNP) were determined by high-performance liquid chromatography with mass spectrometry (HPLC-MS/MS). Urinary concentration of MEHP was positively associated with ratio of forced expiratory volume in 1 s to forced vital capacity % (FEV1/FVC) (r = 0.431; p = 0.018) and MiNP with fat free mass index (FFMI) (r = 0.439; p = 0.015). The strongest predictor of pulmonary function was the pack/year index as smoking history that predicted a decrease of pulmonary parameters, the FEV1/FVC, % of predicted values of peak expiratory flow (PEF % of PV) and FEV1 % of PV. Unexpectedly, urinary MEHP and MINP were positively associated with pulmonary function expressed as PEF % of PV and FEV1/FVC. We hypothesize that occupational exposure to phthalates estimated from urinary metabolites (MEHP, MiNP) can modify pulmonary function on top of lifestyle factors. Full article
Open AccessArticle Socioeconomic Context and the Food Landscape in Texas: Results from Hotspot Analysis and Border/Non-Border Comparison of Unhealthy Food Environments
Int. J. Environ. Res. Public Health 2014, 11(6), 5640-5650; doi:10.3390/ijerph110605640
Received: 28 February 2014 / Revised: 14 May 2014 / Accepted: 15 May 2014 / Published: 26 May 2014
Cited by 1 | PDF Full-text (378 KB) | HTML Full-text | XML Full-text
Abstract
Purpose: The purpose of this paper is to describe the food landscape of Texas using the CDC’s Modified Retail Food Environment (mRFEI) and to make comparisons by border/non-border. Methods: The Modified Retail Food Environment index (mRFEI (2008)) is an index developed
[...] Read more.
Purpose: The purpose of this paper is to describe the food landscape of Texas using the CDC’s Modified Retail Food Environment (mRFEI) and to make comparisons by border/non-border. Methods: The Modified Retail Food Environment index (mRFEI (2008)) is an index developed by the CDC that measures what percent of the total food vendors in a census track sell healthy food. The range of values is 0 (unhealthy areas with limited access to fruits and vegetables) to (100—Healthy). These data were linked to 2010 US Census socioeconomic and ethnic concentration data. Spatial analysis and GIS techniques were applied to assess the differences between border and non-border regions. Variables of interest were mRFEI score, median income, total population, percent total population less than five years, median age, % receiving food stamps, % Hispanic, and % with a bachelor degree. Results: Findings from this study reveal that food environment in Texas tends to be characteristic of a “food desert”. Analysis also demonstrates differences by border/non-border location and percent of the population that is foreign born and by percent of families who receive food stamps. Conclusions: Identifying the relationship between socioeconomic disparity, ethnic concentration and mRFEI score could be a fundamental step in improving health in disadvantage communities, particularly those on the Texas-Mexico border. Full article
Open AccessArticle The Epidemiology of Imported Malaria in Taiwan between 2002–2013: The Importance of Sensitive Surveillance and Implications for Pre-Travel Medical Advice
Int. J. Environ. Res. Public Health 2014, 11(6), 5651-5664; doi:10.3390/ijerph110605651
Received: 13 March 2014 / Revised: 8 May 2014 / Accepted: 20 May 2014 / Published: 27 May 2014
Cited by 3 | PDF Full-text (566 KB) | HTML Full-text | XML Full-text
Abstract
The purpose of this study was to assess the epidemiology of imported malaria in Taiwan between 2002 and 2013. We analyzed the national data recorded by the Taiwan Centers for Disease Control (Taiwan CDC). Malaria cases were diagnosed by blood films, polymerase chain
[...] Read more.
The purpose of this study was to assess the epidemiology of imported malaria in Taiwan between 2002 and 2013. We analyzed the national data recorded by the Taiwan Centers for Disease Control (Taiwan CDC). Malaria cases were diagnosed by blood films, polymerase chain reaction, or rapid diagnostic tests. The risk of re-establishment of malarial transmission in Taiwan was assessed. A total of 229 malaria cases were included in our analysis. All of the cases were imported. One hundred and ninety-two cases (84%) were diagnosed within 13 days of the start of symptoms/signs; 43% of these cases were acquired in Africa and 44% were acquired in Asia. Plasmodium falciparum was responsible for the majority (56%) of these cases. Travel to an endemic area was associated with the acquisition of malaria. The malaria importation rate was 2.36 per 1,000,000 travelers (range 1.20–5.74). The reproductive number under control (Rc) was 0. No endemic transmission of malaria in Taiwan was identified. This study suggests that a vigilant surveillance system, vector-control efforts, case management, and an educational approach focused on travelers and immigrants who visit malaria endemic countries are needed to prevent outbreaks and sustain the elimination of malaria in Taiwan. Full article
(This article belongs to the Special Issue Epidemiology, Prevention and Control of Malaria)
Open AccessArticle Engaging a Chemical Disaster Community: Lessons from Graniteville
Int. J. Environ. Res. Public Health 2014, 11(6), 5684-5697; doi:10.3390/ijerph110605684
Received: 13 February 2014 / Revised: 25 April 2014 / Accepted: 21 May 2014 / Published: 27 May 2014
Cited by 5 | PDF Full-text (225 KB) | HTML Full-text | XML Full-text
Abstract
Community engagement remains a primary objective of public health practice. While this approach has been adopted with success in response to many community health issues, it is rarely adopted in chemical disaster response. Empirical research suggests that management of chemical disasters focuses on
[...] Read more.
Community engagement remains a primary objective of public health practice. While this approach has been adopted with success in response to many community health issues, it is rarely adopted in chemical disaster response. Empirical research suggests that management of chemical disasters focuses on the emergency response with almost no community engagement for long-term recovery. Graniteville, an unincorporated and medically underserved community in South Carolina was the site of one of the largest chlorine exposures by a general US population. Following the immediate response, we sought community participation and partnered with community stakeholders and representatives in order to address community-identified health and environmental concerns. Subsequently, we engaged the community through regular town hall meetings, harnessing community capacity, forming coalitions with existing local assets like churches, schools, health centers, and businesses, and hosting community-wide events like health picnics and screenings. Information obtained from these events through discussions, interviews, and surveys facilitated focused public health service which eventually transitioned to community-driven public health research. Specific outcomes of the community engagement efforts and steps taken to ensure sustainability of these efforts and outcomes will be discussed. Full article
(This article belongs to the Special Issue Preparedness and Emergency Response)
Open AccessArticle Effects of Partially Ionised Medical Oxygen, Especially with O2, in Vibration White Finger Patients
Int. J. Environ. Res. Public Health 2014, 11(6), 5698-5707; doi:10.3390/ijerph110605698
Received: 12 March 2014 / Revised: 16 May 2014 / Accepted: 16 May 2014 / Published: 27 May 2014
PDF Full-text (435 KB) | HTML Full-text | XML Full-text
Abstract
A major symptom of hand-arm vibration syndrome is a secondary Raynaud’s phenomenon—vibration white finger (VWF)—which results from a vasospasm of the digital arteries caused by work with vibration devices leading to occupational disease. Pharmacotherapy of VWF is often ineffective or has adverse effects.
[...] Read more.
A major symptom of hand-arm vibration syndrome is a secondary Raynaud’s phenomenon—vibration white finger (VWF)—which results from a vasospasm of the digital arteries caused by work with vibration devices leading to occupational disease. Pharmacotherapy of VWF is often ineffective or has adverse effects. The aim of this work was to verify the influence of inhalation of partially ionized oxygen (O2) on peripheral blood vessels in the hands of patients with VWF. Ninety one (91)patients with VWF underwent four-finger adsorption plethysmography, and the pulse wave amplitude was recorded expressed in numeric parameters—called the native record. Next, a cold water test was conducted following with second plethysmography. The patients were divided in to the three groups. First and second inhaled 20-min of ionized oxygen O2 or oxygen O2 respectively. Thirth group was control without treatment. All three groups a follow-up third plethysmography—the post-therapy record. Changes in the pulse wave amplitudes were evaluated. Inpatients group inhaling O2 a modest increase of pulse wave amplitude was observed compared to the native record; patients inhaling medical oxygen O2 and the control showed a undesirable decline of pulse wave amplitude in VWF fingers. Strong vasodilatation were more frequent in the group inhaling O2 compare to O2 (p < 0.05). Peripheral vasodilatation achieved by inhalation of O2 could be used for VWF treatment without undesirable side effect in hospital as well as at home environment. Full article
Open AccessArticle Evaluation of the Relationship between the Adenosine Triphosphate (ATP) Bioluminescence Assay and the Presence of Bacillus anthracis Spores and Vegetative Cells
Int. J. Environ. Res. Public Health 2014, 11(6), 5708-5719; doi:10.3390/ijerph110605708
Received: 8 April 2014 / Revised: 15 May 2014 / Accepted: 20 May 2014 / Published: 28 May 2014
Cited by 2 | PDF Full-text (232 KB) | HTML Full-text | XML Full-text
Abstract
Background: The Adenosine triphosphate (ATP) bioluminescence assay was utilized in laboratory evaluations to determine the presence and concentration of vegetative and spore forms of Bacillus anthracis Sterne 34F2. Methods: Seventeen surfaces from the healthcare environment were selected for evaluation. Surfaces were
[...] Read more.
Background: The Adenosine triphosphate (ATP) bioluminescence assay was utilized in laboratory evaluations to determine the presence and concentration of vegetative and spore forms of Bacillus anthracis Sterne 34F2. Methods: Seventeen surfaces from the healthcare environment were selected for evaluation. Surfaces were inoculated with 50 µL of organism suspensions at three concentrations of 104, 106, 108 colony forming units per surface (CFU/surface) of B. anthracis. Culture-based methods and ATP based methods were utilized to determine concentrations. Results: When all concentrations were evaluated together, a positive correlation between log-adjusted CFU and Relative Light Units (RLU) for endospores and vegetative cells was established. When concentrations were evaluated separately, a significant correlation was not demonstrated. Conclusions: This study demonstrated a positive correlation for ATP and culture-based methods for the vegetative cells of B. anthracis. When evaluating the endospores and combining both metabolic states, the ATP measurements and CFU recovered did not correspond to the initial concentrations on the evaluated surfaces. The results of our study show that the low ATP signal which does not correlate well to the CFU results would not make the ATP measuring devises effective in confirming contamination residual from a bioterrorist event. Full article
(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)
Open AccessArticle Assessing Alcohol Dependence in Hospitalized Patients
Int. J. Environ. Res. Public Health 2014, 11(6), 5783-5791; doi:10.3390/ijerph110605783
Received: 10 December 2013 / Revised: 6 April 2014 / Accepted: 29 April 2014 / Published: 28 May 2014
Cited by 1 | PDF Full-text (191 KB) | HTML Full-text | XML Full-text
Abstract
Alcohol misuse is generally not detected in hospital settings. The goal of this study was to estimate the prevalence of alcohol abuse and dependence in hospitalized patients in a university hospital in Sao Paulo (Brazil). Patients were randomly selected from all hospital admissions.
[...] Read more.
Alcohol misuse is generally not detected in hospital settings. The goal of this study was to estimate the prevalence of alcohol abuse and dependence in hospitalized patients in a university hospital in Sao Paulo (Brazil). Patients were randomly selected from all hospital admissions. The final sample consisted of 169 adult inpatients. Two screening tools were used: the Short Alcohol Dependence Data (SADD) and the CAGE questionnaires. In this sample, 25.4% of patients could be considered alcohol dependent according to the CAGE questionnaire, whereas 32.9% of patients fulfilled the criteria according to the SADD. The only predictor of alcohol dependence was gender; male inpatients were 3.2 times more prone to alcohol dependence with female inpatients. All inpatients should be systematically screened for alcohol use disorders. The choice of the screening tool will depend on whether the goal is to identify inpatients with hazardous drinking behaviors or with established alcohol-related problems. To maximize proper case identification, the CAGE questionnaire should be used as a first-step screening tool, and patients who screen positive on this scale should be subsequently administered the SADD questionnaire to assess the severity of the condition. Full article
(This article belongs to the Special Issue Alcohol Abuse: Newer Approaches to an Old Problem)
Open AccessArticle Global Research on Smoking and Pregnancy—A Scientometric and Gender Analysis
Int. J. Environ. Res. Public Health 2014, 11(6), 5792-5806; doi:10.3390/ijerph110605792
Received: 20 March 2014 / Revised: 20 May 2014 / Accepted: 21 May 2014 / Published: 28 May 2014
Cited by 10 | PDF Full-text (4006 KB) | HTML Full-text | XML Full-text
Abstract
The exposure to tobacco smoke during pregnancy is considered to be amongst the most harmful avoidable risk factors. In this scientometric and gender study scientific data on smoking and pregnancy was analyzed using a variety of objective scientometric methods like the number of
[...] Read more.
The exposure to tobacco smoke during pregnancy is considered to be amongst the most harmful avoidable risk factors. In this scientometric and gender study scientific data on smoking and pregnancy was analyzed using a variety of objective scientometric methods like the number of scientific contributions, the number of citations and the modified h-index in combination with gender-specific investigations. Covering a time period from 1900 to 2012, publishing activities of 27,955 authors, institutions and countries, reception within the international scientific community and its reactions were analyzed and interpreted. Out of 10,043 publications the highest number of scientific works were published in the USA (35.5%), followed by the UK (9.9%) and Canada (5.3%). These nations also achieve the highest modified h-indices of 128, 79 and 62 and the highest citation rates of 41.4%, 8.6% and 5.3%, respectively. Out of 12,596 scientists 6,935 are female (55.1%), however they account for no more than 49.7% of publications (12,470) and 42.8% of citations (172,733). The highest percentage of female experts about smoking and pregnancy is found in Australasia (60.7%), while the lowest is found in Asia (41.9%). The findings of the study indicate an increase in gender equality as well as in quantity and quality of international scientific research about smoking and pregnancy in the future. Full article
Open AccessArticle Lifestyle Practices and Obesity in Malaysian Adolescents
Int. J. Environ. Res. Public Health 2014, 11(6), 5828-5838; doi:10.3390/ijerph110605828
Received: 21 April 2014 / Revised: 22 May 2014 / Accepted: 27 May 2014 / Published: 30 May 2014
Cited by 2 | PDF Full-text (252 KB) | HTML Full-text | XML Full-text
Abstract
Aim: To determine the influence of physical activity (PA) and sedentary behavior (SB) on obesity profiles of 454 Malaysian adolescents aged 12 to 19. Methods: Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA).
[...] Read more.
Aim: To determine the influence of physical activity (PA) and sedentary behavior (SB) on obesity profiles of 454 Malaysian adolescents aged 12 to 19. Methods: Validated PA and SB questionnaires were used and body composition assessed using anthropometry and dual-energy X-ray absorptiometry (DXA). Results: Gender-specific multivariate analyses showed boys with high levels of total PA and moderate-to-vigorous physical activity (MVPA) exhibited significantly lower levels of total body fat, percent body fat and android fat mass compared with low PA and MVPA groups, after adjusting for potential confounders. Girls with high SB levels showed significantly higher BMI, waist circumference and DXA-derived body fat indices than those at lower SB level. Multiple logistic analyses indicated that boys with low levels of total PA and MVPA had significantly greater obesity risk, 3.0 (OR 3.0; 95% CI, 1.1–8.1; p < 0.05) and 3.8-fold (OR 3.8; 95% CI, 1.4–10.1; p < 0.01), respectively, than more active boys. Only in girls with high SB level was there a significantly increased risk of obesity, 2.9 times higher than girls at low SP levels (OR 2.8; 95% CI, 1.0–7.5; p < 0.05).  Conclusions: The present findings indicate that higher PA duration and intensity reduced body fat and obesity risk while high screen-based sedentary behaviors significantly adversely influenced body fat mass, particularly amongst girls when the PA level was low. Full article
(This article belongs to the Special Issue Childhood Obesity: Novel Approaches to a Global Problem)
Open AccessArticle Sudomotor Function as a Tool for Cardiorespiratory Fitness Level Evaluation: Comparison with Maximal Exercise Capacity
Int. J. Environ. Res. Public Health 2014, 11(6), 5839-5848; doi:10.3390/ijerph110605839
Received: 8 April 2014 / Revised: 13 May 2014 / Accepted: 15 May 2014 / Published: 30 May 2014
Cited by 9 | PDF Full-text (324 KB) | HTML Full-text | XML Full-text
Abstract
Physical inactivity is a modifiable risk factor for cardiovascular (CV) and metabolic disorders. VO2max is the best method to assess cardio-respiratory fitness level but it is poorly adopted in clinical practice. Sudomotor dysfunction may develop early in metabolic diseases. This study
[...] Read more.
Physical inactivity is a modifiable risk factor for cardiovascular (CV) and metabolic disorders. VO2max is the best method to assess cardio-respiratory fitness level but it is poorly adopted in clinical practice. Sudomotor dysfunction may develop early in metabolic diseases. This study aimed at comparing established CV risk evaluation techniques with SUDOSCAN; a quick and non-invasive method to assess sudomotor function. A questionnaire was filled-in; physical examination and VO2max estimation using a maximal test on a bicycle ergometer were performed on active Finish workers. Hand and foot electrochemical skin conductance (ESC) were measured to assess sudomotor function. Subjects with the lowest fitness level were involved in a 12 month training program with recording of their weekly physical activity and a final fitness level evaluation. Significant differences in BMI; waist and body fat were seen according to SUDOSCAN risk score classification. Correlation between the risk score and estimated VO2max was r = −0.57, p < 0.0001 for women and −0.48, p < 0.0001 for men. A significant increase in estimated VO2max, in hand and foot ESC and in risk score was observed after lifestyle intervention and was more important in subjects with the highest weekly activity. SUDOSCAN could be used to assess cardio-metabolic disease risk status in a working population and to follow individual lifestyle interventions. Full article
(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)
Open AccessArticle Walkability is Only Part of the Story: Walking for Transportation in Stuttgart, Germany
Int. J. Environ. Res. Public Health 2014, 11(6), 5849-5865; doi:10.3390/ijerph110605849
Received: 19 December 2013 / Revised: 22 May 2014 / Accepted: 23 May 2014 / Published: 30 May 2014
Cited by 9 | PDF Full-text (1064 KB) | HTML Full-text | XML Full-text
Abstract
In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way
[...] Read more.
In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way that supports people in leading more active and healthy lifestyles. Within this context there are several methods, predominantly used in the US, to measure the suitability of built environments for walking and cycling. Empirical studies show that people living in highly walkable areas are more physically active (for example, walk more or cycle more). The question is, however, whether these results are also valid for European cities given their different urban planning characteristics and infrastructure standards. To answer this question we used the Walkability-Index and the Walk Score to empirically investigate the associations between walkability and active transportation in the city of Stuttgart, Germany. In a sample of household survey data (n = 1.871) we found a noticeable relationship between walkability and active transportation—the more walkable an area was, the more active residents were. Although the statistical effect is small, the health impact might be of relevance. Being physically active is multi-determined and not only affected by the walkability of an area. We highlight these points with an excursion into research that the health and exercise sciences contribute to the topic. We propose to strengthen interdisciplinary research between the disciplines and to specifically collect data that captures the influence of the environment on physical activity in the future. Full article
Open AccessArticle Drinking Water Management: Health Risk Perceptions and Choices in First Nations and Non-First Nations Communities in Canada
Int. J. Environ. Res. Public Health 2014, 11(6), 5889-5903; doi:10.3390/ijerph110605889
Received: 7 March 2014 / Revised: 23 May 2014 / Accepted: 26 May 2014 / Published: 30 May 2014
Cited by 8 | PDF Full-text (246 KB) | HTML Full-text | XML Full-text
Abstract
The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000–2001. This study reports the perspectives on health risks from tap
[...] Read more.
The relationship between tap water and health has been a topic of public concern and calls for better management in Canada since well-publicized contamination events in two provinces (Ontario and Saskatchewan) in 2000–2001. This study reports the perspectives on health risks from tap water and corresponding use of, and spending on, bottled water in a number of different communities in Canada. In 2009–2010, four First Nations communities (three from Ontario and one from Saskatchewan) and a geographically diverse sample of non-First Nations Canadians were surveyed about their beliefs concerning health risks from tap water and their spending practices for bottled water as a substitute. Responses to five identical questions were examined, revealing that survey respondents from Ontario First Nations communities were more likely than non-First Nations Canadians to believe bottled water is safer than tap water (OR 1.6); more likely to report someone became ill from tap water (OR 3.6); more likely to express water and health concerns related to tap water consumption (OR 2.4); and more likely to spend more on bottled water (OR 4.9). On the other hand, participants from one Saskatchewan First Nations community were less likely than non-First Nations Canadians to believe that someone had become ill from drinking tap water (OR 3.8), less likely to believe bottled water is safer than tap (OR 2.0), and less likely to have health concerns with tap water (OR 1.5). These differences, however, did not translate into differences in the likelihood of high bottled water expenditures or being a 100% bottled water consumer. The paper discusses how the differences observed may be related to water supply and regulation, trust, perceived control, cultural background, location, and past experience. Full article
Open AccessArticle How to Reduce the Latent Social Risk of Disease: The Determinants of Vaccination against Rabies in Taiwan
Int. J. Environ. Res. Public Health 2014, 11(6), 5934-5950; doi:10.3390/ijerph110605934
Received: 24 December 2013 / Revised: 20 May 2014 / Accepted: 23 May 2014 / Published: 4 June 2014
PDF Full-text (656 KB) | HTML Full-text | XML Full-text
Abstract
To control the latent social risk of disease, the government usually spreads accurate information and attempts to improve the public’s attitude toward adopting prevention. However, these methods with the Knowledge, Attitudes, and Practices (KAP) model do not always work. Therefore, we used the
[...] Read more.
To control the latent social risk of disease, the government usually spreads accurate information and attempts to improve the public’s attitude toward adopting prevention. However, these methods with the Knowledge, Attitudes, and Practices (KAP) model do not always work. Therefore, we used the theory of planned behavior (TPB) to understand dog owners’ behavior and distinguished the knowledge effect as objective knowledge (OK) and subjective knowledge (SK). A total of 310 dog owners completed a questionnaire based on our model. We employed structural equation modeling to verify the structural relationships and found three main results. First, our model was fit, and each path was significant. People with better attitudes, stronger subjective norms, and more perceptive behavioral control have stronger behavioral intention. Second, perceived behavioral control, not attitude, was the best predictive index in this model. Finally, on perceived behavioral control, subjective knowledge showed more influence than objective knowledge. We successfully extended TPB to explain the behavioral intention of dog owners and presented more workable recommendations. To reduce the latent social risk of disease, the government should not only address dog owners’ attitudes, but also their subjective norms and perceptive behavioral control. Indeed, perceptive behavioral control and SK showed the most influence in this model. It is implied that the self-efficacy of dog owners is the most important factor in such a behavior. Therefore, the government should focus on enhancing dog owners’ self-efficacy first while devoted to prevention activities. Full article
Open AccessArticle A Qualitative Process Evaluation of Classroom-Based Cognitive Behaviour Therapy to Reduce Adolescent Depression
Int. J. Environ. Res. Public Health 2014, 11(6), 5951-5969; doi:10.3390/ijerph110605951
Received: 26 December 2013 / Revised: 26 May 2014 / Accepted: 27 May 2014 / Published: 5 June 2014
Cited by 6 | PDF Full-text (209 KB) | HTML Full-text | XML Full-text
Abstract
Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT) for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a
[...] Read more.
Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT) for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a classroom-based CBT depression prevention programme as part of a large (n = 5,030) randomised controlled trial across eight UK secondary schools which was not found to be effective (PROMISE, ISRCTN19083628). The views of young people (n = 42), teachers (n = 12) and facilitators (n = 16) involved in the Resourceful Adolescent Programme (RAP) were obtained via focus groups and interviews which were thematically analysed. The programme was considered to be well structured and contain useful content, particularly for younger pupils. However, challenges associated with implementation were its age appropriateness for all year groups, its perceived lack of flexibility, the consistency of quality of delivery, the competing demands for teacher time and a culture where academic targets were prioritised over personal, social and health education. Whilst schools are convenient locations for introducing such programmes and allow good reach, the culture around improving well-being of young people in schools, increasing engagement with teachers and young people and sustaining such programmes are issues that need addressing. Full article
(This article belongs to the Special Issue Adolescent Depression Prevention)
Open AccessArticle The Public Health Impacts of Climate Change in the former Yugoslav Republic of Macedonia
Int. J. Environ. Res. Public Health 2014, 11(6), 5975-5988; doi:10.3390/ijerph110605975
Received: 1 April 2014 / Revised: 30 April 2014 / Accepted: 30 April 2014 / Published: 5 June 2014
Cited by 3 | PDF Full-text (202 KB) | HTML Full-text | XML Full-text
Abstract
Projected climatic changes for the former Yugoslav Republic of Macedonia for the period 2025–2100 will be most intense in the warmest period of the year with more frequent and more intense heat-waves, droughts and flood events compared with the period 1961–1990. The country
[...] Read more.
Projected climatic changes for the former Yugoslav Republic of Macedonia for the period 2025–2100 will be most intense in the warmest period of the year with more frequent and more intense heat-waves, droughts and flood events compared with the period 1961–1990. The country has examined their vulnerabilities to climate change and many public health impacts have been projected. A variety of qualitative and quantitative methodologies were used in the assessment: literature reviews, interviews, focus groups, time series and regression analysis, damage and adaptation cost estimation, and scenario-based assessment. Policies and interventions to minimize the risks and development of long-term adaptation strategies have been explored. The generation of a robust evidence base and the development of stakeholder engagement have been used to support the development of an adaptation strategy and to promote adaptive capacity by improving the resilience of public health systems to climate change. Climate change adaptation has been established as a priority within existing national policy instruments. The lessons learnt from the process are applicable to countries considering how best to improve adaptive capacity and resilience of health systems to climate variability and its associated impacts. Full article
Open AccessArticle Higher Urinary Heavy Metal, Phthalate, and Arsenic but Not Parabens Concentrations in People with High Blood Pressure, U.S. NHANES, 2011–2012
Int. J. Environ. Res. Public Health 2014, 11(6), 5989-5999; doi:10.3390/ijerph110605989
Received: 6 March 2014 / Revised: 26 May 2014 / Accepted: 29 May 2014 / Published: 5 June 2014
Cited by 16 | PDF Full-text (205 KB) | HTML Full-text | XML Full-text
Abstract
Link between environmental chemicals and human health has emerged but not been completely examined in risk factors. Therefore, it was aimed to study the relationships of different sets of urinary environmental chemical concentrations and risk of high blood pressure (BP) in a national,
[...] Read more.
Link between environmental chemicals and human health has emerged but not been completely examined in risk factors. Therefore, it was aimed to study the relationships of different sets of urinary environmental chemical concentrations and risk of high blood pressure (BP) in a national, population-based study. Data were retrieved from United States National Health and Nutrition Examination Surveys, 2011–2012 including demographics, BP readings, and urinary environmental chemical concentrations. Analyses included chi-square test, t-test and survey-weighted logistic regression modeling. After full adjustment (adjusting for urinary creatinine, age, sex, ethnicity, and body mass index), urinary cesium (OR 1.56, 95%CI 1.11–2.20, P = 0.014), molybden (OR 1.46, 95%CI 1.06–2.01, P = 0.023), manganese (OR 1.42, 95%CI 1.09–1.86, P = 0.012), lead (OR 1.58, 95%CI 1.28–1.96, P < 0.001), tin (OR 1.44, 95%CI 1.25–1.66, P < 0.001), antimony (OR 1.39, 95%CI 1.10–1.77, P = 0.010), and tungsten (OR 1.49, 95%CI 1.25–1.77, P < 0.001) concentrations were observed to be associated with high BP. People with higher urinary mono-2-ethyl-5-carboxypentyl phthalate (OR 1.33, 95%CI 1.00–1.62, P = 0.006), mono-n-butyl phthalate (OR 1.35, 95%CI 1.13–1.62, P = 0.002), mono-2-ethyl-5-hydroxyhexyl (OR 1.25, 95%CI 1.05–1.49, P = 0.014), mono-n-methyl phthalate (OR 1.26, 95%CI 1.07–1.48, P = 0.007), mono-2-ethyl-5-oxohexyl (OR 1.25, 95%CI 1.07–1.48, P = 0.009), and monobenzyl phthalate (OR 1.40, 95%CI 1.15–1.69, P = 0.002) tended to have high BP as well. However, there are no clear associations between environmental parabens and high BP, nor between pesticides and high BP. In addition, trimethylarsine oxide (OR 2.47, 95%CI 1.27–4.81, P = 0.011) and dimethylarsonic acid concentrations (OR 1.42, 95%CI 1.12–1.79, P = 0.006) were seen to be associated with high BP. In sum, urinary heavy metal, phthalate, and arsenic concentrations were associated with high BP, although the causal effect cannot be established from the current study design. Elimination of environmental chemicals in humans would still need to be continued. Full article
(This article belongs to the Special Issue Endocrine Disruptors and Human Health)
Open AccessArticle Are We Driving Our Kids to Unhealthy Habits? Results of the Active Healthy Kids Canada 2013 Report Card on Physical Activity for Children and Youth
Int. J. Environ. Res. Public Health 2014, 11(6), 6009-6020; doi:10.3390/ijerph110606009
Received: 25 March 2014 / Revised: 30 April 2014 / Accepted: 12 May 2014 / Published: 5 June 2014
Cited by 9 | PDF Full-text (339 KB) | HTML Full-text | XML Full-text
Abstract
This article examines the time trends in patterns of school travel mode among Canadian children and youth to inform the Active Transportation (AT) indicator of the 2013 Active Healthy Kids Canada Report Card on Physical Activity for Children and Youth. The AT grade
[...] Read more.
This article examines the time trends in patterns of school travel mode among Canadian children and youth to inform the Active Transportation (AT) indicator of the 2013 Active Healthy Kids Canada Report Card on Physical Activity for Children and Youth. The AT grade was assigned based on a comprehensive synthesis of the 2000 and 2010 Physical Activity Monitor studies from the Canadian Fitness and Lifestyle Research Institute and the 1992, 1998, 2005, and 2010 General Social Survey from Statistics Canada. The results showed that in 2013, AT was graded a D, because less than half of Canadian children and youth used only active modes of transportation to get to and from school. The proportion of Canadian children and youth who used only inactive modes of transportation for school travel increased significantly from 51% to 62% over the last decade. Children and youth from larger communities and those with lower household income levels were significantly more likely to use AT than those living in smaller communities and those in higher income households, respectively. In conclusion, motorized transport for school travel has increased steadily over the last decade across Canada. Regional and socio-demographic disparities should be considered in efforts to increase the number of children using AT. Full article
Open AccessArticle Attitude and Impact of Perceived Depression in the Workplace
Int. J. Environ. Res. Public Health 2014, 11(6), 6021-6036; doi:10.3390/ijerph110606021
Received: 28 March 2014 / Revised: 21 May 2014 / Accepted: 3 June 2014 / Published: 6 June 2014
Cited by 2 | PDF Full-text (633 KB) | HTML Full-text | XML Full-text
Abstract
Information concerning the occurrence and consequences of depression in the workplace is scarce. This study estimates how workers perceive depression, to investigate depression-related disabilities, and management of depression in the workplace. This investigation is based on a cross-sectional web-based survey of 1,000 workers
[...] Read more.
Information concerning the occurrence and consequences of depression in the workplace is scarce. This study estimates how workers perceive depression, to investigate depression-related disabilities, and management of depression in the workplace. This investigation is based on a cross-sectional web-based survey of 1,000 workers recruited from online sources. The participants were Brazilian workers, aged 16–64 years, current workers and managers, or who have worked within the past year. Subjects answered a 13-item questionnaire about depression, its related consequences in the workplace, and available resources to handle depression. Common symptoms attributable to depression were crying, loss of interest, and sadness. Almost one in five participants reported having ever been labeled by a doctor/medical professional as suffering from depression. However, the majority of ever-depressed workers (73.5%) remained working. Performance-related impairments were reported by around 60% of depressed workers who continued working. Over half of them also complained about cognitive symptoms (concentration difficulties, indecisiveness, forgetfulness). One in three workers had taken off work due to depression (mean 65.7 out-of-role days), with these periods being lengthier for men than women. Managers underestimated the number of days out-of-role (29.5 days). The findings suggested that identification and management of symptoms of depression should be set as a priority in worker’s health care. Full article
Open AccessArticle Importance-Satisfaction Analysis for Primary Care Physicians’ Perspective on EHRs in Taiwan
Int. J. Environ. Res. Public Health 2014, 11(6), 6037-6051; doi:10.3390/ijerph110606037
Received: 27 February 2014 / Revised: 28 May 2014 / Accepted: 3 June 2014 / Published: 6 June 2014
Cited by 3 | PDF Full-text (574 KB) | HTML Full-text | XML Full-text
Abstract
The Taiwan government has been promoting Electronic Health Records (EHRs) to primary care physicians. How to extend EHRs adoption rate by measuring physicians’ perspective of importance and performance of EHRs has become one of the critical issues for healthcare organizations. We conducted a
[...] Read more.
The Taiwan government has been promoting Electronic Health Records (EHRs) to primary care physicians. How to extend EHRs adoption rate by measuring physicians’ perspective of importance and performance of EHRs has become one of the critical issues for healthcare organizations. We conducted a comprehensive survey in 2010 in which a total of 1034 questionnaires which were distributed to primary care physicians. The project was sponsored by the Department of Health to accelerate the adoption of EHRs. 556 valid responses were analyzed resulting in a valid response rate of 53.77%. The data were analyzed based on a data-centered analytical framework (5-point Likert scale). The mean of importance and satisfaction of four dimensions were 4.16, 3.44 (installation and maintenance), 4.12, 3.51 (product effectiveness), 4.10, 3.31 (system function) and 4.34, 3.70 (customer service) respectively. This study provided a direction to government by focusing on attributes which physicians found important but were dissatisfied with, to close the gap between actual and expected performance of the EHRs. The authorities should emphasize the potential advantages in meaningful use and provide training programs, conferences, technical assistance and incentives to enhance the national level implementation of EHRs for primary physicians. Full article
Open AccessArticle Narratives of Natural Recovery: Youth Experience of Social Inclusion through Green Care
Int. J. Environ. Res. Public Health 2014, 11(6), 6052-6068; doi:10.3390/ijerph110606052
Received: 5 March 2014 / Revised: 19 May 2014 / Accepted: 28 May 2014 / Published: 6 June 2014
PDF Full-text (194 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this study has been to investigate the effects of Green Care services for youth in vulnerable situations risking social exclusion. Green Care enterprises represent alternative arenas in which people can work with animals, agriculture and other tasks related to nature.
[...] Read more.
The aim of this study has been to investigate the effects of Green Care services for youth in vulnerable situations risking social exclusion. Green Care enterprises represent alternative arenas in which people can work with animals, agriculture and other tasks related to nature. We interviewed nine persons, aged 17–27, working in three different places, two or more times over a two-year period. We looked at essential beneficial factors in order to better understand how the “green” element could add to more traditional recovery factors. We found that the youth described core success factors corresponding to well-known recovery factors such as recognition, supportive relationships, motivation, meaning, positive coping, self-esteem, confidence and hope. The effective factors can be described as: (a) The leader’s ability to create a good group atmosphere, (b) the varied tasks which allow step-wise increases in self-efficacy, and (c) experiences with animals and in nature that provide comfort for youth who lack trust in people and need safe situations to recover a positive sense of self. We followed a process in which several persons gradually regained self-respect and the motivation for further education or a job outside the Green Care enterprise. The study illustrates that Green Care can be an important supplement in helping people back to a satisfying life and meaningful roles in society. Full article
Open AccessArticle Identification and Assessment of Potential Water Quality Impact Factors for Drinking-Water Reservoirs
Int. J. Environ. Res. Public Health 2014, 11(6), 6069-6084; doi:10.3390/ijerph110606069
Received: 16 January 2014 / Revised: 19 May 2014 / Accepted: 3 June 2014 / Published: 10 June 2014
Cited by 6 | PDF Full-text (882 KB) | HTML Full-text | XML Full-text
Abstract
Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs.
[...] Read more.
Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources. Full article
(This article belongs to the Special Issue Evaluation of Rural Water Systems and Public Health)
Open AccessArticle Effort-Reward Imbalance at School and Depressive Symptoms in Chinese Adolescents: The Role of Family Socioeconomic Status
Int. J. Environ. Res. Public Health 2014, 11(6), 6085-6098; doi:10.3390/ijerph110606085
Received: 10 March 2014 / Revised: 16 May 2014 / Accepted: 26 May 2014 / Published: 10 June 2014
Cited by 3 | PDF Full-text (218 KB) | HTML Full-text | XML Full-text
Abstract
Depression is a major mental health problem during adolescence. This study, using a sample of Chinese adolescents, examined the separate and combined effects of perceived school-related stress and of family socioeconomic status (SES) on the prevalence of depressive symptoms. A total of 1774
[...] Read more.
Depression is a major mental health problem during adolescence. This study, using a sample of Chinese adolescents, examined the separate and combined effects of perceived school-related stress and of family socioeconomic status (SES) on the prevalence of depressive symptoms. A total of 1774 Chinese students from Grades 7–12 were recruited into our questionnaire survey. School-related stress was measured by the Effort-Reward Imbalance Questionnaire-School Version, family SES was assessed by a standardized question, and depressive symptoms were evaluated by the Center for Epidemiological Studies Depression Scale for Children. Multivariate logistic regression was applied, adjusting for age, gender, grade, smoking, alcohol drinking and physical activity. It was found that high school-related stress and low family SES were associated with elevated odds of depressive symptoms, respectively. The effect of school-related stress was particularly strong in low SES group. In adolescents with both high stress at school and low SES, the odds ratio was 9.18 (95% confidence interval = 6.53–12.89) compared to the reference group (low stress at school and high SES). A significant synergistic interaction effect was observed (synergy index = 2.28, 95% confidence interval = 1.56–3.32). The findings indicated that perceived school-related stress, in terms of effort-reward imbalance, was related to depressive symptoms in this sample of Chinese adolescents. The strong interaction with family SES suggests that health promoting efforts in school settings should be targeted specifically at these socially deprived groups. Full article
Open AccessArticle Biosorption of Strontium from Simulated Nuclear Wastewater by Scenedesmus spinosus under Culture Conditions: Adsorption and Bioaccumulation Processes and Models
Int. J. Environ. Res. Public Health 2014, 11(6), 6099-6118; doi:10.3390/ijerph110606099
Received: 31 March 2014 / Revised: 22 May 2014 / Accepted: 28 May 2014 / Published: 10 June 2014
Cited by 4 | PDF Full-text (1066 KB) | HTML Full-text | XML Full-text
Abstract
Algae biosorption is an ideal wastewater treatment method when coupled with algae growth and biosorption. The adsorption and bioaccumulation of strontium from simulated nuclear wastewater by Scenedesmus spinosus were investigated in this research. One hundred mL of cultured S. spinosus cells with a
[...] Read more.
Algae biosorption is an ideal wastewater treatment method when coupled with algae growth and biosorption. The adsorption and bioaccumulation of strontium from simulated nuclear wastewater by Scenedesmus spinosus were investigated in this research. One hundred mL of cultured S. spinosus cells with a dry weight of 1.0 mg in simulated nuclear wastewater were used to analyze the effects on S. spinosus cell growth as well as the adsorption and bioaccumulation characters under conditions of 25 ± 1 °C with approximately 3,000 lux illumination. The results showed that S. spinosus had a highly selective biosorption capacity for strontium, with a maximum bioremoval ratio of 76%. The adsorbed strontium ion on cell walls was approximately 90% of the total adsorbed amount; the bioaccumulation in the cytoplasm varied by approximately10%. The adsorption quantity could be described with an equilibrium isotherm. The pseudo-second-order kinetic model suggested that adsorption was the rate-limiting step of the biosorption process. A new bioaccumulation model with three parameters was proposed and could give a good fit with the experiment data. The results suggested that S. spinosus may be a potential biosorbent for the treatment of nuclear wastewater in culture conditions. Full article
Figures

Open AccessArticle Water Quality of a Reservoir and Its Major Tributary Located in East-Central Mexico
Int. J. Environ. Res. Public Health 2014, 11(6), 6119-6135; doi:10.3390/ijerph110606119
Received: 13 March 2014 / Revised: 30 May 2014 / Accepted: 30 May 2014 / Published: 10 June 2014
Cited by 1 | PDF Full-text (483 KB) | HTML Full-text | XML Full-text
Abstract
A reservoir with ecological and economic importance and its major tributary, localized in east-central Mexico, were studied. The aim of this work was to know the physicochemical water characteristics of both water bodies and to contrast these by their different uses, and also
[...] Read more.
A reservoir with ecological and economic importance and its major tributary, localized in east-central Mexico, were studied. The aim of this work was to know the physicochemical water characteristics of both water bodies and to contrast these by their different uses, and also estimate overall water quality using a Water Quality Index (WQI). Water samples from the reservoir and the tributary were obtained in different climatic seasons. In the tributary, anoxic and hypoxic conditions and high levels of organic matter, orthophosphate, and ammonium showed that this is strongly impacted by wastewater discharges and that the water is not suitable for different uses; independently of the season, the WQI showed “poor” quality (34.4–47.2). In contrast, in the reservoir a better water quality was determined; the WQI in the sampling months ranged from 72.1–76.6 (“good” quality), and spatially, this was from 66.5–79.5 (“fair” and “good” quality). Full article
Open AccessArticle Parity, Age at First Birth, and Risk of Death from Asthma: Evidence from a Cohort in Taiwan
Int. J. Environ. Res. Public Health 2014, 11(6), 6147-6155; doi:10.3390/ijerph110606147
Received: 21 March 2014 / Revised: 30 May 2014 / Accepted: 3 June 2014 / Published: 11 June 2014
Cited by 1 | PDF Full-text (169 KB) | HTML Full-text | XML Full-text
Abstract
This study was undertaken to examine whether there is an association between age at first birth and parity and risk of asthma death. The study cohort consisted of 1,292,462 women in Taiwan who had a first live birth between 1 January 1978 and
[...] Read more.
This study was undertaken to examine whether there is an association between age at first birth and parity and risk of asthma death. The study cohort consisted of 1,292,462 women in Taiwan who had a first live birth between 1 January 1978 and 31 December 1987. We tracked each woman from the date of their first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate hazard ratios of death from asthma associated with parity and age at first birth. A trend of increasing risk of asthma death was seen with increasing age at first birth. The adjusted hazard ratio was 0.75 (95% confidence interval (CI) = 0.53–1.08) among women with two live births and 0.53 (95% CI = 0.36–0.78) among those with three or more births, compared with women who had one live birth. There was a significant decreasing trend in adjusted hazard ratios of asthma death with increasing parity. This study is the first to provide evidences to support an association between reproductive factors (parity and early age at first birth) and the risk of asthma death. Full article
Open AccessArticle Quality of Water and Antibiotic Resistance of Escherichia coli from Water Sources of Hilly Tribal Villages with and without Integrated Watershed Management—A One Year Prospective Study
Int. J. Environ. Res. Public Health 2014, 11(6), 6156-6170; doi:10.3390/ijerph110606156
Received: 23 April 2014 / Revised: 3 June 2014 / Accepted: 4 June 2014 / Published: 12 June 2014
Cited by 5 | PDF Full-text (224 KB) | HTML Full-text | XML Full-text
Abstract
In many hilly tribal areas of the world, water scarcity is a major problem and diarrhoea is common. Poor quality of water also affects the environment. An integrated watershed management programme (IWMP) aims to increase availability of water and to improve life conditions.
[...] Read more.
In many hilly tribal areas of the world, water scarcity is a major problem and diarrhoea is common. Poor quality of water also affects the environment. An integrated watershed management programme (IWMP) aims to increase availability of water and to improve life conditions. Globally, there is a lack of information on water contamination, occurrence of diarrhoea and antibiotic resistance, a serious global concern, in relation to IWMP in hilly tribal areas. Therefore, a prospective observational study was conducted during 2011–2012 in six villages in a hilly tribal belt of India, three with and three without implementation of an IWMP, to explore quality of water, diarrhoeal cases in the community and antibiotic resistance of Escherichia coli from water sources. The results showed that physico-chemical quality of water was within limits of safe consumption in all samples. The odds of coliform contamination in water samples was 2.3 times higher in non-watershed management villages (NWMV) compared to integrated watershed management villages (IWMV) (95% CI 0.8–6.45, p = 0.081). The number of diarrhoeal cases (18/663 vs. 42/639, p < 0.05) was lower in IWMV as compared to NWMV. Overall E. coli isolates showed high susceptibility to antibiotics. Resistance to a wider range of antibiotics was observed in NWMV. Full article
Open AccessArticle Engaging with Peri-Urban Woodlands in England: The Contribution to People’s Health and Well-Being and Implications for Future Management
Int. J. Environ. Res. Public Health 2014, 11(6), 6171-6192; doi:10.3390/ijerph110606171
Received: 25 March 2014 / Revised: 21 May 2014 / Accepted: 31 May 2014 / Published: 12 June 2014
Cited by 6 | PDF Full-text (1194 KB) | HTML Full-text | XML Full-text
Abstract
In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin’s ideas of co-construction and Gibson’s theory of affordances. We focus on peri-urban woodlands in England as important places where
[...] Read more.
In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin’s ideas of co-construction and Gibson’s theory of affordances. We focus on peri-urban woodlands in England as important places where people can interact with nature for health and well-being. Qualitative data were collected in situ via walks in the woods, focus group discussions and photo elicitation, with a sample of 49 people. These methods provide rich data on the wide range of meanings associated with woodlands that can have a perceived impact on people’s health and well-being. The findings link to contemporary debates about health, well-being and ecosystem services. We explore the inter-play between attributes of the physical environment and the range of facilities provided to enable access, social interactions and the benefits people attribute to their woodland experiences. We conclude that peri-urban woodlands can clearly contribute to self-reported health and well-being in multiple ways, and that organized activities can be important for those who face barriers to accessing woodlands. A strong message emerging from the research is the opportunity afforded by woodlands for social connections with others, as well as the provision of a range of sensory benefits and opportunities to observe and enjoy seasonal change in woodlands. Mental restoration via connection with nature also emerged as important, confirming previous research. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
Open AccessArticle Dietary Phthalate Exposure in Pregnant Women and the Impact of Consumer Practices
Int. J. Environ. Res. Public Health 2014, 11(6), 6193-6215; doi:10.3390/ijerph110606193
Received: 4 April 2014 / Revised: 3 June 2014 / Accepted: 4 June 2014 / Published: 12 June 2014
Cited by 12 | PDF Full-text (251 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Phthalates are ubiquitous endocrine-disrupting chemicals that are contaminants in food and contribute to significant dietary exposures. We examined associations between reported consumption of specific foods and beverages and first trimester urinary phthalate metabolite concentrations in 656 pregnant women within a multicenter cohort study,
[...] Read more.
Phthalates are ubiquitous endocrine-disrupting chemicals that are contaminants in food and contribute to significant dietary exposures. We examined associations between reported consumption of specific foods and beverages and first trimester urinary phthalate metabolite concentrations in 656 pregnant women within a multicenter cohort study, The Infant Development and Environment Study (TIDES), using multivariate regression analysis. We also examined whether reported use of ecofriendly and chemical-free products was associated with lower phthalate biomarker levels in comparison to not following such practices. Consumption of one additional serving of dairy per week was associated with decreases of 1% in the sum of di-2-ethylhexyl phthalate (DEHP) metabolite levels (95% CI: −2.0, −0.2). Further, participants who reported sometimes eating homegrown food had monoisobutyl phthalate (MiBP) levels that were 16.6% lower (95% CI: −29.5, −1.3) in comparison to participants in the rarely/never category. In contrast to rarely/never eating frozen fruits and vegetables, participants who reported sometimes following this practice had monobenzyl phthalate (MBzP) levels that were 21% higher (95% CI: 3.3, 41.7) than rarely/ever respondents. Future study on prenatal dietary phthalate exposure and the role of consumer product choices in reducing such exposure is needed. Full article
Open AccessArticle A Study of Handling Cytotoxic Drugs and Risk of Birth Defects in Offspring of Female Veterinarians
Int. J. Environ. Res. Public Health 2014, 11(6), 6216-6230; doi:10.3390/ijerph110606216
Received: 30 April 2014 / Revised: 3 June 2014 / Accepted: 4 June 2014 / Published: 12 June 2014
Cited by 1 | PDF Full-text (226 KB) | HTML Full-text | XML Full-text
Abstract
We examined the association of occupational exposure to handling cytotoxic drugs at work with risk of birth defects among a cohort of female veterinarians. This study is a follow up survey of 321 female participants (633 pregnancies) who participated in the Health Risks
[...] Read more.
We examined the association of occupational exposure to handling cytotoxic drugs at work with risk of birth defects among a cohort of female veterinarians. This study is a follow up survey of 321 female participants (633 pregnancies) who participated in the Health Risks of Australian Veterinarian project. Data on pregnancies and exposure during each pregnancy was obtained by self-administered mailed questionnaire. Female veterinarians handling cytotoxic drugs during their pregnancy had a two-fold increased risk of birth defects in their offspring (RR = 2.08, 95% CI (1.05–4.15)). Results were consistent in subgroup analysis of those who graduated during the period of 1961 to 1980 (RR = 5.04, 95% CI (1.81, 14.03) and in those working specifically in small and large animal practice. There was no increased risk in the subgroup that graduated after 1980. Women with unplanned pregnancies were more likely to handle cytotoxic drugs on a daily basis (RR = 1.86, 95% CI, 1.00–3.48) and had a higher increased risk of birth defects than those who planned their pregnancies in recent graduates and in those who worked specifically in small animal practice (RR = 2.53, 95% CI, 1.18–5.42). This study suggests that the adverse effects of handling cytotoxic drugs in pregnant women may include an increased risk of birth defects. Pregnancy intention status is an important health behavior and should be considered in prenatal programs. Full article
Open AccessArticle Patients’ Perspective of the Design of Provider-Patients Electronic Communication Services
Int. J. Environ. Res. Public Health 2014, 11(6), 6231-6245; doi:10.3390/ijerph110606231
Received: 27 February 2014 / Revised: 3 June 2014 / Accepted: 6 June 2014 / Published: 12 June 2014
PDF Full-text (503 KB) | HTML Full-text | XML Full-text
Abstract
Information Delivery is one the most important tasks in healthcare practice. This article discusses patient’s tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also
[...] Read more.
Information Delivery is one the most important tasks in healthcare practice. This article discusses patient’s tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design. Full article
Figures

Open AccessArticle The Deployment of Carbon Monoxide Wireless Sensor Network (CO-WSN) for Ambient Air Monitoring
Int. J. Environ. Res. Public Health 2014, 11(6), 6246-6264; doi:10.3390/ijerph110606246
Received: 24 April 2014 / Revised: 3 June 2014 / Accepted: 4 June 2014 / Published: 16 June 2014
Cited by 4 | PDF Full-text (1872 KB) | HTML Full-text | XML Full-text
Abstract
Wireless sensor networks are becoming increasingly important as an alternative solution for environment monitoring because they can reduce cost and complexity. Also, they can improve reliability and data availability in places where traditional monitoring methods are difficult to site. In this study, a
[...] Read more.
Wireless sensor networks are becoming increasingly important as an alternative solution for environment monitoring because they can reduce cost and complexity. Also, they can improve reliability and data availability in places where traditional monitoring methods are difficult to site. In this study, a carbon monoxide wireless sensor network (CO-WSN) was developed to measure carbon monoxide concentrations at a major traffic intersection near the University of Cincinnati main campus. The system has been deployed over two weeks during Fall 2010, and Summer 2011–2012, traffic data was also recorded by using a manual traffic counter and a video camcorder to characterize vehicles at the intersection 24 h, particularly, during the morning and evening peak hour periods. According to the field test results, the 1 hr-average CO concentrations were found to range from 0.1–1.0 ppm which is lower than the National Ambient Air Quality Standards (NAAQS) 35 ppm on a one-hour averaging period. During rush hour periods, the traffic volume at the intersection varied from 2,067 to 3,076 vehicles per hour with 97% being passenger vehicles. Furthermore, the traffic volume based on a 1-h average showed good correlation (R2 = 0.87) with the 1-h average CO-WSN concentrations for morning and evening peak time periods whereas CO-WSN results provided a moderate correlation (R2 = 0.42) with 24 hours traffic volume due to fluctuated changes of meteorological conditions. It is concluded that the performance and the reliability of wireless ambient air monitoring networks can be used as an alternative method for real time air monitoring. Full article
Figures

Open AccessArticle Protecting Health from Climate Change in the WHO European Region
Int. J. Environ. Res. Public Health 2014, 11(6), 6265-6280; doi:10.3390/ijerph110606265
Received: 31 March 2014 / Revised: 20 May 2014 / Accepted: 26 May 2014 / Published: 16 June 2014
Cited by 3 | PDF Full-text (661 KB) | HTML Full-text | XML Full-text
Abstract
“How far are we in implementing climate change and health action in the WHO European Region?” This was the question addressed to representatives of WHO European Member States of the working group on health in climate change (HIC). Twenty-two Member States provided answers
[...] Read more.
“How far are we in implementing climate change and health action in the WHO European Region?” This was the question addressed to representatives of WHO European Member States of the working group on health in climate change (HIC). Twenty-two Member States provided answers to a comprehensive questionnaire that focused around eight thematic areas (Governance; Vulnerability, impact and adaptation (health) assessments; Adaptation strategies and action plans; Climate change mitigation; Strengthening health systems; Raising awareness and building capacity; Greening health services; and Sharing best practices). Strong areas of development are climate change vulnerability and impact assessments, as well as strengthening health systems and awareness raising. Areas where implementation would benefit from further action are the development of National Health Adaptation Plans, greening health systems, sharing best practice and reducing greenhouse gas emissions in other sectors. At the Parma Conference in 2010, the European Ministerial Commitment to Act on climate change and health and the European Regional Framework for Action to protect health from climate change were endorsed by fifty three European Member States. The results of this questionnaire are the most comprehensive assessment so far of the progress made by WHO European Member States to protecting public health from climate change since the agreements in Parma and the World Health Assembly Resolution in 2008. Full article
Open AccessArticle Microbial Community Structures and Dynamics in the O3/BAC Drinking Water Treatment Process
Int. J. Environ. Res. Public Health 2014, 11(6), 6281-6290; doi:10.3390/ijerph110606281
Received: 21 April 2014 / Revised: 30 May 2014 / Accepted: 30 May 2014 / Published: 16 June 2014
Cited by 2 | PDF Full-text (626 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Effectiveness of drinking water treatment, in particular pathogen control during the water treatment process, is always a major public health concern. In this investigation, the application of PCR-DGGE technology to the analysis of microbial community structures and dynamics in the drinking water treatment
[...] Read more.
Effectiveness of drinking water treatment, in particular pathogen control during the water treatment process, is always a major public health concern. In this investigation, the application of PCR-DGGE technology to the analysis of microbial community structures and dynamics in the drinking water treatment process revealed several dominant microbial populations including: α-Proteobacteria, β-Proteobacteria, γ-Proteobacteria, Bacteroidetes, Actinobacteria Firmicutes and Cyanobacteria. α-Proteobacteria and β-Proteobacteria were the dominant bacteria during the whole process. Bacteroidetes and Firmicutes were the dominant bacteria before and after treatment, respectively. Firmicutes showed season-dependent changes in population dynamics. Importantly, γ-Proteobacteria, which is a class of medically important bacteria, was well controlled by the O3/biological activated carbon (BAC) treatment, resulting in improved effluent water bio-safety. Full article
Open AccessArticle Evaluating Determinants of Environmental Risk Perception for Risk Management in Contaminated Sites
Int. J. Environ. Res. Public Health 2014, 11(6), 6291-6313; doi:10.3390/ijerph110606291
Received: 6 March 2014 / Revised: 4 June 2014 / Accepted: 5 June 2014 / Published: 16 June 2014
Cited by 3 | PDF Full-text (1005 KB) | HTML Full-text | XML Full-text
Abstract
Understanding the differences in the risk judgments of residents of industrial communities potentially provides insights into how to develop appropriate risk communication strategies. This study aimed to explore citizens’ fundamental understanding of risk-related judgments and to identify the factors contributing to perceived risks.
[...] Read more.
Understanding the differences in the risk judgments of residents of industrial communities potentially provides insights into how to develop appropriate risk communication strategies. This study aimed to explore citizens’ fundamental understanding of risk-related judgments and to identify the factors contributing to perceived risks. An exploratory model was created to investigate the public’s risk judgments. In this model, the relationship between laypeople’s perceived risks and the factors related to the physical nature of risks (such as perceived probability of environmental contamination, probability of receiving impacts, and severity of catastrophic consequences) were examined by means of multiple regression analysis. Psychological factors, such as the ability to control the risks, concerns, experiences, and perceived benefits of industrial development were also included in the analysis. The Maptaphut industrial area in Rayong Province, Thailand was selected as a case study. A survey of 181 residents of communities experiencing different levels of hazardous gas contamination revealed rational risk judgments by inhabitants of high-risk and moderate-risk communities, based on their perceived probability of contamination, probability of receiving impacts, and perceived catastrophic consequences. However, risks assessed by people in low-risk communities could not be rationally explained and were influenced by their collective experiences. Full article
Open AccessArticle Validation of a Framework for Measuring Hospital Disaster Resilience Using Factor Analysis
Int. J. Environ. Res. Public Health 2014, 11(6), 6335-6353; doi:10.3390/ijerph110606335
Received: 1 April 2014 / Revised: 6 June 2014 / Accepted: 9 June 2014 / Published: 18 June 2014
Cited by 5 | PDF Full-text (244 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This
[...] Read more.
Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies. Full article
(This article belongs to the Special Issue Preparedness and Emergency Response)
Open AccessArticle Health Risk Assessment of Ambient Air Concentrations of Benzene, Toluene and Xylene (BTX) in Service Station Environments
Int. J. Environ. Res. Public Health 2014, 11(6), 6354-6374; doi:10.3390/ijerph110606354
Received: 30 April 2014 / Revised: 6 June 2014 / Accepted: 9 June 2014 / Published: 18 June 2014
Cited by 7 | PDF Full-text (2885 KB) | HTML Full-text | XML Full-text
Abstract
A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted
[...] Read more.
A comprehensive evaluation of the adverse health effects of human exposures to BTX from service station emissions was carried out using BTX exposure data from the scientific literature. The data was grouped into different scenarios based on activity, location and occupation and plotted as Cumulative Probability Distributions (CPD) plots. Health risk was evaluated for each scenario using the Hazard Quotient (HQ) at 50% (CEXP50) and 95% (CEXP95) exposure levels. HQ50 and HQ95 > 1 were obtained with benzene in the scenario for service station attendants and mechanics repairing petrol dispensing pumps indicating a possible health risk. The risk was minimized for service stations using vapour recovery systems which greatly reduced the benzene exposure levels. HQ50 and HQ95 < 1 were obtained for all other scenarios with benzene suggesting minimal risk for most of the exposed population. However, HQ50 and HQ95 < 1 was also found with toluene and xylene for all scenarios, suggesting minimal health risk. The lifetime excess Cancer Risk (CR) and Overall Risk Probability for cancer on exposure to benzene was calculated for all Scenarios and this was higher amongst service station attendants than any other scenario. Full article
Open AccessArticle The Role of Civic Engagement for Men’s Health and Well Being in Norway—A Contribution to Public Health
Int. J. Environ. Res. Public Health 2014, 11(6), 6375-6387; doi:10.3390/ijerph110606375
Received: 25 March 2014 / Revised: 5 June 2014 / Accepted: 13 June 2014 / Published: 18 June 2014
PDF Full-text (187 KB) | HTML Full-text | XML Full-text
Abstract
Objectives: Using the example of older men volunteering on teams that restore historic ships, this article examines the effects of volunteering on the well-being of older adults. We consider particularly how volunteering impacts levels of social engagement and explore how the men’s
[...] Read more.
Objectives: Using the example of older men volunteering on teams that restore historic ships, this article examines the effects of volunteering on the well-being of older adults. We consider particularly how volunteering impacts levels of social engagement and explore how the men’s reminiscences as they bond with their fellows in highly skilled work helps integrate their life experiences. Methods: Data are based on 14 in-depth interviews with volunteers working on historic vessels in Norway. Self-rated health, functional dependency, and well-being measures were collected using semi-structured questionnaire. Results: Volunteering in a context of skilled, group-bonded, culturally prestigious activity adds considerably to social capital among elderly men in Norway. Respondents explain their involvement in terms of prior relationships and current social benefits. They spoke of the value of maintaining past personal connections to a particular ship, shipping company, or local community. These were reinforced by current social benefits, such as the experience of companionship, unity, and the feeling of making an important contribution to the society. The group dynamics and strong collective aspect of these voluntary associations maintains internal cohesion, and members only leave when forced by increasing age, poor health, or insufficient financial resources. Conclusions: This article illuminates a case study of gender-specific engagement of older adults in volunteer roles returning high benefits both to participants and society, and adds knowledge to public-health programs and policies in the volunteer- and cultural-heritage sector. Full article
Open AccessArticle Evaluating the Impact of Environmental Temperature on Global Highly Pathogenic Avian Influenza (HPAI) H5N1 Outbreaks in Domestic Poultry
Int. J. Environ. Res. Public Health 2014, 11(6), 6388-6399; doi:10.3390/ijerph110606388
Received: 16 March 2014 / Revised: 6 May 2014 / Accepted: 8 May 2014 / Published: 19 June 2014
Cited by 2 | PDF Full-text (871 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The emergence and spread of highly pathogenic avian influenza (HPAI) A virus subtype H5N1 in Asia, Europe and Africa has had an enormously socioeconomic impact and presents an important threat to human health because of its efficient animal-to-human transmission. Many factors contribute to
[...] Read more.
The emergence and spread of highly pathogenic avian influenza (HPAI) A virus subtype H5N1 in Asia, Europe and Africa has had an enormously socioeconomic impact and presents an important threat to human health because of its efficient animal-to-human transmission. Many factors contribute to the occurrence and transmission of HPAI H5N1 virus, but the role of environmental temperature remains poorly understood. Based on an approach of integrating a Bayesian Cox proportional hazards model and a Besag-York-Mollié (BYM) model, we examined the specific impact of environmental temperature on HPAI H5N1 outbreaks in domestic poultry around the globe during the period from 1 December 2003 to 31 December 2009. The results showed that higher environmental temperature was a significant risk factor for earlier occurrence of HPAI H5N1 outbreaks in domestic poultry, especially for a temperature of 25 °C. Its impact varied with epidemic waves (EWs), and the magnitude of the impact tended to increase over EWs. Full article
Open AccessArticle Humidity and Gravimetric Equivalency Adjustments for Nephelometer-Based Particulate Matter Measurements of Emissions from Solid Biomass Fuel Use in Cookstoves
Int. J. Environ. Res. Public Health 2014, 11(6), 6400-6416; doi:10.3390/ijerph110606400
Received: 10 February 2014 / Revised: 16 May 2014 / Accepted: 9 June 2014 / Published: 19 June 2014
Cited by 6 | PDF Full-text (501 KB) | HTML Full-text | XML Full-text
Abstract
Great uncertainty exists around indoor biomass burning exposure-disease relationships due to lack of detailed exposure data in large health outcome studies. Passive nephelometers can be used to estimate high particulate matter (PM) concentrations during cooking in low resource environments. Since passive nephelometers do
[...] Read more.
Great uncertainty exists around indoor biomass burning exposure-disease relationships due to lack of detailed exposure data in large health outcome studies. Passive nephelometers can be used to estimate high particulate matter (PM) concentrations during cooking in low resource environments. Since passive nephelometers do not have a collection filter they are not subject to sampler overload. Nephelometric concentration readings can be biased due to particle growth in high humid environments and differences in compositional and size dependent aerosol characteristics. This paper explores relative humidity (RH) and gravimetric equivalency adjustment approaches to be used for the pDR-1000 used to assess indoor PM concentrations for a cookstove intervention trial in Nepal. Three approaches to humidity adjustment performed equivalently (similar root mean squared error). For gravimetric conversion, the new linear regression equation with log-transformed variables performed better than the traditional linear equation. In addition, gravimetric conversion equations utilizing a spline or quadratic term were examined. We propose a humidity adjustment equation encompassing the entire RH range instead of adjusting for RH above an arbitrary 60% threshold. Furthermore, we propose new integrated RH and gravimetric conversion methods because they have one response variable (gravimetric PM2.5 concentration), do not contain an RH threshold, and is straightforward. Full article
(This article belongs to the Special Issue Air Pollution Modeling)
Open AccessArticle Environmental Factors and Multiple Sclerosis Severity: A Descriptive Study
Int. J. Environ. Res. Public Health 2014, 11(6), 6417-6432; doi:10.3390/ijerph110606417
Received: 15 April 2014 / Revised: 4 June 2014 / Accepted: 5 June 2014 / Published: 19 June 2014
Cited by 7 | PDF Full-text (225 KB) | HTML Full-text | XML Full-text
Abstract
Growing evidence suggests that environmental factors play a key role in the onset of multiple sclerosis (MS). This study was conducted to examine whether environmental factors may also be associated with the evolution of the disease. We collected data on smoking habits, sunlight
[...] Read more.
Growing evidence suggests that environmental factors play a key role in the onset of multiple sclerosis (MS). This study was conducted to examine whether environmental factors may also be associated with the evolution of the disease. We collected data on smoking habits, sunlight exposure and diet (particularly consumption of vitamin D-rich foods) from a sample of 131 MS patients. We also measured their serum vitamin D concentration. The clinical impact of MS was quantified using the Multiple Sclerosis Severity Score (MSSS); MS was considered “severe” in patients with MSSS ≥ 6, and “mild” in patients with MSSS ≤ 1. The results showed a strong association between serum vitamin D concentration and both sunlight exposure (26.4 ± 11.9 ng/mL vs. 16.5 ± 12.1 ng/mL, p = 0.0004) and a fish-rich diet (23.5 ± 12.1 ng/mL vs. 16.1 ± 12.4 ng/mL, p = 0.005). Patients reporting frequent sunlight exposure had a lower MSSS (2.6 ± 2.4 h vs. 4.6 ± 2.6 h, p < 0.001). The mild MS patients reported much more frequent sunlight exposure (75% mild MS vs. 25% severe MS p = 0.004, Chi square test). A higher serum vitamin D concentration determined a lower risk of developing severe MS, adjusted for sunlight exposure (OR = 0.92 for one unit increase in vitamin D, 95% CI: 0.86–0.97, p = 0.005). A stronger inverse association emerged between frequent sunlight exposure and the risk of severe MS (OR = 0.26, 95% CI: 0.09–0.71, p = 0.009). Our data show that an appropriate diet and adequate expose to sunlight are associated with less aggressive MS. Full article
Open AccessArticle Building Resilience against Climate Effects—A Novel Framework to Facilitate Climate Readiness in Public Health Agencies
Int. J. Environ. Res. Public Health 2014, 11(6), 6433-6458; doi:10.3390/ijerph110606433
Received: 8 April 2014 / Revised: 3 June 2014 / Accepted: 6 June 2014 / Published: 20 June 2014
Cited by 11 | PDF Full-text (569 KB) | HTML Full-text | XML Full-text
Abstract
Climate change is anticipated to have several adverse health impacts. Managing these risks to public health requires an iterative approach. As with many risk management strategies related to climate change, using modeling to project impacts, engaging a wide range of stakeholders, and regularly
[...] Read more.
Climate change is anticipated to have several adverse health impacts. Managing these risks to public health requires an iterative approach. As with many risk management strategies related to climate change, using modeling to project impacts, engaging a wide range of stakeholders, and regularly updating models and risk management plans with new information—hallmarks of adaptive management—are considered central tenets of effective public health adaptation. The Centers for Disease Control and Prevention has developed a framework, entitled Building Resilience Against Climate Effects, or BRACE, to facilitate this process for public health agencies. Its five steps are laid out here. Following the steps laid out in BRACE will enable an agency to use the best available science to project likely climate change health impacts in a given jurisdiction and prioritize interventions. Adopting BRACE will also reinforce public health’s established commitment to evidence-based practice and institutional learning, both of which will be central to successfully engaging the significant new challenges that climate change presents. Full article
(This article belongs to the collection Climate Change and Human Health)
Open AccessArticle Differences in Birthweight Outcomes: A Longitudinal Study Based on Siblings
Int. J. Environ. Res. Public Health 2014, 11(6), 6472-6484; doi:10.3390/ijerph110606472
Received: 10 March 2014 / Revised: 8 May 2014 / Accepted: 14 May 2014 / Published: 20 June 2014
Cited by 1 | PDF Full-text (202 KB) | HTML Full-text | XML Full-text
Abstract
Objectives: We investigate the differences in birthweight between first- and second-borns, evaluating the impact of changes in pregnancy (e.g., gestational age), demographic (e.g., age), and social (e.g., education level, marital status) maternal characteristics. Data and Methods: All analyses are performed on data collected
[...] Read more.
Objectives: We investigate the differences in birthweight between first- and second-borns, evaluating the impact of changes in pregnancy (e.g., gestational age), demographic (e.g., age), and social (e.g., education level, marital status) maternal characteristics. Data and Methods: All analyses are performed on data collected in Umbria (Italy) taking into account a set of 792 women who delivered twice from 2005 to 2008. Firstly, we use a univariate paired t-test for the comparison between weights of first- and second-borns; Secondly, we use linear and nonlinear regression approaches in order to: (i) evaluate the effect of demographic and social maternal characteristics and (ii) predict the odds-ratio of low and high birthweight infants, respectively. Results: We find that the birthweight of second-borns is significantly higher than that of first-borns. Statistically significant effects are related with a longer gestational age, an increased number of visits during the pregnancy, and the gender of infants. On the other hand, we do not observe any significant effect related with mother’s age and with other characteristics of interest. Full article
Open AccessArticle Prevalence of Self-Reported Shaking and Smothering and Their Associations with Co-Sleeping among 4-Month-Old Infants in Japan
Int. J. Environ. Res. Public Health 2014, 11(6), 6485-6493; doi:10.3390/ijerph110606485
Received: 22 April 2014 / Revised: 6 June 2014 / Accepted: 11 June 2014 / Published: 20 June 2014
Cited by 8 | PDF Full-text (160 KB) | HTML Full-text | XML Full-text
Abstract
Few studies have investigated the prevalence of shaking and smothering and whether they are associated with co-sleeping. In Japan, co-sleeping is common during infancy and early childhood. This study investigates the prevalence of shaking and smothering and their associations with co-sleeping among 4-month-old
[...] Read more.
Few studies have investigated the prevalence of shaking and smothering and whether they are associated with co-sleeping. In Japan, co-sleeping is common during infancy and early childhood. This study investigates the prevalence of shaking and smothering and their associations with co-sleeping among 4-month-old infants in Japan. A questionnaire was administered to mothers who participated in a 4-month health checkup program in Kamagaya City in Japan (n = 1307; valid response rate, 82%). The questionnaire investigated the frequency of self-reported shaking and smothering during the past one month, co-sleeping status, and living arrangements with grandparents, in addition to traditional risk factors such as stress due to crying. Associations between co-sleeping and self-reported shaking or smothering were analyzed using multiple logistic regression. The prevalence of self-reported shaking and smothering at least one time during the past one month was 3.4% (95% confidence interval (CI), 2.4%–4.3%) and 2.4% (95% CI, 1.5%–3.2%), respectively. Co-sleeping was marginally associated with the amount of crying and not associated with stress due to crying. Further, co-sleeping was not associated with either self-reported shaking or smothering, although stress due to crying showed strong association with shaking and smothering. Co-sleeping was not a risk factor for shaking and smothering. Full article
Open AccessArticle Interaction of Intercellular Adhesion Molecule 1 (ICAM1) Polymorphisms and Environmental Tobacco Smoke on Childhood Asthma
Int. J. Environ. Res. Public Health 2014, 11(6), 6504-6516; doi:10.3390/ijerph110606504
Received: 10 March 2014 / Revised: 29 May 2014 / Accepted: 11 June 2014 / Published: 20 June 2014
Cited by 3 | PDF Full-text (306 KB) | HTML Full-text | XML Full-text
Abstract
Asthma is a chronic disease that is particularly common in children. The association between polymorphisms of the gene encoding intercellular adhesion molecule 1 (ICAM1) and gene-environment interactions with childhood asthma has not been fully investigated. A cross-sectional study was undertaken to investigate these
[...] Read more.
Asthma is a chronic disease that is particularly common in children. The association between polymorphisms of the gene encoding intercellular adhesion molecule 1 (ICAM1) and gene-environment interactions with childhood asthma has not been fully investigated. A cross-sectional study was undertaken to investigate these associations among children in Taiwan. The effects of two functional single-nucleotide polymorphisms (SNPs) of ICAM1, rs5491 (K56M) and rs5498 (K469E), and exposure to environmental tobacco smoke (ETS) were studied. Two hundred and eighteen asthmatic and 877 nonasthmatic children were recruited from elementary schools. It was found that the genetic effect of each SNP was modified by the other SNP and by exposure to ETS. The risk of asthma was higher for children carrying the rs5491 AT or TT genotypes and the rs5498 GG genotype (odds ratio = 1.68, 95% confidence interval 1.09–2.59) than for those with the rs5491 AA and rs5498 AA or AG genotypes (the reference group). The risk for the other two combinations of genotypes did not differ significantly from that of the reference group (p of interaction = 0.0063). The two studied ICAM1 SNPs were associated with childhood asthma among children exposed to ETS, but not among those without ETS exposure (p of interaction = 0.05 and 0.01 for rs5491 and rs5498, respectively). Both ICAM1 and ETS, and interactions between these two factors are likely to be involved in the development of asthma in childhood. Full article
(This article belongs to the Special Issue Genetic Impact on the Development of Allergic Disease)
Open AccessArticle Field Survey of Health Perception and Complaints of Pennsylvania Residents in the Marcellus Shale Region
Int. J. Environ. Res. Public Health 2014, 11(6), 6517-6527; doi:10.3390/ijerph110606517
Received: 31 March 2014 / Revised: 10 June 2014 / Accepted: 12 June 2014 / Published: 20 June 2014
Cited by 5 | PDF Full-text (175 KB) | HTML Full-text | XML Full-text
Abstract
Pennsylvania Marcellus Shale region residents have reported medical symptoms they believe are related to nearby Unconventional Natural Gas Development (UNGD). Associations between medical symptoms and UNGD have been minimally explored. The objective of this descriptive study is to explore whether shale region Pennsylvania
[...] Read more.
Pennsylvania Marcellus Shale region residents have reported medical symptoms they believe are related to nearby Unconventional Natural Gas Development (UNGD). Associations between medical symptoms and UNGD have been minimally explored. The objective of this descriptive study is to explore whether shale region Pennsylvania residents perceive UNGD as a health concern and whether they attribute health symptoms to UNGD exposures. A questionnaire was administered to adult volunteers with medical complaints in a primary-care medical office in a county where UNGD was present. Participants were asked whether they were concerned about health effects from UNGD, and whether they attributed current symptoms to UNGD or to some other environmental exposure. There were 72 respondents; 22% perceived UNGD as a health concern and 13% attributed medical symptoms to UNGD exposures. Overall, 42% attributed one or more of their medical symptoms to environmental causes, of which UNGD was the most frequent. A medical record review conducted on six participants who attributed their medical symptoms to UNGD revealed that only one of these records documented both the symptoms in question and the attribution to UNGD. The results of this pilot study suggest that there is substantial concern about adverse health effects of UNGD among Pennsylvania Marcellus Shale residents, and that these concerns may not be adequately represented in medical records. Further efforts to determine the relationship between UNGD and health are recommended in order to address community concerns. Full article
Figures

Open AccessArticle The Role of Open Space in Urban Neighbourhoods for Health-Related Lifestyle
Int. J. Environ. Res. Public Health 2014, 11(6), 6547-6570; doi:10.3390/ijerph110606547
Received: 8 February 2014 / Revised: 9 June 2014 / Accepted: 12 June 2014 / Published: 23 June 2014
Cited by 2 | PDF Full-text (3795 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in
[...] Read more.
The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in the early nineties. Compared to the older neighborhoods, these are typically single-use residential areas, with small open spaces and poor landscape design. The research is concerned with the quality of life in these areas, especially from the perspective of the vulnerable users, like the elderly and children. Both depend on easily accessible green areas in close proximity to their homes. The hypothesis is that the poor open space quality affects their health-related behavior and their perceived health status. The research has three methodological phases: (1) a comparison between urban residential areas by criteria describing their physical characteristics; (2) behavior observation and mapping and (3) a resident opinion survey. The results confirm differences between open spaces of the selected residential areas as well as their relation with outdoor activities: a lack of outdoor programs correlates with poor variety of outdoor activities, limited to transition type, less time spent outdoors and lower satisfaction with their home environment. The survey also disclosed a strong influence of a set of socio-economic variables such as education and economic status on physical activity and self-perceived health status of people. The results therefore confirm the hypothesis especially for less affluent and educated; i.e., vulnerable groups. Full article
Figures

Open AccessArticle Identifying Determinants of Oncomelania hupensis Habitats and Assessing the Effects of Environmental Control Strategies in the Plain Regions with the Waterway Network of China at the Microscale
Int. J. Environ. Res. Public Health 2014, 11(6), 6571-6585; doi:10.3390/ijerph110606571
Received: 21 March 2014 / Revised: 4 June 2014 / Accepted: 5 June 2014 / Published: 23 June 2014
Cited by 5 | PDF Full-text (1203 KB) | HTML Full-text | XML Full-text
Abstract
This study aims to identify the landscape ecological determinants related to Oncomelania hupensis distribution, map the potential high risk of O. hupensis habitats at the microscale, and assess the effects of two environmental control strategies. Sampling was performed on 242 snail sites and
[...] Read more.
This study aims to identify the landscape ecological determinants related to Oncomelania hupensis distribution, map the potential high risk of O. hupensis habitats at the microscale, and assess the effects of two environmental control strategies. Sampling was performed on 242 snail sites and 726 non-snail sites throughout Qianjiang City, Hubei Province, China. An integrated approach of landscape pattern analysis coupled with multiple logistic regression modeling was applied to investigate the effects of environmental factors on snail habitats. The risk probability of snail habitats positively correlated with patch fractal dimension (FD), paddy farm land proportion, and wetness index but inversely correlated with categorized normalized difference vegetation index (NDVI) and elevation. These findings indicate that FD can identify irregular features (e.g., irrigation ditches) in plain regions and that a moderate NDVI increases the microscale risk probability. Basing on the observed determinants, we predicted a map showing high-risk areas of snail habitats and simulated the effects of conduit hardening and paddy farming land rotation to dry farming land. The two approaches were confirmed effective for snail control. These findings provide an empirical basis for health professionals in local schistosomiasis control stations to identify priority areas and promising environmental control strategies for snail control and prevention. Full article
(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)
Open AccessArticle Nature-Based Stress Management Course for Individuals at Risk of Adverse Health Effects from Work-Related Stress—Effects on Stress Related Symptoms, Workability and Sick Leave
Int. J. Environ. Res. Public Health 2014, 11(6), 6586-6611; doi:10.3390/ijerph110606586
Received: 14 April 2014 / Revised: 3 June 2014 / Accepted: 12 June 2014 / Published: 23 June 2014
Cited by 3 | PDF Full-text (665 KB) | HTML Full-text | XML Full-text
Abstract
Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as
[...] Read more.
Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as outcome measures. Few studies have used sick-leave to compare effects of stress interventions. A new approach is to use nature and garden in a multimodal stress management context. This study aimed to explore effects on burnout, work ability, stress-related health symptoms, and sick leave for 33 women participating in a 12-weeks nature based stress management course and to investigate how the nature/garden activities were experienced. A mixed method approach was used. Measures were taken at course start and three follow-ups. Results showed decreased burnout-scores and long-term sick leaves, and increased work ability; furthermore less stress-related symptoms were reported. Tools and strategies to better handle stress were achieved and were widely at use at all follow-ups. The garden and nature content played an important role for stress relief and for tools and strategies to develop. The results from this study points to beneficial effects of using garden activities and natural environments in a stress management intervention. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
Figures

Review

Jump to: Research, Other

Open AccessReview Prevention of Adolescent Depression in the Spanish-Speaking World
Int. J. Environ. Res. Public Health 2014, 11(6), 5665-5683; doi:10.3390/ijerph110605665
Received: 15 February 2014 / Revised: 19 May 2014 / Accepted: 20 May 2014 / Published: 27 May 2014
PDF Full-text (284 KB) | HTML Full-text | XML Full-text
Abstract
This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America.
[...] Read more.
This paper aims at presenting programs targeted at the prevention of adolescent depression applied with Spanish-speaking populations that have been developed in Spanish-speaking countries and are mostly published in Spanish. These programs have been developed under different cultural contexts in Spain and Latin-America. The main goal of this paper is to make the studies and movements of the Spanish-speaking literature in this field accessible to the non-Spanish-speaking part of the research community. Therefore, after an introduction referring to possible cultural differences regarding depression in general and epidemiological basics, several programs are introduced. In total 11 programs will be shortly presented and discussed. After revising the programs it can be concluded that in the Spanish-speaking world many programs have been developed and conducted following current state of the art-approaches for adolescent depression prevention. Further research is needed especially targeting possible cultural and contextual aspects of prevention measures and their efficacy and efficiency. Full article
(This article belongs to the Special Issue Adolescent Depression Prevention)
Open AccessReview Engineered Nanomaterials in Food: Implications for Food Safety and Consumer Health
Int. J. Environ. Res. Public Health 2014, 11(6), 5720-5750; doi:10.3390/ijerph110605720
Received: 24 January 2014 / Revised: 2 April 2014 / Accepted: 14 May 2014 / Published: 28 May 2014
Cited by 21 | PDF Full-text (365 KB) | HTML Full-text | XML Full-text
Abstract
From the current state-of-the-art, it is clear that nanotechnology applications are expected to bring a range of benefits to the food sector aiming at providing better quality and conservation. In the meantime, a growing number of studies indicate that the exposure to certain
[...] Read more.
From the current state-of-the-art, it is clear that nanotechnology applications are expected to bring a range of benefits to the food sector aiming at providing better quality and conservation. In the meantime, a growing number of studies indicate that the exposure to certain engineered nanomaterials (ENMs) has a potential to lead to health complications and that there is a need for further investigations in order to unravel the biological outcomes of nanofood consumption. In the current review, we summarize the existing data on the (potential) use of ENMs in the food industry, information on the toxicity profiles of the commonly applied ENMs, such as metal (oxide) nanoparticles (NPs), address the potential food safety implications and health hazards connected with the consumption of nanofood. A number of health complications connected with the human exposure to ENMs are discussed, demonstrating that there is a real basis for the arisen concern not only connected with the gut health, but also with the potency to lead to systemic toxicity. The toxicological nature of hazard, exposure levels and risk to consumers from nanotechnology-derived food are on the earliest stage of investigation and this review also highlights the major gaps that need further research and regulation. Full article
(This article belongs to the Special Issue Recent Advances on Environmental and Toxicologic Pathology)
Open AccessReview Is Hunting Still Healthy? Understanding the Interrelationships between Indigenous Participation in Land-Based Practices and Human-Environmental Health
Int. J. Environ. Res. Public Health 2014, 11(6), 5751-5782; doi:10.3390/ijerph110605751
Received: 7 February 2014 / Revised: 5 May 2014 / Accepted: 13 May 2014 / Published: 28 May 2014
Cited by 3 | PDF Full-text (736 KB) | HTML Full-text | XML Full-text
Abstract
Indigenous participation in land-based practices such as hunting, fishing, ceremony, and land care has a long history. In recent years, researchers and policy makers have advocated the benefits of these practices for both Indigenous people and the places they live. However, there have
[...] Read more.
Indigenous participation in land-based practices such as hunting, fishing, ceremony, and land care has a long history. In recent years, researchers and policy makers have advocated the benefits of these practices for both Indigenous people and the places they live. However, there have also been documented risks associated with participation in these activities. Environmental change brought about by shifts in land use, climate changes, and the accumulation of contaminants in the food chain sit alongside equally rapid shifts in social, economic and cultural circumstances, preferences and practices. To date, the literature has not offered a wide-ranging review of the available cross-disciplinary or cross-ecozone evidence for these intersecting benefits and risks, for both human and environmental health and wellbeing. By utilising hunting as a case study, this paper seeks to fill part of that gap through a transdisciplinary meta-analysis of the international literature exploring the ways in which Indigenous participation in land-based practices and human-environmental health have been studied, where the current gaps are, and how these findings could be used to inform research and policy. The result is an intriguing summary of disparate research that highlights the patchwork of contradictory understandings, and uneven regional emphasis, that have been documented. A new model was subsequently developed that facilitates a more in-depth consideration of these complex issues within local-global scale considerations. These findings challenge the bounded disciplinary and geographic spaces in which much of this work has occurred to date, and opens a dialogue to consider the importance of approaching these issues holistically. Full article
(This article belongs to the Special Issue IJERPH: 10th Anniversary)
Open AccessReview What Causes Environmental Inequalities and Related Health Effects? An Analysis of Evolving Concepts
Int. J. Environ. Res. Public Health 2014, 11(6), 5807-5827; doi:10.3390/ijerph110605807
Received: 4 July 2013 / Revised: 30 April 2014 / Accepted: 20 May 2014 / Published: 30 May 2014
Cited by 5 | PDF Full-text (323 KB) | HTML Full-text | XML Full-text
Abstract
Early environmental justice studies were exposure-oriented, lacked an integrated approach, and did not address the health impact of environmental inequalities. A coherent conceptual framework, needed to understand and tackle environmental inequalities and the related health effects, was lacking. We analyzed the more recent
[...] Read more.
Early environmental justice studies were exposure-oriented, lacked an integrated approach, and did not address the health impact of environmental inequalities. A coherent conceptual framework, needed to understand and tackle environmental inequalities and the related health effects, was lacking. We analyzed the more recent environmental justice literature to find out how conceptual insights have evolved. The conceptual framework of the WHO Commission on Social Determinants of Health (CSDH) was analyzed for additional explanations for environmental inequalities and the related health effects. This paper points out that recent environmental justice studies have broadened their scope by incorporating a broader set of physical and social environmental indicators, and by focusing on different geographic levels and on health impacts of environmental inequalities. The CSDH framework provided additional elements such as the role of structural determinants, the role of health-related behavior in relation to the physical and social environment, access to health care, as well as the life course perspective. Incorporating elements of the CSDH framework into existing environmental justice concepts, and performing more empirical research on the interactions between the different determinants at different geographical levels would further improve our understanding of environmental inequalities and their health effects and offer new opportunities for policy action. Full article
(This article belongs to the Special Issue Inequalities in Health)
Open AccessReview What Works in Community-Based Interventions Promoting Physical Activity and Healthy Eating? A Review of Reviews
Int. J. Environ. Res. Public Health 2014, 11(6), 5866-5888; doi:10.3390/ijerph110605866
Received: 28 February 2014 / Revised: 14 May 2014 / Accepted: 20 May 2014 / Published: 30 May 2014
Cited by 9 | PDF Full-text (489 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Chronic diseases, such as type II diabetes, are on the rise worldwide. There is consistent evidence that physical activity and healthy eating are important lifestyle factors which affect the risk for chronic diseases. Community-based interventions are of particular public health interest as they
[...] Read more.
Chronic diseases, such as type II diabetes, are on the rise worldwide. There is consistent evidence that physical activity and healthy eating are important lifestyle factors which affect the risk for chronic diseases. Community-based interventions are of particular public health interest as they reach target groups in their natural living environment and may thus achieve high population-level impacts. We conducted a systematic literature search to assess the effectiveness of community-based interventions to promote physical activity and healthy eating. Specifically, we searched for promising intervention strategies in this setting. We narratively summarized the results of 18 systematic reviews. Among children and adolescents, we found moderate evidence for effects on weight change in primary school-aged children for interventions containing a school component. The evidence for interventions aimed at general adult populations was inconclusive. Self-monitoring, group-based components, and motivational signs to encourage stair use were identified as promising strategies to increase physical activity. Among adults at risk for type II diabetes, evidence was found for beneficial effects on weight change and diabetes incidence. However, interventions for this group were not integrated in more comprehensive community-based approaches. Full article
(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)
Open AccessReview Indoor Exposure and Adverse Birth Outcomes Related to Fetal Growth, Miscarriage and Prematurity—A Systematic Review
Int. J. Environ. Res. Public Health 2014, 11(6), 5904-5933; doi:10.3390/ijerph110605904
Received: 4 March 2014 / Revised: 19 May 2014 / Accepted: 21 May 2014 / Published: 3 June 2014
Cited by 11 | PDF Full-text (378 KB) | HTML Full-text | XML Full-text
Abstract
The purpose of this review was to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution and all-day personal exposure with adverse birth outcomes including fetal growth, prematurity and miscarriage. We carried out a systematic literature search of
[...] Read more.
The purpose of this review was to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution and all-day personal exposure with adverse birth outcomes including fetal growth, prematurity and miscarriage. We carried out a systematic literature search of MEDLINE and EMBASE databases with the aim of summarizing and evaluating the results of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed indoor air pollution and all-day personal exposure with specific quantitative methods. This comprehensive literature search identified 16 independent studies which were deemed relevant for further review and two additional studies were added through searching the reference lists of all included studies. Two reviewers independently and critically appraised all eligible articles using the Critical Appraisal Skills Programme (CASP) tool. Of the 18 selected studies, 14 adopted a prospective cohort design, three were case-controls and one was a retrospective cohort study. In terms of pollutants of interest, seven studies assessed exposure to electro-magnetic fields, four studies assessed exposure to polycyclic aromatic hydrocarbons, four studies assessed PM2.5 exposure and three studies assessed benzene, phthalates and noise exposure respectively. Furthermore, 12 studies examined infant growth as the main birth outcome of interest, six examined spontaneous abortion and three studies assessed gestational age at birth and preterm delivery. This survey demonstrates that there is insufficient research on the possible association of indoor exposure and early life effects and that further research is needed. Full article
Open AccessReview Genetic Epidemiology and Preventive Healthcare in Multiethnic Societies: The Hemoglobinopathies
Int. J. Environ. Res. Public Health 2014, 11(6), 6136-6146; doi:10.3390/ijerph110606136
Received: 25 March 2014 / Revised: 30 May 2014 / Accepted: 3 June 2014 / Published: 11 June 2014
Cited by 8 | PDF Full-text (330 KB) | HTML Full-text | XML Full-text | Correction
Abstract
Healthy carriers of severe Hemoglobinopathies are usually asymptomatic and only efficiently detected through screening campaigns. Based upon epidemiological data, screenings have been offered for decades to populations of endemic Southern Europe for primary prevention of Thalassemia Major, while for many populations of the
[...] Read more.
Healthy carriers of severe Hemoglobinopathies are usually asymptomatic and only efficiently detected through screening campaigns. Based upon epidemiological data, screenings have been offered for decades to populations of endemic Southern Europe for primary prevention of Thalassemia Major, while for many populations of the highly endemic African and Asian countries prevention for Sickle Cell Disease and Thalassemia Major is mainly unavailable. The massive migrations of the last decades have brought many healthy carriers of these diseases to live and reproduce in non-endemic immigration areas changing the epidemiological pattern of the local recessive diseases and bringing an urgent need for treatment and primary prevention in welfare countries. Nonetheless, no screening for an informed reproductive choice is actively offered by the healthcare systems of most of these welfare countries. As a consequence more children affected with severe Hemoglobinopathies are born today in the immigration countries of Northern Europe than in the endemic Southern European area. Following the Mediterranean example, some countries like the UK and The Netherlands have been offering early pregnancy carrier screening at different levels and/or in specific areas but more accessible measures need to be taken at the national level in all immigration countries. Identification of carriers using simple and inexpensive methods should be included in the Rhesus and infectious diseases screening which is offered early in pregnancy in most developed countries. This would allow identification of couples at risk in time for an informed choice and for prenatal diagnosis if required before the first affected child is born. Full article
(This article belongs to the Special Issue Genetic Epidemiology)
Open AccessReview Exploring Childhood Lead Exposure through GIS: A Review of the Recent Literature
Int. J. Environ. Res. Public Health 2014, 11(6), 6314-6334; doi:10.3390/ijerph110606314
Received: 8 March 2014 / Revised: 22 May 2014 / Accepted: 6 June 2014 / Published: 18 June 2014
Cited by 2 | PDF Full-text (250 KB) | HTML Full-text | XML Full-text
Abstract
Childhood exposure to lead remains a critical health control problem in the US. Integration of Geographic Information Systems (GIS) into childhood lead exposure studies significantly enhanced identifying lead hazards in the environment and determining at risk children. Research indicates that the toxic threshold
[...] Read more.
Childhood exposure to lead remains a critical health control problem in the US. Integration of Geographic Information Systems (GIS) into childhood lead exposure studies significantly enhanced identifying lead hazards in the environment and determining at risk children. Research indicates that the toxic threshold for lead exposure was updated three times in the last four decades: 60 to 30 micrograms per deciliter (µg/dL) in 1975, 25 µg/dL in 1985, and 10 µb/dL in 1991. These changes revealed the extent of lead poisoning. By 2012 it was evident that no safe blood lead threshold for the adverse effects of lead on children had been identified and the Center for Disease Control (CDC) currently uses a reference value of 5 µg/dL. Review of the recent literature on GIS-based studies suggests that numerous environmental risk factors might be critical for lead exposure. New GIS-based studies are used in surveillance data management, risk analysis, lead exposure visualization, and community intervention strategies where geographically-targeted, specific intervention measures are taken. Full article
Open AccessReview Impact of the 2008 Economic and Financial Crisis on Child Health: A Systematic Review
Int. J. Environ. Res. Public Health 2014, 11(6), 6528-6546; doi:10.3390/ijerph110606528
Received: 18 April 2014 / Revised: 9 June 2014 / Accepted: 10 June 2014 / Published: 23 June 2014
Cited by 20 | PDF Full-text (366 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health
[...] Read more.
The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children, published since 2007 and related to the 2008 economic crisis were included. Two reviewers independently assessed studies for inclusion. Data were synthesised as a narrative review. Five hundred and six titles and abstracts were reviewed, from which 22 studies were included. The risk of bias for quantitative studies was mixed while qualitative studies showed low risk of bias. An excess of 28,000–50,000 infant deaths in 2009 was estimated in sub-Saharan African countries, and increased infant mortality in Greece was reported. Increased price of foods was related to worsening nutrition habits in disadvantaged families worldwide. An increase in violence against children was reported in the U.S., and inequalities in health-related quality of life appeared in some countries. Most studies suggest that the economic crisis has harmed children’s health, and disproportionately affected the most vulnerable groups. There is an urgent need for further studies to monitor the child health effects of the global recession and to inform appropriate public policy responses. Full article

Other

Jump to: Research, Review

Open AccessCorrection Correction: Carrozzi, L.; et al. Life Gain in Italian Smokers Who Quit. Int. J. Environ. Res. Public Health 2014, 11, 2395–2406
Int. J. Environ. Res. Public Health 2014, 11(6), 5970-5974; doi:10.3390/ijerph110605970
Received: 28 May 2014 / Accepted: 30 May 2014 / Published: 5 June 2014
PDF Full-text (150 KB) | HTML Full-text | XML Full-text
Abstract The authors wish to add the following amendments and corrections on their paper published in IJERPH [1]. [...] Full article
Open AccessComment A Global, Multi-Disciplinary, Multi-Sectorial Initiative to Combat Leptospirosis: Global Leptospirosis Environmental Action Network (GLEAN)
Int. J. Environ. Res. Public Health 2014, 11(6), 6000-6008; doi:10.3390/ijerph110606000
Received: 4 February 2014 / Revised: 26 May 2014 / Accepted: 28 May 2014 / Published: 5 June 2014
Cited by 3 | PDF Full-text (165 KB) | HTML Full-text | XML Full-text
Abstract
Leptospirosis has emerged as a major public health problem in both animals and humans. The true burden of this epidemic and endemic disease is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the difficulty of laboratory
[...] Read more.
Leptospirosis has emerged as a major public health problem in both animals and humans. The true burden of this epidemic and endemic disease is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the difficulty of laboratory confirmation. The complexity that surrounds the transmission dynamics, particularly in epidemic situations, requires a coordinated, multi-disciplinary effort. Therefore, the Global Leptospirosis Environmental Action Network (GLEAN) was developed to improve global and local strategies of how to predict, prevent, detect, and intervene in leptospirosis outbreaks in order to prevent and control leptospirosis in high-risk populations. Full article
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
Open AccessDiscussion The Case in Favor of E-Cigarettes for Tobacco Harm Reduction
Int. J. Environ. Res. Public Health 2014, 11(6), 6459-6471; doi:10.3390/ijerph110606459
Received: 10 April 2014 / Revised: 19 May 2014 / Accepted: 9 June 2014 / Published: 20 June 2014
Cited by 8 | PDF Full-text (186 KB) | HTML Full-text | XML Full-text
Abstract
A carefully structured Tobacco Harm Reduction (THR) initiative, with e-cigarettes as a prominent THR modality, added to current tobacco control programming, is the most feasible policy option likely to substantially reduce tobacco-attributable illness and death in the United States over the next 20
[...] Read more.
A carefully structured Tobacco Harm Reduction (THR) initiative, with e-cigarettes as a prominent THR modality, added to current tobacco control programming, is the most feasible policy option likely to substantially reduce tobacco-attributable illness and death in the United States over the next 20 years. E-cigarettes and related vapor products are the most promising harm reduction modalities because of their acceptability to smokers. There are about 46 million smokers in the United States, and an estimated 480,000 deaths per year attributed to cigarette smoking. These numbers have been essentially stable since 2004. Currently recommended pharmaceutical smoking cessation protocols fail in about 90% of smokers who use them as directed, even under the best of study conditions, when results are measured at six to twelve months. E-cigarettes have not been attractive to non-smoking teens or adults. Limited numbers non-smokers have experimented with them, but hardly any have continued their use. The vast majority of e-cigarette use is by current smokers using them to cut down or quit cigarettes. E-cigarettes, even when used in no-smoking areas, pose no discernable risk to bystanders. Finally, addition of a THR component to current tobacco control programming will likely reduce costs by reducing the need for counseling and drugs. Full article
(This article belongs to the Special Issue Electronic Cigarettes as a Tool in Tobacco Harm Reduction)
Open AccessCommentary Mobile Health in Maternal and Newborn Care: Fuzzy Logic
Int. J. Environ. Res. Public Health 2014, 11(6), 6494-6503; doi:10.3390/ijerph110606494
Received: 28 April 2014 / Revised: 11 June 2014 / Accepted: 16 June 2014 / Published: 20 June 2014
PDF Full-text (163 KB) | HTML Full-text | XML Full-text
Abstract
Whether mHealth improves maternal and newborn health outcomes remains uncertain as the response is perhaps not true or false but lies somewhere in between when considering unintended harmful consequences. Fuzzy logic, a mathematical approach to computing, extends the traditional binary “true or false”
[...] Read more.
Whether mHealth improves maternal and newborn health outcomes remains uncertain as the response is perhaps not true or false but lies somewhere in between when considering unintended harmful consequences. Fuzzy logic, a mathematical approach to computing, extends the traditional binary “true or false” (one or zero) to exemplify this notion of partial truths that lies between completely true and false. The commentary explores health, socio-ecological and environmental consequences–positive, neutral or negative. Of particular significance is the negative influence of mHealth on maternal care-behaviors, which can increase stress reactivity and vulnerability to stress-induced illness across the lifespan of the child and establish pathways for intergenerational transmission of behaviors. A mHealth “fingerprinting” approach is essential to monitor psychosocial, economic, cultural, environmental and physical impact of mHealth intervention and make evidence-informed decision(s) about use of mHealth in maternal and newborn care. Full article

Journal Contact

MDPI AG
IJERPH Editorial Office
St. Alban-Anlage 66, 4052 Basel, Switzerland
ijerph@mdpi.com
Tel. +41 61 683 77 34
Fax: +41 61 302 89 18
Editorial Board
Contact Details Submit to IJERPH
Back to Top