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Int. J. Environ. Res. Public Health, Volume 14, Issue 10 (October 2017)

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Editorial

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Open AccessEditorial Landscapes and Human Health
Int. J. Environ. Res. Public Health 2017, 14(10), 1212; doi:10.3390/ijerph14101212
Received: 1 October 2017 / Revised: 1 October 2017 / Accepted: 9 October 2017 / Published: 11 October 2017
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Abstract
As urbanization increases around the world and fewer and fewer people have easy access to completely natural places, there is a growing need to understand how the landscapes we design and inhabit impact our health and wellbeing.[...] Full article
(This article belongs to the Special Issue Landscapes and Human Health)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Using Upper Extremity Skin Temperatures to Assess Thermal Comfort in Office Buildings in Changsha, China
Int. J. Environ. Res. Public Health 2017, 14(10), 1092; doi:10.3390/ijerph14101092
Received: 25 August 2017 / Revised: 14 September 2017 / Accepted: 15 September 2017 / Published: 21 September 2017
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Abstract
Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments’ conclusions may not represent a realistic thermal environment
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Existing thermal comfort field studies are mainly focused on the relationship between the indoor physical environment and the thermal comfort. In numerous chamber experiments, physiological parameters were adopted to assess thermal comfort, but the experiments’ conclusions may not represent a realistic thermal environment due to the highly controlled thermal environment and few occupants. This paper focuses on determining the relationships between upper extremity skin temperatures (i.e., finger, wrist, hand and forearm) and the indoor thermal comfort. Also, the applicability of predicting thermal comfort by using upper extremity skin temperatures was explored. Field studies were performed in office buildings equipped with split air-conditioning (SAC) located in the hot summer and cold winter (HSCW) climate zone of China during the summer of 2016. Psychological responses of occupants were recorded and physical and physiological factors were measured simultaneously. Standard effective temperature (SET*) was used to incorporate the effect of humidity and air velocity on thermal comfort. The results indicate that upper extremity skin temperatures are good indicators for predicting thermal sensation, and could be used to assess the thermal comfort in terms of physiological mechanism. In addition, the neutral temperature was 24.7 °C and the upper limit for 80% acceptability was 28.2 °C in SET*. Full article
(This article belongs to the Special Issue Indoor Environmental Quality)
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Open AccessArticle The Role of Body Adiposity Index in Determining Body Fat Percentage in Colombian Adults with Overweight or Obesity
Int. J. Environ. Res. Public Health 2017, 14(10), 1093; doi:10.3390/ijerph14101093
Received: 26 July 2017 / Revised: 27 August 2017 / Accepted: 16 September 2017 / Published: 21 September 2017
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Abstract
The aim of this study is to investigate the accuracy of body adiposity index (BAI) as a convenient tool for assessing body fat percentage (BF%) in a sample of adults with overweight/obesity using bioelectrical impedance analysis (BIA). The study population was composed of
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The aim of this study is to investigate the accuracy of body adiposity index (BAI) as a convenient tool for assessing body fat percentage (BF%) in a sample of adults with overweight/obesity using bioelectrical impedance analysis (BIA). The study population was composed of 96 volunteers (60% female, mean age 40.6 ± 7.5 years old). Anthropometric characteristics (body mass index, height, waist-to-height ratio, hip and waist circumference), socioeconomic status, and diet were assessed, and BF% was measured by BIA-BF% and by BAI-BF%. Pearson’s correlation coefficient was used to evaluate the correlation between BAI-BF% and BF% assessed by BIA-BF%, while controlling for potential confounders. The concordance between the BF% measured by both methods was obtained with a paired sample t-test, Lin’s concordance correlation coefficient, and Bland-Altman plot analysis. Overall, the correlation between BF% obtained by BIA-BF% and estimated by BAI-BF% was r = 0.885, p < 0.001, after adjusting for potential confounders (age, socioeconomic status, and diet). Lin’s concordance correlation coefficient was moderate in both sexes. In the men, the paired t-test showed a significant mean difference in BF% between the methods (−5.6 (95%CI −6.4 to −4.8); p < 0.001). In the women, these differences were (−3.6 (95%CI −4.7 to −2.5); p < 0.001). Overall, the bias of the BAI-BF% was −4.8 ± 3.2 BF%; p < 0.001), indicating that the BAI-BF% method significantly underestimated the BF% in comparison with the reference method. In adults with overweight/obesity, the BAI presents low agreement with BF% measured by BIA-BF%; therefore, we conclude that BIA-BF% is not accurate in either sex when body fat percentage levels are low or high. Further studies are necessary to confirm our findings in different ethnic groups. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Involuntary Smoking in Adolescents, Their Awareness of Its Harmfulness, and Attitudes towards Smoking in the Presence of Non-Smokers
Int. J. Environ. Res. Public Health 2017, 14(10), 1095; doi:10.3390/ijerph14101095
Received: 13 July 2017 / Revised: 9 September 2017 / Accepted: 20 September 2017 / Published: 21 September 2017
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Abstract
The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged
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The aim of the study was to examine involuntary smoking among young people, their awareness of its harmfulness and the factors associated with attitudes towards smoking in the presence of non-smokers. A cross-sectional study was conducted among 3552 students from a socially disadvantaged rural area in central Poland. Almost 40% of the participants were exposed to involuntary smoking at home and 60% outside of home on a daily or almost daily basis. More than 80% of the students felt that smoking should be banned around children at home, 59% thought it should be banned in vehicles, and 41% in the presence of non-smokers. The majority of the students were aware of the health consequences of active smoking, and 69% understood the threats of passive smoking. Females, never-smokers and current non-smokers, as well as those without smoking parents were more likely to claim that smoking should be banned at home and in vehicles (p < 0.05). Those aware of the fact that smoking was harmful to health, who discussed those issues with their parents and teachers, and who saw school tobacco control policies, were more likely to maintain that passive smoking should be banned (p < 0.05). The study results highlight the need for programs and policies to eliminate involuntary smoking among young people. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Frailty and Its Contributory Factors in Older Adults: A Comparison of Two Asian Regions (Hong Kong and Taiwan)
Int. J. Environ. Res. Public Health 2017, 14(10), 1096; doi:10.3390/ijerph14101096
Received: 18 July 2017 / Revised: 12 September 2017 / Accepted: 15 September 2017 / Published: 21 September 2017
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Abstract
This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study
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This study aimed to compare the prevalence of frailty across three Chinese populations: Hong Kong, Taiwan-urban and Taiwan-rural. Contributing factors to disparities in frailty were also examined. Data were derived from the Osteoporotic Fractures in Men (MrOs) and Women (MsOs) (Hong Kong) Study (n = 4000) and the Taiwan Longitudinal Study on Aging (n = 2392). Frailty was defined as an index calculated from 30 multiple deficits. The ratio of the frailty index to life expectancy at birth (FI/LE) was used as an indicator of compression of morbidity. Frailty was more prevalent in Taiwan-urban (33.1%) and Taiwan-rural (38.1%) compared to Hong Kong (16.6%, p < 0.05) and was higher in women (22.6–49.7%) than in men (10.5–27.5%, p < 0.05). The ratios of FI/LE were higher in Taiwan-urban and Taiwan-rural (both 0.27) compared to Hong Kong (0.20, p < 0.05). Multivariate analyses revealed that older age, being a woman and low levels of physical activity were common risk factors for frailty across the three populations. Alcohol use was inversely associated with frailty in both Hong Kong and Taiwan-urban populations, but not in Taiwan-rural. Living alone was associated with frailty in Hong Kong men, but not in Hong Kong women or Taiwanese people. For all study populations, older age and being a woman constituted the highest attributable factor. This comparison provides useful data to inform government policies. Full article
(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)
Open AccessArticle Attitudes, Beliefs and Predictors of Male Circumcision Promotion among Medical University Students in a Traditionally Non-Circumcising Region
Int. J. Environ. Res. Public Health 2017, 14(10), 1097; doi:10.3390/ijerph14101097
Received: 8 August 2017 / Revised: 12 September 2017 / Accepted: 18 September 2017 / Published: 21 September 2017
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Abstract
Objective: To evaluate the beliefs of medical university students regarding male circumcision (MC), as well as attitudes and the predictors of its promotion in the case of adults at risk of HIV. Methods: A cross-sectional survey was conducted between 2013–2016 at the
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Objective: To evaluate the beliefs of medical university students regarding male circumcision (MC), as well as attitudes and the predictors of its promotion in the case of adults at risk of HIV. Methods: A cross-sectional survey was conducted between 2013–2016 at the Medical University in Szczecin, Poland, among final year Polish/foreign students from Northern Europe, using a standardized questionnaire. Results: There were 539 participants, median age 25 years, 40.8% males, and 66.8% were Polish nationals. The MC rate was 16.7%. Regarding HIV/AIDS knowledge, 66.6% of the students scored more than 75%; and, 34.2% knew that MC reduces the risk of HIV infection. One in eleven respondents (9.1%) believed that circumcised men felt more intense sexual pleasure. More than half of the respondents (54.8%) declared that they would recommend MC to adult patients at risk for HIV. The belief that circumcised men felt more intense sexual pleasure, and knowledge on MC regarding HIV risk reduction was associated with greater odds of recommending adult MC (OR = 3.35 and OR = 2.13, respectively). Conclusions: Poor knowledge of its benefits and a low willingness to promote the procedure—strongly dependent on personal beliefs—suggest that medical students may need additional training to help them to discuss MC more openly with adult men at risk for HIV infection. Knowledge may be an effective tool when making decisions regarding MC promotion. Full article
(This article belongs to the Section Global Health)
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Open AccessFeature PaperArticle Neighborhood Context, Homeownership and Home Value: An Ecological Analysis of Implications for Health
Int. J. Environ. Res. Public Health 2017, 14(10), 1098; doi:10.3390/ijerph14101098
Received: 1 August 2017 / Revised: 4 September 2017 / Accepted: 19 September 2017 / Published: 22 September 2017
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Abstract
While homeownership has been linked to positive health outcomes there is limited evidence regarding the conditions under which it may be health protective. We present a conceptual model linking homeownership to health, highlighting key potential pathways. Using the Detroit Metropolitan Area as a
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While homeownership has been linked to positive health outcomes there is limited evidence regarding the conditions under which it may be health protective. We present a conceptual model linking homeownership to health, highlighting key potential pathways. Using the Detroit Metropolitan Area as a case study, and data from the American Community Survey (2009–2013; 5-years estimates) and Michigan Department of Community Health, we tested the following questions: (1) Is neighborhood percentage non-Hispanic Black (NHB) associated with homeownership? (2) Is neighborhood percentage NHB associated with health? (3) Is the association between percentage NHB and health mediated by homeownership? (4) Does neighborhood housing value modify associations between percentage NHB and health, or between homeownership and health? Percentage NHB was associated with homeownership and health outcomes; Associations between percentage NHB and mortality, but not disability, were partially mediated by neighborhood homeownership. Neighborhood housing value modified associations between neighborhood homeownership and both disability and mortality, but not between percentage NHB and health outcomes. Findings are consistent with the thesis that health-promoting effects of homeownership may be contingent upon house values. These results add to a limited body of evidence suggesting that variations in homeownership may contribute to persistent racial and socioeconomic health inequities. Full article
(This article belongs to the Special Issue Housing and Health)
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Open AccessArticle Comparison of Patterns of Use of Unrecorded and Recorded Spirits: Survey of Adult Drinkers in Rural Central China
Int. J. Environ. Res. Public Health 2017, 14(10), 1099; doi:10.3390/ijerph14101099
Received: 27 July 2017 / Revised: 15 September 2017 / Accepted: 19 September 2017 / Published: 22 September 2017
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Abstract
About 70% of the beverage alcohol consumed in China annually is spirits. Recorded spirits make up most spirit consumption, but about 25% of total alcohol consumption (1.7 L pure alcohol per capita annually) is unrecorded spirits (bai jiu), either homemade or made in
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About 70% of the beverage alcohol consumed in China annually is spirits. Recorded spirits make up most spirit consumption, but about 25% of total alcohol consumption (1.7 L pure alcohol per capita annually) is unrecorded spirits (bai jiu), either homemade or made in unregulated distilleries. In some parts of China, the consumption of unrecorded spirits is higher than average. This paper compares the patterns of use of unrecorded distilled spirits and recorded distilled spirits among rural residents in Central China. Interviews were conducted with 3298 individuals in 21 towns/villages in 10 counties in the Hubei, Anhui, and Hebei provinces in the People’s Republic of China. Unrecorded bai jiu drinkers chose it because of its taste and its low price. It was consumed mostly by older men, mostly at home with family, more regularly and at higher alcohol by volume (ABV) compared to recorded alcohol. Recorded bai jiu drinkers were more likely to drink away from their homes, consumed more bai jiu at memorable drinking occasions, and reported feeling sick after drinking more often than unrecorded bai jiu drinkers. This comparison of patterns of use of unrecorded bai jiu and recorded bai jiu does not suggest that unrecorded bai jiu is more problematic for drinkers. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Characterization of Diarrheagenic Escherichia coli Isolated in Organic Waste Products (Cattle Fecal Matter, Manure and, Slurry) from Cattle’s Markets in Ouagadougou, Burkina Faso
Int. J. Environ. Res. Public Health 2017, 14(10), 1100; doi:10.3390/ijerph14101100
Received: 2 August 2017 / Revised: 13 September 2017 / Accepted: 14 September 2017 / Published: 22 September 2017
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Abstract
Cattle farming can promote diarrheal disease transmission through waste, effluents or cattle fecal matter. The study aims to characterize the diarrheagenic Escherichia coli (DEC) isolated from cattle feces, manure in the composting process and slurry, collected from four cattle markets in Ouagadougou. A
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Cattle farming can promote diarrheal disease transmission through waste, effluents or cattle fecal matter. The study aims to characterize the diarrheagenic Escherichia coli (DEC) isolated from cattle feces, manure in the composting process and slurry, collected from four cattle markets in Ouagadougou. A total of 585 samples (340 cattle feces, 200 slurries and 45 manures in the composting process) were collected from the four cattle markets between May 2015 and May 2016. A multiplex Polymerase Chain Reaction (PCR), namely 16-plex PCR, was used to screen simultaneously the virulence genes specific for shiga toxin-producing E. coli (STEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC) and enteroaggregative E. coli (EAEC). DEC was detected in 10.76% of samples. ETEC was the most prevalent (9.91%). STEC and EAEC have been observed with the same rate (0.51%). ETEC were detected in 12.64% of cattle feces, in 6.66% of manure in the composting process and in 5% of slurry. STEC were detected in 0.58% of cattle feces and in 2.22% of manure in the composting process. EAEC was detected only in 1% of slurry and in 2.22% of manure in the composting process. ETEC strains were identified based on estIa gene and/or estIb gene and/or elt gene amplification. Of the 58 ETEC, 10.34% contained astA, 17.24% contained elt, 3.44% contained estIa and 79.31% contained estIb. The two positive EAEC strains contained only the aggR gene, and the third was positive only for the pic gene. The results show that effluent from cattle markets could contribute to the spreading of DEC in the environment in Burkina Faso. Full article
(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)
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Open AccessArticle Job Satisfaction among Health-Care Staff in Township Health Centers in Rural China: Results from a Latent Class Analysis
Int. J. Environ. Res. Public Health 2017, 14(10), 1101; doi:10.3390/ijerph14101101
Received: 25 July 2017 / Revised: 8 September 2017 / Accepted: 19 September 2017 / Published: 22 September 2017
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Abstract
Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate
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Background: The lower job satisfaction of health-care staff will lead to more brain drain, worse work performance, and poorer health-care outcomes. The aim of this study was to identify patterns of job satisfaction among health-care staff in rural China, and to investigate the association between the latent clusters and health-care staff’s personal and professional features; Methods: We selected 12 items of five-point Likert scale questions to measure job satisfaction. A latent-class analysis was performed to identify subgroups based on the items of job satisfaction; Results: Four latent classes of job satisfaction were identified: 8.9% had high job satisfaction, belonging to “satisfied class”; 38.2% had low job satisfaction, named as “unsatisfied class”; 30.5% were categorized into “unsatisfied class with the exception of interpersonal relationships”; 22.4% were identified as “pseudo-satisfied class”, only satisfied with management-oriented items. Low job satisfaction was associated with specialty, training opportunity, and income inequality. Conclusions: The minority of health-care staff belong to the “satisfied class”. Three among four subgroups are not satisfied with income, benefit, training, and career development. Targeting policy interventions should be implemented to improve the items of job satisfaction based on the patterns and health-care staff’s features. Full article
(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)
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Open AccessArticle Assessing the Allocation of Special Elderly Nursing Homes in Tokyo, Japan
Int. J. Environ. Res. Public Health 2017, 14(10), 1102; doi:10.3390/ijerph14101102
Received: 17 July 2017 / Revised: 2 September 2017 / Accepted: 20 September 2017 / Published: 22 September 2017
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Abstract
Social welfare and public health departments require reliable assessments to enhance the rationality of phased construction of special elderly nursing homes (SENHs). This paper aims to assess the allocation of SENHs based on a beds-needed index for SENHs (BNIS). This may help departments
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Social welfare and public health departments require reliable assessments to enhance the rationality of phased construction of special elderly nursing homes (SENHs). This paper aims to assess the allocation of SENHs based on a beds-needed index for SENHs (BNIS). This may help departments determine the priority for approving locations of SENHs more accurately with a limited budget. Traditional assessments in Tokyo use the sphere of welfare, ward, and sphere of daily life as spatial units for estimating beds-to-elderly population ratios. We calculate the BNIS by introducing a parameter-improved floating catchment area method (PI-FCA) at a smaller spatial unit, the Chome. In the PI-FCA, the catchment area is generated according to the standard of average population served by SENHs and capacity, the population demand is the population of the elderly requiring care levels 3–5 and is further modified by a coefficient of potential demand via building a multivariate linear model. Improved results were obtained using the PI-FCA. Finally, this study maps the distribution of the degree of BNIS, to provide a basis for the allocation assessment of SENHs. This caters to the needs of departments and is easily applicable in other public healthcare facilities. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Association between Long-Term Exposure to Particulate Matter Air Pollution and Mortality in a South Korean National Cohort: Comparison across Different Exposure Assessment Approaches
Int. J. Environ. Res. Public Health 2017, 14(10), 1103; doi:10.3390/ijerph14101103
Received: 2 August 2017 / Revised: 15 September 2017 / Accepted: 18 September 2017 / Published: 23 September 2017
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Abstract
Increasing numbers of cohort studies have reported that long-term exposure to ambient particulate matter is associated with mortality. However, there has been little evidence from Asian countries. We aimed to explore the association between long-term exposure to particulate matter with a diameter ≤10
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Increasing numbers of cohort studies have reported that long-term exposure to ambient particulate matter is associated with mortality. However, there has been little evidence from Asian countries. We aimed to explore the association between long-term exposure to particulate matter with a diameter ≤10 µm (PM10) and mortality in South Korea, using a nationwide population-based cohort and an improved exposure assessment (EA) incorporating time-varying concentrations and residential addresses (EA1). We also compared the association across different EA approaches. We used information from 275,337 people who underwent health screening from 2002 to 2006 and who had follow-up data for 12 years in the National Health Insurance Service-National Sample Cohort. Individual exposures were computed as 5-year averages using predicted residential district-specific annual-average PM10 concentrations for 2002–2006. We estimated hazard ratios (HRs) of non-accidental and five cause-specific mortalities per 10 µg/m3 increase in PM10 using the Cox proportional hazards model. Then, we compared the association of EA1 with three other approaches based on time-varying concentrations and/or addresses: predictions in each year and addresses at baseline (EA2); predictions at baseline and addresses in each year (EA3); and predictions and addresses at baseline (EA4). We found a marginal association between long-term PM10 and non-accidental mortality. The HRs of five cause-specific mortalities were mostly higher than that of non-accidental mortality, but statistically insignificant. In the comparison between EA approaches, the HRs of EA1 were similar to those of EA2 but higher than EA3 and EA4. Our findings confirmed the association between long-term exposure to PM10 and mortality based on a population-representative cohort in South Korea, and suggested the importance of assessing individual exposure incorporating air pollution changes over time. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Dietary Inflammatory Index and Cardiometabolic Risk Parameters in Overweight and Sedentary Subjects
Int. J. Environ. Res. Public Health 2017, 14(10), 1104; doi:10.3390/ijerph14101104
Received: 3 September 2017 / Revised: 15 September 2017 / Accepted: 21 September 2017 / Published: 6 October 2017
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Abstract
Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia.
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Nutrition has been established as a relevant factor in the development of cardiovascular disease (CVD). We aimed to investigate the relationship between the dietary inflammatory index (DII) and cardiometabolic risk parameters in a cohort of 90 overweight and sedentary adults from Bogotá, Colombia. A 24-h dietary record was used to calculate the DII. Body composition variables, flow-mediated dilation (FMD), pulse wave velocity (PWV), lipid profile, glucose, glycosylated hemoglobin (Hb1Ac), and blood pressure were measured and a cardiometabolic risk score (MetScore) was calculated. A lower DII score (anti-inflammatory diet) was significantly associated with higher high-density lipoprotein-cholesterol (HDL-C) and FMD, and lower Hb1Ac and MetScore (p < 0.05). A lower DII score was inversely correlated with plasma triglyceride levels (r = −0.354, p < 0.05), glucose (r = −0.422, p < 0.05), MetScore (r = −0.228, p < 0.05), and PWV (r = −0.437, p < 0.05), and positively with FMD (r = 0.261, p < 0.05). In contrast, a higher DII score (pro-inflammatory diet) showed a positive relationship with MetScore (r = 0.410, p < 0.05) and a negative relationship with FMD (r = −0.233, p < 0.05). An increased inflammatory potential of diet was inversely associated with an improved cardiometabolic profile, suggesting the importance of promoting anti-inflammatory diets as an effective strategy for preventing CVD. Full article
(This article belongs to the Special Issue Nutrition and Public Health)
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Open AccessArticle Environmental Tobacco Smoke Exposure at Home and High-Sensitivity C-Reactive Protein Levels in Three-to-Five-Year-Old Children
Int. J. Environ. Res. Public Health 2017, 14(10), 1105; doi:10.3390/ijerph14101105
Received: 8 August 2017 / Revised: 15 September 2017 / Accepted: 19 September 2017 / Published: 23 September 2017
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Abstract
Exposure to harmful environmental factors is particularly detrimental to younger children. We investigated the relationship between environmental tobacco smoke (ETS) exposure in pre-schoolers at home and the level of high-sensitivity C-reactive protein (hs-CRP), a predictive factor for cardiovascular disease. This study was conducted
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Exposure to harmful environmental factors is particularly detrimental to younger children. We investigated the relationship between environmental tobacco smoke (ETS) exposure in pre-schoolers at home and the level of high-sensitivity C-reactive protein (hs-CRP), a predictive factor for cardiovascular disease. This study was conducted in 2014 and was based on the data of preschool children from the Korean Environmental Health Survey in Children and Adolescents (2012 to 2014), a nationally representative sample. Of 577 children, aged three to five years, 482 were eventually selected for the analysis after excluding those with missing variables, or whose hs-CRP level exceeded the reference value. The proportion of pre-school children exposed to ETS at home was 14.8%. The odd ratios (OR)s of hs-CRP > 1mg/L were 4.90 (95% Confidence Interval (CI) = 1.04–23.17) and 11.66 (95% CI = 1.90–71.65) in the groups exposed to ETS 3–4 times and ≥5 times daily, respectively, compared to the non-exposed group. The risk of elevated levels of hs-CRP showed an increasing trend proportionally to the increase in ETS exposure frequency (p for trend = 0.03). Anti-smoking educational programs for parents and guardians may be helpful to reduce ETS exposure at home. Full article
(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)
Open AccessArticle Agricultural Capacity to Increase the Production of Select Fruits and Vegetables in the US: A Geospatial Modeling Analysis
Int. J. Environ. Res. Public Health 2017, 14(10), 1106; doi:10.3390/ijerph14101106
Received: 7 September 2017 / Revised: 18 September 2017 / Accepted: 22 September 2017 / Published: 23 September 2017
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Abstract
The capacity of US agriculture to increase the output of specific foods to accommodate increased demand is not well documented. This research uses geospatial modeling to examine the capacity of the US agricultural landbase to increase the per capita availability of an example
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The capacity of US agriculture to increase the output of specific foods to accommodate increased demand is not well documented. This research uses geospatial modeling to examine the capacity of the US agricultural landbase to increase the per capita availability of an example set of nutrient-dense fruits and vegetables. These fruits and vegetables were selected based on nutrient content and an increasing trend of domestic production and consumption. Geographic information system models were parameterized to identify agricultural land areas meeting crop-specific growing requirements for monthly precipitation and temperature; soil depth and type; cropland availability; and proximity to existing production centers. The results of these analyses demonstrate that crop production can be expanded by nearly 144,000 ha within existing national production centers, generating an additional 0.05 cup-equivalents of fruits and vegetables per capita per day, representing a 1.7% increase above current total F&V availability. Expanding the size of national crop production centers can further increase the availability of all F&V by 2.5%–5.4%, which is still less than the recommended amount. Challenges to increasing F&V production in the US include lack of labor availability, barriers to adoption among producers, and threats to crop yields from environmental concerns. Full article
(This article belongs to the Special Issue Nutrition and Public Health)
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Open AccessArticle Methylmercury Exposure Induces Sexual Dysfunction in Male and Female Drosophila Melanogaster
Int. J. Environ. Res. Public Health 2017, 14(10), 1108; doi:10.3390/ijerph14101108
Received: 5 September 2017 / Revised: 19 September 2017 / Accepted: 20 September 2017 / Published: 24 September 2017
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Abstract
Mercury, an environmental health hazard, is a neurotoxic heavy metal. In this study, the effect of methylmercury (MeHg) exposure was analyzed on sexual behavior in Drosophila melanogaster (fruit fly), because neurons play a vital role in sexual functions. The virgin male and female
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Mercury, an environmental health hazard, is a neurotoxic heavy metal. In this study, the effect of methylmercury (MeHg) exposure was analyzed on sexual behavior in Drosophila melanogaster (fruit fly), because neurons play a vital role in sexual functions. The virgin male and female flies were fed a diet mixed with different concentrations of MeHg (28.25, 56.5, 113, 226, and 339 µM) for four days, and the effect of MeHg on copulation of these flies was studied. While male and female control flies (no MeHg) and flies fed with lower concentrations of MeHg (28.25, 56.5 µM) copulated in a normal manner, male and female flies exposed to higher concentrations of MeHg (113, 226, and 339 µM) did not copulate. When male flies exposed to higher concentrations of MeHg were allowed to copulate with control female flies, only male flies fed with 113 µM MeHg were able to copulate. On the other hand, when female flies exposed to higher concentrations of MeHg were allowed to copulate with control male flies, none of the flies could copulate. After introduction of male and female flies in the copulation chamber, duration of wing flapping by male flies decreased in a MeHg-concentration-dependent manner from 101 ± 24 seconds (control) to 100.7 ± 18, 96 ±12, 59 ± 44, 31 ± 15, and 3.7 ± 2.7 seconds at 28.25, 56.5, 113, 226, and 339 µM MeHg, respectively. On the other hand, grooming in male and female flies increased in a MeHg-concentration-dependent manner. These findings suggest that MeHg exposure causes sexual dysfunction in male and female Drosophila melanogaster. Further studies showed that MeHg exposure increased oxidative stress and decreased triglyceride levels in a concentration–dependent manner in both male and female flies, suggesting that MeHg-induced oxidative stress and decreased triglyceride levels may partly contribute to sexual dysfunction in fruit flies. Full article
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Open AccessArticle Circadian Rhythm of Wrist Temperature among Shift Workers in South Korea: A Prospective Observational Study
Int. J. Environ. Res. Public Health 2017, 14(10), 1109; doi:10.3390/ijerph14101109
Received: 29 June 2017 / Revised: 14 September 2017 / Accepted: 22 September 2017 / Published: 24 September 2017
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Abstract
Background: Human body temperature varies with circadian rhythm. To determine the effect of shift work on the circadian rhythm of the distal-skin temperature, wrist temperatures were measured. Methods: Wrist-skin temperatures were measured by an iButton® Temperature Logger. It was measured
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Background: Human body temperature varies with circadian rhythm. To determine the effect of shift work on the circadian rhythm of the distal-skin temperature, wrist temperatures were measured. Methods: Wrist-skin temperatures were measured by an iButton® Temperature Logger. It was measured every 3 min for two and eight consecutive working days in the day and shift workers, respectively. Mesor, amplitude, and acrophase were measured by Cosinor analysis. Results: The shift-worker amplitude dropped significantly as the night shift progressed (0.92 to 0.85 °C), dropped further during rest (0.69 °C), and rose during the morning-shift days (0.82 °C). Day workers still had higher amplitudes (0.93 °C) than the morning-shift workers. The acrophase was delayed during the four night-shift days, then advanced during rest days and the morning-shift days. Nevertheless, the morning-shift worker acrophase was still significantly delayed compared to the day workers (08:03 a.m. vs. 04:11 a.m.). Conclusions: The further reduction of wrist-temperature amplitude during rest after the night shift may be due to the signal circadian rhythm disruption. Reduced amplitudes have been reported to be associated with intolerance to shift work. The findings of our study may help to design the most desirable schedule for shift workers. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Knowledge, Attitude and Practice of Pregnant Women towards Varicella and Their Children’s Varicella Vaccination: Evidence from Three Distrcits in Zhejiang Province, China
Int. J. Environ. Res. Public Health 2017, 14(10), 1110; doi:10.3390/ijerph14101110
Received: 26 August 2017 / Revised: 15 September 2017 / Accepted: 22 September 2017 / Published: 24 September 2017
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Abstract
Background: The objectives of this study were to examine the knowledge, attitudes and practice (KAP) towards varicella and varicella vaccine (VarV) vaccination among pregnant women in three distrcits in Zhejiang Province, China. Methods: From 1 January to 31 March 2014, pregnant
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Background: The objectives of this study were to examine the knowledge, attitudes and practice (KAP) towards varicella and varicella vaccine (VarV) vaccination among pregnant women in three distrcits in Zhejiang Province, China. Methods: From 1 January to 31 March 2014, pregnant women with ≥12 gestational weeks were recruited and received a self-administrated questionnaire. The first dose of VarV (VarV1) vaccination status of children from present pregnancy was extracted at 24 months of age from Zhejiang provincial immunization information system (ZJIIS). Three variables was defined as the main outcomes, which included: (1) knowing about both the availability of VarV and the number of doses required; (2) positive attitude towards the utility of varicella vaccination; (3) the vaccination coverage of VarV1, which meant the proportion of children having received the VarV1. Counts and proportions were used to describe the socio-demographic characteristics of study participants, and their relationship with study outcomes were tested using chi-square tests in univariate analysis and logistic regression in multivariable analysis. Results: A total of 629 pregnant women participated in this study. The majority of the participants (68.0%) answered correctly about the transmission route of varicella. The proportion of participants who heard about varicella vaccination was 76.5% and 66.8% knew that VarV was currently available. Only 13.5% of the participants answered correctly that the complete VarV series needed two doses. Age, immigration status, education level, household income, and number of children of the pregnant women were significant predictors of the KAP regarding the VarV vaccination. Conclusions: The current survey indicated that optimal KAP levels and coverage on VarV vaccination were observed in three districts of Zhejiang Province. Health education programs on varicella and VarV vaccination directed towards both pre-natal and post-natal women are needed, which will result in a better attitude on vaccination of VarV and in a high coverage of VarV. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Occurrence of Virulence Genes Associated with Human Pathogenic Vibrios Isolated from Two Commercial Dusky Kob (Argyrosmus japonicus) Farms and Kareiga Estuary in the Eastern Cape Province, South Africa
Int. J. Environ. Res. Public Health 2017, 14(10), 1111; doi:10.3390/ijerph14101111
Received: 11 August 2017 / Revised: 16 September 2017 / Accepted: 21 September 2017 / Published: 25 September 2017
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Abstract
Background: Seafood-borne Vibrio infections, often linked to contaminated seafood and water, are of increasing global public health concern. The aim of this study was to evaluate the prevalence of human pathogenic vibrios and their associated virulence genes isolated from fish and water
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Background: Seafood-borne Vibrio infections, often linked to contaminated seafood and water, are of increasing global public health concern. The aim of this study was to evaluate the prevalence of human pathogenic vibrios and their associated virulence genes isolated from fish and water samples from 2 commercial dusky kob farms and Kareiga estuary, South Africa. Methods: A total of 200 samples including dusky kob fish (n = 120) and seawater (n = 80) were subjected to Vibrio screening on thiosulfate-citrate-bile salts-sucrose agar (TCBS). Presumptive isolates were confirmed and delineated to V. cholerae, V. parahaemolyticus, V. vulnificus, and V. fluvialis by PCR. Various pathogenic gene markers were screened: V. parahaemolyticus (trh and tdh), V. vulnificus (vcgE and vcgC) and V. fluvialis (stn, vfh, hupO, vfpA). Restriction Fragment Length Polymorphism (RFLP) of the vvhA gene of V. vulnificus strains was performed to determine the associated biotypes. Results: Total Vibrio prevalence was 59.4% (606/1020) of which V. fluvialis was the most predominant 193 (31.85%), followed by Vibrio vulnificus 74 (12.21%) and V. parahaemolyticus 33 (5.45%). No V. cholerae strain was detected. One of the V. parahaemolyticus strains possessed the trh gene 7 (9.46%) while most (91.9%; 68/74) V. vulnificus isolates were of the E-type genotype. V. fluvialis virulence genes detected were stn (13.5%), hupO (10.4%) and vfpA (1.0%). 12.16% (9/74) of V. vulnificus strains exhibited a biotype 3 RFLP pattern. Conclusions: This is the first report of potentially pathogenic vibrios from healthy marine fish in the study area, and therefore a public health concern. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Using Structural Equation Modeling to Assess the Links between Tobacco Smoke Exposure, Volatile Organic Compounds, and Respiratory Function for Adolescents Aged 6 to 18 in the United States
Int. J. Environ. Res. Public Health 2017, 14(10), 1112; doi:10.3390/ijerph14101112
Received: 17 August 2017 / Revised: 15 September 2017 / Accepted: 15 September 2017 / Published: 25 September 2017
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Abstract
Asthma is an inflammatory airway disease that affects 22 million Americans in the United States. Research has found associations between impaired respiratory function, including asthma and increased symptoms among asthmatics, and common indoor air pollutants, including tobacco smoke exposure and volatile organic compounds
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Asthma is an inflammatory airway disease that affects 22 million Americans in the United States. Research has found associations between impaired respiratory function, including asthma and increased symptoms among asthmatics, and common indoor air pollutants, including tobacco smoke exposure and volatile organic compounds (VOCs). However, findings linking VOC exposure and asthma are inconsistent and studies are of mixed quality due to design limitations, challenges measuring VOC exposure, small sample sizes, and suboptimal statistical methodologies. Because of the correlation between tobacco smoke exposure and VOCs, and associations between both tobacco smoke and VOCs with respiratory function, it is crucial that statistical methodology employed to assess links between respiratory function and individual air pollutants control for these complex relationships. This research uses Structural Equation Modeling (SEM) to assess the relationships between respiratory function, tobacco smoke exposure, and VOC exposure among a nationally-representative sample of adolescents. SEM allows for multiple outcome variables, the inclusion of both observed and latent variables, and controls the effects of confounding and correlated variables, which is critically important and is lacking in earlier studies when estimating the effects of correlated air pollutants on respiratory function. We find evidence of associations between respiratory function and some types of VOCs, even when controlling for the effects of tobacco smoke exposure and additional covariates. Furthermore, we find that poverty has an indirect effect on respiratory function through its relationships with tobacco smoke exposure and some types of VOCs. This analysis demonstrates how SEM is a robust analytic tool for assessing associations between respiratory function and multiple exposures to pollutants. Full article
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Open AccessArticle Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China
Int. J. Environ. Res. Public Health 2017, 14(10), 1114; doi:10.3390/ijerph14101114
Received: 17 August 2017 / Revised: 19 September 2017 / Accepted: 22 September 2017 / Published: 25 September 2017
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Abstract
Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic
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Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP) and Geographic International System (GIS). Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Usability of a Medication Event Reminder Monitor System (MERM) by Providers and Patients to Improve Adherence in the Management of Tuberculosis
Int. J. Environ. Res. Public Health 2017, 14(10), 1115; doi:10.3390/ijerph14101115
Received: 31 July 2017 / Revised: 11 September 2017 / Accepted: 16 September 2017 / Published: 25 September 2017
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Abstract
Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of
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Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of DOT is burdensome for providers and patients, especially in resource-limited settings, where most of the burden of active TB is located. Among the alternatives to DOT is electronic monitoring (EM) of drug dosing histories. Here we report a usability study of a newly-designed, modular electronic monitor product, called the MERM (Medication Event and Reminder Monitor), that is compatible with TB medication formats and supply chains in resource-limited settings. This study, done in a rural setting in China, showed that the use of the MERM for EM of TB medications was associated with a high degree of user performance, acceptability, and satisfaction among both TB patients and medical staff. Based on these data, EM is becoming the standard of care for drug-susceptible TB patients in China and scaled implementations in several other countries with high TB burden have begun. In addition, the MERM is being used in MDR-TB patients and in clinical trials involving patients with TB/HIV and latent TB. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle School Bullying in Urban China: Prevalence and Correlation with School Climate
Int. J. Environ. Res. Public Health 2017, 14(10), 1116; doi:10.3390/ijerph14101116
Received: 28 August 2017 / Revised: 13 September 2017 / Accepted: 21 September 2017 / Published: 25 September 2017
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Abstract
School violence and bullying in China is under investigated, though it has become a national concern recently. Using updated national representative survey data collected in 2016 from seven provinces across China, covering students from all pre-college school types (primary, middle, high and vocational
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School violence and bullying in China is under investigated, though it has become a national concern recently. Using updated national representative survey data collected in 2016 from seven provinces across China, covering students from all pre-college school types (primary, middle, high and vocational schools), this paper analyzes the prevalence of school bullying and the correlation with several school attributes. The incidences of reported bullying, bullying others and witnessing bullying are 26.10%, 9.03% and 28.90%, respectively. Primary school students are more likely to be involved in bullying behaviors. Students from elite schools (leading schools) are also more likely to be involved. Relation with teachers, relation with peers and perceived academic achievement are protective factors. Being a boy is the only significant predictor of school bullying among the family and demographic characteristics used. The results highlight the importance of school climate on preventing school violence and bullying, and a whole-school intervention approach is needed for future intervention. Full article
(This article belongs to the Special Issue Youth Violence as a Public Health Issue)
Open AccessArticle How Fencing Affects the Soil Quality and Plant Biomass in the Grassland of the Loess Plateau
Int. J. Environ. Res. Public Health 2017, 14(10), 1117; doi:10.3390/ijerph14101117
Received: 13 September 2017 / Revised: 21 September 2017 / Accepted: 21 September 2017 / Published: 25 September 2017
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Abstract
Overgrazing is a severe problem in several regions in Northwestern China and has caused serious land degradation. Secondary natural succession plays an important role in the accumulation of soil carbon and nitrogen contents. Estimating the effects of grazing exclusion on soil quality and
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Overgrazing is a severe problem in several regions in Northwestern China and has caused serious land degradation. Secondary natural succession plays an important role in the accumulation of soil carbon and nitrogen contents. Estimating the effects of grazing exclusion on soil quality and plant diversity will improve our understanding of the succession process after overgrazing and promote judicious management of degraded pastures. This experiment was designed to measure soil properties and plant diversity following an age chronosequence of grasslands (ages ranged from one year, 12 years, 20 years, and 30 years) in Northwestern China. The results showed that continuous fencing resulted in a considerable increase in plant coverage, plant biomass (above- and below-ground biomass), and plant diversity, which can directly or indirectly improve the accumulation of soil organic carbon and total nitrogen content. The plant coverage and the above- and below-ground biomass linearly increased along the succession time, whereas soil organic C and N contents showed a significant decline in the first 12 years and, subsequently, a significant increase. The increased plant biomass caused an increase in soil organic carbon and soil total nitrogen. These results suggested that soil restoration and plant cover were an incongruous process. Generally, soil restoration is a slow process and falls behind vegetation recovery after grazing exclusion. Although the accumulation of soil C and N stocks needed a long term, vegetation restoration was a considerable option for the degraded grassland due to the significant increase of plant biomass, diversity, and soil C and N stocks. Therefore, fencing with natural succession should be considered in the design of future degraded pastures. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Health Care Payments in Vietnam: Patients’ Quagmire of Caring for Health versus Economic Destitution
Int. J. Environ. Res. Public Health 2017, 14(10), 1118; doi:10.3390/ijerph14101118
Received: 2 August 2017 / Revised: 21 September 2017 / Accepted: 22 September 2017 / Published: 25 September 2017
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Abstract
In the last three decades many developing and middle-income nations’ health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing
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In the last three decades many developing and middle-income nations’ health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam’s current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment). Empirical results however suggest that this may be catastrophic for low-income earners: if insurance cover reimbursement decreases below 50% of actual health expenditures, the probability of Vietnamese falling into destitution will rise further. Our findings provide policy implications and directions to improve Vietnam’s health care system, in particular by ensuring the utilization of health services and financial protection for the people. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Comparison of Malaria Simulations Driven by Meteorological Observations and Reanalysis Products in Senegal
Int. J. Environ. Res. Public Health 2017, 14(10), 1119; doi:10.3390/ijerph14101119
Received: 4 July 2017 / Revised: 14 September 2017 / Accepted: 18 September 2017 / Published: 25 September 2017
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Abstract
The analysis of the spatial and temporal variability of climate parameters is crucial to study the impact of climate-sensitive vector-borne diseases such as malaria. The use of malaria models is an alternative way of producing potential malaria historical data for Senegal due to
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The analysis of the spatial and temporal variability of climate parameters is crucial to study the impact of climate-sensitive vector-borne diseases such as malaria. The use of malaria models is an alternative way of producing potential malaria historical data for Senegal due to the lack of reliable observations for malaria outbreaks over a long time period. Consequently, here we use the Liverpool Malaria Model (LMM), driven by different climatic datasets, in order to study and validate simulated malaria parameters over Senegal. The findings confirm that the risk of malaria transmission is mainly linked to climate variables such as rainfall and temperature as well as specific landscape characteristics. For the whole of Senegal, a lag of two months is generally observed between the peak of rainfall in August and the maximum number of reported malaria cases in October. The malaria transmission season usually takes place from September to November, corresponding to the second peak of temperature occurring in October. Observed malaria data from the Programme National de Lutte contre le Paludisme (PNLP, National Malaria control Programme in Senegal) and outputs from the meteorological data used in this study were compared. The malaria model outputs present some consistencies with observed malaria dynamics over Senegal, and further allow the exploration of simulations performed with reanalysis data sets over a longer time period. The simulated malaria risk significantly decreased during the 1970s and 1980s over Senegal. This result is consistent with the observed decrease of malaria vectors and malaria cases reported by field entomologists and clinicians in the literature. The main differences between model outputs and observations regard amplitude, but can be related not only to reanalysis deficiencies but also to other environmental and socio-economic factors that are not included in this mechanistic malaria model framework. The present study can be considered as a validation of the reliability of reanalysis to be used as inputs for the calculation of malaria parameters in the Sahel using dynamical malaria models. Full article
(This article belongs to the Special Issue Malaria Epidemiology and Control: Current Situation and Perspectives)
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Open AccessArticle Mercury, Fatty Acids Content and Lipid Quality Indexes in Muscles of Freshwater and Marine Fish on the Polish Market. Risk Assessment of Fish Consumption
Int. J. Environ. Res. Public Health 2017, 14(10), 1120; doi:10.3390/ijerph14101120
Received: 26 July 2017 / Revised: 14 September 2017 / Accepted: 19 September 2017 / Published: 25 September 2017
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Abstract
Mercury content and fatty acids in muscles of Perca fluviatilis L. (European perch), Leuciscus idus L. (ide), Cyprinus carpio L. (European or common carp), Oncorhynchus mykiss Walb. (rainbow trout), Platichthys flesus L. (European flounder). and Clupea harengus L. (bream) from the Polish market
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Mercury content and fatty acids in muscles of Perca fluviatilis L. (European perch), Leuciscus idus L. (ide), Cyprinus carpio L. (European or common carp), Oncorhynchus mykiss Walb. (rainbow trout), Platichthys flesus L. (European flounder). and Clupea harengus L. (bream) from the Polish market were investigated. The total mercury was processed with AAS. The fatty acids were analyzed by gas chromatography. The concentration of mercury in muscles varied from 0.006 to 0.138 mg/kg and decreased as follows: perch ≈ ide > flounder > herring ≈ bream ≈ rainbow trout > carp (p ≤ 0.05). There were only significant positive correlations between body weight and mercury content in muscle tissue of carp (r = 0.878), flounder (r = 0.925) and herring (r = 0.982) (p ≤ 0.05). The atherogenic index (AI), thrombogenicity index (TI) and flesh-lipid quality index (FLQ) were calculated as follows 0.33–0.70 (IA), 0.16–0.31 (IT) and 13.01–33.22 (FLQ). Hypocholesterolemic (OFA) and hypercholesterolemic fatty acids (DFA) in muscles of fish ranged from 18.26 to 23.01 and from 73.91 to 78.46, respectively. In most cases, there were not significant correlations between size (body weight and total length) and fatty acids in the muscles of the examined fish (p > 0.05). The Target Hazard Quotient (THQ) values were below 1, which shows that there is no non-carcinogenic health risk to the consumer by consuming the examined fish. Full article
(This article belongs to the Special Issue Dietary Exposures)
Open AccessArticle Vitamin D Concentration in Maternal and Umbilical Cord Blood by Season
Int. J. Environ. Res. Public Health 2017, 14(10), 1121; doi:10.3390/ijerph14101121
Received: 11 August 2017 / Revised: 21 September 2017 / Accepted: 22 September 2017 / Published: 26 September 2017
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Abstract
Summer is generally considered to be the season when the body is well-supplied with vitamin D. The aim of this study was to compare maternal and umbilical cord blood concentrations of vitamin D during two extreme seasons of the year in Poland—winter and
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Summer is generally considered to be the season when the body is well-supplied with vitamin D. The aim of this study was to compare maternal and umbilical cord blood concentrations of vitamin D during two extreme seasons of the year in Poland—winter and summer. A total of 100 pregnant women with no history of chronic diseases before pregnancy were included in the study. Pre-delivery maternal venous blood and neonatal cord blood samples were collected and total 25(OH)D concentration was measured. Data on vitamin D consumption (collected with the use of Food Frequency Questionnaire) and lifestyle factors were taken. Both, maternal and umbilical cord blood concentrations of vitamin D were higher in the summer group as compared to the winter group (mean 22.2 ± 6.5 ng/mL vs. 16.5 ± 8.2 ng/mL (p < 0.001), respectively for the mothers and 31.3 ± 9.4 ng/mL vs. 22.7 ± 11.0 ng/mL (p < 0.0001), respectively for the neonates). However, only 16% of the pregnant women reached the optimal vitamin D concentration during summer. Therefore, summer improves the levels of vitamin D in the body but does not guarantee the recommended concentration and supplementation throughout the whole year is essential. Full article
(This article belongs to the Special Issue Maternal and Child Health)
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Open AccessArticle Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents
Int. J. Environ. Res. Public Health 2017, 14(10), 1122; doi:10.3390/ijerph14101122
Received: 2 August 2017 / Revised: 19 September 2017 / Accepted: 21 September 2017 / Published: 26 September 2017
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Abstract
Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use
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Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use of appropriate CRS and insights into the preferences of various technological approaches to deliver CRS education. Focus groups (eight groups with 21 participants) and a quantitative national survey (N = 1251) using MTurk were conducted. Although there were differences in the age, racial/ethnic background, and educational level between the focus group participants and the national sample, there was a great deal of consistency in the need for more timely and personalized information about CRS. The majority of parents did not utilize car seat check professionals although they expressed interest in and lack of knowledge about how to access these resources. Although there was some interest in an app that would be personalized and able to push just-in-time content (e.g., new guidelines, location and times of car seat checks), content that has sporadic relevance (e.g., initial installation) seemed more appropriate for a website. Stakeholder input is critical to guide the development and delivery of acceptable and useful child safety education. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
Open AccessArticle How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?
Int. J. Environ. Res. Public Health 2017, 14(10), 1123; doi:10.3390/ijerph14101123
Received: 13 July 2017 / Revised: 16 September 2017 / Accepted: 22 September 2017 / Published: 26 September 2017
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Abstract
Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured
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Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X2 tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and “organizational learning and continuous improvement” were ≥75%, which denoted strengths, and the PPRs for “staffing” and “non-punitive response to errors” were ≤50%, which denoted weaknesses in surgical units and other units. Three dimensions for surgical departments were weaker than those for other departments (p < 0.05). The staff from surgical units reported more events compared with the other units, but only a few respondents in surgical settings evaluated patient safety grade as good/excellent. Four dimensions influenced patient safety grade, and three dimensions influenced event reporting in surgical units. Conclusions: Strategies including recruiting workers, using the reporting system, and building a non-punitive culture should be adopted in the surgical units of county hospitals in China to improve safety culture. Supervisors should also prioritise patient safety. Full article
(This article belongs to the Special Issue Quality of Patient-Centered Care)
Open AccessArticle Alcohol-Related Physical Abuse of Children in the Slums of Kampala, Uganda
Int. J. Environ. Res. Public Health 2017, 14(10), 1124; doi:10.3390/ijerph14101124
Received: 3 August 2017 / Revised: 13 September 2017 / Accepted: 21 September 2017 / Published: 26 September 2017
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Abstract
This study examines the patterns of alcohol-related physical abuse and alcohol use and related behaviors among children living in the slums of Kampala, Uganda. The study is based on a cross-sectional survey, conducted in spring 2014, of service-seeking children ages 12 to 18
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This study examines the patterns of alcohol-related physical abuse and alcohol use and related behaviors among children living in the slums of Kampala, Uganda. The study is based on a cross-sectional survey, conducted in spring 2014, of service-seeking children ages 12 to 18 years (n = 1134) attending Uganda Youth Development Link drop-in centers for vulnerable children in the slums. Descriptive statistics, chi-squares, and bivariate and multivariable logistic regression analyses were conducted to determine patterns of children’s alcohol-related behaviors, based on alcohol-related physical abuse and neglect. Nearly 34% of children (n = 380) reported experiencing physical abuse, and 12.4% (n = 140) reported experiencing alcohol-related physical abuse. Alcohol-related neglect was reported among 19.6% (n = 212) of the children. Past year alcohol use was significantly more prevalent among children who reported experiencing alcohol-related neglect ( χ 2 = 79.18, df = 1, p < 0.0001) and alcohol-related physical abuse ( χ 2 = 62.02, df = 1, p < 0.0001). Reporting physical abuse was also associated with parental alcohol use (OR: 1.85; 95% CI: 1.38, 2.48) and parental partner violence (OR: 5.51; 95% CI: 4.09, 7.43), after adjusting for other variables in the model. Given the high levels of alcohol-related abuse and neglect reported in this population, both primary and secondary prevention initiatives are needed to improve parenting strategies and to reduce alcohol-related harm. Similarly, strategies to reduce and delay alcohol use among these vulnerable children are also needed. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
Open AccessArticle Industrial Cooling Tower Disinfection Treatment to Prevent Legionella spp.
Int. J. Environ. Res. Public Health 2017, 14(10), 1125; doi:10.3390/ijerph14101125
Received: 28 July 2017 / Revised: 19 September 2017 / Accepted: 22 September 2017 / Published: 26 September 2017
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Abstract
The contamination of industrial cooling towers has been identified as one cause of legionellosis, but the real risk has been underestimated. Two different disinfection treatments were tested on Legionella colonization in an industrial Cooling Tower System (CTS). Environmental monitoring of Legionella, P.
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The contamination of industrial cooling towers has been identified as one cause of legionellosis, but the real risk has been underestimated. Two different disinfection treatments were tested on Legionella colonization in an industrial Cooling Tower System (CTS). Environmental monitoring of Legionella, P. aeruginosa, and a heterotrophic plate count (HPC) at 36 °C was performed from June to October 2016. The disinfection procedures adopted were based on hydrogen peroxide (H2O2) and silver salts (Ag+), in addition to an anti-algal treatment, then using hyperclorination as a shock, and then continuous treatment by sodium hypochlorite (NaClO). L. pneumophila serogroup 8 was found at a concentration of 5.06 Log cfu/L after the CTS filling; a shock treatment performed by H2O2/Ag+ produced a rapid increase in contamination up to 6.14 Log cfu/L. The CTS activity was stopped and two subsequent shock treatments were performed using NaClO, followed by continuous hyperclorination. These procedures showed a significant decrease (p < 0.05) in Legionella concentration (1.77 Log cfu/L). The same trend was observed for P. aeruginosa (0.55 Log cfu/100 mL) and HPC (1.95 Log cfu/mL) at 36 °C. Environmental monitoring and the adoption of maintenance procedures, including anti-scale treatment, and physical, chemical, and microbiological control, ensure the good performance of a CTS, reducing the Legionella risk for public health. Full article
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Open AccessArticle Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland
Int. J. Environ. Res. Public Health 2017, 14(10), 1126; doi:10.3390/ijerph14101126
Received: 30 August 2017 / Revised: 18 September 2017 / Accepted: 19 September 2017 / Published: 26 September 2017
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Abstract
Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski
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Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%), lack of time (28.1%), no willingness to exercise (25.4%). Close to 82% of the surveyed population did not practice commuting physical activity (CPA). The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11–1.65; p ≤ 0.05). Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessFeature PaperArticle Socioeconomic Inequalities in Health and Perceived Unmet Needs for Healthcare among the Elderly in Germany
Int. J. Environ. Res. Public Health 2017, 14(10), 1127; doi:10.3390/ijerph14101127
Received: 17 July 2017 / Revised: 18 September 2017 / Accepted: 21 September 2017 / Published: 26 September 2017
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Abstract
Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived
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Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived from the Robert Koch Institute’s cross-sectional German Health Update study. The sample was restricted to participants aged 50–85 years (n = 11,811). Socioeconomic status (SES) was measured based on education, (former) occupation, and income. Odds ratios and prevalence differences were estimated using logistic regression and linear probability models, respectively. Our results show that self-reported health problems were more prevalent among men and women with lower SES. The extent of SES-related health inequalities decreased at older ages, predominantly among men. Although the prevalence of perceived unmet needs for healthcare was low overall, low SES was associated with higher perceptions of unmet needs in both sexes and for several kinds of health services. In conclusion, socioeconomic inequalities in health exist in a late working age and early retirement but may narrow at older ages, particularly among men. Socially disadvantaged elderly people perceive greater barriers to accessing healthcare services than those who are better off. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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Open AccessArticle Worsening Inequalities in Child Injury Deaths in the WHO European Region
Int. J. Environ. Res. Public Health 2017, 14(10), 1128; doi:10.3390/ijerph14101128
Received: 8 August 2017 / Revised: 2 September 2017 / Accepted: 19 September 2017 / Published: 26 September 2017
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Abstract
This article compares the mortality data for injuries in children aged 0–14 years in the World Health Organization WHO European region as estimated by the WHO Global Health Estimates for 2000 and 2015. While the region has seen a decline in child mortality
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This article compares the mortality data for injuries in children aged 0–14 years in the World Health Organization WHO European region as estimated by the WHO Global Health Estimates for 2000 and 2015. While the region has seen a decline in child mortality due to injuries over the years, inequality persists between the low- and middle-income countries and high-income countries in the region. The gap in child mortality due to unintentional injuries has widened over the years between these two socioeconomic regions, particularly in terms of road injuries. In contrast, mortality rate ratios due to intentional injuries have narrowed between 2000 and 2015. The low- and middle-income countries need to scale up their efforts in injury prevention by adopting stricter regulations and higher safety practices to narrow the East-West gap in unintentional injuries. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
Open AccessArticle The Study of Titanium and Zirconium Ions in Water by MPT-LTQ Mass Spectrometry in Negative Mode
Int. J. Environ. Res. Public Health 2017, 14(10), 1129; doi:10.3390/ijerph14101129
Received: 7 July 2017 / Revised: 3 September 2017 / Accepted: 18 September 2017 / Published: 26 September 2017
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Abstract
Microwave plasma torches (MPTs) can be used as simple and low power-consumption ambient ion sources. When MPT-mass spectrometry (MPT-MS) is applied in the detection of some metal elements, the metallic ions exhibit some novel features which are significantly different with those obtained by
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Microwave plasma torches (MPTs) can be used as simple and low power-consumption ambient ion sources. When MPT-mass spectrometry (MPT-MS) is applied in the detection of some metal elements, the metallic ions exhibit some novel features which are significantly different with those obtained by the traditional inductively coupled plasma (ICP)-mass spectrometry (ICP-MS) and may be helpful for metal element analysis. As the representative elements of group IVA, titanium and zirconium are both of importance and value in modern industry, and they have impacts on human health. Here, we first provide a study on the complex anions of titanium and zirconium in water by using the MPT as ion source and a linear ion trap mass spectrometer (LTQ-MS). These complex anions were produced in the plasma flame by an aqueous solution flowing through the central tube of the MPT, and were introduced into the inlet of the mass spectrometry working in negative ion mode to get the feature mass spectrometric signals. Moreover, the feature fragment patterns of these ions in multi-step collision- induced dissociation processes have been explained. Under the optimized conditions, the limit of detection (LOD) using the MS2 (the second tandem mass spectrometry) procedure was estimated to be at the level of 10μg/L for titanium and 20 μg/L for zirconium with linear dynamics ranges that cover at least two orders of magnitude, i.e., between 0–500 μg/L and 20–200 μg/L, respectively. These experimental data demonstrated that the MPT-MS is a promising and useful tool in field analysis of titanium and zirconium ions in water, and can be applied in many fields, such as environmental control, hydrogeology, and water quality inspection. In addition, MPT-MS could also be used as a supplement of ICP-MS for the rapid and on-site analysis of metal ions. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Developmental Assessments during Injury Research: Is Enrollment of Very Young Children in Crèches Associated with Better Scores?
Int. J. Environ. Res. Public Health 2017, 14(10), 1130; doi:10.3390/ijerph14101130
Received: 11 July 2017 / Revised: 18 September 2017 / Accepted: 18 September 2017 / Published: 26 September 2017
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Abstract
The Developmental Study is part of a larger intervention on “saving of lives from drowning (SoLiD)” where children were enrolled either into crèches (daycare centers) or playpens to prevent drowning in rural Bangladesh. Sampling ~1000 children between the ages of 9–17 months, we
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The Developmental Study is part of a larger intervention on “saving of lives from drowning (SoLiD)” where children were enrolled either into crèches (daycare centers) or playpens to prevent drowning in rural Bangladesh. Sampling ~1000 children between the ages of 9–17 months, we compared problem-solving, communication, motor and personal-social outcomes assessed by the Ages and Stages Questionnaire in the two interventions. After controlling for variables such as home stimulation in multivariate regressions, children in crèches performed about a quarter of a standard deviation better in total scores (p < 0.10) and 0.45 standard deviations higher in fine motor skills (p < 0.05). Moreover, once the sample was stratified by length of exposure to the intervention, then children in crèches performed significantly better in a number of domains: those enrolled the longest (about 5 months) have higher fine motor (1.47, p < 0.01), gross motor (0.40, p < 0.05) and personal-social skills (0.95, p < 0.01) than children in playpens. In addition, children in crèches with the longer exposure (about 5 months) have significantly higher personal-social and problem-solving scores than those in crèches with minimum exposure. Enrollment in crèches of very young children may be positively associated with psychosocial scores after accounting for important confounding variables. Full article
Open AccessArticle Self-Certified Sickness Absence among Young Municipal Employees—Changes from 2002 to 2016 and Occupational Class Differences
Int. J. Environ. Res. Public Health 2017, 14(10), 1131; doi:10.3390/ijerph14101131
Received: 29 August 2017 / Revised: 17 September 2017 / Accepted: 23 September 2017 / Published: 26 September 2017
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Abstract
We examined changes in self-certified, one-to-three day sickness absence (SA) among young employees from 2002 to 2016 and the magnitude of occupational class differences during that period. All 18–34-year-old employees of the City of Helsinki, Finland were included (2002–2016, n = ~11,725 per
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We examined changes in self-certified, one-to-three day sickness absence (SA) among young employees from 2002 to 2016 and the magnitude of occupational class differences during that period. All 18–34-year-old employees of the City of Helsinki, Finland were included (2002–2016, n = ~11,725 per year). Employer’s personnel and SA registers were used. Occupational class was categorized to four groups. Changes in self-certified SA from 2002 to 2016 were analyzed with Joinpoint regression and the magnitudes of occupational class differences were estimated with the relative index of inequality (RII). Most of the trends first increased and turned to decrease in 2007/2010. Managers and professionals had the least amount of SA, but steadily increasing trends were observed among men. Self-certified SA followed only partially the typical socioeconomic gradient, as routine non-manuals had the highest levels of SA. The magnitude of occupational class differences in self-certified SA was stable during the study period only among women. Self-certified SA and occupational class differences have increased in recent years among men in the lower occupational classes. Socioeconomic differences exist in self-certified SA among young employees, but gradient is only partial. Overall, high amounts of self-certified SA especially in the lower occupational classes require further studies and preventive measures. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Prenatal Exposure to Environmental Tobacco Smoke and Hyperactivity Behavior in Chinese Young Children
Int. J. Environ. Res. Public Health 2017, 14(10), 1132; doi:10.3390/ijerph14101132
Received: 13 July 2017 / Revised: 12 September 2017 / Accepted: 21 September 2017 / Published: 27 September 2017
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Abstract
This study aimed to examine the association between prenatal environmental tobacco smoke (ETS) exposure and hyperactivity behaviors in young children. A cross-sectional study was undertaken among 21,243 participants from all of the kindergartens in Longhua District of Shenzhen, China. Multivariate logistic regression models
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This study aimed to examine the association between prenatal environmental tobacco smoke (ETS) exposure and hyperactivity behaviors in young children. A cross-sectional study was undertaken among 21,243 participants from all of the kindergartens in Longhua District of Shenzhen, China. Multivariate logistic regression models and hierarchical linear models were employed to assess the associations. After adjusting for potential confounders of gender, preterm birth, birth asphyxiation, etc., prenatal ETS exposure was significantly associated with an increased risk of hyperactivity behaviors in young children (OR (95% CI) = 1.51 (1.28–1.77); β (95% CI) = 0.017 (0.013–0.020)). Along with increases in children’s prenatal ETS exposure dose (measured by daily ETS exposure duration, daily cigarette consumption by household members, and overall score of prenatal ETS exposure), the children were also increasingly more likely to exhibit hyperactivity behaviors. Furthermore, children whose mothers had prenatal ETS exposure in any one or more of the pregnancy trimesters were more likely to exhibit hyperactivity behaviors as compared with those born to non-exposure mothers (all p < 0.05). Overall, prenatal ETS exposure could be associated with a detrimental impact on offspring’s hyperactivity behaviors, and public health efforts are needed to reduce prenatal ETS exposure. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle Discrete Choice Model of Food Store Trips Using National Household Food Acquisition and Purchase Survey (FoodAPS)
Int. J. Environ. Res. Public Health 2017, 14(10), 1133; doi:10.3390/ijerph14101133
Received: 1 July 2017 / Revised: 8 August 2017 / Accepted: 21 September 2017 / Published: 27 September 2017
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Abstract
Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and
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Where households across income levels shop for food is of central concern within a growing body of research focused on where people live relative to where they shop, what they purchase and eat, and how those choices influence the risk of obesity and chronic disease. We analyzed data from the National Household Food Acquisition and Purchase Survey (FoodAPS) using a conditional logit model to determine where participants shop for food to be prepared and eaten at home and how individual and household characteristics of food shoppers interact with store characteristics and distance from home in determining store choice. Store size, whether or not it was a full-service supermarket, and the driving distance from home to the store constituted the three significant main effects on store choice. Overall, participants were more likely to choose larger stores, conventional supermarkets rather than super-centers and other types of stores, and stores closer to home. Interaction effects show that participants receiving Supplemental Nutrition Assistance Program (SNAP) were even more likely to choose larger stores. Hispanic participants were more likely than non-Hispanics to choose full-service supermarkets while White participants were more likely to travel further than non-Whites. This study demonstrates the value of explicitly spatial discrete choice models and provides evidence of national trends consistent with previous smaller, local studies. Full article
(This article belongs to the Special Issue Food Environment, Diet, and Health)
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Open AccessArticle An Efficient Test for Gene-Environment Interaction in Generalized Linear Mixed Models with Family Data
Int. J. Environ. Res. Public Health 2017, 14(10), 1134; doi:10.3390/ijerph14101134
Received: 19 August 2017 / Revised: 20 September 2017 / Accepted: 25 September 2017 / Published: 27 September 2017
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Abstract
Gene-environment (GE) interaction has important implications in the etiology of complex diseases that are caused by a combination of genetic factors and environment variables. Several authors have developed GE analysis in the context of independent subjects or longitudinal data using a gene-set. In
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Gene-environment (GE) interaction has important implications in the etiology of complex diseases that are caused by a combination of genetic factors and environment variables. Several authors have developed GE analysis in the context of independent subjects or longitudinal data using a gene-set. In this paper, we propose to analyze GE interaction for discrete and continuous phenotypes in family studies by incorporating the relatedness among the relatives for each family into a generalized linear mixed model (GLMM) and by using a gene-based variance component test. In addition, we deal with collinearity problems arising from linkage disequilibrium among single nucleotide polymorphisms (SNPs) by considering their coefficients as random effects under the null model estimation. We show that the best linear unbiased predictor (BLUP) of such random effects in the GLMM is equivalent to the ridge regression estimator. This equivalence provides a simple method to estimate the ridge penalty parameter in comparison to other computationally-demanding estimation approaches based on cross-validation schemes. We evaluated the proposed test using simulation studies and applied it to real data from the Baependi Heart Study consisting of 76 families. Using our approach, we identified an interaction between BMI and the Peroxisome Proliferator Activated Receptor Gamma (PPARG) gene associated with diabetes. Full article
(This article belongs to the Special Issue Gene-Environment Interactions and Disease)
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Open AccessArticle How Canada Changed from Exporting Asbestos to Banning Asbestos: The Challenges That Had to Be Overcome
Int. J. Environ. Res. Public Health 2017, 14(10), 1135; doi:10.3390/ijerph14101135
Received: 5 September 2017 / Revised: 21 September 2017 / Accepted: 22 September 2017 / Published: 27 September 2017
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Abstract
Less than ten years ago, the asbestos industry enjoyed the support of every Quebec and Canadian political party. The Chrysotile Institute and the International Chrysotile Association, both located in Quebec, aggressively marketed asbestos around the world, claiming scientific evidence showed that chrysotile asbestos
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Less than ten years ago, the asbestos industry enjoyed the support of every Quebec and Canadian political party. The Chrysotile Institute and the International Chrysotile Association, both located in Quebec, aggressively marketed asbestos around the world, claiming scientific evidence showed that chrysotile asbestos could be safely used. The industry created a climate of intimidation. Consequently, no groups advocating for victims of asbestos or campaigning for its outright ban existed in Quebec to challenge the industry. A campaign was launched to mobilize the scientific community to speak out. Working with scientists, activists, and asbestos victims around the world, a small group of Quebec scientists exposed the false arguments of the asbestos industry. They publicly and repeatedly challenged the unscientific and unethical asbestos policy of the government. By appealing to Quebec values and holding those in power accountable, the campaign won public support and succeeded against all odds in defeating the asbestos industry. Full article
Open AccessArticle Incidence of Cancer in Shenzhen, Guangdong Province during 2001–2015: A Retrospective Population-Based Study
Int. J. Environ. Res. Public Health 2017, 14(10), 1137; doi:10.3390/ijerph14101137
Received: 11 August 2017 / Revised: 22 September 2017 / Accepted: 22 September 2017 / Published: 27 September 2017
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Abstract
Cancer is a serious public health issue and the leading cause of death around the world. This article aimed to estimate the cancer incidence and the trend in standardized cancer incidence in Shenzhen, Guangdong province, South China during 2001–2015 by analyzing the cancer
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Cancer is a serious public health issue and the leading cause of death around the world. This article aimed to estimate the cancer incidence and the trend in standardized cancer incidence in Shenzhen, Guangdong province, South China during 2001–2015 by analyzing the cancer data of the population-based cancer registry in Shenzhen. Data were collected from the cancer registry in Shenzhen, which was conducted during 2001–2015. In this registry, the crude incidence rates, age-specific incidence rates, age-standardized incidence rates and cumulative incidence rates were calculated in every five years. Trends for standardized incidence rates of cancers were analyzed by using the joinpoint regression analysis. In total, 33,374.3 thousand person-years (17,593.9 thousand for males and 15,780.4 thousand for females) were monitored over this time period. The number of new cancer cases during 2001–2015 was 59,218 (30,144 and 29,074 for males and females, respectively). The crude incidence during 2001–2005 was 136.44 per 100,000 persons, while the age-standardized rates by Chinese standard population (ASR-China) and by world standard population (ASR-world) were 165.13 and 212.48 per 100,000 persons, respectively. The crude incidence during 2006–2010 was 179.01 per 100,000 persons, while the ASR-China and ASR-world were 168.08 and 214.44 per 100,000 persons, respectively. The crude incidence during 2011–2015 was 196.53 per 100,000 persons, while the ASR-China and ASR-world were 171.44 and 219.99 per 100,000 persons, respectively. During 2001 and 2015, the joinpoint regression analysis showed that the ASR-China of cancer had an overall increase of 0.96% per year and 0.84% per year for males and females respectively, although both of these values (males and females) were non-significant increases. The leading cancer types during 2011–2015 were lung, colorectal, thyroid gland, breast, liver, stomach, cervix, nasopharynx, leukemia and lymphoma. For males, the top five common cancers were lung, liver, colorectal, stomach and thyroid gland. For females, the top five common cancers were breast, thyroid gland, lung, colorectal and cervix. The results of this study showed a heavy cancer burden among the population of Shenzhen, China. Future researches of the etiology and prevention of cancers should be planned in order to reduce the incidence associated with cancers in the future. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle LRBA Gene Polymorphisms and Risk of Coal Workers’ Pneumoconiosis: A Case–Control Study from China
Int. J. Environ. Res. Public Health 2017, 14(10), 1138; doi:10.3390/ijerph14101138
Received: 3 August 2017 / Revised: 28 August 2017 / Accepted: 21 September 2017 / Published: 27 September 2017
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Abstract
The lipopolysaccharide (LPS)-responsive beige-like anchor protein (LRBA) is a member of the WDL-BEACH-WD (WBW) gene family. Defects in this gene are associated with the disordered autoimmunity in various diseases, including pulmonary fibrosis. In this study, we investigated the association between the functional polymorphisms
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The lipopolysaccharide (LPS)-responsive beige-like anchor protein (LRBA) is a member of the WDL-BEACH-WD (WBW) gene family. Defects in this gene are associated with the disordered autoimmunity in various diseases, including pulmonary fibrosis. In this study, we investigated the association between the functional polymorphisms in LRBA and risk of coal workers’ pneumoconiosis (CWP) in a Chinese population. Three potentially functional polymorphisms (rs2290846, rs3749574, and rs1782360) in LRBA were genotyped and analyzed in a case–control study, including 703 CWP cases and 705 controls. Genotyping was performed by the ABI 7900HT Real Time PCR system. Our results suggested that genotype rs2290846 AA was significantly associated with decreased risk of CWP (Adjusted OR = 0.61, 95% CI = 0.41–0.92), and the recessive model also supported the protective role of the genotype (Adjusted OR = 0.60, 95% CI = 0.40–0.89). Further, the polymorphism of rs2290846 decreased the CWP risk among cases over 27 years of dust exposure (adjusted OR = 0.51, 95% CI = 0.28–0.94) and non-smokers (adjusted OR = 0.58, 95% CI = 0.34–1.00). A potential role of rs2290846 AA has been proposed by expression quantitative trait loci (eQTL) and The Cancer Genome Atlas (TCGA). The present results suggest that LRBA SNPs are associated with CWP susceptibility in a Chinese population. Further studies focused on detailed mechanism or larger cohorts are warranted to validate our findings. Full article
(This article belongs to the Special Issue Lung Diseases Associated with Environmental Pollutants)
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Open AccessArticle Occurrence, Ecological and Human Health Risks, and Seasonal Variations of Phenolic Compounds in Surface Water and Sediment of a Potential Polluted River Basin in China
Int. J. Environ. Res. Public Health 2017, 14(10), 1140; doi:10.3390/ijerph14101140
Received: 30 August 2017 / Revised: 22 September 2017 / Accepted: 23 September 2017 / Published: 27 September 2017
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Abstract
Five phenolic compounds in water and sediment of Yinma River Basin were investigated. The average concentration of phenol was the highest in water samples as well as in sediment samples during the wet season, 101.68 ng/L and 127.76 ng/g, respectively. 2,4,6-Trichlorophenol (2,4,6-TCP) and
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Five phenolic compounds in water and sediment of Yinma River Basin were investigated. The average concentration of phenol was the highest in water samples as well as in sediment samples during the wet season, 101.68 ng/L and 127.76 ng/g, respectively. 2,4,6-Trichlorophenol (2,4,6-TCP) and pentachlorophenol (PCP) was not detected in some sampling sites. Shitou Koumen Reservoir and the neighboring area were the severest areas of phenolic pollution. The lower reach was more polluted in three water seasons than the middle reach and upper reach. Phenol had ecological risks in sediment during three water seasons. 2-Nitrophenol (2-NP) and 2,4-dichlorophenol (2,4-DCP) had ecological risks in sediment in both the normal and wet season. The concentrations of five phenolic compounds from high to low were in the wet season, normal season, and dry season in water and sediment, respectively. There were middle risks in water of total concentrations for five phenolic compounds in several sampling sites. Total concentrations for five phenolic compounds in sediment had high ecological risks in all sampling sites. However, there was no human health risk in the Yinma River Basin. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle A Longitudinal Study of Child Maltreatment and Mental Health Predictors of Admission to Psychiatric Residential Treatment Facilities
Int. J. Environ. Res. Public Health 2017, 14(10), 1141; doi:10.3390/ijerph14101141
Received: 1 August 2017 / Revised: 18 September 2017 / Accepted: 25 September 2017 / Published: 28 September 2017
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Abstract
The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs) are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children
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The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs) are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children in out-of-home care, research is needed to examine the factors that predict entry in PRTFs among children investigated for maltreatment. This exploratory study used cross-sector administrative records linked across multiple systems, including child welfare records and Medicaid claims, from a single state over a five-year period (n = 105,982). Cox proportional hazards modeling was used to predict entry into a PRTF. After controlling for many factors, PRTF entry was predicted by diagnosis code indicating a trauma-related condition, antipsychotic medication prescriptions, and entry into lower levels of out-of-home care, supporting the view that youth are admitted to PRTFs largely due to clinical need. However, PRTF admission is also associated with characteristics of their experiences with the social service system, primarily foster care placement stability and permanency. Implications for practice and research are discussed. Full article
(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)
Open AccessArticle Sun Exposure, Sun-Related Symptoms, and Sun Protection Practices in an African Informal Traditional Medicines Market
Int. J. Environ. Res. Public Health 2017, 14(10), 1142; doi:10.3390/ijerph14101142
Received: 11 September 2017 / Revised: 22 September 2017 / Accepted: 25 September 2017 / Published: 28 September 2017
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Abstract
Informal workers in African market trade have little formal protection against sun exposure. We aimed to examine sun exposure, sun-related symptoms, and sun protection practices in an informal occupational setting. Trained fieldworkers asked 236 workers in the Warwick Junction market about their workplace,
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Informal workers in African market trade have little formal protection against sun exposure. We aimed to examine sun exposure, sun-related symptoms, and sun protection practices in an informal occupational setting. Trained fieldworkers asked 236 workers in the Warwick Junction market about their workplace, skin and eye sensitivity and skin colour, symptoms faced at work during the summer due to heat, and preventive measures. Data were analyzed using univariate logistic regression to assess the effect of gender and the risk of experiencing symptoms to sun exposure in relation to pre-existing diseases and perception of sun exposure as a hazard. Of the 236 participants, 234 were Black African and 141 (59.7%) were female. Portable shade was the most commonly used form of sun protection (69.9%). Glare from the sun (59.7%) and excessive sweating (57.6%) were commonly reported sun-related health symptoms. The use of protective clothing was more prevalent among those who perceived sun exposure as a hazard (p = 0.003). In an informal occupational setting, sun exposure was high. Protective clothing and portable shade to eliminate heat and bright light were self-implemented. Action by local authorities to protect informal workers should consider sun exposure to support workers in their efforts to cope in hot weather. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Effect Modification by Environmental Quality on the Association between Heatwaves and Mortality in Alabama, United States
Int. J. Environ. Res. Public Health 2017, 14(10), 1143; doi:10.3390/ijerph14101143
Received: 28 August 2017 / Revised: 22 September 2017 / Accepted: 24 September 2017 / Published: 28 September 2017
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Abstract
Background: Previous studies have shown that heatwaves are associated with increased mortality. However, it remains unclear whether the associations between heatwaves and mortality are modified by the environmental quality. Methods: We used the United States (US) Environmental Protection Agency’s Environmental Quality
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Background: Previous studies have shown that heatwaves are associated with increased mortality. However, it remains unclear whether the associations between heatwaves and mortality are modified by the environmental quality. Methods: We used the United States (US) Environmental Protection Agency’s Environmental Quality Index (EQI) and its five domain indices (air, water, land, built, and sociodemographic) to represent the cumulative environmental quality. We applied a time-stratified case-crossover design to analyze the disparities in the association between heatwaves and non-accidental deaths (NAD) among counties with different environmental qualities, in metropolitan areas in Alabama (AL), United States. Results: We found significant associations between heatwaves and NAD and a significant effect modification of this relationship by EQI. There were higher odds ratios in counties with the worst cumulative environmental qualities compared to counties with the best cumulative environmental qualities. For example, the percent change in odds ratio (mean and (95% CI)) between heatwave days and non-heatwave days was −10.3% (−26.6, 9.6) in counties with an overall EQI of 1 (the best overall environment) and 13.2% (4.9, 22.2) in counties with an overall EQI of 3 (the worst overall environment). Among the five domains, air quality had the strongest effect modification on the association. Conclusion: Our findings provide evidence that the associations between heatwaves and NAD vary among areas with different environmental qualities. These findings suggest that integration of air quality and heatwave warning systems may provide greater protection to public health. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Health-Related Quality of Life and Function after Paediatric Injuries in India: A Longitudinal Study
Int. J. Environ. Res. Public Health 2017, 14(10), 1144; doi:10.3390/ijerph14101144
Received: 7 September 2017 / Revised: 22 September 2017 / Accepted: 25 September 2017 / Published: 28 September 2017
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Abstract
Paediatric injuries can lead to long-term functional impairment and reduced health-related quality of life, and are a growing public health issue in India. To date, however, the burden has been poorly characterized. This study assessed the impact of non-fatal injuries on health-related quality
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Paediatric injuries can lead to long-term functional impairment and reduced health-related quality of life, and are a growing public health issue in India. To date, however, the burden has been poorly characterized. This study assessed the impact of non-fatal injuries on health-related quality of life in a prospective cohort study of 373 children admitted to three hospitals in Chandigarh and Haryana states in India. The Pediatric Quality of Life Inventory (PedsQL) and King’s Outcome Scale for Childhood Head Injury (KOSCHI) were administered at baseline (pre-injury) and at 1, 2, 4, and 12 months post-injury by telephone interview. Follow-up at all-time points was completed for 277 (77%) of all living participants. Less than one percent reported ongoing disability at 4 months, and no disability was reported at 12 months. PedsQL physical health scores were below healthy child norms (83.4) at 1 month in the cohort for ages 8–12 years and 13–16 years. Although injuries are prevalent, ongoing impact on functioning and disability from most childhood injuries at 12 months was reported to be low. The results raise questions about reliability of generic, Western-centric tools in low- and middle-income settings, and highlight the need for local context-specific tools. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
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Open AccessArticle The Adsorption of Cd(II) on Manganese Oxide Investigated by Batch and Modeling Techniques
Int. J. Environ. Res. Public Health 2017, 14(10), 1145; doi:10.3390/ijerph14101145
Received: 2 September 2017 / Revised: 22 September 2017 / Accepted: 22 September 2017 / Published: 28 September 2017
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Abstract
Manganese (Mn) oxide is a ubiquitous metal oxide in sub-environments. The adsorption of Cd(II) on Mn oxide as function of adsorption time, pH, ionic strength, temperature, and initial Cd(II) concentration was investigated by batch techniques. The adsorption kinetics showed that the adsorption of
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Manganese (Mn) oxide is a ubiquitous metal oxide in sub-environments. The adsorption of Cd(II) on Mn oxide as function of adsorption time, pH, ionic strength, temperature, and initial Cd(II) concentration was investigated by batch techniques. The adsorption kinetics showed that the adsorption of Cd(II) on Mn oxide can be satisfactorily simulated by pseudo-second-order kinetic model with high correlation coefficients (R2 > 0.999). The adsorption of Cd(II) on Mn oxide significantly decreased with increasing ionic strength at pH < 5.0, whereas Cd(II) adsorption was independent of ionic strength at pH > 6.0, which indicated that outer-sphere and inner-sphere surface complexation dominated the adsorption of Cd(II) on Mn oxide at pH < 5.0 and pH > 6.0, respectively. The maximum adsorption capacity of Mn oxide for Cd(II) calculated from Langmuir model was 104.17 mg/g at pH 6.0 and 298 K. The thermodynamic parameters showed that the adsorption of Cd(II) on Mn oxide was an endothermic and spontaneous process. According to the results of surface complexation modeling, the adsorption of Cd(II) on Mn oxide can be satisfactorily simulated by ion exchange sites (X2Cd) at low pH and inner-sphere surface complexation sites (SOCd+ and (SO)2CdOH species) at high pH conditions. The finding presented herein plays an important role in understanding the fate and transport of heavy metals at the water–mineral interface. Full article
(This article belongs to the Special Issue Environmental Cadmium Exposure and Public Health)
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Open AccessArticle Multiple Gene-Environment Interactions on the Angiogenesis Gene-Pathway Impact Rectal Cancer Risk and Survival
Int. J. Environ. Res. Public Health 2017, 14(10), 1146; doi:10.3390/ijerph14101146
Received: 30 July 2017 / Revised: 6 September 2017 / Accepted: 23 September 2017 / Published: 28 September 2017
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Abstract
Characterization of gene-environment interactions (GEIs) in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from
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Characterization of gene-environment interactions (GEIs) in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from 747 rectal cancer cases and 956 controls from the Diet, Activity and Lifestyle as a Risk Factor for Rectal Cancer study. We applied a 3-step analysis approach: first, we searched for interactions among single nucleotide polymorphisms on the pathway genes; second, we searched for interactions among the genes, both steps using Logic regression; third, we examined the GEIs significant at the 5% level using logistic regression for cancer risk and Cox proportional hazards models for survival. Permutation-based test was used for multiple testing adjustment. We identified 8 significant GEIs associated with risk among 6 genes adjusting for multiple testing: TNF (OR = 1.85, 95% CI: 1.10, 3.11), TLR4 (OR = 2.34, 95% CI: 1.38, 3.98), and EGR2 (OR = 2.23, 95% CI: 1.04, 4.78) with smoking; IGF1R (OR = 1.69, 95% CI: 1.04, 2.72), TLR4 (OR = 2.10, 95% CI: 1.22, 3.60) and EGR2 (OR = 2.12, 95% CI: 1.01, 4.46) with alcohol; and PDGFB (OR = 1.75, 95% CI: 1.04, 2.92) and MMP1 (OR = 2.44, 95% CI: 1.24, 4.81) with protein. Five GEIs were associated with survival at the 5% significance level but not after multiple testing adjustment: CXCR1 (HR = 2.06, 95% CI: 1.13, 3.75) with smoking; and KDR (HR = 4.36, 95% CI: 1.62, 11.73), TLR2 (HR = 9.06, 95% CI: 1.14, 72.11), EGR2 (HR = 2.45, 95% CI: 1.42, 4.22), and EGFR (HR = 6.33, 95% CI: 1.95, 20.54) with protein. GEIs between angiogenesis genes and smoking, alcohol, and animal protein impact rectal cancer risk. Our results support the importance of considering the biologic hypothesis to characterize GEIs associated with cancer outcomes. Full article
(This article belongs to the Special Issue Gene-Environment Interactions and Disease)
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Open AccessArticle Assessing and Validating an Educational Resource Package for Health Professionals to Improve Smoking Cessation Care in Aboriginal and Torres Strait Islander Pregnant Women
Int. J. Environ. Res. Public Health 2017, 14(10), 1148; doi:10.3390/ijerph14101148
Received: 26 August 2017 / Revised: 18 September 2017 / Accepted: 25 September 2017 / Published: 29 September 2017
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Abstract
Australian Aboriginal pregnant women have a high smoking prevalence (45%). Health professionals lack adequate educational resources to manage smoking. Resources need to be tailored to ensure saliency, cultural-sensitivity and account for diversity of Indigenous populations. As part of an intervention to improve health
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Australian Aboriginal pregnant women have a high smoking prevalence (45%). Health professionals lack adequate educational resources to manage smoking. Resources need to be tailored to ensure saliency, cultural-sensitivity and account for diversity of Indigenous populations. As part of an intervention to improve health professionals’ smoking cessation care in Aboriginal pregnant women, a resource package was developed collaboratively with two Aboriginal Medical Services. The purpose of this study was to assess and validate this resource package. A multi-centred community-based participatory 4-step process (with three Aboriginal Medical Services from three Australian states), included: (1) Scientific review by an expert panel (2) ‘Suitability of Materials’ scoring by two Aboriginal Health Workers (3) Readability scores (4) Focus groups with health professionals. Content was analysed using six pre-determined themes (attraction, comprehension, self-efficacy, graphics and layout, cultural acceptability, and persuasion), with further inductive analysis for emerging themes. Suitability of Material scoring was adequate or superior. Average readability was grade 6.4 for patient resources (range 5.1–7.2), and 9.8 for health provider resources (range 8.5–10.6). Emergent themes included ‘Getting the message right’; ‘Engaging with family’; ‘Needing visual aids’; and ‘Requiring practicality under a tight timeframe’. Results were presented back to a Stakeholder and Consumer Aboriginal Advisory Panel and resources were adjusted accordingly. This process ensured materials used for the intervention were culturally responsive, evidence-based and useful. This novel formative evaluation protocol could be adapted for other Indigenous and culturally diverse interventions. The added value of this time-consuming and costly process is yet to be justified in research, and might impact the potential adaption by other projects. Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
Open AccessArticle A Marine Bacterium, Bacillus sp. Isolated from the Sediment Samples of Algoa Bay in South Africa Produces a Polysaccharide-Bioflocculant
Int. J. Environ. Res. Public Health 2017, 14(10), 1149; doi:10.3390/ijerph14101149
Received: 1 September 2017 / Revised: 21 September 2017 / Accepted: 25 September 2017 / Published: 29 September 2017
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Abstract
Bioflocculants mediate the removal of suspended particles from solution and the efficiency of flocculation is dependent on the characteristics of the flocculant. Apart from the merits of biodegradability and harmlessness, bioflocculants could be viable as industrially relevant flocculants as they are a renewable
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Bioflocculants mediate the removal of suspended particles from solution and the efficiency of flocculation is dependent on the characteristics of the flocculant. Apart from the merits of biodegradability and harmlessness, bioflocculants could be viable as industrially relevant flocculants as they are a renewable resource. Additionally, the shortcomings associated with the conventionally used flocculants such as aluminium salts and acrylamide polymers, which include dementia and cancer, highlight more the need to use bioflocculants as an alternative. Consequently, in this study a marine sediment bacterial isolate was screened for bioflocculant production. Basic local alignment search tools (BLAST) analysis of 16S ribosomal deoxyribonucleic acid (rDNA) sequence of the bacterial isolate showed 98% similarity to Bacillus thuringiensis MR-R1. The bacteria produced bioflocculant optimally with inoculum size (4% v/v) (85%), glucose (85.65%) and mixed nitrogen source (urea, ammonium chloride and yeast extract) (75.9%) and the divalent cation (Ca2+) (62.3%). Under optimal conditions, a maximum flocculating activity of over 85% was attained after 60 h of cultivation. The purified polysaccharide-bioflocculant flocculated optimally at alkaline pH 12 (81%), in the presence of Mn2+ (73%) and Ca2+ (72.8%). The high flocculation activity shown indicates that the bioflocculant may contend favourably as an alternative to the conventionally used flocculants in water treatment. Full article
(This article belongs to the Special Issue Microbiological Evaluation of Wastewater Treatment)
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Open AccessArticle The Spatiotemporal Trend of City Parks in Mainland China between 1981 and 2014: Implications for the Promotion of Leisure Time Physical Activity and Planning
Int. J. Environ. Res. Public Health 2017, 14(10), 1150; doi:10.3390/ijerph14101150
Received: 15 August 2017 / Revised: 26 September 2017 / Accepted: 27 September 2017 / Published: 29 September 2017
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Abstract
City parks, important environments built for physical activity, play critical roles in preventing chronic diseases and promoting public health. We used five commonly used park indicators to investigate the spatiotemporal trend of city parks in mainland China between 1981 and 2014 at three
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City parks, important environments built for physical activity, play critical roles in preventing chronic diseases and promoting public health. We used five commonly used park indicators to investigate the spatiotemporal trend of city parks in mainland China between 1981 and 2014 at three scales: national, provincial and city class. City parks in China increased significantly with a turning point occurring around the year 2000. Up until the end of 2014, there were 13,074 city parks totaling 367,962 ha with 0.29 parks per 10,000 residents, 8.26 m2 of park per capita and 2.00% of parkland as a percentage of urban area. However, there is still a large gap compared to the established American and Japanese city park systems, and only 5.4% of people aged above 20 access city parks for physical activity. The low number of parks per 10,000 residents brings up the issue of the accessibility to physical activity areas that public parks provide. The concern of spatial disparity, also apparent for all five city park indicators, differed strongly at provincial and city class scales. The southern and eastern coastal provinces of Guangdong, Fujian, Zhejiang and Shandong have abundant city park resources. At the scale of the city classes, mega-city II had the highest of the three ratio indicators and the large city class had the lowest. On one hand, the leading province Guangdong and its mega-cities Shenzhen and Dongguan had park indicators comparable to the United States and Japan. On the other hand, there were still five cities with no city parks and many cities with extremely low park indicators. In China, few cities have realized the importance of city parks for the promotion of leisure time physical activity. It is urgent that state and city park laws or guidelines are passed that can serve as baselines for planning a park system and determining a minimum standard for city parks with free, accessible and safe physical activity areas and sports facilities. Full article
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Open AccessArticle The Monetary Valuation of Lifetime Health Improvement and Life Expectancy Gains in Turkey
Int. J. Environ. Res. Public Health 2017, 14(10), 1151; doi:10.3390/ijerph14101151
Received: 19 July 2017 / Revised: 15 September 2017 / Accepted: 23 September 2017 / Published: 29 September 2017
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Abstract
The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year
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The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year (VOLY) and the value of the healthier and longer life (VHLL) for Turkey. Contingent valuation method is adopted to reveal individuals’ willingness to pay for an improvement of health condition and the extension of their life expectancy by avoiding respiratory and lung related illnesses. VHLL is composed of two parts, WTP for an extension of one’s life years (VOLY) and for an increase in the number of healthy days throughout one’s life time (VHLL-VOLY). We found that close to 80% of WTP is allocated to the latter component of VHLL and only 20% is for VOLY mainly due to Islamic beliefs of the respondents. A total of 1314 observations are collected by face-to-face interviews from Afsin-Elbistan, Kutahya-Tavsanli and Ankara. The estimated VHLL and VOLY are [41,750 TL, 10,258 TL] with all the observations, [30,185 TL, 7132 TL] for Afsin-Elbistan, [31,718 TL, 7081 TL] for Kutahya-Tavsanli and [52,334 TL, 14,813 TL] for Ankara. The Inverse-U shaped relationship between Age and WTP is confirmed. The income elasticities of WTP is found to be close to 0.5 for all study areas while an Inverse-U shaped relationship between the household income and Income Elasticity of WTP is observed in the income group based analysis. Age and household income are the two prominent determinants of VHLL. Full article
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Open AccessArticle Antibiotic Self-Medication among Non-Medical University Students in Punjab, Pakistan: A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2017, 14(10), 1152; doi:10.3390/ijerph14101152
Received: 25 July 2017 / Revised: 11 September 2017 / Accepted: 15 September 2017 / Published: 29 September 2017
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Abstract
Background: Antibiotic resistance is a global threat. Scarce knowledge about safe and appropriate antibiotic use is coupled with frequent self-administration, e.g., in China. This repeated self-medication poses potential risk in terms of antibiotic resistance. Low-resource countries are facing an elevated burden of
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Background: Antibiotic resistance is a global threat. Scarce knowledge about safe and appropriate antibiotic use is coupled with frequent self-administration, e.g., in China. This repeated self-medication poses potential risk in terms of antibiotic resistance. Low-resource countries are facing an elevated burden of antibiotic self-medication as compared to developed ones. Thus, this study focused on evaluating the pervasiveness of antibiotic self-medication in 3 universities of Southern Punjab, Pakistan. Methods: We conducted a descriptive cross-sectional survey in three government sector universities of Southern Punjab, Pakistan. The study was carried out with self-administered paper-based questionnaires. Data was analyzed using SPSS version 18.0 (IBM, Chicago, IL, USA). Results: Seven hundred twenty-seven students out of 750 (response rate 97%) with a mean age ± SD of 23.0 ± 3.4 years agreed to participate in the study. The proportion of females was slightly greater (52%) compared with males (48%), and almost one-third of the respondents (36%) were in their 2nd year of university. Out of the total, 58.3% practiced self-medication in the preceding six months, and 326 (45%) confirmed the use of antibiotics. Metronidazole was the most frequently self-medicated antibiotic (48%). Out of the total, 72% demonstrated awareness regarding the side effects of antibiotics. Diarrhea was the well-known adverse effect (38%). Forty-three percent affirmed having antibiotic resistance knowledge, and 30% knew that the irregular use of antibiotics would lead to increased antibiotic resistance. Conclusion: Despite having ample awareness of the adverse antibiotic reactions, self-medication among the university students was high and antibiotic resistance was a fairly unknown term. Full article
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Open AccessArticle Interaction between Social/Psychosocial Factors and Genetic Variants on Body Mass Index: A Gene-Environment Interaction Analysis in a Longitudinal Setting
Int. J. Environ. Res. Public Health 2017, 14(10), 1153; doi:10.3390/ijerph14101153
Received: 1 August 2017 / Revised: 25 September 2017 / Accepted: 26 September 2017 / Published: 29 September 2017
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Abstract
Obesity, which develops over time, is one of the leading causes of chronic diseases such as cardiovascular disease. However, hundreds of BMI (body mass index)-associated genetic loci identified through large-scale genome-wide association studies (GWAS) only explain about 2.7% of BMI variation. Most common
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Obesity, which develops over time, is one of the leading causes of chronic diseases such as cardiovascular disease. However, hundreds of BMI (body mass index)-associated genetic loci identified through large-scale genome-wide association studies (GWAS) only explain about 2.7% of BMI variation. Most common human traits are believed to be influenced by both genetic and environmental factors. Past studies suggest a variety of environmental features that are associated with obesity, including socioeconomic status and psychosocial factors. This study combines both gene/regions and environmental factors to explore whether social/psychosocial factors (childhood and adult socioeconomic status, social support, anger, chronic burden, stressful life events, and depressive symptoms) modify the effect of sets of genetic variants on BMI in European American and African American participants in the Health and Retirement Study (HRS). In order to incorporate longitudinal phenotype data collected in the HRS and investigate entire sets of single nucleotide polymorphisms (SNPs) within gene/region simultaneously, we applied a novel set-based test for gene-environment interaction in longitudinal studies (LGEWIS). Childhood socioeconomic status (parental education) was found to modify the genetic effect in the gene/region around SNP rs9540493 on BMI in European Americans in the HRS. The most significant SNP (rs9540488) by childhood socioeconomic status interaction within the rs9540493 gene/region was suggestively replicated in the Multi-Ethnic Study of Atherosclerosis (MESA) (p = 0.07). Full article
(This article belongs to the Special Issue Gene-Environment Interactions and Disease)
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Open AccessArticle Playing Chemical Plant Environmental Protection Games with Historical Monitoring Data
Int. J. Environ. Res. Public Health 2017, 14(10), 1155; doi:10.3390/ijerph14101155
Received: 12 August 2017 / Revised: 26 September 2017 / Accepted: 27 September 2017 / Published: 29 September 2017
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Abstract
The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a
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The chemical industry is very important for the world economy and this industrial sector represents a substantial income source for developing countries. However, existing regulations on controlling atmospheric pollutants, and the enforcement of these regulations, often are insufficient in such countries. As a result, the deterioration of surrounding ecosystems and a quality decrease of the atmospheric environment can be observed. Previous works in this domain fail to generate executable and pragmatic solutions for inspection agencies due to practical challenges. In addressing these challenges, we introduce a so-called Chemical Plant Environment Protection Game (CPEP) to generate reasonable schedules of high-accuracy air quality monitoring stations (i.e., daily management plans) for inspection agencies. First, so-called Stackelberg Security Games (SSGs) in conjunction with source estimation methods are applied into this research. Second, high-accuracy air quality monitoring stations as well as gas sensor modules are modeled in the CPEP game. Third, simplified data analysis on the regularly discharging of chemical plants is utilized to construct the CPEP game. Finally, an illustrative case study is used to investigate the effectiveness of the CPEP game, and a realistic case study is conducted to illustrate how the models and algorithms being proposed in this paper, work in daily practice. Results show that playing a CPEP game can reduce operational costs of high-accuracy air quality monitoring stations. Moreover, evidence suggests that playing the game leads to more compliance from the chemical plants towards the inspection agencies. Therefore, the CPEP game is able to assist the environmental protection authorities in daily management work and reduce the potential risks of gaseous pollutants dispersion incidents. Full article
(This article belongs to the Special Issue Environmental Risk Assessment)
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Open AccessArticle Contributions of Work-Related Stress and Emotional Intelligence to Teacher Engagement: Additive and Interactive Effects
Int. J. Environ. Res. Public Health 2017, 14(10), 1156; doi:10.3390/ijerph14101156
Received: 16 August 2017 / Revised: 25 September 2017 / Accepted: 27 September 2017 / Published: 29 September 2017
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Abstract
This study examined the additive and interactive effects of role stress and emotional intelligence for predicting engagement among 288 teachers. Emotional intelligence and engagement were positively associated. Role ambiguity and role conflict showed negative associations with vigor and dedication scores. The interaction of
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This study examined the additive and interactive effects of role stress and emotional intelligence for predicting engagement among 288 teachers. Emotional intelligence and engagement were positively associated. Role ambiguity and role conflict showed negative associations with vigor and dedication scores. The interaction of role ambiguity and emotional intelligence was significant in explaining engagement dimensions. Similar results were found considering overall teacher engagement. Emotional intelligence boosted engagement when the levels of role ambiguity were higher. Our findings suggest the need for future research examining the impact of job hindrances on the links between emotional intelligence and teachers’ occupational well-being indicators. Finally, the implications for emotional intelligence training in education are discussed. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Factors Affecting Transfer of Pyrethroid Residues from Herbal Teas to Infusion and Influence of Physicochemical Properties of Pesticides
Int. J. Environ. Res. Public Health 2017, 14(10), 1157; doi:10.3390/ijerph14101157
Received: 1 September 2017 / Revised: 23 September 2017 / Accepted: 25 September 2017 / Published: 30 September 2017
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Abstract
The transfer of pesticide residues from herbal teas to their infusion is a subject of particular interest. In this study, a multi-residue analytical method for the determination of pyrethroids (fenpropathrin, beta-cypermethrin, lambda-cyhalothrin, and fenvalerate) in honeysuckle, chrysanthemum, wolfberry, and licorice and their infusion
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The transfer of pesticide residues from herbal teas to their infusion is a subject of particular interest. In this study, a multi-residue analytical method for the determination of pyrethroids (fenpropathrin, beta-cypermethrin, lambda-cyhalothrin, and fenvalerate) in honeysuckle, chrysanthemum, wolfberry, and licorice and their infusion samples was validated. The transfer of pyrethroid residues from tea to infusion was investigated at different water temperatures, tea/water ratios, and infusion intervals/times. The results show that low amounts (0–6.70%) of pyrethroids were transferred under the different tea brewing conditions examined, indicating that the infusion process reduced the pyrethroid content in the extracted liquid by over 90%. Similar results were obtained for the different tea varieties, and pesticides with high water solubility and low octanol–water partition coefficients (log Kow) exhibited high transfer rates. Moreover, the estimated values of the exposure risk to the pyrethroids were in the range of 0.0022–0.33, indicating that the daily intake of the four pyrethroid residues from herbal tea can be regarded as safe. The present results can support the identification of suitable tea brewing conditions for significantly reducing the pesticide residue levels in the infusion. Full article
(This article belongs to the Special Issue Dietary Exposures)
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Open AccessArticle Identification of Linkages between EDCs in Personal Care Products and Breast Cancer through Data Integration Combined with Gene Network Analysis
Int. J. Environ. Res. Public Health 2017, 14(10), 1158; doi:10.3390/ijerph14101158
Received: 14 August 2017 / Revised: 22 September 2017 / Accepted: 27 September 2017 / Published: 30 September 2017
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Abstract
Approximately 1000 chemicals have been reported to possibly have endocrine disrupting effects, some of which are used in consumer products, such as personal care products (PCPs) and cosmetics. We conducted data integration combined with gene network analysis to: (i) identify causal molecular mechanisms
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Approximately 1000 chemicals have been reported to possibly have endocrine disrupting effects, some of which are used in consumer products, such as personal care products (PCPs) and cosmetics. We conducted data integration combined with gene network analysis to: (i) identify causal molecular mechanisms between endocrine disrupting chemicals (EDCs) used in PCPs and breast cancer; and (ii) screen candidate EDCs associated with breast cancer. Among EDCs used in PCPs, four EDCs having correlation with breast cancer were selected, and we curated 27 common interacting genes between those EDCs and breast cancer to perform the gene network analysis. Based on the gene network analysis, ESR1, TP53, NCOA1, AKT1, and BCL6 were found to be key genes to demonstrate the molecular mechanisms of EDCs in the development of breast cancer. Using GeneMANIA, we additionally predicted 20 genes which could interact with the 27 common genes. In total, 47 genes combining the common and predicted genes were functionally grouped with the gene ontology and KEGG pathway terms. With those genes, we finally screened candidate EDCs for their potential to increase breast cancer risk. This study highlights that our approach can provide insights to understand mechanisms of breast cancer and identify potential EDCs which are in association with breast cancer. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Concentration Levels, Pollution Characteristics and Potential Ecological Risk of Dust Heavy Metals in the Metropolitan Area of Beijing, China
Int. J. Environ. Res. Public Health 2017, 14(10), 1159; doi:10.3390/ijerph14101159
Received: 26 August 2017 / Revised: 25 September 2017 / Accepted: 26 September 2017 / Published: 30 September 2017
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Abstract
This study aims to investigate the concentration levels, pollution characteristics and the associated potential ecological risks of the heavy metals found in dust in the metropolitan area of Beijing, China during the winter. Dust samples were collected at 49 different spatial locations of
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This study aims to investigate the concentration levels, pollution characteristics and the associated potential ecological risks of the heavy metals found in dust in the metropolitan area of Beijing, China during the winter. Dust samples were collected at 49 different spatial locations of Beijing’s metropolitan area from November 2013 to January 2014, in which the concentration levels of Cd, Cr, Pb, Cu, Zn, Ni, Co, V, Bi and Mo were measured by Elan DRC II type inductively coupled plasma mass spectrometry (ICP-MS). Test results showed that the concentrations of dust heavy metals Pb, Cr, Cu and Zn in the urban areas (147.1 mg·kg−1, 195.9 mg·kg−1, 239.2 mg·kg−1 and 713.2 mg·kg−1) were significantly higher than those in the suburbs (91.6 mg·kg−1, 125.1 mg·kg−1, 131.9 mg·kg−1 and 514.5 mg·kg−1). Enrichment factors and the geo-accumulation index were used to describe the pollution characteristics of dust heavy metals in urban and suburban areas. Results indicated that Zn and Cu were moderately polluting in both urban and suburban areas, Cd was severely polluting in urban areas and heavily polluting in the suburbs. Furthermore, potential ecological risk assessment revealed that the degrees of ecological harm of dust heavy metals were very strong in both urban and suburban areas, but especially in urban areas. The potential ecological risk of heavy metal Cd, whose single factor of ecological damage was extremely strong, accounted for about 90% of the total ecological risk. Full article
(This article belongs to the Special Issue Environmental Risk Assessment)
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Open AccessArticle “It’s a Battle… You Want to Do It, but How Will You Get It Done?”: Teachers’ and Principals’ Perceptions of Implementing Additional Physical activity in School for Academic Performance
Int. J. Environ. Res. Public Health 2017, 14(10), 1160; doi:10.3390/ijerph14101160
Received: 28 August 2017 / Revised: 27 September 2017 / Accepted: 28 September 2017 / Published: 30 September 2017
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Abstract
School is an ideal setting to promote and increase physical activity (PA) in children. However, implementation of school-based PA programmes seems difficult, in particular due to schools’ focus on academic performance and a lack of involvement of school staff in program development. The
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School is an ideal setting to promote and increase physical activity (PA) in children. However, implementation of school-based PA programmes seems difficult, in particular due to schools’ focus on academic performance and a lack of involvement of school staff in program development. The potential cognitive and academic benefits of PA might increase chances of successful implementation. Therefore, the aim of this qualitative study was: (1) to explore the perceptions of teachers and principals with regard to implementation of additional PA aimed at improving cognitive and academic performance, and (2) to identify characteristics of PA programmes that according to them are feasible in daily school practice. Twenty-six face-to-face semi-structured interviews were conducted with primary school teachers (grades 5 and 6) and principals in The Netherlands, and analysed using inductive content analysis. Teachers and principals expressed their willingness to implement additional PA if it benefits learning. Time constraints appeared to be a major barrier, and strongly influenced participants’ perceptions of feasible PA programmes. Teachers and principals emphasised that additional PA needs to be short, executed in the classroom, and provided in “ready-to-use” materials, i.e., that require no or little preparation time (e.g., a movie clip). Future research is needed to strengthen the evidence on the effects of PA for academic purposes, and should examine the forms of PA that are both effective as well as feasible in the school setting. Full article
(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)
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Open AccessArticle Higher Mortality in Trauma Patients Is Associated with Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia: A Cross-Sectional Analysis Based on a Propensity-Score Matching Approach
Int. J. Environ. Res. Public Health 2017, 14(10), 1161; doi:10.3390/ijerph14101161
Received: 18 August 2017 / Revised: 25 September 2017 / Accepted: 29 September 2017 / Published: 30 September 2017
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Abstract
Background: Stress-induced hyperglycemia (SIH) is a form of hyperglycemia secondary to stress and commonly occurs in patients with trauma. Trauma patients with SIH have been reported to have an increased risk of mortality. However, information regarding whether these trauma patients with SIH represent
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Background: Stress-induced hyperglycemia (SIH) is a form of hyperglycemia secondary to stress and commonly occurs in patients with trauma. Trauma patients with SIH have been reported to have an increased risk of mortality. However, information regarding whether these trauma patients with SIH represent a distinct group with differential outcomes when compared to those with diabetic hyperglycemia (DH) remains limited. Methods: Diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) ≥6.5%. Non-diabetic normoglycemia (NDN) was determined by a serum glucose level <200 mg/dL in the patients without DM. Diabetic normoglycemia (DN) was determined by a serum glucose level <200 mg/dL in the patients with DM. DH and SIH was diagnosed by a serum glucose level ≥200 mg/dL in the patients with and without DM, respectively. Detailed data of these four groups of hospitalized patients, which included NDN (n = 7806), DN (n = 950), SIH (n = 493), and DH (n = 897), were retrieved from the Trauma Registry System at a level I trauma center between 1 January 2009 and 31 December 2015. Patients with incomplete registered data were excluded. Categorical data were compared with Pearson chi-square tests or two-sided Fisher exact tests. The unpaired Student’s t-test and the Mann–Whitney U-test were used to analyze normally distributed continuous data and non-normally distributed data, respectively. Propensity-score-matched cohorts in a 1:1 ratio were allocated using NCSS software with logistic regression to evaluate the effect of SIH and DH on the outcomes of patients. Results: The SIH (median [interquartile range: Q1–Q3], 13 [9–24]) demonstrated a significantly higher Injury Severity Score (ISS) than NDN (9 [4–10]), DN (9 [4–9]), and DH (9 [5–13]). SIH and DH had a 12.3-fold (95% confidence interval [CI] 9.31–16.14; p < 0.001) and 2.4-fold (95% CI 1.71–3.45; p < 0.001) higher odds of mortality, respectively, when compared to NDN. However, in the selected propensity-score-matched patient population, SIH had a 3.0-fold higher odd ratio of mortality (95% CI 1.96–4.49; p < 0.001) than NDN, but DH did not have a significantly higher mortality (odds ratio 1.2, 95% CI 0.99–1.38; p = 0.065). In addition, SIH had 2.4-fold higher odds of mortality (95% CI 1.46–4.04; p = 0.001) than DH. These results suggest that the characteristics and injury severity of the trauma patients contributed to the higher mortality of these patients with hyperglycemia upon admission, and that the pathophysiological effect of SIH was different from that of DH. Conclusions: Although there were worse mortality outcomes among trauma patients presenting with hyperglycemia, this effect was only seen in patients with SIH, but not DH when controlling for age, sex, pre-existed co-morbidities, and ISS. Full article
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Open AccessArticle Living Close to Natural Outdoor Environments in Four European Cities: Adults’ Contact with the Environments and Physical Activity
Int. J. Environ. Res. Public Health 2017, 14(10), 1162; doi:10.3390/ijerph14101162
Received: 9 August 2017 / Revised: 18 September 2017 / Accepted: 21 September 2017 / Published: 30 September 2017
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Abstract
This study investigated whether residential availability of natural outdoor environments (NOE) was associated with contact with NOE, overall physical activity and physical activity in NOE, in four different European cities using objective measures. A nested cross-sectional study was conducted in Barcelona (Spain); Stoke-on-Trent
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This study investigated whether residential availability of natural outdoor environments (NOE) was associated with contact with NOE, overall physical activity and physical activity in NOE, in four different European cities using objective measures. A nested cross-sectional study was conducted in Barcelona (Spain); Stoke-on-Trent (United Kingdom); Doetinchem (The Netherlands); and Kaunas (Lithuania). Smartphones were used to collect information on the location and physical activity (overall and NOE) of around 100 residents of each city over seven days. We used Geographic Information Systems (GIS) to determine residential NOE availability (presence/absence of NOE within 300 m buffer from residence), contact with NOE (time spent in NOE), overall PA (total physical activity), NOE PA (total physical activity in NOE). Potential effect modifiers were investigated. Participants spent around 40 min in NOE and 80 min doing overall PA daily, of which 11% was in NOE. Having residential NOE availability was consistently linked with higher NOE contact during weekdays, but not to overall PA. Having residential NOE availability was related to NOE PA, especially for our Barcelona participants, people that lived in a city with low NOE availability. Full article
Open AccessArticle Modeling of Chromium, Copper, Zinc, Arsenic and Lead Using Portable X-ray Fluorescence Spectrometer Based on Discrete Wavelet Transform
Int. J. Environ. Res. Public Health 2017, 14(10), 1163; doi:10.3390/ijerph14101163
Received: 31 August 2017 / Revised: 28 September 2017 / Accepted: 29 September 2017 / Published: 30 September 2017
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Abstract
A modeling method based on discrete wavelet transform (DWT) was introduced to analyze the concentration of chromium, copper, zinc, arsenic and lead in soil with a portable X-ray fluorescence (XRF) spectrometer. A total of 111 soil samples were collected and observed. Denoising and
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A modeling method based on discrete wavelet transform (DWT) was introduced to analyze the concentration of chromium, copper, zinc, arsenic and lead in soil with a portable X-ray fluorescence (XRF) spectrometer. A total of 111 soil samples were collected and observed. Denoising and baseline correction were performed on each spectrum before modeling. The optimum conditions for pre-processing were denoising with Coiflet 3 on the 3rd level and baseline correction with Coiflet 3 on the 9th level. Calibration curves were established for the five heavy metals (HMs). The detection limits were compared before and after the application of DWT, the qualitative detection limits and the quantitative detection limits were calculated to be three and ten times as high as the standard deviation with silicon dioxide (blank), respectively. The results showed that the detection limits of the instrument using DWT were lower, and that they were below national soil standards; the determination coefficients (R2) based on DWT-processed spectra were higher, and ranged from 0.990 to 0.996, indicating a high degree of linearity between the contents of the HMs in soil and the XRF spectral characteristic peak intensity with the instrument measurement. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Joint Toxicity of Different Heavy Metal Mixtures after a Short-Term Oral Repeated-Administration in Rats
Int. J. Environ. Res. Public Health 2017, 14(10), 1164; doi:10.3390/ijerph14101164
Received: 3 September 2017 / Revised: 28 September 2017 / Accepted: 28 September 2017 / Published: 1 October 2017
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Abstract
The systemic toxicity of different combinations of heavy metal mixtures (HMMs) was studied according to equivalent proportions of the eight most common detectable heavy metals found in fish consumption in the Ningbo area of China. The ion mass proportions of Zn, Cu, Mn,
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The systemic toxicity of different combinations of heavy metal mixtures (HMMs) was studied according to equivalent proportions of the eight most common detectable heavy metals found in fish consumption in the Ningbo area of China. The ion mass proportions of Zn, Cu, Mn, Cr, Ni, Cd, Pb, and Hg were 1070.0, 312.6, 173.1, 82.6, 30.0, 13.3, 6.6, and 1.0, respectively. In this study, 10 experimental groups were set as follows: M8 (Pb + Cd + Hg + Ni + Cu + Zn + Mn + Cr); M5 (Pb + Cd + Hg + Ni + Cr); M4A (Pb + Cd + Hg + Ni); M4B (Cu + Zn + Mn + Cr); M3 (Cu + Zn + Mn); Cr; Cu; Zn; Mn; and control. Sprague Dawley (SD) rats were orally treated with a single dose of each group every three days (10 times in total) for 34 days. After Morris water maze test, blood and tissue samples were collected to obtain biochemical, histopathological and western blot analysis. Results show abnormalities could be observed in different treatment groups, the M4B combination had the most significant change compared to all other groups. In conclusion, combination HMMs may have adverse effects on the hematologic, hepatic, renal and neurobehavioral function, and may also disturb electrolyte and lipid balance. Why M4B combination generated much higher toxic effects than any other combination mixtures or individual heavy metal needs to be further evaluated. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Tackling Complex Emergency Response Solutions Evaluation Problems in Sustainable Development by Fuzzy Group Decision Making Approaches with Considering Decision Hesitancy and Prioritization among Assessing Criteria
Int. J. Environ. Res. Public Health 2017, 14(10), 1165; doi:10.3390/ijerph14101165
Received: 28 August 2017 / Revised: 27 September 2017 / Accepted: 28 September 2017 / Published: 2 October 2017
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Abstract
In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE
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In order to be prepared against potential balance-breaking risks affecting economic development, more and more countries have recognized emergency response solutions evaluation (ERSE) as an indispensable activity in their governance of sustainable development. Traditional multiple criteria group decision making (MCGDM) approaches to ERSE have been facing simultaneous challenging characteristics of decision hesitancy and prioritization relations among assessing criteria, due to the complexity in practical ERSE problems. Therefore, aiming at the special type of ERSE problems that hold the two characteristics, we investigate effective MCGDM approaches by hiring interval-valued dual hesitant fuzzy set (IVDHFS) to comprehensively depict decision hesitancy. To exploit decision information embedded in prioritization relations among criteria, we firstly define an fuzzy entropy measure for IVDHFS so that its derivative decision models can avoid potential information distortion in models based on classic IVDHFS distance measures with subjective supplementing mechanism; further, based on defined entropy measure, we develop two fundamental prioritized operators for IVDHFS by extending Yager’s prioritized operators. Furthermore, on the strength of above methods, we construct two hesitant fuzzy MCGDM approaches to tackle complex scenarios with or without known weights for decision makers, respectively. Finally, case studies have been conducted to show effectiveness and practicality of our proposed approaches. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Distance, Duration, and Velocity in Cycle Commuting: Analyses of Relations and Determinants of Velocity
Int. J. Environ. Res. Public Health 2017, 14(10), 1166; doi:10.3390/ijerph14101166
Received: 17 August 2017 / Revised: 26 September 2017 / Accepted: 26 September 2017 / Published: 2 October 2017
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Abstract
Background: The distance, duration, and velocity of cycling for transport purposes are used in health economic assessments, epidemiological studies, traffic modelling, and planning. It is therefore of value to determine relevant levels for them, and analyze how they relate, as well as
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Background: The distance, duration, and velocity of cycling for transport purposes are used in health economic assessments, epidemiological studies, traffic modelling, and planning. It is therefore of value to determine relevant levels for them, and analyze how they relate, as well as to what extent other relevant variables may affect cycling velocities. 1661 cycle commuters (34% males) in Greater Stockholm, Sweden have been studied for that purpose. Methods: The participants were recruited with advertisements. They received questionnaires and individually adjusted maps to draw their normal cycling route. Route distances were measured by a criterion method. Age, sex, weight, height, and cycling durations to work were self-reported. The commuting routes were positioned in relation to inner urban and/or suburban–rural areas. Linear multiple regression analyses were used. Results: Cycling speeds were positively related to commuting distances or durations, being male, of younger age, having higher body weight but lower body mass index (BMI), and using the last digits 1–4 or 6–9 in duration reports (as compared to 0 and 5), as well as cycling in suburban (versus inner urban) areas. Conclusions: The study provides new knowledge about how distance and duration, as well as other factors, relate to the velocity of commuter cycling. It thereby enables the use of more appropriate input values in, for instance, health economic assessments and epidemiological health studies. Full article
(This article belongs to the Special Issue Sustainable Transportation and Health)
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Open AccessArticle Arsenic Removal from Groundwater by Solar Driven Inline-Electrolytic Induced Co-Precipitation and Filtration—A Long Term Field Test Conducted in West Bengal
Int. J. Environ. Res. Public Health 2017, 14(10), 1167; doi:10.3390/ijerph14101167
Received: 24 August 2017 / Revised: 24 September 2017 / Accepted: 28 September 2017 / Published: 2 October 2017
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Abstract
Arsenic contamination in drinking water resources is of major concern in the Ganga delta plains of West Bengal in India and Bangladesh. Here, several laboratory and field studies on arsenic removal from drinking water resources were conducted in the past and the application
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Arsenic contamination in drinking water resources is of major concern in the Ganga delta plains of West Bengal in India and Bangladesh. Here, several laboratory and field studies on arsenic removal from drinking water resources were conducted in the past and the application of strong-oxidant-induced co-precipitation of arsenic on iron hydroxides is still considered as the most promising mechanism. This paper suggests an autonomous, solar driven arsenic removal setting and presents the findings of a long term field test conducted in West Bengal. The system applies an inline-electrolytic cell for in situ chlorine production using the natural chloride content of the water and by that substituting the external dosing of strong oxidants. Co-precipitation of As(V) occurs on freshly formed iron hydroxide, which is removed by Manganese Greensand Plus® filtration. The test was conducted for ten months under changing source water conditions considering arsenic (187 ± 45 µg/L), iron (5.5 ± 0.8 mg/L), manganese (1.5 ± 0.4 mg/L), phosphate (2.4 ± 1.3 mg/L) and ammonium (1.4 ± 0.5 mg/L) concentrations. Depending on the system setting removal rates of 94% for arsenic (10 ± 4 µg/L), >99% for iron (0.03 ± 0.03 mg/L), 96% for manganese (0.06 ± 0.05 mg/L), 72% for phosphate (0.7 ± 0.3 mg/L) and 84% for ammonium (0.18 ± 0.12 mg/L) were achieved—without the addition of any chemicals/adsorbents. Loading densities of arsenic on iron hydroxides averaged to 31 µgAs/mgFe. As the test was performed under field conditions and the here proposed removal mechanisms work fully autonomously, it poses a technically feasible treatment alternative, especially for rural areas. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessArticle Multi-Elements in Source Water (Drinking and Surface Water) within Five Cities from the Semi-Arid and Arid Region, NW China: Occurrence, Spatial Distribution and Risk Assessment
Int. J. Environ. Res. Public Health 2017, 14(10), 1168; doi:10.3390/ijerph14101168
Received: 8 August 2017 / Revised: 27 September 2017 / Accepted: 29 September 2017 / Published: 2 October 2017
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Abstract
The purpose of this study was to identify the concentration of multi-elements (MEs) in source water (surface and drinking water) and assess their quality for sustainability. A total of 161 water samples including 88 tap drinking waters (DW) and 73 surface waters (SW)
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The purpose of this study was to identify the concentration of multi-elements (MEs) in source water (surface and drinking water) and assess their quality for sustainability. A total of 161 water samples including 88 tap drinking waters (DW) and 73 surface waters (SW) were collected from five cities in Xi’an, Yan’an, Xining, Lanzhou, and Urumqi in northwestern China. Eighteen parameters including pH, electrical conductivity (EC), total organic carbon (TOC) total nitrogen (TN), chemical compositions of anions (F, Cl, NO3,HCO3, SO42−), cations (NH4+, K+, Na+, Ca2+,Mg2+), and metals (lead (Pb), chromium (Cr), cadmium (Cd), copper (Cu)) were analyzed in the first time at the five cities . The results showed that pH values and concentrations of Cl, SO42−, Na+, K+, Ca2+, Mg2+ and Cd, Cr, Cu in DW were within the permissible limits of the Chinese Drinking Water Quality Criteria, whereas the concentrations of other ions (F, NO3, NH4+ and Pb) exceeded their permissible values. In terms of the SW, the concentrations of F, Cl, NO3, SO42− were over the third range threshold i.e., water suitable for fishing and swimming of the Surface Water Quality Standards in China. The spatial distributions of most MEs in source water are similar, and there was no clear variation for all ions and metals. The metals in DW may be caused by water pipes, faucets and their fittings. The noncarcinogenic risk of metals in DW for local children are in decreasing order Cr > Cd > Pb > Cu. The carcinogenic risk from Cr exposure was at the acceptable level according to threshold of USEPA. Although the comprehensive index of potential ecological assessment of Cr, Cd, Pb and Cu in SW ranked at low risk level and was in the order of Huang River in Xining > Peaceful Canal in Urumqi > Yan River in Yan’an > Yellow River in Lanzhou, their adverse effects to ecology and human health at a low concentration in local semi-arid and arid areas should not be ignored in the long run. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Tigecycline Resistant Klebsiella pneumoniae Isolated from Austrian River Water
Int. J. Environ. Res. Public Health 2017, 14(10), 1169; doi:10.3390/ijerph14101169
Received: 4 September 2017 / Revised: 29 September 2017 / Accepted: 30 September 2017 / Published: 3 October 2017
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Abstract
Abstract: Antibiotic-resistant bacteria are spreading worldwide in medical settings but also in the environment. These resistant bacteria illustrate a major health problem in our times, and last-line antibiotics such as tigecycline represent an ultimate therapy option. Reports on tigecycline non-susceptible Enterobacteriaceae are
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Abstract: Antibiotic-resistant bacteria are spreading worldwide in medical settings but also in the environment. These resistant bacteria illustrate a major health problem in our times, and last-line antibiotics such as tigecycline represent an ultimate therapy option. Reports on tigecycline non-susceptible Enterobacteriaceae are presented with regard to medical settings but are rare with that for the environment. The aim of this study was to characterize two tigecycline non-susceptible Klebsiella pneumoniae isolates from the river Mur, and to question the resistance mechanism. The screening for chromosomal mutations revealed a deletion and a silent point mutation in one isolate and a point mutation in the other isolate all within the ramR allele. RamR acts as repressor and prevents overexpression of ramA. These mutations are likely to cause a resistant phenotype due to the overexpression of AcrAB-TolC. MLST revealed that the isolates belonged to two unrelated MLST types (ST2392 and ST2394). Both isolates only revealed resistance to tigecycline and tetracycline. This is one of the rare reports of tigecycline-resistant Klebsiella pneumoniae from surface water. The presence of two genetically different isolates suggests that the river water may bear substances that favor mutations that can lead to this efflux pump-driven resistance. Full article
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
Open AccessArticle Housing as a Determinant of Tongan Children’s Health: Innovative Methodology Using Wearable Cameras
Int. J. Environ. Res. Public Health 2017, 14(10), 1170; doi:10.3390/ijerph14101170
Received: 8 September 2017 / Revised: 27 September 2017 / Accepted: 28 September 2017 / Published: 4 October 2017
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Abstract
Housing is a significant determinant of health, particularly in developing countries such as Tonga. Currently, very little is known about the quality of the housing in Tonga, as is the case with many developing countries, nor about the interaction between children and the
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Housing is a significant determinant of health, particularly in developing countries such as Tonga. Currently, very little is known about the quality of the housing in Tonga, as is the case with many developing countries, nor about the interaction between children and the home environment. This study aimed to identify the nature and extent of health risk factors and behaviours in Tongan houses from a child’s perspective. An innovative methodology was used, Kids’Cam Tonga. Seventy-two Class 6 children (10 to 13-year-olds) were randomly selected from 12 randomly selected schools in Tongatapu, the main island. Each participating child wore a wearable camera on lanyards around their neck. The device automatically took wide-angled, 136° images of the child’s perspective every seven seconds. The children were instructed to wear the camera all day from Friday morning to Sunday evening, inclusive. The analysis showed that the majority of Tongan children in the study live in houses that have structural deficiencies and hazards, including water damage (42%), mould (36%), and electrical (89%) and burn risk factors (28%). The findings suggest that improvements to the housing stock may reduce the associated health burden and increase buildings’ resilience to natural hazards. A collaborative approach between communities, community leaders, government and non-governmental organisations (NGOs) is urgently needed. This research methodology may be of value to other developing countries. Full article
(This article belongs to the Special Issue Housing and Health)
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Open AccessArticle Survey on Tuberculosis Patients in Rural Areas in China: Tracing the Role of Stigma in Psychological Distress
Int. J. Environ. Res. Public Health 2017, 14(10), 1171; doi:10.3390/ijerph14101171
Received: 28 July 2017 / Revised: 26 September 2017 / Accepted: 2 October 2017 / Published: 4 October 2017
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Abstract
Depressed patients had risks of non-adherence to medication, which brought a big challenge for the control of tuberculosis (TB). The stigma associated with TB may be the reason for distress. This study aimed to assess the psychological distress among TB patients living in
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Depressed patients had risks of non-adherence to medication, which brought a big challenge for the control of tuberculosis (TB). The stigma associated with TB may be the reason for distress. This study aimed to assess the psychological distress among TB patients living in rural areas in China and to further explore the relation of experienced stigma to distress. This study was a cross-sectional study with multi-stage randomized sampling for recruiting TB patients. Data was collected by the use of interviewer-led questionnaires. A total of 342 eligible and accessible TB patients being treated at home were included in the survey. Psychological distress was measured using the Kessler Psychological Distress Scale (K10). Experienced stigma was measured using a developed nine-item stigma questionnaire. Univariate analysis and multiple logistic regression were used to analyze the variables related to distress, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to present the strength of the associations. Finally, the prediction of logistic model was assessed in form of the Receiver Operating Characteristic (ROC) curve and the area under the ROC curve (AUC). According to the referred cut-off point from K10, this study revealed that 65.2% (223/342) of the participants were categorized as having psychological distress. Both the stigma questionnaire and the K10 were proven to be reliable and valid in measurement. Further analysis found that experienced stigma and illness severity were significant variables to psychological distress in the model of logistic regression. The model was assessed well in predicting distress by use of experienced stigma and illness severity in form of ROC and AUC. Rural TB patients had a high prevalence of psychological distress. Experience of stigma played a significant role in psychological distress. To move the barrier of stigma from the surroundings could be a good strategy in reducing distress for the patients and TB controlling for public health management. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle The Development of Three Questionnaires to Assess Beliefs about Green Exercise
Int. J. Environ. Res. Public Health 2017, 14(10), 1172; doi:10.3390/ijerph14101172
Received: 8 September 2017 / Revised: 28 September 2017 / Accepted: 29 September 2017 / Published: 4 October 2017
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Abstract
Green exercise is physical activity that takes place in the presence of natural environments. Despite the promising evidence of the benefits, little is known about how individuals’ thoughts and feelings influence participation in green exercise and subsequent outcomes. The aim of the current
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Green exercise is physical activity that takes place in the presence of natural environments. Despite the promising evidence of the benefits, little is known about how individuals’ thoughts and feelings influence participation in green exercise and subsequent outcomes. The aim of the current research was to develop questionnaires using the Theory of Planned Behaviour as a framework that could both directly and indirectly assess attitudes, subjective norms and perceived behaviour control, along with intention toward green exercise. Confirmatory factor analyses confirmed that the indirect, direct, and intention measures all had good overall model fits when tested on a refinement (n = 253) and validation (n = 230) sample. The questionnaires will contribute towards helping to better understanding individuals’ beliefs about green exercise, how these influence behaviour, and ultimately to enable the development of effective interventions promoting green exercise. Full article
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Open AccessArticle Environmental Influences on Physical Activity among Rural Adults in Montana, United States: Views from Built Environment Audits, Resident Focus Groups, and Key Informant Interviews
Int. J. Environ. Res. Public Health 2017, 14(10), 1173; doi:10.3390/ijerph14101173
Received: 21 August 2017 / Revised: 18 September 2017 / Accepted: 30 September 2017 / Published: 4 October 2017
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Abstract
Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults
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Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults in Montana. Eight built environment audits, 15 resident focus groups, and 24 key informant interviews were conducted between August and December 2014. Themes were triangulated and summarized into five categories of environmental factors: built, social, organizational, policy, and natural environments. Although the existence of active living features was documented by environmental audits, residents and key informants agreed that additional indoor recreation facilities and more well-maintained and conveniently located options were needed. Residents and key informants also agreed on the importance of age-specific, well-promoted, and structured physical activity programs, offered in socially supportive environments, as facilitators to physical activity. Key informants, however, noted that funding constraints and limited political will were barriers to developing these opportunities. Since building new recreational facilities and structures to support active transportation pose resource challenges, especially for rural communities, our results suggest that enhancing existing features, making small improvements, and involving stakeholders in the city planning process would be more fruitful to build momentum towards larger changes. Full article
(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)
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Open AccessArticle Simple vs. Complex Carbohydrate Dietary Patterns and the Global Overweight and Obesity Pandemic
Int. J. Environ. Res. Public Health 2017, 14(10), 1174; doi:10.3390/ijerph14101174
Received: 24 July 2017 / Revised: 11 September 2017 / Accepted: 29 September 2017 / Published: 4 October 2017
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Abstract
Nowadays, obesity and being overweight are among the major global health concerns. Many, diet-related diseases impose high tangible and intangible costs, and threaten the sustainability of health-care systems worldwide. In this study, we model, at the macroeconomic level, the impact of energy intake
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Nowadays, obesity and being overweight are among the major global health concerns. Many, diet-related diseases impose high tangible and intangible costs, and threaten the sustainability of health-care systems worldwide. In this study, we model, at the macroeconomic level, the impact of energy intake from different types of carbohydrates on the population’s BMI (body mass index). We proceed in three steps. First, we develop a framework to analyse both the consumption choices between simple and complex carbohydrates and the effects of these choices on people health conditions. Second, we collect figures for 185 countries (over the period 2012–2014) regarding the shares of simple (sugar and sweetener) and complex (cereal) carbohydrates in each country’s total dietary energy supply. Third, we use regression techniques to: (1) estimate the impact of these shares on the country’s prevalence of obesity and being overweight; (2) compute for each country an indicator of dietary pattern based on the ratio between simple and complex carbohydrates, weighted by their estimated effects on the prevalence of obesity and being overweight; and (3) measure the elasticity of the prevalence of obesity and being overweight with respect to changes in both carbohydrate dietary pattern and income per capita. We find that unhealthy eating habits and the associated prevalence of excessive body fat accumulation tend to behave as a ‘normal good’ in low, medium- and high-HDI (Human Development Index) countries, but as an ‘inferior good’ in very high-HDI countries. Full article
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Open AccessArticle Development and Preliminary Validation of Refugee Trauma History Checklist (RTHC)—A Brief Checklist for Survey Studies
Int. J. Environ. Res. Public Health 2017, 14(10), 1175; doi:10.3390/ijerph14101175
Received: 28 July 2017 / Revised: 23 September 2017 / Accepted: 30 September 2017 / Published: 4 October 2017
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Abstract
A high proportion of refugees have been subjected to potentially traumatic experiences (PTEs), including torture. PTEs, and torture in particular, are powerful predictors of mental ill health. This paper reports the development and preliminary validation of a brief refugee trauma checklist applicable for
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A high proportion of refugees have been subjected to potentially traumatic experiences (PTEs), including torture. PTEs, and torture in particular, are powerful predictors of mental ill health. This paper reports the development and preliminary validation of a brief refugee trauma checklist applicable for survey studies. Methods: A pool of 232 items was generated based on pre-existing instruments. Conceptualization, item selection and item refinement was conducted based on existing literature and in collaboration with experts. Ten cognitive interviews using a Think Aloud Protocol (TAP) were performed in a clinical setting, and field testing of the proposed checklist was performed in a total sample of n = 137 asylum seekers from Syria. Results: The proposed refugee trauma history checklist (RTHC) consists of 2 × 8 items, concerning PTEs that occurred before and during the respondents’ flight, respectively. Results show low item non-response and adequate psychometric properties Conclusion: RTHC is a usable tool for providing self-report data on refugee trauma history surveys of community samples. The core set of included events can be augmented and slight modifications can be applied to RTHC for use also in other refugee populations and settings. Full article
(This article belongs to the Special Issue Refugee Health)
Open AccessArticle Commuting, Life-Satisfaction and Internet Addiction
Int. J. Environ. Res. Public Health 2017, 14(10), 1176; doi:10.3390/ijerph14101176
Received: 13 September 2017 / Revised: 28 September 2017 / Accepted: 2 October 2017 / Published: 5 October 2017
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Abstract
The focus of the present work was on the association between commuting (business and private), life satisfaction, stress, and (over-) use of the Internet. Considering that digital devices are omnipresent in buses and trains, no study has yet investigated if commuting contributes to
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The focus of the present work was on the association between commuting (business and private), life satisfaction, stress, and (over-) use of the Internet. Considering that digital devices are omnipresent in buses and trains, no study has yet investigated if commuting contributes to the development of Internet addiction. Overall, N = 5039 participants (N = 3477 females, age M = 26.79, SD = 10.68) took part in an online survey providing information regarding their commuting behavior, Internet addiction, personality, life satisfaction, and stress perception. Our findings are as follows: Personality seems to be less suitable to differentiate between commuter and non-commuter groups, which is possibly due to commuters often not having a choice but simply must accept offered job opportunities at distant locations. Second, the highest levels of satisfaction were found with income and lodging in the group commuting for business purposes. This might be related to the fact that commuting results in higher salaries (hence also better and more expensive housing style) due to having a job in another city which might exceed job opportunities at one’s own living location. Third, within the business-commuters as well as in the private-commuter groups, females had significantly higher levels of stress than males. This association was not present in the non-commuter group. For females, commuting seems to be a higher burden and more stressful than for males, regardless of whether they commute for business or private reasons. Finally, we observed an association between higher stress perception (more negative attitude towards commuting) and Internet addiction. This finding suggests that some commuters try to compensate their perceived stress with increased Internet use. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
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Open AccessArticle Inhibitory Effects of 3,4-Dimethylpyrazole Phosphate on CH4 and N2O Emissions in Paddy Fields of Subtropical China
Int. J. Environ. Res. Public Health 2017, 14(10), 1177; doi:10.3390/ijerph14101177
Received: 22 August 2017 / Revised: 25 September 2017 / Accepted: 25 September 2017 / Published: 5 October 2017
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Abstract
3,4-Dimethylpyrazole phosphate (DMPP) has been widely employed to reduce nitrogen leaching and greenhouse gas emissions in the soils of dry farmlands. However, the effects of DMPP on the dynamics of nitrogen in paddy fields remain unclear. For this study, treatments with 0%, 0.25%,
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3,4-Dimethylpyrazole phosphate (DMPP) has been widely employed to reduce nitrogen leaching and greenhouse gas emissions in the soils of dry farmlands. However, the effects of DMPP on the dynamics of nitrogen in paddy fields remain unclear. For this study, treatments with 0%, 0.25%, 0.5%, 1%, or 1.5% DMPP levels of nitrogen fertilization plus urea were designed to determine the effects on greenhouse gas emissions in paddy fields of subtropical China. All DMPP treatments significantly reduced CH4 and N2O emissions, from 54% to 34%, and 94% to 39%, respectively, compared with a urea fertilizer treatment alone. The soil NH4+ content decreased and NO3− increased more slowly with the application of DMPP. The crop yields under the various DMPP treatments showed no significant difference (p < 0.05). We concluded that the application of 0.5% and 1% DMPP may significantly reduce CH4 and N2O emissions in contrast to other treatments. This has important implications for the maintenance of rice yields, while reducing greenhouse gas emissions in paddy fields. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle The Impact of a School-Based Weight Management Program Involving Parents via mHealth for Overweight and Obese Children and Adolescents with Intellectual Disability: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2017, 14(10), 1178; doi:10.3390/ijerph14101178
Received: 26 June 2017 / Revised: 24 August 2017 / Accepted: 18 September 2017 / Published: 5 October 2017
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Abstract
There is a scarcity of resources and studies that utilize targeted weight management interventions to engage parents via mHealth tools targeting obese children and adolescents with mild intellectual disabilities (MIDs) extended from school to a home setting. To test the feasibility and acceptability
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There is a scarcity of resources and studies that utilize targeted weight management interventions to engage parents via mHealth tools targeting obese children and adolescents with mild intellectual disabilities (MIDs) extended from school to a home setting. To test the feasibility and acceptability of a school-based weight program (SBWMP) involving parents via mHealth tools designed to reduce weight, enhance knowledge and adopt healthy lifestyles, and thereby achieve better psychosocial well-being among children and adolescents with MIDs. Four special schools were randomly assigned as intervention or control schools. Students from the intervention group (n = 63) were compared to those in the control group (n = 52), which comprised those with usual school planned activities and no parental involvement. Demographics were considered as covariates in a general linear model, an ordinal regression model and a binary logistic regression model analyzing the relationships between the SBWMP and the outcome variables at baseline (T0) and six months later (T1). Body weight, body mass index, and triceps and subscapular skinfold thickness were lower in the intervention group compared to the control group, although the differences were not statistically significant. There was a positive and direct impact of the SBWMP on students’ health knowledge and psychological impacts in the intervention group. The SBWMP extended to the home involving parents via mHealth tools is a feasible and acceptable program for this group with MIDs and their parents. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Restructuring the Production of Medicines: An Investigation on the Pharmaceutical Sector in China and the Role of Mergers and Acquisitions
Int. J. Environ. Res. Public Health 2017, 14(10), 1179; doi:10.3390/ijerph14101179
Received: 29 July 2017 / Revised: 22 September 2017 / Accepted: 23 September 2017 / Published: 5 October 2017
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Abstract
In places like China, an ageing population coupled with changes in living standards and increases in disposable income, imply a shift of the demand for health-related goods and services which is likely to affect the whole organization of the industries that supply such
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In places like China, an ageing population coupled with changes in living standards and increases in disposable income, imply a shift of the demand for health-related goods and services which is likely to affect the whole organization of the industries that supply such goods and services at the global level. One of the industries most likely to be affected is the pharmaceutical sector. In the early 2000s China was already the second largest global producer of pharmaceutical ingredients. The pharmaceutical sector has become one of the most important industries promoted by the Chinese government and Five-Year Plan of China’s Strategic Emerging Sectors, mergers and acquisition (M&A) activity has been the key strategy to restructure the sector and increase its competitiveness. This paper firstly provides an updated picture of the evolution of M&As in the pharmaceutical sector, compared to other sectors, in China in the period 2005–2013. Secondly, we develop a composite indicator to measure the industrial performance of all Chinese industrial sectors over time, which allows us to assess the performance of the pharmaceutical industry compared to that of other sectors of the Chinese economy. Finally, we develop and estimate an empirical model that tests the relationship between the number of M&A in a sector and its performance, with a particular focus on the pharmaceutical case. The results offer some initial evidence of positive effects from the process of restructuring of the pharmaceutical sector in China. Full article
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Open AccessArticle Negative Peer Relationships on Piracy Behavior: A Cross-Sectional Study of the Associations between Cyberbullying Involvement and Digital Piracy
Int. J. Environ. Res. Public Health 2017, 14(10), 1180; doi:10.3390/ijerph14101180
Received: 6 September 2017 / Revised: 24 September 2017 / Accepted: 3 October 2017 / Published: 5 October 2017
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Abstract
The present study examines the relationship between different roles in cyberbullying behaviors (cyberbullies, cybervictims, cyberbullies-victims, and uninvolved) and self-reported digital piracy. In a region of central Spain, 643 (49.3% females, 50.7% males) students (grades 7–10) completed a number of self-reported measures, including cyberbullying
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The present study examines the relationship between different roles in cyberbullying behaviors (cyberbullies, cybervictims, cyberbullies-victims, and uninvolved) and self-reported digital piracy. In a region of central Spain, 643 (49.3% females, 50.7% males) students (grades 7–10) completed a number of self-reported measures, including cyberbullying victimization and perpetration, self-reported digital piracy, ethical considerations of digital piracy, time spent on the Internet, and leisure activities related with digital content. The results of a series of hierarchical multiple regression models for the whole sample indicate that cyberbullies and cyberbullies-victims are associated with more reports of digital piracy. Subsequent hierarchical multiple regression analyses, done separately for males and females, indicate that the relationship between cyberbullying and self-reported digital piracy is sustained only for males. The ANCOVA analysis show that, after controlling for gender, self-reported digital piracy and time spent on the Internet, cyberbullies and cyberbullies-victims believe that digital piracy is a more ethically and morally acceptable behavior than victims and uninvolved adolescents believe. The results provide insight into the association between two deviant behaviors. Full article
(This article belongs to the Special Issue Youth Violence as a Public Health Issue)
Open AccessArticle Foster Care Dynamics and System Science: Implications for Research and Policy
Int. J. Environ. Res. Public Health 2017, 14(10), 1181; doi:10.3390/ijerph14101181
Received: 5 September 2017 / Revised: 28 September 2017 / Accepted: 30 September 2017 / Published: 5 October 2017
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Abstract
Although system is a word frequently invoked in discussions of foster care policy and practice, there have been few if any attempts by child welfare researchers to understand the ways in which the foster care system is a system. As a consequence, insights
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Although system is a word frequently invoked in discussions of foster care policy and practice, there have been few if any attempts by child welfare researchers to understand the ways in which the foster care system is a system. As a consequence, insights from system science have yet to be applied in meaningful ways to the problem of making foster care systems more effective. In this study, we draw on population biology to organize a study of admissions and discharges to foster care over a 15-year period. We are interested specifically in whether resource constraints, which are conceptualized here as the number of beds, lead to a coupling of admissions and discharges within congregate care. The results, which are descriptive in nature, are consistent with theory that ties admissions and discharges together because of a resource constraint. From the data, it is clear that the underlying system exerts an important constraint on what are normally viewed as individual-level decisions. Our discussion calls on extending efforts to understand the role of system science in studies of child welfare systems, with a particular emphasis on the role of feedback as a causal influence. Full article
(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)
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Open AccessArticle Changing the Smoking Trajectory: Evaluating the Impact of School-Based Tobacco Interventions on Changes to Susceptibility to Future Smoking
Int. J. Environ. Res. Public Health 2017, 14(10), 1182; doi:10.3390/ijerph14101182
Received: 18 August 2017 / Revised: 29 September 2017 / Accepted: 2 October 2017 / Published: 5 October 2017
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Abstract
School-based programs and policies can reduce student smoking rates. However, their impact on never-smoking students has not been investigated despite the clear transition between non-susceptible, susceptible, and ever tried smoking statuses. The objective of this paper was to examine the longitudinal student-level impact
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School-based programs and policies can reduce student smoking rates. However, their impact on never-smoking students has not been investigated despite the clear transition between non-susceptible, susceptible, and ever tried smoking statuses. The objective of this paper was to examine the longitudinal student-level impact of six changes in school-based tobacco control programs and policies on student transitions in susceptibility to smoking over one year. Two multinomial logistic regression models identified the relative risk of a change in self-reported susceptibility to smoking or in trying a cigarette among never-smoking students in each of the six intervention schools compared to the relative risk among never-smoking students in control schools. Model 1 identified the relative risk of a change in smoking susceptibility status among baseline non-susceptible never smoking students, while Model 2 identified the relative risk of a change in smoking susceptibility status among baseline susceptible never smoking students. Students at some intervention schools were at increased risk of becoming susceptible to or trying a cigarette at one year follow-up. Intervention studies should examine changes to susceptibility to future smoking when evaluating impact to ensure that school-based tobacco control programs and policies do not negatively change the risk status of never-smoking students. Full article
Open AccessArticle Effect of Health Messages on Alcohol Attitudes and Intentions in a Sample of 16–17-Year-Old Underage Drinkers
Int. J. Environ. Res. Public Health 2017, 14(10), 1183; doi:10.3390/ijerph14101183
Received: 28 June 2017 / Revised: 26 September 2017 / Accepted: 27 September 2017 / Published: 5 October 2017
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Abstract
Background: Responsible drinking messages (RDMs) are a key component of many education-based interventions for reducing alcohol harms. The evidence base for the effectiveness of RDMs is extremely limited, with some recent research suggesting iatrogenic effects of such messages. Objective: To examine
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Background: Responsible drinking messages (RDMs) are a key component of many education-based interventions for reducing alcohol harms. The evidence base for the effectiveness of RDMs is extremely limited, with some recent research suggesting iatrogenic effects of such messages. Objective: To examine the effects of exposure to health messages on attitudes towards drinking and drunkenness, and intentions to drink and get drunk, amongst underage drinkers. Methods: Ninety-four underage drinkers were recruited from colleges in the UK. Participants were either actively or passively exposed to one of two health messages (RDM or general wellbeing). Measures of attitudes and intentions towards drinking and drunkenness were obtained one week before and immediately after participation in the study. A unit estimation task was also included. Results: Active exposure to RDMs led to more positive attitude towards drunkenness, while passive exposure led to more negative attitudes. Passive RDM exposure led to increased intentions to get drunk in future. Wellbeing posters produced the opposite effect in some but not all of these measures. Conclusions: Exposure to RDMs may have some beneficial effects in terms of creating more negative attitudes towards alcohol consumption, but we also identified potential iatrogenic effects regarding attitudes and intentions towards drunkenness amongst an underage sample of drinkers. Further research is required to better understand optimal ways of framing RDMs to produce positive changes in attitudes, intentions, and prospective drinking behaviour. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Open AccessArticle Subsistence Food Production Practices: An Approach to Food Security and Good Health
Int. J. Environ. Res. Public Health 2017, 14(10), 1184; doi:10.3390/ijerph14101184
Received: 11 August 2017 / Revised: 26 September 2017 / Accepted: 1 October 2017 / Published: 5 October 2017
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Abstract
Food security is a prerequisite for health. Availability and accessibility of food in rural areas is mainly achieved through subsistence production in which community members use local practices to produce and preserve food. Subsistence food production ensures self-sufficiency and reduction of poverty and
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Food security is a prerequisite for health. Availability and accessibility of food in rural areas is mainly achieved through subsistence production in which community members use local practices to produce and preserve food. Subsistence food production ensures self-sufficiency and reduction of poverty and hunger. The main emphasis with the present study is examining subsistence farming and collection of edible plant materials to fulfill dietary requirements, thereby ensuring food security and good health. Data collected from a purposive sample show that subsistence crops produced in the home-gardens and fields, and those collected from the wild, are sources of grain, vegetables and legumes. Sources of grain and legumes are produced in the home-gardens and fields, whereas vegetables sources are mostly collected in the wild and fewer in the home-gardens. These food sources have perceived health potential in child and maternal care of primary health care. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Histopathology of Cervical Cancer and Arsenic Concentration in Well Water: An Ecological Analysis
Int. J. Environ. Res. Public Health 2017, 14(10), 1185; doi:10.3390/ijerph14101185
Received: 8 August 2017 / Revised: 14 September 2017 / Accepted: 1 October 2017 / Published: 6 October 2017
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Abstract
Arsenic in drinking water is causally linked with cancer of the skin, lung, and urinary bladder, but there is very little data on a possible role for arsenic in the etiology of cervical cancer, a disease in which human papilloma virus is held
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Arsenic in drinking water is causally linked with cancer of the skin, lung, and urinary bladder, but there is very little data on a possible role for arsenic in the etiology of cervical cancer, a disease in which human papilloma virus is held to be a necessary but not sufficient cause. All histopathology results from cervical specimens from the National Institute of Cancer Research and Hospital (NICRH), Dhaka (1997–2015), and the Anowara Medical Services (2003–2015), both serving the whole of Bangladesh, were classified by cell type. Arsenic concentrations in well water in the thana of residence were estimated from systematic sampling carried out by the British Geological Survey. In a case-referent analysis arsenic estimates for cases of cervical cancer were compared with those found to have benign lesions. In this study, 3464 NICRH (CH) cervical specimens and 30,050 community medical service (CMS) specimens were available: 3329 (CH) and 899 (CMS) were recorded as malignant. Most were squamous cell carcinoma, of which 4.9% were poorly differentiated. Overall, there was no increase in cervical cancer with increasing arsenic concentration. Among those with squamous cell histology, a strong dose response was seen for poorly differentiated cancer with increasing arsenic exposure. The odds ratio increased monotonically, compared with exposure <10 μg/L, from 1.58 at 10 < 50 μg/L to 8.11 at >200 μg/L (p < 0.001). Given the high proportion of Bangladeshis using drinking water containing >50 μg/L of arsenic, the evidence that arsenic is implicated in cancer grade suggests a need for further investigation and the introduction of cervical screening in high arsenic areas. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessArticle Contribution of Drinking Water Softeners to Daily Phosphate Intake in Slovenia
Int. J. Environ. Res. Public Health 2017, 14(10), 1186; doi:10.3390/ijerph14101186
Received: 16 July 2017 / Revised: 3 October 2017 / Accepted: 4 October 2017 / Published: 6 October 2017
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Abstract
The cumulative phosphate intake in a typical daily diet is high and, according to several studies, already exceeds recommended values. The exposure of the general population to phosphorus via drinking water is generally not known. One of the hidden sources of phosphorus in
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The cumulative phosphate intake in a typical daily diet is high and, according to several studies, already exceeds recommended values. The exposure of the general population to phosphorus via drinking water is generally not known. One of the hidden sources of phosphorus in a daily diet is sodium polyphosphate, commonly used as a drinking water softener. In Slovenia, softening of drinking water is carried out exclusively within the internal (household) drinking water supply systems to prevent the accumulation of limescale. The aim of the study was to determine the prevalence of sodium phosphates in the drinking water in Slovenia in different types of buildings, to determine residents’ awareness of the presence of chemical softeners in their drinking water, and to provide an exposure assessment on the phosphorus intake from drinking water. In the current study, the presence of phosphates in the samples of drinking water was determined using a spectrophotometric method with ammonium molybdate. In nearly half of the samples, the presence of phosphates as water softeners was confirmed. The measured concentrations varied substantially from 0.2 mg PO4/L to 24.6 mg PO4/L. Nearly 70% of the respondents were not familiar with the exact data on water softening in their buildings. It follows that concentrations of added phosphates should be controlled and the consumers should be informed of the added chemicals in their drinking water. The health risks of using sodium polyphosphate as a drinking water softener have not been sufficiently investigated and assessed. It is highly recommended that proper guidelines and regulations are developed and introduced to protect human health from adverse effects of chemicals in water intended for human consumption. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle A Novel and Native Microcystin-Degrading Bacterium of Sphingopyxis sp. Isolated from Lake Taihu
Int. J. Environ. Res. Public Health 2017, 14(10), 1187; doi:10.3390/ijerph14101187
Received: 22 August 2017 / Revised: 28 September 2017 / Accepted: 30 September 2017 / Published: 6 October 2017
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Abstract
A native, highly efficient microcystin-LR (MC-LR)-degrading bacterium named a7 was isolated from Lake Taihu and identified as Sphingopyxis sp. by 16S rDNA sequence analysis. The strain a7 could totally degrade MC-LR at a rate of 3.33 mg/(L•h), as detected by high-performance liquid chromatography
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A native, highly efficient microcystin-LR (MC-LR)-degrading bacterium named a7 was isolated from Lake Taihu and identified as Sphingopyxis sp. by 16S rDNA sequence analysis. The strain a7 could totally degrade MC-LR at a rate of 3.33 mg/(L•h), as detected by high-performance liquid chromatography (HPLC). The mlrA, mlrC, and mlrD genes were detected in the strain a7 by sequence analysis. Tetrapeptide and Adda—which are the middle metabolites of MC-LR—were analyzed via liquid chromatography time-of-flight mass spectrometry (LC-TOF-MS) during degradation. These metabolites were degraded completely, which suggested that the native Sphingopyxis sp. a7 was highly efficient in MC-LR degradation under bench conditions. Thus, strain a7 exhibited a significant potential application for bioremediation in water bodies contaminated by MC-LR produced by harmful cyanobacterial blooms. Full article
(This article belongs to the Special Issue Microbiological Evaluation of Wastewater Treatment)
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Open AccessArticle Baseline Assessment of a Healthy Corner Store Initiative: Associations between Food Store Environments, Shopping Patterns, Customer Purchases, and Dietary Intake in Eastern North Carolina
Int. J. Environ. Res. Public Health 2017, 14(10), 1189; doi:10.3390/ijerph14101189
Received: 27 July 2017 / Revised: 2 October 2017 / Accepted: 3 October 2017 / Published: 7 October 2017
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Abstract
In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose
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In 2016, the North Carolina (NC) Legislature allocated $250,000 to the NC Department of Agriculture, to identify and equip small food retailers to stock healthier foods and beverages in eastern NC food deserts (the NC Healthy Food Small Retailer Program, HFSRP). The purpose of this study was to examine associations between food store environments, shopping patterns, customer purchases, and dietary consumption among corner store customers. We surveyed 479 customers in 16 corner stores regarding demographics, food purchased, shopping patterns, and self-reported fruit, vegetable, and soda consumption. We objectively assessed fruit and vegetable consumption using a non-invasive reflection spectroscopy device to measure skin carotenoids. We examined associations between variables of interest, using Pearson’s correlation coefficients and adjusted linear regression analyses. A majority (66%) of participants were African American, with a mean age of 43 years, and a mean body mass index (BMI) of 30.0 kg/m2. There were no significant associations between the healthfulness of food store offerings, customer purchases, or dietary consumption. Participants who said they had purchased fruits and vegetables at the store previously reported higher produce intake (5.70 (4.29) vs. 4.60 (3.28) servings per day, p = 0.021) versus those who had not previously purchased fresh produce. The NC Legislature has allocated another $250,000 to the HFSRP for the 2018 fiscal year. Thus, evaluation results will be important to inform future healthy corner store policies and initiatives. Full article
(This article belongs to the Special Issue Food Environment, Diet, and Health)
Open AccessArticle Investigation of Oxidation Methods for Waste Soy Sauce Treatment
Int. J. Environ. Res. Public Health 2017, 14(10), 1190; doi:10.3390/ijerph14101190
Received: 30 August 2017 / Revised: 29 September 2017 / Accepted: 5 October 2017 / Published: 7 October 2017
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Abstract
To obtain a suitable oxidation method for removing the color and lowering the chemical oxygen demand (COD) of waste soy sauce, Fenton (Fe2+), Fenton-like (Fe3+), and ozone (O3) oxidation methods are used as the target reactions. In
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To obtain a suitable oxidation method for removing the color and lowering the chemical oxygen demand (COD) of waste soy sauce, Fenton (Fe2+), Fenton-like (Fe3+), and ozone (O3) oxidation methods are used as the target reactions. In experimental conditions for Fenton oxidation, the dose of Fe2+ and Fe3+ was varied between 100 mg/L and 300 mg/L. The dose of hydrogen peroxide for the reaction was injected from 100–1000 mg/L. For ozone oxidation, the pH was increased from 3 to 14 and the O3-containing gas was supplied continuously for 30 min through a gas diffuser at the bottom of the reactor at different applied O3 doses (10–90 mg/L). We subjected it to a simple 1:20 dilution with deionized water to identify the comparison result in detail. O3 oxidation shows the highest efficiencies of color removal (81.1%) and COD lowering (64.9%) among the three oxidation methods. This is mainly due to the fact that it has a relatively large amount of hydroxyl radical, resulting in the degradation of organics. Thus, O3 oxidation could be a promising method for removing the color and lowering the COD of waste soy sauce. The critical parameters (pH and applied O3 dose) were varied systematically to optimize O3 oxidation. It was found that the optimum pH and applied O3 dose are 11.0 mg/L and 50.0 mg/L, respectively (color removal = 34.2%, COD removal = 27.4%). Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Impact of Living Alone on Depressive Symptoms in Older Korean Widows
Int. J. Environ. Res. Public Health 2017, 14(10), 1191; doi:10.3390/ijerph14101191
Received: 17 September 2017 / Revised: 2 October 2017 / Accepted: 3 October 2017 / Published: 7 October 2017
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Abstract
We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data
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We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data from widows, 65 years of age and older, who participated in the Living Profiles of Older People Survey (LPOPS). A logistic regression analysis was used to evaluate the contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. Working status and equivalent household income were significantly associated with depressive symptoms in both those living with others and those living alone. Adjustment for health status and social ties did not change the impact of living alone on the prevalence of depressive symptoms. However, adjustment for equivalent household income eliminated the negative association between living alone and depressive symptoms. Our findings indicate that economic resources are more important than health and social ties for alleviating the negative impact of living alone on the development of depressive symptoms in older widows. Full article
Open AccessArticle Analysis of Transmission and Control of Tuberculosis in Mainland China, 2005–2016, Based on the Age-Structure Mathematical Model
Int. J. Environ. Res. Public Health 2017, 14(10), 1192; doi:10.3390/ijerph14101192
Received: 13 August 2017 / Revised: 20 September 2017 / Accepted: 30 September 2017 / Published: 7 October 2017
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Abstract
Tuberculosis (TB), an air-borne infectious disease, is a major public-health problem in China. The reported number of the active tuberculosis cases is about one million each year. The morbidity data for 2005–2012 reflect that the difference in morbidity based on age group is
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Tuberculosis (TB), an air-borne infectious disease, is a major public-health problem in China. The reported number of the active tuberculosis cases is about one million each year. The morbidity data for 2005–2012 reflect that the difference in morbidity based on age group is significant, thus the role of age-structure on the transmission of TB needs to be further developed. In this work, based on the reported data and the observed morbidity characteristics, we propose a susceptible-exposed-infectious-recovered (SEIR) epidemic model with age groupings, involving three categories: children, the middle-aged, and senior to investigate the role of age on the transmission of tuberculosis in Mainland China from 2005 to 2016. Then, we evaluated the parameters by the Least Square method and simulated the model and it had good alignment with the reported infected TB data in Mainland China. Furthermore, we estimated the basic reproduction number R0 of 1.7858, with an obtained 95% confidence interval for R0 of (1.7752, 1.7963) by Latin hypercube sampling, and we completed a sensitivity analysis of R0 in terms of some parameters. Our study demonstrates that diverse age groups have different effects on TB. Two effective measures were found that would help reach the goals of theWorld Health Organization (WHO) End TB Strategy: an increase in the recovery rate and the reduction in the infectious rate of the senior age group. Full article
(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)
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Open AccessArticle Comparison of Health Risk Assessments of Heavy Metals and As in Sewage Sludge from Wastewater Treatment Plants (WWTPs) for Adults and Children in the Urban District of Taiyuan, China
Int. J. Environ. Res. Public Health 2017, 14(10), 1194; doi:10.3390/ijerph14101194
Received: 17 August 2017 / Revised: 25 September 2017 / Accepted: 5 October 2017 / Published: 8 October 2017
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Abstract
Abstract: To compare the human health risk of heavy metals and As in sewage sludge between adults and children, samples were collected from five wastewater treatment plants (WWTPs) located in the urban district of Taiyuan, the capital of Shanxi. Heavy metals and
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Abstract: To compare the human health risk of heavy metals and As in sewage sludge between adults and children, samples were collected from five wastewater treatment plants (WWTPs) located in the urban district of Taiyuan, the capital of Shanxi. Heavy metals and As in sewage sludge can be ranked according to the mean concentration in the following order: Cu > Cr > Zn > Pb > As > Hg > Cd. Compared with the concentration limit set by different countries, the heavy metals contents in sewage sludge were all within the standard limits, except for the content of As, which was higher than the threshold limit established by Canada. A health risk assessment recommended by the United States Environmental Protection Agency (USEPA) was used to compare the non-cancer risk and cancer risk between adults and children. Based on the mean and 95% upper confidence limit (UCL) of the average daily dose (ADD), heavy metals and As can be ranked in the order of Cu > Cr > Zn > Pb > As > Hg > Cd for adults, and Cu > Cr > Zn > Pb > Hg > As > Cd for children. Moreover, results of ADDingest and ADDinhale indicated that ingestion was the main pathway for heavy metals and As exposure for both adults and children, and the sum of ADD implied that the exposure to all heavy metals and As for children was 8.65 and 9.93 times higher, respectively, than that for adults according to the mean and 95% UCL. For the non-carcinogenic risk, according to the hazard quotient (HQ), the risk of Cu, Hg and Cr was higher than the risk of Zn and Pb. The hazard index (HI) for adults was 0.144 and 0.208 for the mean and 95% UCL, which was less than the limit value of 1; for children, the HI was 1.26 and 2.25, which is higher than the limit value of 1. This result indicated that children had non-carcinogenic risk, but adults did not. Furthermore, ingestion was the main pathway for non-carcinogenic risk exposure by the HQingest and HQinhale. For the carcinogenic risk, Cd and As were classified as carcinogenic pollutants. The values of RISK for the mean and 95% UCL for adults and children all exceeded the limit value of 1 × 10−5, which implied that adults and children had a carcinogenic risk, and this risk was higher for children than for adults. The results of RISK for As and Cd implied that As was the main pollutant for carcinogenic risk. Moreover, the results of RISKingest and RISKinhale indicated that ingestion was the main pathway. Uncertainty analysis was performed, and the risk ranges of it were greater than certainty analysis, which implied that uncertainty analysis was more conservative than certainty analysis. A comparison of the non-carcinogenic risk and carcinogenic risk for adults and children indicated that children were more sensitive and vulnerable than adults when exposed to the same pollutant in the environment. Full article
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Open AccessArticle Relationships among Environment, Climate, and Longevity in China
Int. J. Environ. Res. Public Health 2017, 14(10), 1195; doi:10.3390/ijerph14101195
Received: 2 September 2017 / Revised: 3 October 2017 / Accepted: 6 October 2017 / Published: 8 October 2017
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Abstract
Human longevity is influenced by environment and nutrition. We considered environmental and nutritional factors relating to longevity in Chinese cities. We found higher 85+/65+ distribution ratios, indicating enhanced longevity, in the coastal and southern regions of China. These areas also featured higher humidity,
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Human longevity is influenced by environment and nutrition. We considered environmental and nutritional factors relating to longevity in Chinese cities. We found higher 85+/65+ distribution ratios, indicating enhanced longevity, in the coastal and southern regions of China. These areas also featured higher humidity, low standard deviation of monthly temperature, higher levels of selenium (Se) distribution in soil, and greater sea fish consumption. Moderate climate is more conducive to longevity, however, there is no significant difference in longevity between different sub-climatic types within moderate climate; the relation between humidity and longevity is not always positive, the relation between altitude and longevity is not always negative. Nutritional factors like Se and omega-3 fatty acids contained in sea fish were crucial to longevity. In contrast, the consumption of meat and freshwater fish were less related to longevity. Taken together, humidity, altitude, and per capita sea fish consumption, when evaluated via geographically weighted regression, explained 66% and 68% of longevity among Chinese individuals in 2000 and 2010, respectively. Other factors require further discussion. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Modelling the Ozone-Based Treatments for Inactivation of Microorganisms
Int. J. Environ. Res. Public Health 2017, 14(10), 1196; doi:10.3390/ijerph14101196
Received: 18 August 2017 / Revised: 2 October 2017 / Accepted: 4 October 2017 / Published: 9 October 2017
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Abstract
The paper presents the development of a model for ozone treatment in a dynamic bed of different microorganisms (Bacillus subtilis, B. cereus, B. pumilus, Escherichia coli, Pseudomonas fluorescens, Aspergillus niger, Eupenicillium cinnamopurpureum) on a heterogeneous
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The paper presents the development of a model for ozone treatment in a dynamic bed of different microorganisms (Bacillus subtilis, B. cereus, B. pumilus, Escherichia coli, Pseudomonas fluorescens, Aspergillus niger, Eupenicillium cinnamopurpureum) on a heterogeneous matrix (juniper berries, cardamom seeds) initially treated with numerous ozone doses during various contact times was studied. Taking into account various microorganism susceptibility to ozone, it was of great importance to develop a sufficiently effective ozone dose to preserve food products using different strains based on the microbial model. For this purpose, we have chosen the Weibull model to describe the survival curves of different microorganisms. Based on the results of microorganism survival modelling after ozone treatment and considering the least susceptible strains to ozone, we selected the critical ones. Among tested strains, those from genus Bacillus were recognized as the most critical strains. In particular, B. subtilis and B. pumilus possessed the highest resistance to ozone treatment because the time needed to achieve the lowest level of its survival was the longest (up to 17.04 min and 16.89 min for B. pumilus reduction on juniper berry and cardamom seed matrix, respectively). Ozone treatment allow inactivate microorganisms to achieving lower survival rates by ozone dose (20.0 g O3/m3 O2, with a flow rate of 0.4 L/min) and contact time (up to 20 min). The results demonstrated that a linear correlation between parameters p and k in Weibull distribution, providing an opportunity to calculate a fitted equation of the process. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessFeature PaperArticle Predicting Child Protective Services (CPS) Involvement among Low-Income U.S. Families with Young Children Receiving Nutritional Assistance
Int. J. Environ. Res. Public Health 2017, 14(10), 1197; doi:10.3390/ijerph14101197
Received: 4 August 2017 / Revised: 29 September 2017 / Accepted: 3 October 2017 / Published: 11 October 2017
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Abstract
This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065
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This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele. Full article
(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)
Open AccessArticle Distributions and Sources of Polycyclic Aromatic Hydrocarbons (PAHs) in Soils around a Chemical Plant in Shanxi, China
Int. J. Environ. Res. Public Health 2017, 14(10), 1198; doi:10.3390/ijerph14101198
Received: 10 August 2017 / Revised: 12 September 2017 / Accepted: 14 September 2017 / Published: 9 October 2017
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Abstract
Background: Yearly the Shanxi coal chemical industry extracts many coal resources, producing at the same time many polycyclic aromatic hydrocarbons (PAHs) that are emitted as by-products of coal incomplete combustion. Methods: Sixty-six soil samples collected from 0 to 100 cm vertical
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Background: Yearly the Shanxi coal chemical industry extracts many coal resources, producing at the same time many polycyclic aromatic hydrocarbons (PAHs) that are emitted as by-products of coal incomplete combustion. Methods: Sixty-six soil samples collected from 0 to 100 cm vertical sections of three different agricultural (AS), roadside (RS) and park (PS) functional soils around a chemical plant in Shanxi, China were analyzed for the presence of the 16 priority control PAHs. Results: The total concentrations (∑16PAHs) varied in a range of 35.4–116 mg/kg, 5.93–66.5 mg/kg and 3.87–76.0 mg/kg for the RS, PS and AS surface soil, respectively, and 5-ring PAHs were found to be dominant (44.4–49.0%), followed by 4-ring PAHs (15.9–24.5%). Moreover, the average value of ∑16PAHs decreased with the depth, 7.87 mg/kg (0–25 cm), 4.29 mg/kg (25–50 cm), 3.00 mg/kg (50–75 cm), 2.64 mg/kg (75–100 cm) respectively, in PS and AS soil vertical sections. Conclusions: The PAH levels in the studied soils were the serious contamination level (over 1.00 mg/kg) according to the Soils Quality Guidelines. The carcinogenic PAHs (ΣBPAHsBapeq) were approximately 14.8 times higher than the standard guideline level (0.60 mg/kg) and 90.3% of PAHs were produced by coal/wood/grass combustion processes. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Associations between Perceived Neighborhood Walkability and Walking Time, Wellbeing, and Loneliness in Community-Dwelling Older Chinese People in Hong Kong
Int. J. Environ. Res. Public Health 2017, 14(10), 1199; doi:10.3390/ijerph14101199
Received: 28 August 2017 / Revised: 4 October 2017 / Accepted: 5 October 2017 / Published: 9 October 2017
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Abstract
This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged
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This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged 60+ (n = 181). Walkability was measured using nine items selected from the Chinese version of the abbreviated Neighborhood Environment Walkability Scales (NEWS) and NEWS for Chinese Seniors. Outcomes were walking time, physical activity, wellbeing (life satisfaction, happiness, sense of purpose and meaning in life), and loneliness. The mean age of the participants was 71.7 ± 7.8 years. Walkability was positively associated with walking time (p = 0.001, p for trend <0.001) but not with physical activity. After adjusting for socio-demographic characteristics, health conditions, lifestyle, and negative life events, those who perceived their neighborhoods as walkable had higher scores for life satisfaction (p = 0.002) and happiness (p = 0.002), and lower scores for loneliness (p = 0.019), compared with those who perceived their neighborhoods as less walkable. However, perceived neighborhood walkability was not associated with sense of purpose and meaning in life. Among components of walkability, land use mix-access, infrastructure and safety for walking, and traffic safety showed the strongest associations with the measures of wellbeing. The results of this study support the importance of neighborhood walkability for health behavior and wellbeing of older adults. The wellbeing of older adults may be enhanced through the improvement of land use mix-access, infrastructure for walking, and traffic safety. Full article
(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)
Open AccessFeature PaperArticle The Prevalence and Characteristics of E-Cigarette Users in the U.S.
Int. J. Environ. Res. Public Health 2017, 14(10), 1200; doi:10.3390/ijerph14101200
Received: 4 July 2017 / Revised: 23 September 2017 / Accepted: 6 October 2017 / Published: 11 October 2017
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Abstract
Studies have examined the characteristics of individuals who use e-cigarettes, including sociodemographic and smoking characteristics, and the relationship of e-cigarette use to tobacco control policies. While most studies consider a subset of these characteristics with weak measures of regular e-cigarette use, this study
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Studies have examined the characteristics of individuals who use e-cigarettes, including sociodemographic and smoking characteristics, and the relationship of e-cigarette use to tobacco control policies. While most studies consider a subset of these characteristics with weak measures of regular e-cigarette use, this study uses a large, recent U.S. survey to simultaneously consider the association of each of these factors with different use measures. Data from the May 2014 Tobacco Use Supplement-Current Population Survey is supplemented with information on tobacco control policies. The prevalence of ever, current (at least 1 of the last 30 days), and regular (at least 20 of the last 30 days) e-cigarette use were 7.7%, 2.1% and 0.9%, implying that 27.0% of ever users were current users of which 45.3% were regular users. E-cigarette use varied by socio-demographic characteristics and by smoking status, and depended on the measure of use adopted. However, regardless of measures, e-cigarette use was higher among those smokers who smoked more cigarettes. The association with policies was generally weak, but we found more regular use by smokers in low tax and low tobacco control spending states. The results indicate that the user characteristics differ depending on the e-cigarette use measure. The measure of use should be carefully considered in analyzing how e-cigarette use affects cigarette use. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
Open AccessArticle Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis
Int. J. Environ. Res. Public Health 2017, 14(10), 1201; doi:10.3390/ijerph14101201
Received: 29 August 2017 / Revised: 24 September 2017 / Accepted: 8 October 2017 / Published: 10 October 2017
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Abstract
(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on
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(1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing’s Center for Disease Control and Prevention (CDC) and Funing People’s Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China. Full article
(This article belongs to the Special Issue Public Health and Disasters)
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Open AccessArticle Blood Lead Levels and Learning Disabilities: A Cross-Sectional Study of the 2003–2004 National Health and Nutrition Examination Survey (NHANES)
Int. J. Environ. Res. Public Health 2017, 14(10), 1202; doi:10.3390/ijerph14101202
Received: 7 September 2017 / Revised: 6 October 2017 / Accepted: 8 October 2017 / Published: 10 October 2017
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Abstract
Difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities are present among persons diagnosed with learning disabilities (LDs). Previous studies suggest a significant relationship between lead (Pb) exposure and LDs. This study evaluated the potential dose-response relationship
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Difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities are present among persons diagnosed with learning disabilities (LDs). Previous studies suggest a significant relationship between lead (Pb) exposure and LDs. This study evaluated the potential dose-response relationship between blood Pb levels and the risk of LDs. This cross-sectional study examined 1411 children (32,788,743 weighted-persons) between 6 and 15 years old from the 2003–2004 National Health and Nutrition Examination Survey (NHANES) by analyzing demographics, health related-questions, and laboratory tests using survey logistic and frequency modeling in SAS. On a µg Pb/dL basis, a significant dose-dependent relationship between increasing blood Pb levels and increasing risk of LDs was observed (odds ratio (OR) = 1.21, 95% confidence interval (CI) = 1.03–1.43). The relationship remained significant when examining covariates such as gender and race (OR = 1.19, 95% CI = 1.00–1.40). By contrast, no dose-dependence was observed between increasing blood Pb levels and the risk of hay fever in the last year (OR = 0.77, 95% CI = 0.56–1.056), a non-plausibly biologically related outcome of blood Pb levels. Persons in the 50th–75th (12.80%) and 75th–100th (17.14%) percentiles of blood Pb were significantly more likely to have LDs than persons in the 0–50th percentile of blood Pb (8.78%). An estimated 1 million persons born in the US from 1989 to 1998 developed LDs from elevated blood Pb levels. Overall, this study revealed a significant dose-dependent association between increasing childhood blood Pb levels and the risk of a LD diagnosis, but it was not possible to ascribe a direct cause-effect relationship between blood Pb exposure and LD diagnosis. Childhood Pb exposure should be considered when evaluating children with LDs, and continuing efforts should be made to reduce Pb exposure. Full article
Open AccessArticle Priority of a Hesitant Fuzzy Linguistic Preference Relation with a Normal Distribution in Meteorological Disaster Risk Assessment
Int. J. Environ. Res. Public Health 2017, 14(10), 1203; doi:10.3390/ijerph14101203
Received: 8 September 2017 / Revised: 29 September 2017 / Accepted: 6 October 2017 / Published: 10 October 2017
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Abstract
As meteorological disaster systems are large complex systems, disaster reduction programs must be based on risk analysis. Consequently, judgment by an expert based on his or her experience (also known as qualitative evaluation) is an important link in meteorological disaster risk assessment. In
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As meteorological disaster systems are large complex systems, disaster reduction programs must be based on risk analysis. Consequently, judgment by an expert based on his or her experience (also known as qualitative evaluation) is an important link in meteorological disaster risk assessment. In some complex and non-procedural meteorological disaster risk assessments, a hesitant fuzzy linguistic preference relation (HFLPR) is often used to deal with a situation in which experts may be hesitant while providing preference information of a pairwise comparison of alternatives, that is, the degree of preference of one alternative over another. This study explores hesitation from the perspective of statistical distributions, and obtains an optimal ranking of an HFLPR based on chance-restricted programming, which provides a new approach for hesitant fuzzy optimisation of decision-making in meteorological disaster risk assessments. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle “He’s the Number One Thing in My World”: Application of the PRECEDE-PROCEED Model to Explore Child Car Seat Use in a Regional Community in New South Wales
Int. J. Environ. Res. Public Health 2017, 14(10), 1206; doi:10.3390/ijerph14101206
Received: 7 September 2017 / Revised: 30 September 2017 / Accepted: 2 October 2017 / Published: 10 October 2017
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Abstract
We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at
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We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at three early learning centres on the Australian south-east coast. Survey data were triangulated with qualitative data from focus groups and analysed using the PRECEDE-PROCEED conceptual framework. Of the 133 eligible families, 97 (73%) parents completed the survey including 31% of parents who reported their children were Aboriginal. Use of age-appropriate car seats was reported by 80 (83%) of the participants, and awareness of the child car seat legislation was high (91/97, 94%). Children aged 2–3 years were less likely reported to be restrained in an age-appropriate car seat than were older children aged 4–5 years (60% versus 95%: χ2 = 19.14, p < 0.001). Focus group participants highlighted how important their child’s safety was to them, spoke of the influence grandparents had on their use of child car seats and voiced mixed views on the value of authorised child car seat fitters. Future programs should include access to affordable car seats and target community members as well as parents with clear, consistent messages highlighting the safety benefits of using age-appropriate car seats. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
Open AccessArticle Social Hazards as Manifested Workplace Discrimination and Health (Vietnamese and Ukrainian Female and Male Migrants in Czechia)
Int. J. Environ. Res. Public Health 2017, 14(10), 1207; doi:10.3390/ijerph14101207
Received: 9 June 2017 / Revised: 14 September 2017 / Accepted: 2 October 2017 / Published: 10 October 2017
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Abstract
Social hazards as one of the dimensions of workplace discrimination are a potential social determinant of health inequalities. The aim of this study was to investigate relations between self-reported health and social hazard characteristics (defined as—discrimination as such, violence or threat of violence,
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Social hazards as one of the dimensions of workplace discrimination are a potential social determinant of health inequalities. The aim of this study was to investigate relations between self-reported health and social hazard characteristics (defined as—discrimination as such, violence or threat of violence, time pressure or work overload and risk of accident) among Vietnamese and Ukrainian migrants (males and females) in Czechia by age, education level and marital status. This study is based on data from a survey of 669 immigrants in Czechia in 2013. Logistic regression analysis indicates that the given independent variables (given social hazards and socio-demographic characteristics), as predictors of a quality of self-reported health are more important for immigrant females than for males, irrespective of citizenship, albeit only for some of them and to differing extents. We found out that being exposed to the selected social hazards in the workplace leads to worsening self-rated health, especially for females. On the other hand, there was no statistically significant relationship found between poor self-rated health and discrimination as such. Reality calls for more research and, consequently, better policies and practices in the field of health inequalities. Full article
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
Open AccessArticle Association of Waist Circumference Gain and Incident Prediabetes Defined by Fasting Glucose: A Seven-Year Longitudinal Study in Beijing, China
Int. J. Environ. Res. Public Health 2017, 14(10), 1208; doi:10.3390/ijerph14101208
Received: 15 August 2017 / Revised: 1 October 2017 / Accepted: 3 October 2017 / Published: 10 October 2017
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Abstract
The risk of incident prediabetes with gain in waist circumference (WC) has not been addressed among Chinese adults. A total of 7951 participants who underwent health check-ups at the Beijing Physical Examination Center and Beijing Xiaotangshan hospital were recruited in 2009 and followed
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The risk of incident prediabetes with gain in waist circumference (WC) has not been addressed among Chinese adults. A total of 7951 participants who underwent health check-ups at the Beijing Physical Examination Center and Beijing Xiaotangshan hospital were recruited in 2009 and followed up in 2016. Participants were classified into four groups according to categories of percent WC gain: ≤−2.5%, −2.5–2.5%, 2.5–5%, and >5%. The effect of WC gain on prediabetes was evaluated using modified Poisson regression models. Over seven years of follow-up, we identified 1034 prediabetes cases (413 women). Compared with a WC gain of ≤−2.5%, participants with a WC gain of >5% have a higher risk of prediabetes, be they male (non-abdominal obesity at baseline group: RR = 1.57, 95% CI: 1.10–2.24, abdominal obesity at baseline group: RR = 1.66, 95% CI: 1.20–2.30) or female (non-abdominal obesity at baseline group: RR = 1.74, 95% CI: 1.14–2.64, abdominal obesity at baseline group: RR = 2.47, 95% CI: 1.43–4.28). In conclusion, the risk of prediabetes increased significantly with increasing WC for both genders in the Chinese population. Lifestyle interventions aiming at preventing abdominal obesity are urgently needed to reduce the increasing burden of prediabetes, diabetes, and its complications. Full article
Open AccessArticle Toxic Elements in Different Medicinal Plants and the Impact on Human Health
Int. J. Environ. Res. Public Health 2017, 14(10), 1209; doi:10.3390/ijerph14101209
Received: 19 September 2017 / Revised: 8 October 2017 / Accepted: 9 October 2017 / Published: 11 October 2017
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Abstract
Local medicinal plants from Madina, Saudi Arabia, are used to cure various diseases. However, some can cause adverse health effects. Five different medicinal plants were collected in the city of Madina: mahareeb (Cymbopogon), sheeh (Artemisia), harjal (Cynanchum argel
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Local medicinal plants from Madina, Saudi Arabia, are used to cure various diseases. However, some can cause adverse health effects. Five different medicinal plants were collected in the city of Madina: mahareeb (Cymbopogon), sheeh (Artemisia), harjal (Cynanchum argel delile), nabipoot (Equisetum), and kafmariam (Vitex agnus-castus). In total, four toxic elements including Al, Pb, As, and Cd were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). The range of recoveries fell between 86.1% and 90.6% for all measured elements. Al levels were the highest of any of the studied elements in all plant samples, with Cymbopogon showing the highest levels. The range of concentrations of Al was 156–1609 mg/kg. Cd appeared at the lowest levels in all plants samples, with Vitex agnus-castus containing this element at the highest levels. Cd concentrations were in the range of 0.01–0.10 mg/kg. A washing process lowered the toxic elements in all plants; average % recoveries were Al (47.32%), As (59.1%), Cd (62.03%), and Pb (32.40%). The calculated human health risk assessment in one dose for toxic elements in all plants was as follows: Al (1.33 × 10−3–5.57 × 10−2 mg/kg.bw), Pb (0–8.86 × 10−5 mg/kg.bw), As (3.43 × 10−7–1.33 × 10−5 mg/kg.bw), and Cd (0–3.14 × 10−6 mg/kg.bw). Medicinal plants are a source of exposure to toxic elements. However, none of the plants in this study exceeded the daily guideline set by the WHO for any element based on conventional use by the local population. We may cautiously conclude that these medicinal plants pose no risk to users based on conventional use. Full article
(This article belongs to the Special Issue Dietary Exposures)
Open AccessArticle Socioeconomic Differences and Trends in the Place of Death among Elderly People in China
Int. J. Environ. Res. Public Health 2017, 14(10), 1210; doi:10.3390/ijerph14101210
Received: 19 August 2017 / Revised: 3 October 2017 / Accepted: 5 October 2017 / Published: 11 October 2017
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Abstract
China is facing a dramatic aging of its population. Little is known about the factors that influence the place of death and the trends in the place of death for elderly people in China. The purposes of this study were: (1) to examine
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China is facing a dramatic aging of its population. Little is known about the factors that influence the place of death and the trends in the place of death for elderly people in China. The purposes of this study were: (1) to examine the impact of the socioeconomic status (SES) on place of death for elderly Chinese residents; and (2) to assess temporal trends in the place of death over the last 15 years. Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998–2012). Place-of-death as an outcome was dichotomized into either death at home or death outside the home. Logistic regression analyses were used to examine the impact of SES on place of death. The results showed that, of the 23,098 deaths during the study period, 87.78% occurred at home. The overall trend in home death has increased since 2005. SES was shown to be an important factor affecting place of death. The elderly with higher SES were more likely to die where health resources were concentrated, i.e., in a hospital or other type of institution. Our finding suggests that the trend towards a greater emphasis on death at home may call for the development of more supportive home care programs in China. Our finding also suggests that the socioeconomic differences in the place of death may be related to the availability of or access to health care services. Full article
Open AccessArticle Validation and Assessment of Three Methods to Estimate 24-h Urinary Sodium Excretion from Spot Urine Samples in High-Risk Elder Patients of Stroke from the Rural Areas of Shaanxi Province
Int. J. Environ. Res. Public Health 2017, 14(10), 1211; doi:10.3390/ijerph14101211
Received: 18 August 2017 / Revised: 27 September 2017 / Accepted: 28 September 2017 / Published: 11 October 2017
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Abstract
Background: 24-h urine collection is regarded as the “gold standard” for monitoring sodium intake at the population level, but ensuring high quality urine samples is difficult to achieve. The Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT) and Tanaka methods
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Background: 24-h urine collection is regarded as the “gold standard” for monitoring sodium intake at the population level, but ensuring high quality urine samples is difficult to achieve. The Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT) and Tanaka methods have been used to estimate 24-h urinary sodium excretion from spot urine samples in some countries, but few studies have been performed to compare and validate these methods in the Chinese population. Objective: To compare and validate the Kawasaki, INTERSALT and Tanaka formulas in predicting 24-h urinary sodium excretion using spot urine samples in 365 high-risk elder patients of strokefrom the rural areas of Shaanxi province. Methods: Data were collected from a sub-sample of theSalt Substitute and Stroke Study. 365 high-risk elder patients of stroke from the rural areas of Shaanxi province participated and their spot and 24-h urine specimens were collected. The concentrations of sodium, potassium and creatinine in spot and 24-h urine samples wereanalysed. Estimated 24-h sodium excretion was predicted from spot urine concentration using the Kawasaki, INTERSALT, and Tanaka formulas. Pearson correlation coefficients and agreement by Bland-Altman method were computed for estimated and measured 24-h urinary sodium excretion. Results: The average 24-h urinary sodium excretion was 162.0 mmol/day, which representing a salt intake of 9.5 g/day. Three predictive equations had low correlation with the measured 24-h sodium excretion (r = 0.38, p < 0.01; ICC = 0.38, p < 0.01 for the Kawasaki; r = 0.35, p < 0.01; ICC = 0.31, p < 0.01 for the INTERSALT; r = 0.37, p < 0.01; ICC = 0.34, p < 0.01 for the Tanaka). Significant biases between estimated and measured 24-h sodium excretion were observed (all p < 0.01 for three methods). Among the three methods, the Kawasaki method was the least biased compared with the other two methods (mean bias: 31.90, 95% Cl: 23.84, 39.97). Overestimation occurred when the Kawasaki and Tanaka methods were used while the INTERSALT method underestimated 24-h sodium excretion. Conclusion: The Kawasaki, INTERSALT and Tanaka methods for estimation of 24-h urinary sodium excretion from spot urine specimens were inadequate for the assessment of sodium intake at the population level in high-risk elder patients of stroke from the rural areas of Shaanxi province, although the Kawasaki method was the least biased compared with the other two methods. Full article
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Open AccessArticle Adsorption Removal of 17β-Estradiol from Water by Rice Straw-Derived Biochar with Special Attention to Pyrolysis Temperature and Background Chemistry
Int. J. Environ. Res. Public Health 2017, 14(10), 1213; doi:10.3390/ijerph14101213
Received: 7 September 2017 / Revised: 3 October 2017 / Accepted: 6 October 2017 / Published: 11 October 2017
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Abstract
Rice straw biochar that produced at three pyrolysis temperatures (400, 500 and 600 °C) were used to investigate the adsorption properties of 17β-estradiol (E2). The biochar samples were characterized by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), elemental analysis and BET surface
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Rice straw biochar that produced at three pyrolysis temperatures (400, 500 and 600 °C) were used to investigate the adsorption properties of 17β-estradiol (E2). The biochar samples were characterized by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), elemental analysis and BET surface area measurements. The influences of pyrolysis temperature, E2 concentration, pH, ionic strength, background electrolyte and humic acid were studied. Kinetic and isotherm results illustrated that the adsorption process could be well described by pseudo-second-order and Freundlich models. Experimental results showed that ionic strength had less influence on the adsorption of E2 by 500 and 600 °C rice straw biochar. Further, multivalent ions had positive impact on E2 removal than monovalent ions and the influence of the pyrolysis temperature was unremarkable when background electrolyte existed in solutions. The adsorption capacity of E2 decreased with the pH ranged from 3.0 to 12.0 and the humic acid concentration from 2 to 10 mg L–1. Electrostatic attractions and π-π interaction were involved in the adsorption mechanisms. Compared to low-temperature biochar, high-temperature biochar exhibited a better adsorption capacity for E2 in aqueous solution, indicated it had a greater potential for E2 pollution control. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Trends and Comparisons of Utilization of Emergency Departments Due to Traumatic or Non-Traumatic Causes among the HIV-Positive Population in Taiwan, 2006–2011
Int. J. Environ. Res. Public Health 2017, 14(10), 1214; doi:10.3390/ijerph14101214
Received: 14 August 2017 / Revised: 2 October 2017 / Accepted: 9 October 2017 / Published: 11 October 2017
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Abstract
It is important that the utilization of emergency departments (EDs) among people living with the human immunodeficiency virus (HIV) be epidemiologically evaluated in order to assess and improve the HIV care continuum. All participants newly-diagnosed with HIV in Taiwan registered in the National
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It is important that the utilization of emergency departments (EDs) among people living with the human immunodeficiency virus (HIV) be epidemiologically evaluated in order to assess and improve the HIV care continuum. All participants newly-diagnosed with HIV in Taiwan registered in the National Health Insurance Database from 2000 to 2005 were enrolled in this study and followed-up from 2006 to 2011. In total, 3500 participants newly-diagnosed with HIV in 2000–2005 were selected as a fixed-cohort population and followed-up from 2006 to 2011. Overall, 704, 645, 591, 573, 578, and 568 cases made 1322, 1275, 1050, 1061, 1136, and 992 ED visits in 2006, 2007, 2008, 2009, 2010 and 2011, respectively, with an average number of ED visits ranging from 1.75 to 1.98 per person, accounting for 20.1–22.6% of the whole HIV-positive population. Fewer ED visits were due to traumatic reasons, accounting for 19.6–24.4% of all cases. The incidence of traumatic and non-traumatic ED visits among the HIV-positive participants ranged from 7.2–9.3 and 27.0–33.9 per 100 people, respectively. The average direct medical cost of traumatic and non-traumatic ED visits ranged from $89.3–112.0 and $96.6–120.0, respectively. In conclusion, a lower incidence of ED visits for all reasons and fewer ED visits owing to traumatic causes were observed in the population living with HIV in comparison with the general population; however, the direct medical cost of each ED visit owing to both traumatic and non-traumatic causes was greater among those living with HIV than in the general population. Full article
(This article belongs to the Special Issue Insurance and Health)
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Open AccessFeature PaperArticle The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly—A Qualitative Study
Int. J. Environ. Res. Public Health 2017, 14(10), 1215; doi:10.3390/ijerph14101215
Received: 31 August 2017 / Revised: 27 September 2017 / Accepted: 5 October 2017 / Published: 11 October 2017
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Abstract
Abstract: Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of
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Abstract: Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
Open AccessArticle The Effects of Data Collection Method and Monitoring of Workers’ Behavior on the Generation of Demolition Waste
Int. J. Environ. Res. Public Health 2017, 14(10), 1216; doi:10.3390/ijerph14101216
Received: 27 September 2017 / Revised: 7 October 2017 / Accepted: 10 October 2017 / Published: 12 October 2017
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Abstract
The roles of both the data collection method (including proper classification) and the behavior of workers on the generation of demolition waste (DW) are important. By analyzing the effect of the data collection method used to estimate DW, and by investigating how workers’
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The roles of both the data collection method (including proper classification) and the behavior of workers on the generation of demolition waste (DW) are important. By analyzing the effect of the data collection method used to estimate DW, and by investigating how workers’ behavior can affect the total amount of DW generated during an actual demolition process, it was possible to identify strategies that could improve the prediction of DW. Therefore, this study surveyed demolition waste generation rates (DWGRs) for different types of building by conducting on-site surveys immediately before demolition in order to collect adequate and reliable data. In addition, the effects of DW management strategies and of monitoring the behavior of workers on the actual generation of DW were analyzed. The results showed that when monitoring was implemented, the estimates of DW obtained from the DWGRs that were surveyed immediately before demolition and the actual quantities of DW reported by the demolition contractors had an error rate of 0.63% when the results were compared. Therefore, this study has shown that the proper data collection method (i.e., data were collected immediately before demolition) applied in this paper and monitoring on the demolition site have a significant impact on waste generation. Full article
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Open AccessArticle Effect of Early Pelvic Binder Use in the Emergency Management of Suspected Pelvic Trauma: A Retrospective Cohort Study
Int. J. Environ. Res. Public Health 2017, 14(10), 1217; doi:10.3390/ijerph14101217
Received: 3 September 2017 / Revised: 4 October 2017 / Accepted: 10 October 2017 / Published: 12 October 2017
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Abstract
Background: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. Methods: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The
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Background: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. Methods: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: a loss of consciousness or a Glasgow coma score (GCS) of <13; systolic blood pressure of <90 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury. Various parameters, including gender, age, mechanism of injury, GCS, mortality, hospital stay, initial vital signs, revised trauma score, injury severity score, and outcome, were assessed and compared with historical controls. Results: A total of 204 patients with high-energy multiple-trauma from a single level I trauma center in North Taiwan were enrolled in the study from August 2013 to July 2014. The two group baseline patient characteristics were all collected and compared. The trauma patients with suspected pelvic fractures initially stabilized with a pelvic binder had shorter hospital and intensive care unit (ICU) stays. The study group achieved statistically significantly improved survival and lower mean blood transfusion volume and mortality rate, although they were more severe in the trauma score. Conclusions: We recommend prompt pelvic binder use for suspected pelvic injury before definitive imaging is available, as a cervical spine collar is used to protect the cervical spine from further injury prior to definitive identification and characterization of an injury. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Peer Victimization among Classmates—Associations with Students’ Internalizing Problems, Self-Esteem, and Life Satisfaction
Int. J. Environ. Res. Public Health 2017, 14(10), 1218; doi:10.3390/ijerph14101218
Received: 17 September 2017 / Revised: 5 October 2017 / Accepted: 6 October 2017 / Published: 13 October 2017
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Abstract
Bullying is a major problem in schools and a large number of studies have demonstrated that victims have a high excess risk of poor mental health. It may however also affect those who are not directly victimized by peers. The present study investigates
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Bullying is a major problem in schools and a large number of studies have demonstrated that victims have a high excess risk of poor mental health. It may however also affect those who are not directly victimized by peers. The present study investigates whether peer victimization among classmates is linked to internalizing problems, self-esteem, and life satisfaction at the individual level, when the student’s own victimization has been taken into account. The data were derived from the first wave of the Swedish part of Youth in Europe Study (YES!), including information on 4319 students in grade 8 (14–15 years of age) distributed across 242 classes. Results from multilevel analyses show a significant association between classes with a high proportion of students being victimized and higher levels of internalizing problems, lower self-esteem, and lower life satisfaction at the student level. This association holds when the student’s own victimization has been taken into account. This suggests that peer victimization negatively affects those who are directly exposed, as well as their classmates. We conclude that efficient methods and interventions to reduce bullying in school are likely to benefit not only those who are victimized, but all students. Full article
(This article belongs to the Special Issue Youth Violence as a Public Health Issue)
Open AccessArticle Regional Sustainable Development Analysis Based on Information Entropy—Sichuan Province as an Example
Int. J. Environ. Res. Public Health 2017, 14(10), 1219; doi:10.3390/ijerph14101219
Received: 12 September 2017 / Revised: 8 October 2017 / Accepted: 10 October 2017 / Published: 13 October 2017
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Abstract
According to the implementation of a scientific development perspective, sustainable development needs to consider regional development, economic and social development, and the harmonious development of society and nature, but regional sustainable development is often difficult to quantify. Through an analysis of the structure
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According to the implementation of a scientific development perspective, sustainable development needs to consider regional development, economic and social development, and the harmonious development of society and nature, but regional sustainable development is often difficult to quantify. Through an analysis of the structure and functions of a regional system, this paper establishes an evaluation index system, which includes an economic subsystem, an ecological environmental subsystem and a social subsystem, to study regional sustainable development capacity. A sustainable development capacity measure model for Sichuan Province was established by applying the information entropy calculation principle and the Brusselator principle. Each subsystem and entropy change in a calendar year in Sichuan Province were analyzed to evaluate Sichuan Province’s sustainable development capacity. It was found that the established model could effectively show actual changes in sustainable development levels through the entropy change reaction system, at the same time this model could clearly demonstrate how those forty-six indicators from the three subsystems impact on the regional sustainable development, which could make up for the lack of sustainable development research. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessFeature PaperArticle Cusp Catastrophe Regression and Its Application in Public Health and Behavioral Research
Int. J. Environ. Res. Public Health 2017, 14(10), 1220; doi:10.3390/ijerph14101220
Received: 9 August 2017 / Revised: 25 September 2017 / Accepted: 10 October 2017 / Published: 13 October 2017
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Abstract
The cusp catastrophe model is an innovative approach for investigating a phenomenon that consists of both continuous and discrete changes in one modeling framework. However, its application to empirical health and behavior data has been hindered by the complexity in data-model fit. In
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The cusp catastrophe model is an innovative approach for investigating a phenomenon that consists of both continuous and discrete changes in one modeling framework. However, its application to empirical health and behavior data has been hindered by the complexity in data-model fit. In this study, we reported our work in the development of a new modeling method—cusp catastrophe regression (RegCusp in short) by casting the cusp catastrophe into a statistical regression. With the RegCusp approach, unbiased model parameters can be estimated with the maximum likelihood estimation method. To validate the RegCusp method, a series of simulations were conducted to demonstrate the unbiasedness of parameter estimation. Since the estimated residual variance with the Fisher information matrix method was over-dispersed, a bootstrap re-sampling procedure was developed and used as a remedy. We also demonstrate the practical applicability of the RegCusp with empirical data from an NIH-funded project to evaluate an HIV prevention intervention program to educate adolescents in the Bahamas for condom use. Study findings indicated that the model parameters estimated with RegCusp were practically more meaningful than those estimated with comparable methods, especially the estimated cusp point. Full article
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Open AccessArticle Nicotine Component of Cigarette Smoke Extract (CSE) Decreases the Cytotoxicity of CSE in BEAS-2B Cells Stably Expressing Human Cytochrome P450 2A13
Int. J. Environ. Res. Public Health 2017, 14(10), 1221; doi:10.3390/ijerph14101221
Received: 29 July 2017 / Revised: 6 October 2017 / Accepted: 9 October 2017 / Published: 13 October 2017
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Abstract
Cytochrome P450 2A13 (CYP2A13), an extrahepatic enzyme mainly expressed in the human respiratory system, has been reported to mediate the metabolism and toxicity of cigarette smoke. We previously found that nicotine inhibited 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) metabolism by CYP2A13, but its influence on other components
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Cytochrome P450 2A13 (CYP2A13), an extrahepatic enzyme mainly expressed in the human respiratory system, has been reported to mediate the metabolism and toxicity of cigarette smoke. We previously found that nicotine inhibited 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) metabolism by CYP2A13, but its influence on other components of cigarette smoke remains unclear. The nicotine component of cigarette smoke extract (CSE) was separated, purified, and identified using high-performance liquid chromatography (HPLC) and ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS), splitting CSE into a nicotine section (CSE-N) and nicotine-free section (CSE-O). Cell viability and apoptosis by Cell Counting Kit-8 (CCK-8) and flow cytometry assays were conducted on immortalized human bronchial epithelial (BEAS-2B) cells stably expressing CYP2A13 (B-2A13) or vector (B-V), respectively. Interestingly, CSE and CSE-O were toxic to BEAS-2B cells whereas CSE-N showed less cytotoxicity. CSE-O was more toxic to B-2A13 cells than to B-V cells (IC50 of 2.49% vs. 7.06%), which was flatted by 8-methoxypsoralen (8-MOP), a CYP inhibitor. CSE-O rather than CSE or CSE-N increased apoptosis of B-2A13 cells rather than B-V cells. Accordingly, compared to CSE-N and CSE, CSE-O significantly changed the expression of three pairs of pro- and anti-apoptotic proteins, Bcl-2 Associated X Protein/B cell lymphoma-2 (Bax/Bcl-2), Cleaved Poly (Adenosine Diphosphate-Ribose) Polymerase/Poly (Adenosine Diphosphate-Ribose) Polymerase (C-PARP/PARP), and C-caspase-3/caspase-3, in B-2A13 cells. In addition, recombination of CSE-N and CSE-O (CSE-O/N) showed similar cytotoxicity and apoptosis to the original CSE. These results demonstrate that the nicotine component decreases the metabolic activation of CYP2A13 to CSE and aids in understanding the critical role of CYP2A13 in human respiratory diseases caused by cigarette smoking. Full article
(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)
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Open AccessArticle To Facilitate or Curb? The Role of Financial Development in China’s Carbon Emissions Reduction Process: A Novel Approach
Int. J. Environ. Res. Public Health 2017, 14(10), 1222; doi:10.3390/ijerph14101222
Received: 5 September 2017 / Revised: 8 October 2017 / Accepted: 10 October 2017 / Published: 13 October 2017
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Abstract
With the Paris Agreement coming into effect, China, as the largest CO2 emitter in the world, will be facing greater pressure to reduce its carbon emissions. This paper discusses how to solve this issue from the perspective of financial development in China.
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With the Paris Agreement coming into effect, China, as the largest CO2 emitter in the world, will be facing greater pressure to reduce its carbon emissions. This paper discusses how to solve this issue from the perspective of financial development in China. Although many studies have analyzed its impact on carbon emissions, the conclusions are contradictory. A major criticism of the existing studies is the reasonability of the selection of appropriate indicators and panel estimation techniques. Almost all studies use only one or limited indicators to represent the financial development and ignore the cross-sectional dependence. To fulfil the gaps mentioned above, a financial development index system is built, and with the framework of the STIRPAT (Stochastic impacts by regression on population, affluence, and technology) model, this paper applies an ARDL approach to investigating the long-run relationship between financial development and carbon emissions and a dynamic panel error-corrected model to capture the short-run impact. The empirical results show that financial development can improve carbon emissions, and such impact not only shows a regional difference but also reflects the features of stage differences. Additionally, based on the discussion on seven specific aspects of financial development, our findings can be helpful for policy makers to enact corresponding policies to realize the goal of reducing carbon emissions in China. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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