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Int. J. Environ. Res. Public Health, Volume 14, Issue 12 (December 2017)

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Editorial

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Open AccessEditorial How Can We Achieve Healthy Aging?
Int. J. Environ. Res. Public Health 2017, 14(12), 1583; doi:10.3390/ijerph14121583 (registering DOI)
Received: 30 November 2017 / Revised: 30 November 2017 / Accepted: 5 December 2017 / Published: 15 December 2017
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Abstract
Population aging affects all countries, and all income groups.[...] Full article
(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Dietary Intake of Cadmium, Lead and Mercury and Its Association with Bone Health in Healthy Premenopausal Women
Int. J. Environ. Res. Public Health 2017, 14(12), 1437; doi:10.3390/ijerph14121437
Received: 27 September 2017 / Revised: 27 October 2017 / Accepted: 28 October 2017 / Published: 23 November 2017
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Abstract
The bone is one of the relevant target organs of heavy metals, and heavy metal toxicity is associated with several degenerative processes, such osteoporosis and bone mineral alterations, that could lead to fractures. We aimed to study a presumed relationship between bone density,
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The bone is one of the relevant target organs of heavy metals, and heavy metal toxicity is associated with several degenerative processes, such osteoporosis and bone mineral alterations, that could lead to fractures. We aimed to study a presumed relationship between bone density, evaluated by quantitative bone ultrasound (QUS), dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) and the dietary intake of cadmium, lead and mercury in healthy premenopausal women. A total of 158 healthy, non-smoking, premenopausal women were incorporated into the study. A validated food frequency questionnaire (FFQ) was administered to assess intake during the preceding seven days. The median predicted dietary cadmium intake among the 158 women studied was 25.29 μg/day (18.62–35.00) and 2.74 μg/kg body weight/week (b.w./w) (1.92–3.83). Dietary lead intake was 43.85 μg/day (35.09–51.45) and 4.82 μg/kg b.w./w (3.67–6.13). The observed dietary mercury intake was 9.55 μg/day (7.18–13.57) and 1.02 μg/kg b.w./w (0.71–1.48). Comparisons, in terms of heavy metal intake, showed no significant results after further adjusting for energy intake. No statistically significant correlations between heavy metal intake and the QUS, DXA and pQCT parameters were observed. Levels of dietary exposure of cadmium, lead and mercury were mostly within the recommendations. We did not find associations between the QUS, DXA and pQCT parameters and the dietary intake of the studied heavy metals in healthy premenopausal women. Full article
(This article belongs to the Special Issue Studies on Heavy Metals and Health)
Open AccessArticle Optimization of the Use of His6-OPH-Based Enzymatic Biocatalysts for the Destruction of Chlorpyrifos in Soil
Int. J. Environ. Res. Public Health 2017, 14(12), 1438; doi:10.3390/ijerph14121438
Received: 30 October 2017 / Revised: 16 November 2017 / Accepted: 21 November 2017 / Published: 23 November 2017
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Abstract
Applying enzymatic biocatalysts based on hexahistidine-containing organophosphorus hydrolase (His6-OPH) is suggested for the decomposition of chlorpyrifos, which is actively used in agriculture in many countries. The application conditions were optimized and the following techniques was suggested to ensure the highest efficiency
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Applying enzymatic biocatalysts based on hexahistidine-containing organophosphorus hydrolase (His6-OPH) is suggested for the decomposition of chlorpyrifos, which is actively used in agriculture in many countries. The application conditions were optimized and the following techniques was suggested to ensure the highest efficiency of the enzyme: first, the soil is alkalinized with hydrated calcitic lime Ca(OH)2, then the enzyme is introduced into the soil at a concentration of 1000 U/kg soil. Non-equilibrium low temperature plasma (NELTP)-modified zeolite is used for immobilization of the relatively inexpensive polyelectrolyte complexes containing the enzyme His6-OPH and a polyanionic polymer: poly-l-glutamic acid (PLE50) or poly-l-aspartic acid (PLD50). The soil’s humidity is then increased up to 60–80%, the top layer (10–30 cm) of soil is thoroughly stirred, and then exposed for 48–72 h. The suggested approach ensures 100% destruction of the pesticide within 72 h in soils containing as much as 100 mg/kg of chlorpyrifos. It was concluded that using this type of His6-OPH-based enzyme chemical can be the best approach for soils with relatively low humus concentrations, such as sandy and loam-sandy chestnut soils, as well as types of soil with increased alkalinity (pH 8.0–8.4). Such soils are often encountered in desert, desert-steppe, foothills, and subtropical regions where chlorpyrifos is actively used. Full article
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Open AccessArticle FRED: Exergame to Prevent Dependence and Functional Deterioration Associated with Ageing. A Pilot Three-Week Randomized Controlled Clinical Trial
Int. J. Environ. Res. Public Health 2017, 14(12), 1439; doi:10.3390/ijerph14121439
Received: 1 October 2017 / Revised: 4 November 2017 / Accepted: 10 November 2017 / Published: 23 November 2017
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Abstract
Introduction: Frailty syndrome and advanced age may decrease the acceptance of illness and quality of life, and worsen patients’ existing health conditions, as well as leading to an increase in health care expenses. Purpose: The purpose of this study is to reduce frailty
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Introduction: Frailty syndrome and advanced age may decrease the acceptance of illness and quality of life, and worsen patients’ existing health conditions, as well as leading to an increase in health care expenses. Purpose: The purpose of this study is to reduce frailty risk via the use of a FRED game which has been expressly designed and put together for the study. Materials and methods: A total of 40 frail volunteers with a score of <10 points in the short physical performance battery (SPPB) took part in a feasibility study in order to validate the FRED game. Following randomisation, the study group (20 subjects) took part in nine sessions of 20 min each over a three-week period. The control group (19 subjects) continued to lead their daily lives in the course of which they had no physical activity scheduled; Results: After three weeks and having taken part in nine physical activity sessions with the FRED game, 60% of subjects from the study group (12/20) obtained a score of ≥10 points at the end of the study, i.e., less risk of evidencing frailty. This result proved to be statistically significant (p < 0.001). The degree of compliance with and adherence to the game was confirmed by 100% attendance of the sessions. Discussion: Our findings support the hypothesis that FRED, an ad hoc designed exergame, significantly reduced the presence and severity of frailty in a sample of sedentary elders, thus potentially modifying their risk profile. Conclusions: The FRED game is a tool that shows a 99% certain improvement in the degree of frailty in frail elderly subjects. The effectiveness of the design of ad hoc games in a certain pathology or population group is therefore evidenced. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Association of Emotional Labor and Occupational Stressors with Depressive Symptoms among Women Sales Workers at a Clothing Shopping Mall in the Republic of Korea: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1440; doi:10.3390/ijerph14121440
Received: 24 September 2017 / Revised: 18 November 2017 / Accepted: 20 November 2017 / Published: 23 November 2017
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Abstract
In the distribution service industry, sales people often experience multiple occupational stressors such as excessive emotional labor, workplace mistreatment, and job insecurity. The present study aimed to explore the associations of these stressors with depressive symptoms among women sales workers at a clothing
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In the distribution service industry, sales people often experience multiple occupational stressors such as excessive emotional labor, workplace mistreatment, and job insecurity. The present study aimed to explore the associations of these stressors with depressive symptoms among women sales workers at a clothing shopping mall in Korea. A cross sectional study was conducted on 583 women who consist of clothing sales workers and manual workers using a structured questionnaire to assess demographic factors, occupational stressors, and depressive symptoms. Multiple regression analyses were performed to explore the association of these stressors with depressive symptoms. Scores for job stress subscales such as job demand, job control, and job insecurity were higher among sales workers than among manual workers (p < 0.01). The multiple regression analysis revealed the association between occupation and depressive symptoms after controlling for age, educational level, cohabiting status, and occupational stressors (sβ = 0.08, p = 0.04). A significant interaction effect between occupation and social support was also observed in this model (sβ = −0.09, p = 0.02). The multiple regression analysis stratified by occupation showed that job demand, job insecurity, and workplace mistreatment were significantly associated with depressive symptoms in both occupations (p < 0.05), although the strength of statistical associations were slightly different. We found negative associations of social support (sβ = −0.22, p < 0.01) and emotional effort (sβ = −0.17, p < 0.01) with depressive symptoms in another multiple regression model for sales workers. Emotional dissonance (sβ = 0.23, p < 0.01) showed positive association with depressive symptoms in this model. The result of this study indicated that reducing occupational stressors would be effective for women sales workers to prevent depressive symptoms. In particular, promoting social support could be the most effective way to promote women sales workers’ mental health. Full article
Open AccessArticle The Content of Structural and Trace Elements in the Knee Joint Tissues
Int. J. Environ. Res. Public Health 2017, 14(12), 1441; doi:10.3390/ijerph14121441
Received: 28 October 2017 / Revised: 14 November 2017 / Accepted: 14 November 2017 / Published: 23 November 2017
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Abstract
Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure,
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Many elements are responsible for the balance in bone tissue, including those which constitute a substantial proportion of bone mass, i.e., calcium, phosphorus and magnesium, as well as minor elements such as strontium. In addition, toxic elements acquired via occupational and environmental exposure, e.g., Pb, are included in the basic bone tissue composition. The study objective was to determine the content of strontium, lead, calcium, phosphorus, sodium and magnesium in chosen components of the knee joint, i.e., tibia, femur and meniscus. The levels of Sr, Pb, Ca, P, Na and Mg were the highest in the tibia in both men and women, whereas the lowest in the meniscus. It should be noted that the levels of these elements were by far higher in the tibia and femur as compared to the meniscus. In the components of the knee joint, the level of strontium showed the greatest variation. Significant statistical differences were found between men and women only in the content of lead. Full article
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Open AccessArticle Factors Effecting the Total Volatile Organic Compound (TVOC) Concentrations in Slovak Households
Int. J. Environ. Res. Public Health 2017, 14(12), 1443; doi:10.3390/ijerph14121443
Received: 17 October 2017 / Revised: 16 November 2017 / Accepted: 20 November 2017 / Published: 23 November 2017
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Abstract
Thirty five Slovak households were selected for an investigation of indoor environmental quality. Measuring of indoor air physical and chemical factors and a questionnaire survey was performed during May 2017. The range of permissible operative temperature was not met in 11% of objects.
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Thirty five Slovak households were selected for an investigation of indoor environmental quality. Measuring of indoor air physical and chemical factors and a questionnaire survey was performed during May 2017. The range of permissible operative temperature was not met in 11% of objects. Relative humidity met the legislative requirements in all monitored homes. Concentrations of total volatile organic compounds (TVOCs) were significantly higher in the apartments than in the family houses. The average TVOC levels in the apartments and family houses were 519.7 µg/m3 and 330.2 µg/m3, respectively. Statistical analysis confirmed the effect of indoor air temperature, relative humidity and particulate matter (PM0.5 and PM1) on the levels of TVOCs. Higher TVOC levels were observed also in homes where it is not a common practice to open windows during cleaning activities. Other factors that had a statistically significant effect on concentrations of volatile organic compounds were heating type, attached garage, location of the apartment within residential building (the floor), as well as number of occupants. Higher TVOC concentrations were observed in indoor than outdoor environment, while further analysis showed the significant impact of indoor emission sources on the level of these compounds in buildings. The questionnaire study showed a discrepancy between objective measurement and subjective assessment in the household environment, and pointed to insufficient public awareness about volatile organic compounds (VOCs). Full article
(This article belongs to the Special Issue Indoor Environmental Quality)
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Open AccessArticle Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia
Int. J. Environ. Res. Public Health 2017, 14(12), 1444; doi:10.3390/ijerph14121444
Received: 29 September 2017 / Revised: 14 November 2017 / Accepted: 17 November 2017 / Published: 23 November 2017
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Abstract
Dental caries persists as one of the most prevalent chronic diseases among children worldwide. This study aims to determine factors that influence dental caries in primary dentition among primary school children residing in the rural non-fluoridated community of Lithgow, New South Wales, Australia.
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Dental caries persists as one of the most prevalent chronic diseases among children worldwide. This study aims to determine factors that influence dental caries in primary dentition among primary school children residing in the rural non-fluoridated community of Lithgow, New South Wales, Australia. A total of 495 children aged 5–10 years old from all the six primary schools in Lithgow were approached to participate in a cross-sectional survey prior to implementation of water fluoridation in 2014. Following parental consent, children were clinically examined for caries in their primary teeth, and parents were requested to complete a questionnaire on previous fluoride exposure, diet and relevant socio-demographic characteristics that influence oral health. Multiple logistic regression analysis was employed to examine the independent risk factors of primary dentition caries. Overall, 51 percent of children had dental caries in one or more teeth. In the multiple logistic regression analysis, child’s age (Adjusted Odd’s Ratio (AOR) = 1.30, 95% CI: 1.14–1.49) and mother’s extraction history (AOR = 2.05, 95% CI: 1.40–3.00) were significantly associated with caries experience in the child’s primary teeth. In addition, each serve of chocolate consumption was associated with 52 percent higher odds (AOR = 1.52, 95% CI: 1.19–1.93) of primary dentition caries. Full article
(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)
Open AccessArticle Lead Emissions and Population Vulnerability in the Detroit (Michigan, USA) Metropolitan Area, 2006–2013: A Spatial and Temporal Analysis
Int. J. Environ. Res. Public Health 2017, 14(12), 1445; doi:10.3390/ijerph14121445
Received: 23 September 2017 / Revised: 16 November 2017 / Accepted: 20 November 2017 / Published: 23 November 2017
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Abstract
Objective: The purpose of this research is to geographically model airborne lead emission concentrations and total lead deposition in the Detroit Metropolitan Area (DMA) from 2006 to 2013. Further, this study characterizes the racial and socioeconomic composition of recipient neighborhoods and estimates
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Objective: The purpose of this research is to geographically model airborne lead emission concentrations and total lead deposition in the Detroit Metropolitan Area (DMA) from 2006 to 2013. Further, this study characterizes the racial and socioeconomic composition of recipient neighborhoods and estimates the potential for IQ (Intelligence Quotient) loss of children residing there. Methods: Lead emissions were modeled from emitting facilities in the DMA using AERMOD (American Meteorological Society/Environmental Protection Agency Regulatory Model). Multilevel modeling was used to estimate local racial residential segregation, controlling for poverty. Global Moran’s I bivariate spatial autocorrelation statistics were used to assess modeled emissions with increasing segregation. Results: Lead emitting facilities were primarily located in, and moving to, highly black segregated neighborhoods regardless of poverty levels—a phenomenon known as environmental injustice. The findings from this research showed three years of elevated airborne emission concentrations in these neighborhoods to equate to a predicted 1.0 to 3.0 reduction in IQ points for children living there. Across the DMA there are many areas where annual lead deposition was substantially higher than recommended for aquatic (rivers, lakes, etc.) and terrestrial (forests, dunes, etc.) ecosystems. These lead levels result in decreased reproductive and growth rates in plants and animals, and neurological deficits in vertebrates. Conclusions: This lead-hazard and neighborhood context assessment will inform future childhood lead exposure studies and potential health consequences in the DMA. Full article
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Open AccessArticle Effects of A 60 Hz Magnetic Field of Up to 50 milliTesla on Human Tremor and EEG: A Pilot Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1446; doi:10.3390/ijerph14121446
Received: 21 September 2017 / Revised: 15 November 2017 / Accepted: 20 November 2017 / Published: 24 November 2017
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Abstract
Humans are surrounded by sources of daily exposure to power-frequency (60 Hz in North America) magnetic fields (MFs). Such time-varying MFs induce electric fields and currents in living structures which possibly lead to biological effects. The present pilot study examined possible extremely low
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Humans are surrounded by sources of daily exposure to power-frequency (60 Hz in North America) magnetic fields (MFs). Such time-varying MFs induce electric fields and currents in living structures which possibly lead to biological effects. The present pilot study examined possible extremely low frequency (ELF) MF effects on human neuromotor control in general, and physiological postural tremor and electroencephalography (EEG) in particular. Since the EEG cortical mu-rhythm (8–12 Hz) from the primary motor cortex and physiological tremor are related, it was hypothesized that a 60 Hz MF exposure focused on this cortical region could acutely modulate human physiological tremor. Ten healthy volunteers (age: 23.8 ± 4 SD) were fitted with a MRI-compatible EEG cap while exposed to 11 MF conditions (60 Hz, 0 to 50 mTrms, 5 mTrms increments). Simultaneously, physiological tremor (recorded from the contralateral index finger) and EEG (from associated motor and somatosensory brain regions) were measured. Results showed no significant main effect of MF exposure conditions on any of the analyzed physiological tremor characteristics. In terms of EEG, no significant effects of the MF were observed for C1, C3, C5 and CP1 electrodes. However, a significant main effect was found for CP3 and CP5 electrodes, both suggesting a decreased mu-rhythm spectral power with increasing MF flux density. This is however not confirmed by Bonferroni corrected pairwise comparisons. Considering both EEG and tremor findings, no effect of the MF exposure on human motor control was observed. However, MF exposure had a subtle effect on the mu-rhythm amplitude in the brain region involved in tactile perception. Current findings are to be considered with caution due to the small size of this pilot work, but they provide preliminary insights to international agencies establishing guidelines regarding electromagnetic field exposure with new experimental data acquired in humans exposed to high mT-range MFs. Full article
(This article belongs to the Special Issue Electromagnetic Fields and Health—Effects on the Nervous System)
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Open AccessArticle Grip Strength as an Indicator of Health-Related Quality of Life in Old Age—A Pilot Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1447; doi:10.3390/ijerph14121447
Received: 11 October 2017 / Revised: 21 November 2017 / Accepted: 22 November 2017 / Published: 24 November 2017
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Abstract
Over the last century life expectancy has increased dramatically nearly all over the world. This dramatic absolute and relative increase of the old aged people component of the population has influenced not only population structure but also has dramatic implications for the individuals
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Over the last century life expectancy has increased dramatically nearly all over the world. This dramatic absolute and relative increase of the old aged people component of the population has influenced not only population structure but also has dramatic implications for the individuals and public health services. The aim of the present pilot study was to examine the impact of physical well-being assessed by hand grip strength and social factors estimated by social contact frequency on health-related quality of life among 22 men and 41 women ranging in age between 60 and 94 years. Physical well-being was estimated by hand grip strength, data concerning subjective wellbeing and health related quality of life were collected by personal interviews based on the WHOQOL-BREF questionnaires. Number of offspring and intergenerational contacts were not related significantly to health-related quality of life, while social contacts with non-relatives and hand grip strength in contrast had a significant positive impact on health related quality of life among old aged men and women. Physical well-being and in particular muscle strength—estimated by grip strength—may increase health-related quality of life and is therefore an important source for well-being during old age. Grip strength may be used as an indicator of health-related quality of life. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
Open AccessArticle Forging a Frailty-Ready Healthcare System to Meet Population Ageing
Int. J. Environ. Res. Public Health 2017, 14(12), 1448; doi:10.3390/ijerph14121448
Received: 25 September 2017 / Revised: 20 November 2017 / Accepted: 23 November 2017 / Published: 24 November 2017
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Abstract
The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present
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The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization’s World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered. These reforms can be achieved through building partnerships and relationships that engage, empower, and activate patients and their support systems. To meet the challenges of population ageing, Singapore has reorganised its public healthcare into regional healthcare systems (RHSs) aimed at improving population health and the experience of care, and reducing costs. This paper will describe initiatives within the RHS frameworks of the National Health Group (NHG) and the Alexandra Health System (AHS) to forge a frailty-ready healthcare system across the spectrum, which includes the well healthy (“living well”), the well unhealthy (“living with illness”), the unwell unhealthy (“living with frailty”), and the end-of-life (EoL) (“dying well”). For instance, the AHS has adopted a community-centered population health management strategy in older housing estates such as Yishun to build a geographically-based care ecosystem to support the self-management of chronic disease through projects such as “wellness kampungs” and “share-a-pot”. A joint initiative by the Lien Foundation and Khoo Teck Puat Hospital aims to launch dementia-friendly communities across the island by building a network comprising community partners, businesses, and members of the public. At the National Healthcare Group, innovative projects to address the needs of the frail elderly have been developed in the areas of: (a) admission avoidance through joint initiatives with long-term care facilities, nurse-led geriatric assessment at the emergency department and geriatric assessment clinics; (b) inpatient care, such as the Framework for Inpatient care of the Frail Elderly, orthogeriatric services, and geriatric surgical services; and (c) discharge to care, involving community transitional care teams and the development of community infrastructure for post-discharge support; and an appropriate transition to EoL care. In the area of EoL care, the National Strategy for Palliative Care has been developed to build an integrated system to: provide care for frail elderly with advance illnesses, develop advance care programmes that respect patients’ choices, and equip healthcare professionals to cope with the challenges of EoL care. Full article
(This article belongs to the Special Issue Ageing Well: The Role of Age-Friendly Environments)
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Open AccessFeature PaperArticle Bullying and Cyberbullying: Their Legal Status and Use in Psychological Assessment
Int. J. Environ. Res. Public Health 2017, 14(12), 1449; doi:10.3390/ijerph14121449
Received: 31 October 2017 / Revised: 16 November 2017 / Accepted: 18 November 2017 / Published: 24 November 2017
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Abstract
Bullying and cyberbullying have severe psychological and legal consequences for those involved. However, it is unclear how or even if previous experience of bullying and cyberbullying is considered in mental health assessments. Furthermore, the relevance and effectiveness of current legal solutions has been
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Bullying and cyberbullying have severe psychological and legal consequences for those involved. However, it is unclear how or even if previous experience of bullying and cyberbullying is considered in mental health assessments. Furthermore, the relevance and effectiveness of current legal solutions has been debated extensively, resulting in a desire for a specific legislation. The purpose of this study is to investigate the psychological and legal components of bullying and cyberbullying. This is a qualitative research that includes interviews with five practitioner psychologists and four lawyers in the United Kingdom (UK). Thematic analysis revealed three main themes. One theme is related to the definition, characteristics, and impact of bullying and cyberbullying and the need for more discussion among the psychological and legal professions. Another theme is related to current professional procedures and the inclusion of questions about bullying and cyberbullying in psychological risk assessments. The third theme emphasised the importance of intervention through education. Two key messages were highlighted by the lawyers: ample yet problematic legislation exists, and knowledge will ensure legal success. The study recommends the necessity of performing revisions in the clinical psychological practices and assessments, and the legal policies regarding bullying and cyberbullying. In addition to improving legal success, this will reduce bullying prevalence rates, psychological distress, and psychopathology that can be comorbid or emerge as a result of this behaviour. Full article
Open AccessArticle Improving Pool Fencing Legislation in Queensland, Australia: Attitudes and Impact on Child Drowning Fatalities
Int. J. Environ. Res. Public Health 2017, 14(12), 1450; doi:10.3390/ijerph14121450
Received: 20 September 2017 / Revised: 21 November 2017 / Accepted: 22 November 2017 / Published: 24 November 2017
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Abstract
Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes
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Four-sided, non-climbable pool fencing is an effective strategy for preventing children from drowning in home swimming pools. In 2009, the Queensland Government introduced legislation to improve the effectiveness of pool fencing. This study explores community attitudes towards the effectiveness of these legislative changes and examines child (<5 years) drowning deaths in pools. Data from the 2011 Queensland Computer-Assisted Telephone Interviewing (CATI) Social Survey include results from questions related to pool ownership and pool fencing legislation. Fatal child drowning cases between 1 January 2005 and 31 December 2015 were sourced from coronial data. Of the 1263 respondents, 26/100 households had a pool. A total of 58% believed tightening legislation would be effective in reducing child drowning deaths. Pool owners were more likely to doubt the effectiveness of legislation (p < 0.001) when compared to non-pool owners. Perceptions of effectiveness did not differ by presence of children under the age of five. There were 46 children who drowned in Queensland home pools (7.8/100,000 pools with children residing in the residence/annum) between 2005 and 2015. While pool owners were less likely to think that tightening the legislation would be effective, the number of children drowning in home swimming pools declined over the study period. Drowning prevention agencies have more work to do to ensure that the most vulnerable (young children in houses with swimming pools) are protected. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
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Open AccessArticle Intuitionistic Linguistic Multiple Attribute Decision-Making with Induced Aggregation Operator and Its Application to Low Carbon Supplier Selection
Int. J. Environ. Res. Public Health 2017, 14(12), 1451; doi:10.3390/ijerph14121451
Received: 15 October 2017 / Revised: 21 November 2017 / Accepted: 22 November 2017 / Published: 24 November 2017
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Abstract
The main focus of this paper is to investigate the multiple attribute decision making (MADM) method under intuitionistic linguistic (IL) environment, based on induced aggregation operators and analyze possibilities for its application in low carbon supplier selection. More specifically, a new aggregation operator,
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The main focus of this paper is to investigate the multiple attribute decision making (MADM) method under intuitionistic linguistic (IL) environment, based on induced aggregation operators and analyze possibilities for its application in low carbon supplier selection. More specifically, a new aggregation operator, called intuitionistic linguistic weighted induced ordered weighted averaging (ILWIOWA), is introduced to facilitate the IL information. Some of its desired properties are explored. A further generalization of the ILWIOWA, called intuitionistic linguistic generalized weighted induced ordered weighted averaging (ILGWIOWA), operator is developed. Furthermore, by employing the proposed operators, a MADM approach based on intuitionistic linguistic information is presented. Finally, an illustrative example concerning low carbon supplier selection and comparative analyses are conducted to demonstrate the effectiveness and practicality of the proposed approach. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
Open AccessArticle Radioactive Cobalt(II) Removal from Aqueous Solutions Using a Reusable Nanocomposite: Kinetic, Isotherms, and Mechanistic Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1453; doi:10.3390/ijerph14121453
Received: 24 September 2017 / Revised: 15 November 2017 / Accepted: 21 November 2017 / Published: 24 November 2017
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Abstract
A lignocellulose/montmorillonite (LMT) nanocomposite was prepared as a reusable adsorbent for cobalt(II) ions, and characterized by nitrogen (N2) adsorption/desorption isotherm, X-ray Diffraction (XRD), Scanning Electron Microscope (SEM), Transmission Electron Microscopy (TEM), and Fourier Transform Infrared Spectroscopy (FTIR). LMT exhibited efficient adsorption
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A lignocellulose/montmorillonite (LMT) nanocomposite was prepared as a reusable adsorbent for cobalt(II) ions, and characterized by nitrogen (N2) adsorption/desorption isotherm, X-ray Diffraction (XRD), Scanning Electron Microscope (SEM), Transmission Electron Microscopy (TEM), and Fourier Transform Infrared Spectroscopy (FTIR). LMT exhibited efficient adsorption of cobalt ions (Co(II)), and the adsorbed Co(II) was readily desorbed by nitric acid (HNO3). All parameters affecting the adsorption and/or desorption of Co(II), including initial Co(II) concentration, pH value, temperature, HNO3 concentration, and time, were optimized. The kinetic data analysis showed that the adsorption followed the pseudo-second-order kinetic model and fit well into the Langmuir isotherm equation. Notably, the nanocomposite can be used four times without significantly losing adsorbent capability. The Energy-Dispersive X-ray (EDX) and FTIR spectra analysis also revealed that the adsorption mechanism may be mainly a chemical adsorption dominated process. Full article
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Open AccessArticle School Gardens: A Qualitative Study on Implementation Practices
Int. J. Environ. Res. Public Health 2017, 14(12), 1454; doi:10.3390/ijerph14121454
Received: 9 November 2017 / Revised: 17 November 2017 / Accepted: 22 November 2017 / Published: 25 November 2017
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Abstract
School gardens have beneficial effects on children’s dietary behaviors but information on its implementation is scarce. The current study aimed to gain insight in implementation practices of school gardens and in perceptions of key members and children towards a school garden. We conducted
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School gardens have beneficial effects on children’s dietary behaviors but information on its implementation is scarce. The current study aimed to gain insight in implementation practices of school gardens and in perceptions of key members and children towards a school garden. We conducted twelve interviews involving 14 key members and five focus groups with 38 children from fifth to sixth grade (10–13 years old) in four primary schools in Ghent (Flanders, Belgium). We analyzed the interviews and focus groups in NVivo, using thematic analysis. School gardens were mainly initiated to involve children in nature, not to improve vegetable consumption. Participants were positive about having a school garden, experienced facilitating factors (e.g., adaptability of the garden, having a person responsible for the garden), but also various barriers (e.g., difficulties with startup, maintenance during summer holidays and integration in the school curriculum) and suggested some solutions (e.g., involving external organizations and parents, expanding the garden) and motivating factors for children (e.g., colorful plants, use of gloves). In order to improve implementation and to contribute to children’s health, future school gardening projects should take the recommendations of key members and children into account. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Urinary Phthalate Concentrations in Mothers and Their Children in Ireland: Results of the DEMOCOPHES Human Biomonitoring Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1456; doi:10.3390/ijerph14121456
Received: 20 October 2017 / Revised: 17 November 2017 / Accepted: 22 November 2017 / Published: 25 November 2017
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Abstract
Background: Phthalates are chemicals which are widespread in the environment. Although the impacts on health of such exposure are unclear, there is evidence of a possible impact on the incidence of a diverse range of diseases. Monitoring of human exposure to phthalates
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Background: Phthalates are chemicals which are widespread in the environment. Although the impacts on health of such exposure are unclear, there is evidence of a possible impact on the incidence of a diverse range of diseases. Monitoring of human exposure to phthalates is therefore important. This study aimed to determine the extent of phthalate exposure among mothers and their children in both rural and urban areas in Ireland, and to identify factors associated with elevated concentrations. It formed part of the ‘Demonstration of a study to Co-ordinate and Perform Human Biomonitoring on a European Scale’ (DEMOCOPHES) pilot biomonitoring study. Methods: the concentration of phthalate metabolites were determined from a convenience sample of 120 mother/child pairs. The median age of the children was 8 years. A questionnaire was used to collect information regarding lifestyle and environmental conditions of the children and mothers. Rigorous quality assurance within DEMOCOPHES guaranteed the accuracy and international comparability of results. Results: Phthalate metabolites were detected in all of the samples from both children and mothers. Concentrations were significantly higher in respondents from families with lower educational attainment and in those exposed to such items as polyvinyl chloride (PVC), fast food and personal care products (PCP). Conclusions: The study demonstrates that human biomonitoring for assessing exposure to phthalates can be undertaken in Ireland and that the exposure of the population is widespread. Further work will be necessary before the consequences of this exposure are understood. Full article
Open AccessArticle Banning Asbestos in New Zealand, 1936–2016, an 80-Year Long Saga
Int. J. Environ. Res. Public Health 2017, 14(12), 1457; doi:10.3390/ijerph14121457
Received: 25 October 2017 / Revised: 21 November 2017 / Accepted: 21 November 2017 / Published: 25 November 2017
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Abstract
The banning by the New Zealand Government of the import and export of asbestos-containing products resulted from the interplay of a number of factors. At a personal level, there were the actions of the asbestos sufferers, their families and support groups. At the
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The banning by the New Zealand Government of the import and export of asbestos-containing products resulted from the interplay of a number of factors. At a personal level, there were the actions of the asbestos sufferers, their families and support groups. At the political level, there were the activities of progressive trade union groups representing the hazardous trades, such as labourers, construction workers and demolition workers, and at a Government level, there was a positive response to these public health pressures. The Prohibition Order 2016 concerning Imports and Exports (asbestos-containing products) was the outcome of this 80-year long saga. Full article
Open AccessCommunication Systematic Review and Meta-Analysis of Human Skin Diseases Due to Particulate Matter
Int. J. Environ. Res. Public Health 2017, 14(12), 1458; doi:10.3390/ijerph14121458
Received: 19 October 2017 / Revised: 22 November 2017 / Accepted: 23 November 2017 / Published: 25 November 2017
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Abstract
This study investigated the effects of particulate matter (PM) on human skin diseases by conducting a systematic review of existing literature and performing a meta-analysis. It considered articles reporting an original effect of PM on human skin. From among 918 articles identified, 13
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This study investigated the effects of particulate matter (PM) on human skin diseases by conducting a systematic review of existing literature and performing a meta-analysis. It considered articles reporting an original effect of PM on human skin. From among 918 articles identified, 13 articles were included for further consideration after manual screening of the articles resulted in the exclusion of articles that did not contain data, review articles, editorials, and also articles in languages other than English. Random-effects models and forest plots were used to estimate the effect of PM on the skin by Meta-Disc analysis. According to people’s reports of exposure and negative skin effects (atopic dermatitis (AD), eczema, and skin aging, etc.) due to air pollution, the summary relative risk (odds ratio) of PM10 was determined to be 0.99 (95% confidence interval (CI) 0.89–1.11) whereas PM2.5 was determined to be 1.04 (95% CI 0.96–1.12). Simultaneously, there was a different extent of impact between PM10 and PM2.5 on atopic dermatitis (AD) for those of young age: the odds ratio of PM10 and PM2.5 were 0.96 (95% CI 0.83–1.11; I2 = 62.7%) and 1.05 (95% CI 0.95–1.16; I2 = 46%), respectively. Furthermore, the results suggest an estimated increase of disease incidence per 10 μg/m3 PM of 1.01% (0.08–2.05) due to PM10 and 1.60% (0.45–2.82) due to PM2.5. Following the results, PM10 and PM2.5 are associated with increased risks of human skin diseases, especially AD, whose risk is higher in infants and school children. With its smaller size and a high concentration of metals, PM2.5 is more closely related to AD in younger people, compared to PM10. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Mental Health of the Prison Medical Workers (PMWs) and Influencing Factors in Jiangxi, China
Int. J. Environ. Res. Public Health 2017, 14(12), 1459; doi:10.3390/ijerph14121459
Received: 16 October 2017 / Revised: 22 November 2017 / Accepted: 24 November 2017 / Published: 26 November 2017
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Abstract
Prison medical workers (PMWs) are critically important, but they are also vulnerable to psychological problems. Currently, there is no study on examining PMWs’ mental health conditions and possible influencing factors in China. Hence, we conducted this cross-sectional survey, aiming to understand the mental
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Prison medical workers (PMWs) are critically important, but they are also vulnerable to psychological problems. Currently, there is no study on examining PMWs’ mental health conditions and possible influencing factors in China. Hence, we conducted this cross-sectional survey, aiming to understand the mental health status of the PMWs and related impact factors in Jiangxi province of China. We employed the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the mental disorders and psychological health conditions of PMWs in Jiangxi. The t tests were used to compare the differences for the average score of SCL-90-R between the Chinese general population and targeted PMWs of this study. Multivariable logistic regression analyses were conducted to identify the main factors associated with overall detection rate of PMWs’ psychological health conditions. The scores of four dimensions (somatization, obsessive-compulsive symptoms, anxiety, and paranoid ideation) were significantly higher than the Chinese national norm, and the total positive rate was 49.09% among the PMWs. Gender, marital status, age, and length of employment are identified to be the most significant predictors to affect PMWs’ mental health. Positive correlations between each of the nine dimensions of the SCL-90-R have been verified. This study demonstrated for the first time that PMWs are facing mental health risk and suffering serious psychological problems with psychopathology symptoms, which has become a growing concern in China. Our current findings suggest a need for more in-depth studies on this subject going forward to validate our conclusions and also to identify more impact factors, since such studies and knowledge of PMWs’ mental health and influencing factors are very limited in China. Full article
(This article belongs to the Special Issue Mental Health and its Social and Cultural Implications)
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Open AccessCommunication Insecticidal Effects of Plasma Treated Water
Int. J. Environ. Res. Public Health 2017, 14(12), 1460; doi:10.3390/ijerph14121460
Received: 12 October 2017 / Revised: 9 November 2017 / Accepted: 22 November 2017 / Published: 27 November 2017
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Abstract
The efficacy of plasma-treated tap water (PTW) for the possible treatment of a mealybug (Planococcus citri) infestation was studied under laboratory conditions. Mealybugs growing on Nerium oleander have been treated using PTW after being transferred to Petri dishes, thus avoiding possible
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The efficacy of plasma-treated tap water (PTW) for the possible treatment of a mealybug (Planococcus citri) infestation was studied under laboratory conditions. Mealybugs growing on Nerium oleander have been treated using PTW after being transferred to Petri dishes, thus avoiding possible buffering effects that might occur in an in-situ study. When treating tap water with a dielectric barrier discharge for several minutes (1, 3, 5 and 10 min) a distinct acidification of the water can be determined, resulting in a pH value of 1.8 after 10 min treatment. The efficacies of the treated tap water samples were compared to the efficacies achieved using classically acidified water. The classical acidification of tap water was carried out using nitric acid and hydrochloric acid to see any possible influences of the salt of the acid in question. The application of PTW revealed high mortality rates of approx. 90% after an observation period of 24 h. PTW appears promising for the treatment of smaller plant stock and commodities as produced by small scale farmers or in greenhouses as an environmentally friendly substitute or supplement to conventional pesticides. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Investigation of Health Effects According to the Exposure of Low Concentration Arsenic Contaminated Ground Water
Int. J. Environ. Res. Public Health 2017, 14(12), 1461; doi:10.3390/ijerph14121461
Received: 6 October 2017 / Revised: 22 November 2017 / Accepted: 24 November 2017 / Published: 27 November 2017
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Abstract
Recent epidemiological studies have reported adverse health effects, including skin cancer, due to low concentrations of arsenic via drinking water. We conducted a study to assess whether low arsenic contaminated ground water affected health of the residents who consumed it. For precise biomonitoring
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Recent epidemiological studies have reported adverse health effects, including skin cancer, due to low concentrations of arsenic via drinking water. We conducted a study to assess whether low arsenic contaminated ground water affected health of the residents who consumed it. For precise biomonitoring results, the inorganic (trivalent arsenite (As III) and pentavalent arsenate (As V)) and organic forms (monomethylarsonate (MMA) and dimethylarsinate (DMA)) of arsenic were separately quantified by combining high-performance liquid chromatography and inductively coupled plasma mass spectroscopy from urine samples. In conclusion, urinary As III, As V, MMA, and hair arsenic concentrations were significantly higher in residents who consumed arsenic contaminated ground water than control participants who consumed tap water. But, most health screening results did not show a statistically significant difference between exposed and control subjects. We presume that the elevated arsenic concentrations may not be sufficient to cause detectable health effects. Consumption of arsenic contaminated ground water could result in elevated urinary organic and inorganic arsenic concentrations. We recommend immediate discontinuation of ground water supply in this area for the safety of the residents. Full article
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Open AccessArticle Indigenous Values and Health Systems Stewardship in Circumpolar Countries
Int. J. Environ. Res. Public Health 2017, 14(12), 1462; doi:10.3390/ijerph14121462
Received: 15 September 2017 / Revised: 29 October 2017 / Accepted: 23 November 2017 / Published: 27 November 2017
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Abstract
Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared
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Circumpolar regions, and the nations within which they reside, have recently gained international attention because of shared and pressing public policy issues such as climate change, resource development, endangered wildlife and sovereignty disputes. In a call for national and circumpolar action on shared areas of concern, the Arctic states health ministers recently met and signed a declaration that identified shared priorities for international cooperation. Among the areas for collaboration raised, the declaration highlighted the importance of enhancing intercultural understanding, promoting culturally appropriate health care delivery and strengthening circumpolar collaboration in culturally appropriate health care delivery. This paper responds to the opportunity for further study to fully understand indigenous values and contexts, and presents these as they may apply to a framework that will support international comparisons and systems improvements within circumpolar regions. We explored the value base of indigenous peoples and provide considerations on how these values might interface with national values, health systems values and value bases between indigenous nations particularly in the context of health system policy-making that is inevitably shared between indigenous communities and jurisdictional or federal governments. Through a mixed methods nominal consensus process, nine values were identified and described: humanity, cultural responsiveness, teaching, nourishment, community voice, kinship, respect, holism and empowerment. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
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Open AccessArticle Joint Decision-Making and the Coordination of a Sustainable Supply Chain in the Context of Carbon Tax Regulation and Fairness Concerns
Int. J. Environ. Res. Public Health 2017, 14(12), 1464; doi:10.3390/ijerph14121464
Received: 6 November 2017 / Revised: 18 November 2017 / Accepted: 21 November 2017 / Published: 27 November 2017
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Abstract
Carbon tax regulation and consumers’ low-carbon preference act as incentives for firms to abate emissions. Manufacturers can improve product sustainability and retailers can strengthen the promotion of low-carbon products as part of such abatement. Current incomplete rationality also affects product sustainability and low-carbon
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Carbon tax regulation and consumers’ low-carbon preference act as incentives for firms to abate emissions. Manufacturers can improve product sustainability and retailers can strengthen the promotion of low-carbon products as part of such abatement. Current incomplete rationality also affects product sustainability and low-carbon promotion level. In this context, we consider a supply chain with a manufacturer and a retailer and investigate the impacts of the manufacturer’s and the retailer’s fairness concerns on their production sustainability level, low-carbon promotion level and profitability. We also explore the coordination contract. The results show that the manufacturer’s and the retailer’s fairness concerns decrease their product sustainability and low-carbon promotion level, together with the profits of the system and the manufacturer. With regard to the retailer’s fairness concern, the product sustainability level and the manufacturer’s profit are lower; moreover, the low-carbon promotion level and the profits of the supply chain and the retailer are higher. A revenue-sharing contract can coordinate the supply chain perfectly; however, members’ fairness concerns increase the difficulty of coordination. Finally, the numerical results reveal that carbon tax regulation can encourage the manufacturer to enhance the product sustainability level. Further, the impacts on the low-carbon promotion level and firms’ profitability are related to the cost coefficients of product sustainability. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Depressive Symptom and Related Factors: A Cross-Sectional Study of Korean Female Workers Working at Traditional Markets
Int. J. Environ. Res. Public Health 2017, 14(12), 1465; doi:10.3390/ijerph14121465
Received: 25 October 2017 / Revised: 16 November 2017 / Accepted: 16 November 2017 / Published: 27 November 2017
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Abstract
Background: Depression is one of the psychiatric diseases with a high prevalence rate, globally, and reportedly more prevalent among women than among men. Especially, women workers working at traditional markets are in depressive conditions without occupational health services. The purpose of this study
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Background: Depression is one of the psychiatric diseases with a high prevalence rate, globally, and reportedly more prevalent among women than among men. Especially, women workers working at traditional markets are in depressive conditions without occupational health services. The purpose of this study is to investigate factors having a significant effect on the depressive symptoms of women workers at traditional markets in South Korea. Methods: A cross-sectional study was used and subjects for the present study were 500 female workers in three selected representative traditional marketplaces in South Korea. Results: The results of hierarchical regression analysis indicated that increased BMI (β = 0.297, p = 0.017), poor nutritional status (β = 0.596, p < 0.001), street vendor status (β = 2.589, p = 0.001), job stress (β = 0.491, p < 0.001), lower back pain (β = 0.377, p = 0.011), lower self-efficacy (β = −0.368, p = 0.002) and diminished family function (β = −0.633, p = 0.001) affected workers’ depressive symptoms. The explanatory power of these variables was 38.5%. Conclusions: Based on these results, future research should focus on incorporating theses significant factors into effective interventions designed to decrease depressive symptoms in this population. Moreover, this study will increase interest in occupational health nursing, particularly in relation to vulnerable social groups, and expand the scope of practice in the field. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
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Open AccessArticle Mixture Toxicity of Bensulfuron-Methyl and Acetochlor to Red Swamp Crayfish (Procambarus clarkii): Behavioral, Morphological and Histological Effects
Int. J. Environ. Res. Public Health 2017, 14(12), 1466; doi:10.3390/ijerph14121466
Received: 24 October 2017 / Revised: 14 November 2017 / Accepted: 15 November 2017 / Published: 27 November 2017
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Abstract
The mixture of bensulfuron-methyl and acetochlor (MBA) has been widely applied as a rice herbicide in China, but the mixture toxicity of MBA to aquatic organisms is largely unknown. The current study aims to investigate the acute effects of MBA to juvenile red
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The mixture of bensulfuron-methyl and acetochlor (MBA) has been widely applied as a rice herbicide in China, but the mixture toxicity of MBA to aquatic organisms is largely unknown. The current study aims to investigate the acute effects of MBA to juvenile red swamp crayfish, Procambarus clarkii. Firstly, a 96 h semi-static exposure was conducted to determine the Lethal Concentration 50 (LC50) values at 24, 48, 72 and 96 h, as well as to assess the behavioral and morphological effects. A second 96 h exposure was conducted at an MBA concentration of 50% of the 96 h LC50 (72.62 mg/L) to assess the histological changes in the gill, perigastric organ, muscle, heart, stomach, and midgut. The results showed that MBA exhibited low acute toxicity with the 24, 48, 72 and 96 h LC50 values of 191.25 (179.37–215.75), 166.81 (159.49–176.55), 154.30 (148.36–160.59) and 145.24 (138.94–151.27) mg/L, respectively. MBA-exposed crayfish showed body jerk, belly arch, equilibrium loss, body and appendage sway, and lethargy; and the dead crayfish showed dark gray or grayish-white body color and separated cephalothorax and abdomen. At 72.62 mg/L, MBA exposure caused significant histopathological alterations, mainly including the cuticular and epithelial degeneration of all the gills; atrophy of tubule lumina and cellular vacuolation of the perigastric organs (61.15 ± 9.90% of the tubules showed lesions); epithelial hyperplasia (48.40 ± 9.00%), myocardial fibers and epithelial cell lysis (17.30 ± 2.01%), and hemocytic infiltration of the hearts; cuticular swelling (15.82 ± 2.98%) and vacuolate connective tissue (11.30 ± 2.47%) of the stomachs; atrophied bladder cell and fragmented longitudinal muscles (95.23 ± 4.77%) of the midguts; and slight myofibers fragmentation and lysis (7.37 ± 0.53%) of the abdominal muscles. Our results indicate that MBA can cause behavioral, morphological and histopathological effects on juvenile P. clarkii at relatively high concentrations, but its acute toxicity is low compared with many other common herbicides. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Contextual Exploration of a New Family Caregiver Support Concept for Geriatric Settings Using a Participatory Health Research Strategy
Int. J. Environ. Res. Public Health 2017, 14(12), 1467; doi:10.3390/ijerph14121467
Received: 29 September 2017 / Revised: 17 November 2017 / Accepted: 23 November 2017 / Published: 28 November 2017
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Abstract
Family caregivers are the backbone of the long-term care support system within the home environment. Comprehensive caregiver support programs require collaboration and coordination within the system. A new public health concept, Vade Mecum, aims to harmonize and professionalize family caregiver support initiatives in
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Family caregivers are the backbone of the long-term care support system within the home environment. Comprehensive caregiver support programs require collaboration and coordination within the system. A new public health concept, Vade Mecum, aims to harmonize and professionalize family caregiver support initiatives in geriatric care settings in the Euregion Maas-Rhine. Exploration of the new concept recently started in Germany to gain in-depth insight into current support and the needs of the geriatric care team and family caregivers. Within the context of an exploratory qualitative study, a participatory health research (PHR) strategy was applied to make optimal use of experience and knowledge from the system. Care professionals, engaged as co-researchers, were responsible for decisions about the research question, data collection methods and procedures of engaging family caregivers. A research team representing all professions within the geriatric department was formed. Research objectives were formulated and an appropriate mix of qualitative data collection methods consisting of interviews, focus groups and story-telling was chosen. Needs and expectations of the new concept, and practical solutions for involving family caregivers were discussed. A PHR strategy resulted in initiating a qualitative study in a geriatric care setting carried out by care professionals from the department. Knowledge was generated in a co-creative manner, and co-researchers were empowered. A comprehensive understanding of the system serves as a starting point for advancement of the new family caregiver concept. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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Open AccessArticle Oral Mucositis in Pediatric Patients in Treatment for Acute Lymphoblastic Leukemia
Int. J. Environ. Res. Public Health 2017, 14(12), 1468; doi:10.3390/ijerph14121468
Received: 18 September 2017 / Revised: 9 October 2017 / Accepted: 16 October 2017 / Published: 28 November 2017
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Abstract
Oral mucositis in oncologic patients is the most undesirable event of the chemotherapeutic treatment. This study aimed to identify damage to the oral cavity resulting from chemotherapy in pediatric patients with acute lymphoblastic leukemia (ALL). This is a prospective study with a sample
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Oral mucositis in oncologic patients is the most undesirable event of the chemotherapeutic treatment. This study aimed to identify damage to the oral cavity resulting from chemotherapy in pediatric patients with acute lymphoblastic leukemia (ALL). This is a prospective study with a sample of 42 children and adolescents evaluated for 10 consecutive weeks after diagnosis. The modified Oral Assessment Guide (OAG) was used, and data were analyzed by Spearman’s rank correlation coefficient (α = 5%). Changes to the normal lips and saliva were positively related to an increase in the OAG score during all 10 weeks of evaluation. Alterations to the labial mucosa were correlated with an increase in the OAG score from the 2nd to 10th week, which was also found for changes in the tongue and in the swallowing function in Weeks 1, 6, 8, 9, and 10 and for gum changes from the 5th to 7th week. No significant vocal changes were correlated with the total OAG score at any point during the monitoring period. Changes in lips, cheek and/or palatal mucosa, labial mucosa, and gum areas and in swallowing function were positively correlated with an increase in the severity of oral mucositis in patients with ALL after beginning chemotherapeutic treatment. Full article
Open AccessArticle Climatic Factors and Influenza Transmission, Spain, 2010–2015
Int. J. Environ. Res. Public Health 2017, 14(12), 1469; doi:10.3390/ijerph14121469
Received: 15 September 2017 / Revised: 23 November 2017 / Accepted: 24 November 2017 / Published: 28 November 2017
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Abstract
The spatio-temporal distribution of influenza is linked to variations in meteorological factors, like temperature, absolute humidity, or the amount of rainfall. The aim of this study was to analyse the association between influenza activity, and meteorological variables in Spain, across five influenza seasons:
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The spatio-temporal distribution of influenza is linked to variations in meteorological factors, like temperature, absolute humidity, or the amount of rainfall. The aim of this study was to analyse the association between influenza activity, and meteorological variables in Spain, across five influenza seasons: 2010–2011 through to 2014–2015 using generalized linear negative binomial mixed models that we calculated the weekly influenza proxies, defined as the weekly influenza-like illness rates, multiplied by the weekly proportion of respiratory specimens that tested positive for influenza. The results showed an association between influenza transmission and dew point and cumulative precipitation. In increase in the dew point temperature of 5 degrees produces a 7% decrease in the Weekly Influenza Proxy (RR 0.928, IC: 0.891–0.966), and while an increase of 10 mm in weekly rainfall equates to a 17% increase in the Weekly Influenza Proxy (RR 1.172, IC: 1.097–1.251). Influenza transmission in Spain is influenced by variations in meteorological variables as temperature, absolute humidity, or the amount of rainfall. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Effects of Group Counseling Programs, Cognitive Behavioral Therapy, and Sports Intervention on Internet Addiction in East Asia: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2017, 14(12), 1470; doi:10.3390/ijerph14121470
Received: 21 October 2017 / Revised: 21 November 2017 / Accepted: 21 November 2017 / Published: 28 November 2017
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Abstract
To evaluate the effects of group counseling programs, cognitive behavioral therapy (CBT), and sports intervention on Internet addiction (IA), a systematic search in ten databases was performed to identify eligible studies without language restrictions up to January 2017. A meta-analysis and trial sequential
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To evaluate the effects of group counseling programs, cognitive behavioral therapy (CBT), and sports intervention on Internet addiction (IA), a systematic search in ten databases was performed to identify eligible studies without language restrictions up to January 2017. A meta-analysis and trial sequential analysis (TSA) was performed, respectively. A total of 58 randomized controlled trials (RCTs), which included 2871 participants, were incorporated into our meta-analysis. The results showed that group counseling programs, CBT, and sports intervention could significantly reduce IA levels (group counseling program: standardized mean difference (SMD), −1.37; 95% confidence interval (CI), −1.89 to −0.85; CBT: SMD, −1.88; 95% CI, −2.53 to −1.23; sports intervention: SMD, −1.70; 95% CI, −2.14 to −1.26). For group counseling programs, this treatment was more effective in four dimensions of IA, including time management, interpersonal and health issues, tolerance, and compulsive Internet use. For CBT, this treatment yielded a positive change in depression, anxiousness, aggressiveness, somatization, social insecurity, phobic anxiety, paranoid ideation, and psychoticism. For sports intervention, the significant effects were also observed in all dimensions of the IA scale. Each of group counseling programs, cognitive behavioral therapy, and sports intervention had a significant effect on IA and psychopathological symptoms. Sports intervention could improve withdrawal symptoms especially. Full article
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Open AccessArticle Characterization and Computation of Yb/TiO2 and Its Photocatalytic Degradation with Benzohydroxamic Acid
Int. J. Environ. Res. Public Health 2017, 14(12), 1471; doi:10.3390/ijerph14121471
Received: 31 October 2017 / Revised: 20 November 2017 / Accepted: 20 November 2017 / Published: 28 November 2017
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Abstract
Yb-doped TiO2 (Yb/TiO2) compositions were synthesized by sol-gel method, and the prepared materials were characterized by X-ray Diffraction (XRD), X-ray photoelectron spectroscopy (XPS), UV-visible diffuse-reflectance spectrum (UV-Vis DRS), transmission electron microscope (TEM) and high resolution transmission electron microscope (HRTEM), energy
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Yb-doped TiO2 (Yb/TiO2) compositions were synthesized by sol-gel method, and the prepared materials were characterized by X-ray Diffraction (XRD), X-ray photoelectron spectroscopy (XPS), UV-visible diffuse-reflectance spectrum (UV-Vis DRS), transmission electron microscope (TEM) and high resolution transmission electron microscope (HRTEM), energy dispersive spectrometer (EDS), and N2 adsorption. A beneficiation reagent of benzohydroxamic acid (BHA) was used to test the photocatalytic activity of Yb/TiO2. The characterizations indicate that the doping of Yb could inhibit the crystal growth of TiO2, enhance the specific surface area, increase the binding energy of Ti2p, and also slightly expand the adsorption ranges to visible light. Furthermore, the computation of band structure also indicates that Yb-doped TiO2 could make the forbidden band narrower than pure anatase TiO2, which presents a red shift in the absorption spectrum. As a result of the photodegradation experiment on BHA, Yb/TiO2 (0.50% in mass) sintered at 450 °C displayed the highest catalytic activity for BHA when compared with pure TiO2 or other doped Yb/TiO2 compositions, and more than 89.2% of the total organic carbon was removed after 120 min. Almost all anions, including Cl, HCO3, NO3, and SO42−, inhibited the degradation of BHA by Yb/TiO2, and their inhibition effects followed the order of HCO3 > NO3 > SO42− > Cl. Cations of Na+, K+, Ca2+, and Mg2+ displayed a slight suppressing effect due to the impact of Cl coexisting in the solution. In addition, Yb/TiO2 maintained a high photocatalytic ability with respect to BHA after four runs. It is hypothesized that ·OH is one of the main species involved in the photodegradation of BHA, and the mutual transformation of Yb3+ and Yb2+ could promote the separation of electron-hole pairs. Full article
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Open AccessArticle The Moderating Effects of Students’ Personality Traits on Pro-Environmental Behavioral Intentions in Response to Climate Change
Int. J. Environ. Res. Public Health 2017, 14(12), 1472; doi:10.3390/ijerph14121472
Received: 13 October 2017 / Revised: 18 November 2017 / Accepted: 23 November 2017 / Published: 29 November 2017
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Abstract
This study developed a model that examined the relationship between undergraduate students’ beliefs, norms and pro-environment behavioral intentions in the context of global climate change (GCC). The model was further evaluated to determine whether latent variables, such as sustainability value, environmental concern, social
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This study developed a model that examined the relationship between undergraduate students’ beliefs, norms and pro-environment behavioral intentions in the context of global climate change (GCC). The model was further evaluated to determine whether latent variables, such as sustainability value, environmental concern, social norms, perceived risk, pro-environmental attitude, as defined by the theory of planned behavior and value-belief-norm theory, significantly influenced students’ intentions towards pro-environmental behavior. The research model was empirically tested using data collected form 275 undergraduate students. Empirical results found support for four interaction effects of personality traits and the related latent variables of environmental attitude, including sustainability value, social norms, environmental concern and perceived risk. The impact of undergraduate students’ environmental attitudes was moderated by personality traits. The findings of this research offer policy makers and enterprises better understandings of undergraduate students’ attitudes and behavioral intentions towards GCC and promote the visibility of this issue. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Are Changes in Neighbourhood Perceptions Associated with Changes in Self-Rated Mental Health in Adults? A 13-Year Repeat Cross-Sectional Study, UK
Int. J. Environ. Res. Public Health 2017, 14(12), 1473; doi:10.3390/ijerph14121473
Received: 9 November 2017 / Revised: 23 November 2017 / Accepted: 25 November 2017 / Published: 29 November 2017
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Abstract
The aim of this study was to examine changes in neighbourhood perceptions on self-rated mental health problems over time, and to explore demographic, geographic and socio-economic factors as determinants of increased or decreased anxiety and depression symptoms. We conducted a repeat cross-sectional study
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The aim of this study was to examine changes in neighbourhood perceptions on self-rated mental health problems over time, and to explore demographic, geographic and socio-economic factors as determinants of increased or decreased anxiety and depression symptoms. We conducted a repeat cross-sectional study of individuals (N: 4480) living in the same areas of west central Scotland in 1997 and 2010. Individuals were asked to complete a questionnaire at both time-points, containing 14 questions relating to neighbourhood perceptions and the Hospital Anxiety and Depression Scale (HADS). A three-level linear regression model was fitted to HADS scores and changes in neighbourhood perceptions over time; controlling for a number of individual and area-level variables. Overall, area-level mean HADS scores decreased from 1997 to 2010. When adjusted for individual and area-level variables, this decrease did not remain for HADS anxiety. Applying an overall 14-scale neighbourhood perception measure, worsening neighbourhood perceptions were associated with small increases in depression (0.04, 95% confidence interval (CI) 0.01 to 0.07) and anxiety (0.04, 95% CI 0.00 to 0.08) scores over time. This highlights a need for local and national policy to target areas where neighbourhood characteristics are substantially deteriorating in order to ensure the mental health of individuals does not worsen. Full article
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Open AccessArticle Effect of CaO on NOx Reduction by Selective Non-Catalytic Reduction under Variable Gas Compositions in a Simulated Cement Precalciner Atmosphere
Int. J. Environ. Res. Public Health 2017, 14(12), 1474; doi:10.3390/ijerph14121474
Received: 16 October 2017 / Revised: 20 November 2017 / Accepted: 25 November 2017 / Published: 29 November 2017
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Abstract
High-concentration CaO particles and gas compositions have a significant influence on NOx reduction by selective non-catalytic reduction (SNCR) in cement precalciners. The effect of gas composition on NOx reduction by SNCR with NH3 was studied in a cement precalciner atmosphere
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High-concentration CaO particles and gas compositions have a significant influence on NOx reduction by selective non-catalytic reduction (SNCR) in cement precalciners. The effect of gas composition on NOx reduction by SNCR with NH3 was studied in a cement precalciner atmosphere with and without CaO at 700–1100 °C. It was found that CaO significantly lowers NOx reduction efficiency between 750 °C and 1000 °C, which is attributed to the catalytic oxidation of NH3 to NO. Although increasing NH3 concentration was advantageous to NOx reduction, the existence of CaO led to the opposite result at 750–900 °C. Adding H2O can suppress the negative effect of CaO on NOx reduction. Decreasing O2 content from 10% to 1% shifts the temperature range in which CaO has a significant effect from 750–1000 °C to 800–1050 °C. CO has a variety of influences on the CaO effect under different experimental conditions. The influences of NH3, H2O, O2, and CO on the effect of CaO can be attributed to the impacts of the gas compositions on gas-phase NH3 conversion, gas-solid catalytic NH3 oxidation, or both processes. A proposed pathway for the effect of gas compositions on NOx reduction in CaO-containing SNCR process was developed that well predicted the CaO-containing SNCR process. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Risk Assessment and Source Identification of 17 Metals and Metalloids on Soils from the Half-Century Old Tungsten Mining Areas in Lianhuashan, Southern China
Int. J. Environ. Res. Public Health 2017, 14(12), 1475; doi:10.3390/ijerph14121475
Received: 11 October 2017 / Revised: 22 November 2017 / Accepted: 27 November 2017 / Published: 29 November 2017
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Abstract
Background: Mining activities always emit metal(loid)s into the surrounding environment, where their accumulation in the soil may pose risks and hazards to humans and ecosystems. Objective: This paper aims to determine of the type, source, chemical form, fate and transport, and accurate
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Background: Mining activities always emit metal(loid)s into the surrounding environment, where their accumulation in the soil may pose risks and hazards to humans and ecosystems. Objective: This paper aims to determine of the type, source, chemical form, fate and transport, and accurate risk assessment of 17 metal(loid) contaminants including As, Cd, Cu, Ni, Pb, Zn, Cr, Ag, B, Bi, Co, Mo, Sb, Ti, V, W and Sn in the soils collected from an abandoned tungsten mining area, and to guide the implementing of appropriate remediation strategies. Methods: Contamination factors (CFs) and integrated pollution indexes (IPIs) and enrichment factors (EFs) were used to assess their ecological risk and the sources were identified by using multivariate statistics analysis, spatial distribution investigation and correlation matrix. Results: The IPI and EF values indicated the soils in the mine site and the closest downstream one were extremely disturbed by metal(loid)s such as As, Bi, W, B, Cu, Pb and Sn, which were emitted from the mining wastes and acid drainages and delivered by the runoff and human activities. Arsenic contamination was detected in nine sites with the highest CF values at 24.70 next to the mining site. The Cd contamination scattered in the paddy soils around the resident areas with higher fraction of bioavailable forms, primarily associated with intense application of phosphorus fertilizer. The lithogenic elements V, Ti, Ag, Ni, Sb, Mo exhibit low contamination in all sampling points and their distribution were depended on the soil texture and pedogenesis process. Conclusions: The long term historical mining activities have caused severe As contamination and higher enrichment of the other elements of orebody in the local soils. The appropriate remediation treatment approach should be proposed to reduce the bioavailability of Cd in the paddy soils and to immobilize As to reclaim the soils around the mining site. Furthermore, alternative fertilizing way and irrigating water sources are urgencies to reduce the input of Cd and As into the local soils effectively. Full article
(This article belongs to the Special Issue Soil Pollution and Public Health)
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Open AccessArticle Partial and Total Annoyance Due to Road Traffic Noise Combined with Aircraft or Railway Noise: Structural Equation Analysis
Int. J. Environ. Res. Public Health 2017, 14(12), 1478; doi:10.3390/ijerph14121478
Received: 2 October 2017 / Revised: 23 November 2017 / Accepted: 23 November 2017 / Published: 30 November 2017
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Abstract
Structural equation modeling was used to analyze partial and total in situ annoyance in combined transportation noise situations. A psychophysical total annoyance model and a perceptual total annoyance model were proposed. Results show a high contribution of Noise exposure and Noise sensitivity to
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Structural equation modeling was used to analyze partial and total in situ annoyance in combined transportation noise situations. A psychophysical total annoyance model and a perceptual total annoyance model were proposed. Results show a high contribution of Noise exposure and Noise sensitivity to Noise annoyance, as well as a causal relationship between noise annoyance and lower Dwelling satisfaction. Moreover, the Visibility of noise source may increase noise annoyance, even when the visible noise source is different from the annoying source under study. With regards to total annoyance due to road traffic noise combined with railway or aircraft noise, even though in both situations road traffic noise may be considered background noise and the other noise source event noise, the contribution of road traffic noise to the models is greater than railway noise and smaller than aircraft noise. This finding may be explained by the difference in sound pressure levels between these two types of combined exposures or by the aircraft noise level, which may also indicate the city in which the respondents live. Finally, the results highlight the importance of sample size and variable distribution in the database, as different results can be observed depending on the sample or variables considered. Full article
(This article belongs to the Special Issue Noise-Related Annoyance)
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Open AccessArticle Dental Procedures in Primary Health Care of the Brazilian National Health System
Int. J. Environ. Res. Public Health 2017, 14(12), 1480; doi:10.3390/ijerph14121480
Received: 24 October 2017 / Revised: 27 November 2017 / Accepted: 29 November 2017 / Published: 1 December 2017
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Abstract
The aim of this study was to examine the procedures of primary dental health care performed by oral health teams (OHTs) adhering to the second cycle of the ‘National Programme for Improving Access and Quality of Primary Care’ (PMAQ-AB) in Brazil. A cross-sectional
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The aim of this study was to examine the procedures of primary dental health care performed by oral health teams (OHTs) adhering to the second cycle of the ‘National Programme for Improving Access and Quality of Primary Care’ (PMAQ-AB) in Brazil. A cross-sectional descriptive analysis was performed, across 23 dental procedures comprising preventive, restorative/prosthetic, surgical, endodontic and oral cancer monitoring. Descriptive analysis shows that most of the oral health teams carry out basic dental procedures. However, most of the time, they do not keep adequate records of suspected cases of oral cancer, diagnosis tests or follow-ups, and do not perform dental prosthetic procedures. Data also showed disparities in the average number of procedures performed in each Brazilian geographical region in 2013–2014, ranging from 13.9 in the northern to 16.5 in the southern and south-eastern regions, reinforcing the great social disparities between them. Brazilian regions with the highest volume of dental need deliver the lowest number of dental procedures. The need to tackle inequalities and further shape the supply of appropriate primary health care (PHC) is evident. Full article
Open AccessArticle The Role of China in the UK Relative Imports from Three Selected Trading Regions: The Case of Textile Raw Material Industry
Int. J. Environ. Res. Public Health 2017, 14(12), 1481; doi:10.3390/ijerph14121481
Received: 10 October 2017 / Revised: 10 November 2017 / Accepted: 20 November 2017 / Published: 30 November 2017
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Abstract
The UK textile industry was very prosperous in the past but in the 1970s Britain started to import textile materials from abroad. Since 1990, half of its textile materials have been imported from the EEA (European Economic Area), ASEAN (Association of Southeast Asian
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The UK textile industry was very prosperous in the past but in the 1970s Britain started to import textile materials from abroad. Since 1990, half of its textile materials have been imported from the EEA (European Economic Area), ASEAN (Association of Southeast Asian Nations) and North America countries. Meanwhile, UK imports from China have increased dramatically. Through comparisons, this paper calculates the trade competitiveness index and relative competitive advantages of regions and investigates the impact of Chinese textiles on UK imports from three key free trade regions across the textile sectors in the period 1990–2016 on the basis of United Nation Comtrade Rev. 3. We find that China’s textile prices, product techniques, political trade barriers and even tax system have made a varied impact on the UK’s imports across related sectors in the context of green trade and the strengthening of barriers, which helps us recognize China’s competitiveness in international trading and also provides advice on China’s sustainable development of textile exports. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Multi-Source Generation Mechanisms for Low Frequency Noise Induced by Flood Discharge and Energy Dissipation from a High Dam with a Ski-Jump Type Spillway
Int. J. Environ. Res. Public Health 2017, 14(12), 1482; doi:10.3390/ijerph14121482
Received: 20 October 2017 / Revised: 9 November 2017 / Accepted: 22 November 2017 / Published: 30 November 2017
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Abstract
As excess water is discharged from a high dam, low frequency noise (air pulsation lower than 10 Hz, LFN) is generated and propagated in the surrounding areas, causing environmental hazards such as the vibration of windows and doors and the discomfort of local
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As excess water is discharged from a high dam, low frequency noise (air pulsation lower than 10 Hz, LFN) is generated and propagated in the surrounding areas, causing environmental hazards such as the vibration of windows and doors and the discomfort of local residents. To study the generation mechanisms and key influencing factors of LFN induced by flood discharge and energy dissipation from a high dam with a ski-jump type spillway, detailed prototype observations and analyses of LFN are carried out. The discharge flow field is simulated and analyzed using a gas-liquid turbulent flow model. The acoustic response characteristics of the air cavity, which is formed between the discharge nappe and dam body, are analyzed using an acoustic numerical model. The multi-sources generation mechanisms are first proposed basing on the prototype observation results, vortex sound model, turbulent flow model and acoustic numerical model. Two kinds of sources of LFN are studied. One comes from the energy dissipation of submerged jets in the plunge pool, the other comes from nappe-cavity coupled vibration. The results of the analyses reveal that the submerged jets in the plunge pool only contribute to an on-site LFN energy of 0–1.0 Hz, and the strong shear layers around the high-velocity submerged jets and wall jet development areas are the main acoustic source regions of LFN in the plunge pool. In addition, the nappe-cavity coupled vibration, which is induced when the discharge nappe vibrates with close frequency to the model frequency of the cavity, can induce on-site LFN energy with wider frequency spectrum energy within 0–4.0 Hz. By contrast, the contribution degrees to LFN energy from two acoustic sources are almost same, while the contribution degree from nappe-cavity coupled vibration is slightly higher. Full article
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Open AccessArticle Microbial Insight into a Pilot-Scale Enhanced Two-Stage High-Solid Anaerobic Digestion System Treating Waste Activated Sludge
Int. J. Environ. Res. Public Health 2017, 14(12), 1483; doi:10.3390/ijerph14121483
Received: 9 November 2017 / Revised: 24 November 2017 / Accepted: 27 November 2017 / Published: 30 November 2017
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Abstract
High solid anaerobic digestion (HSAD) is a rapidly developed anaerobic digestion technique for treating municipal sludge, and has been widely used in Europe and Asia. Recently, the enhanced HSAD process with thermal treatment showed its advantages in both methane production and VS reduction.
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High solid anaerobic digestion (HSAD) is a rapidly developed anaerobic digestion technique for treating municipal sludge, and has been widely used in Europe and Asia. Recently, the enhanced HSAD process with thermal treatment showed its advantages in both methane production and VS reduction. However, the understanding of the microbial community is still poor. This study investigated microbial communities in a pilot enhanced two-stage HSAD system that degraded waste activated sludge at 9% solid content. The system employed process “thermal pre-treatment (TPT) at 70 °C, thermophilic anaerobic digestion (TAD), and mesophilic anaerobic digestion (MAD)”. Hydrogenotrophic methanogens Methanothermobacter spp. dominated the system with relative abundance up to about 100% in both TAD and MAD. Syntrophic acetate oxidation (SAO) bacteria were discovered in TAD, and they converted acetate into H2 and CO2 to support hydrogenotrophic methanogenesis. The microbial composition and conversion route of this system are derived from the high solid content and protein content in raw sludge, as well as the operational conditions. This study could facilitate the understanding of the enhanced HSAD process, and is of academic and industrial importance. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessFeature PaperArticle Health Challenges in Refugee Reception: Dateline Europe 2016
Int. J. Environ. Res. Public Health 2017, 14(12), 1484; doi:10.3390/ijerph14121484
Received: 12 October 2017 / Revised: 21 November 2017 / Accepted: 21 November 2017 / Published: 30 November 2017
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Abstract
The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present
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The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC) funded project, this article considers the physical and mental health of asylum–seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300) and in Sicily (400), and complemented by in-depth interviews with migrants (45) and key informants (50) including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services. Full article
(This article belongs to the Special Issue Refugee Health)
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Open AccessArticle Microbial Risk Assessment of Tidal−Induced Urban Flooding in Can Tho City (Mekong Delta, Vietnam)
Int. J. Environ. Res. Public Health 2017, 14(12), 1485; doi:10.3390/ijerph14121485
Received: 15 October 2017 / Revised: 16 November 2017 / Accepted: 17 November 2017 / Published: 30 November 2017
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Abstract
Public health risks from urban flooding are a global concern. Contaminated floodwater may expose residents living in cities as they are in direct contact with the water. However, the recent literature does not provide much information about this issue, especially for developing countries.
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Public health risks from urban flooding are a global concern. Contaminated floodwater may expose residents living in cities as they are in direct contact with the water. However, the recent literature does not provide much information about this issue, especially for developing countries. In this paper, the health risk due to a flood event occurred in Can Tho City (Mekong Delta, Vietnam) on 7 October 2013 was investigated. The Quantitative Microbial Risk Assessment method was used in this study. The data showed that the pathogen concentrations were highly variable during the flood event and exceeded water standards for surface water. Per 10,000 people in contact with the floodwater, we found Salmonella caused the highest number of infections to adults and children (137 and 374, respectively), while E. coli caused 4 and 12 cases, per single event, respectively. The results show that further investigations on health risk related to flood issues in Can Tho City are required, especially because of climate change and urbanization. In addition, activities to raise awareness- about floods, e.g., “living with floods”, in the Mekong Delta should also consider health risk issues. Full article
(This article belongs to the Special Issue Environmental Risk Assessment)
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Open AccessArticle A Comprehensive Approach to Motorcycle-Related Head Injury Prevention: Experiences from the Field in Vietnam, Cambodia, and Uganda
Int. J. Environ. Res. Public Health 2017, 14(12), 1486; doi:10.3390/ijerph14121486
Received: 25 October 2017 / Revised: 21 November 2017 / Accepted: 22 November 2017 / Published: 30 November 2017
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Abstract
Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%;
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Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%; however, both child and adult helmet use are low in many countries where motorcycles are a primary mode of transportation. In response to the need to increase helmet use by all drivers and their passengers, the Global Helmet Vaccine Initiative (GHVI) was established to increase helmet use in three countries where a substantial portion of road users are motorcyclists and where helmet use is low. The GHVI approach includes five strategies to increase helmet use: targeted programs, helmet access, public awareness, institutional policies, and monitoring and evaluation. The application of GHVI to Vietnam, Cambodia, and Uganda resulted in four key lessons learned. First, motorcyclists are more likely to wear helmets when helmet use is mandated and enforced. Second, programs targeted to at-risk motorcyclists, such as child passengers, combined with improved awareness among the broader population, can result in greater public support needed to encourage action by decision-makers. Third, for broad population-level change, using multiple strategies in tandem can be more effective than using a single strategy alone. Lastly, the successful expansion of GHVI into Cambodia and Uganda has been hindered by the lack of helmet accessibility and affordability, a core component contributing to its success in Vietnam. This paper will review the development of the GHVI five-pillar approach in Vietnam, subsequent efforts to implement the model in Cambodia and Uganda, and lessons learned from these applications to protect motorcycle drivers and their adult and child passengers from injury. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
Open AccessArticle Automated Ecological Assessment of Physical Activity: Advancing Direct Observation
Int. J. Environ. Res. Public Health 2017, 14(12), 1487; doi:10.3390/ijerph14121487
Received: 17 October 2017 / Revised: 23 November 2017 / Accepted: 30 November 2017 / Published: 1 December 2017
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Abstract
Technological advances provide opportunities for automating direct observations of physical activity, which allow for continuous monitoring and feedback. This pilot study evaluated the initial validity of computer vision algorithms for ecological assessment of physical activity. The sample comprised 6630 seconds per camera (three
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Technological advances provide opportunities for automating direct observations of physical activity, which allow for continuous monitoring and feedback. This pilot study evaluated the initial validity of computer vision algorithms for ecological assessment of physical activity. The sample comprised 6630 seconds per camera (three cameras in total) of video capturing up to nine participants engaged in sitting, standing, walking, and jogging in an open outdoor space while wearing accelerometers. Computer vision algorithms were developed to assess the number and proportion of people in sedentary, light, moderate, and vigorous activity, and group-based metabolic equivalents of tasks (MET)-minutes. Means and standard deviations (SD) of bias/difference values, and intraclass correlation coefficients (ICC) assessed the criterion validity compared to accelerometry separately for each camera. The number and proportion of participants sedentary and in moderate-to-vigorous physical activity (MVPA) had small biases (within 20% of the criterion mean) and the ICCs were excellent (0.82–0.98). Total MET-minutes were slightly underestimated by 9.3–17.1% and the ICCs were good (0.68–0.79). The standard deviations of the bias estimates were moderate-to-large relative to the means. The computer vision algorithms appeared to have acceptable sample-level validity (i.e., across a sample of time intervals) and are promising for automated ecological assessment of activity in open outdoor settings, but further development and testing is needed before such tools can be used in a diverse range of settings. Full article
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Open AccessArticle Social Networks, Engagement and Resilience in University Students
Int. J. Environ. Res. Public Health 2017, 14(12), 1488; doi:10.3390/ijerph14121488
Received: 29 October 2017 / Revised: 24 November 2017 / Accepted: 27 November 2017 / Published: 1 December 2017
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Abstract
Analysis of social networks may be a useful tool for understanding the relationship between resilience and engagement, and this could be applied to educational methodologies, not only to improve academic performance, but also to create emotionally sustainable networks. This descriptive study was carried
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Analysis of social networks may be a useful tool for understanding the relationship between resilience and engagement, and this could be applied to educational methodologies, not only to improve academic performance, but also to create emotionally sustainable networks. This descriptive study was carried out on 134 university students. We collected the network structural variables, degree of resilience (CD-RISC 10), and engagement (UWES-S). The computer programs used were excel, UCINET for network analysis, and SPSS for statistical analysis. The analysis revealed results of means of 28.61 for resilience, 2.98 for absorption, 4.82 for dedication, and 3.13 for vigour. The students had two preferred places for sharing information: the classroom and WhatsApp. The greater the value for engagement, the greater the degree of centrality in the friendship network among students who are beginning their university studies. This relationship becomes reversed as the students move to later academic years. In terms of resilience, the highest values correspond to greater centrality in the friendship networks. The variables of engagement and resilience influenced the university students’ support networks. Full article
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Open AccessArticle Quantitative Properties of the Macro Supply and Demand Structure for Care Facilities for Elderly in Japan
Int. J. Environ. Res. Public Health 2017, 14(12), 1489; doi:10.3390/ijerph14121489
Received: 17 October 2017 / Revised: 17 November 2017 / Accepted: 28 November 2017 / Published: 1 December 2017
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Abstract
As the Asian country with the most aged population, Japan, has been modifying its social welfare system. In 2000, the Japanese social care vision turned towards meeting the elderly’s care needs in their own homes with proper formal care services. This study aims
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As the Asian country with the most aged population, Japan, has been modifying its social welfare system. In 2000, the Japanese social care vision turned towards meeting the elderly’s care needs in their own homes with proper formal care services. This study aims to understand the quantitative properties of the macro supply and demand structure for facilities for the elderly who require support or long-term care throughout Japan and present them as index values. Additionally, this study compares the targets for establishing long-term care facilities set by Japan’s Ministry of Health, Labor and Welfare for 2025. In 2014, approximately 90% of all the people who were certified as requiring support and long-term care and those receiving preventive long-term care or long-term care services, were 75 years or older. The target increases in the number of established facilities by 2025 (for the 75-years-or-older population) were calculated to be 3.3% for nursing homes; 2.71% for long-term-care health facilities; 1.7% for group living facilities; and, 1.84% for community-based multi-care facilities. It was revealed that the establishment targets for 2025 also increase over current projections with the expected increase of the absolute number of users of group living facilities and community-based multi-care facilities. On the other hand, the establishment target for nursing homes remains almost the same as the current projection, whereas that for long-term-care health facilities decreases. These changes of facility ratios reveal that the Japanese social care system is shifting to realize ‘Ageing in Place’. When considering households’ tendencies, the target ratios for established facilities are expected to be applied to the other countries in Asia. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Hazard Ranking Method for Populations Exposed to Arsenic in Private Water Supplies: Relation to Bedrock Geology
Int. J. Environ. Res. Public Health 2017, 14(12), 1490; doi:10.3390/ijerph14121490
Received: 22 September 2017 / Revised: 10 November 2017 / Accepted: 24 November 2017 / Published: 1 December 2017
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Abstract
Approximately one million people in the UK are served by private water supplies (PWS) where main municipal water supply system connection is not practical or where PWS is the preferred option. Chronic exposure to contaminants in PWS may have adverse effects on health.
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Approximately one million people in the UK are served by private water supplies (PWS) where main municipal water supply system connection is not practical or where PWS is the preferred option. Chronic exposure to contaminants in PWS may have adverse effects on health. South West England is an area with elevated arsenic concentrations in groundwater and over 9000 domestic dwellings here are supplied by PWS. There remains uncertainty as to the extent of the population exposed to arsenic (As), and the factors predicting such exposure. We describe a hazard assessment model based on simplified geology with the potential to predict exposure to As in PWS. Households with a recorded PWS in Cornwall were recruited to take part in a water sampling programme from 2011 to 2013. Bedrock geologies were aggregated and classified into nine Simplified Bedrock Geological Categories (SBGC), plus a cross-cutting “mineralized” area. PWS were sampled by random selection within SBGCs and some 508 households volunteered for the study. Transformations of the data were explored to estimate the distribution of As concentrations for PWS by SBGC. Using the distribution per SBGC, we predict the proportion of dwellings that would be affected by high concentrations and rank the geologies according to hazard. Within most SBGCs, As concentrations were found to have log-normal distributions. Across these areas, the proportion of dwellings predicted to have drinking water over the prescribed concentration value (PCV) for As ranged from 0% to 20%. From these results, a pilot predictive model was developed calculating the proportion of PWS above the PCV for As and hazard ranking supports local decision making and prioritization. With further development and testing, this can help local authorities predict the number of dwellings that might fail the PCV for As, based on bedrock geology. The model presented here for Cornwall could be applied in areas with similar geologies. Application of the method requires independent validation and further groundwater-derived PWS sampling on other geological formations. Full article
(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)
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Open AccessArticle Exposure to Night-Time Traffic Noise, Melatonin-Regulating Gene Variants and Change in Glycemia in Adults
Int. J. Environ. Res. Public Health 2017, 14(12), 1492; doi:10.3390/ijerph14121492
Received: 8 November 2017 / Revised: 24 November 2017 / Accepted: 29 November 2017 / Published: 1 December 2017
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Abstract
Traffic noise has been linked to diabetes, with limited understanding of its mechanisms. We hypothesize that night-time road traffic noise (RTN) may impair glucose homeostasis through circadian rhythm disturbances. We prospectively investigated the relationship between residential night-time RTN and subsequent eight-year change in
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Traffic noise has been linked to diabetes, with limited understanding of its mechanisms. We hypothesize that night-time road traffic noise (RTN) may impair glucose homeostasis through circadian rhythm disturbances. We prospectively investigated the relationship between residential night-time RTN and subsequent eight-year change in glycosylated hemoglobin (ΔHbA1c) in 3350 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), adjusting for diabetes risk factors and air pollution levels. Annual average RTN (Lnight) was assigned to participants in 2001 using validated Swiss noise models. HbA1c was measured in 2002 and 2011 using liquid chromatography. We applied mixed linear models to explore RTN–ΔHbA1c association and its modification by a genetic risk score of six common circadian-related MTNR1B variants (MGRS). A 10 dB difference in RTN was associated with a 0.02% (0.003–0.04%) increase in mean ΔHbA1c in 2142 non-movers. RTN–ΔHbA1c association was modified by MGRS among diabetic participants (Pinteraction = 0.001). A similar trend in non-diabetic participants was non-significant. Among the single variants, we observed strongest interactions with rs10830963, an acknowledged diabetes risk variant also implicated in melatonin profile dysregulation. Night-time RTN may impair glycemic control, especially in diabetic individuals, through circadian rhythm disturbances. Experimental sleep studies are needed to test whether noise control may help individuals to attain optimal glycemic levels. Full article
(This article belongs to the Special Issue IJERPH: 15th Anniversary)
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Open AccessArticle Research and Development of a DNDC Online Model for Farmland Carbon Sequestration and GHG Emissions Mitigation in China
Int. J. Environ. Res. Public Health 2017, 14(12), 1493; doi:10.3390/ijerph14121493
Received: 15 October 2017 / Revised: 13 November 2017 / Accepted: 23 November 2017 / Published: 1 December 2017
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Abstract
Appropriate agricultural practices for carbon sequestration and emission mitigation have a significant influence on global climate change. However, various agricultural practices on farmland carbon sequestration usually have a major impact on greenhouse gas (GHG) emissions. It is very important to accurately quantify the
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Appropriate agricultural practices for carbon sequestration and emission mitigation have a significant influence on global climate change. However, various agricultural practices on farmland carbon sequestration usually have a major impact on greenhouse gas (GHG) emissions. It is very important to accurately quantify the effect of agricultural practices. This study developed a platform—the Denitrification Decomposition (DNDC) online model—for simulating and evaluating the agricultural carbon sequestration and emission mitigation based on the scientific process of the DNDC model, which is widely used in the simulation of soil carbon and nitrogen dynamics. After testing the adaptability of the platform on two sampling fields, it turned out that the simulated values matched the measured values well for crop yields and GHG emissions. We used the platform to estimate the effect of three carbon sequestration practices in a sampling field: nitrogen fertilization reduction, straw residue and midseason drainage. The results indicated the following: (1) moderate decrement of the nitrogen fertilization in the sampling field was able to decrease the N2O emission while maintaining the paddy rice yield; (2) ground straw residue had almost no influence on paddy rice yield, but the CH4 emission and the surface SOC concentration increased along with the quantity of the straw residue; (3) compared to continuous flooding, midseason drainage would not decrease the paddy rice yield and could lead to a drop in CH4 emission. Thus, this study established the DNDC online model, which is able to serve as a reference and support for the study and evaluation of the effects of agricultural practices on agricultural carbon sequestration and GHG emissions mitigation in China. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids’ Choice Restaurant Program
Int. J. Environ. Res. Public Health 2017, 14(12), 1494; doi:10.3390/ijerph14121494
Received: 1 August 2017 / Revised: 20 November 2017 / Accepted: 20 November 2017 / Published: 1 December 2017
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Abstract
Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in
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Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in independently owned restaurants. Eight pair-matched restaurants that met the eligibility criteria were randomized to a menu-only versus a menu-plus intervention condition. Both of the conditions implemented new healthy child menu items and received support for implementation for eight weeks. The menu-plus condition also conducted a marketing campaign involving employee trainings and promotional materials. Process evaluation data captured intervention implementation. Sales of new and existing child menu items were tracked for 16 weeks. Results indicated that the interventions were implemented with moderate to high fidelity depending on the component. Sales of new healthy child menu items occurred immediately, but decreased during the post-intervention period in both conditions. Sales of existing child menu items demonstrated a time by condition effect with restaurants in the menu-plus condition observing significant decreases and menu-only restaurants observing significant increases in sales of existing child menu items. Additional efforts are needed to inform sustainable methods for improving access to healthy foods and beverages in restaurants. Full article
(This article belongs to the Special Issue Food Environment, Diet, and Health)
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Open AccessArticle Efficient Removal of Tetracycline from Aqueous Media with a Fe3O4 Nanoparticles@graphene Oxide Nanosheets Assembly
Int. J. Environ. Res. Public Health 2017, 14(12), 1495; doi:10.3390/ijerph14121495
Received: 16 October 2017 / Revised: 23 November 2017 / Accepted: 28 November 2017 / Published: 1 December 2017
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Abstract
A readily separated composite was prepared via direct assembly of Fe3O4 magnetic nanoparticles onto the surface of graphene oxide (GO) (labeled as Fe3O4@GO) and used as an adsorbent for the removal of tetracycline (TC) from wastewater.
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A readily separated composite was prepared via direct assembly of Fe3O4 magnetic nanoparticles onto the surface of graphene oxide (GO) (labeled as Fe3O4@GO) and used as an adsorbent for the removal of tetracycline (TC) from wastewater. The effects of external environmental conditions, such as pH, ionic strength, humic acid (HA), TC concentration, and temperature, on the adsorption process were studied. The adsorption data were analyzed by kinetics and isothermal models. The results show that the Fe3O4@GO composite has excellent sorptive properties and can efficiently remove TC. At low pH, the adsorption capacity of Fe3O4@GO toward TC decreases slowly with increasing pH value, while the adsorption capacity decreases rapidly at higher pH values. The ionic strength has insignificant effect on TC adsorption. The presence of HA affects the affinity of Fe3O4@GO to TC. The pseudo-second-order kinetics model and Langmuir model fit the adsorption data well. When the initial concentration of TC is 100 mg/L, a slow adsorption process dominates. Film diffusion is the rate limiting step of the adsorption. Importantly, Fe3O4@GO has good regeneration performance. The above results are of great significance to promote the application of Fe3O4@GO in the treatment of antibiotic wastewater. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Incentive Policy Options for Product Remanufacturing: Subsidizing Donations or Resales?
Int. J. Environ. Res. Public Health 2017, 14(12), 1496; doi:10.3390/ijerph14121496
Received: 13 November 2017 / Revised: 27 November 2017 / Accepted: 27 November 2017 / Published: 1 December 2017
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Abstract
Remanufactured products offer better environmental benefits, and governments encourage manufacturers to remanufacture through various subsidy policies. This practice has shown that, in addition to product sales, remanufactured product can also achieve its value through social donation. Based on the remanufactured product value realization
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Remanufactured products offer better environmental benefits, and governments encourage manufacturers to remanufacture through various subsidy policies. This practice has shown that, in addition to product sales, remanufactured product can also achieve its value through social donation. Based on the remanufactured product value realization approaches, governments provide two kinds of incentive policies, which are remanufactured product sales subsidies and remanufactured product donation subsidies. This paper constructs a two-stage Stackelberg game model including a government and a manufacturer under two different policies, which can be solved by backward induction. By comparing the optimal decision of the two policies, our results show that, compared with the remanufacturing sales subsidy, donation subsidy weakens the cannibalization of remanufactured products for new products and increases the quantity of new products. It reduces the sales quantity of remanufactured products, but increases their total quantity. Under certain conditions of low subsidy, the manufacturer adopting sales subsidy provides better economic and environmental benefits. Under certain conditions of high subsidy, the manufacturer adopting donation subsidy offers better economic and environmental benefits. When untreated product environmental impact is large enough, donation subsidy policy has a better social welfare. Otherwise, the choice of social welfare of these two different policies depends on the social impact of remanufactured product donated. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle The Cost-Effectiveness of Lowering Permissible Noise Levels Around U.S. Airports
Int. J. Environ. Res. Public Health 2017, 14(12), 1497; doi:10.3390/ijerph14121497
Received: 11 October 2017 / Revised: 26 November 2017 / Accepted: 26 November 2017 / Published: 2 December 2017
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Abstract
Aircraft noise increases the risk of cardiovascular diseases and mental illness. The allowable limit for sound in the vicinity of an airport is 65 decibels (dB) averaged over a 24-h ‘day and night’ period (DNL) in the United States. We evaluate the trade-off
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Aircraft noise increases the risk of cardiovascular diseases and mental illness. The allowable limit for sound in the vicinity of an airport is 65 decibels (dB) averaged over a 24-h ‘day and night’ period (DNL) in the United States. We evaluate the trade-off between the cost and the health benefits of changing the regulatory DNL level from 65 dB to 55 dB using a Markov model. The study used LaGuardia Airport (LGA) as a case study. In compliance with 55 dB allowable limit of aircraft noise, sound insulation would be required for residential homes within the 55 dB to 65 dB DNL. A Markov model was built to assess the cost-effectiveness of installing sound insulation. One-way sensitivity analyses and Monte Carlo simulation were conducted to test uncertainty of the model. The incremental cost-effectiveness ratio of installing sound insulation for residents exposed to airplane noise from LGA was $11,163/QALY gained (95% credible interval: cost-saving and life-saving to $93,054/QALY gained). Changing the regulatory standard for noise exposure around airports from 65 dB to 55 dB comes at a very good value. Full article
(This article belongs to the Special Issue Economic Evaluation of Environmental Policies and Interventions)
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Open AccessArticle Accumulation of De-Icing Salt and Leaching in Spanish Soils Surrounding Roadways
Int. J. Environ. Res. Public Health 2017, 14(12), 1498; doi:10.3390/ijerph14121498
Received: 31 October 2017 / Revised: 26 November 2017 / Accepted: 30 November 2017 / Published: 2 December 2017
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Abstract
The environmental implications of soil salinity caused by accumulation of de-icing salt and leaching in soils of northeastern Spain were examined. For this purpose, the concentrations of ions associated with diagnosing and managing this problem were evaluated from several measurements performed over one
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The environmental implications of soil salinity caused by accumulation of de-icing salt and leaching in soils of northeastern Spain were examined. For this purpose, the concentrations of ions associated with diagnosing and managing this problem were evaluated from several measurements performed over one year along a road. This analysis demonstrated a higher concentration of soluble Na+ in the soil 3 m from a road in the northernmost part of the study area in February, which made the soil saline-sodic. Data from the rest of the study period (during the spring and summer) demonstrated that the de-icing salt moved to areas farther south by runoff water, which caused environmental impacts by modifying soil characteristics. These results suggest that leaching of Ca2+ and Mg2+ cations occurred faster in the studied systems in sodic soils. Leaching of these cations may affect plant yield, and results in environmental impacts within 3–30 m from the road. Awareness of this impact will be useful for developing future strategies for evaluating and reporting these complex relationships within Spain’s transport system and environment. Full article
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Open AccessArticle Nutrition Counselling Practices among General Practitioners in Croatia
Int. J. Environ. Res. Public Health 2017, 14(12), 1499; doi:10.3390/ijerph14121499
Received: 10 October 2017 / Revised: 16 November 2017 / Accepted: 29 November 2017 / Published: 4 December 2017
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Abstract
Chronic non-communicable diseases are a significant public health problem and imbalanced nutrition is one of the most significant risk factor for them. The objective of this study was to examine Croatia’s general practitioners’ nutrition counselling practice and determine the factors that influence such
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Chronic non-communicable diseases are a significant public health problem and imbalanced nutrition is one of the most significant risk factor for them. The objective of this study was to examine Croatia’s general practitioners’ nutrition counselling practice and determine the factors that influence such practice. A cross-sectional study was conducted among 444 (17.0%) randomly selected general practitioners (GPs) in Croatia from May to July 2013 via a 32-item anonymous questionnaire. Study showed that 77.0% of participants had provided nutrition counselling exclusively to patients with specific health risks; 18.7% participants had provided nutrition counselling for all patients, regardless of their individual risks, while 4.3% had not provide nutrition counselling. As the most significant stimulating factor for implementing nutrition counselling in their daily work with patients, 55.6% of the participants identified personal interest regarding nutrition and the effects it has on health. The latter factor was more frequently emphasized among female general practitioners (p < 0.001) and general practitioners without chronic diseases (p < 0.001). The most significant barrier for nutrition counselling was lack of time (81.6%). It is necessary to make additional efforts to increase the frequency of nutrition counselling provided by general practitioners in Croatia. The majority of Croatian general practitioners could increase their nutrition counselling practice in order to promote balanced nutrition and improve the overall health status of their patients. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Do Cervical Cancer Patients Diagnosed with Opportunistic Screening Live Longer? An Arkhangelsk Cancer Registry Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1500; doi:10.3390/ijerph14121500
Received: 8 October 2017 / Revised: 16 November 2017 / Accepted: 23 November 2017 / Published: 26 November 2017
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Abstract
The aim of the current study was to compare cervical cancer (СС) patients diagnosed with and without screening in terms of: (i) sociodemographic and clinical characteristics; (ii) factors associated with survival; and (iii), and levels of risk. A registry-based study was conducted using
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The aim of the current study was to compare cervical cancer (СС) patients diagnosed with and without screening in terms of: (i) sociodemographic and clinical characteristics; (ii) factors associated with survival; and (iii), and levels of risk. A registry-based study was conducted using data from the Arkhangelsk Cancer Registry. It included women with newly diagnosed malignant neoplasm of the uterine cervix during the period of 1 January 2005 to 11 November 2016 (N = 1548). The Kaplan-Meier method, the log-rank test, and Cox regression were applied. Most participants who were diagnosed by screening were at stage I and died less frequently from CC than those diagnosed without screening. The latter group was also diagnosed with СС at a younger age and died younger. Younger individuals and urban residents diagnosed with stage I and II, squamous cell carcinoma had longer survival times. Cox regression modeling indicated that the hazard ratio for death among women with CC diagnosed without screening was 1.61 (unadjusted) and 1.37 (adjusted). CC diagnosed by screening, cancer stage, patient residence, histological tumor type, and age at diagnosis were independent prognostic variables of longer survival time with CC. Diagnosis of CC made within a screening program improved survival. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessFeature PaperArticle “I Am Ready and Willing to Provide the Service … Though My Religion Frowns on Abortion”—Ghanaian Midwives’ Mixed Attitudes to Abortion Services: A Qualitative Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1501; doi:10.3390/ijerph14121501
Received: 27 October 2017 / Revised: 24 November 2017 / Accepted: 28 November 2017 / Published: 4 December 2017
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Abstract
Background: Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. Objective:
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Background: Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. Objective: The aim of the study was to understand midwives’ readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. Methods: A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis. Results: Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana’s abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women. Conclusion: The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy. Full article
Open AccessArticle The Synergetic Effect of Cash Transfers for Families, Child Sensitive Social Protection Programs, and Capacity Building for Effective Social Protection on Children’s Nutritional Status in Nepal
Int. J. Environ. Res. Public Health 2017, 14(12), 1502; doi:10.3390/ijerph14121502
Received: 30 October 2017 / Revised: 30 October 2017 / Accepted: 22 November 2017 / Published: 4 December 2017
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Abstract
Objective: The aim of this study was to evaluate the effectiveness of the synergetic effect of child sensitive social protection programs, augmented by a capacity building for social protection and embedded within existing government’s targeted resource transfers for families on child nutritional status.
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Objective: The aim of this study was to evaluate the effectiveness of the synergetic effect of child sensitive social protection programs, augmented by a capacity building for social protection and embedded within existing government’s targeted resource transfers for families on child nutritional status. Design: A repeat cross-sectional quasi-experimental design with measures taken pre- (October–December 2009) and post- (December 2014–February 2015) intervention in the intervention and comparison district. The comparison district received standard social welfare services in the form of targeted resource transfers (TRTs) for eligible families. The intervention district received the TRTs plus a child cash payment, augmented by a capacity building for effective social protection outcomes. Propensity scores were used in difference-in-differences models to compare the changes over time between the intervention and control groups. Results: Propensity score matched/weighted models produced better results than the unmatched analyses, and hence we report findings from the radius matching. The intervention resulted in a 5.16 (95% CI: 9.55, 0.77), 7.35 (95% CI: 11.62, 3.08) and 2.84 (95% CI: 5.58, 0.10) percentage point reduction in the prevalence of stunting, underweight, and wasting among children under the age, respectively. The intervention impact was greater in boys than girls for stunting and wasting; and greater in girls than boys for underweight. The intervention also resulted in a 6.66 (95% CI: 2.13, 3.18), 11.40 (95% CI: 16.66, 6.13), and 4.0 (95% CI: 6.43, 1.78) percentage point reduction in the prevalence of stunting, underweight, and wasting among older children (≥24 months). No impact was observed among younger children (<24 months). Conclusions: Targeted resource transfers for families, augmented with a child sensitive social protection program and capacity building for social protection can address effectively child malnutrition. To increase the intervention effectiveness on younger children, the child cash payment amount needs to be revisited and closely embedded into infant and young child feeding initiatives, but also adjusted to equate to 20% of household expenditure or more to maximize the diversity of food available to young children. Full article
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Open AccessArticle Low Levels of Physical Activity and Sedentary Behavior in Adults with Intellectual Disabilities
Int. J. Environ. Res. Public Health 2017, 14(12), 1503; doi:10.3390/ijerph14121503
Received: 20 October 2017 / Revised: 26 November 2017 / Accepted: 29 November 2017 / Published: 4 December 2017
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Abstract
Adults with intellectual disabilities (ID) are more likely to lead sedentary lifestyles and have low levels of physical activity (LLPA). The present study investigated the prevalence of reported LLPA and time spent watching TV in adults with ID and identified the associated factors
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Adults with intellectual disabilities (ID) are more likely to lead sedentary lifestyles and have low levels of physical activity (LLPA). The present study investigated the prevalence of reported LLPA and time spent watching TV in adults with ID and identified the associated factors for these behaviors. The proxy informants of 1618 adults with ID completed the surveys regarding their health behaviors. Multiple logistic regressions were employed for LLPA and multiple linear regressions for time spent watching TV. About 60% of adults with ID had LLPA and average time spent watching TV was 3.4 h a day. Some characteristics and health and function variables were identified as associated factors. While engaging in community activities and involvement in Special Olympics were inversely associated with LLPA, they were not associated with time spent watching TV. Attending day/educational programs or being employed were associated with spending less time watching TV. Findings highlight differential factors associated with LLPA versus TV-watching behavior in adults with ID. Hence, a key strategy aimed at increasing physical activity includes promoting participation in social and community activities, while targeted activities for reducing sedentary behavior might focus on providing day programs or employment opportunities for adults with ID. Full article
(This article belongs to the Special Issue Health Promotion Interventions for People with Disabilities)
Open AccessArticle The Impact of Technological Progress in the Energy Sector on Carbon Emissions: An Empirical Analysis from China
Int. J. Environ. Res. Public Health 2017, 14(12), 1505; doi:10.3390/ijerph14121505
Received: 17 October 2017 / Revised: 14 November 2017 / Accepted: 30 November 2017 / Published: 4 December 2017
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Abstract
This paper investigates the relationship between technological progress in the energy sector and carbon emissions based on the Environment Kuznets Curve (EKC) and data from China during the period of 1995–2012. Our study confirms that the situation in China conforms to the EKC
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This paper investigates the relationship between technological progress in the energy sector and carbon emissions based on the Environment Kuznets Curve (EKC) and data from China during the period of 1995–2012. Our study confirms that the situation in China conforms to the EKC hypothesis and presents the inverted U-curve relationship between per capita income and carbon emissions. Furthermore, the inflection point will be reached in at least five years. Then, we use research and development (R & D) investment in the energy industry as the quantitative indicator of its technological progress to test its impact on carbon emissions. Our results show that technological progress in the energy sector contributes to a reduction in carbon emissions with hysteresis. Furthermore, our results show that energy efficiency improvements are also helpful in reducing carbon emissions. However, climate policy and change in industrial structure increase carbon emissions to some extent. Our conclusion demonstrates that currently, China is not achieving economic growth and pollution reduction simultaneously. To further achieve the goal of carbon reduction, the government should increase investment in the energy industry research and improve energy efficiency. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle The Effects of Industrial Protective Gloves and Hand Skin Temperatures on Hand Grip Strength and Discomfort Rating
Int. J. Environ. Res. Public Health 2017, 14(12), 1506; doi:10.3390/ijerph14121506
Received: 29 October 2017 / Revised: 27 November 2017 / Accepted: 1 December 2017 / Published: 4 December 2017
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Abstract
Daily working activities and functions require a high contribution of hand and forearm muscles in executing grip force. To study the effects of wearing different gloves on grip strength, under a variety of hand skin temperatures, an assessment of the maximum grip strength
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Daily working activities and functions require a high contribution of hand and forearm muscles in executing grip force. To study the effects of wearing different gloves on grip strength, under a variety of hand skin temperatures, an assessment of the maximum grip strength was performed with 32 healthy male workers with a mean age (standard deviation) of 30.44 (5.35) years wearing five industrial gloves at three hand skin temperatures. Their ages and anthropometric characteristics including body mass index (BMI), hand length, hand width, hand depth, hand palm, and wrist circumference were measured. The hand was exposed to different bath temperatures (5 °C, 25 °C, and 45 °C) and hand grip strength was measured using a Jamar hydraulic hand dynamometer with and without wearing the gloves (chemical protection glove, rubber insulating glove, anti-vibration impact glove, cotton yarn knitted glove, and RY-WG002 working glove). The data were analyzed using the Shapiro–Wilk test, Pearson correlation coefficient, Tukey test, and analysis of variance (ANOVA) of the within-subject design analysis. The results showed that wearing gloves significantly affected the maximum grip strength. Wearing the RY-WG002 working glove produced a greater reduction on the maximum grip when compared with the bare hand, while low temperatures (5 °C) had a significant influence on grip when compared to medium (25 °C) and high (45 °C) hand skin temperatures. In addition, participants felt more discomfort in both environmental extreme conditions. Furthermore, they reported more discomfort while wearing neoprene, rubber, and RY-WG002 working gloves. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle How Does Health-Related Advertising with a Regulatory Focus and Goal Framing Affect Attitudes toward Ads and Healthy Behavior Intentions?
Int. J. Environ. Res. Public Health 2017, 14(12), 1507; doi:10.3390/ijerph14121507
Received: 27 September 2017 / Revised: 20 November 2017 / Accepted: 30 November 2017 / Published: 4 December 2017
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Abstract
The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI) and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan advocate that people have to change their unhealthy behaviors;
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The health costs of colorectal cancer have increased over the years in Taiwan. The National Health Insurance Administration (NHI) and the Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan advocate that people have to change their unhealthy behaviors; however, the number of patients of colorectal cancer is increasing annually. This research discussed the effects of healthy diet advocacy advertisements (ads) on healthy diet behavior intentions as influenced by the interactions between regulatory focus theory (RFT) and message framing effects. Both regulatory focus theory and message framing effect were discussed for the relationship between advertisement and behavior change in many fields, such as health-related behavior, pro-environmental behavior, consumer choice, etc. We executed an experiment with four different types of public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (message framing: gain framing vs. loss framing) two-factor experiment was adopted, and 201 valid participants responded to the questionnaire. Results indicated that if the ad’s regulatory focus is promotion focus, viewers’ attitudes toward the ad and their behavior intentions are more positive when the slogan of the ad is gain framing rather than loss framing via the multiple analysis of variance (MANOVA), and vice versa. Respondents found the communication easier to comprehend when the ads evoked the respondents’ regulatory focus and applied the appropriate message framing, thus improving the efficacy of health-related advertising. We offer suggestions regarding the future use of health-related advertising for the MOHW. Full article
(This article belongs to the Special Issue Nutrition and Public Health)
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Open AccessArticle Study on Spatial Spillover Effects of Logistics Industry Development for Economic Growth in the Yangtze River Delta City Cluster Based on Spatial Durbin Model
Int. J. Environ. Res. Public Health 2017, 14(12), 1508; doi:10.3390/ijerph14121508
Received: 24 October 2017 / Revised: 30 November 2017 / Accepted: 1 December 2017 / Published: 4 December 2017
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Abstract
The overall entropy method is used to evaluate the development level of the logistics industry in the city based on a mechanism analysis of the spillover effect of the development of the logistics industry on economic growth, according to the panel data of
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The overall entropy method is used to evaluate the development level of the logistics industry in the city based on a mechanism analysis of the spillover effect of the development of the logistics industry on economic growth, according to the panel data of 26 cities in the Yangtze River delta. On this basis, the paper uses the spatial durbin model to study the direct impact of the development of the logistics industry on economic growth and the spatial spillover effect. The results show that the direct impact coefficient of the development of the logistics industry in the Yangtze River Delta urban agglomeration on local economic growth is 0.092, and the significant spatial spillover effect on the economic growth in the surrounding area is 0.197. Compared with the labor force input, capital investment and the degree of opening to the world, and government functions, the logistics industry’s direct impact coefficient is the largest, other than capital investment; the coefficient of the spillover effect is higher than other control variables, making it a “strong engine” of the Yangtze River Delta urban agglomeration economic growth. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Pollution Emissions, Environmental Policy, and Marginal Abatement Costs
Int. J. Environ. Res. Public Health 2017, 14(12), 1509; doi:10.3390/ijerph14121509
Received: 23 October 2017 / Revised: 23 November 2017 / Accepted: 2 December 2017 / Published: 5 December 2017
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Abstract
Pollution emissions impose serious social negative externalities, especially in terms of public health. To reduce pollution emissions cost-effectively, the marginal abatement costs (MACs) of pollution emissions must be determined. Since the industrial sectors are the essential pillars of China’s economic growth, as well
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Pollution emissions impose serious social negative externalities, especially in terms of public health. To reduce pollution emissions cost-effectively, the marginal abatement costs (MACs) of pollution emissions must be determined. Since the industrial sectors are the essential pillars of China’s economic growth, as well as leading energy consumers and sulfur dioxide (SO2) emitters, estimating MACs of SO2 emissions at the industrial level can provide valuable information for all abatement efforts. This paper tries to address the critical and essential issue in pollution abatement: How do we determine the MACs of pollution emissions in China? This paper first quantifies the SO2 emission contribution of different industrial sectors in the Chinese economy by an Input-Output method and then estimates MACs of SO2 for industrial sectors at the national level, provincial level, and sectoral level by the shadow price theory. Our results show that six sectors (e.g., the Mining and Washing of Coal sector) should be covered in the Chinese pollution emission trading system. We have also found that the lowest SO2 shadow price is 2000 Yuan/ton at the national level, and that shadow prices should be set differently at the provincial level. Our empirical study has several important policy implications, e.g., the estimated MACs may be used as a pricing benchmark through emission allowance allocation. In this paper, the MACs of industrial sectors are calculated from the national, provincial and sectoral levels; therefore, we provide an efficient framework to track the complex relationship between sectors and provinces. Full article
(This article belongs to the Special Issue Economic Evaluation of Environmental Policies and Interventions)
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Open AccessArticle The Relationships between PM2.5 and Meteorological Factors in China: Seasonal and Regional Variations
Int. J. Environ. Res. Public Health 2017, 14(12), 1510; doi:10.3390/ijerph14121510
Received: 27 October 2017 / Revised: 26 November 2017 / Accepted: 29 November 2017 / Published: 5 December 2017
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Abstract
The interactions between PM2.5 and meteorological factors play a crucial role in air pollution analysis. However, previous studies that have researched the relationships between PM2.5 concentration and meteorological conditions have been mainly confined to a certain city or district, and the
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The interactions between PM2.5 and meteorological factors play a crucial role in air pollution analysis. However, previous studies that have researched the relationships between PM2.5 concentration and meteorological conditions have been mainly confined to a certain city or district, and the correlation over the whole of China remains unclear. Whether spatial and seasonal variations exist deserves further research. In this study, the relationships between PM2.5 concentration and meteorological factors were investigated in 68 major cities in China for a continuous period of 22 months from February 2013 to November 2014, at season, year, city, and regional scales, and the spatial and seasonal variations were analyzed. The meteorological factors were relative humidity (RH), temperature (TEM), wind speed (WS), and surface pressure (PS). We found that spatial and seasonal variations of their relationships with PM2.5 exist. Spatially, RH is positively correlated with PM2.5 concentration in north China and Urumqi, but the relationship turns to negative in other areas of China. WS is negatively correlated with PM2.5 everywhere except for Hainan Island. PS has a strong positive relationship with PM2.5 concentration in northeast China and mid-south China, and in other areas the correlation is weak. Seasonally, the positive correlation between PM2.5 concentration and RH is stronger in winter and spring. TEM has a negative relationship with PM2.5 in autumn and the opposite in winter. PS is more positively correlated with PM2.5 in autumn than in other seasons. Our study investigated the relationships between PM2.5 and meteorological factors in terms of spatial and seasonal variations, and the conclusions about the relationships between PM2.5 and meteorological factors are more comprehensive and precise than before. We suggest that the variations could be considered in PM2.5 concentration prediction and haze control to improve the prediction accuracy and policy efficiency. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Gaming Device Usage Patterns Predict Internet Gaming Disorder: Comparison across Different Gaming Device Usage Patterns
Int. J. Environ. Res. Public Health 2017, 14(12), 1512; doi:10.3390/ijerph14121512
Received: 10 October 2017 / Revised: 19 November 2017 / Accepted: 2 December 2017 / Published: 5 December 2017
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Abstract
Gaming behaviors have been significantly influenced by smartphones. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD). Responders of an online survey regarding smartphone
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Gaming behaviors have been significantly influenced by smartphones. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD). Responders of an online survey regarding smartphone and online game usage were classified by different gaming device usage patterns: (1) individuals who played only computer games; (2) individuals who played computer games more than smartphone games; (3) individuals who played computer and smartphone games evenly; (4) individuals who played smartphone games more than computer games; (5) individuals who played only smartphone games. Data on demographics, gaming-related behaviors, and scales for Internet and smartphone addiction, depression, anxiety disorder, and substance use were collected. Combined users, especially those who played computer and smartphone games evenly, had higher prevalence of IGD, depression, anxiety disorder, and substance use disorder. These subjects were more prone to develop IGD than reference group (computer only gamers) (B = 0.457, odds ratio = 1.579). Smartphone only gamers had the lowest prevalence of IGD, spent the least time and money on gaming, and showed lowest scores of Internet and smartphone addiction. Our findings suggest that gaming device usage patterns may be associated with the occurrence, course, and prognosis of IGD. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
Open AccessArticle Associations between Urinary Phthalate Metabolites and Serum Anti-Müller Hormone Levels in U.S. Men Based on National Health and Nutrition Examination Survey 2003–2004
Int. J. Environ. Res. Public Health 2017, 14(12), 1513; doi:10.3390/ijerph14121513
Received: 10 November 2017 / Revised: 29 November 2017 / Accepted: 1 December 2017 / Published: 5 December 2017
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Abstract
Anti-Müller hormone (AMH) plays an important role in reproductive development and has a wide potential clinical application value. Phthalates have been widely found in human living environment and have negative effects on human reproduction. This study aimed to explore the relationship between urinary
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Anti-Müller hormone (AMH) plays an important role in reproductive development and has a wide potential clinical application value. Phthalates have been widely found in human living environment and have negative effects on human reproduction. This study aimed to explore the relationship between urinary phthalate metabolites and serum AMH level in the general male population. Cross-sectional analyses were performed with a population of 489 men aged more than 12 years who participated in National Health and Nutrition Examination Survey (NHANES) 2003–2004 by Centers for Disease Control and Prevention, the United States. NHANES public data (demographic and socioeconomic information, examinations, and laboratory tests) were analyzed using Kruskal-Wallis test, Wilcoxon test and multivariable regression. Results showed that the urine concentration of mono (3-carboxypropyl) phthalate (MCPP) of 12–20 age group was significantly positively correlated with serum AMH concentration in the model without any covariates (p < 0.05). In the 60-year-old group, the monomethyl phthalate (MEP), mono (2-ethyl-5-carboxypentyl) phthalate (MECPP) concentrations were significantly correlated with serum AMH concentrations in models both with and without covariates (all p < 0.05). It could be concluded that exposure to phthalates might have negative effects on AMH level, especially in seniors. AMH could be used as a marker of exposure to phthalates in aged males. How exposure to phthalates affected AMH level and what the potential long-term health consequences of their relationship are needs more investigation. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle How to Obtain Forty Percent Less Environmental Impact by Healthy, Protein-Optimized Snacks for Older Adults
Int. J. Environ. Res. Public Health 2017, 14(12), 1514; doi:10.3390/ijerph14121514
Received: 27 October 2017 / Revised: 28 November 2017 / Accepted: 30 November 2017 / Published: 6 December 2017
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Abstract
It is well known that meals containing less meat are more sustainable, but little is known about snack-meals, which typically do not contain meat. This study investigates the diversity in environmental impacts associated with snack production based on 20 common recipes optimized for
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It is well known that meals containing less meat are more sustainable, but little is known about snack-meals, which typically do not contain meat. This study investigates the diversity in environmental impacts associated with snack production based on 20 common recipes optimized for protein content, energy content and sensory aspects for older adults. The purpose is to improve sustainability of public procurement by serving more sustainable snack-meals. Public procurement serves Danish older adults over millions of snack-meals every year, and millions more are served in countries with a similar social service. The environmental impact of snack production was estimated by consequential life cycle assessment. The average impact of producing the 10 least environmentally harmful snacks was 40% less than the average impact of producing the 10 most harmful snacks. This is true whether the functional unit was mass, energy, or protein content, and whether the environmental impact was measured as global warming potential or the monetized value of 16 impact categories. We conclude that large-scale public procurement of snack-meals by private and municipal kitchens can be reduced by up to 40% if the kitchens evaluate the environmental impact of all their snacks and serve the better half more frequently. Full article
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Open AccessArticle Evaluation of Chronic Disease Prevention and Control Public Service Advertisement on the Awareness and Attitude Change among Urban Population in Chongqing, China: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2017, 14(12), 1515; doi:10.3390/ijerph14121515
Received: 2 October 2017 / Revised: 18 November 2017 / Accepted: 27 November 2017 / Published: 5 December 2017
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Abstract
The aim of this study is to evaluate the influence of public service advertising on the awareness and attitude of Chongqing urban citizens. The theme of the public service advertisement launched in Chongqing was chronic disease prevention and control. A self-designed questionnaire was
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The aim of this study is to evaluate the influence of public service advertising on the awareness and attitude of Chongqing urban citizens. The theme of the public service advertisement launched in Chongqing was chronic disease prevention and control. A self-designed questionnaire was used in an outdoor intercept survey to collect information about the perception of citizens toward the effect of the advertisement on awareness and attitude situation. Respondents had good knowledge of chronic disease (17.11 ± 3.23, total score: 23), but only 58.4% of participants thought cancer is one type of chronic disease. The awareness of cancer as a chronic disease among the group who had seen this advertisement (63.6%) was higher than that of the group who had not seen the advertisement (56.5%) (p = 0.046). The attitude of respondents was good after watching the advertisement, approximately 77.4% of respondents attempted to remind their family and friends to prevent chronic diseases, roughly. 78.2% tried to persuade their family and friends to change their unhealthy lifestyle habits, and 84.7% of participants reported that the advertising increased the possibility of their own future lifestyle change. There was minimal change of awareness of the participants who saw the advertisement. This study did not show significant differences on chronic disease related knowledge between the participants who have seen the advertisement and who have not seen the advertisement. The public service advertisement may help participants improve the attitude of future behavior change. Further researches combining the sustained intervention and support through clinical and community health programs media campaigns are needed to support public health. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Psychological Distress and Zika, Dengue and Chikungunya Symptoms Following the 2016 Earthquake in Bahía de Caráquez, Ecuador
Int. J. Environ. Res. Public Health 2017, 14(12), 1516; doi:10.3390/ijerph14121516
Received: 10 November 2017 / Revised: 24 November 2017 / Accepted: 29 November 2017 / Published: 5 December 2017
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Abstract
On 16 April 2016, a 7.8 magnitude earthquake struck coastal Ecuador, resulting in significant mortality and morbidity, damages to infrastructure, and psychological trauma. This event coincided with the first outbreak of Zika virus (ZIKV) and co-circulation with dengue virus (DENV) and chikungunya virus
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On 16 April 2016, a 7.8 magnitude earthquake struck coastal Ecuador, resulting in significant mortality and morbidity, damages to infrastructure, and psychological trauma. This event coincided with the first outbreak of Zika virus (ZIKV) and co-circulation with dengue virus (DENV) and chikungunya virus (CHIKV). We tested whether the degree of psychological distress was associated with the presence of suspected DENV, CHIKV, ZIKV (DCZ) infections three months after the earthquake. In July 2016, 601 household members from four communities in Bahía de Caráquez, Manabí Province, Ecuador, were surveyed in a post-disaster health evaluation. Information was collected on demographics, physical damages and injuries, chronic diseases, self-reported psychological distress, and DCZ symptoms. We calculated the prevalence of arbovirus and distress symptoms by community. ANOVA was used to compare the mean number of psychological distress symptoms between people with versus without suspected DCZ infections by age, gender, community and the need to sleep outside of the home due to damages. The prevalence of suspected DCZ infections was 9.7% and the prevalence of psychological distress was 58.1%. The average number of psychological distress symptoms was significantly higher among people with suspected DCZ infections in the periurban community of Bella Vista, in women, in adults 40–64 years of age and in individuals not sleeping at home (p < 0.05). The results of this study highlight the need to investigate the interactions between psychological distress and arboviral infections following natural disasters. Full article
(This article belongs to the Special Issue Public Health and Disasters)
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Open AccessArticle The Effect of Branding to Promote Healthy Behavior: Reducing Tobacco Use among Youth and Young Adults
Int. J. Environ. Res. Public Health 2017, 14(12), 1517; doi:10.3390/ijerph14121517
Received: 5 October 2017 / Revised: 14 November 2017 / Accepted: 25 November 2017 / Published: 7 December 2017
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Abstract
Policy interventions such as public health mass media campaigns disseminate messages in order to improve health-related knowledge, attitudes, beliefs and behaviors at the population level. Only more recently have campaigns that promote health-related behaviors adopted branding, a well-established marketing strategy, to influence how
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Policy interventions such as public health mass media campaigns disseminate messages in order to improve health-related knowledge, attitudes, beliefs and behaviors at the population level. Only more recently have campaigns that promote health-related behaviors adopted branding, a well-established marketing strategy, to influence how consumers think and feel about a message. This study examines whether positive brand equity for the national truth® campaign is associated with lower likelihood of cigarette use over time using the nationally representative Truth Longitudinal Cohort of youth and young adults, aged 15–21. Logistic regression models were used to examine the relationship between brand equity and the likelihood of reporting past 30-day smoking over a 12-month period. Respondents who reported positive brand equity were significantly less likely to report past 30-day smoking 12 months later (OR = 0.66, p < 0.05), controlling for covariates known to influence tobacco use behavior. Findings also translate the effect size difference to a population estimate of more than 300,000 youth and young adults having been prevented from current smoking over the course of a year. Building brand equity is a strategic process for health promotion campaigns, not only to improve message recall and salience but also to influence behavioral outcomes. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Exploring Determinants of Spatial Variations in the Dengue Fever Epidemic Using Geographically Weighted Regression Model: A Case Study in the Joint Guangzhou-Foshan Area, China, 2014
Int. J. Environ. Res. Public Health 2017, 14(12), 1518; doi:10.3390/ijerph14121518
Received: 14 November 2017 / Revised: 4 December 2017 / Accepted: 4 December 2017 / Published: 6 December 2017
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Abstract
Dengue fever (DF) is a common and rapidly spreading vector-borne viral disease in tropical and subtropical regions. In recent years, this imported disease has posed an increasing threat to public health in China, especially in many southern cities. Although the severity of DF
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Dengue fever (DF) is a common and rapidly spreading vector-borne viral disease in tropical and subtropical regions. In recent years, this imported disease has posed an increasing threat to public health in China, especially in many southern cities. Although the severity of DF outbreaks in these cities is generally associated with known risk factors at various administrative levels, spatial heterogeneities of these associations remain little understood on a finer scale. In this study, the neighboring Guangzhou and Foshan (GF) cities were considered as a joint area for characterizing the spatial variations in the 2014 DF epidemic at various grid levels from 1 × 1 km2 to 6 × 6 km2. On an appropriate scale, geographically weighted regression (GWR) models were employed to interpret the influences of socioeconomic and environmental factors on this epidemic across the GF area. DF transmissions in Guangzhou and Foshan cities presented synchronous temporal changes and spatial expansions during the main epidemic months. Across the GF area, this epidemic was obviously spatially featured at various grid levels, especially on the 2 × 2 km2 scale. Its spatial variations were relatively sufficiently explained by population size, road density, and economic status integrated in the GWR model with the lowest Akaike Information Criterion (AICc = 5227.97) and highest adjusted R square (0.732) values. These results indicated that these three socioeconomic factors acted as geographical determinants of spatial variability of the 2014 DF epidemic across the joint GF area, although some other potential factors should be added to improve the explaining the spatial variations in the central zones. This work improves our understanding of the effects of socioeconomic conditions on the spatial variations in this epidemic and helps local hygienic authorities to make targeted joint interventions for preventing and controlling this epidemic across the GF area. Full article
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Open AccessArticle Promoting Long-Term Health among People with Spinal Cord Injury: What’s New?
Int. J. Environ. Res. Public Health 2017, 14(12), 1520; doi:10.3390/ijerph14121520
Received: 20 October 2017 / Revised: 29 November 2017 / Accepted: 2 December 2017 / Published: 6 December 2017
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Abstract
A key ingredient to successful health promotion is a primary care provider who can offer an informed first response to lifestyle issues, emerging problems and chronic challenges. This article aims to assist family physicians to play their role in promoting the health of
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A key ingredient to successful health promotion is a primary care provider who can offer an informed first response to lifestyle issues, emerging problems and chronic challenges. This article aims to assist family physicians to play their role in promoting the health of people with SCI, by summarizing the latest evidence in the management of spinal cord injury in primary care. This study used a scoping review methodology to survey peer-reviewed journal articles and clinical guidelines published between January 2012 to June 2016. This search strategy identified 153 articles across 20 topics. A prevention framework is used to identify five primary, nine secondary, four tertiary, and two quaternary prevention issues about which family physicians require current information. Major changes in the management of SCI in primary care were noted for 8 of the 20 topics, specifically in the areas of pharmacological management of neuropathic pain and urinary tract infection; screening for bowel and bladder cancer; improvements in wound care; and clarification of dietary fibre recommendations. All of these changes are represented in the 3rd edition of Actionable Nuggets—an innovative tool to assist family physicians to be aware of the best practices in primary care for spinal cord injury. Full article
(This article belongs to the Special Issue Health Promotion Interventions for People with Disabilities)
Open AccessArticle Building-Based Analysis of the Spatial Provision of Urban Parks in Shenzhen, China
Int. J. Environ. Res. Public Health 2017, 14(12), 1521; doi:10.3390/ijerph14121521
Received: 30 September 2017 / Revised: 24 November 2017 / Accepted: 27 November 2017 / Published: 6 December 2017
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Abstract
Urban parks provide important environmental, social, and economic benefits to people and urban areas. The literature demonstrates that proximity to urban parks is one of the key factors influencing people’s willingness to use them. Therefore, the provision of urban parks near residential areas
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Urban parks provide important environmental, social, and economic benefits to people and urban areas. The literature demonstrates that proximity to urban parks is one of the key factors influencing people’s willingness to use them. Therefore, the provision of urban parks near residential areas and workplaces is one of the key factors influencing quality of life. This study designed a solution based on the spatial association between urban parks and buildings where people live or work to identify whether people in different buildings have nearby urban parks available for their daily lives. A building density map based on building floor area (BFA) was used to illustrate the spatial distribution of urban parks and five indices were designed to measure the scales, service coverage and potential service loads of urban parks and reveal areas lacking urban park services in an acceptable walking distance. With such solution, we investigated the provision of urban parks in ten districts of Shenzhen in China, which has grown from several small villages to a megacity in only 30 years. The results indicate that the spatial provision of urban parks in Shenzhen is not sufficient since people in about 65% of the buildings cannot access urban parks by walking 10-min. The distribution and service coverage of the existing urban parks is not balanced at the district level. In some districts, the existing urban parks have good numbers of potential users and even have large service loads, while in some districts, the building densities surrounding the existing parks are quite low and at the same time there is no urban parks nearby some high-density areas. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Association of Social Support and Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus
Int. J. Environ. Res. Public Health 2017, 14(12), 1522; doi:10.3390/ijerph14121522
Received: 18 August 2017 / Revised: 6 November 2017 / Accepted: 7 November 2017 / Published: 6 December 2017
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Abstract
The prevalence of diabetes is steadily increasing in China. When diabetes is uncontrolled, it generates dire consequences for health and well-being. Numerous studies have shown that health outcomes were associated with social support and medication adherence. Previous study confirmed that social support was
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The prevalence of diabetes is steadily increasing in China. When diabetes is uncontrolled, it generates dire consequences for health and well-being. Numerous studies have shown that health outcomes were associated with social support and medication adherence. Previous study confirmed that social support was associated with medication adherence in patients with heart failure, HIV diseases, and first-episode psychosis. However, the relationship between social support and medication adherence in patients with type 2 diabetes mellitus (T2DM) is remains unclear. This study aims to examine whether social support is associated with medication adherence in patients with T2DM. This study was conducted in the First Affiliated Hospital of the General Hospital of the People’s Liberation Army (PLA). In Beijing, a systematic random sample of 412 patients with T2DM over 18 years was recruited at baseline, and demographic characteristics, clinical data and their assessment of social support were collected from medical records and self-reported questionnaires. 330 of these patients completed a self-report measure of medication adherence at the sixth month after baseline data collection. Regression analysis showed that social support presented a positive effect on medication adherence, additionally, support utilization and the subscale of social support exhibited a significantly strong influence on medication adherence in patients with T2DM. Although medication adherence was influenced by multiple factors, this finding confirmed that social support must be recognized as a core element in interventions aimed at improving in the management of patients with T2DM. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Prevalence of Self-Reported Diagnosed Cataract and Associated Risk Factors among Elderly South Africans
Int. J. Environ. Res. Public Health 2017, 14(12), 1523; doi:10.3390/ijerph14121523
Received: 16 August 2017 / Revised: 29 November 2017 / Accepted: 30 November 2017 / Published: 6 December 2017
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Abstract
This paper estimates the prevalence of self-reported cataract and associated risk factors among individuals aged ≥50 years in South Africa. Data from a nationally-representative cross-sectional Study on Global AGEing and Adult Health (SAGE) (N = 3646) conducted in South Africa from 2007–2008
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This paper estimates the prevalence of self-reported cataract and associated risk factors among individuals aged ≥50 years in South Africa. Data from a nationally-representative cross-sectional Study on Global AGEing and Adult Health (SAGE) (N = 3646) conducted in South Africa from 2007–2008 was analyzed. The primary outcome was self-reported cataract, and exposures included socio-demographics, self-reported co-morbidities, and behavioral factors. Linearized multivariate logistic regression models were used. The weighted prevalence of self-reported diagnosed cataract was 4.4% (95%CI: 3.4–5.8). Prevalence was greater among individuals with advancing age (10.2%), higher quality of life (QoL) (5.9%), education (5.2%), and wealth (5.8%) than their counterparts. Prevalence was also higher among individuals with depression (17.5%), diabetes (13.3%), hypertension (9.1%), and stroke (8.4%) compared to those without these conditions, with the exception of obesity (4.2%). In the final multivariate model, the odds of self-reported cataract were: 4.14 times higher among people ≥70 years than 50 to 59 year olds (95%CI: 2.28–7.50); 2.48 times higher in urban than rural residents (95%CI: 1.25–4.92); 5.16, 2.99, and 1.97 times higher for individuals with depression (95%CI: 1.92–13.86), hypertension (95%CI: 1.60–5.59), and diabetes (95%CI: 1.07–3.61), compared to those without these conditions. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Impacts of Small-Scale Industrialized Swine Farming on Local Soil, Water and Crop Qualities in a Hilly Red Soil Region of Subtropical China
Int. J. Environ. Res. Public Health 2017, 14(12), 1524; doi:10.3390/ijerph14121524
Received: 3 November 2017 / Revised: 28 November 2017 / Accepted: 30 November 2017 / Published: 6 December 2017
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Abstract
Industrialized small-scale pig farming has been rapidly developed in developing regions such as China and Southeast Asia, but the environmental problems accompanying pig farming have not been fully recognized. This study investigated 168 small-scale pig farms and 29 example pig farms in Yujiang
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Industrialized small-scale pig farming has been rapidly developed in developing regions such as China and Southeast Asia, but the environmental problems accompanying pig farming have not been fully recognized. This study investigated 168 small-scale pig farms and 29 example pig farms in Yujiang County of China to examine current and potential impacts of pig wastes on soil, water and crop qualities in the hilly red soil region, China. The results indicated that the small-scale pig farms produced considerable annual yields of wastes, with medians of 216, 333 and 773 ton yr−1 per pig farm for manure, urine and washing wastewater, respectively, which has had significant impact on surface water quality. Taking NH4+-N, total nitrogen (TN) or total phosphorus (TP) as a criterion to judge water quality, the proportions of Class III and below Class III waters in the local surface waters were 66.2%, 78.7% and 72.5%. The well water (shallow groundwater) quality near these pig farms met the water quality standards by a wide margin. The annual output of pollutants from pig farms was the most important factor correlated with the nutrients and heavy metals in soils, and the relationship can be described by a linear equation. The impact on croplands was marked by the excessive accumulation of available phosphorus and heavy metals such as Cu and Zn. For crop safety, the over-limit ratio of Zn in vegetable samples reached 60%, other heavy metals in vegetable and rice samples tested met the food safety standard at present. Full article
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Open AccessArticle Nature Cure and Non-Communicable Diseases: Ecological Therapy as Health Care in India
Int. J. Environ. Res. Public Health 2017, 14(12), 1525; doi:10.3390/ijerph14121525
Received: 24 August 2017 / Revised: 28 November 2017 / Accepted: 29 November 2017 / Published: 7 December 2017
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Abstract
With rapidly increasing rates of non-communicable diseases, India is experiencing a dramatic public health crisis that is closely linked to changing lifestyles and the growth of the middle-class. In this essay we discuss how the practice of Nature Cure provides a way of
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With rapidly increasing rates of non-communicable diseases, India is experiencing a dramatic public health crisis that is closely linked to changing lifestyles and the growth of the middle-class. In this essay we discuss how the practice of Nature Cure provides a way of understanding the scale and scope of the crisis, as it is embodied, and a way to understand key elements of a solution to problems that the crisis presents for institutionalized health care. As institutionalized in contemporary India, Nature Cure involves treatment and managed care using earth, air, sunlight, and water as well as a strict dietary regimen. In this regard, the essay shows how Nature Cure’s bio-ecological orientation toward public health, which is grounded in the history of its modern incorporation into India, provides an expansionist, ecological model for holistic care that counters the reductionist logic of bio-medical pharmaceuticalization. Full article
Open AccessArticle Pets, Purity and Pollution: Why Conventional Models of Disease Transmission Do Not Work for Pet Rat Owners
Int. J. Environ. Res. Public Health 2017, 14(12), 1526; doi:10.3390/ijerph14121526
Received: 2 November 2017 / Revised: 2 December 2017 / Accepted: 2 December 2017 / Published: 7 December 2017
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Abstract
In the United Kingdom, following the emergence of Seoul hantavirus in pet rat owners in 2012, public health authorities tried to communicate the risk of this zoonotic disease, but had limited success. To explore this lack of engagement with health advice, we conducted
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In the United Kingdom, following the emergence of Seoul hantavirus in pet rat owners in 2012, public health authorities tried to communicate the risk of this zoonotic disease, but had limited success. To explore this lack of engagement with health advice, we conducted in-depth, semi-structured interviews with pet rat owners and analysed them using a grounded theory approach. The findings from these interviews suggest that rat owners construct their pets as different from wild rats, and by elevating the rat to the status of a pet, the powerful associations that rats have with dirt and disease are removed. Removing the rat from the contaminated outside world moves their pet rat from being ‘out of place’ to ‘in place’. A concept of ‘bounded purity’ keeps the rat protected within the home, allowing owners to interact with their pet, safe in the knowledge that it is clean and disease-free. Additionally, owners constructed a ‘hierarchy of purity’ for their pets, and it is on this structure of disease and risk that owners base their behaviour, not conventional biomedical models of disease. Full article
Open AccessArticle Stress-Induced Hyperglycemia in Diabetes: A Cross-Sectional Analysis to Explore the Definition Based on the Trauma Registry Data
Int. J. Environ. Res. Public Health 2017, 14(12), 1527; doi:10.3390/ijerph14121527
Received: 9 November 2017 / Revised: 5 December 2017 / Accepted: 5 December 2017 / Published: 7 December 2017
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Abstract
Background: The diagnosis of diabetic hyperglycemia (DH) does not preclude a diabetes patient from having a stress-induced hyperglycemic response. This study aimed to define the optimal level of elevated glucose concentration for determining the occurrence of stress-induced hyperglycemia (SIH) in patients with diabetes.
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Background: The diagnosis of diabetic hyperglycemia (DH) does not preclude a diabetes patient from having a stress-induced hyperglycemic response. This study aimed to define the optimal level of elevated glucose concentration for determining the occurrence of stress-induced hyperglycemia (SIH) in patients with diabetes. Methods: This retrospective study reviewed the data of all hospitalized trauma patients, in a Level I trauma center, from 1 January 2009 to 31 December 2016. Only adult patients aged ≥20 years, with available data on serum glucose and glycated hemoglobin A1c (HbA1c) levels upon admission, were included in the study. Long-term average glucose levels, as A1c-derived average glucose (ADAG), using the equation, ADAG = ((28.7 × HbA1c) − 46.7), were calculated. Patients with high glucose levels were divided into three SIH groups with diabetes mellitus (DM), based on the following definitions: (1) same glycemic gap from ADAG; (2) same percentage of elevated glucose of ADAG, from which percentage could also be reflected by the stress hyperglycemia ratio (SHR), calculated as the admission glucose level divided by ADAG; or (3) same percentage of elevated glucose as patients with a defined SIH level, in trauma patients with and without diabetes. Patients with incomplete registered data were excluded. The primary hypothesis of this study was that SIH in patients with diabetes would present worse mortality outcomes than in those without. Detailed data of SIH in patients with diabetes were retrieved from the Trauma Registry System. Results: Among the 546 patients with DH, 332 (32.0%), 188 (18.1%), and 106 (10.2%) were assigned as diabetes patients with SIH, based on defined glucose levels, set at 250 mg/dL, 300 mg/dL, and 350 mg/dL, respectively. In patients with defined cut-off glucose levels of 250 mg/dL and 300 mg/dL, SIH was associated with a 3.5-fold (95% confidence interval (CI) 1.61–7.46; p = 0.001) and 3-fold (95% CI 1.11–8.03; p = 0.030) higher odds of mortality, adjusted by sex, age, pre-existing comorbidities, and injury severity score, than the 491 patients with diabetic normoglycemia (DN). However, in patients with a defined cut-off glucose level of 350 mg/dL, adjusted mortality in SIH in DM was insignificantly different than that in DM. According to the receiver operating characteristic (ROC) curve analysis, a blood sugar of 233 mg/dL, a glycemic gap of 79 (i.e., blood sugar of 251 mg/dL), and a SHR of 1.45 (i.e., blood sugar of 250 mg/dL) were identified as cut-offs for mortality outcomes, with AUCs of 0.622, 0.653, and 0.658, respectively. Conclusions: In this study, a cut-off glucose level of 250 mg/dL was selected to provide a better definition of SIH in DM than glucose levels of 300 mg/dL or 350 mg/dL. Full article
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Open AccessArticle Adsorption of Pb(II) and Cu(II) by Ginkgo-Leaf-Derived Biochar Produced under Various Carbonization Temperatures and Times
Int. J. Environ. Res. Public Health 2017, 14(12), 1528; doi:10.3390/ijerph14121528
Received: 9 November 2017 / Revised: 23 November 2017 / Accepted: 5 December 2017 / Published: 7 December 2017
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Abstract
Ginkgo trees are common street trees in Korea, and the large amounts of leaves that fall onto the streets annually need to be cleaned and treated. Therefore, fallen gingko leaves have been used as a raw material to produce biochar for the removal
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Ginkgo trees are common street trees in Korea, and the large amounts of leaves that fall onto the streets annually need to be cleaned and treated. Therefore, fallen gingko leaves have been used as a raw material to produce biochar for the removal of heavy metals from solutions. Gingko-leaf-derived biochar was produced under various carbonization temperatures and times. This study evaluated the physicochemical properties and adsorption characteristics of gingko-leaf-derived biochar samples produced under different carbonization conditions regarding Pb(II) and Cu(II). The biochar samples that were produced at 800 °C for 90 and 120 min contained the highest oxygen- and nitrogen-substituted carbons, which might contribute to a high metal-adsorption rate. The intensity of the phosphate bond was increased with the increasing of the carbonization temperature up to 800 °C and after 90 min of carbonization. The Pb(II) and Cu(II) adsorption capacities were the highest when the gingko-leaf-derived biochar was produced at 800 °C, and the removal rates were 99.2% and 34.2%, respectively. The highest removal rate was achieved when the intensity of the phosphate functional group in the biochar was the highest. Therefore, the gingko-leaf-derived biochar produced at 800 °C for 90 min can be used as an effective bio-adsorbent in the removal of metals from solutions. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle A Qualitative Study of Secondary School Teachers’ Perception of Social Network Analysis Metrics in the Context of Alcohol Consumption among Adolescents
Int. J. Environ. Res. Public Health 2017, 14(12), 1531; doi:10.3390/ijerph14121531
Received: 29 October 2017 / Revised: 4 December 2017 / Accepted: 6 December 2017 / Published: 8 December 2017
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Abstract
Adolescence is a transitional period during which a number of changes occur. Social relationships established during this period influence adolescent behaviour and affect academic performance or alcohol consumption habits, among other issues. Teachers are very important actors in observing and guiding the evolution
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Adolescence is a transitional period during which a number of changes occur. Social relationships established during this period influence adolescent behaviour and affect academic performance or alcohol consumption habits, among other issues. Teachers are very important actors in observing and guiding the evolution of their students, and should therefore have the appropriate knowledge and tools to gain insight into the complex social relationships that exist in their classes. The use of social network analysis (SNA) techniques may be helpful in order to study and monitor the evolution of these social networks. This study tries to understand how teachers perceive SNA metrics from an intuitive point of view. Using this information, useful tools could be created that allow teachers to use SNA techniques to improve their understanding of student relationships. A number of interviews with different teachers were held in secondary schools in Spain, allowing SNA concepts to be related to the everyday terms used by the teachers to characterize their students. Results from the study have an impact on questionnaire design for gathering data from students in order to perform an SNA analysis and on the design of software applications that can help teachers to understand the results of this analysis. Full article
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Open AccessArticle Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China
Int. J. Environ. Res. Public Health 2017, 14(12), 1532; doi:10.3390/ijerph14121532
Received: 3 October 2017 / Revised: 25 November 2017 / Accepted: 30 November 2017 / Published: 8 December 2017
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Abstract
Objectives: This study aimed to identify the prevalence of gestational diabetes mellitus (GDM) and to examine its associations with social and behavioral factors, maternal body mass index (BMI), anemia, and hypertension. Methods: A cross-sectional analysis was performed on data collected from 2345 pregnant
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Objectives: This study aimed to identify the prevalence of gestational diabetes mellitus (GDM) and to examine its associations with social and behavioral factors, maternal body mass index (BMI), anemia, and hypertension. Methods: A cross-sectional analysis was performed on data collected from 2345 pregnant women from 16 hospitals in five selected provinces in mainland China. Results: Prevalence of GDM was as follows: overall: 3.7%; pregnant women in the first pregnancy: 3.4%; pregnant women in the second pregnancy: 4.6%. Compared with early pregnancy women, late-stage pregnant women were more likely to have GDM (OR = 4.32, 95% CI (1.82, 10.27)). Compared with 18–25 years old pregnant women, women aged 36–45 years were more likely to have GDM (OR = 3.98, 95% CI (1.41, 11.28). Compared with non-hypertensive patients, hypertensive patients were more likely to have GDM (OR = 6.93, 95% CI (1.28, 37.64)). However, second pregnancy, high maternal BMI, prolonged screen time (TV-viewing time, computer-using time, and mobile-phone using time), insufficient and excessive sleep duration, poor sleep quality, smoking, and secondhand smoke exposure were not significantly associated with an increased risk of GDM. Conclusions: Women in the second pregnancy do not appear to predict an increased risk for developing GDM than women in the first pregnancy. High-risk groups of GDM included women in their late pregnancy, aged 36–45 years old, and with hypertension. The findings will contribute to an improved understanding of social and behavioral determinants of GDM in Chinese population and contribute to the development of health-prevention promotion interventions to address GDM. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Class and Health Inequality in Later Life: Patterns, Mechanisms and Implications for Policy
Int. J. Environ. Res. Public Health 2017, 14(12), 1533; doi:10.3390/ijerph14121533
Received: 14 November 2017 / Revised: 3 December 2017 / Accepted: 4 December 2017 / Published: 8 December 2017
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Abstract
The growth of the post-retirement population, which has occurred as a result of rapid growth in life expectancy coupled with the ageing of the baby boomer cohort, has led to significant concern. This concern, however, typically neglects the heterogeneity of later life experiences
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The growth of the post-retirement population, which has occurred as a result of rapid growth in life expectancy coupled with the ageing of the baby boomer cohort, has led to significant concern. This concern, however, typically neglects the heterogeneity of later life experiences and how these are patterned by inequalities that reflect how process of social stratification continue to operate into later life. This paper draws on a programme of work, based on analysis of the English Longitudinal Study of Ageing, to empirically examine questions of inequality in later life. It begins by illustrating the patterning of health inequality. It then investigates the importance of later life contexts and events in shaping inequality through and after the retirement process. In doing so it examines the extent to which later life continues to reflect stable social structures that shape inequalities and, consequently, health and wellbeing in later life. The paper then illustrates how the effects of socioeconomic position on health in later life can be theorised as a product of class processes, borrowing in part from Bourdieu. Other dimensions of inequality, such as gender, ethnicity, area and sexuality, are not discussed here. The paper concludes with a discussion of the need for a close focus on inequalities in later life in research, policy and practice. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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Open AccessArticle Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems
Int. J. Environ. Res. Public Health 2017, 14(12), 1534; doi:10.3390/ijerph14121534
Received: 27 October 2017 / Revised: 28 November 2017 / Accepted: 1 December 2017 / Published: 11 December 2017
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Abstract
To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support
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To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of ‘trust’ and ‘scientific uncertainty’ appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop. Full article
(This article belongs to the Special Issue Human Health, Risk Analysis and Environmental Hazards)
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Open AccessArticle Tackling Health Disparities for People Who Are Homeless? Start with Social Determinants
Int. J. Environ. Res. Public Health 2017, 14(12), 1535; doi:10.3390/ijerph14121535
Received: 13 October 2017 / Revised: 29 November 2017 / Accepted: 4 December 2017 / Published: 8 December 2017
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Abstract
Background: Homelessness is associated with enormous health inequalities, including shorter life expectancy, higher morbidity and greater usage of acute hospital services. Viewed through the lens of social determinants, homelessness is a key driver of poor health, but homelessness itself results from accumulated adverse
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Background: Homelessness is associated with enormous health inequalities, including shorter life expectancy, higher morbidity and greater usage of acute hospital services. Viewed through the lens of social determinants, homelessness is a key driver of poor health, but homelessness itself results from accumulated adverse social and economic conditions. Indeed, in people who are homeless, the social determinants of homelessness and health inequities are often intertwined, and long term homelessness further exacerbates poor health. Aggregated health service data can mask this, and case histories thus provide important insights. Methods: This paper presents three case histories of homeless patients seen at an inner city public hospital in Perth, Western Australia. The case histories draw on several data sources: hospital data, information collected from rough sleepers and clinical observations. Estimates of the cost to the health system of the observed hospital usage by the three patients are included. Findings: The case histories illustrate the interplay of social determinants of health in homelessness that help explain the high level of hospital usage by rough sleepers. The cumulative healthcare costs for the three individuals over a 33 months period were substantial. Hospital attendance plummeted even in the short term when housing needs were addressed. Conclusions: Treating homelessness as a combined health and social issue is critical to improving the abysmal health outcomes of people experiencing homelessness. In addition, the enormous economic costs of hospital care for people who are homeless can be reduced when housing and other social determinants are taken into account. Full article
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
Open AccessArticle Using Grey Relational Analysis to Evaluate Energy Consumption, CO2 Emissions and Growth Patterns in China’s Provincial Transportation Sectors
Int. J. Environ. Res. Public Health 2017, 14(12), 1536; doi:10.3390/ijerph14121536
Received: 13 October 2017 / Revised: 29 November 2017 / Accepted: 1 December 2017 / Published: 8 December 2017
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Abstract
The transportation sector is a complex system. Collecting transportation activity and the associated emissions data is extremely expensive and time-consuming. Grey Relational Analysis provides a viable alternative to overcome data insufficiency and gives insights for decision makers into such a complex system. In
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The transportation sector is a complex system. Collecting transportation activity and the associated emissions data is extremely expensive and time-consuming. Grey Relational Analysis provides a viable alternative to overcome data insufficiency and gives insights for decision makers into such a complex system. In this paper, we achieved three major goals: (i) we explored the inter-relationships among transportation development, energy consumption and CO2 emissions for 30 provincial units in China; (ii) we identified the transportation development mode for each individual province; and (iii) we revealed policy implications regarding the sustainable transportation development at the provincial level. We can classify the 30 provinces into eight development modes according to the calculated Grey Relational Grades. Results also indicated that energy consumption has the largest influence on CO2 emission changes. Lastly, sustainable transportation policies were discussed at the province level according to the level of economy, urbanization and transportation energy structure. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle A Meta-Analysis of Risk Factors for Post-Traumatic Stress Disorder (PTSD) in Adults and Children after Earthquakes
Int. J. Environ. Res. Public Health 2017, 14(12), 1537; doi:10.3390/ijerph14121537
Received: 27 August 2017 / Revised: 1 November 2017 / Accepted: 7 November 2017 / Published: 8 December 2017
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Abstract
PTSD is considered the most common negative psychological reactions among survivors following an earthquake. The present study sought to find out the determinants of PTSD in earthquake survivors using a systematic meta-analysis. Four electronic databases (PubMed, Embase, Web of Science, and PsycInfo) were
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PTSD is considered the most common negative psychological reactions among survivors following an earthquake. The present study sought to find out the determinants of PTSD in earthquake survivors using a systematic meta-analysis. Four electronic databases (PubMed, Embase, Web of Science, and PsycInfo) were used to search for observational studies about PTSD following earthquakes. The literature search, study selection, and data extraction were conducted independently by two authors. 52 articles were included in the study. Summary estimates, subgroup analysis, and publication bias tests were performed on the data. The prevalence of PTSD after earthquakes ranged from 4.10% to 67.07% in adults and from 2.50% to 60.00% in children. For adults, the significant predictors were being female, low education level or socio-economic status, prior trauma; being trapped, experiencing fear, injury, or bereavement during the disaster. For children, the significant predictors were being older age, high education level; being trapped, experiencing fear, injury, or bereavement, witnessing injury/death during the earthquakes. Our study provides implications for the understanding of risk factors for PTSD among earthquake survivors. Post-disaster mental health recovery programs that include early identification, on-going monitoring, and sustained psychosocial support are needed for earthquake survivors. Full article
(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)
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Open AccessArticle Spatiotemporal Variations and Driving Factors of Air Pollution in China
Int. J. Environ. Res. Public Health 2017, 14(12), 1538; doi:10.3390/ijerph14121538
Received: 24 October 2017 / Revised: 4 December 2017 / Accepted: 5 December 2017 / Published: 8 December 2017
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Abstract
In recent years, severe and persistent air pollution episodes in China have drawn wide public concern. Based on ground monitoring air quality data collected in 2015 in Chinese cities above the prefectural level, this study identifies the spatiotemporal variations of air pollution and
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In recent years, severe and persistent air pollution episodes in China have drawn wide public concern. Based on ground monitoring air quality data collected in 2015 in Chinese cities above the prefectural level, this study identifies the spatiotemporal variations of air pollution and its associated driving factors in China using descriptive statistics and geographical detector methods. The results show that the average air pollution ratio and continuous air pollution ratio across Chinese cities in 2015 were 23.1 ± 16.9% and 16.2 ± 14.8%. The highest levels of air pollution ratio and continuous air pollution ratio were observed in northern China, especially in the Bohai Rim region and Xinjiang province, and the lowest levels were found in southern China. The average and maximum levels of continuous air pollution show distinct spatial variations when compared with those of the continuous air pollution ratio. Monthly changes in both air pollution ratio and continuous air pollution ratio have a U-shaped variation, indicating that the highest levels of air pollution occurred in winter and the lowest levels happened in summer. The results of the geographical detector model further reveal that the effect intensity of natural factors on the spatial disparity of the air pollution ratio is greater than that of human-related factors. Specifically, among natural factors, the annual average temperature, land relief, and relative humidity have the greatest and most significant negative effects on the air pollution ratio, whereas human factors such as population density, the number of vehicles, and Gross Domestic Product (GDP) witness the strongest and most significant positive effects on air pollution ratio. Full article
(This article belongs to the Special Issue Remediation and Analysis of Soil, Air, and Water Pollution)
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Open AccessArticle The Family Affluence Scale as an Indicator for Socioeconomic Status: Validation on Regional Income Differences in the Czech Republic
Int. J. Environ. Res. Public Health 2017, 14(12), 1540; doi:10.3390/ijerph14121540
Received: 25 September 2017 / Revised: 19 November 2017 / Accepted: 5 December 2017 / Published: 8 December 2017
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Abstract
The Health Behaviour in School-Aged Children study (HBSC) uses the Family Affluence Scale (FAS) as a tool to identify the socioeconomic status of children and adolescents. Even though it is now widely applied in research studies, the external criterion validation of FAS has
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The Health Behaviour in School-Aged Children study (HBSC) uses the Family Affluence Scale (FAS) as a tool to identify the socioeconomic status of children and adolescents. Even though it is now widely applied in research studies, the external criterion validation of FAS has not been verified in terms of objective economic indicators in Central Europe. The aim of this study is to validate FAS in terms of disposable income per capita in 14 Czech administrative regions. Regional differences in the FAS score were analyzed using Pearson correlation and linear regression to measure the dependency of the aggregated mean of the FAS index at the regional level on data from the Czech HSBC survey carried out from April to June 2014 (n = 10,361). The data analysis has shown an overall positive correlation between the FAS index and regional disposable income (R = 0.77, p < 0.01). The regional disposable income per person could explain 59.7% of the variance in the FAS index (p < 0.01). By validating individual items, the authors identified three items with a significant correlation (p < 0.01): number of computers, dishwasher at home, and number of holidays. FAS seems to be a valid instrument to measure adolescents’ socioeconomic status. Full article
Open AccessFeature PaperArticle Cumulative IT Use Is Associated with Psychosocial Stress Factors and Musculoskeletal Symptoms
Int. J. Environ. Res. Public Health 2017, 14(12), 1541; doi:10.3390/ijerph14121541
Received: 10 October 2017 / Revised: 27 November 2017 / Accepted: 5 December 2017 / Published: 8 December 2017
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Abstract
This study aimed to examine the relationship between cumulative use of electronic devices and musculoskeletal symptoms. Smartphones and tablet computers are very popular and people may own or operate several devices at the same time. High prevalence rates of musculoskeletal symptoms associated with
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This study aimed to examine the relationship between cumulative use of electronic devices and musculoskeletal symptoms. Smartphones and tablet computers are very popular and people may own or operate several devices at the same time. High prevalence rates of musculoskeletal symptoms associated with intensive computer use have been reported. However, research focusing on mobile devices is only just emerging in recent years. In this study, 285 persons participated including 140 males and 145 females (age range 18–50). The survey consisted of self-reported estimation of daily information technology (IT) exposure hours, tasks performed, psychosocial stress factors and relationship to musculoskeletal discomfort in the past 12 months. Total IT exposure time was an average of 7.38 h (±5.2) per day. The psychosocial factor of “working through pain” showed the most significant association with odds ratio (OR) ranging from 1.078 (95% CI = 1.021–1.138) for elbow discomfort, to 1.111 (95% CI = 1.046–1.180) for shoulder discomfort. Desktop time was also significantly associated with wrist/hand discomfort (OR = 1.103). These findings indicate only a modest relationship but one that is statistically significant with accounting for confounders. It is anticipated that prevalence rates of musculoskeletal disorders would rise in the future with increasing contribution due to psychosocial stress factors. Full article
(This article belongs to the Special Issue Musculoskeletal Disorders)
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Open AccessArticle Setting Housing Standards to Improve Global Health
Int. J. Environ. Res. Public Health 2017, 14(12), 1542; doi:10.3390/ijerph14121542
Received: 16 October 2017 / Revised: 29 November 2017 / Accepted: 5 December 2017 / Published: 9 December 2017
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Abstract
Developing World Health Organization international guidelines is a highly formal process. Yet the resulting guidelines, which Member States are encouraged, but not required to adopt, are a powerful way of developing rigorous policy and fostering implementation. Using the example of the housing and
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Developing World Health Organization international guidelines is a highly formal process. Yet the resulting guidelines, which Member States are encouraged, but not required to adopt, are a powerful way of developing rigorous policy and fostering implementation. Using the example of the housing and health guidelines, which are currently being finalised, this paper outlines the process for developing WHO guidelines. This includes: forming a Guidelines Review Group that represents all regions of the world, and ensures gender balance and technical expertise; identifying key health outcomes of interest; commissioning systematic reviews of the evidence; assessing the evidence; and formulating recommendations. The strength of each recommendation is assessed based on the quality of the evidence, along with consideration of issues such as equity, acceptability, and feasibility of the implementation of the recommendation. The proposed housing guidelines will address: cold and hot indoor temperatures, home injuries, household crowding, accessibility and access to active travel infrastructure. Full article
(This article belongs to the Special Issue Housing and Health)
Open AccessArticle An Exploration of Intent to Use Telehealth at Home for Patients with Chronic Diseases
Int. J. Environ. Res. Public Health 2017, 14(12), 1544; doi:10.3390/ijerph14121544
Received: 15 October 2017 / Revised: 5 December 2017 / Accepted: 5 December 2017 / Published: 9 December 2017
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Abstract
Telecare is defined as care practiced at a distance. It is an effective strategy for improving the self-health care management of home-patients with chronic diseases. The purpose of this study was to explore the intent to use of telehealth patients. The correlation between
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Telecare is defined as care practiced at a distance. It is an effective strategy for improving the self-health care management of home-patients with chronic diseases. The purpose of this study was to explore the intent to use of telehealth patients. The correlation between the self-care behaviors, the intent to use of telehealth, and the effects on physiological indicators of patients with chronic disease at home were studied. A cross-sectional study design employing purposive sampling was selected. The structured questionnaire ‘Telecare Usage Intention Scale and Self-Care Behavior Scale’ were used, ‘HbA1c, glucose levels and monthly blood pressure measurements’ were analyzed in this thirteen month study. The self-care behaviors of the participants were positively correlated with their intent to use telehealth (p < 0.01). The results also indicated that HbA1c, glucose levels and frequency BP measurement of the participants improved significantly after using telecare (p < 0.005). The results indicated a strong intent to use telehealth and positive perception of telecare services by in-home patients with a chronic disease. Telehealth improves the self-care behavior of in-home chronic disease patients and enhances medical professionals’ ability to deliver quality and effective healthcare. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Urinary Concentrations of Triclosan, Benzophenone-3, and Bisphenol A in Taiwanese Children and Adolescents
Int. J. Environ. Res. Public Health 2017, 14(12), 1545; doi:10.3390/ijerph14121545
Received: 9 October 2017 / Revised: 28 November 2017 / Accepted: 5 December 2017 / Published: 10 December 2017
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Abstract
The purpose of this study was to determine the levels of urinary triclosan (TCS), benzophenone-3 (BP-3), and bisphenol A (BPA) in 52 children and 71 adolescents. The effects of age and sex on the levels of urinary TCS, BP-3, and BPA were explored,
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The purpose of this study was to determine the levels of urinary triclosan (TCS), benzophenone-3 (BP-3), and bisphenol A (BPA) in 52 children and 71 adolescents. The effects of age and sex on the levels of urinary TCS, BP-3, and BPA were explored, respectively. Results demonstrated the overall detection rates of urinary TCS, BP-3, and BPA were 18.7%, 8.1%, and 49.6%, respectively. The females had higher TCS concentrations than males (p = 0.051). The detection rate of urinary BP-3 in females (12.3%) was higher than that in males (0%) (p = 0.015). Moreover, the detection rate of urinary BP-3 in adolescents (14.1%) was higher than that in children (0%) (p = 0.005). For children, no urinary BP-3 was found. There were no differences in detection rates and concentrations of urinary TCS, BP-3, and BPA between males and females, respectively. For adolescents, urinary BP-3 was only found in the females. Urinary TCS levels in females were higher than those in males (p = 0.047). The present study showed that urinary TCS concentrations in females were significantly higher than those in males, respectively. In addition, BP-3 was only detected in urine samples of female adolescents. Sex and age were the important factors influencing urinary TCS and BP-3 concentrations. Full article
Open AccessArticle Race, Ethnicity, Income Concentration and 10-Year Change in Urban Greenness in the United States
Int. J. Environ. Res. Public Health 2017, 14(12), 1546; doi:10.3390/ijerph14121546
Received: 10 November 2017 / Revised: 4 December 2017 / Accepted: 9 December 2017 / Published: 10 December 2017
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Abstract
Background: Cross-sectional studies suggest urban greenness is unequally distributed by neighborhood demographics. However, the extent to which inequalities in greenness have changed over time remains unknown. Methods: We estimated 2001 and 2011 greenness using Moderate-resolution Imaging Spectroradiometer (MODIS) satellite-derived normalized difference vegetative index
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Background: Cross-sectional studies suggest urban greenness is unequally distributed by neighborhood demographics. However, the extent to which inequalities in greenness have changed over time remains unknown. Methods: We estimated 2001 and 2011 greenness using Moderate-resolution Imaging Spectroradiometer (MODIS) satellite-derived normalized difference vegetative index (NDVI) in 59,483 urban census tracts in the contiguous U.S. We fit spatial error models to estimate the association between baseline census tract demographic composition in 2000 and (1) 2001 greenness and (2) change in greenness between 2001 and 2011. Results: In models adjusted for population density, climatic factors, housing tenure, and Index of Concentration at the Extremes for income (ICE), an SD increase in percent White residents (a 30% increase) in 2000 was associated with 0.021 (95% CI: 0.018, 0.023) higher 2001 NDVI. We observed a stepwise reduction in 2001 NDVI with increased concentration of poverty. Tracts with a higher proportion of Hispanic residents in 2000 lost a small, statistically significant amount of greenness between 2001 and 2011 while tracts with higher proportions of Whites experienced a small, statistically significant increase in greenness over the same period. Conclusions: Census tracts with a higher proportion of racial/ethnic minorities, compared to a higher proportion of White residents, had less greenness in 2001 and lost more greenness between 2001 and 2011. Policies are needed to increase greenness, a health-promoting neighborhood asset, in disadvantaged communities. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Does the Short-Term Effect of Air Pollution Influence the Incidence of Spontaneous Intracerebral Hemorrhage in Different Patient Groups? Big Data Analysis in Taiwan
Int. J. Environ. Res. Public Health 2017, 14(12), 1547; doi:10.3390/ijerph14121547
Received: 2 November 2017 / Revised: 5 December 2017 / Accepted: 8 December 2017 / Published: 10 December 2017
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Abstract
Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that the occurrence of sICH is related to air pollution. This study used big data analysis to explore the impact of air pollution on the risk of sICH in patients of
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Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that the occurrence of sICH is related to air pollution. This study used big data analysis to explore the impact of air pollution on the risk of sICH in patients of differing age and geographic location. 39,053 cases were included in this study; 14,041 in the Taipei region (Taipei City and New Taipei City), 5537 in Taoyuan City, 7654 in Taichung City, 4739 in Tainan City, and 7082 in Kaohsiung City. The results of correlation analysis indicated that there were two pollutants groups, the CO and NO2 group and the PM2.5 and PM10 group. Furthermore, variations in the correlations of sICH with air pollutants were identified in different age groups. The co-factors of the influence of air pollutants in the different age groups were explored using regression analysis. This study integrated Taiwan National Health Insurance data and air pollution data to explore the risk factors of sICH using big data analytics. We found that PM2.5 and PM10 are very important risk factors for sICH, and age is an important modulating factor that allows air pollutants to influence the incidence of sICH. Full article
(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)
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Open AccessArticle Differences in Spontaneous Intracerebral Hemorrhage Cases between Urban and Rural Regions of Taiwan: Big Data Analytics of Government Open Data
Int. J. Environ. Res. Public Health 2017, 14(12), 1548; doi:10.3390/ijerph14121548
Received: 2 November 2017 / Revised: 1 December 2017 / Accepted: 6 December 2017 / Published: 10 December 2017
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Abstract
This study evaluated the differences in spontaneous intracerebral hemorrhage (sICH) between rural and urban areas of Taiwan with big data analysis. We used big data analytics and visualization tools to examine government open data, which included the residents’ health medical administrative data, economic
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This study evaluated the differences in spontaneous intracerebral hemorrhage (sICH) between rural and urban areas of Taiwan with big data analysis. We used big data analytics and visualization tools to examine government open data, which included the residents’ health medical administrative data, economic status, educational status, and relevant information. The study subjects included sICH patients of Taipei region (29,741 cases) and Eastern Taiwan (4565 cases). The incidence of sICH per 100,000 population per year in Eastern Taiwan (71.3 cases) was significantly higher than that of the Taipei region (42.3 cases). The mean coverage area per hospital in Eastern Taiwan (452.4 km2) was significantly larger than the Taipei region (24 km2). The residents educational level in the Taipei region was significantly higher than that in Eastern Taiwan. The mean hospital length of stay in the Taipei region (17.9 days) was significantly greater than that in Eastern Taiwan (16.3 days) (p < 0.001). There were no significant differences in other medical profiles between two areas. Distance and educational barriers were two possible reasons for the higher incidence of sICH in the rural area of Eastern Taiwan. Further studies are necessary in order to understand these phenomena in greater depth. Full article
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Open AccessArticle Practicing Dentists’ Self-Efficacy and Associated Factors in Managing the Treatment of Adults with Mental and Physical Disabilities: An Exploratory Cross-Sectional Study in Riyadh, Saudi Arabia
Int. J. Environ. Res. Public Health 2017, 14(12), 1549; doi:10.3390/ijerph14121549
Received: 21 September 2017 / Revised: 25 November 2017 / Accepted: 5 December 2017 / Published: 11 December 2017
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Abstract
Background: Provision of oral healthcare to adults with mental and physical disabilities (AMPD) remains a challenging area across various healthcare systems. The present study aimed to assess self-reported efficacy and investigate factors associated with self-efficacy in the management of AMPD among practicing dentists
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Background: Provision of oral healthcare to adults with mental and physical disabilities (AMPD) remains a challenging area across various healthcare systems. The present study aimed to assess self-reported efficacy and investigate factors associated with self-efficacy in the management of AMPD among practicing dentists in Saudi Arabia. Methods: A pilot-tested, self-administered questionnaire was distributed to a convenience sample of 1000 dentists. Descriptive and inferential analyses were performed on the collected responses. Results: Among the respondents (54%), 43% were males. Only 14% described their self-efficacy in managing AMPD as “High”. Multivariable regression analyses revealed significant associations between “High” self-efficacy and male gender (Odd ratio (OR) = 2.39, 95% CI = 1.16–4.89), experience practicing dentistry for 11 years or more (OR = 2.19, 95% CI = 1.04–4.47), specialization in pediatric dentistry (OR = 3.98, 95% CI = 1.31–12.07), previous experience in managing AMPD (OR = 4.23, 95% CI = 1.59–11.22), and awareness of regulations for managing AMPD (OR = 2.62, 95% CI = 1.42–4.38). The interaction of gender x age was significantly associated (p = 0.028) with “High” self-efficacy. Gender-stratified analyses revealed a significant association between age and “High” self-efficacy among male dentists only. Conclusions: The findings of the present study highlight that a large percentage of dentists reported “Low/Moderate” self-efficacy in managing AMPD, particularly among female dentists. However, further studies are required to verify the factors associated with self-efficacy in the present study, and to identify other factors that may influence self-efficacy in managing AMPD. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Effective Partnership in Community-Based Health Promotion: Lessons from the Health Literacy Partnership
Int. J. Environ. Res. Public Health 2017, 14(12), 1550; doi:10.3390/ijerph14121550
Received: 16 October 2017 / Revised: 14 November 2017 / Accepted: 30 November 2017 / Published: 11 December 2017
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Abstract
This paper aims to explore key elements needed to successfully develop healthy partnerships and collaborative working in community-based health promotion. It draws upon the lessons learned from a case study with the Health Literacy Partnership in Stoke-on-Trent, UK in developing the health literacy
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This paper aims to explore key elements needed to successfully develop healthy partnerships and collaborative working in community-based health promotion. It draws upon the lessons learned from a case study with the Health Literacy Partnership in Stoke-on-Trent, UK in developing the health literacy strategy in the area. The process was underpinned by respect for diverse yet complementary perspectives and skills from the grassroots up. This involved engagement with key stakeholders, development and support for community projects, and sharing of good practice with other national and local organizations. Stakeholders involved in developing the strategy also had a keen interest in health literacy and a strong commitment to promoting health and well-being in the area. Through patience, perseverance, and continuous open communication and learning, the health literacy strategy in Stoke-on-Trent, UK is beginning to have a ripple effect into local practice, and will potentially influence policy in the future. Full article
(This article belongs to the Special Issue Health Literacy in Context—Settings, Media, and Populations)
Open AccessArticle Seasonal Influenza Vaccine Acceptance among Pregnant Women in Zhejiang Province, China: Evidence Based on Health Belief Model
Int. J. Environ. Res. Public Health 2017, 14(12), 1551; doi:10.3390/ijerph14121551
Received: 22 November 2017 / Revised: 8 December 2017 / Accepted: 9 December 2017 / Published: 11 December 2017
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Abstract
Background: Reasons for acceptance of seasonal influenza vaccine (SIV) vaccination among pregnant women in China are poorly understood. We assessed the intention to accept SIV among pregnant women in Zhejiang province, by using a self-administrated structured questionnaire developed on the basis of health
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Background: Reasons for acceptance of seasonal influenza vaccine (SIV) vaccination among pregnant women in China are poorly understood. We assessed the intention to accept SIV among pregnant women in Zhejiang province, by using a self-administrated structured questionnaire developed on the basis of health belief model (HBM). Methods: From 1 January to 31 March 2014, pregnant women with ≥12 gestational weeks who attended antenatal clinics (ANCs) at public hospitals in 6 out of 90 districts were surveyed using a self-administered questionnaire that covered knowledge, attitudes, and beliefs related to SIV vaccination and influenza infection. We examined the associations between the acceptance of SIV vaccination and the demographic factors and HBM constructs using the logistic regression model, calculating the adjusted odds ratio (AOR). Results: Of the 1252 participants, 76.28% were willing to receive the SIV vaccination during their current pregnancy. High levels of perceived susceptibility of influenza (AOR = 1.75 (95%CI: 1.36–2.08)), high levels of perceived severity of influenza (AOR = 1.62 (95%CI: 1.25–1.95)), high level of perceived benefits of vaccination (AOR = 1.97 (95%CI: 1.76–2.21)), and high levels of cues to action were positively associated with the acceptance of SIV vaccination among pregnant women (AOR = 2.03 (95%CI: 1.70–2.69)), while high level of perceived barriers of vaccination was a negative determinant (AOR = 0.76 (95%CI: 0.62–0.94)). Conclusions: Poor knowledge and negative attitude towards SIV were associated with the poor acceptance of SIV. Health providers’ recommendations were important to pregnant women’s acceptance of SIV. Health education and direct communication strategies on SIV vaccination and influenza infection are necessary to improve the acceptance of SIV vaccination among pregnant women. Full article
Open AccessArticle Same Abbreviated Injury Scale Values May Be Associated with Different Risks to Mortality in Trauma Patients: A Cross-Sectional Retrospective Study Based on the Trauma Registry System in a Level I Trauma Center
Int. J. Environ. Res. Public Health 2017, 14(12), 1552; doi:10.3390/ijerph14121552
Received: 21 November 2017 / Revised: 4 December 2017 / Accepted: 8 December 2017 / Published: 11 December 2017
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Abstract
The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury
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The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury Severity Score (ISS). It assumes that the mortality of a given AIS value is similar across all body regions. However, such an assumption is less explored in the literature. In this study, we aimed to compare the mortality rates of the patients with the same AIS value in different injured body regions in a level I trauma center. Hospitalized adult trauma patients with isolated serious to critical injury (AIS of 3 to 5) between 1 January 2009, and 31 December 2016, from the Trauma Registry System in a level I trauma center were grouped according to the injured body regions (including, the head/neck, thorax, abdomen, or extremities) and were exclusively compared according to their AIS stratum. Categorical data were compared using the two-sided Fisher exact or Pearson chi-square tests. ANOVA with Games-Howell post hoc test was performed to assess the differences in continuous data of the patients with injury in different body regions. The primary outcome of the study was in-hospital mortality. The adjusted odds ratios (AORs) were estimated using a stepwise selection of a multivariable regression model adjusted by controlling the confounding variables such as sex, age, comorbidities, and ISS. Survival curves were estimated with the Kaplan–Meier approach with a corresponding log-rank test. The patients with AIS of 5 for abdomen injury and those with AIS of 3 for extremity injury had a significantly lower odds of adjusted mortality (adjusted odds ratio (AOR) 0.1, 95% confidence interval (CI) 0.01–0.39, p = 0.004 and AOR 0.3, 95% CI 0.15–0.51, p < 0.001, respectively) than that of the patients with head/neck injury. However, the patients with AIS of 4 for extremity injury demonstrated significantly higher odds of adjusted mortality (AOR 8.4, 95% CI 2.84–25.07, p < 0.001) than the patients with head/neck injury. This study found that the risks to mortality in the patients with a given AIS value of serious to critical injury in different injured body regions were not the same, even after controlling for confounding variables such as sex, age, comorbidities, and ISS. Full article
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Open AccessCommunication Effects of Weight Loss on Advanced Glycation End Products in Subjects with and without Diabetes: A Preliminary Report
Int. J. Environ. Res. Public Health 2017, 14(12), 1553; doi:10.3390/ijerph14121553
Received: 31 October 2017 / Revised: 1 December 2017 / Accepted: 8 December 2017 / Published: 11 December 2017
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Abstract
Advanced glycation end-products (AGEs) are formed endogenously as a normal ageing process and during food processing. High levels of AGEs have been implicated in the development of both macrovascular disease and microvascular disease. The purpose of this secondary analysis was to determine whether
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Advanced glycation end-products (AGEs) are formed endogenously as a normal ageing process and during food processing. High levels of AGEs have been implicated in the development of both macrovascular disease and microvascular disease. The purpose of this secondary analysis was to determine whether a major AGE species, Nε-carboxymethyllysine (CML), was reduced after weight loss. CML values decreased by 17% after weight loss. Participants with diabetes and pre-diabetes had a lower CML values at baseline and a smaller change in CML than overweight participants without diabetes. We conclude that, in addition to the known health benefits, weight loss may reduce AGEs. Randomized studies of the effect of weight loss on AGE in people with and without type 2 diabetes are needed to confirm these results. Full article
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Open AccessArticle Food (In)Security in Rapidly Urbanising, Low-Income Contexts
Int. J. Environ. Res. Public Health 2017, 14(12), 1554; doi:10.3390/ijerph14121554
Received: 2 November 2017 / Revised: 26 November 2017 / Accepted: 6 December 2017 / Published: 11 December 2017
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Abstract
Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of
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Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space. Full article
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
Open AccessArticle Exploratory Temporal and Spatial Analysis of Myocardial Infarction Hospitalizations in Calgary, Canada
Int. J. Environ. Res. Public Health 2017, 14(12), 1555; doi:10.3390/ijerph14121555
Received: 14 October 2017 / Revised: 25 November 2017 / Accepted: 6 December 2017 / Published: 11 December 2017
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Abstract
Spatial and temporal analyses are critical to understand the pattern of myocardial infarction (MI) hospitalizations over space and time, and to identify their underlying determinants. In this paper, we analyze MI hospitalizations in Calgary from 2004 to 2013, stratified by age and gender.
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Spatial and temporal analyses are critical to understand the pattern of myocardial infarction (MI) hospitalizations over space and time, and to identify their underlying determinants. In this paper, we analyze MI hospitalizations in Calgary from 2004 to 2013, stratified by age and gender. First, a seasonal trend decomposition analyzes the seasonality; then a linear regression models the trend component. Moran’s I and hot spot analyses explore the spatial pattern. Though exploratory, results show that most age and gender groups feature a statistically significant decline over the 10 years, consistent with previous studies in Canada. Decline rates vary across ages and genders, with the slowest decline observed for younger males. Each gender exhibits a seasonal pattern with peaks in both winter and summer. Spatially, MI hot spots are identified in older communities, and in socioeconomically and environmentally disadvantaged communities. In the older communities, higher MI rates appear to be more highly associated with demographics. Conversely, worse air quality appears to be locally associated with higher MI incidence in younger age groups. The study helps identify areas of concern, where MI hot spots are identified for younger age groups, suggesting the need for localized public health policies to target local risk factors. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Investigating Lushan Earthquake Victims’ Individual Behavior Response and Rescue Organization
Int. J. Environ. Res. Public Health 2017, 14(12), 1556; doi:10.3390/ijerph14121556
Received: 15 October 2017 / Revised: 14 November 2017 / Accepted: 22 November 2017 / Published: 11 December 2017
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Abstract
Research concerning the impact of earthquake victims’ individual behavior and its association with earthquake-related injuries is lacking. This study examined this relationship along with effectiveness of earthquake rescue measures. The six most severely destroyed townships during the Lushan earthquake were examined; 28 villages
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Research concerning the impact of earthquake victims’ individual behavior and its association with earthquake-related injuries is lacking. This study examined this relationship along with effectiveness of earthquake rescue measures. The six most severely destroyed townships during the Lushan earthquake were examined; 28 villages and three earthquake victims’ settlement camp areas were selected as research areas. Inclusion criteria comprised living in Lushan county for a longtime, living in Lushan county during the 2013 Lushan earthquake, and having one’s home destroyed. Earthquake victims with an intellectual disability or communication problems were excluded. The earthquake victims (N (number) = 5165, male = 2396) completed a questionnaire (response rate: 94.7%). Among them, 209 were injured (5.61%). Teachers (p < 0.0001, OR (odds ratios) = 3.33) and medical staff (p = 0.001, OR = 4.35) were more vulnerable to the earthquake than were farmers. Individual behavior was directly related to injuries, such as the first reaction after earthquake and fear. There is an obvious connection between earthquake-related injury and individual behavior characteristics. It is strongly suggested that victims receive mental health support from medical practitioners and the government to minimize negative effects. The initial reaction after an earthquake also played a vital role in victims’ trauma; therefore, earthquake-related experience and education may prevent injuries. Self-aid and mutual help played key roles in emergency, medical rescue efforts. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Heavy Metal Contamination and Health Risk Assessment in the Vicinity of a Tailing Pond in Guangdong, China
Int. J. Environ. Res. Public Health 2017, 14(12), 1557; doi:10.3390/ijerph14121557
Received: 27 October 2017 / Revised: 29 November 2017 / Accepted: 30 November 2017 / Published: 12 December 2017
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Abstract
The purpose of this study was to assess heavy metal contamination and health risks for residents in the vicinity of a tailing pond in Guangdong, southern China. Water, soil, rice, and vegetable samples were collected from the area in the vicinity of the
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The purpose of this study was to assess heavy metal contamination and health risks for residents in the vicinity of a tailing pond in Guangdong, southern China. Water, soil, rice, and vegetable samples were collected from the area in the vicinity of the tailing pond. Results showed that surface water was just polluted by Ni and As, while groundwater was not contaminated by heavy metals. The concentrations of Pb, Zn, Cu, Cd, Ni, and As in the paddy soil exceeded the standard values but not those of Cr. In vegetable soils, the concentration of heavy metals was above the standard values except for Ni and As. Soil heavy metal concentrations generally decreased with increasing distance from the polluting source. Leafy vegetables were contaminated by Pb, Cr, Cd, and Ni, while the non-leafy vegetables were contaminated only by Cr. There was a significant difference in heavy metal concentrations between leafy vegetables and non-leafy vegetables. Almost all the rice was polluted by heavy metals. Diet was the most significant contributor to non-carcinogenic risk, which was significantly higher than the safe level of 1. The total cancer risk was also beyond the safe range (10−6–10−4). Results revealed that there is a risk of potential health problems to residents in the vicinity of the tailing pond. Full article
(This article belongs to the Special Issue Environmental Risk Assessment)
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Open AccessArticle Does Practicing CSR Makes Consumers Like Your Shop More? Consumer-Retailer Love Mediates CSR and Behavioral Intentions
Int. J. Environ. Res. Public Health 2017, 14(12), 1558; doi:10.3390/ijerph14121558
Received: 9 November 2017 / Revised: 5 December 2017 / Accepted: 7 December 2017 / Published: 12 December 2017
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Abstract
This research paper was designed to examine the influence of corporate social responsibility (CSR) associations and environmental concerns on consumer-retailer love and attitude toward the retailer, as well as the subsequent effects on consumer behavioral intentions regarding the retailer, such as repeat patronage
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This research paper was designed to examine the influence of corporate social responsibility (CSR) associations and environmental concerns on consumer-retailer love and attitude toward the retailer, as well as the subsequent effects on consumer behavioral intentions regarding the retailer, such as repeat patronage intention and willingness to pay a premium price for products offered by the retailer. In this study, a questionnaire survey was conducted on consumers for the purpose of investigating five proposed hypotheses. This research applied partial least squares (PLS) to exam the hypotheses and analyze the data. The findings of this research indicated that CSR association and environmental concern both have positive effects on consumer-retailer love and attitude toward the retailer. Also, the results showed that consumer-retailer love has a significantly positive effect on consumer attitude towards the retailer. This paper establishes that consumer-retailer love and attitude toward a retailer are main mediators of the relationship between CSR associations, environmental concern, and consumer behavioral intentions. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Do Individual and Neighborhood Characteristics Influence Perceived Air Quality?
Int. J. Environ. Res. Public Health 2017, 14(12), 1559; doi:10.3390/ijerph14121559
Received: 27 October 2017 / Revised: 4 December 2017 / Accepted: 5 December 2017 / Published: 12 December 2017
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Abstract
Background: Despite improvements, air pollution still remains a major public health issue. Numerous epidemiological studies have demonstrated the adverse health effects of air pollution exposure based on modeled measures, but only a few have considered the health impact of perceived air quality.
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Background: Despite improvements, air pollution still remains a major public health issue. Numerous epidemiological studies have demonstrated the adverse health effects of air pollution exposure based on modeled measures, but only a few have considered the health impact of perceived air quality. Improving our knowledge of individual perceptions is crucial to defining targeted actions and promoting appropriate intervention measures. Our objective is to investigate the relationship between subjective and objective measures of air pollution and to focus on how individual characteristics combined with the neighborhood socioeconomic deprivation index, measured at a fine spatial scale, may or may not alter this relationship. Materials and Methods: The subjective measures of air quality reported by a sample of Lyon residents were collected via an individual questionnaire. The objective measures of air pollution were modeled by the local air quality monitoring network of the Rhône-Alpes region at census block level. We used a socioeconomic deprivation index to capture the different socioeconomic dimensions at census block level. The statistical analysis was structured in two steps: (1) identification of individual determinants of the subjective measures of air quality using multiple correspondence analysis followed by hierarchical clustering; (2) identification of individual and contextual characteristics that may alter the relationship between the objective and subjective measures of air pollution. Results: Among the youngest and the middle aged population (ages 30 to 59), consistent results between level of satisfaction, perceived air quality and objective measures of air pollution were found whatever the individual characteristics of the population. It is less clear among the oldest population: globally no significant difference between the NO2 concentrations and the level of satisfaction was observed. Conclusions: We found a significant relationship between the subjective and objective measures of air pollution in many population sub-groups with different combinations of individual characteristics. The relationship is less clear among the oldest population, which confirms previous findings. Our finding highlights that age combined with low level of education and unemployment, or women or health problems as well as the neighborhood deprivation index influence the level of air quality satisfaction. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Stress-Induced Endocrine and Immune Dysfunctions in Caregivers of People with Eating Disorders
Int. J. Environ. Res. Public Health 2017, 14(12), 1560; doi:10.3390/ijerph14121560
Received: 24 October 2017 / Revised: 20 November 2017 / Accepted: 7 December 2017 / Published: 13 December 2017
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Abstract
Caregivers have to cope repeatedly with acute stressors in their daily lives, and this is associated with disturbances in the hypothalamic–pituitary–adrenal (HPA) axis and the immune system. Such disturbances could contribute to the development of health problems in informal caregivers of people with
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Caregivers have to cope repeatedly with acute stressors in their daily lives, and this is associated with disturbances in the hypothalamic–pituitary–adrenal (HPA) axis and the immune system. Such disturbances could contribute to the development of health problems in informal caregivers of people with chronic illnesses, such as eating disorders (EDs). The main objective of this study was to examine endocrine (salivary cortisol levels (Csal)), immune (immunoglobulin-A (IgA)), and psychological (anxiety, mood, and anger feelings) responses to an acute psychological stressor in a sample of informal caregivers of individuals with EDs compared to a sample of non-caregivers. In addition, it also aimed to analyze the potential relationship of the aforementioned endocrine and immune response parameters with psychological variables in the caregivers. Caregivers had lower Csal and IgA levels at all assessment points except baseline. Moreover, they also exhibited lower Csal and IgA responses and greater worsening of mood in response to acute psychosocial stress than the non-caregivers, which suggests that caregivers had dampened endocrine and immune reactivity to acute stress. On the other hand, endocrine and immune parameters were unrelated to psychological variables. These findings advance our understanding of how a chronically stressed population reacts to acute stress, and should be considered for the development of effective interventions focused on stress management that could help caregivers to reduce their stress levels, which, in turn, would improve their health. Full article
(This article belongs to the Special Issue Stress and Health)
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Open AccessArticle The Multi-Attribute Group Decision-Making Method Based on Interval Grey Trapezoid Fuzzy Linguistic Variables
Int. J. Environ. Res. Public Health 2017, 14(12), 1561; doi:10.3390/ijerph14121561
Received: 3 November 2017 / Revised: 6 December 2017 / Accepted: 6 December 2017 / Published: 13 December 2017
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Abstract
With respect to multi-attribute group decision-making (MAGDM) problems, where attribute values take the form of interval grey trapezoid fuzzy linguistic variables (IGTFLVs) and the weights (including expert and attribute weight) are unknown, improved grey relational MAGDM methods are proposed. First, the concept of
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With respect to multi-attribute group decision-making (MAGDM) problems, where attribute values take the form of interval grey trapezoid fuzzy linguistic variables (IGTFLVs) and the weights (including expert and attribute weight) are unknown, improved grey relational MAGDM methods are proposed. First, the concept of IGTFLV, the operational rules, the distance between IGTFLVs, and the projection formula between the two IGTFLV vectors are defined. Second, the expert weights are determined by using the maximum proximity method based on the projection values between the IGTFLV vectors. The attribute weights are determined by the maximum deviation method and the priorities of alternatives are determined by improved grey relational analysis. Finally, an example is given to prove the effectiveness of the proposed method and the flexibility of IGTFLV. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
Open AccessArticle Impacts of the 2015 Heat Waves on Mortality in the Czech Republic—A Comparison with Previous Heat Waves
Int. J. Environ. Res. Public Health 2017, 14(12), 1562; doi:10.3390/ijerph14121562
Received: 29 September 2017 / Revised: 10 November 2017 / Accepted: 8 December 2017 / Published: 13 December 2017
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Abstract
This study aimed to assess the impacts of heat waves during the summer of 2015 on mortality in the Czech Republic and to compare them with those of heat waves back to the previous record-breaking summer of 1994. We analyzed daily natural-cause mortality
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This study aimed to assess the impacts of heat waves during the summer of 2015 on mortality in the Czech Republic and to compare them with those of heat waves back to the previous record-breaking summer of 1994. We analyzed daily natural-cause mortality across the country’s entire population. A mortality baseline was determined using generalized additive models adjusted for long-term trends, seasonal and weekly cycles, and identified heat waves. Mortality deviations from the baseline were calculated to quantify excess mortality during heat waves, defined as periods of at least three consecutive days with mean daily temperature higher than the 95th percentile of annual distribution. The summer of 2015 was record-breaking in the total duration of heat waves as well as their total heat load. Consequently, the impact of the major heat wave in 2015 on the increase in excess mortality relative to the baseline was greater than during the previous record-breaking heat wave in 1994 (265% vs. 240%). Excess mortality was comparable among the younger age group (0–64 years) and the elderly (65+ years) in the 1994 major heat wave while it was significantly larger among the elderly in 2015. The results suggest that the total heat load of a heat wave needs to be considered when assessing its impact on mortality, as the cumulative excess heat factor explains the magnitude of excess mortality during a heat wave better than other characteristics such as duration or average daily mean temperature during the heat wave. Comparison of the mortality impacts of the 2015 and 1994 major heat waves suggests that the recently reported decline in overall heat-related mortality in Central Europe has abated and simple extrapolation of the trend would lead to biased conclusions even for the near future. Further research is needed toward understanding the additional mitigation measures required to prevent heat-related mortality in the Czech Republic and elsewhere. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Microwave-Enhanced Photolysis of Norfloxacin: Kinetics, Matrix Effects, and Degradation Pathways
Int. J. Environ. Res. Public Health 2017, 14(12), 1564; doi:10.3390/ijerph14121564
Received: 21 September 2017