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Int. J. Environ. Res. Public Health, Volume 15, Issue 1 (January 2018)

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Editorial

Jump to: Research, Review, Other

Open AccessEditorial Acknowledgement to Reviewers of IJERPH in 2017
Int. J. Environ. Res. Public Health 2018, 15(1), 118; doi:10.3390/ijerph15010118
Received: 11 January 2018 / Revised: 11 January 2018 / Accepted: 11 January 2018 / Published: 11 January 2018
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Abstract
Peer review is an essential part in the publication process, ensuring that IJERPH maintains high quality standards for its published papers [...] Full article
Open AccessEditorial Refugee Health: An Ongoing Commitment and Challenge
Int. J. Environ. Res. Public Health 2018, 15(1), 131; doi:10.3390/ijerph15010131
Received: 9 January 2018 / Revised: 9 January 2018 / Accepted: 10 January 2018 / Published: 13 January 2018
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Abstract
Refugees represent a diverse group of displaced individuals with unique health issues and disease risks. The obstacles facing this population have their origins in war, violence, oppression, exploitation, and fear of persecution. Regardless of country of origin, a common bond exists, with refugees
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Refugees represent a diverse group of displaced individuals with unique health issues and disease risks. The obstacles facing this population have their origins in war, violence, oppression, exploitation, and fear of persecution. Regardless of country of origin, a common bond exists, with refugees often confronting inadequate healthcare resources, xenophobia, discrimination, and a complex web of legal barriers in their new homelands. In many cases, the plight of refugees is multigenerational, manifesting as mental health issues, abuse, poverty, and family disruption. The health trajectory of refugees remains an ongoing commitment and challenge. Full article
(This article belongs to the Special Issue Refugee Health)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Bicycle Facilities That Address Safety, Crime, and Economic Development: Perceptions from Morelia, Mexico
Int. J. Environ. Res. Public Health 2018, 15(1), 1; doi:10.3390/ijerph15010001
Received: 13 November 2017 / Revised: 7 December 2017 / Accepted: 8 December 2017 / Published: 22 December 2017
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Abstract
México is a developing nation and, in the city of Morelia, the concept of the bicyclist as a road user appeared only recently in the Municipal Traffic Regulations. Perhaps the right bicycle infrastructure could address safety, crime, and economic development. To identify the
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México is a developing nation and, in the city of Morelia, the concept of the bicyclist as a road user appeared only recently in the Municipal Traffic Regulations. Perhaps the right bicycle infrastructure could address safety, crime, and economic development. To identify the best infrastructure, six groups in Morelia ranked and commented on pictures of bicycle environments that exist in bicycle-friendly nations. Perceptions about bike paths, but only those with impossible-to-be-driven-over solid barriers, were associated with safety from crashes, lowering crime, and contributing to economic development. Shared use paths were associated with lowering the probability of car/bike crashes but lacked the potential to deter crime and foster the local economy. Joint bus and bike lanes were associated with lower safety because of the unwillingness by Mexican bus drivers to be courteous to bicyclists. Gender differences about crash risk biking in the road with the cars (6 best/0 worst scenario) were statistically significant (1.4 for male versus 0.69 for female; p < 0.001). For crashes, crime, and economic development, perceptions about bicycle infrastructure were different in this developing nation perhaps because policy, institutional context, and policing (ticketing for unlawful parking) are not the same as in a developed nation. Countries such as Mexico should consider building cycle tracks with solid barriers to address safety, crime, and economic development. Full article
(This article belongs to the Special Issue Sustainable Transportation and Health)
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Open AccessArticle Climate Change and Health under the Shared Socioeconomic Pathway Framework
Int. J. Environ. Res. Public Health 2018, 15(1), 3; doi:10.3390/ijerph15010003
Received: 28 October 2017 / Revised: 2 December 2017 / Accepted: 18 December 2017 / Published: 21 December 2017
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Abstract
A growing body of literature addresses how climate change is likely to have substantial and generally adverse effects on population health and health systems around the world. These effects are likely to vary within and between countries and, importantly, will vary depending on
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A growing body of literature addresses how climate change is likely to have substantial and generally adverse effects on population health and health systems around the world. These effects are likely to vary within and between countries and, importantly, will vary depending on different socioeconomic development patterns. Transitioning to a more resilient and sustainable world to prepare for and manage the effects of climate change is likely to result in better health outcomes. Sustained fossil fuel development will likely result in continued high burdens of preventable conditions, such as undernutrition, malaria, and diarrheal diseases. Using a new set of socioeconomic development trajectories, the Shared Socioeconomic Pathways (SSPs), along with the World Health Organization’s Operational Framework for Building Climate Resilient Health Systems, we extend existing storylines to illustrate how various aspects of health systems are likely to be affected under each SSP. We also discuss the implications of our findings on how the burden of mortality and the achievement of health-related Sustainable Development Goal targets are likely to vary under different SSPs. Full article
(This article belongs to the Special Issue Health Impacts of Warming of 1.5 °C and 2 °C)
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Open AccessArticle Care Model Design for E-Health: Integration of Point-of-Care Testing at Dutch General Practices
Int. J. Environ. Res. Public Health 2018, 15(1), 4; doi:10.3390/ijerph15010004
Received: 31 October 2017 / Revised: 5 December 2017 / Accepted: 14 December 2017 / Published: 21 December 2017
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Abstract
Point-of-care testing (POCT)—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by
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Point-of-care testing (POCT)—laboratory tests performed with new mobile devices and online technologies outside of the central laboratory—is rapidly outpacing the traditional laboratory test market, growing at a rate of 12 to 15% each year. POCT impacts the diagnostic process of care providers by yielding high efficiency benefits in terms of turnaround time and related quality improvements in the reduction of errors. However, the implementation of this disruptive eHealth technology requires the integration and transformation of diagnostic services across the boundaries of healthcare organizations. Research has revealed both advantages and barriers of POCT implementations, yet to date, there is no business model for the integration of POCT within general practice. The aim of this article is to contribute with a design for a care model that enables the integration of POCT in primary healthcare. In this research, we used a design modelling toolkit for data collection at five general practices. Through an iterative design process, we modelled the actors and value transactions, and designed an optimized care model for the dynamic integration of POCTs into the GP’s network of care delivery. The care model design will have a direct bearing on improving the integration of POCT through the connectivity and norm guidelines between the general practice, the POC technology, and the diagnostic centre. Full article
(This article belongs to the Special Issue eHealth: The Impact of Technology on Healthcare)
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Open AccessArticle Relationship between Telomere Length, Genetic Traits and Environmental/Occupational Exposures in Bladder Cancer Risk by Structural Equation Modelling
Int. J. Environ. Res. Public Health 2018, 15(1), 5; doi:10.3390/ijerph15010005
Received: 16 November 2017 / Revised: 15 December 2017 / Accepted: 17 December 2017 / Published: 21 December 2017
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Abstract
Background: Telomere length (TL) maintenance plays an important role in bladder cancer (BC) and prognosis. However the manifold influence of everyday life exposures and genetic traits on leucocyte TL (LTL), is not fully elucidated. Methods: Within the framework of a hospital-based
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Background: Telomere length (TL) maintenance plays an important role in bladder cancer (BC) and prognosis. However the manifold influence of everyday life exposures and genetic traits on leucocyte TL (LTL), is not fully elucidated. Methods: Within the framework of a hospital-based case (n = 96)/control (n = 94) study (all Caucasian males), we investigated the extent to which LTL and BC risk were modulated by genetic polymorphisms and environmental and occupational exposures. Data on lifetime smoking, alcohol and coffee drinking, dietary habits and occupational exposures, pointing to aromatic amines (AAs) and polycyclic aromatic hydrocarbons (PAHs) were collected. Structural equation modelling (SEM) analysis appraised this complex relationships. Results: The SEM analysis indicates negative direct links (p < 0.05) between LTL with age, DNA adducts, alcohol and NAT2, and positive ones with coffee, MPO and XRCC3; and between BC risk (p < 0.01) with cigarettes, cumulative exposure to AAs and coffee, while are negative with LTL and age. There was evidence of indirect effects (p < 0.05) on BC risk, probably via LTL reduction, by age and NAT2 (positive link), MPO and XRCC3 (negative link). Conclusions: Our study supports evidence that LTL attrition is a critical event in BC. The new finding that LTL erosion depends on some preventable everyday life exposures genetically modulated, opens new perspectives in BC prevention. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Demand for Long-Term Care Insurance in China
Int. J. Environ. Res. Public Health 2018, 15(1), 6; doi:10.3390/ijerph15010006
Received: 24 October 2017 / Revised: 2 December 2017 / Accepted: 16 December 2017 / Published: 22 December 2017
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Abstract
The aim of this study was to estimate willingness to pay (WTP) for long-term care insurance (LTCI) and to explore the determinants of demand for LTCI in China. We collected data from a household survey conducted in Qinghai and Zhejiang on a sample
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The aim of this study was to estimate willingness to pay (WTP) for long-term care insurance (LTCI) and to explore the determinants of demand for LTCI in China. We collected data from a household survey conducted in Qinghai and Zhejiang on a sample of 1842 households. We relied on contingent valuation methods to elicit the demand for LTCI and random effects logistic regression to analyze the factors associated with the demand for LTCI. Complementarily, we used document analysis to compare the LTCI designed in this study and the current LTCI policies in the pilot cities. More than 90% of the respondents expressed their willingness to buy LTCI. The median WTP for LTCI was estimated at 370.14 RMB/year, accounting for 2.29% of average annual per capita disposable income. Price, age, education status, and income were significantly associated with demand for LTCI. Most pilot cities were found to mainly rely on Urban Employees Basic Medical Insurance funds as the financing source for LTCI. Considering that financing is one of the greatest challenges in the development of China’s LTCI, we suggest that policy makers consider individual contribution as an important and possible option as a source of financing for LTCI. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Personal, Psychosocial and Environmental Factors Related to Sick Building Syndrome in Official Employees of Taiwan
Int. J. Environ. Res. Public Health 2018, 15(1), 7; doi:10.3390/ijerph15010007
Received: 20 November 2017 / Revised: 18 December 2017 / Accepted: 20 December 2017 / Published: 22 December 2017
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Abstract
Sick building syndrome (SBS) is a combination of symptoms that can be attributed to exposure to specific building conditions. The present study recruited 389 participants aged 20–65 years from 87 offices of 16 institutions to examine if personal factors, work-related psychosocial stress, and
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Sick building syndrome (SBS) is a combination of symptoms that can be attributed to exposure to specific building conditions. The present study recruited 389 participants aged 20–65 years from 87 offices of 16 institutions to examine if personal factors, work-related psychosocial stress, and work environments, were associated with five groups of SBS symptoms, including symptoms for eyes, upper respiratory tract, lower respiratory tract, skin, and non-specific systems. Indoor environmental conditions were monitored. Data were analyzed using multivariate logistic regression (MLR) analyses and were reported as adjusted Odds Ratios (aOR). SBS symptoms for eyes were associated with older age, sensitivity to tobacco, and low indoor air flow. Upper respiratory symptoms were related to smoking, low social support, longer work days, and dry air. High indoor air flow was associated with reduced upper respiratory symptoms (aOR = 0.29; 95% confidence interval (CI) = 0.13–0.67). Lower respiratory symptoms were associated with high work pressure, longer work hours, chemical exposure, migraine, and exposure to new interior painting. Recent interior painting exposure was associated with a high estimated relative risk of low respiratory symptoms (aOR = 20.6; 95% CI = 2.96–143). Smoking, longer work days, low indoor air flow, indoor dryness, and volatile organics exposure, were associated with other non-specified symptoms including headache, tiredness, difficulty concentrating, anger, and dizziness. In conclusion, there are various SBS symptoms associated with different personal characteristics, psychosocial, and environmental factors. Psychosocial factors had stronger relationships with lower respiratory symptoms than with other types of SBS symptoms. Good ventilation could reduce risk factors and may relieve SBS symptoms. Full article
(This article belongs to the Special Issue Indoor Air Pollution and Health)
Open AccessArticle Adsorption Property and Mechanism of Oxytetracycline onto Willow Residues
Int. J. Environ. Res. Public Health 2018, 15(1), 8; doi:10.3390/ijerph15010008
Received: 7 November 2017 / Revised: 13 December 2017 / Accepted: 20 December 2017 / Published: 22 December 2017
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Abstract
To elucidate the adsorption property and the mechanism of plant residues to reduce oxytetracycline (OTC), the adsorption of OTC onto raw willow roots (WR-R), stems (WS-R), leaves (WL-R), and adsorption onto desugared willow roots (WR-D), stems (WS-D), and leaves (WL-D) were investigated. The
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To elucidate the adsorption property and the mechanism of plant residues to reduce oxytetracycline (OTC), the adsorption of OTC onto raw willow roots (WR-R), stems (WS-R), leaves (WL-R), and adsorption onto desugared willow roots (WR-D), stems (WS-D), and leaves (WL-D) were investigated. The structural characterization was analyzed by scanning electron microscopy, Fourier-transform infrared spectra, and an elemental analyzer. OTC adsorption onto the different tissues of willow residues was compared and correlated with their structures. The adsorption kinetics of OTC onto willow residues was found to follow the pseudo-first-order model. The isothermal adsorption process of OTC onto the different tissues of willow residues followed the Langmuir and Freundlich model and the process was also a spontaneous endothermic reaction, which was mainly physical adsorption. After the willow residues were desugared, the polarity decreased and the aromaticity increased, which explained why the adsorption amounts of the desugared willow residues were higher than those of the unmodified residues. These observations suggest that the raw and modified willow residues have great potential as adsorbents to remove organic pollutants. Full article
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Open AccessArticle Efficacy of Natural Polymer Derivatives on Soil Physical Properties and Erosion on an Experimental Loess Hillslope
Int. J. Environ. Res. Public Health 2018, 15(1), 9; doi:10.3390/ijerph15010009
Received: 28 October 2017 / Revised: 19 December 2017 / Accepted: 20 December 2017 / Published: 22 December 2017
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Abstract
Raindrops disperse large soil aggregates into smaller particles, which can clog soil pores, cause soil crusting, reduce rainfall infiltration and increase soil loss. It was found that natural polymer derivatives were effective in improving soil physical properties and decreasing soil erosion on an
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Raindrops disperse large soil aggregates into smaller particles, which can clog soil pores, cause soil crusting, reduce rainfall infiltration and increase soil loss. It was found that natural polymer derivatives were effective in improving soil physical properties and decreasing soil erosion on an experimental loess hillslope. This study investigated the effect of new natural polymer derivatives (Jag S and Jag C162) on soil properties, rainfall infiltration and sediment yield at four rates of sprayed polymers (0, 1, 3 and 5 g/m2), three rainfall intensities (1, 1.5 and 2 mm/min) and a slope gradient of 15° with a silt loam soil through simulated rain. The results showed that both Jag S and Jag C162 significantly increased the shear strength and improved the aggregates composition of the soil surface. The water-stable soil aggregates >0.25 mm increased from 9% to 50% with increasing rates of Jag S and Jag C162. Jag S and Jag C162 also effectively increased rainfall infiltration and final infiltration rate, and reduced erosion compared to controls without natural polymer derivatives added. However, higher rates of Jag S produced lower infiltration rates. Although both Jag S and Jag C162 effectively influenced soil physical properties and erosion, the effect of Jag C162 was more significant than that of Jag S. Full article
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Open AccessArticle Measurement of Scenic Spots Sustainable Capacity Based on PCA-Entropy TOPSIS: A Case Study from 30 Provinces, China
Int. J. Environ. Res. Public Health 2018, 15(1), 10; doi:10.3390/ijerph15010010
Received: 19 November 2017 / Revised: 20 December 2017 / Accepted: 21 December 2017 / Published: 22 December 2017
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Abstract
In connection with the sustainable development of scenic spots, this paper, with consideration of resource conditions, economic benefits, auxiliary industry scale and ecological environment, establishes a comprehensive measurement model of the sustainable capacity of scenic spots; optimizes the index system by principal components
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In connection with the sustainable development of scenic spots, this paper, with consideration of resource conditions, economic benefits, auxiliary industry scale and ecological environment, establishes a comprehensive measurement model of the sustainable capacity of scenic spots; optimizes the index system by principal components analysis to extract principal components; assigns the weight of principal components by entropy method; analyzes the sustainable capacity of scenic spots in each province of China comprehensively in combination with TOPSIS method and finally puts forward suggestions aid decision-making. According to the study, this method provides an effective reference for the study of the sustainable development of scenic spots and is very significant for considering the sustainable development of scenic spots and auxiliary industries to establish specific and scientific countermeasures for improvement. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Evaluation of Behavior Change Communication Campaigns to Promote Modern Cookstove Purchase and Use in Lower Middle Income Countries
Int. J. Environ. Res. Public Health 2018, 15(1), 11; doi:10.3390/ijerph15010011
Received: 31 October 2017 / Revised: 18 December 2017 / Accepted: 19 December 2017 / Published: 22 December 2017
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Abstract
Nearly three billion people worldwide burn solid fuels and kerosene in open fires and inefficient stoves to cook, light, and heat their homes. Cleaner-burning stoves reduce emissions and can have positive health, climate, and women’s empowerment benefits. This article reports on the protocol
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Nearly three billion people worldwide burn solid fuels and kerosene in open fires and inefficient stoves to cook, light, and heat their homes. Cleaner-burning stoves reduce emissions and can have positive health, climate, and women’s empowerment benefits. This article reports on the protocol and baseline data from the evaluation of four behavior change communication (BCC) campaigns carried out in lower to middle income countries aimed at promoting the sale and use of cleaner-burning stoves. Interventions implemented in Bangladesh, Kenya, and Nigeria are using a range of BCC methods including mass media, digital media, outdoor advertising, and inter-personal communication. The mixed methods evaluation comprises three large-scale surveys: one pre-BCC and two follow-ups, along with smaller scale assessments of stove uptake and patterns of use. Baseline results revealed varying levels of awareness of previous promotions and positive attitudes and beliefs about modern (i.e., relatively clean-burning) cookstoves. Differences in cookstove preferences and behaviors by gender, socio-demographics, media use, and country/region were observed that may affect outcomes. Across all three countries, cost (lack of funds) a key perceived barrier to buying a cleaner-burning stove. Future multivariate analyses will examine potential dose-response effects of BCC on cookstove uptake and patterns of use. BCC campaigns have the potential to promote modern cookstoves at scale. More research on campaign effectiveness is needed, and on how to optimize messages and channels. This evaluation builds on a limited evidence base in the field. Full article
(This article belongs to the Special Issue Environmental Hygiene)
Open AccessArticle Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes
Int. J. Environ. Res. Public Health 2018, 15(1), 12; doi:10.3390/ijerph15010012
Received: 24 November 2017 / Revised: 19 December 2017 / Accepted: 21 December 2017 / Published: 23 December 2017
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Abstract
(1) Background: Many smokers completely switch to vaping (switchers), whereas others use e-cigarettes (e-cigs) alongside tobacco cigarettes (dual users). To the extent that dual users substantially lower the number of cigarettes, they will reduce health risks from smoking. However, from a medical point
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(1) Background: Many smokers completely switch to vaping (switchers), whereas others use e-cigarettes (e-cigs) alongside tobacco cigarettes (dual users). To the extent that dual users substantially lower the number of cigarettes, they will reduce health risks from smoking. However, from a medical point of view, exclusive vaping is preferable to dual use; (2) Methods: Using an online questionnaire we assessed behavioral, cognitive and attitudinal aspects of e-cig use in smoking and ex-smoking vapers; (3) Results: Our sample consisted of 19% dual users and 81% switchers. Before e-cig initiation, both groups smoked on average 22 cigarettes per day (CPD). After e-cig initiation, dual users decreased tobacco consumption by 82% and were low-to-moderately cigarette dependent. Both groups had been vaping for on average 22 months, were highly e-cig dependent, used state-of-the-art e-cigs, nicotine concentrations of 4–8 mg/mL and often flavors other than tobacco. Dual users used substantially less e-liquid per week than switchers but reported a similar number of puffs/day, experienced less e-cig efficacy, more practical problems, more negative and less positive consequences, and endorsed smoking reduction (rather than quitting) as a more important reason to start vaping. For both groups, e-cig risk perception was low and little stigmatization was experienced. Dual users preferred tobacco cigarettes in stressful situations and when rapid nicotine uptake is required. E-cigs were preferred where cigarettes are prohibited and to reduce second-hand smoke; (4) Conclusions: Differences between dual users and switchers center around variables proximal to the vaping behavior and its experienced effects rather than hinging on more general vaping-related beliefs and attitudes. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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Open AccessArticle On the Impact of Anomalous Noise Events on Road Traffic Noise Mapping in Urban and Suburban Environments
Int. J. Environ. Res. Public Health 2018, 15(1), 13; doi:10.3390/ijerph15010013
Received: 3 November 2017 / Revised: 19 December 2017 / Accepted: 21 December 2017 / Published: 23 December 2017
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Abstract
Noise pollution is a critical factor affecting public health, the relationship between road traffic noise (RTN) and several diseases in urban areas being especially disturbing. The Environmental Noise Directive 2002/49/EC and the CNOSSOS-EU framework are the main instruments of the European Union to
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Noise pollution is a critical factor affecting public health, the relationship between road traffic noise (RTN) and several diseases in urban areas being especially disturbing. The Environmental Noise Directive 2002/49/EC and the CNOSSOS-EU framework are the main instruments of the European Union to identify and combat noise pollution, requiring Member States to compose and publish noise maps and noise management action plans every five years. Nowadays, the noise maps are starting to be tailored by means of Wireless Acoustic Sensor Networks (WASN). In order to exclusively monitor the impact of RTN on the well-being of citizens through WASN-based approaches, those noise sources unrelated to RTN denoted as Anomalous Noise Events (ANEs) should be removed from the noise map generation. This paper introduces an analysis methodology considering both Signal-to-Noise Ratio (SNR) and duration of ANEs to evaluate their impact on the A-weighted equivalent RTN level calculation for different integration times. The experiments conducted on 9 h of real-life data from the WASN-based DYNAMAP project show that both individual high-impact events and aggregated medium-impact events bias significantly the equivalent noise levels of the RTN map, making any derived study about public health impact inaccurate. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Oral Health Status and Behavior among Cancer Survivors in Korea Using Nationwide Survey
Int. J. Environ. Res. Public Health 2018, 15(1), 14; doi:10.3390/ijerph15010014
Received: 20 November 2017 / Revised: 14 December 2017 / Accepted: 20 December 2017 / Published: 23 December 2017
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Abstract
Cancer survivors remain at life-long risk of developing oral complications. This study investigated the oral health status and behavior among cancer survivors in comparison to subjects without a history of cancer using a nationwide survey. Cancer survivors and control subjects were selected from
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Cancer survivors remain at life-long risk of developing oral complications. This study investigated the oral health status and behavior among cancer survivors in comparison to subjects without a history of cancer using a nationwide survey. Cancer survivors and control subjects were selected from the sixth Korean National Health and Nutrition Examination Survey (2013–2015). Survivors reported chewing (34.8%) and speaking difficulties (15.3%) resulting from oral health problems. More than 36% of survivors had periodontal disease and 15.9% needed dentures. In multiple logistic regression analysis, age, household income, education level, smoking status, cancer site, and current cancer status were associated with oral health status. Approximately 43.3% of cancer survivors brushed their teeth more than three times a day. In addition, 44.9% of survivors used secondary oral products, and 30.8% had been screened for oral health problems over the past year. Age, household income and education level were associated with oral health behavior. The oral health status and behavior excepting periodontal disease and the use of secondary oral products were not significantly different between cancer survivors and controls. Although oral health status of cancer survivors was not worse than that of controls, more than half of the survivors maintained unhealthy oral practices. Full article
Open AccessArticle 1950MHz Radio Frequency Electromagnetic Radiation Inhibits Testosterone Secretion of Mouse Leydig Cells
Int. J. Environ. Res. Public Health 2018, 15(1), 17; doi:10.3390/ijerph15010017
Received: 25 October 2017 / Revised: 5 December 2017 / Accepted: 18 December 2017 / Published: 23 December 2017
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Abstract
More studies that are focused on the bioeffects of radio-frequency (RF) electromagnetic radiation that is generated from the communication devices, but there were few reports with confirmed results about the bioeffects of RF radiation on reproductive cells. To explore the effects of 1950
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More studies that are focused on the bioeffects of radio-frequency (RF) electromagnetic radiation that is generated from the communication devices, but there were few reports with confirmed results about the bioeffects of RF radiation on reproductive cells. To explore the effects of 1950 MHz RF electromagnetic radiation (EMR) on mouse Leydig (TM3) cells. TM3 cells were irradiated or sham-irradiated continuously for 24 h by the specific absorption rate (SAR) 3 W/kg radiation. At 0, 1, 2, 3, 4, and 5 days after irradiation, cell proliferation was detected by cell counting kit-8 (CCK-8) method, cell cycle distribution, percentage of apoptosis, and cellular reactive oxygen species (ROS) were examined by flow cytometry, Testosterone level was measured using enzyme-linked immunosorbent assay (ELISA) assay, messenger ribonucleic acid (mRNA) expression level of steroidogenic acute regulatory protein (StAR) and P450scc in TM3 cells was detected by real-time polymerase chain reaction (PCR). After being irradiated for 24 h, cell proliferation obviously decreased and cell cycle distribution, secretion capacity of Testosterone, and P450scc mRNA level were reduced. While cell apoptosis, ROS, and StAR mRNA level did not change significantly. The current results indicated that 24 h of exposure at 1950 MHz 3 W/kg radiation could cause some adverse effects on TM3 cells proliferation and Testosterone secretion, further studies about the biological effects in the reproductive system that are induced by RF radiation are also needed. Full article
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Open AccessArticle Indigenous Infant Mortality by Age and Season of Birth, 1800–1899: Did Season of Birth Affect Children’s Chances for Survival?
Int. J. Environ. Res. Public Health 2018, 15(1), 18; doi:10.3390/ijerph15010018
Received: 16 October 2017 / Revised: 1 December 2017 / Accepted: 20 December 2017 / Published: 23 December 2017
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Abstract
This paper focuses on the influence of season of birth on infant mortality among the Sami and non-Sami populations in northern Sweden during the nineteenth century. The source material is a set of data files from the Demographic Data Base at Umeå University,
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This paper focuses on the influence of season of birth on infant mortality among the Sami and non-Sami populations in northern Sweden during the nineteenth century. The source material is a set of data files from the Demographic Data Base at Umeå University, making it possible to combine age at death (in days), month of death, and month of birth over the course of the entire century. Cox regression models reveal that for the first week of life, season of birth had no influence on the risk of mortality. For the Sami, the results showed that being born during winter was related to a higher risk of neonatal mortality, and being born during summer was related to a higher risk of mortality after six months of age. Furthermore, for the Sami, the neonatal mortality showed a U-shaped pattern with a minimum in June–August, whereas the corresponding pattern among the non-Sami was flatter. The findings shed light on vulnerability in two populations sharing the same environment, but diverging in terms of social, economic, and cultural factors. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
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Open AccessArticle Is There Any Relationship between Plasma 25-Hydroxyvitamin D3, Adipokine Profiles and Excessive Body Weight in Type 2 Diabetic Patients?
Int. J. Environ. Res. Public Health 2018, 15(1), 19; doi:10.3390/ijerph15010019
Received: 7 November 2017 / Revised: 17 December 2017 / Accepted: 20 December 2017 / Published: 23 December 2017
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Abstract
A growing interest in the role of vitamin D in metabolic diseases led us to study the relationships between 25-hydroxyvitamin D3 (25(OH)D3) and the profiles of selected adipokines in type 2 diabetic (T2DM) patients. The study comprised 92 type 2
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A growing interest in the role of vitamin D in metabolic diseases led us to study the relationships between 25-hydroxyvitamin D3 (25(OH)D3) and the profiles of selected adipokines in type 2 diabetic (T2DM) patients. The study comprised 92 type 2 diabetics divided into quartiles regarding 25(OH)D3 concentration. Each group was divided into male and female subgroups. All the studied patients had their anthropometric and biochemical parameters determined. Plasma 25-hydroxyvitamin D3 concentration was determined by HPLC, while the selected adipokines (leptin, adiponectin, resistin and visfatin) by ELISA methods. The ratio of leptin to adiponectin (L/A) was calculated for all the patients. In 85.3% of diabetics a full (<20 ng/mL) or moderate (20–30 ng/mL) vitamin D deficit was found. Irrespective of sex, plasma leptin concentration decreased across increasing quartiles of 25(OH)D3 level. In women, 25(OH)D3 was negatively correlated with BMI, leptin level as well as L/A ratio, and positively with adiponectin concentration. In men, 25(OH)D3 was positively correlated with HDL and negatively with systolic blood pressure (SBP), leptin level and L/A ratio. Considering all the patients, there ocurred a significant negative correlation between 25(OH)D3 and SBP, BMI, WHR, TG, leptin and L/A ratio and positive ones between 25(OH)D3 and both adiponectin and HDL. The results of the study support the existence of the relationship among vitamin D, obesity and leptin in type 2 diabetic patients. Full article
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Open AccessArticle Forecasting the Amount of Waste-Sewage Water Discharged into the Yangtze River Basin Based on the Optimal Fractional Order Grey Model
Int. J. Environ. Res. Public Health 2018, 15(1), 20; doi:10.3390/ijerph15010020
Received: 20 November 2017 / Revised: 19 December 2017 / Accepted: 20 December 2017 / Published: 23 December 2017
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Abstract
With the rapid development of the Yangtze River economic belt, the amount of waste-sewage water discharged into the Yangtze River basin increases sharply year by year, which has impeded the sustainable development of the Yangtze River basin. The water security along the Yangtze
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With the rapid development of the Yangtze River economic belt, the amount of waste-sewage water discharged into the Yangtze River basin increases sharply year by year, which has impeded the sustainable development of the Yangtze River basin. The water security along the Yangtze River basin is very important for China, It is something aboutwater security of roughly one-third of China’s population and the sustainable development of the 19 provinces, municipalities and autonomous regions among the Yangtze River basin. Therefore, a scientific prediction of the amount of waste-sewage water discharged into Yangtze River basin has a positive significance on sustainable development of industry belt along with Yangtze River basin. This paper builds the fractional DWSGM(1,1)(DWSGM(1,1) model is short for Discharge amount of Waste Sewage Grey Model for one order equation and one variable) model based on the fractional accumulating generation operator and fractional reducing operator, and calculates the optimal order of “r” by using particle swarm optimization(PSO)algorithm for solving the minimum average relative simulation error. Meanwhile, the simulation performance of DWSGM(1,1)model with the optimal fractional order is tested by comparing the simulation results of grey prediction models with different orders. Finally, the optimal fractional order DWSGM(1,1)grey model is applied to predict the amount of waste-sewage water discharged into the Yangtze River basin, and corresponding countermeasures and suggestions are put forward through analyzing and comparing the prediction results. This paper has positive significance on enriching the fractional order modeling method of the grey system. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessFeature PaperArticle Exposure to Ambient Fine Particulate Air Pollution in Utero as a Risk Factor for Child Stunting in Bangladesh
Int. J. Environ. Res. Public Health 2018, 15(1), 22; doi:10.3390/ijerph15010022
Received: 8 November 2017 / Revised: 20 December 2017 / Accepted: 21 December 2017 / Published: 23 December 2017
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Abstract
Pregnant mothers in Bangladesh are exposed to very high and worsening levels of ambient air pollution. Maternal exposure to fine particulate matter has been associated with low birth weight at much lower levels of exposure, leading us to suspect the potentially large effects
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Pregnant mothers in Bangladesh are exposed to very high and worsening levels of ambient air pollution. Maternal exposure to fine particulate matter has been associated with low birth weight at much lower levels of exposure, leading us to suspect the potentially large effects of air pollution on stunting in children in Bangladesh. We estimate the relationship between exposure to air pollution in utero and child stunting by pooling outcome data from four waves of the nationally representative Bangladesh Demographic and Health Survey conducted between 2004 and 2014, and calculating children’s exposure to ambient fine particulate matter in utero using high resolution satellite data. We find significant increases in the relative risk of child stunting, wasting, and underweight with higher levels of in utero exposure to air pollution, after controlling for other factors that have been found to contribute to child anthropometric failure. We estimate the relative risk of stunting in the second, third, and fourth quartiles of exposure as 1.074 (95% confidence interval: 1.014–1.138), 1.150 (95% confidence interval: 1.069–1.237, and 1.132 (95% confidence interval: 1.031–1.243), respectively. Over half of all children in Bangladesh in our sample were exposed to an annual ambient fine particulate matter level in excess of 46 µg/m3; these children had a relative risk of stunting over 1.13 times that of children in the lowest quartile of exposure. Reducing air pollution in Bangladesh could significantly contribute to the Sustainable Development Goal of reducing child stunting. Full article
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Open AccessArticle Preparation and Optimisation of Cross-Linked Enzyme Aggregates Using Native Isolate White Rot Fungi Trametes versicolor and Fomes fomentarius for the Decolourisation of Synthetic Dyes
Int. J. Environ. Res. Public Health 2018, 15(1), 23; doi:10.3390/ijerph15010023
Received: 23 October 2017 / Revised: 11 December 2017 / Accepted: 12 December 2017 / Published: 23 December 2017
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Abstract
The key to obtaining an optimum performance of an enzyme is often a question of devising a suitable enzyme and optimisation of conditions for its immobilization. In this study, laccases from the native isolates of white rot fungi Fomes fomentarius and/or Trametes versicolor
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The key to obtaining an optimum performance of an enzyme is often a question of devising a suitable enzyme and optimisation of conditions for its immobilization. In this study, laccases from the native isolates of white rot fungi Fomes fomentarius and/or Trametes versicolor, obtained from Czech forests, were used. From these, cross-linked enzyme aggregates (CLEA) were prepared and characterised when the experimental conditions were optimized. Based on the optimization steps, saturated ammonium sulphate solution (75 wt.%) was used as the precipitating agent, and different concentrations of glutaraldehyde as a cross-linking agent were investigated. CLEA aggregates formed under the optimal conditions showed higher catalytic efficiency and stabilities (thermal, pH, and storage, against denaturation) as well as high reusability compared to free laccase for both fungal strains. The best concentration of glutaraldehyde seemed to be 50 mM and higher efficiency of cross-linking was observed at a low temperature 4 °C. An insignificant increase in optimum pH for CLEA laccases with respect to free laccases for both fungi was observed. The results show that the optimum temperature for both free laccase and CLEA laccase was 35 °C for T. versicolor and 30 °C for F. fomentarius. The CLEAs retained 80% of their initial activity for Trametes and 74% for Fomes after 70 days of cultivation. Prepared cross-linked enzyme aggregates were also investigated for their decolourisation activity on malachite green, bromothymol blue, and methyl red dyes. Immobilised CLEA laccase from Trametes versicolor showed 95% decolourisation potential and CLEA from Fomes fomentarius demonstrated 90% decolourisation efficiency within 10 h for all dyes used. These results suggest that these CLEAs have promising potential in dye decolourisation. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle Concept of Aided Phytostabilization of Contaminated Soils in Postindustrial Areas
Int. J. Environ. Res. Public Health 2018, 15(1), 24; doi:10.3390/ijerph15010024
Received: 3 November 2017 / Revised: 20 December 2017 / Accepted: 21 December 2017 / Published: 23 December 2017
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Abstract
The experiment was carried out in order to evaluate the effects of trace element immobilizing soil amendments, i.e., chalcedonite, dolomite, halloysite, and diatomite on the chemical characteristics of soil contaminated with Cr and the uptake of metals by plants. The study utilized analysis
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The experiment was carried out in order to evaluate the effects of trace element immobilizing soil amendments, i.e., chalcedonite, dolomite, halloysite, and diatomite on the chemical characteristics of soil contaminated with Cr and the uptake of metals by plants. The study utilized analysis of variance (ANOVA), principal component analysis (PCA) and Factor Analysis (FA). The content of trace elements in plants, pseudo-total and extracted by 0.01 M CaCl2, were determined using the method of spectrophotometry. All of the investigated element contents in the tested parts of Indian mustard (Brassica juncea L.) differed significantly in the case of applying amendments to the soil, as well as Cr contamination. The greatest average above-ground biomass was observed when halloysite and dolomite were amended to the soil. Halloysite caused significant increases of Cr concentrations in the roots. The obtained values of bioconcentration and translocation factors observed for halloysite treatment indicate the effectiveness of using Indian mustard in phytostabilization techniques. The addition of diatomite significantly increased soil pH. Halloysite and chalcedonite were shown to be the most effective and decreased the average Cr, Cu and Zn contents in soil. Full article
(This article belongs to the Special Issue Soil Pollution and Remediation)
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Open AccessArticle Diabetic Ketoacidosis Severity at Diagnosis and Glycaemic Control in the First Year of Childhood Onset Type 1 Diabetes—A Longitudinal Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(1), 26; doi:10.3390/ijerph15010026
Received: 19 October 2017 / Revised: 15 December 2017 / Accepted: 18 December 2017 / Published: 25 December 2017
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Abstract
It is unclear whether diabetic ketoacidosis (DKA) severity at diagnosis affects the natural history of type 1 diabetes (T1D). We analysed associations between DKA severity at diagnosis and glycaemic control during the first year post-diagnosis. We followed 341 children with T1D, <19 years
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It is unclear whether diabetic ketoacidosis (DKA) severity at diagnosis affects the natural history of type 1 diabetes (T1D). We analysed associations between DKA severity at diagnosis and glycaemic control during the first year post-diagnosis. We followed 341 children with T1D, <19 years (64% non-white) attending paediatric diabetes clinics in East London. Data were extracted from routine medical registers. Subjects were categorized with normal, mild, moderate, or severe DKA. Linear mixed-effects modelling was used to assess differences in longitudinal HbA1c trajectories (glycaemic control) during 12 months post-diagnosis (1288 HbA1c data-points) based on DKA, adjusting for sex, age, ethnicity, SES (Socioeconomic Status) and treatment type. Females (OR 1.6, 95% CI 1.1–2.4) and younger age, 0–6 vs. 13–18 years (OR 2.9, 95% CI 1.5–5.6) had increased risk for DKA at diagnosis. Moderate or severe DKA was associated with higher HbA1c at diagnosis (adjusted estimates 8 mmol/mol, 2–14, and 10 mmol/mol, 4–15, respectively, compared to normal DKA). Differences in HbA1c trajectories by DKA were no longer apparent at six months post-diagnosis. All subjects experienced a steep decrease in HbA1c during the first three months followed by a gradual increase. While, DKA severity was not associated with glycaemic control at 12 months post-diagnosis, age at diagnosis, ethnicity, gender, and treatment type were significantly associated. For example, Black and mixed ethnicity children had increased risk for poor glycaemic control compared to White children (adjusted RRR 5.4, 95% CI 1.7–17.3 and RRR 2.5, 95% CI 1.2–6.0, respectively). DKA severity at diagnosis is associated with higher initial HbA1c but not glycaemic control from six months post-diagnosis. Age at diagnosis, ethnicity, gender, and insulin pump are associated with glycaemic control at one year post-diagnosis. Full article
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Open AccessArticle Association between Exposure to Ambient Air Particulates and Metabolic Syndrome Components in a Saudi Arabian Population
Int. J. Environ. Res. Public Health 2018, 15(1), 27; doi:10.3390/ijerph15010027
Received: 3 December 2017 / Revised: 14 December 2017 / Accepted: 19 December 2017 / Published: 25 December 2017
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Abstract
Recent epidemiological evidence suggests that exposure to particulates may be a factor in the etiology of metabolic syndrome (MetS). In this novel study, we investigated the relationship between particulate levels and prevalence of MetS component abnormalities (hypertension, hyperglycemia, obesity) in a recruited cohort
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Recent epidemiological evidence suggests that exposure to particulates may be a factor in the etiology of metabolic syndrome (MetS). In this novel study, we investigated the relationship between particulate levels and prevalence of MetS component abnormalities (hypertension, hyperglycemia, obesity) in a recruited cohort (N = 2025) in Jeddah, Saudi Arabia. We observed significant associations between a 10 μg/m3 increase in PM2.5 and increased risks for MetS (Risk Ratio (RR): 1.12; 95% Confidence Interval (CI): 1.06–1.19), hyperglycemia (RR: 1.08; 95% CI: 1.03–1.14), and hypertension (RR: 1.09; 95% CI: 1.04–1.14). PM2.5 from soil/road dust was found to be associated with hyperglycemia (RR: 1.12; 95% CI: 1.06–1.19) and hypertension (RR: 1.11; 95% CI: 1.05–1.18), while PM2.5 from traffic was associated with hyperglycemia (RR: 1.33; 95% CI: 1.05–1.71). We did not observe any health associations with source-specific mass exposures. Our findings suggest that exposure to specific elemental components of PM2.5, especially Ni, may contribute to the development of cardiometabolic disorders. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Mortality Rate Associated with Admission Hyperglycemia in Traumatic Femoral Fracture Patients Is Greater Than Non-Diabetic Normoglycemic Patients but Not Diabetic Normoglycemic Patients
Int. J. Environ. Res. Public Health 2018, 15(1), 28; doi:10.3390/ijerph15010028
Received: 25 September 2017 / Revised: 27 November 2017 / Accepted: 21 December 2017 / Published: 25 December 2017
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Abstract
Background: Admission hyperglycemia is associated with increased morbidity and mortality in trauma patients. However, admission hyperglycemia is not only associated with stress-induced hyperglycemia (SIH) but also with diabetic hyperglycemia (DH); furthermore, patients with normoglycemia may not only have non-diabetic normoglycemia (NDN) but also
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Background: Admission hyperglycemia is associated with increased morbidity and mortality in trauma patients. However, admission hyperglycemia is not only associated with stress-induced hyperglycemia (SIH) but also with diabetic hyperglycemia (DH); furthermore, patients with normoglycemia may not only have non-diabetic normoglycemia (NDN) but also have a possibility of diabetic normoglycemia (DN), with the diabetes under control. This study aimed to assess the effects of SIH and DH on the mortality outcomes of traumatic femoral fracture patients with NDN and DN. Methods: Admission hyperglycemia was diagnosed as a serum glucose ≥200 mg/dL upon arrival at the emergency department. Diabetes mellitus (DM) was determined by patient history and/or admission HbA1c ≥ 6.5%. DH and SIH were diagnosed by admission hyperglycemia in patients with and without DM. DN and NDN were determined by absence of admission hyperglycemia in patients with and without DM. These patients were allocated into four groups: SIH (n = 75), DH (n = 280), DN (n = 309), and NDN (n = 1326), with detailed information retracted from the Trauma Registry System at a level I trauma center between 1 January 2009, and 31 December 2016. Patients with incomplete registered data were excluded. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for mortality were estimated through a stepwise model selection of a multiple regression model that was adjusted by controlling the cofounding variables such age, sex, co-morbidities, and Injury Severity Score. Results: Compared to NDN, a 9.8-fold (95% CI 1.54–62.05; p = 0.016) and a 5.8-fold (95% CI 1.46–22.67; p = 0.012) increase in the adjusted mortality odds ratio of patients with SIH and DH, respectively, were found in this study. In addition, the adjusted odds of mortality between SIH (AOR = 0.3; 95% CI 0.03–2.99; p = 0.302) as well as DH patients (AOR = 0.6; 95% CI 0.20–1.89; p = 0.394) and DN patients had no significant difference. Conclusions: This study demonstrated that SIH and DH patients with traumatic femoral fractures had higher mortality when compared with NDN patients, but not when compared with DN patients, with or without adjustment of the differences in patient’s age, sex, co-morbidities, and injury severity. Full article
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Open AccessArticle Stimulating Parenting Practices in Indigenous and Non-Indigenous Mexican Communities
Int. J. Environ. Res. Public Health 2018, 15(1), 29; doi:10.3390/ijerph15010029
Received: 16 October 2017 / Revised: 11 December 2017 / Accepted: 11 December 2017 / Published: 25 December 2017
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Abstract
Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range
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Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range of child-level (age; sex; and cognitive and socio-emotional development); household-level (indigenous ethnicity; poverty; and parental education); and community-level (economic marginalization and majority indigenous population) variables among 1893 children ages 4–18 months in poor; rural communities in Mexico. We also explored modifiers of associations between living in an indigenous community and parenting. Key findings were that stimulating parenting was negatively associated with living in an indigenous community or family self-identification as indigenous (β = −4.25; SE (Standard Error) = 0.98; β = −1.58; SE = 0.83 respectively). However; living in an indigenous community was associated with significantly more stimulating parenting among indigenous families than living in a non-indigenous community (β = 2.96; SE = 1.25). Maternal education was positively associated with stimulating parenting only in indigenous communities; and household crowding was negatively associated with stimulating parenting only in non-indigenous communities. Mothers’ parenting practices were not associated with child sex; father’s residential status; education; or community marginalization. Our findings demonstrate that despite greater community marginalization; living in an indigenous community is protective for stimulating parenting practices of indigenous mothers. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
Open AccessArticle Emotional Regulation in Young Adults with Internet Gaming Disorder
Int. J. Environ. Res. Public Health 2018, 15(1), 30; doi:10.3390/ijerph15010030
Received: 5 November 2017 / Revised: 8 December 2017 / Accepted: 22 December 2017 / Published: 25 December 2017
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Abstract
People diagnosed with Internet gaming disorder (IGD) have been frequently reported to experience depression, anxiety, and hostility. Emotional regulation contributes to these mood symptoms. This study evaluated emotional regulation in subjects with IGD and examined relationships between emotional regulation, depression, anxiety, and hostility
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People diagnosed with Internet gaming disorder (IGD) have been frequently reported to experience depression, anxiety, and hostility. Emotional regulation contributes to these mood symptoms. This study evaluated emotional regulation in subjects with IGD and examined relationships between emotional regulation, depression, anxiety, and hostility in young adults with IGD. We recruited 87 people with IGD and a control group of 87 people without a history of IGD. All participants underwent a diagnostic interview based on the IGD criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and they completed a questionnaire on emotional regulation, depression, anxiety, and hostility. We found that subjects with IGD were less likely to practice cognitive reappraisal and were more likely to suppress their emotions. Linear regression revealed the higher cognitive reappraisal and lower expressive suppression associated with depression, anxiety, and hostility among subjects with IGD. The emotional regulation strategies that characterize those with IGD could be contributing factors to the depression and hostility tendencies of these people. When treating patients with IGD, in addition to providing appropriate interventions to relieve depression and hostility, practitioners should effectively assess emotional regulation strategies and provide emotional regulation therapy to prevent a vicious cycle of negative emotions. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
Open AccessArticle Contact to Nature Benefits Health: Mixed Effectiveness of Different Mechanisms
Int. J. Environ. Res. Public Health 2018, 15(1), 31; doi:10.3390/ijerph15010031
Received: 31 October 2017 / Revised: 5 December 2017 / Accepted: 12 December 2017 / Published: 25 December 2017
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Abstract
How can urban nature contribute to the reduction of chronic stress? We twice measured the concentration of the “stress hormone” cortisol in the hair of 85 volunteer gardeners (six months apart), relating cortisol level change to (self-reported) characteristics of their recreational activities. Both
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How can urban nature contribute to the reduction of chronic stress? We twice measured the concentration of the “stress hormone” cortisol in the hair of 85 volunteer gardeners (six months apart), relating cortisol level change to (self-reported) characteristics of their recreational activities. Both time spent in nature and physical activity led to decreases in cortisol, while time spent being idle led to an increase. At high levels of present stressors, however, the relationship for time spent in nature and for idleness was reversed. Time spent with social interaction had no effect on cortisol levels. Our results indicate that physical activity is an effective means of mitigating the negative effects of chronic stress. The results regarding the time spent in nature and time spent being idle are less conclusive, suggesting the need for more research. We conclude that if chronic stress cannot be abolished by eradicating its sources, public health may take to measures to reduce it—providing urban nature being one effective possibility. Full article
(This article belongs to the Special Issue Stress and Health)
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Open AccessArticle Environment-Aware Production Scheduling for Paint Shops in Automobile Manufacturing: A Multi-Objective Optimization Approach
Int. J. Environ. Res. Public Health 2018, 15(1), 32; doi:10.3390/ijerph15010032
Received: 22 November 2017 / Revised: 19 December 2017 / Accepted: 20 December 2017 / Published: 25 December 2017
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Abstract
The traditional way of scheduling production processes often focuses on profit-driven goals (such as cycle time or material cost) while tending to overlook the negative impacts of manufacturing activities on the environment in the form of carbon emissions and other undesirable by-products. To
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The traditional way of scheduling production processes often focuses on profit-driven goals (such as cycle time or material cost) while tending to overlook the negative impacts of manufacturing activities on the environment in the form of carbon emissions and other undesirable by-products. To bridge the gap, this paper investigates an environment-aware production scheduling problem that arises from a typical paint shop in the automobile manufacturing industry. In the studied problem, an objective function is defined to minimize the emission of chemical pollutants caused by the cleaning of painting devices which must be performed each time before a color change occurs. Meanwhile, minimization of due date violations in the downstream assembly shop is also considered because the two shops are interrelated and connected by a limited-capacity buffer. First, we have developed a mixed-integer programming formulation to describe this bi-objective optimization problem. Then, to solve problems of practical size, we have proposed a novel multi-objective particle swarm optimization (MOPSO) algorithm characterized by problem-specific improvement strategies. A branch-and-bound algorithm is designed for accurately assessing the most promising solutions. Finally, extensive computational experiments have shown that the proposed MOPSO is able to match the solution quality of an exact solver on small instances and outperform two state-of-the-art multi-objective optimizers in literature on large instances with up to 200 cars. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Modelling the Transmission Dynamics and Control of Mumps in Mainland China
Int. J. Environ. Res. Public Health 2018, 15(1), 33; doi:10.3390/ijerph15010033
Received: 15 November 2017 / Revised: 17 December 2017 / Accepted: 22 December 2017 / Published: 26 December 2017
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Abstract
Mumps is a common childhood viral disease and children have been vaccinated throughout the world since 1967. The incidence of mumps has increased with more than 300,000 young people infected with mumps annually in mainland China since 2005. Therefore, we designed and analyzed
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Mumps is a common childhood viral disease and children have been vaccinated throughout the world since 1967. The incidence of mumps has increased with more than 300,000 young people infected with mumps annually in mainland China since 2005. Therefore, we designed and analyzed long-term mumps surveillance data in an SVEILR (susceptible–vaccinated–exposed–severely infectious–mildly infectious–recovered) dynamic transmission model with optimized parameter values to describe the dynamics of mumps infections in China. There were 18.02% of mumps infected young adults seeking medical advice. The vaccine coverage has been insufficient in China. Young adults with frequent contact and mild infection were identified as a major driver of mumps epidemics. The reproduction number of mumps was determined 4.28 in China. Sensitivity analysis of the basic reproduction number and the endemic equilibrium was conducted to evaluate the effectiveness of mumps control measures. We propose to increase the vaccine coverage and make two doses of MMR (Measles, mumps and rubella) vaccines freely available in China. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Comparison Study on the Estimation of the Spatial Distribution of Regional Soil Metal(loid)s Pollution Based on Kriging Interpolation and BP Neural Network
Int. J. Environ. Res. Public Health 2018, 15(1), 34; doi:10.3390/ijerph15010034
Received: 27 November 2017 / Revised: 20 December 2017 / Accepted: 22 December 2017 / Published: 26 December 2017
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Abstract
Soil pollution by metal(loid)s resulting from rapid economic development is a major concern. Accurately estimating the spatial distribution of soil metal(loid) pollution has great significance in preventing and controlling soil pollution. In this study, 126 topsoil samples were collected in Kunshan City and
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Soil pollution by metal(loid)s resulting from rapid economic development is a major concern. Accurately estimating the spatial distribution of soil metal(loid) pollution has great significance in preventing and controlling soil pollution. In this study, 126 topsoil samples were collected in Kunshan City and the geo-accumulation index was selected as a pollution index. We used Kriging interpolation and BP neural network methods to estimate the spatial distribution of arsenic (As) and cadmium (Cd) pollution in the study area. Additionally, we introduced a cross-validation method to measure the errors of the estimation results by the two interpolation methods and discussed the accuracy of the information contained in the estimation results. The conclusions are as follows: data distribution characteristics, spatial variability, and mean square errors (MSE) of the different methods showed large differences. Estimation results from BP neural network models have a higher accuracy, the MSE of As and Cd are 0.0661 and 0.1743, respectively. However, the interpolation results show significant skewed distribution, and spatial autocorrelation is strong. Using Kriging interpolation, the MSE of As and Cd are 0.0804 and 0.2983, respectively. The estimation results have poorer accuracy. Combining the two methods can improve the accuracy of the Kriging interpolation and more comprehensively represent the spatial distribution characteristics of metal(loid)s in regional soil. The study may provide a scientific basis and technical support for the regulation of soil metal(loid) pollution. Full article
(This article belongs to the Special Issue Soil Pollution and Remediation)
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Open AccessArticle Aerobic Biodegradation Characteristic of Different Water-Soluble Azo Dyes
Int. J. Environ. Res. Public Health 2018, 15(1), 35; doi:10.3390/ijerph15010035
Received: 10 November 2017 / Revised: 17 December 2017 / Accepted: 20 December 2017 / Published: 26 December 2017
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Abstract
This study investigated the biodegradation performance and characteristics of Sudan I and Acid Orange 7 (AO7) to improve the biological dye removal efficiency in wastewater and optimize the treatment process. The dyes with different water-solubility and similar molecular structure were biologically treated under
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This study investigated the biodegradation performance and characteristics of Sudan I and Acid Orange 7 (AO7) to improve the biological dye removal efficiency in wastewater and optimize the treatment process. The dyes with different water-solubility and similar molecular structure were biologically treated under aerobic condition in parallel continuous-flow mixed stirred reactors. The biophase analysis using microscopic examination suggested that the removal process of the two azo dyes is different. Removal of Sudan I was through biosorption, since it easily assembled and adsorbed on the surface of zoogloea due to its insolubility, while AO7 was biodegraded incompletely and bioconverted, the AO7 molecule was decomposed to benzene series and inorganic ions, since it could reach the interior area of zoogloea due to the low oxidation-reduction potential conditions and corresponding anaerobic microorganisms. The transformation of NH3-N, SO42− together with the presence of tryptophan-like components confirm that AO7 can be decomposed to non-toxic products in an aerobic bioreactor. This study provides a theoretical basis for the use of biosorption or biodegradation mechanisms for the treatment of different azo dyes in wastewater. Full article
(This article belongs to the Special Issue Remediation and Analysis of Soil, Air, and Water Pollution)
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Open AccessArticle Risk Assessment and Implication of Human Exposure to Road Dust Heavy Metals in Jeddah, Saudi Arabia
Int. J. Environ. Res. Public Health 2018, 15(1), 36; doi:10.3390/ijerph15010036
Received: 16 November 2017 / Revised: 11 December 2017 / Accepted: 13 December 2017 / Published: 26 December 2017
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Abstract
Data dealing with the assessment of heavy metal pollution in road dusts in Jeddah, Saudi Arabia and its implication to human health risk of human exposure to heavy metals, are scarce. Road dusts were collected from five different functional areas (traffic areas (TA),
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Data dealing with the assessment of heavy metal pollution in road dusts in Jeddah, Saudi Arabia and its implication to human health risk of human exposure to heavy metals, are scarce. Road dusts were collected from five different functional areas (traffic areas (TA), parking areas (PA), residential areas (RA), mixed residential commercial areas (MCRA) and suburban areas (SA)) in Jeddah and one in a rural area (RUA) in Hada Al Sham. We aimed to measure the pollution levels of heavy metals and estimate their health risk of human exposure applying risk assessment models described by United States Environmental Protection Agency (USEPA). Using geo-accumulation index (Igeo), the pollution level of heavy metals in urban road dusts was in the following order Cd > As > Pb > Zn > Cu > Ni > Cr > V > Mn > Co > Fe. Urban road dust was found to be moderately to heavily contaminated with As, Pb and Zn, and heavily to extremely contaminated with Cd. Calculation of enrichment factor (EF) revealed that heavy metals in TA had the highest values compared to that of the other functional areas. Cd, As, Pb, Zn and Cu were severely enriched, while Mn, V, Co, Ni and Cr were moderately enriched. Fe was considered as a natural element and consequently excluded. The concentrations of heavy metals in road dusts of functional areas were in the following order: TA > PA > MCRA > SA > RA > RUA. The study revealed that both children and adults in all studied areas having health quotient (HQ) < 1 are at negligible non-carcinogenic risk. The only exception was for children exposed to As in TA. They had an ingestion health quotient (HQing) 1.18 and a health index (HI) 1.19. The most prominent exposure route was ingestion. The cancer risk for children and adults from exposure to Pb, Cd, Co, Ni, and Cr was found to be negligible (≤1 × 10−6). Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle A Survey of Naturally-Occurring Steroid Hormones in Raw Milk and the Associated Health Risks in Tangshan City, Hebei Province, China
Int. J. Environ. Res. Public Health 2018, 15(1), 38; doi:10.3390/ijerph15010038
Received: 8 November 2017 / Revised: 17 December 2017 / Accepted: 18 December 2017 / Published: 26 December 2017
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Abstract
In recent years, high levels of hormone residue in food, capable of damaging the health of consumers, have been recorded frequently. In this study, 195 raw milk samples were obtained from Tangshan City, China, and the concentrations of 22 steroid hormones were measured
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In recent years, high levels of hormone residue in food, capable of damaging the health of consumers, have been recorded frequently. In this study, 195 raw milk samples were obtained from Tangshan City, China, and the concentrations of 22 steroid hormones were measured by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Cortisol was detected in 12.5% of raw milk samples (mean 0.61 µg/kg; range: <limit of quantification (LOQ)–0.94 µg/kg). Progesterone was detected in 85.9% of raw milk samples (mean 5.12 µg/kg; range: <LOQ–9.04 µg/kg). The concentration of cortisol present in milk was lower than the maximum residue limit defined in Japan (10 µg/kg). Children aged between one and five years were expected to be the at-risk population when exposed to detectable steroid hormone concentrations. Based on the mean and maximum concentrations of progesterone detected in milk, the contribution was 0.85% and 0.9%, and 1.48% and 1.6% of the acceptable daily intake for boys and girls, respectively. These results imply that the concentrations of steroid hormones present in raw milk should not present a health risk for young children. Full article
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Open AccessArticle Estimating the Causal Impact of Proximity to Gold and Copper Mines on Respiratory Diseases in Chilean Children: An Application of Targeted Maximum Likelihood Estimation
Int. J. Environ. Res. Public Health 2018, 15(1), 39; doi:10.3390/ijerph15010039
Received: 29 November 2017 / Revised: 21 December 2017 / Accepted: 22 December 2017 / Published: 27 December 2017
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Abstract
In a town located in a desert area of Northern Chile, gold and copper open-pit mining is carried out involving explosive processes. These processes are associated with increased dust exposure, which might affect children’s respiratory health. Therefore, we aimed to quantify the causal
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In a town located in a desert area of Northern Chile, gold and copper open-pit mining is carried out involving explosive processes. These processes are associated with increased dust exposure, which might affect children’s respiratory health. Therefore, we aimed to quantify the causal attributable risk of living close to the mines on asthma or allergic rhinoconjunctivitis risk burden in children. Data on the prevalence of respiratory diseases and potential confounders were available from a cross-sectional survey carried out in 2009 among 288 (response: 69 % ) children living in the community. The proximity of the children’s home addresses to the local gold and copper mine was calculated using geographical positioning systems. We applied targeted maximum likelihood estimation to obtain the causal attributable risk (CAR) for asthma, rhinoconjunctivitis and both outcomes combined. Children living more than the first quartile away from the mines were used as the unexposed group. Based on the estimated CAR, a hypothetical intervention in which all children lived at least one quartile away from the copper mine would decrease the risk of rhinoconjunctivitis by 4.7 percentage points (CAR: 4.7 ; 95 % confidence interval ( 95 % CI): 8.4 ; 0.11 ); and 4.2 percentage points (CAR: 4.2 ; 95 % CI: 7.9 ; 0.05 ) for both outcomes combined. Overall, our results suggest that a hypothetical intervention intended to increase the distance between the place of residence of the highest exposed children would reduce the prevalence of respiratory disease in the community by around four percentage points. This approach could help local policymakers in the development of efficient public health strategies. Full article
(This article belongs to the Special Issue Global Children’s Environmental Health)
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Open AccessArticle Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics
Int. J. Environ. Res. Public Health 2018, 15(1), 40; doi:10.3390/ijerph15010040
Received: 18 October 2017 / Revised: 27 November 2017 / Accepted: 19 December 2017 / Published: 27 December 2017
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Abstract
Background: Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods:
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Background: Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods: Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results: The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetitive goals (1.105), money spent on gaming (1.005), weekday game time (1.081), offline community meeting attendance (2.060), and game community membership (1.393; p < 0.05 for all eight risk factors); Conclusions: These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
Open AccessArticle Selection of a Very Active Microbial Community for the Coupled Treatment of Tetramethylammonium Hydroxide and Photoresist in Aqueous Solutions
Int. J. Environ. Res. Public Health 2018, 15(1), 41; doi:10.3390/ijerph15010041
Received: 13 October 2017 / Revised: 20 December 2017 / Accepted: 21 December 2017 / Published: 27 December 2017
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Abstract
Aerobic treatment of wastewater containing Tetramethylammonium hydroxide (TMAH) and photoresist was investigated using a lab scale reactor inoculated with activated sludge coming from urban wastewater treatment that never received TMAH before. The consumption of TMAH was monitored by liquid ion chromatography. Biodiversity indices
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Aerobic treatment of wastewater containing Tetramethylammonium hydroxide (TMAH) and photoresist was investigated using a lab scale reactor inoculated with activated sludge coming from urban wastewater treatment that never received TMAH before. The consumption of TMAH was monitored by liquid ion chromatography. Biodiversity indices were calculated from Denaturing Gradient Gel Electrophoresis (DGGE) bands distribution and used to estimate changes in community composition related to adaptation to the new feeding compound. The first week of adaptation was crucial, and it was analyzed in detail: many organisms died, and the microbial community suffered a great shock. TMAH levels remained constant through the first four days, and then suddenly dropped to undetectable, and at the same time NH4+ increased. When the community showed complete adaptation, predominant groups of bacteria were obtained by the Illumina sequencing of 16s rDNA amplicons, to provide insights on ecology of the adapted community, focusing on the main actors of TMAH abatement. Richness of species (Rr) peaks suggest that the development of TMAH-consuming bacteria leads to persistent consortia that maintain toxicity resistance over time. This showed adaptation and changes of the population to the different feeding conditions, and it opens new perspectives in the in situ treatment of these important residues of industrial processes without relying on external processing plants. Full article
(This article belongs to the Special Issue Microbiological Evaluation of Wastewater Treatment)
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Open AccessArticle Biomarkers for Pulmonary Inflammation and Fibrosis and Lung Ventilation Function in Chinese Occupational Refractory Ceramic Fibers-Exposed Workers
Int. J. Environ. Res. Public Health 2018, 15(1), 42; doi:10.3390/ijerph15010042
Received: 15 November 2017 / Revised: 23 December 2017 / Accepted: 25 December 2017 / Published: 27 December 2017
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Abstract
Refractory ceramic fibers (RCFs) can cause adverse health effects on workers’ respiratory system, yet no proper biomarkers have been used to detect early pulmonary injury of RCFs-exposed workers. This study assessed the levels of two biomarkers that are related to respiratory injury in
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Refractory ceramic fibers (RCFs) can cause adverse health effects on workers’ respiratory system, yet no proper biomarkers have been used to detect early pulmonary injury of RCFs-exposed workers. This study assessed the levels of two biomarkers that are related to respiratory injury in RCFs-exposed workers, and explored their relations with lung function. The exposure levels of total dust and respirable fibers were measured simultaneously in RCFs factories. The levels of TGF-β1 and ceruloplasmin (CP) increased with the RCFs exposure level (p < 0.05), and significantly increased in workers with high exposure level (1.21 ± 0.49 ng/mL, 115.25 ± 32.44 U/L) when compared with the control group (0.99 ± 0.29 ng/mL, 97.90 ± 35.01 U/L) (p < 0.05). The levels of FVC and FEV1 were significantly decreased in RCFs exposure group (p < 0.05). Negative relations were found between the concentrations of CP and FVC (B = −0.423, p = 0.025), or FEV1 (B = −0.494, p = 0.014). The concentration of TGF-β1 (B = 0.103, p = 0.001) and CP (B = 8.027, p = 0.007) were associated with respirable fiber exposure level. Occupational exposure to RCFs can impair lung ventilation function and may have the potential to cause pulmonary inflammation and fibrosis. TGF-β1 and CP might be used as sensitive and noninvasive biomarkers to detect lung injury in occupational RCFs-exposed workers. Respirable fiber concentration can better reflect occupational RCFs exposure and related respiratory injuries. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Contamination of Tea and Tea Infusion with Polycyclic Aromatic Hydrocarbons
Int. J. Environ. Res. Public Health 2018, 15(1), 45; doi:10.3390/ijerph15010045
Received: 18 October 2017 / Revised: 23 December 2017 / Accepted: 25 December 2017 / Published: 28 December 2017
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Abstract
The aim of this work was to validate the method of determination of polycyclic aromatic hydrocarbons (PAHs), i.e., benzo(a)pyrene and sum of benzo(a)pyrene, benz(a)anthracene, benzo(b)fluoranthene and chrysene in different types of tea, as well as to assess the transfer of these contaminants from
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The aim of this work was to validate the method of determination of polycyclic aromatic hydrocarbons (PAHs), i.e., benzo(a)pyrene and sum of benzo(a)pyrene, benz(a)anthracene, benzo(b)fluoranthene and chrysene in different types of tea, as well as to assess the transfer of these contaminants from tea to tea infusion. The research materials were popular types of black, green, red and white tea. Quantitative and qualitative determination of PAHs was performed by High Performance Liquid Chromatography with fluorimetric detection (HPLC-FLD). The samples were prepared by QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) technique followed by cleaning-up by dispersion solid-phase extraction (d-SPE). Values of limit of detection and limit of quantification obtained in the validation of the method were lower than the respective maximum values given in Commission Regulation (EU) No. 836/2011. The level of contamination of popular teas commercially available on the Polish market with PAHs is similar to that of teas available in other countries, with a very large variation in the concentration of each of the compounds. The highest benzo(a)pyrene and Σ4PAHs contents (209 ± 42 μg/kg and 756 ± 151 μg/kg, respectively) were found for black tea leaves. The transfer of Σ4PAHs from black tea to tea infusions was 0.48%, while it was 1.55–1.72% for red, white and green teas. Full article
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Open AccessArticle Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting
Int. J. Environ. Res. Public Health 2018, 15(1), 46; doi:10.3390/ijerph15010046
Received: 29 November 2017 / Revised: 19 December 2017 / Accepted: 27 December 2017 / Published: 28 December 2017
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Abstract
The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and
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The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and the staff compliance to the SSI evidence-based control measures. Ten operating rooms were examined for microbiological contamination of air and surfaces, after cleaning procedures, in “at rest” conditions. Furthermore, 10 surgical operations were monitored to assess staff compliance to the recommended practices. None of the air samples exceeded microbiological reference standards and only six of the 200 surface samples (3.0%) were slightly above recommended levels. Potentially pathogenic bacteria and moulds were never detected. Staff compliance to best practices varied depending on the type of behaviour investigated and the role of the operator. The major not compliant behaviours were: pre-operative skin antisepsis, crowding of the operating room and hand hygiene of the anaesthetist. The good environmental microbiological quality observed is indicative of the efficacy of the cleaning-sanitization procedures adopted. The major critical point was staff compliance to recommended practices. Awareness campaigns are therefore necessary, aimed at improving the organisation of work so as to facilitate compliance to operative protocols. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
Open AccessArticle Spatiotemporal Risk of Bacillary Dysentery and Sensitivity to Meteorological Factors in Hunan Province, China
Int. J. Environ. Res. Public Health 2018, 15(1), 47; doi:10.3390/ijerph15010047
Received: 7 September 2017 / Revised: 27 November 2017 / Accepted: 8 December 2017 / Published: 29 December 2017
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Abstract
Bacillary dysentery remains a public health concern in the world. Hunan Province is one of the provinces having the highest risk of bacillary dysentery in China, however, the spatial-temporal distribution, variation of bacillary dysentery and sensitivity to meteorological factors in there are unclear.
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Bacillary dysentery remains a public health concern in the world. Hunan Province is one of the provinces having the highest risk of bacillary dysentery in China, however, the spatial-temporal distribution, variation of bacillary dysentery and sensitivity to meteorological factors in there are unclear. In this paper, a Bayesian space-time hierarchical model (BSTHM) was used to detect space-time variation, and effects of meteorological factors between 2010 and 2015. The risk of bacillary dysentery showed apparent spatial-temporal heterogeneity. The highest risk occurred in the summer season. Economically undeveloped mountainous areas in the west and south of the province had the highest incidence rates. Twenty three (18.9%) and 20 (16.4%) counties were identified as hot and cold spots, respectively. Among the hotspots, 11 counties (47.8%) exhibited a rapidly decreasing trend, suggesting they may become low-risk areas in the future. Of the cold spot counties, six (30%) showed a slowly decreasing trend, and may have a higher risk in the future. Among meteorological factors, air temperature, relative humidity, and wind speed all played a significant role in the spatial-temporal distribution of bacillary dysentery risk. These findings can contribute to the implementation of an early warning system for controlling and preventing bacillary dysentery. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle The Vulnerability of People to Damaging Hydrogeological Events in the Calabria Region (Southern Italy)
Int. J. Environ. Res. Public Health 2018, 15(1), 48; doi:10.3390/ijerph15010048
Received: 23 November 2017 / Revised: 19 December 2017 / Accepted: 20 December 2017 / Published: 29 December 2017
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Abstract
Background: Damaging Hydrogeological Events (DHEs) are severe weather periods during which floods, landslides, lightning, windstorms, hail or storm surges can harm people. Climate change is expected to increase the frequency/intensity of DHEs and, consequently, the potential harm to people. Method: We investigated the
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Background: Damaging Hydrogeological Events (DHEs) are severe weather periods during which floods, landslides, lightning, windstorms, hail or storm surges can harm people. Climate change is expected to increase the frequency/intensity of DHEs and, consequently, the potential harm to people. Method: We investigated the impacts of DHEs on people in Calabria (Italy) over 37 years (1980–2016). Data on 7288 people physically affected by DHEs were gathered from the systematic analysis of regional newspapers and collected in the database named PEOPLE. The damage was codified in three severity levels as follows: fatalities (people who were killed), injured (people who suffered physical harm) and involved (people who were present at the place where an accident occurred but survived and were not harmed). During the study period, we recorded 68 fatalities, 566 injured and 6654 people involved in the events. Results: Males were more frequently killed, injured and involved than females, and females who suffered fatalities were older than males who suffered fatalities, perhaps indicating that younger females tended to be more cautious than same-aged males, while older females showed an intrinsic greater vulnerability. Involved people were younger than injured people and fatalities, suggesting that younger people show greater promptness in reacting to dangerous situations. Floods caused the majority of the fatalities, injured and involved people, followed by landslides. Lightning was the most dangerous phenomenon, and it affected a relatively low number of people, killing 11.63% of them and causing injuries to 37.2%. Fatalities and injuries mainly occurred outdoors, largely along roads. In contrast, people indoors, essentially in public or private buildings, were more frequently involved without suffering harm. Being “dragged by water/mud” and “surrounded by water/mud”, respectively, represented the two extremes of dynamic dangerousness. The dragging effect of rapid-flowing water totally or partially obstructed the attempts of people to save their lives. In contrast, people surrounded by steady water/mud encountered difficulties but ultimately could survive. Conclusions: The study outcomes can be used in informational campaigns to increase risk awareness among both administrators and citizens and to improve community resilience, particularly in promoting self-protective behaviors and avoiding the underestimation of hazardous situations. Full article
(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)
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Open AccessArticle Impact of Interprofessional Relationships from Nurses’ Perspective on the Decision-Making Capacity of Patients in a Clinical Setting
Int. J. Environ. Res. Public Health 2018, 15(1), 49; doi:10.3390/ijerph15010049
Received: 8 November 2017 / Revised: 12 December 2017 / Accepted: 27 December 2017 / Published: 29 December 2017
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Abstract
Interprofessional relationships may impact the decision making of patients in a clinical setting. The objective of this study was to analyse the decision-making capabilities of patients from nurses’ perspectives of interprofessional relationships using Foucauldian ethics. This qualitative study was based on poststructuralist Foucault
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Interprofessional relationships may impact the decision making of patients in a clinical setting. The objective of this study was to analyse the decision-making capabilities of patients from nurses’ perspectives of interprofessional relationships using Foucauldian ethics. This qualitative study was based on poststructuralist Foucault references with in-depth interviews of nurses working in internal medicine and specialties in a general hospital. The patients constantly appeared in the definition of teamwork, but also as a passive element used by every professional to communicate with others. Nurses continue modelling a type of patient passivity, or what Foucault called passive subjectivity in relation to oneself, because the patient is guided and directed to take charge of a truth provided by professionals. Nurses must break the rigid design of sections or professional skills, and adopt a model of teamwork that meets the needs of the patient and increases their decision-making power. The quality of care will increase to the extent that professionals establish a relationship of equality with the patient, allowing the patient to make real decisions about their care. An egalitarian model of teamwork is beneficial to the patient, abandoning the idea of a team where the patient and family are constantly excluded from decisions about their care. Full article
(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)
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Open AccessArticle Estimating the Excess Mortality Risk during Two Red Alert Periods in Beijing, China
Int. J. Environ. Res. Public Health 2018, 15(1), 50; doi:10.3390/ijerph15010050
Received: 14 October 2017 / Revised: 26 December 2017 / Accepted: 28 December 2017 / Published: 29 December 2017
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Abstract
The magnitude of excess mortality risk due to exposures to heavy air pollution during the red alert periods in Beijing remains unknown. A health impact assessment tool combined with the PM2.5-mortality relationship was applied to estimate the number of excess deaths
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The magnitude of excess mortality risk due to exposures to heavy air pollution during the red alert periods in Beijing remains unknown. A health impact assessment tool combined with the PM2.5-mortality relationship was applied to estimate the number of excess deaths due to high air pollution exposure during two red alert periods in Beijing, China in December 2015. Daily PM2.5 concentration increased from 80.2 µg/m3 to 159.8 µg/m3 during the first red alert period and from 61.9 µg/m3 to 226 µg/m3 during the second period in 2015 when compared to daily PM2.5 concentrations during the same calendar date of 2013 and 2014. It was estimated that 26 to 42 excessive deaths (including 14 to 34 cardiovascular deaths, and four to 16 respiratory deaths) occurred during the first period, and 40 to 65 excessive deaths (22 to 53 cardiovascular deaths, and six to 13 respiratory deaths) occurred during the second period. The results show that heavy smog may have substantially increased the mortality risk in Beijing, suggesting more stringent air pollution controlling measures should be implemented to protect the public health. Full article
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Open AccessArticle Influence of Land Use and Point Source Pollution on Water Quality in a Developed Region: A Case Study in Shunde, China
Int. J. Environ. Res. Public Health 2018, 15(1), 51; doi:10.3390/ijerph15010051
Received: 28 November 2017 / Revised: 21 December 2017 / Accepted: 27 December 2017 / Published: 30 December 2017
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Abstract
To design and implement policy to manage water quality, it is important to investigate land use and possible sources of pollution. In this study, using Pearson regression analysis, redundancy analysis and multiple regression analysis, we assess the influence of land use and point
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To design and implement policy to manage water quality, it is important to investigate land use and possible sources of pollution. In this study, using Pearson regression analysis, redundancy analysis and multiple regression analysis, we assess the influence of land use and point sources on water quality in the river system in Shunde district in 2000 and 2010. The results show that water quality was related positively with water surface but negatively with impervious and urban greening area. Additionally, water quality was related negatively to point source emissions of chemical oxygen demand (COD) and ammonium-nitrogen (NH4-N). The total explanatory power of spatial variation of water quality was improved from 43.4% to 60.0% in 2000 and from 31.3% to 57.8% in 2010, respectively, when the influence of point sources was added into redundancy analysis between water quality and land use. Thus, both land use management and point source pollution control should be considered for improving river water quality. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Antibiotic Resistance of Acinetobacter spp. Isolates from the River Danube: Susceptibility Stays High
Int. J. Environ. Res. Public Health 2018, 15(1), 52; doi:10.3390/ijerph15010052
Received: 29 November 2017 / Revised: 22 December 2017 / Accepted: 28 December 2017 / Published: 30 December 2017
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Abstract
Acinetobacter spp. occur naturally in many different habitats, including food, soil, and surface waters. In clinical settings, Acinetobacter poses an increasing health problem, causing infections with limited to no antibiotic therapeutic options left. The presence of human generated multidrug resistant strains is well
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Acinetobacter spp. occur naturally in many different habitats, including food, soil, and surface waters. In clinical settings, Acinetobacter poses an increasing health problem, causing infections with limited to no antibiotic therapeutic options left. The presence of human generated multidrug resistant strains is well documented but the extent to how widely they are distributed within the Acinetobacter population is unknown. In this study, Acinetobacter spp. were isolated from water samples at 14 sites of the whole course of the river Danube. Susceptibility testing was carried out for 14 clinically relevant antibiotics from six different antibiotic classes. Isolates showing a carbapenem resistance phenotype were screened with PCR and sequencing for the underlying resistance mechanism of carbapenem resistance. From the Danube river water, 262 Acinetobacter were isolated, the most common species was Acinetobacter baumannii with 135 isolates. Carbapenem and multiresistant isolates were rare but one isolate could be found which was only susceptible to colistin. The genetic background of carbapenem resistance was mostly based on typical Acinetobacter OXA enzymes but also on VIM-2. The population of Acinetobacter (baumannii and non-baumannii) revealed a significant proportion of human-generated antibiotic resistance and multiresistance, but the majority of the isolates stayed susceptible to most of the tested antibiotics. Full article
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
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Open AccessArticle Factors Associated with Maintaining the Mental Health of Employees after the Fukushima Nuclear Disaster: Findings from Companies Located in the Evacuation Area
Int. J. Environ. Res. Public Health 2018, 15(1), 53; doi:10.3390/ijerph15010053
Received: 12 December 2017 / Revised: 26 December 2017 / Accepted: 30 December 2017 / Published: 31 December 2017
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Abstract
After the nuclear disaster in Fukushima on 11 March 2011, some businesses were permitted to continue operating even though they were located in the evacuation area designated by the Japanese government. The aim of this study was to examine differences in the mental
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After the nuclear disaster in Fukushima on 11 March 2011, some businesses were permitted to continue operating even though they were located in the evacuation area designated by the Japanese government. The aim of this study was to examine differences in the mental health status, workplace, living environment, and lifestyle of employees in the evacuation and non-evacuation areas. We also investigated factors related to their mental health status. Data for this cross-sectional study were collected from the questionnaire responses of 647 employees at three medium-sized manufacturing companies in the evacuation and non-evacuation areas. Through a cross-tabulation analysis, employees who worked at companies in the evacuation areas showed an increase in the duration of overtime work, work burden, and commute time, and had experienced separation from family members due to the radiation disaster and perceived radiation risks. The results of a multivariate logistic regression analysis showed that, even in a harsh workplace and living environment, being younger, participating regularly in physical activity, having a social network (Lubben Social Network Scale-6 ≤ 12), laughing frequently, and feeling satisfied with one’s workplace and domestic life were significantly associated with maintaining a healthy mental health status after the disaster. These findings are applicable for workers’ health management measures after disasters. Full article
(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)
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Open AccessArticle Favourable Perceptions of Electronic Cigarettes Relative to Cigarettes and the Associations with Susceptibility to Electronic Cigarette Use in Hong Kong Chinese Adolescents
Int. J. Environ. Res. Public Health 2018, 15(1), 54; doi:10.3390/ijerph15010054
Received: 26 September 2017 / Revised: 24 December 2017 / Accepted: 29 December 2017 / Published: 1 January 2018
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Abstract
We investigated favourable perceptions of electronic cigarettes (ECs) relative to cigarettes and their associations with EC use susceptibility in adolescents. Hong Kong Chinese Secondary 1–6 (U.S. grade 7–12) students (n = 40,202) were surveyed in 2014/2015 on EC use, cigarette smoking, favourable
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We investigated favourable perceptions of electronic cigarettes (ECs) relative to cigarettes and their associations with EC use susceptibility in adolescents. Hong Kong Chinese Secondary 1–6 (U.S. grade 7–12) students (n = 40,202) were surveyed in 2014/2015 on EC use, cigarette smoking, favourable perceptions of ECs relative to cigarettes, EC use susceptibility, family smoking, and socio-demographic characteristics. Cox regression yielded adjusted prevalence ratios (APRs) of EC use susceptibility in never users, excluding those unaware of ECs. In all students, 8.9% were ever EC users, 47.2% reported favourable perceptions of ECs relative to cigarettes, such as less likely to cause accidents (25.2%) and less harmful to users (24.5%), and 28.9% did not know ECs. Among never EC users who were aware of ECs (n = 24,663), EC use susceptibility was associated with each of the favourable perceptions, especially greater attractiveness (APR 2.84, 95% CI 2.53–3.19), and better parental (2.75, 2.41–3.15) and school acceptability (2.56, 2.15–3.05). An increased number of favourable perceptions of ECs relative to cigarettes was associated more strongly with the susceptibility (p for trend < 0.001). Our findings inform strategies to reduce unwarranted favourable perceptions and prevent adolescent EC use. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Application of SCM with Bayesian B-Spline to Spatio-Temporal Analysis of Hypertension in China
Int. J. Environ. Res. Public Health 2018, 15(1), 55; doi:10.3390/ijerph15010055
Received: 17 October 2017 / Revised: 20 December 2017 / Accepted: 23 December 2017 / Published: 2 January 2018
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Abstract
Most previous research on the disparities of hypertension risk has neither simultaneously explored the spatio-temporal disparities nor considered the spatial information contained in the samples, thus the estimated results may be unreliable. Our study was based on the China Health and Nutrition Survey
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Most previous research on the disparities of hypertension risk has neither simultaneously explored the spatio-temporal disparities nor considered the spatial information contained in the samples, thus the estimated results may be unreliable. Our study was based on the China Health and Nutrition Survey (CHNS), including residents over 12 years old in seven provinces from 1991 to 2011. Bayesian B-spline was used in the extended shared component model (SCM) for fitting temporal-related variation to explore spatio-temporal distribution in the odds ratio (OR) of hypertension, reveal gender variation, and explore latent risk factors. Our results revealed that the prevalence of hypertension increased from 14.09% in 1991 to 32.37% in 2011, with men experiencing a more obvious change than women. From a spatial perspective, a standardized prevalence ratio (SPR) remaining at a high level was found in Henan and Shandong for both men and women. Meanwhile, before 1997, the temporal distribution of hypertension risk for both men and women remained low. After that, notably since 2004, the OR of hypertension in each province increased to a relatively high level, especially in Northern China. Notably, the OR of hypertension in Shandong and Jiangsu, which was over 1.2, continuously stood out after 2004 for males, while that in Shandong and Guangxi was relatively high for females. The findings suggested that obvious spatial–temporal patterns for hypertension exist in the regions under research and this pattern was quite different between men and women. Full article
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Open AccessArticle The Development Evaluation of Economic Zones in China
Int. J. Environ. Res. Public Health 2018, 15(1), 56; doi:10.3390/ijerph15010056
Received: 19 September 2017 / Revised: 31 October 2017 / Accepted: 15 November 2017 / Published: 2 January 2018
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Abstract
After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China’s economic development. Currently, against the background of Chinese economic transition, research on development evaluation
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After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China’s economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Assessment of Nutritional Status of Infants Living in Arsenic-Contaminated Areas in Bangladesh and Its Association with Arsenic Exposure
Int. J. Environ. Res. Public Health 2018, 15(1), 57; doi:10.3390/ijerph15010057
Received: 26 November 2017 / Revised: 26 December 2017 / Accepted: 27 December 2017 / Published: 2 January 2018
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Abstract
Data is scarce on early life exposure to arsenic and its association with malnutrition during infancy. This study followed the nutritional status of a cohort of 120 infants from birth to 9 months of age in an arsenic contaminated area in Bangladesh. Anthropometric
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Data is scarce on early life exposure to arsenic and its association with malnutrition during infancy. This study followed the nutritional status of a cohort of 120 infants from birth to 9 months of age in an arsenic contaminated area in Bangladesh. Anthropometric data was collected at 3, 6 and 9 months of the infant’s age for nutritional assessment whereas arsenic exposure level was assessed via tube well drinking water arsenic concentration at the initiation of the study. Weight and height measurements were converted to Z-scores of weight for age (WAZ-underweight), height for age (HAZ-stunting), weight for height (WHZ-wasting) for children by comparing with WHO growth standard. Arsenic exposure levels were categorized as <50 μg/L and ≥50 μg/L. Stunting rates (<−2 SD) were 10% at 3 months and 44% at both 6 and 9 months. Wasting rates (<−2 SD) were 23.3% at 3 months and underweight rates (<−2 SD) were 25% and 10% at 3 and 6 months of age, respectively. There was a significant association of stunting with household drinking water arsenic exposure ≥50 μg/L at age of 9 months (p = 0.009). Except for stunting at 9 months of age, we did not find any significant changes in other nutritional indices over time or with levels of household arsenic exposure in this study. Our study suggests no association between household arsenic exposure and under-nutrition during infancy; with limiting factors being small sample size and short follow-up. Difference in stunting at 9 months by arsenic exposure at ≥50 μg/L might be a statistical incongruity. Further longitudinal studies are warranted to establish any association. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
Open AccessArticle Analysis of Gambling in the Media Related to Screens: Immersion as a Predictor of Excessive Use?
Int. J. Environ. Res. Public Health 2018, 15(1), 58; doi:10.3390/ijerph15010058
Received: 12 November 2017 / Revised: 25 December 2017 / Accepted: 27 December 2017 / Published: 2 January 2018
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Abstract
This study investigates the intricacies between the player interface proposed by the screens, (in particular on smartphone applications or in video games) and gambling. Recent research indicates connections between “immersion” and excessive screen practice. We want to understand the causal-effects between online gambling
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This study investigates the intricacies between the player interface proposed by the screens, (in particular on smartphone applications or in video games) and gambling. Recent research indicates connections between “immersion” and excessive screen practice. We want to understand the causal-effects between online gambling and the “immersion” variable and understand their relationship and its contingencies. This article empirically investigates whether and how it is possible to observe immersion with its sub-dimensions in gambling on different screens. The objective of this study was to analyze: (1) the costs and benefits associated with gambling practice on screens (2) the link between gambling practice and screen practice (video game, Internet, mobile screen); (3) to observe the propensity to immersion for individuals practicing gambling on screens; and (4) to examine the comorbidities and cognitive factors associated with the practice of gambling on screen. A total of 432 adults (212 men, 220 women), recruited from Ile-de-France (France), responded to a battery of questionnaires. Our study suggests that immersion variables make it possible to understand the cognitive participation of individuals towards screens in general, the practice of gambling on screens and the excessive practice of screens. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
Open AccessArticle The Neonatal Intensive Care Unit: Environmental Stressors and Supports
Int. J. Environ. Res. Public Health 2018, 15(1), 60; doi:10.3390/ijerph15010060
Received: 13 November 2017 / Revised: 18 December 2017 / Accepted: 21 December 2017 / Published: 3 January 2018
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Abstract
The relationship between maternal mental health and infant development has been established in the literature. The Neonatal Intensive Care Unit (NICU) is a particularly challenging environment for new mothers as several natural processes are disrupted. The objective of this study is to elucidate
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The relationship between maternal mental health and infant development has been established in the literature. The Neonatal Intensive Care Unit (NICU) is a particularly challenging environment for new mothers as several natural processes are disrupted. The objective of this study is to elucidate protective factors and environmental deficits associated with the NICU. The experiences of forty-six (n = 46) mothers of infants admitted to a Level III NICU in the Midwestern United States, who responded to a related open-ended question, were analyzed thematically. Five themes related to the NICU environment emerged as being either stressful or helpful: (1) amount and quality of communication with medical staff, (2) bedside manner of medical staff, (3) feeling alienated from infant’s care, (4) support from other NICU mothers and families, and (5) NICU Physical Environment and Regulations. There is a need for medical staff training on awareness, communication, empathy, and other behaviors that might improve maternal (and parental) experiences in the NICU. The physical environment, including rules and regulations of the NICU, should be reexamined with family comfort in mind in addition to the clinical care of the infant. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle The Emergence and Unfolding of Telemonitoring Practices in Different Healthcare Organizations
Int. J. Environ. Res. Public Health 2018, 15(1), 61; doi:10.3390/ijerph15010061
Received: 27 October 2017 / Revised: 19 December 2017 / Accepted: 22 December 2017 / Published: 3 January 2018
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Abstract
Telemonitoring, a sub-category of telemedicine, is promoted as a solution to meet the challenges in Western healthcare systems in terms of an increasing population of people with chronic conditions and fragmentation issues. Recent findings from large-scale telemonitoring programs reveal that these promises are
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Telemonitoring, a sub-category of telemedicine, is promoted as a solution to meet the challenges in Western healthcare systems in terms of an increasing population of people with chronic conditions and fragmentation issues. Recent findings from large-scale telemonitoring programs reveal that these promises are difficult to meet in complex real-life settings which may be explained by concentrating on the practices that emerge when telemonitoring is used to treat patients with chronic conditions. This paper explores the emergence and unfolding of telemonitoring practices in relation to a large-scale, inter-organizational home telemonitoring program which involved 5 local health centers, 10 district nurse units, four hospitals, and 225 general practice clinics in Denmark. Twenty-eight interviews and 28 h of observations of health professionals and administrative staff were conducted over a 12-month period from 2014 to 2015. This study’s findings reveal how telemonitoring practices emerged and unfolded differently among various healthcare organizations. This study suggests that the emergence and unfolding of novel practices is the result of complex interplay between existing work practices, alterations of core tasks, inscriptions in the technology, and the power to either adopt or ignore such novel practices. The study enhances our understanding of how novel technology like telemonitoring impacts various types of healthcare organizations when implemented in a complex inter-organizational context. Full article
(This article belongs to the Special Issue eHealth: The Impact of Technology on Healthcare)
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Open AccessArticle An Empirical Study on Low-Carbon: Human Resources Performance Evaluation
Int. J. Environ. Res. Public Health 2018, 15(1), 62; doi:10.3390/ijerph15010062
Received: 24 August 2017 / Revised: 12 December 2017 / Accepted: 17 December 2017 / Published: 3 January 2018
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Abstract
Low-carbon logistics meets the requirements of a low-carbon economy and is the most effective operating model for logistic development to achieve sustainability by coping with severe energy consumption and global warming. Low-carbon logistics aims to reduce carbon intensity rather than simply reduce energy
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Low-carbon logistics meets the requirements of a low-carbon economy and is the most effective operating model for logistic development to achieve sustainability by coping with severe energy consumption and global warming. Low-carbon logistics aims to reduce carbon intensity rather than simply reduce energy consumption and carbon emissions. Human resources are an important part of the great competition in the logistics market and significantly affect the operations of enterprises. Performance evaluations of human resources are particularly important for low-carbon logistics enterprises with scarce talents. Such evaluations in these enterprises are of great significance for their strategic development. This study constructed a human resource performance evaluation system to assess non-managerial employees’ low-carbon job capacity, job performance, and job attitude in the low-carbon logistics sector. The case study results revealed that the investigated company enjoyed initial success after having promoted low-carbon concepts and values to its non-managerial employees, and the success was demonstrated by excellent performance in its employees’ job attitude and knowledge. This study adopts the AHP method to reasonably determine an indicator system of performance evaluation and its weight to avoid certain human-caused bias. This study not only fills the gap in the related literature, but can also be applied to industrial practice. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Food Safety Knowledge, Attitudes and Behavior among Dairy Plant Workers in Beijing, Northern China
Int. J. Environ. Res. Public Health 2018, 15(1), 63; doi:10.3390/ijerph15010063
Received: 16 October 2017 / Revised: 2 December 2017 / Accepted: 20 December 2017 / Published: 3 January 2018
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Abstract
The safety of milk and dairy products has always been one of the focuses of consumers, the food industry and regulatory agencies. The purpose of this study was to gain insight into the food safety knowledge, attitudes and behavior of dairy plant workers.
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The safety of milk and dairy products has always been one of the focuses of consumers, the food industry and regulatory agencies. The purpose of this study was to gain insight into the food safety knowledge, attitudes and behavior of dairy plant workers. A cross-sectional survey was performed between May and August 2015 in three dairy plants in Beijing, northern China. A total of 194 dairy plant workers were interviewed to collect information on food safety knowledge, attitudes and self-reported behavior. The 194 dairy plant workers interviewed showed a sufficient level of knowledge (mean score 34 on a scale from 0–58), perfect attitudes (mean score 17 on a scale from 0–18), and perfect behavior (mean score 38 on a scale from 8–40). Only 39% of workers correctly determined specific pathogens or diseases that could be conveyed through milk and dairy products. 24% of workers knew the correct method of washing hands. A significant positive association was observed between attitudes and knowledge (p < 0.001) as well as behavior (p < 0.01). Education level was positively and significantly associated with food safety knowledge, attitudes, and behavior (p < 0.05). Workers in dairy enterprises in northern China have relatively low levels of knowledge, yet satisfactory attitudes and behavior. The knowledge of microbial food hazards and hand hygiene remains an issue that needs to be emphasized in future training programs. Education level is a determinant of attitudes and behavior with regard to the proper handling of milk and dairy products. Full article
Open AccessArticle Evaluation of Well Designs to Improve Access to Safe and Clean Water in Rural Tanzania
Int. J. Environ. Res. Public Health 2018, 15(1), 64; doi:10.3390/ijerph15010064
Received: 26 August 2017 / Revised: 16 November 2017 / Accepted: 12 December 2017 / Published: 4 January 2018
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Abstract
The objective of this study was to examine three well designs: drilled wells (20–30 m deep), closed dug wells (>5 m deep), and hand-dug open wells (<5 m deep), to determine the water quality for improving access to safe and clean water in
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The objective of this study was to examine three well designs: drilled wells (20–30 m deep), closed dug wells (>5 m deep), and hand-dug open wells (<5 m deep), to determine the water quality for improving access to safe and clean water in rural communities. Heterotrophic plate count (HPC), total coliforms (TC), Escherichia coli (E. coli) and turbidity, were used to assess the water quality of 97 wells. Additionally, the study looked at the microflora diversity of the water, focusing on potential pathogens using outgrowth, PCR, and genome sequencing for 10 wells. Concentrations of TC for the open dug wells (4 × 104 CFU/100 mL) were higher than the drilled (2 × 103 CFU/100 mL) and closed dug wells (3 × 103 CFU/100 mL). E. coli concentration for drilled and closed dug wells was <22 MPN (most probable number)/100 mL, but higher for open wells (>154 MPN/100 mL). The drilled well turbidity (11 NTU) was within the standard deviation of the closed well (28 NTU) compared to open dug wells (49 NTU). Drilled and closed wells had similar microbial diversity. There were no significant differences between drilled and closed dug wells. The covering and lining of hand-dug wells should be considered as an alternative to improve access to safe and clean water in rural communities. Full article
(This article belongs to the Section Global Health)
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Open AccessFeature PaperArticle Systematic Screening for Occupational Exposures in Lung Cancer Patients: A Prospective French Cohort
Int. J. Environ. Res. Public Health 2018, 15(1), 65; doi:10.3390/ijerph15010065
Received: 1 December 2017 / Revised: 22 December 2017 / Accepted: 27 December 2017 / Published: 4 January 2018
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Abstract
Occupational lung cancers are under-reported and under-compensated worldwide. We assessed systematic screening for occupational exposure to carcinogens combining a self-administered questionnaire and an occupational consultation to improve the detection of occupational lung cancers and their compensation. Social deprivation and the costs of this
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Occupational lung cancers are under-reported and under-compensated worldwide. We assessed systematic screening for occupational exposure to carcinogens combining a self-administered questionnaire and an occupational consultation to improve the detection of occupational lung cancers and their compensation. Social deprivation and the costs of this investigation were estimated. Patients with lung cancer received a self-administered questionnaire to collect their job history, potential exposure to carcinogens and deprivation. A physician assessed the questionnaire and recommended an occupational consultation if necessary. During the consultation, a physician assessed if the lung cancer was work-related and, if it was, delivered a medical certificate to claim for compensation. Over 18 months, 440 patients received the self-administered questionnaire: 234 returned a completed questionnaire and a consultation was required for 120 patients. Compensation was judged possible for 41 patients. Among the 35 medical certificates delivered, 19 patients received compensation. Nearly half the patients (46%) were assessed as socially deprived and these patients took significantly longer to return the questionnaire compared with those who were not deprived. The mean cost of the process was €62.65 per patient. Our results showed a systematic self-administered questionnaire can be used to identify patients potentially exposed to carcinogens and to improve compensation. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Risk Assessment for Children Exposed to Arsenic on Baseball Fields with Contaminated Fill Material
Int. J. Environ. Res. Public Health 2018, 15(1), 67; doi:10.3390/ijerph15010067
Received: 24 November 2017 / Revised: 24 December 2017 / Accepted: 27 December 2017 / Published: 4 January 2018
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Abstract
Children can be exposed to arsenic through play areas which may have contaminated fill material from historic land use. The objective of the current study was to evaluate the risk to children who play and/or spend time at baseball fields with soils shown
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Children can be exposed to arsenic through play areas which may have contaminated fill material from historic land use. The objective of the current study was to evaluate the risk to children who play and/or spend time at baseball fields with soils shown to have arsenic above background levels. Arsenic in soils at the study sites located in Miami, FL, USA showed distinct distributions between infield, outfield, and areas adjacent to the fields. Using best estimates of exposure factors for children baseball scenarios, results show that non-cancer risks depend most heavily upon the age of the person and the arsenic exposure level. For extreme exposure scenarios evaluated in this study, children from 1 to 2 years were at highest risk for non-cancer effects (Hazard Quotient, HQ > 2.4), and risks were higher for children exhibiting pica (HQ > 9.7) which shows the importance of testing fill for land use where children may play. At the study sites, concentration levels of arsenic resulted in a range of computed cancer risks that differed by a factor of 10. In these sites, the child’s play position also affected risk. Outfield players, with a lifetime exposure to these arsenic levels, could have 10 times more increased chance of experiencing cancers associated with arsenic (i.e., lung, bladder, skin) in comparison to infielders. The distinct concentration distributions observed between these portions of the baseball fields emphasize the need to delineate contaminated areas in public property where citizens may spend more free time. This study also showed a need for more tools to improve the risk estimates for child play activities. For instance, more refined measurements of exposure factors for intake (e.g., inhalation rates under rigorous play activities, hand to mouth rates), exposure frequency (i.e., time spent in various activities) and other exposure factors (e.g., soil particulate emission rates at baseball play fields) can help pinpoint risk on baseball fields where arsenic levels may be a concern. Full article
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Open AccessArticle Self-Medication Practice and Associated Factors among Residents in Wuhan, China
Int. J. Environ. Res. Public Health 2018, 15(1), 68; doi:10.3390/ijerph15010068
Received: 10 October 2017 / Revised: 6 December 2017 / Accepted: 22 December 2017 / Published: 4 January 2018
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Abstract
Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in
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Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in the survey to collect information of self-medication behavior. Multivariable logistic regression analyses were used to measure correlates of the prevalence of self-medication. Results: Nearly half of the respondents would select self-medication, and 39.1% would see a doctor if they felt sick. The most common self-medicated illnesses were cold and cough, cardiovascular disease and gastrointestinal disease. The main reasons for self-medication were that the illness was not severe (enough) to see the doctor (45%); the patient did not think that the trouble of seeing a doctor was worth the effort (23%); the patient had no time to see the doctor (12%), and the patient did not want to pay high medical costs (15%). Logistic regression results suggested that respondents tended to select self-medication if the illness was minor or short-term (less than seven days). Conclusions: Our findings suggest that more strict regulation on over-the-counter medicines may be required to reduce health risks related to self-medication. Targeted health education on the risks of self-medication should be considered. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle Dynamic Impact of Online Word-of-Mouth and Advertising on Supply Chain Performance
Int. J. Environ. Res. Public Health 2018, 15(1), 69; doi:10.3390/ijerph15010069
Received: 30 November 2017 / Revised: 28 December 2017 / Accepted: 30 December 2017 / Published: 4 January 2018
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Abstract
Cooperative (co-op) advertising investments benefit brand goodwill and further improve supply chain performance. Meanwhile, online word-of-mouth (OWOM) can also play an important role in supply chain performance. On the basis of co-op advertising, this paper considers a single supply chain structure led by
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Cooperative (co-op) advertising investments benefit brand goodwill and further improve supply chain performance. Meanwhile, online word-of-mouth (OWOM) can also play an important role in supply chain performance. On the basis of co-op advertising, this paper considers a single supply chain structure led by a manufacturer and examines a fundamental issue concerning the impact of OWOM on supply chain performance. Firstly, by the method of differential game, this paper analyzes the dynamic impact of OWOM and advertising on supply chain performance (i.e., brand goodwill, sales, and profits) under three different supply chain decisions (i.e., only advertising, and manufacturers with and without sharing cost of OWOM with retailers). We compare and analyze the optimal strategies of advertising and OWOM under the above different supply chain decisions. Secondly, the system dynamics model is established to reflect the dynamic impact of OWOM and advertising on supply chain performance. Finally, three supply chain decisions under two scenarios, strong brand and weak brand, are analyzed through the system dynamics simulation. The results show that the input of OWOM can enhance brand goodwill and improve earnings. It further promotes the OWOM reputation and improves the supply chain performance if manufacturers share the cost of OWOM with retailers. Then, in order to eliminate the retailers from word-of-mouth fraud and establish a fair competition mechanism, the third parties (i.e., regulators or e-commerce platforms) should take appropriate punitive measures against retailers. Furthermore, the effect of OWOM on supply chain performance under a strong brand differed from those under a weak brand. Last but not least, if OWOM is improved, there would be more remarkable performance for the weak brand than that for the strong brand in the supply chain. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Implicit Messages Regarding Unhealthy Foodstuffs in Chinese Television Advertisements: Increasing the Risk of Obesity
Int. J. Environ. Res. Public Health 2018, 15(1), 70; doi:10.3390/ijerph15010070
Received: 17 November 2017 / Revised: 29 December 2017 / Accepted: 30 December 2017 / Published: 4 January 2018
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Abstract
Previous studies indicated that television (TV) advertising is associated with higher rates of obesity. The rate of obesity and overweight continues to rise in mainland China, bringing into question whether TV advertising to young audiences might be partly to blame. This study investigated
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Previous studies indicated that television (TV) advertising is associated with higher rates of obesity. The rate of obesity and overweight continues to rise in mainland China, bringing into question whether TV advertising to young audiences might be partly to blame. This study investigated messaging delivered through TV advertisements regarding healthy and unhealthy foodstuffs. A total of 42 major food brands and 480 advertisements were analysed for content in this study. The results showed that the majority of TV spots advertised products with poor nutritional content and had a potential to mislead audiences concerning products’ actual nutritional value. The tactics of repetition and appeals of premium offerings on food brands have a potential to influence the purchase intentions. Additional qualitative observation involving the social bond, social context and cultural factors pertaining to mood alterations were highlighted. The discussion addressed product attributes reflected by culture and the implicit messages of marketing claims may increase the risk of obesity. Thus, public health policymakers and researchers were encouraged to act urgently to evaluate the obesity risks of unhealthy food advertised in the media and to support healthy foods. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle The Effect of Protracted Exposure to Radiation on Liver Injury: A Cohort Study of Industrial Radiographers in Xinjiang, China
Int. J. Environ. Res. Public Health 2018, 15(1), 71; doi:10.3390/ijerph15010071
Received: 15 November 2017 / Revised: 29 December 2017 / Accepted: 1 January 2018 / Published: 4 January 2018
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Abstract
Background: At present, a large number of studies indicate that high dose ionizing radiation exposure is an important risk factor for liver damage. Whether protracted exposure to low external doses of ionizing radiation could induce liver injury is unclear. The aim of this
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Background: At present, a large number of studies indicate that high dose ionizing radiation exposure is an important risk factor for liver damage. Whether protracted exposure to low external doses of ionizing radiation could induce liver injury is unclear. The aim of this study was to assess the risk of liver injury following protracted exposure to occupational radiation compared to a group of unexposed workers. Methods: A three-year cohort study was initiated in Xinjiang, China in 2010 and included 508 industrial radiographers and 2156 unexposed workers. The incidence of liver injury was assessed clinically based on the evaluation of alanine aminotransferase (ALT) and aspartate transaminase (AST) levels. Logistic regression was used to examine whether radiation is a risk factor for liver injury. Results: Compared with the unexposed group, protracted radiation exposure was found to be a risk factor for liver injury. Sex, age at baseline and alcohol consumption were not associated with liver injury. However, hypertension was a risk factor for liver injury. The association between cumulative recorded radiation dose and liver injury was not found in this study. Conclusions: These findings indicate that protracted exposure to radiation is a risk factor for liver injury. Full article
Open AccessArticle Attitudes towards Potential New Tobacco Control Regulations among U.S. Adults
Int. J. Environ. Res. Public Health 2018, 15(1), 72; doi:10.3390/ijerph15010072
Received: 14 November 2017 / Revised: 21 December 2017 / Accepted: 25 December 2017 / Published: 5 January 2018
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Abstract
Favorable attitudes towards tobacco control policies can facilitate their implementation and success. We examined attitudes toward four potential U.S. Federal tobacco regulations (banning menthol from cigarettes, reducing nicotine levels in cigarettes, banning candy and fruit flavored electronic cigarettes, and banning candy and fruit
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Favorable attitudes towards tobacco control policies can facilitate their implementation and success. We examined attitudes toward four potential U.S. Federal tobacco regulations (banning menthol from cigarettes, reducing nicotine levels in cigarettes, banning candy and fruit flavored electronic cigarettes, and banning candy and fruit flavored little cigars and cigarillos) and associations with individual and state variables. A nationally representative phone survey of 4337 adults assessed attitudes toward potential policies. Weighted logistic regression was used to assess relationships between attitudes and demographic factors, smoking behavior, beliefs about the government (knowledge, trust, and credibility), exposure to tobacco control campaigns, and state variables from the US Centers for Disease Control and Prevention (CDC) State Tobacco Activities Tracking and Evaluation (STATE) System. Most respondents supported three out of four policies. Respondents that were female, non-white, Latino, living below the poverty line, had less than high school education, were of older age, did not smoke, had higher trust in government, and were exposed to national tobacco control campaigns had higher odds of expressing favorable attitudes toward potential new tobacco regulations than did their counterparts. No state-level effects were found. While differences in attitudes were observed by individual demographic characteristics, behaviors, and beliefs, a majority of participants supported most of the potential new tobacco regulations surveyed. Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
Open AccessArticle Workaholism as a Mediator between Work-Related Stressors and Health Outcomes
Int. J. Environ. Res. Public Health 2018, 15(1), 73; doi:10.3390/ijerph15010073
Received: 5 December 2017 / Revised: 30 December 2017 / Accepted: 2 January 2018 / Published: 5 January 2018
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Abstract
It is currently unknown if unfavorable working conditions, reflected by the demand–control–support model and the effort–reward imbalance model, directly influence health or if the effects may be mediated by work-related attitudes and behaviors such as workaholism. In the present study, 988 employees (55.6%
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It is currently unknown if unfavorable working conditions, reflected by the demand–control–support model and the effort–reward imbalance model, directly influence health or if the effects may be mediated by work-related attitudes and behaviors such as workaholism. In the present study, 988 employees (55.6% males, mean age 36.09, SD = 9.23) from a large consultant firm participated in a cross-sectional survey assessing work variables such as job demands, job control, social support, effort, reward, and overcommitment. Workaholism was also assessed together with eight different health-related outcomes. Although direct effects of the work stressors on health were found on most health outcomes, the work-related stressors were overall strongly related to workaholism (R2 = 0.522), which, in turn, was positively related to four (anxiety/insomnia, somatic symptoms, emotional exhaustion, and social dysfunction) of the eight outcome variables. Of a total of 40 relationships between work-related stressors and health outcomes, workaholism fully mediated three of these, and partly mediated 12. Overall, the study suggests that the effects of work-related stressors on health in many cases may be mediated by workaholism. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
Open AccessArticle Living with Smoker(s) and Smoking Cessation in Chinese Adult Smokers: Cross-Sectional and Prospective Evidence from Hong Kong Population Health Survey
Int. J. Environ. Res. Public Health 2018, 15(1), 74; doi:10.3390/ijerph15010074
Received: 19 November 2017 / Revised: 23 December 2017 / Accepted: 27 December 2017 / Published: 5 January 2018
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Abstract
Background: Results on the environmental influence on unassisted quitting are scarce. We investigated the associations of living with smoker(s) with quitting in Chinese adult smokers. Methods: We examined both cross-sectional and prospective data in the Hong Kong Population Health Survey recruited
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Background: Results on the environmental influence on unassisted quitting are scarce. We investigated the associations of living with smoker(s) with quitting in Chinese adult smokers. Methods: We examined both cross-sectional and prospective data in the Hong Kong Population Health Survey recruited participants in 2003/04, and followed up to 2006. Unconditional logistic regression yielded adjusted odds ratios (AORs) of (i) planning to quit, (ii) ex-smoking (cross-sectional), and quitting (prospective) for living with smoker(s). 1679 ever smokers aged 18+ years at baseline, and 323 of them who were successfully followed-up were included in the cross-sectional, and prospective analysis. Results: At baseline, living with smoker(s) was significantly associated with lower odds of planning to quit in current smokers (AOR 0.41, 95% CI 0.25–0.68), and lower odds of ex-smoking (AOR 0.45, 95% CI 0.34–0.58), particularly if the smoker(s) smoked inside home (AOR 0.35, 95% CI 0.26–0.47). Prospectively, living with smoker(s) non-significantly predicted lower odds of new quitting (AOR 0.48, 95% CI 0.13–1.78). Conclusions: Our study has provided the first evidence in a Chinese general population that living with smoker(s) is an important barrier against smoking cessation. To boost quit rate in nonusers of smoking cessation services, smoking at home should be banned, especially for populations living in crowed urban environments that are typical of economically developed cities in China. Full article
(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)
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Open AccessFeature PaperArticle Community Engaged Cumulative Risk Assessment of Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana
Int. J. Environ. Res. Public Health 2018, 15(1), 76; doi:10.3390/ijerph15010076
Received: 8 November 2017 / Revised: 28 December 2017 / Accepted: 30 December 2017 / Published: 5 January 2018
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Abstract
An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on
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An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families’ financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Socio-Demographic and Mental Health Profile of Admitted Cases of Self-Inflicted Harm in the US Population
Int. J. Environ. Res. Public Health 2018, 15(1), 77; doi:10.3390/ijerph15010077
Received: 22 September 2017 / Revised: 24 December 2017 / Accepted: 31 December 2017 / Published: 5 January 2018
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Abstract
Self-inflicted harm (SIH) has a substantial lifetime prevalence, it is associated with tremendous costs, and its rate is increasing on a national scale. To examine the characteristics of those admitted for SIH in the US and to investigate the factors that potentially modify
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Self-inflicted harm (SIH) has a substantial lifetime prevalence, it is associated with tremendous costs, and its rate is increasing on a national scale. To examine the characteristics of those admitted for SIH in the US and to investigate the factors that potentially modify the methods used for SIH. This was a retrospective analysis of admitted cases of SIH including suicide attempts between 2007 and 2012 using the National Trauma Data Bank. We included a total of 204,633 cases admitted for SIH. Our participants were 75.1% males. Those aged 15–24 (21%), 25–34 (22%), 35–44 (19%), 45–54 (19%), and 55–64 (10%) years comprised the largest age groups among our cases—70.8%, 11.5%, 11.1%, and 6.6% were, respectively, Caucasians, Hispanics, Blacks, and Asian/Others. Analyses of the SIH methods revealed that Blacks were less likely to self-poison [Odds Ratio (OR): 0.78] compared to Whites, whereas individuals with psychiatric disorders or substance abuse carried 2.5 and 2.0-fold higher risk, respectively. Blacks were also less likely to use anoxic methods (OR: 0.69), whereas patients with psychiatric disorders or substance abuse carried 1.5-fold higher risk. Being Black, Hispanic, and Asian (OR: 0.58, 0.55, and 0.55, respectively) as well as having psychiatric disorders (OR: 0.80) were associated with lower risks of using firearms, whereas its risk was increased with increasing age. Blacks (OR: 0.77) were less likely to cut or pierce in contrast to Hispanics (OR: 1.4), Asians/Others (OR: 1.29), and those with psychiatric disorders (2.5-fold higher risk) or drug abuse (2-fold higher risk). Blacks (OR: 1.11), Hispanics (OR: 1.13), and Asians/Others (OR: 1.57) were more likely to jump from high places, whereas those with substance abuse were less likely (OR: 0.77). Among patients admitted for SIH, males, those aged 15–64 years, and Whites comprised the largest sex, age, and racial/ethnic groups, respectively. We also found that several factors including race/ethnicity, gender, age, and having concurrent psychiatric or drug abuse disorders can potentially influence the methods used for SIH. Full article
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Open AccessArticle On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues
Int. J. Environ. Res. Public Health 2018, 15(1), 79; doi:10.3390/ijerph15010079
Received: 14 November 2017 / Revised: 28 December 2017 / Accepted: 2 January 2018 / Published: 6 January 2018
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Abstract
This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics
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This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Lipoprotein-Cholesterol Fractions in Marginalized Roma versus Majority Population
Int. J. Environ. Res. Public Health 2018, 15(1), 81; doi:10.3390/ijerph15010081
Received: 30 November 2017 / Revised: 22 December 2017 / Accepted: 27 December 2017 / Published: 6 January 2018
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Abstract
The trend of modern clinical biochemistry is to emphasize the composition and the quality of lipoproteins over their quantity. The serum lipoprotein fractions and subfractions were analyzed by the Lipoprint Lipoprotein Subfractions Testing System, the parameters of lipid profile, as total cholesterol (TC),
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The trend of modern clinical biochemistry is to emphasize the composition and the quality of lipoproteins over their quantity. The serum lipoprotein fractions and subfractions were analyzed by the Lipoprint Lipoprotein Subfractions Testing System, the parameters of lipid profile, as total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and triacylglycerides (TAG) were determined by an automated selective biochemical analyzer. Our results showed a significantly lower concentration of cholesterol in the LDL fractions 1 and 2 and in the HDL fractions 8 to 10 in Roma compared to the majority population. The most significant differences between Roma and the majority population when considering body mass index (BMI), waist-to-hip ratio and the index of central obesity were in very low-density lipoproteins (VLDL), intermediate-density lipoproteins, fraction A (IDL-A) and LDL-2. The last two listed were significantly higher in the majority population. VLDL was significantly higher in overweight or obese Roma men and in Roma men with central obesity compared to men from the majority population, as well as in Roma women with normal weight and physiological waist-to-hip ratio compared to the women from majority population. Our study is among the first describing the distribution of lipoprotein subfractions in different ethnic groups. Full article
(This article belongs to the Special Issue Roma Health)
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Open AccessArticle Trajectories of Emotional Symptoms and Peer Relationship Problems in Children after Nuclear Disaster: Evidence from the Fukushima Health Management Survey
Int. J. Environ. Res. Public Health 2018, 15(1), 82; doi:10.3390/ijerph15010082
Received: 11 December 2017 / Revised: 31 December 2017 / Accepted: 3 January 2018 / Published: 6 January 2018
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Abstract
The Fukushima Daiichi Nuclear Power Plant accident, which occurred in March 2011, is having long-term effects on children. We planned this study to describe the trajectories of emotional symptoms and peer relationship problems in children and to examine potential risks and protective factors
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The Fukushima Daiichi Nuclear Power Plant accident, which occurred in March 2011, is having long-term effects on children. We planned this study to describe the trajectories of emotional symptoms and peer relationship problems in children and to examine potential risks and protective factors over the 35 months following the accident. The sample was 11,791 children in the first to sixth elementary grades. We identified four patterns for emotional symptoms and three patterns for peer relationship problems, using group-based trajectory modelling. For emotional symptoms, female gender, experience of tsunami and nuclear plant accident, out-of-prefecture evacuees, and insufficient physical activity were associated with the very severe trajectory. In contrast, for peer relationship problems, male gender, experience of nuclear plant accident, and insufficient physical activity were associated with the very severe trajectory. Different factors might be related to the very severe trajectories of emotional symptoms and peer relationship problems. Full article
(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)
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Open AccessArticle Impact of Smoking Ban on Passive Smoke Exposure in Pregnant Non-Smokers in the Southeastern United States
Int. J. Environ. Res. Public Health 2018, 15(1), 83; doi:10.3390/ijerph15010083
Received: 31 October 2017 / Revised: 3 January 2018 / Accepted: 3 January 2018 / Published: 6 January 2018
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Abstract
Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the
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Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the effect of a ban enacted in the southeastern U.S. on pregnant women’s cotinine levels. Additional analyses compared self-reported exposure to cotinine and identified characteristics associated with passive exposure. Pregnant women (N = 851) were recruited prospectively between 2005 and 2011 in North Carolina. Sociodemographic and health data were collected via surveys; maternal blood samples were assayed for cotinine. Among non-active smokers who provided self-report data regarding passive exposure (N = 503), 20% were inconsistent with corresponding cotinine. Among all non-smokers (N = 668), being unmarried, African American, and less educated were each associated with greater passive exposure. Controlling for covariates, mean cotinine was higher prior to the ban compared to after, F(1, 640) = 24.65, p < 0.001. Results suggest that banning smoking in public spaces may reduce passive smoke exposure for non-smoking pregnant women. These data are some of the first to examine the impact of legislation on passive smoke exposure in pregnant women within the U.S. using a biomarker and can inform policy in regions lacking comprehensive smoke-free legislation. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle Neighborhood Perceptions and Cumulative Impacts of Low Level Chronic Exposure to Fine Particular Matter (PM2.5) on Cardiopulmonary Health
Int. J. Environ. Res. Public Health 2018, 15(1), 84; doi:10.3390/ijerph15010084
Received: 29 November 2017 / Revised: 20 December 2017 / Accepted: 29 December 2017 / Published: 6 January 2018
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Abstract
Adverse perceptions of neighborhood safety, aesthetics and quality including access to resources can induce stress and may make individuals more sensitive to cardiopulmonary effects of air pollution exposure. Few studies have examined neighborhood perceptions as important and modifiable non-chemical stressors of the built
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Adverse perceptions of neighborhood safety, aesthetics and quality including access to resources can induce stress and may make individuals more sensitive to cardiopulmonary effects of air pollution exposure. Few studies have examined neighborhood perceptions as important and modifiable non-chemical stressors of the built environment that may exacerbate effects of air pollution on cardiopulmonary health outcomes, particularly among general population based cohorts. This study examined associations between low-level chronic exposure to fine particulate matter (PM2.5) and cardiopulmonary health, and the potential mediating or modifying effects of adverse neighborhood perceptions. Using data from the Survey of the Health of Wisconsin (SHOW), 2230 non-asthmatic adults age 21–74 were included in the analyses. The overall goals of this study were to assess if individuals who experience stress from neighborhood environments in which they live were more sensitive to low levels of fine particular matter (PM2.5 μg/m3). Demographic predictors of air pollution exposure included younger age, non-White race, lower education and middle class income. After adjustments, objective lung function measures (FEV1 and FEV1 to FVC ratio) were the only cardiopulmonary health indicators significantly associated with chronic three-year annual averages of PM2.5. Among all non-asthmatics, a ten unit increase in estimated three year annual average PM2.5 exposure was significantly associated with lower forced expiratory volume (L) in one second FEV1 (β = −0.40 μg/L; 95% CI −0.45, −0.06). Among all individuals, adverse perceptions of the neighborhood built environment did not appear to statistically moderate or mediate associations. However, stratified analysis did reveal significant associations between PM2.5 and lung function (FEV1) only among individuals with negative perceptions and increased reports of neighborhood stressors. These findings included individuals who felt their neighborhoods were poorly maintained (β = −0.82; 95% CI −1.35, −0.28), experienced stress from crime (β = −0.45; 95% CI −0.94, 0.04) or reported neighborhood is not well maintained (β = −1.13, CI −2.04, −0.24). These significant associations were similar for FEV1 to FVC ratio. Multi-pronged approaches addressing both neighborhood built environment aesthetics and air pollution regulation may be necessary to protect vulnerable and susceptible individuals and reduce persistent inequalities. Full article
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
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Open AccessArticle Risk Assessment of Potentially Toxic Elements (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned Metallurgy Factory in North China
Int. J. Environ. Res. Public Health 2018, 15(1), 85; doi:10.3390/ijerph15010085
Received: 28 November 2017 / Revised: 29 December 2017 / Accepted: 3 January 2018 / Published: 6 January 2018
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Abstract
The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key
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The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key PTEs were measured. The soil properties and speciation of the PTEs were also identified. Extremely high concentrations of As, Cd, Pb, and Zn were observed in the surface soils. Using the PTEs concentration in the top soils of the rural industrial wasteland, the following indices of pollution were calculated: the pollution load index (PLI), the geo-accumulation Index (Igeo), the risk assessment code (RAC), and the health risk assessment (HRA). The analysis of the PLI and Igeo indicated that site #1 was relatively clean, while sites #2 and #3 were heavily polluted. The results of the RAC showed that PTEs in top soils at sites #2 and #3 were significantly increased (p <  0.05) for Cd and Zn. The HRA indicated that both As and Pb presented non-carcinogenic risks to children and adults at sites #2 and #3. Our findings can be a reference for risk prevention of industrially abandoned land in rural China. Full article
(This article belongs to the Special Issue Environmental Risk Assessment)
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Open AccessArticle Optimization of Location–Routing Problem for Cold Chain Logistics Considering Carbon Footprint
Int. J. Environ. Res. Public Health 2018, 15(1), 86; doi:10.3390/ijerph15010086
Received: 6 December 2017 / Revised: 1 January 2018 / Accepted: 2 January 2018 / Published: 6 January 2018
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Abstract
In order to solve the optimization problem of logistics distribution system for fresh food, this paper provides a low-carbon and environmental protection point of view, based on the characteristics of perishable products, and combines with the overall optimization idea of cold chain logistics
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In order to solve the optimization problem of logistics distribution system for fresh food, this paper provides a low-carbon and environmental protection point of view, based on the characteristics of perishable products, and combines with the overall optimization idea of cold chain logistics distribution network, where the green and low-carbon location–routing problem (LRP) model in cold chain logistics is developed with the minimum total costs as the objective function, which includes carbon emission costs. A hybrid genetic algorithm with heuristic rules is designed to solve the model, and an example is used to verify the effectiveness of the algorithm. Furthermore, the simulation results obtained by a practical numerical example show the applicability of the model while provide green and environmentally friendly location-distribution schemes for the cold chain logistics enterprise. Finally, carbon tax policies are introduced to analyze the impact of carbon tax on the total costs and carbon emissions, which proves that carbon tax policy can effectively reduce carbon dioxide emissions in cold chain logistics network. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Comparing U.S. Injury Death Estimates from GBD 2015 and CDC WONDER
Int. J. Environ. Res. Public Health 2018, 15(1), 87; doi:10.3390/ijerph15010087
Received: 3 November 2017 / Revised: 31 December 2017 / Accepted: 3 January 2018 / Published: 7 January 2018
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Abstract
Objective: The purpose of the present study was to examine consistency in injury death statistics from the United States CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) with those from GBD 2015 estimates. Methods: Differences in deaths and the percent
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Objective: The purpose of the present study was to examine consistency in injury death statistics from the United States CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) with those from GBD 2015 estimates. Methods: Differences in deaths and the percent difference in deaths between GBD 2015 and CDC WONDER were assessed, as were changes in deaths between 2000 and 2015 for the two datasets. Results: From 2000 to 2015, GBD 2015 estimates for the U.S. injury deaths were somewhat higher than CDC WONDER estimates in most categories, with the exception of deaths from falls and from forces of nature, war, and legal intervention in 2015. Encouragingly, the difference in total injury deaths between the two data sources narrowed from 44,897 (percent difference in deaths = 41%) in 2000 to 34,877 (percent difference in deaths = 25%) in 2015. Differences in deaths and percent difference in deaths between the two data sources varied greatly across injury cause and over the assessment years. The two data sources present consistent changes in direction from 2000 to 2015 for all injury causes except for forces of nature, war, and legal intervention, and adverse effects of medical treatment. Conclusions: We conclude that further studies are warranted to interpret the inconsistencies in data and develop estimation approaches that increase the consistency of the two datasets. Full article
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Open AccessArticle Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study
Int. J. Environ. Res. Public Health 2018, 15(1), 89; doi:10.3390/ijerph15010089
Received: 22 November 2017 / Revised: 31 December 2017 / Accepted: 1 January 2018 / Published: 8 January 2018
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Abstract
The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of
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The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1) peripheral neuropathy without ulcer, (2) non-infected foot ulcer, (3) infected foot ulcer, and (4) clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP) (1 Int$ = 1.748 BRL). We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13%) was for inpatient, and Int$ 333.5 million (87%) for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients. Although we have various reasons to believe that the hospital costs are underestimated, the estimated DFD burden is significant. As such, public health preventive strategies to reduce DFD related morbidity and mortality and costs are of utmost importance. Full article
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Open AccessArticle Characteristics of Refractive Errors in a Population of Adults in the Central Region of Poland
Int. J. Environ. Res. Public Health 2018, 15(1), 90; doi:10.3390/ijerph15010090
Received: 18 November 2017 / Revised: 19 December 2017 / Accepted: 6 January 2018 / Published: 8 January 2018
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Abstract
Background: To investigate the distribution of refractive errors and their characteristics in older adults from a Polish population. Methods: The study design was a cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998
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Background: To investigate the distribution of refractive errors and their characteristics in older adults from a Polish population. Methods: The study design was a cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998 subjects underwent refraction. Myopia was defined as spherical equivalent (SER) refraction ≤−0.5 dioptres (D) and hyperopia was defined as SER ≥+0.5 dioptres (D). Results: Among those who were refracted the distribution of myopia and hyperopia was 24.1% (95% CI 21.4–26.7) and 37.5% (95% CI 34.5–40.5), respectively. Myopia decreased from 28.7% in subjects aged 35–59 years to 19.3% in those aged 60 years or older and hyperopia increased from 21.8% at 35–59 years of age to 53.3% in subjects aged ≥60 years. Multiple regression analysis showed decreasing age (OR 0.98, 95% CI 0.96–1.00), female gender (OR 1.87, 95% CI 1.18–2.95) and presence of cataract (OR 2.40, 95% CI 1.24–4.63) were independent risk factors associated with myopia. Conclusions: The distribution of refractive errors found in our study is similar to those reported in other Caucasian populations and differs from Asian populations. Myopia was positively associated with younger age, female gender and presence of cataract. Full article
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Open AccessArticle Climate Change Risk Perception in Taiwan: Correlation with Individual and Societal Factors
Int. J. Environ. Res. Public Health 2018, 15(1), 91; doi:10.3390/ijerph15010091
Received: 11 November 2017 / Revised: 30 December 2017 / Accepted: 4 January 2018 / Published: 8 January 2018
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Abstract
This study differentiates the risk perception and influencing factors of climate change along the dimensions of global severity and personal threat. Using the 2013 Taiwan Social Change Survey (TSGS) data (N = 2001) as a representative sample of adults from Taiwan, we investigated
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This study differentiates the risk perception and influencing factors of climate change along the dimensions of global severity and personal threat. Using the 2013 Taiwan Social Change Survey (TSGS) data (N = 2001) as a representative sample of adults from Taiwan, we investigated the influencing factors of the risk perceptions of climate change in these two dimensions (global severity and personal threat). Logistic regression models were used to examine the correlations of individual factors (gender, age, education, climate-related disaster experience and risk awareness, marital status, employment status, household income, and perceived social status) and societal factors (religion, organizational embeddedness, and political affiliations) with the above two dimensions. The results demonstrate that climate-related disaster experience has no significant impact on either the perception of global severity or the perception of personal impact. However, climate-related risk awareness (regarding typhoons, in particular) is positively associated with both dimensions of the perceived risks of climate change. With higher education, individuals are more concerned about global severity than personal threat. Regarding societal factors, the supporters of political parties have higher risk perceptions of climate change than people who have no party affiliation. Religious believers have higher risk perceptions of personal threat than non-religious people. This paper ends with a discussion about the effectiveness of efforts to enhance risk perception of climate change with regard to global severity and personal threat. Full article
(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)
Open AccessArticle Problematic Smartphone Use, Deep and Surface Approaches to Learning, and Social Media Use in Lectures
Int. J. Environ. Res. Public Health 2018, 15(1), 92; doi:10.3390/ijerph15010092
Received: 22 November 2017 / Revised: 28 December 2017 / Accepted: 4 January 2018 / Published: 8 January 2018
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Abstract
Several studies have shown that problematic smartphone use (PSU) is related to detrimental outcomes, such as worse psychological well-being, higher cognitive distraction, and poorer academic outcomes. In addition, many studies have shown that PSU is strongly related to social media use. Despite this,
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Several studies have shown that problematic smartphone use (PSU) is related to detrimental outcomes, such as worse psychological well-being, higher cognitive distraction, and poorer academic outcomes. In addition, many studies have shown that PSU is strongly related to social media use. Despite this, the relationships between PSU, as well as the frequency of social media use in lectures, and different approaches to learning have not been previously studied. In our study, we hypothesized that both PSU and the frequency of social media use in lectures are negatively correlated with a deep approach to learning (defined as learning for understanding) and positively correlated with a surface approach to learning (defined as superficial learning). The study participants were 415 Estonian university students aged 19–46 years (78.8% females; age M = 23.37, SD = 4.19); the effective sample comprised 405 participants aged 19–46 years (79.0% females; age M = 23.33, SD = 4.21). In addition to basic socio-demographics, participants were asked about the frequency of their social media use in lectures, and they filled out the Estonian Smartphone Addiction Proneness Scale and the Estonian Revised Study Process Questionnaire. Bivariate correlation analysis showed that PSU and the frequency of social media use in lectures were negatively correlated with a deep approach to learning and positively correlated with a surface approach to learning. Mediation analysis showed that social media use in lectures completely mediates the relationship between PSU and approaches to learning. These results indicate that the frequency of social media use in lectures might explain the relationships between poorer academic outcomes and PSU. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
Open AccessFeature PaperArticle Blood Lead Levels and Risk Factors for Lead Exposure in a Pediatric Population in Ho Chi Minh City, Vietnam
Int. J. Environ. Res. Public Health 2018, 15(1), 93; doi:10.3390/ijerph15010093
Received: 9 December 2017 / Revised: 30 December 2017 / Accepted: 2 January 2018 / Published: 8 January 2018
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Abstract
Although lead recycling activities are a known risk factor for elevated blood levels in South East Asia, little is known regarding the prevalence of and risk factors for elevated blood lead levels (BLL) among the general pediatric population in Vietnam. This study is
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Although lead recycling activities are a known risk factor for elevated blood levels in South East Asia, little is known regarding the prevalence of and risk factors for elevated blood lead levels (BLL) among the general pediatric population in Vietnam. This study is a cross-sectional evaluation of 311 children from Children’s Hospital #2 in Ho Chi Minh City, Vietnam. Capillary blood lead testing was performed using the LeadCare II. Mean BLLs were 4.97 μg/dL (Standard Deviation (SD) 5.50), with 7% of the participants having levels greater than 10 μg/dL. Living in Bing Duong province (OR 2.7, 95% CI 1.4–5.6.1) or the Dong Nai province (OR 2.3, 95% CI 1.0–5.1) and having an age greater than 12 months (OR 6.0, 95% CI 3.1–11.8) were associated with higher BLLs. The prevalence of elevated BLLs in Vietnam is consistent with other SE Asian countries. Mean BLLs in Ho Chi Minh City are markedly less than those seen in a separate study of children living near lead recycling activities. Additional evaluation is necessary to better detail potential risk factors if screening is to be implemented within Vietnam. Full article
(This article belongs to the Special Issue Global Children’s Environmental Health)
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Open AccessArticle Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(1), 95; doi:10.3390/ijerph15010095
Received: 11 October 2017 / Revised: 27 December 2017 / Accepted: 7 January 2018 / Published: 8 January 2018
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Abstract
Objectives: The consequences of hip fractures (HFs) in elderly persons include a deterioration in functional capacity to perform activities that enable independent living. Since prior research into this issue in Central Europe is rather scant, this study sought to assess the change in
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Objectives: The consequences of hip fractures (HFs) in elderly persons include a deterioration in functional capacity to perform activities that enable independent living. Since prior research into this issue in Central Europe is rather scant, this study sought to assess the change in activities and instrumental activities of daily living (ADL/IADL) after HF surgery among Polish patients, to study predictors of regaining pre-fracture functional status three and six months later, and to evaluate the correlation between ADL and IADL limitations over time. Methods: A prospective study was conducted between 2011 and 2013 in a tertiary hospital in Western Poland. ADL/IADL were evaluated using the Katz index and Lawton scale, respectively. Results: About half (50.8%) of 120 patients (mean age 80.1 ± SD 7.59) had cognitive impairment (CI). Patients with CI were older (p = 0.002) and had lower scores for pre-fracture ADL/IADL (p = 0.001 and p < 0.001, respectively). Six months after HF, 33.3% of patients failed to return to their pre-fracture ADL and 62.5% failed to return to pre-fracture IADL; 20% of those who could walk before HF were unable to walk after six months. The pre-fracture Spearman correlation coefficient between ADL and IADL summary scores was 0.46; it increased to 0.70 at three months after HF surgery and 0.77 at six months (p < 0.0001). Regaining ADL after six months was more likely in patients with pre-fracture intact intellectual function and independence in pre-fracture ADL; regaining IADL, in younger patients and those with higher pre-fracture IADL scores. Conclusions: Impairment in functional performance is common after HF surgery. ADL and IADL were strongly correlated in these patients, with this increasing over time. Functional outcomes after HF were more dependent on patient characteristics than treatment-related factors. Therefore, more emphasis should be directed towards the pre-fracture period and, in particular, maintaining cognitive function and preserving functional capacity in older persons at high risk of HF. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Impact of Age and Hearing Impairment on Work Performance during Long Working Hours
Int. J. Environ. Res. Public Health 2018, 15(1), 98; doi:10.3390/ijerph15010098
Received: 9 November 2017 / Revised: 19 December 2017 / Accepted: 4 January 2018 / Published: 9 January 2018
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Abstract
Based on demographic prognoses, it must be assumed that a greater number of older workers will be found in the future labor market. How to deal with their possible age-related impairments of sensory functions, like hearing impairment and work performance during extended working
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Based on demographic prognoses, it must be assumed that a greater number of older workers will be found in the future labor market. How to deal with their possible age-related impairments of sensory functions, like hearing impairment and work performance during extended working time, has not been addressed explicitly until now. The study addresses this interplay. The study was performed on two consecutive days after normal working hours. The 55 participants had to “work” in the study at least three additional hours to simulate a situation of long working hours. The tested measures for (job) performance were: general attention, long-term selective attention, concentration, and reaction time. All of the investigated variables were taken at both days of the study (2 × 2 × 2 repeated measurement design). The results show effects for age, the interaction of hearing impairment and time of measurement, and effects of the measurement time. Older participants reacted slower than younger participants did. Furthermore, younger participants reacted more frequently in a correct way. Hearing impairment seems to have a negative impact especially on measures of false reactions, and therefore especially on measurement time 1. The results can be interpreted in a way that hearing-impaired participants are able to compensate their deficits over time. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Spatial and Seasonal Dynamics of Water Environmental Capacity in Mountainous Rivers of the Southeastern Coast, China
Int. J. Environ. Res. Public Health 2018, 15(1), 99; doi:10.3390/ijerph15010099
Received: 15 November 2017 / Revised: 13 December 2017 / Accepted: 8 January 2018 / Published: 9 January 2018
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Abstract
The south-east littoral is one of the most populous and developed regions in China suffering from serious water pollution problems, and the Xian-Jiang Basin in the mid of this region is among the most polluted watersheds. Critical information is needed but lacking for
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The south-east littoral is one of the most populous and developed regions in China suffering from serious water pollution problems, and the Xian-Jiang Basin in the mid of this region is among the most polluted watersheds. Critical information is needed but lacking for improved pollution control and water quality assessment, among which water environmental capacity (WEC) is the most important variable but is difficult to calculate. In this study, a one-dimensional water quality model combined with a matrix calculation algorithm was first developed and calibrated with in-situ observations in the Xian-Jiang basin. Then, the model was applied to analyze the spatial and temporal patterns of WEC of the entire basin. The results indicated that, in 2015, the total pollutant discharges into the river reached 6719.68 t/yr, 488.12 t/yr, and 128.57 t/yr for COD, NH3-N and TP, respectively. The spatial pattern suggested a strong correlation between these water contaminants and industrial enterprises, residential areas, and land-use types in the basin. Furthermore, it was noticed that there was a significant seasonal pattern in WEC that the dry season pollution is much greater than that in the plum season, while that in the typhoon season appears to be the weakest among all seasons. The WEC differed significantly among the 24 sub-basins during the dry season but varied to a smaller extent in other seasons, suggesting differential complex spatial-temporal dependency of the WEC. Full article
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Open AccessArticle Identifying Dietary Patterns Associated with Mild Cognitive Impairment in Older Korean Adults Using Reduced Rank Regression
Int. J. Environ. Res. Public Health 2018, 15(1), 100; doi:10.3390/ijerph15010100
Received: 4 December 2017 / Revised: 3 January 2018 / Accepted: 8 January 2018 / Published: 9 January 2018
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Abstract
Diet plays a crucial role in cognitive function. Few studies have examined the relationship between dietary patterns and cognitive functions of older adults in the Korean population. This study aimed to identify the effect of dietary patterns on the risk of mild cognitive
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Diet plays a crucial role in cognitive function. Few studies have examined the relationship between dietary patterns and cognitive functions of older adults in the Korean population. This study aimed to identify the effect of dietary patterns on the risk of mild cognitive impairment. A total of 239 participants, including 88 men and 151 women, aged 65 years and older were selected from health centers in the district of Seoul, Gyeonggi province, and Incheon, in Korea. Dietary patterns were determined using Reduced Rank Regression (RRR) methods with responses regarding vitamin B6, vitamin C, and iron intakes, based on both a one-day 24-h recall and a food frequency questionnaire. Cognitive function was assessed using the Korean-Mini Mental State Examination (K-MMSE). Multivariable logistic regression models were used to estimate the association between dietary pattern score and the risk of mild cognitive impairment. A total of 20 (8%) out of the 239 participants had mild cognitive impairment. Three dietary patterns were identified: seafood and vegetables, high meat, and bread, ham, and alcohol. Among the three dietary patterns, the older adult population who adhered to the seafood and vegetables pattern, characterized by high intake of seafood, vegetables, fruits, bread, snacks, soy products, beans, chicken, pork, ham, egg, and milk had a decreased risk of mild cognitive impairment compared to those who did not (adjusted odds ratios 0.06, 95% confidence interval 0.01–0.72) after controlling for gender, supplementation, education, history of dementia, physical activity, body mass index (BMI), and duration of sleep. The other two dietary patterns were not significantly associated with the risk of mild cognitive impairment. In conclusion, high consumption of fruits, vegetables, seafood, and protein foods was significantly associated with reduced mild cognitive impairment in older Korean adults. These results can contribute to the establishment of dietary guidelines targeting older Korean adults to reduce mild cognitive impairments. Future prospective cohort studies are warranted to examine the effect of the seafood and vegetable dietary pattern on reducing mild cognitive impairment to prove the cause–effect relationship between dietary patterns and cognitive function. Full article
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Open AccessArticle Adsorption Behavior and Mechanism for the Uptake of Fluoride Ions by Reed Residues
Int. J. Environ. Res. Public Health 2018, 15(1), 101; doi:10.3390/ijerph15010101
Received: 3 November 2017 / Revised: 4 January 2018 / Accepted: 6 January 2018 / Published: 9 January 2018
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Abstract
The adsorption behavior and mechanism for the uptake of fluoride ions by untreated and desugared reed residues (roots, stems and leaves) were studied through adsorption experiments, elemental analysis, infrared spectroscopy and surface area analysis. The results showed that the adsorption capacity of untreated
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The adsorption behavior and mechanism for the uptake of fluoride ions by untreated and desugared reed residues (roots, stems and leaves) were studied through adsorption experiments, elemental analysis, infrared spectroscopy and surface area analysis. The results showed that the adsorption capacity of untreated and desugared reeds followed the order: desugared roots 2136 mg/kg > desugared leaves 1825 mg/kg > desugared stems 1551 mg/kg > untreated roots 191 mg/kg > untreated stems 175 mg/kg > untreated leaves 150 mg/kg, so adsorption capacity of desugared reeds was larger than that of the untreated reeds. The adsorption kinetic of fluoride ions followed a pseudo-first-order model. A Langmuir model could be used to fit the isothermal adsorption process which was a spontaneous endothermic reaction involving mainly physical adsorption. The ΔG for the uptake of fluoride by the desugared reeds was more negative, so the degree of spontaneity was higher than for the use of the untreated reeds. After samples were desugared, the specific surface area and aromaticity of the reed increased, while the polarity and hydrophilicity decreased, which explained the adsorption amount of desugared reed was higher than that of the untreated. This study enriches techniques and methods of removing fluoride ions from water. Full article
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Open AccessFeature PaperArticle Preventive Effect of Residential Green Space on Infantile Atopic Dermatitis Associated with Prenatal Air Pollution Exposure
Int. J. Environ. Res. Public Health 2018, 15(1), 102; doi:10.3390/ijerph15010102
Received: 3 December 2017 / Revised: 28 December 2017 / Accepted: 3 January 2018 / Published: 9 January 2018
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Abstract
Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether
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Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether exposure to nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter of <10 μm (PM10) during pregnancy is associated with increased risk of development of AD in 6-month-old children and also to examine how this association changes with residential green space. This study used prospective data from 659 participants of the Mothers and Children’s Environmental Health study. Subjects were geocoded to their residential addresses and matched with air pollution data modeled using land-use regression. Information on infantile AD was obtained by using a questionnaire administered to the parents or guardians of the children. The association between infantile AD and exposure to NO2 and PM10 was determined using logistic regression models. We assessed the effects of residential green spaces using stratified analyses and by entering product terms into the logistic regression models. The risk of infantile AD significantly increased with an increase in air pollution exposure during the first trimester of pregnancy. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.219 (1.023–1.452) per 10 μg/m3 increase in PM10 and 1.353 (1.027–1.782) per 10 ppb increase in NO2. An increase in the green space within 200 m of residence was associated with a decreased risk of AD (OR = 0.996, 95% CI: 0.993–0.999). The stratified analysis of residential green space revealed stronger associations between infantile AD and PM10 and NO2 exposure during the first trimester in the areas in the lower tertiles of green space. This study indicated that exposure to TRAP during the first trimester of pregnancy is associated with infantile AD. Less residential green space may intensify the association between TRAP exposure and infantile AD. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle A Qualitative Study of HR/OHS Stress Interventions in Australian Universities
Int. J. Environ. Res. Public Health 2018, 15(1), 103; doi:10.3390/ijerph15010103
Received: 30 November 2017 / Revised: 3 January 2018 / Accepted: 3 January 2018 / Published: 9 January 2018
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Abstract
To enhance the understanding of psychosocial factors and extend research on work stress interventions, we investigated the key human resource (HR)/occupational health and safety (OHS) stress interventions implemented at five Australian universities over a three-year period. Five senior HR Directors completed an online
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To enhance the understanding of psychosocial factors and extend research on work stress interventions, we investigated the key human resource (HR)/occupational health and safety (OHS) stress interventions implemented at five Australian universities over a three-year period. Five senior HR Directors completed an online survey to identify the intervention strategies taken at their university in order to reduce stress and enhance employee well-being and morale. We also explored the types of individual-, organization-, and individual/organization-directed interventions that were implemented, and the strategies that were prioritized at each university. Across universities, the dominant interventions were strategies that aimed to balance the social exchange in the work contract between employee-organization with an emphasis on initiatives to: enhance training, career development and promotional opportunities; improve remuneration and recognition practices; and to enhance the fairness of organizational policies and procedures. Strategies to improve work-life balance were also prominent. The interventions implemented were predominantly proactive (primary) strategies focused at the organizational level and aimed at eliminating or reducing or altering work stressors. The findings contribute to the improved management of people at work by identifying university-specific HR/OHS initiatives, specifically leadership development and management skills programs which were identified as priorities at three universities. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
Open AccessArticle The Secretory Response of Rat Peritoneal Mast Cells on Exposure to Mineral Fibers
Int. J. Environ. Res. Public Health 2018, 15(1), 104; doi:10.3390/ijerph15010104
Received: 17 November 2017 / Revised: 27 December 2017 / Accepted: 3 January 2018 / Published: 10 January 2018
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Abstract
Background: Exposure to mineral fibers is of substantial relevance to human health. A key event in exposure is the interaction with inflammatory cells and the subsequent generation of pro-inflammatory factors. Mast cells (MCs) have been shown to interact with titanium oxide (TiO2
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Background: Exposure to mineral fibers is of substantial relevance to human health. A key event in exposure is the interaction with inflammatory cells and the subsequent generation of pro-inflammatory factors. Mast cells (MCs) have been shown to interact with titanium oxide (TiO2) and asbestos fibers. In this study, we compared the response of rat peritoneal MCs challenged with the asbestos crocidolite and nanowires of TiO2 to that induced by wollastonite employed as a control fiber. Methods: Rat peritoneal MCs (RPMCs), isolated from peritoneal lavage, were incubated in the presence of mineral fibers. The quantities of secreted enzymes were evaluated together with the activity of fiber-associated enzymes. The ultrastructural morphology of fiber-interacting RPMCs was analyzed with electron microscopy. Results: Asbestos and TiO2 stimulate MC secretion. Secreted enzymes bind to fibers and exhibit higher activity. TiO2 and wollastonite bind and improve enzyme activity, but to a lesser degree than crocidolite. Conclusions: (1) Mineral fibers are able to stimulate the mast cell secretory process by both active (during membrane interaction) and/or passive (during membrane penetration) interaction; (2) fibers can be found to be associated with secreted enzymes—this process appears to create long-lasting pro-inflammatory environments and may represent the active contribution of MCs in maintaining the inflammatory process; (3) MCs and their enzymes should be considered as a therapeutic target in the pathogenesis of asbestos-induced lung inflammation; and (4) MCs can contribute to the inflammatory effect associated with selected engineered nanomaterials, such as TiO2 nanoparticles. Full article
(This article belongs to the Section Environmental Health)
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Open AccessFeature PaperArticle Modeling Unobserved Heterogeneity in Susceptibility to Ambient Benzo[a]pyrene Concentration among Children with Allergic Asthma Using an Unsupervised Learning Algorithm
Int. J. Environ. Res. Public Health 2018, 15(1), 106; doi:10.3390/ijerph15010106
Received: 8 November 2017 / Revised: 2 January 2018 / Accepted: 4 January 2018 / Published: 10 January 2018
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Abstract
Current studies of gene × air pollution interaction typically seek to identify unknown heritability of common complex illnesses arising from variability in the host’s susceptibility to environmental pollutants of interest. Accordingly, a single component generalized linear models are often used to model the
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Current studies of gene × air pollution interaction typically seek to identify unknown heritability of common complex illnesses arising from variability in the host’s susceptibility to environmental pollutants of interest. Accordingly, a single component generalized linear models are often used to model the risk posed by an environmental exposure variable of interest in relation to a priori determined DNA variants. However, reducing the phenotypic heterogeneity may further optimize such approach, primarily represented by the modeled DNA variants. Here, we reduce phenotypic heterogeneity of asthma severity, and also identify single nucleotide polymorphisms (SNP) associated with phenotype subgroups. Specifically, we first apply an unsupervised learning algorithm method and a non-parametric regression to find a biclustering structure of children according to their allergy and asthma severity. We then identify a set of SNPs most closely correlated with each sub-group. We subsequently fit a logistic regression model for each group against the healthy controls using benzo[a]pyrene (B[a]P) as a representative airborne carcinogen. Application of such approach in a case-control data set shows that SNP clustering may help to partly explain heterogeneity in children’s asthma susceptibility in relation to ambient B[a]P concentration with greater efficiency. Full article
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Open AccessArticle Parents’ Perspectives on Family Sexuality Communication from Middle School to High School
Int. J. Environ. Res. Public Health 2018, 15(1), 107; doi:10.3390/ijerph15010107
Received: 18 December 2017 / Revised: 5 January 2018 / Accepted: 7 January 2018 / Published: 10 January 2018
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Abstract
Parents’ conversations with teens about sex and relationships can play a critical role in improving teenage reproductive health by reducing teens’ risky sexual behavior. However, little is known about how teen-parent communication changes from early to middle adolescence and how parents can tailor
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Parents’ conversations with teens about sex and relationships can play a critical role in improving teenage reproductive health by reducing teens’ risky sexual behavior. However, little is known about how teen-parent communication changes from early to middle adolescence and how parents can tailor their communication to address their teens’ changing development and experiences during these periods. In this longitudinal qualitative study, U.S. parents (N = 23) participated in interviews when their teens were in early adolescence, then again when the teens were in middle adolescence. Participants were largely mothers and were from diverse racial/ethnic and educational backgrounds. Thematic analysis was used to assess continuity and change in parents’ perceptions of teen-parent communication. Findings showed that many parents adapted their conversations with their teens about sex and relationships as teens developed. Once teens had entered high school, more parents described feeling comfortable with their conversations. However, parents also more often reported that their teens responded negatively to the communication in high school than they had in middle school. These findings may help parents to anticipate their own as well as their teens’ responses to family conversations about sex at different developmental time points and to strategize how to effectively talk with their teens about sex and relationships to improve their teens’ overall reproductive health. Full article
Open AccessCommunication Preliminary Analyses Showed Short-Term Mental Health Improvements after a Single-Day Manager Training
Int. J. Environ. Res. Public Health 2018, 15(1), 108; doi:10.3390/ijerph15010108
Received: 30 November 2017 / Revised: 1 January 2018 / Accepted: 1 January 2018 / Published: 10 January 2018
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Abstract
Psychosocial working conditions attract more and more attention when it comes to mental health in the workplace. Trying to support managers to deal with their own as well as their employees’ psychological risk factors, we conducted a specific manager training. Within this investigation,
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Psychosocial working conditions attract more and more attention when it comes to mental health in the workplace. Trying to support managers to deal with their own as well as their employees’ psychological risk factors, we conducted a specific manager training. Within this investigation, we wanted to learn about the training’s effects and acceptance. A single-day manager training was provided in a large industrial company in Germany. The participants were asked to fill out questionnaires regarding their own physical and mental health condition as well as their working situation. Questionnaires were distributed at baseline, 3-month, and 12-month follow-up. At this point of time the investigation is still ongoing. The current article focuses on short-term preliminary effects. Analyses only included participants that already completed baseline and three months follow-up. Preliminary results from three-month follow-up survey (n = 33, nmale = 30, Mage = 47.5) indicated positive changes in the manager’s mental health condition measured by the Patient Health Questionnaire for depression (PHQ-9: Mt1 = 3.82, Mt2 = 3.15). Training managers about common mental disorders and risk factors at the workplace within a single-day workshop seems to promote positive effects on their own mental health. Especially working with the managers on their own early stress symptoms might have been an important element. Full article
(This article belongs to the Section Occupational Safety and Health)
Open AccessArticle Community Characteristics and Leaf Stoichiometric Traits of Desert Ecosystems Regulated by Precipitation and Soil in an Arid Area of China
Int. J. Environ. Res. Public Health 2018, 15(1), 109; doi:10.3390/ijerph15010109
Received: 25 October 2017 / Revised: 7 January 2018 / Accepted: 8 January 2018 / Published: 10 January 2018
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Abstract
Precipitation is a key environmental factor determining plant community structure and function. Knowledge of how community characteristics and leaf stoichiometric traits respond to variation in precipitation is crucial for assessing the effects of global changes on terrestrial ecosystems. In this study, we measured
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Precipitation is a key environmental factor determining plant community structure and function. Knowledge of how community characteristics and leaf stoichiometric traits respond to variation in precipitation is crucial for assessing the effects of global changes on terrestrial ecosystems. In this study, we measured community characteristics, leaf stoichiometric traits, and soil properties along a precipitation gradient (35–209 mm) in a desert ecosystem of Northwest China to explore the drivers of these factors. With increasing precipitation, species richness, aboveground biomass, community coverage, foliage projective cover (FPC), and leaf area index (LAI) all significantly increased, while community height decreased. The hyperarid desert plants were characterized by lower leaf carbon (C) and nitrogen/phosphorus (N/P) levels, and stable N and P, and these parameters did not change significantly with precipitation. The growth of desert plants was limited more by N than P. Soil properties, rather than precipitation, were the main drivers of desert plant leaf stoichiometric traits, whereas precipitation made the biggest contribution to vegetation structure and function. These results test the importance of precipitation in regulating plant community structure and composition together with soil properties, and provide further insights into the adaptive strategy of communities at regional scale in response to global climate change. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessArticle STI Knowledge in Berlin Adolescents
Int. J. Environ. Res. Public Health 2018, 15(1), 110; doi:10.3390/ijerph15010110
Received: 26 November 2017 / Revised: 18 December 2017 / Accepted: 19 December 2017 / Published: 10 January 2018
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Abstract
Sexually transmitted infections (STIs) pose a significant threat to individual and public health. They disproportionately affect adolescents and young adults. In a cross-sectional study, we assessed self-rated and factual STI knowledge in a sample of 9th graders in 13 secondary schools in Berlin,
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Sexually transmitted infections (STIs) pose a significant threat to individual and public health. They disproportionately affect adolescents and young adults. In a cross-sectional study, we assessed self-rated and factual STI knowledge in a sample of 9th graders in 13 secondary schools in Berlin, Germany. Differences by age, gender, migrant background, and school type were quantified using bivariate and multivariable analyses. A total of 1177 students in 61 classes participated. The mean age was 14.6 (SD = 0.7), 47.5% were female, and 52.9% had at least one immigrant parent. Knowledge of human immunodeficiency virus (HIV) was widespread, but other STIs were less known. For example, 46.2% had never heard of chlamydia, 10.8% knew of the HPV vaccination, and only 2.2% were aware that no cure exists for HPV infection. While boys were more likely to describe their knowledge as good, there was no general gender superiority in factual knowledge. Children of immigrants and students in the least academic schools had lower knowledge overall. Our results show that despite their particular risk to contract an STI, adolescents suffer from suboptimal levels of knowledge on STIs beyond HIV. Urgent efforts needed to improve adolescent STI knowledge in order to improve the uptake of primary and secondary prevention. Full article
Open AccessArticle CRP Genotypes Predict Increased Risk to Co-Present with Low Vitamin D and Elevated CRP in a Group of Healthy Black South African Women
Int. J. Environ. Res. Public Health 2018, 15(1), 111; doi:10.3390/ijerph15010111
Received: 13 November 2017 / Revised: 15 December 2017 / Accepted: 30 December 2017 / Published: 10 January 2018
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Abstract
Low 25-hydroxyvitamin D (25(OH)D) and elevated C-reactive protein (CRP) concentrations are independently associated with adverse health outcomes, including cardiovascular disease (CVD). Although an inverse association between these factors has been described, the underlying mechanisms remain unknown. We postulate that environment–gene interactions, through which
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Low 25-hydroxyvitamin D (25(OH)D) and elevated C-reactive protein (CRP) concentrations are independently associated with adverse health outcomes, including cardiovascular disease (CVD). Although an inverse association between these factors has been described, the underlying mechanisms remain unknown. We postulate that environment–gene interactions, through which 25(OH)D interacts with single nucleotide polymorphisms (SNPs) within the CRP gene, modulate CRP; that certain CRP genotypes predispose individuals to a co-phenotype of low 25(OH)D and elevated CRP concentrations; and that this co-phenotype is associated with higher CVD risk. Twelve CRP SNPs were genotyped, and both 25(OH)D and CRP were quantified, in 505 black South African women. Alarmingly, 66% and 60% of the women presented with deficient/insufficient 25(OH)D and elevated CRP concentrations, respectively. CRP concentrations were higher in individuals with lower 25(OH)D concentrations. However, no 25(OH)D–CRP genotype interactions were evident. Several genotypes were associated with an altered risk of presenting with the co-phenotype, indicating a genetic predisposition. Women presenting with this co-phenotype had higher blood pressure and increased anthropometric measures, which may predispose them to develop CVD. We recommend increasing vitamin D fortification and supplementation efforts to reduce inflammation among black women with vitamin D deficiency, thereby possibly curbing diseases contingent on the co-phenotype described here. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland
Int. J. Environ. Res. Public Health 2018, 15(1), 112; doi:10.3390/ijerph15010112
Received: 5 December 2017 / Revised: 28 December 2017 / Accepted: 8 January 2018 / Published: 11 January 2018
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Abstract
Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to
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Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016. The study was conducted in compliance with the methodology recommended by the Healthcare-associated Infections Surveillance Network (HAI-Net) of the European Centre for Disease Prevention and Control (ECDC). During the 10 years of the study, 1849 patients hospitalized in an ICU for a total of 17,599 days acquired 510 with overall HAIs rates of 27.6% and 29.0% infections per 1000 ICU days. Intubation-associated pneumonia (IAP) posed the greatest risk (15.2 per 1000 ventilator days), followed by CLA-BSI (8.0 per 1000 catheter days) and CA-UTI (3.0 per 1000 catheter days). The most common isolated microorganism was Acinetobacter baumannii (25%) followed by Coagulaase-negativ staphylococci (15%), Escherichia coli (9%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (7%), Candida albicans (6%). Acinetobacter baumannii in 87% and were classified as extensive-drug resistant (XDR). In summary, in ICU patients pneumonia and bloodstream infections were the most frequently found. Acinetobacter baumannii strains were most often isolated from clinical materials taken from HAI patients and showed resistance to many groups of antibiotics. A trend of increasing resistance of Acinetobacter baumannii to carbapenems was observed. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Heart Rate Variability Frequency Domain Alterations among Healthy Nurses Exposed to Prolonged Work Stress
Int. J. Environ. Res. Public Health 2018, 15(1), 113; doi:10.3390/ijerph15010113
Received: 17 November 2017 / Revised: 8 January 2018 / Accepted: 9 January 2018 / Published: 11 January 2018
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Abstract
The deregulation of the autonomic nervous system assessed through the heart rate variability (HRV) analysis is a promising pathway linking work stress and cardiovascular diseases. We aim to investigate the associations between HRV High Frequency (HF) and Low Frequency (LF) powers and work
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The deregulation of the autonomic nervous system assessed through the heart rate variability (HRV) analysis is a promising pathway linking work stress and cardiovascular diseases. We aim to investigate the associations between HRV High Frequency (HF) and Low Frequency (LF) powers and work stress in a sample of 36 healthy nurses. Perceived work stress was assessed twice one year apart, using the Job Content and Effort Reward Imbalance questionnaires. This allows to classify nurses in three exposure groups: “prolonged high stress” (PHS), “recent high stress” (RHS) and “stable low stress” (SLS). A 24-h ECG monitoring was later performed during a working day (WD) and a subsequent resting day (RD). Statistically significantly lower (p < 0.02) HF and LF means were found in PHS and RHS nurses during the working periods. In the subsequent resting periods, HF means showed increases over time in the RHS (beta = +0.41, p < 0.05), but not in PHS nurses. LF means did not show any substantial increases in the resting periods, in the PHS group with geometric means lower when compared to SLS, in the non-working and resting periods. Our study evidences that both prolonged and recent perceived high work stress were associated with a reduction of HF and LF powers during work. In addition, prolonged stress was associated with a lack of recovery during not-working and resting periods. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
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Open AccessArticle Spatiotemporal Patterns of Ground Monitored PM2.5 Concentrations in China in Recent Years
Int. J. Environ. Res. Public Health 2018, 15(1), 114; doi:10.3390/ijerph15010114
Received: 30 November 2017 / Revised: 9 January 2018 / Accepted: 10 January 2018 / Published: 11 January 2018
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Abstract
This paper firstly explores the space-time evolution of city-level PM2.5 concentrations showed a very significant seasonal cycle type fluctuation during the period between 13 May 2014 and 30 May 2017. The period from October to April following each year was a heavy
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This paper firstly explores the space-time evolution of city-level PM 2.5 concentrations showed a very significant seasonal cycle type fluctuation during the period between 13 May 2014 and 30 May 2017. The period from October to April following each year was a heavy pollution period, whereas the phase from April to October of the current year was part of a light pollution period. The average monthly PM 2.5 concentrations in mainland China based on ground monitoring, employing a descriptive statistics method and a Bayesian spatiotemporal hierarchy model. Daily and weekly average PM 2.5 concentrations in 338 cities in mainland China presented no significant spatial difference during the severe pollution period but a large spatial difference during light pollution periods. The severe PM 2.5 pollution areas were mainly distributed in the Beijing-Tianjin-Hebei urban agglomeration in the North China Plain during the beginning of each autumn-winter season (September), spreading to the Northeast Plains after October, then later continuing to spread to other cities in mainland China, eventually covering most cities. PM 2.5 pollution in China appeared to be a cyclic characteristic of first spreading and then centralizing in the space in two spring-summer seasons, and showed an obvious process of first diffusing then transferring to shrinkage alternation during the spring-summer season of 2015, but showed no obvious diffusion during the spring-summer season of 2016, maintaining a stable spatial structure after the shrinkage in June, as well as being more concentrated. The heavily polluted areas are continuously and steadily concentrated in East China, Central China and Xinjiang Province. Full article
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Open AccessArticle Inhibiting the Physiological Stress Effects of a Sustained Attention Task on Shoulder Muscle Activity
Int. J. Environ. Res. Public Health 2018, 15(1), 115; doi:10.3390/ijerph15010115
Received: 13 November 2017 / Revised: 8 January 2018 / Accepted: 8 January 2018 / Published: 11 January 2018
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Abstract
Objective: The objective of this study was to investigate if a breathing technique could counteract the effects of hyperventilation due to a sustained attention task on shoulder muscle activity. Background: The trend towards higher levels of automation in industry is increasing. Consequently, manufacturing
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Objective: The objective of this study was to investigate if a breathing technique could counteract the effects of hyperventilation due to a sustained attention task on shoulder muscle activity. Background: The trend towards higher levels of automation in industry is increasing. Consequently, manufacturing operators often monitor automated process for long periods of their work shift. Prolonged monitoring work requires sustained attention, which is a cognitive process that humans are typically poor at and find stressful. As sustained attention becomes an increasing requirement of manufacturing operators’ job content, the resulting stress experienced could contribute to the onset of many health problems, including work related musculoskeletal disorders (WRMSDs). Methods: The SART attention test was completed by a group of participants before and after a breathing intervention exercise. The effects of the abdominal breathing intervention on breathing rate, upper trapezius muscle activity and end-tidal CO2 were evaluated. Results: The breathing intervention reduced the moderation effect of end-tidal CO2 on upper trapezius muscle activity. Conclusions: Abdominal breathing could be a useful technique in reducing the effects of sustained attention work on muscular activity. Application: This research can be applied to highly-automated manufacturing industries, where prolonged monitoring of work is widespread and could, in its role as a stressor, be a potential contributor to WRMSDs. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
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Open AccessArticle Biointeractions of Herbicide Atrazine with Human Serum Albumin: UV-Vis, Fluorescence and Circular Dichroism Approaches
Int. J. Environ. Res. Public Health 2018, 15(1), 116; doi:10.3390/ijerph15010116
Received: 22 December 2017 / Revised: 6 January 2018 / Accepted: 9 January 2018 / Published: 11 January 2018
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Abstract
The herbicide atrazine is widely used across the globe, which is a great concern. To investigate its potential toxicity in the human body, human serum albumin (HSA) was selected as a model protein. The interaction between atrazine and HSA was investigated using steady-state
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The herbicide atrazine is widely used across the globe, which is a great concern. To investigate its potential toxicity in the human body, human serum albumin (HSA) was selected as a model protein. The interaction between atrazine and HSA was investigated using steady-state fluorescence spectroscopy, synchronous fluorescence spectroscopy, UV-Vis spectroscopy, three-dimensional (3D) fluorescence spectroscopy and circular dichroism (CD) spectroscopy. The intrinsic fluorescence of HSA was quenched by the atrazine through a static quenching mechanism. Fluorescence spectra at two excitation wavelengths (280 and 295 nm) showed that the fluorescence quenched in HSA was mainly contributed to by tryptophan residues. In addition, the atrazine bound to HSA, which induced changes in the conformation and secondary structure of HSA and caused an energy transfer. Thermodynamic parameters revealed that this binding is spontaneous. Moreover, electrostatic interactions play a major role in the combination of atrazine and HSA. One atrazine molecule can only bind to one HSA molecule to form a complex, and the atrazine molecule is bound at site II (subdomain IIIA) of HSA. This study furthers the understanding of the potential effects posed by atrazine on humans at the molecular level. Full article
(This article belongs to the Special Issue Occupational Pesticides Exposure)
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Open AccessArticle Residual Inequity: Assessing the Unintended Consequences of New York City’s Clean Heat Transition
Int. J. Environ. Res. Public Health 2018, 15(1), 117; doi:10.3390/ijerph15010117
Received: 22 November 2017 / Revised: 18 December 2017 / Accepted: 9 January 2018 / Published: 11 January 2018
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Abstract
Energy policies and public health are intimately intertwined. In New York City, a series of policies, known as the Clean Heat Program (CHP), were designed to reduce air pollution by banning residual diesel fuel oils, #6 in 2015 and #4 by 2030. This
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Energy policies and public health are intimately intertwined. In New York City, a series of policies, known as the Clean Heat Program (CHP), were designed to reduce air pollution by banning residual diesel fuel oils, #6 in 2015 and #4 by 2030. This measure is expected to yield environmental and public health benefits over time. While there is near-universal compliance with the #6 ban, a substantial number of buildings still use #4. In this paper, geographic analysis and qualitative interviews with stakeholders were used to interrogate the CHP’s policy implementation in Northern Manhattan and the Bronx. A total of 1724 (53%) of all residential residual fuel burning buildings are located in this region. Stakeholders reflected mostly on the need for the program, and overall reactions to its execution. Major findings include that government partnerships with non-governmental organizations were effectively employed. However, weaknesses with the policy were also identified, including missed opportunities for more rapid transitions away from residual fuels, unsuccessful outreach efforts, cost-prohibitive conversion opportunities, and (the perception of) a volatile energy market for clean fuels. Ultimately, this analysis serves as a case study of a unique and innovative urban policy initiative to improve air quality and, consequently, public health. Full article
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Open AccessArticle Evaluation of Controlled Release Urea on the Dynamics of Nitrate, Ammonium, and Its Nitrogen Release in Black Soils of Northeast China
Int. J. Environ. Res. Public Health 2018, 15(1), 119; doi:10.3390/ijerph15010119
Received: 17 November 2017 / Revised: 26 December 2017 / Accepted: 3 January 2018 / Published: 11 January 2018
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Abstract
Controlled release urea (CRU) is considered to enhance crop yields while alleviating negative environmental problems caused by the hazardous gas emissions that are associated with high concentrations of ammonium (NH4+) and nitrate (NO3) in black soils. Short-term
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Controlled release urea (CRU) is considered to enhance crop yields while alleviating negative environmental problems caused by the hazardous gas emissions that are associated with high concentrations of ammonium (NH4+) and nitrate (NO3) in black soils. Short-term effects of sulfur-coated urea (SCU) and polyurethane-coated urea (PCU), compared with conventional urea, on NO3 and NH4+ in black soils were studied through the buried bag experiment conducted in an artificial climate chamber. We also investigated nitrogen (N) release kinetics of CRU and correlations between the cumulative N release rate and concentrations of NO3 and NH4+. CRU can reduce concentrations of NO3 and NH4+, and PCU was more effective in maintaining lower soil NO3/NH4+ ratios than SCU and U. Parabolic equation could describe the kinetics of NO3 and NH4+ treated with PCU. The Elovich equation could describe the kinetics of NO3 and NH4+ treated with SCU. The binary linear regression model was established to predict N release from PCU because of significant correlations between the cumulative N release rate and concentrations of NO3 and NH4+. These results provided a methodology and data support for characterizing and predicting the N release from PCU in black soils. Full article
(This article belongs to the Section Environmental Engineering and Public Health)
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Open AccessFeature PaperArticle Association between Fetal Adipokines and Child Behavioral Problems at Preschool Age: The Hokkaido Study on Environment and Children’s Health
Int. J. Environ. Res. Public Health 2018, 15(1), 120; doi:10.3390/ijerph15010120
Received: 12 October 2017 / Revised: 20 December 2017 / Accepted: 9 January 2018 / Published: 11 January 2018
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Abstract
Studies have suggested associations between maternal obesity and mental health problems of their children. However, the underlying mechanism is largely unknown. A possible mechanism can be via inflammatory states and the other possible mechanism is metabolic hormone-induced programming. Cross-talk between adipokines, including inflammatory
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Studies have suggested associations between maternal obesity and mental health problems of their children. However, the underlying mechanism is largely unknown. A possible mechanism can be via inflammatory states and the other possible mechanism is metabolic hormone-induced programming. Cross-talk between adipokines, including inflammatory cytokines and metabolic hormones secreted from adipose tissue and the central nervous system needs to be further investigated to elucidate the mechanism. Thus, the aim of this study was to investigate the association between fetal adipokine levels and child behavioral problems at preschool age. Cord blood adiponectin, leptin, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) levels were measured and child behavioral problems were assessed using the Strengths and Difficulties Questionnaire at preschool age. Logistic regression models adjusted by related maternal factors were performed to examine the association between cord blood adipokines and child behavioral problems. Three hundred and sixty-one children were included in the final analysis. A significant association between decreased hyperactivity/inattention and increased leptin was found (OR = 0.22, 95% CI: 0.06–0.89). Cord blood adiponectin, TNF-α and IL-6 levels were not associated with child behavioral problems. Our findings suggested that cord blood adipokines, particularly, leptin level, may be a predictor of hyperactivity/inattention problems at preschool age. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle Analysis of Emission Effects Related to Drivers’ Compliance Rates for Cooperative Vehicle-Infrastructure System at Signalized Intersections
Int. J. Environ. Res. Public Health 2018, 15(1), 122; doi:10.3390/ijerph15010122
Received: 16 November 2017 / Revised: 22 December 2017 / Accepted: 30 December 2017 / Published: 12 January 2018
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Abstract
Unknown remaining time of signal phase at a signalized intersection generally results in extra accelerations and decelerations that increase variations of operating conditions and thus emissions. A cooperative vehicle-infrastructure system can reduce unnecessary speed changes by establishing communications between vehicles and the signal
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Unknown remaining time of signal phase at a signalized intersection generally results in extra accelerations and decelerations that increase variations of operating conditions and thus emissions. A cooperative vehicle-infrastructure system can reduce unnecessary speed changes by establishing communications between vehicles and the signal infrastructure. However, the environmental benefits largely depend on drivers’ compliance behaviors. To quantify the effects of drivers’ compliance rates on emissions, this study applied VISSIM 5.20 (Planung Transport Verkehr AG, Karlsruhe, Germany) to develop a simulation model for a signalized intersection, in which light duty vehicles were equipped with a cooperative vehicle-infrastructure system. A vehicle-specific power (VSP)-based model was used to estimate emissions. Based on simulation data, the effects of different compliance rates on VSP distributions, emission factors, and total emissions were analyzed. The results show the higher compliance rate decreases the proportion of VSP bin = 0, which means that the frequencies of braking and idling were lower and light duty vehicles ran more smoothly at the intersection if more light duty vehicles complied with the cooperative vehicle-infrastructure system, and emission factors for light duty vehicles decreased significantly as the compliance rate increased. The case study shows higher total emission reductions were observed with higher compliance rate for all of CO2, NOx, HC, and CO emissions. CO2 was reduced most significantly, decreased by 16% and 22% with compliance rates of 0.3 and 0.7, respectively. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle A Cross-Sectional Study of the Association between Infant Hepatitis B Vaccine Exposure in Boys and the Risk of Adverse Effects as Measured by Receipt of Special Education Services
Int. J. Environ. Res. Public Health 2018, 15(1), 123; doi:10.3390/ijerph15010123
Received: 31 October 2017 / Revised: 2 January 2018 / Accepted: 9 January 2018 / Published: 12 January 2018
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Abstract
The National Center for Education Statistics reported that between 1990–2005 the number of children receiving special education services (SES) rose significantly, and then, from 2004–2012, the number declined significantly. This coincided with the introduction of Thimerosal-containing hepatitis B vaccine in 1991, and the
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The National Center for Education Statistics reported that between 1990–2005 the number of children receiving special education services (SES) rose significantly, and then, from 2004–2012, the number declined significantly. This coincided with the introduction of Thimerosal-containing hepatitis B vaccine in 1991, and the subsequent introduction of Thimerosal-reduced hepatitis B vaccine in the early 2000s. This study examined the potential relationship between infant exposure to mercury from three doses of Thimerosal-containing hepatitis B vaccine and the risk of boys being adversely affected (as measured by receipt of SES). This cross-sectional study examined 1192 boys (weighted n = 24,537,123) 7–8 years of age (born: 1994–2007) from the combined 2001–2014 National Health and Nutritional Examination Survey (NHANES). Survey logistic regression modeling revealed that an exposed population receiving three doses of infant Thimerosal-containing hepatitis B vaccine (weighted n = 11,186,579), in comparison to an unexposed population (weighted n = 704,254), were at an increased risk of receipt of SES. This association was robust (crude odds ratio = 10.143, p = 0.0232), even when considering covariates, such as race and socioeconomic status (adjusted odds ratio = 9.234, p = 0.0259). Survey frequency modeling revealed that receipt of SES for the population that was exposed to three doses of Thimerosal-containing hepatitis B vaccine in infancy (12.91%) was significantly higher than the unexposed population (1.44%) (prevalence ratio = 8.96, p = 0.006, prevalence attributable rate = 0.1147). Despite the limitation of this cross-sectional study not being able to ascribe a direct cause-and-effect relationship between exposure and outcome, it is estimated that an additional 1.2 million boys received SES with excess education costs of about United States (US) $180 billion associated with exposure to Thimerosal-containing hepatitis B vaccine. By contrast, exposure to Thimerosal-reduced hepatitis B vaccine was not associated with an increased risk of receiving SES. Therefore, routine childhood vaccination is important to reduce the morbidity and mortality of infectious diseases, but every effort should be made to eliminate Thimerosal from all vaccines. Full article
Open AccessArticle Effect of Radiological Countermeasures on Subjective Well-Being and Radiation Anxiety after the 2011 Disaster: The Fukushima Health Management Survey
Int. J. Environ. Res. Public Health 2018, 15(1), 124; doi:10.3390/ijerph15010124
Received: 17 November 2017 / Revised: 9 January 2018 / Accepted: 10 January 2018 / Published: 12 January 2018
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Abstract
After the Fukushima Daiichi Nuclear Power Station accident in 2011, concerns about radiation exposure and decline in subjective well-being have been reported. To tackle these problems, various countermeasures in relation to radiation have been implemented. In this study, we comprehensively evaluated the effects
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After the Fukushima Daiichi Nuclear Power Station accident in 2011, concerns about radiation exposure and decline in subjective well-being have been reported. To tackle these problems, various countermeasures in relation to radiation have been implemented. In this study, we comprehensively evaluated the effects of radiological countermeasures on subjective well-being (e.g., satisfaction with life (SWL) and emotional well-being) and radiation anxiety, through a questionnaire survey targeting Fukushima residents (N = 1023). Propensity scores matching was applied to evaluate significant effects of radiological countermeasures on subjective well-being and radiation anxiety. Among the radiological countermeasures, thyroid examination, whole body counter, and air dose monitoring showed the highest proportions of participation, utilization, and useful evaluation, suggesting a high degree of public attention focused on these countermeasures. The basic survey was associated with significant increases in SWL and self-rated health (SH). Thyroid examination was significantly associated with not only a reduction in radiation anxiety but also an increase of emotional stress, suggesting the importance of careful design of system and detailed communication. Food inspection was associated with deterioration in SH. Those who utilized explanatory meetings showed increases in sadness, worry, and radiation anxiety, indicating that additional attention is required of the experts and authorities involved in explanatory meetings. Full article
(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)
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Open AccessArticle Contamination and Risk Assessment of Estrogens in Livestock Manure: A Case Study in Jiangsu Province, China
Int. J. Environ. Res. Public Health 2018, 15(1), 125; doi:10.3390/ijerph15010125
Received: 18 October 2017 / Revised: 25 November 2017 / Accepted: 27 November 2017 / Published: 12 January 2018
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Abstract
This study investigated the occurrence and contamination risk of estrogens in livestock manure in Jiangsu Province, China. Four estrogens—estriol (E3), 17β-estradiol (17β-E2), bisphenol A (BPA), and 17α-ethinyloestradiol (EE2)—were detected in livestock manure from hens, ducks, swine, and cows. The respective mean concentrations of
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This study investigated the occurrence and contamination risk of estrogens in livestock manure in Jiangsu Province, China. Four estrogens—estriol (E3), 17β-estradiol (17β-E2), bisphenol A (BPA), and 17α-ethinyloestradiol (EE2)—were detected in livestock manure from hens, ducks, swine, and cows. The respective mean concentrations of each estrogen found in these manures were 289.8, 334.1, 330.3, and 33.7 μg/kg for E3; 38.6, 10.9, 52.9, and 38.8 μg/kg for 17β-E2; 63.6, 48.7, 51.9, and 11.7 μg/kg for BPA; and 14.3, 11.3, 25.1, and 21.8 μg/kg for EE2. Estrogens were most frequently detected at high concentrations in the manure of finishing pigs, followed by the manure of growing pigs and piglets. Estrogens can be partially degraded after banking up for seven days; yet, great quantities of estrogens remain in livestock manure. The total estradiol equivalent quantity (EEQt) estimated to be present in aquatic environments but originating from livestock waste was 10.5 ng/L, which was greater than the hazard baseline value (1 ng/L) and also higher than the proposed lowest observable effect concentration (10 ng/L) of E2 in aquatic environments. The results of our study demonstrate that livestock waste is an important source of estrogens, which may potentially affect the hormonal metabolism of aquatic organisms. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle The Safety of the Neighborhood Environment and Physical Activity in Czech and Polish Adolescents
Int. J. Environ. Res. Public Health 2018, 15(1), 126; doi:10.3390/ijerph15010126
Received: 29 November 2017 / Revised: 9 January 2018 / Accepted: 10 January 2018 / Published: 12 January 2018
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Abstract
(1) Background: An increase in or at least the sustainment of walking activities across a wide section of the population is a crucial health-related task for Central and East European countries. The aim of this study was to assess the associations between
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(1) Background: An increase in or at least the sustainment of walking activities across a wide section of the population is a crucial health-related task for Central and East European countries. The aim of this study was to assess the associations between adolescents’ walking activities and various levels of perceived safety of the built environment in differing socio-demographic backgrounds of Poland and the Czech Republic. Furthermore, we aimed to determine major moderators affecting the walking habits of adolescents in areas with different levels of walkability. (2) Methods: The surveys were conducted during the 2008–2009 and 2013–2014 school years in 24 Polish and 35 Czech secondary schools, with a sample of 2001 adolescents. All participants completed the International Physical Activity Questionnaire–Long Form and the NEWS–Abbreviated. Selected students took part in objective weekly monitoring of physical activity (PA). (3) Results: Boys and girls who perceived their neighborhood environment as the safest were significantly more likely to meet the recommendations for leisure-time walking. Adolescents from the safest environment achieved 11,024 steps/day on average, while those from the least safe environment achieved 9686 steps/day. (4) Conclusions: A safe neighborhood environment significantly predicts walking activities among girls. Environmental safety improvement can support the active transport and better use of leisure time PA. Full article
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Open AccessArticle How Work Characteristics Are Related to European Workers’ Psychological Well-Being. A Comparison of Two Age Groups
Int. J. Environ. Res. Public Health 2018, 15(1), 127; doi:10.3390/ijerph15010127
Received: 2 November 2017 / Revised: 19 December 2017 / Accepted: 3 January 2018 / Published: 13 January 2018
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Abstract
This study aimed to analyze the mechanisms through which work characteristics are related to psychological well-being, exploring the mediational role of work meaningfulness and job satisfaction, and investigating differences in the patterns of relationships between two age groups. The sample was composed of
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This study aimed to analyze the mechanisms through which work characteristics are related to psychological well-being, exploring the mediational role of work meaningfulness and job satisfaction, and investigating differences in the patterns of relationships between two age groups. The sample was composed of 36,896 workers from the 5th European Working Conditions Survey. Structural equation modeling analyses and multiple group analyses were performed. The results revealed a parallel mediational model, in which work meaningfulness and general job satisfaction mediate the relationships between work characteristics and well-being. Additionally, job satisfaction partially mediates the relationship between meaningfulness and well-being. These results were confirmed in both age groups (under 55 years old and older workers), but age moderates the relationships between social support and the mediating variables and the relationships between the mediating variables and general well-being. The present study uncovers significant pathways through which time pressure, decision latitude, and social support are related to psychological well-being, depicting an important step in better understanding how and when work characteristics are related to positive outcomes. It provides important clues for promoting psychosocial health at work at the European level. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
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Open AccessArticle Atmospheric Environment Vulnerability Cause Analysis for the Beijing-Tianjin-Hebei Metropolitan Region
Int. J. Environ. Res. Public Health 2018, 15(1), 128; doi:10.3390/ijerph15010128
Received: 9 November 2017 / Revised: 7 January 2018 / Accepted: 9 January 2018 / Published: 13 January 2018
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Abstract
Assessing and quantifying atmospheric vulnerability is a key issue in urban environmental protection and management. This paper integrated the Analytical hierarchy process (AHP), fuzzy synthesis evaluation and Geographic Information System (GIS) spatial analysis into an Exposure-Sensitivity-Adaptive capacity (ESA) framework to quantitatively assess atmospheric
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Assessing and quantifying atmospheric vulnerability is a key issue in urban environmental protection and management. This paper integrated the Analytical hierarchy process (AHP), fuzzy synthesis evaluation and Geographic Information System (GIS) spatial analysis into an Exposure-Sensitivity-Adaptive capacity (ESA) framework to quantitatively assess atmospheric environment vulnerability in the Beijing-Tianjin-Hebei (BTH) region with spatial and temporal comparisons. The elaboration of the relationships between atmospheric environment vulnerability and indices of exposure, sensitivity, and adaptive capacity supports enable analysis of the atmospheric environment vulnerability. Our findings indicate that the atmospheric environment vulnerability of 13 cities in the BTH region exhibits obvious spatial heterogeneity, which is caused by regional diversity in exposure, sensitivity, and adaptive capacity indices. The results of atmospheric environment vulnerability assessment and the cause analysis can provide guidance to pick out key control regions and recognize vulnerable indicators for study sites. The framework developed in this paper can also be replicated at different spatial and temporal scales using context-specific datasets to support environmental management. Full article
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Open AccessArticle Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?
Int. J. Environ. Res. Public Health 2018, 15(1), 129; doi:10.3390/ijerph15010129
Received: 12 November 2017 / Revised: 10 January 2018 / Accepted: 11 January 2018 / Published: 13 January 2018
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Abstract
Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined
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Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. ‘Other’ ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal ‘need’, including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Short Vacation Improves Stress-Level and Well-Being in German-Speaking Middle-Managers—A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2018, 15(1), 130; doi:10.3390/ijerph15010130
Received: 17 November 2017 / Revised: 20 December 2017 / Accepted: 11 January 2018 / Published: 13 January 2018
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Abstract
Stress in the work place has a detrimental effect on people’s health. Sufficient recovery is necessary to counteract severe chronic negative load reactions. Previous research has shown that vacationing for at least seven consecutive days provided an efficient recovery strategy. Yet, thus far,
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Stress in the work place has a detrimental effect on people’s health. Sufficient recovery is necessary to counteract severe chronic negative load reactions. Previous research has shown that vacationing for at least seven consecutive days provided an efficient recovery strategy. Yet, thus far, the effects of short vacations and the mode of vacation (whether at home or in a new environment) have rarely been studied. We investigated the immediate and long-term effects of a short vacation (four nights) on well-being and perceived stress and whether the mode of vacation impacted on these results. Data was obtained from 40 middle managers (67.5% men and 32.5% women). The intervention group (n = 20) spent a short vacation in a hotel outside their usual environment. The control group (n = 20) spent their vacation at home. Results indicated that one single short-term vacation, independent of the mode, has large, positive and immediate effects on perceived stress, recovery, strain, and well-being. Strain levels decreased to a greater extent in the intervention group compared to the control group. The effects can still be detected at 30 days (recovery) and 45 days (well-being and strain) post-vacation. Encouraging middle management employees to take short vacations seems to be an efficient health promotion strategy; environmental effects seem to play a minor role. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Investigating Effect of Service Encounter, Value, and Satisfaction on Word of Mouth: An Outpatient Service Context
Int. J. Environ. Res. Public Health 2018, 15(1), 132; doi:10.3390/ijerph15010132
Received: 30 November 2017 / Revised: 8 January 2018 / Accepted: 11 January 2018 / Published: 13 January 2018
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Abstract
This study investigates the relationships among service encounter, service value, patient satisfaction, and word-of-mouth (WOM) intention from the viewpoint of interactive marketing. Data were collected using a questionnaire survey. A total of 372 questionnaires were obtained and 350 of these questionnaires were valid
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This study investigates the relationships among service encounter, service value, patient satisfaction, and word-of-mouth (WOM) intention from the viewpoint of interactive marketing. Data were collected using a questionnaire survey. A total of 372 questionnaires were obtained and 350 of these questionnaires were valid (94.09%), and a structural equation model was used to analyze the data. This study proposed seven hypotheses, and five of the seven hypotheses were supported. Service encounters indirectly affect their patient WOM through service value and satisfaction. Therefore, service value and satisfaction play a crucial mediating role in linking service encounters and WOM. This study determined WOM intentions in an outpatient service context and provides crucial business implications for teaching hospitals to enable them to improve their service quality and achieve a sustainable operation. Full article
(This article belongs to the Special Issue Quality of Patient-Centered Care)
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Open AccessArticle Accumulation of Heavy Metals in Tea Leaves and Potential Health Risk Assessment: A Case Study from Puan County, Guizhou Province, China
Int. J. Environ. Res. Public Health 2018, 15(1), 133; doi:10.3390/ijerph15010133
Received: 27 November 2017 / Revised: 10 January 2018 / Accepted: 10 January 2018 / Published: 13 January 2018
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Abstract
This study features a survey of the concentrations of aluminum (Al) and heavy metals (Mn, Pb, Cd, Hg, As, Cr, Ni, Cu, and Zn) in tea leaves and the corresponding cultivation soils (0–30 cm), carried out in Puan County (Guizhou Province, China). The
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This study features a survey of the concentrations of aluminum (Al) and heavy metals (Mn, Pb, Cd, Hg, As, Cr, Ni, Cu, and Zn) in tea leaves and the corresponding cultivation soils (0–30 cm), carried out in Puan County (Guizhou Province, China). The average concentrations of Al, Mn, Pb, Cd, Hg, As, Cr, Ni, Cu, and Zn in the soil were 106 × 103, 214, 20.9, 0.09, 0.12, 17.5, 121, 27.8, 131.2, and 64 mg·kg−1, respectively. The heavy metals’ pollution indexes in the soil can be ranked as follows: Cu > Cr > Hg > As > Ni > Zn > Pb > Mn > Cd. The soil was moderately polluted by Cu because of the high geochemical background value of Cu in the area. The potential environment risk index (RI) showed that 7.69% out of the total sample sites were within the moderate level. Moreover, the ranges of Al, Mn, Pb, Cd, Hg, As, Cr, Ni, Cu, and Zn concentrations in young tea leaves were 250–660, 194–1130, 0.107–0.400, 0.012–0.092, 0.014–0.085, 0.073–0.456, 0.33–1.26, 6.33–14.90, 14.90–26.10, and 35.8–50.3 mg·kg−1, respectively. While in mature tea leaves, they were 4300–10,400, 536–4610, 0.560–1.265, 0.040–0.087, 0.043–0.089, 0.189–0.453, 0.69–2.91, 3.43–14.20, 6.17–16.25, and 9.1–20.0 mg·kg−1, respectively. Furthermore, the concentrations of Pb, Cu, As, Hg, Cd, and Cr in young tea leaves and mature tea leaves were all lower than the standard limit values (5.0, 30, 2.0, 0.3, 1.0, and 5.0 mg·kg−1 for Pb, Cu, As, Hg, Cd, and Cr, respectively) in China. Besides, the accumulation ability of tea leaves to Mn was the strongest, and the average bioconcentration factor (BCF) of Mn in mature tea leaves was 12.5. In addition, the average target hazard quotients (THQ) were all less than one for the young tea leaves and the average aggregate risk hazard index (HI) to adults was 0.272, indicating that there was not a potential health risk for adults through the consumption of the infusions brewed by young tea leaves. However, for mature tea leaves, the percentage which HI values were above one was 38.46%, and the risk to adults via the consumption of mature tea infusions were mainly contributed by Mn and Al. Full article
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Open AccessArticle How Does Counselling in a Stationary Health Care Setting Affect the Attendance in a Standardised Sports Club Programme? Process Evaluation of a Quasi-Experimental Study
Int. J. Environ. Res. Public Health 2018, 15(1), 134; doi:10.3390/ijerph15010134
Received: 28 November 2017 / Revised: 22 December 2017 / Accepted: 11 January 2018 / Published: 14 January 2018
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Abstract
Actions in partnership across sectors is one principle for the promotion of health behaviours. The objective of this study was to describe the participation in a sports club-based exercise programme—named JACKPOT—following an intervention in a health care setting. Focus was given to the
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Actions in partnership across sectors is one principle for the promotion of health behaviours. The objective of this study was to describe the participation in a sports club-based exercise programme—named JACKPOT—following an intervention in a health care setting. Focus was given to the recruitment into JACKPOT, the attendance level, and whether the different programme elements were implemented as intented. The practicability of the project was also retrospectively rated. Participants were 238 inactive people (50% women) between 30 and 65 years of age who attended a health resort. Of these, 77% were assigned to the intervention group (IG). The recruitment into the 12 JACKPOT sessions and the attendance levels were recorded via attendance lists. The implementation of the intervention standards was assessed with structured interviews and participatory observation. The Pragmatic Explanatory Continuum Indicator Summary (PRECIS)-2 tool served to rate the practicability of the project. Almost 50% of the IG subjects attended JACKPOT sessions at least once and 54% of the attenders visited ≥75% of the 12 sessions. Some of the programme elements were not delivered fully. The process evaluation results showed that the project worked in a real-world setting, and also uncovered potential reasons such as incomplete information delivery for the moderate recruitment and attendance level. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessFeature PaperArticle Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients
Int. J. Environ. Res. Public Health 2018, 15(1), 135; doi:10.3390/ijerph15010135
Received: 9 November 2017 / Revised: 18 December 2017 / Accepted: 4 January 2018 / Published: 15 January 2018
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Abstract
Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely
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Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
Open AccessArticle Asbestos Consumption in Mongolia: 1996–2014
Int. J. Environ. Res. Public Health 2018, 15(1), 136; doi:10.3390/ijerph15010136
Received: 15 December 2017 / Revised: 6 January 2018 / Accepted: 11 January 2018 / Published: 15 January 2018
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Abstract
Asbestos is still used in Mongolia in the energy and construction sectors, among others. However, limited data is available on asbestos consumption and asbestos-related disease in Mongolia. The purpose of this paper is to present the available information on the importation of asbestos
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Asbestos is still used in Mongolia in the energy and construction sectors, among others. However, limited data is available on asbestos consumption and asbestos-related disease in Mongolia. The purpose of this paper is to present the available information on the importation of asbestos into Mongolia. We used data on annual asbestos imports between 1996 and 2014 from Mongolian Customs Statistics and the National Council on Toxic and Hazardous Substances Affairs. The uses of this material are also presented with respect to chrysotile alone. Most asbestos is used for construction. Mongolia started using asbestos in the energy and construction industries as thermal insulation in 1961. Asbestos is still allowed for use in Mongolia under the Law on Toxic and Hazards Substances. There are no asbestos mines in Mongolia, and the manufacture of asbestos-containing materials does not take place there. Thus, asbestos is mainly imported from China and Russia. Mongolia used 44,422 metric tons of asbestos-containing materials between 1996 and 2014. In Mongolia, with the current use of asbestos, there will be a continuing risk of developing asbestos-related diseases from past use, and proper oversight of asbestos-involving activities and the safe removal and disposal of asbestos must be considered. Full article
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Open AccessArticle A Long-Term Follow-Up of the Efficacy of Nature-Based Therapy for Adults Suffering from Stress-Related Illnesses on Levels of Healthcare Consumption and Sick-Leave Absence: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2018, 15(1), 137; doi:10.3390/ijerph15010137
Received: 27 November 2017 / Revised: 4 January 2018 / Accepted: 8 January 2018 / Published: 15 January 2018
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Abstract
Stress-related illnesses are a growing health problem in the Western world; which also has economic significance for society. As a consequence; there is a growing demand for effective treatments. The study investigates the long-term efficacy of the Nacadia® nature-based therapy (NNBT) by
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Stress-related illnesses are a growing health problem in the Western world; which also has economic significance for society. As a consequence; there is a growing demand for effective treatments. The study investigates the long-term efficacy of the Nacadia® nature-based therapy (NNBT) by comparing it to the efficacy of a validated cognitive behavioral therapy, called STreSS. The study is designed as a randomized controlled trial in which 84 participants are randomly allocated between the treatments. Long-term efficacy is investigated through data extracts from the national database of Statistics Denmark on the sick leave and the health-care consumption. The results show that both the NNBT and the STreSS lead to a significant decrease in number of contacts with a general practitioner in the period from twelve months prior to treatment to twelve months after treatment; and, a significant decrease in long-term sick leave from the month prior to treatment to twelve months after treatment. The positive long-term effects provide validation for the NNBT as an efficient treatment of stress-related illnesses. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
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Open AccessArticle Community-Based Health and Exposure Study around Urban Oil Developments in South Los Angeles
Int. J. Environ. Res. Public Health 2018, 15(1), 138; doi:10.3390/ijerph15010138
Received: 7 November 2017 / Revised: 9 December 2017 / Accepted: 11 December 2017 / Published: 15 January 2018
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Abstract
Oilfield-adjacent communities often report symptoms such as headaches and/or asthma. Yet, little data exists on health experiences and exposures in urban environments with oil and gas development. In partnership with Promotoras de Salud (community health workers), we gathered household surveys nearby two oil
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Oilfield-adjacent communities often report symptoms such as headaches and/or asthma. Yet, little data exists on health experiences and exposures in urban environments with oil and gas development. In partnership with Promotoras de Salud (community health workers), we gathered household surveys nearby two oil production sites in Los Angeles. We tested the capacity of low-cost sensors for localized exposure estimates. Bilingual surveys of 205 randomly sampled residences were collected within two 1500 ft. buffer areas (West Adams and University Park) surrounding oil development sites. We used a one-sample proportion test, comparing overall rates from the California Health Interview Survey (CHIS) of Service Planning Area 6 (SPA6) and Los Angeles County for variables of interest such as asthma. Field calibrated low-cost sensors recorded methane emissions. Physician diagnosed asthma rates were reported to be higher within both buffers than in SPA6 or LA County. Asthma prevalence in West Adams but not University Park was significantly higher than in Los Angeles County. Respondents with diagnosed asthma reported rates of emergency room visits in the previous 12 months similar to SPA6. 45% of respondents were unaware of oil development; 63% of residents would not know how to contact local regulatory authorities. Residents often seek information about their health and site-related activities. Low-cost sensors may be useful in highlighting differences between sites or recording larger emission events and can provide localized data alongside resident-reported symptoms. Regulatory officials should help clarify information to the community on methods for reporting health symptoms. Our community-based participatory research (CBPR) partnership supports efforts to answer community questions as residents seek a safety buffer between sensitive land uses and active oil development. Full article
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Open AccessArticle Trypsin Binding with Copper Ions Scavenges Superoxide: Molecular Dynamics-Based Mechanism Investigation
Int. J. Environ. Res. Public Health 2018, 15(1), 139; doi:10.3390/ijerph15010139
Received: 29 November 2017 / Revised: 27 December 2017 / Accepted: 7 January 2018 / Published: 15 January 2018
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Abstract
Trypsin is a serine protease, which has been proved to be a novel superoxide scavenger. The burst of superoxide induced by polychlorinated biphenyls can be impeded by trypsin in both wild type and sod knockout mutants of Escherichia coli. The experimental results
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Trypsin is a serine protease, which has been proved to be a novel superoxide scavenger. The burst of superoxide induced by polychlorinated biphenyls can be impeded by trypsin in both wild type and sod knockout mutants of Escherichia coli. The experimental results demonstrated that the activities of superoxide scavenging of trypsin were significantly accelerated by Cu ions. Also, with the addition of Cu ions, a new β-sheet (β7) transited from a random coil in the Cu(II)-trypsin (TP) system, which was favorable for the formation of more contacts with other sheets of trypsin. Residue–residue network analysis and the porcupine plots proved that the Cu ion in trypsin strengthened some native interactions among residues, which ultimately resulted in much greater stability of the Cu(II)-TP system. Moreover, compact and stable trypsin structures with Cu ions might be responsible for significantly provoking the activity of superoxide scavenging. Full article
(This article belongs to the Special Issue Endocrine Disruptors Leading to Obesity and Related Diseases)
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Open AccessArticle Comparing Classic and Interval Analytical Hierarchy Process Methodologies for Measuring Area-Level Deprivation to Analyze Health Inequalities
Int. J. Environ. Res. Public Health 2018, 15(1), 140; doi:10.3390/ijerph15010140
Received: 7 December 2017 / Revised: 5 January 2018 / Accepted: 12 January 2018 / Published: 16 January 2018
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Abstract
Deprivation indices are useful measures to study health inequalities. Different techniques are commonly applied to construct deprivation indices, including multi-criteria decision methods such as the analytical hierarchy process (AHP). The multi-criteria deprivation index for the city of Quito is an index in which
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Deprivation indices are useful measures to study health inequalities. Different techniques are commonly applied to construct deprivation indices, including multi-criteria decision methods such as the analytical hierarchy process (AHP). The multi-criteria deprivation index for the city of Quito is an index in which indicators are weighted by applying the AHP. In this research, a variation of this index is introduced that is calculated using interval AHP methodology. Both indices are compared by applying logistic generalized linear models and multilevel models, considering self-reported health as the dependent variable and deprivation and self-reported quality of life as the independent variables. The obtained results show that the multi-criteria deprivation index for the city of Quito is a meaningful measure to assess neighborhood effects on self-reported health and that the alternative deprivation index using the interval AHP methodology more thoroughly represents the local knowledge of experts and stakeholders. These differences could support dec