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

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Open AccessArticle The Association of Food Consumption Scores, Body Shape Index, and Hypertension in a Seven-Year Follow-Up among Indonesian Adults: A Longitudinal Study
Int. J. Environ. Res. Public Health 2018, 15(1), 175; https://doi.org/10.3390/ijerph15010175
Received: 13 December 2017 / Revised: 11 January 2018 / Accepted: 20 January 2018 / Published: 22 January 2018
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Abstract
Aims: The concept of food security and its association with chronic diseases are both well-established. During the years within the scope of the study, there was a significant increase in the body shape index (ABSI) of Indonesian adults. This study tested the
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Aims: The concept of food security and its association with chronic diseases are both well-established. During the years within the scope of the study, there was a significant increase in the body shape index (ABSI) of Indonesian adults. This study tested the hypothesis that the association between food security and chronic diseases is mediated, in part, by ABSI. Methods: Data was obtained from 2156 Indonesian adults using the Indonesia Family Life Survey (IFLS) in 2007 and 2014. Longitudinal study participants were interviewed face-to-face for dietary intake data using the food frequency questionnaire (FFQ). Food security, a concept developed by the World Food Programme (WFP), was calculated based on a food consumption score analysis using the FFQ. A generalized estimating equation (GEE) and a Sobel–Goodman test were used to test the hypothesis in this study. Results: The food consumption score was negatively associated with ABSI. It was also negatively associated with systolic blood pressure (p < 0.001). In a formal mediation analysis, ABSI significantly mediated the pathway between the food consumption score and systolic blood pressure (p < 0.001). Conclusions: The effect of food security on hypertension is mediated through body shape. Strategies to improve the prevention of hypertension among adults may need to take the ABSI and food security, along with nutrition education, into account. Full article
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Open AccessArticle Preparedness of Health Care Professionals for Delivering Sexual and Reproductive Health Care to Refugee and Migrant Women: A Mixed Methods Study
Int. J. Environ. Res. Public Health 2018, 15(1), 174; https://doi.org/10.3390/ijerph15010174
Received: 8 December 2017 / Revised: 10 January 2018 / Accepted: 16 January 2018 / Published: 22 January 2018
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Abstract
Past research suggests that factors related to health care professionals’ (HCPs) knowledge, training and competency can contribute to the underutilisation of sexual and reproductive health (SRH) care by refugee and migrant women. The aim of this study was to examine the perceived preparedness
[...] Read more.
Past research suggests that factors related to health care professionals’ (HCPs) knowledge, training and competency can contribute to the underutilisation of sexual and reproductive health (SRH) care by refugee and migrant women. The aim of this study was to examine the perceived preparedness of HCPs in relation to their knowledge, confidence and training needs when it comes to consulting refugee and migrant women seeking SRH care in Australia. A sequential mixed methods design, comprising an online survey with 79 HCPs (45.6% nurses, 30.3% general practitioners (GPs), 16.5% health promotion officers, and 7.6% allied health professionals) and semi-structured interviews with 21 HCPs, was utilised. HCPs recognised refugee and migrant women’s SRH as a complex issue that requires unique skills for the delivery of optimal care. However, they reported a lack of training (59.4% of nurses, 50% of GPs, and 38.6% of health promotion officers) and knowledge (27.8% of nurses, 20.8% of GPs, and 30.8% of health promotion officers) in addressing refugee and migrant women’s SRH. The majority of participants (88.9% of nurses, 75% of GPs, and 76% of health promotion officers) demonstrated willingness to engage with further training in refugee and migrant women’s SRH. The implications of the findings are argued regarding the need to train HCPs in culturally sensitive care and include the SRH of refugee and migrant women in university and professional development curricula in meeting the needs of this growing and vulnerable group of women. Full article
(This article belongs to the Special Issue Refugee, Migrant and Ethnic Minority Health)
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Open AccessArticle Number of Heat Wave Deaths by Diagnosis, Sex, Age Groups, and Area, in Slovenia, 2015 vs. 2003
Int. J. Environ. Res. Public Health 2018, 15(1), 173; https://doi.org/10.3390/ijerph15010173
Received: 6 December 2017 / Revised: 5 January 2018 / Accepted: 18 January 2018 / Published: 22 January 2018
Cited by 2 | PDF Full-text (347 KB) | HTML Full-text | XML Full-text
Abstract
Background: Number of deaths increases during periods of elevated heat. Objectives: To examine whether differences in heat-related deaths between 2003 and 2015 occurred in Slovenia. Materials and Methods: We estimated relative risks for deaths for the observed diagnoses, sex, age,
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Background: Number of deaths increases during periods of elevated heat. Objectives: To examine whether differences in heat-related deaths between 2003 and 2015 occurred in Slovenia. Materials and Methods: We estimated relative risks for deaths for the observed diagnoses, sex, age, and area, as well as 95% confidence intervals and excess deaths associated with heat waves occurring in 2015 and 2003. For comparison between 2015 and 2003, we calculated relative risks ratio and 95% confidence intervals. Results: Statistically significant in 2015 were the following: age group 75+, all causes of deaths (RR = 1.10, 95% CI 1.00–1.22); all population, circulatory system diseases (RR = 1.14, 95% CI 1.01–1.30) and age group 75+, diseases of circulatory system (RR = 1.17, 95% CI 1.01–1.34). Statistically significant in 2003 were the following: female, age group 5–74, circulatory system diseases (RR = 1.69, 95% CI 1.08–2.62). Discussion: Comparison between 2015 and 2003, all, circulatory system diseases (RRR = 1.25, 95% CI 1.01–1.55); male, circulatory system diseases (RRR = 1.85, 95% CI 1.41–2.43); all, age group 75+ circulatory system diseases (RRR = 1.34, 95% CI 1.07–1.69); male, age group 75+, circulatory system diseases (RRR = 1.52, 95% CI 1.03–2.25) and female, age group 75+, circulatory system diseases (RRR = 1.43, 95% CI 1.08–1.89). Conclusions: Public health efforts are urgent and should address circulatory system causes and old age groups. Full article
(This article belongs to the Special Issue Health Impacts of Warming of 1.5 °C and 2 °C)
Open AccessArticle Groundwater Pollution Sources Apportionment in the Ghaen Plain, Iran
Int. J. Environ. Res. Public Health 2018, 15(1), 172; https://doi.org/10.3390/ijerph15010172
Received: 16 November 2017 / Revised: 8 January 2018 / Accepted: 13 January 2018 / Published: 22 January 2018
Cited by 1 | PDF Full-text (5832 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Although Iran’s Ghaen Plain provides saffron to much of the world, no regional groundwater quality (GQ) assessment has yet been undertaken. Given the region’s potential for saltwater intrusion and heavy metal contamination, it is important to assess the GQ and determine its main
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Although Iran’s Ghaen Plain provides saffron to much of the world, no regional groundwater quality (GQ) assessment has yet been undertaken. Given the region’s potential for saltwater intrusion and heavy metal contamination, it is important to assess the GQ and determine its main probable source of pollution (MPSP). Such knowledge would allow for informed mitigation or elimination of the potential adverse health effects of this groundwater through its use as drinking water, or indirectly as a result of the consumption of groundwater-irrigated crops. Total dissolved solids, sodium, and chloride in the water of the majority of 16 wells sampled within the region exceeded World Health Organization and Iranian permissible standards for drinking water. The groundwater proved to only be suitable for irrigating salt tolerant crops under good drainage conditions. Due to the precipitation of calcium carbonate in the water supply facilities, the water from all wells was deemed unsuitable for industrial purposes. Heavy metal pollution and contamination indices showed no groundwater contamination. Analysis of ionic ratios and the application of principal components analysis indicated the MPSP to be saltwater intrusion, with the geology subtending the plain, and to a lesser extent, anthropogenic activities. Reducing groundwater withdrawals, particularly those for agricultural production by using high performance irrigation methods could reduce saltwater intrusion and improve GQ in the Ghaen Plain. Full article
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Open AccessArticle West Nile Virus and Usutu Virus Monitoring of Wild Birds in Germany
Int. J. Environ. Res. Public Health 2018, 15(1), 171; https://doi.org/10.3390/ijerph15010171
Received: 24 November 2017 / Revised: 9 January 2018 / Accepted: 12 January 2018 / Published: 22 January 2018
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Abstract
By systematically setting up a unique nation-wide wild bird surveillance network, we monitored migratory and resident birds for zoonotic arthropod-borne virus infections, such as the flaviviruses West Nile virus (WNV) and Usutu virus (USUV). More than 1900 wild bird blood samples, from 20
[...] Read more.
By systematically setting up a unique nation-wide wild bird surveillance network, we monitored migratory and resident birds for zoonotic arthropod-borne virus infections, such as the flaviviruses West Nile virus (WNV) and Usutu virus (USUV). More than 1900 wild bird blood samples, from 20 orders and 136 different bird species, were collected between 2014 and 2016. Samples were investigated by WNV and USUV-specific real-time polymerase chain reactions as well as by differentiating virus neutralization tests. Dead bird surveillance data, obtained from organ investigations in 2016, were also included. WNV-specific RNA was not detected, whereas four wild bird blood samples tested positive for USUV-specific RNA. Additionally, 73 USUV-positive birds were detected in the 2016 dead bird surveillance. WNV neutralizing antibodies were predominantly found in long-distance, partial and short-distance migrants, while USUV neutralizing antibodies were mainly detected in resident wild bird species, preferentially with low seroprevalences. To date, WNV-specific RNA has neither been detected in wild birds, nor in mosquitoes, thus, we conclude that WNV is not yet present in Germany. Continued wild bird and mosquito monitoring studies are essential to detect the incursion of zoonotic viruses and to allow risk assessments for zoonotic pathogens. Full article
(This article belongs to the Special Issue Emerging Infectious Disease (EID) Research, Management and Response)
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Open AccessArticle Global Mortality Burden of Cirrhosis and Liver Cancer Attributable to Injection Drug Use, 1990–2016: An Age-Period-Cohort and Spatial Autocorrelation Analysis
Int. J. Environ. Res. Public Health 2018, 15(1), 170; https://doi.org/10.3390/ijerph15010170
Received: 5 January 2018 / Revised: 19 January 2018 / Accepted: 20 January 2018 / Published: 22 January 2018
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Abstract
We analyzed the temporal and spatial variations in mortality burden of cirrhosis and liver cancer attributable to injection drug use (IDU) from 1990 to 2016. Mortality data of IDU-attributable cirrhosis and IDU-attributable liver cancer on the global and national scales from 1990 to
[...] Read more.
We analyzed the temporal and spatial variations in mortality burden of cirrhosis and liver cancer attributable to injection drug use (IDU) from 1990 to 2016. Mortality data of IDU-attributable cirrhosis and IDU-attributable liver cancer on the global and national scales from 1990 to 2016 were collected from the Global Burden of Disease (GBD) studies. Age-period-cohort (APC) model analysis was used to analyze the global mortality trends of target disease, and spatial autocorrelation analysis based on Geographic Information System was applied to illustrate the clusters of the most epidemic countries. Globally, from 1990 to 2015, mortality rates (age-standardized, per 100,000) of IDU-attributable cirrhosis increased continually from 1.5 to 1.9, while from 0.4 to 0.9 for IDU-attributable liver cancer. The APC model analysis indicated that the increases of mortality were mainly driven by period effects, with the mortality risk increasing by 6.82-fold for IDU-attributable cirrhosis and 3.08-fold for IDU-attributable liver cancer. The spatial analysis suggested that IDU-attributable cirrhosis mortality were geographically clustered from 1990 to 2016, and hot spots were mainly located in less well developed countries of Latin America, East and Central Europe and Central Asia. Our study provides epidemiological evidence for global interventions against advanced liver disease among injection drug users (IDUs). Full article
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Open AccessEditorial Social and Environmental Influences on Physical Activity Behaviours
Int. J. Environ. Res. Public Health 2018, 15(1), 169; https://doi.org/10.3390/ijerph15010169
Received: 17 January 2018 / Revised: 19 January 2018 / Accepted: 19 January 2018 / Published: 22 January 2018
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Abstract
Physical activity promotion has met with limited success across a range of demographic indicators, largely due to our poor understanding of how drivers of physical activity behaviours vary by context and setting[...] Full article
(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)
Open AccessArticle Arsenic Methylation Capacity and Metabolic Syndrome in the 2013–2014 U.S. National Health and Nutrition Examination Survey (NHANES)
Int. J. Environ. Res. Public Health 2018, 15(1), 168; https://doi.org/10.3390/ijerph15010168
Received: 15 December 2017 / Revised: 9 January 2018 / Accepted: 17 January 2018 / Published: 22 January 2018
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Abstract
Arsenic methylation capacity is associated with metabolic syndrome and its components among highly exposed populations. However, this association has not been investigated in low to moderately exposed populations. Therefore, we investigated arsenic methylation capacity in relation to the clinical diagnosis of metabolic syndrome
[...] Read more.
Arsenic methylation capacity is associated with metabolic syndrome and its components among highly exposed populations. However, this association has not been investigated in low to moderately exposed populations. Therefore, we investigated arsenic methylation capacity in relation to the clinical diagnosis of metabolic syndrome in a low arsenic exposure population. Additionally, we compared arsenic methylation patterns present in our sample to those of more highly exposed populations. Using logistic regression models adjusted for relevant biological and lifestyle covariates, we report no association between increased arsenic methylation and metabolic syndrome in a population in which arsenic is regulated at 10 ppb in drinking water. However, we cannot rule out the possibility of a positive association between arsenic methylation and metabolic syndrome in a subsample of women with normal body mass index (BMI). To our knowledge this is the first investigation of arsenic methylation capacity with respect to metabolic syndrome in a low exposure population. We also report that methylation patterns in our sample are similar to those found in highly exposed populations. Additionally, we report that gender and BMI significantly modify the effect of arsenic methylation on metabolic syndrome. Future studies should evaluate the effectiveness of arsenic policy enforcement on subclinical biomarkers of cardiovascular disease. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessArticle Influence of Muscle Mass and Outdoor Environmental Factors on Appetite and Satiety Feeling in Young Japanese Women
Int. J. Environ. Res. Public Health 2018, 15(1), 167; https://doi.org/10.3390/ijerph15010167
Received: 13 November 2017 / Revised: 13 January 2018 / Accepted: 20 January 2018 / Published: 21 January 2018
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Abstract
Research on the influence of relationships among satiety, muscle mass, and outdoor environmental factors is sparse. In this work the relationships among satiety feeling, body composition, and outdoor environmental factors on eating in healthy young Japanese women are investigated. Fifty three (53) women
[...] Read more.
Research on the influence of relationships among satiety, muscle mass, and outdoor environmental factors is sparse. In this work the relationships among satiety feeling, body composition, and outdoor environmental factors on eating in healthy young Japanese women are investigated. Fifty three (53) women were examined over an approximately 2-year period. All participants ate the same lunch; feelings of satiety and body composition were measured before and immediately after lunch. Satiety was assessed using a visual analog scale. Outdoor environmental factors were recorded at the time of measurement. Results showed that satiety before lunch decreased with increased muscle mass and decreased humidity (p < 0.05). The Δ satiety increased on eating with increased outdoor temperature (p < 0.05). The Δ satiety with high outdoor temperature was significantly greater than with low outdoor temperature (p = 0.005). Decreased muscle mass more influenced Δ satiety with respect to outdoor temperature than increased muscle mass (p = 0.007). The results suggest that increased muscle mass and decreased humidity increase hunger (unlike satiety) before eating. The findings also show that outdoor temperature clearly influences the magnitude of satiety on eating. Increasing muscle mass may be useful for satiety control at various outdoor temperatures in young women. Full article
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Open AccessArticle Organizational and Occupational Stressors, Their Consequences and Coping Strategies: A Questionnaire Survey among Italian Patrol Police Officers
Int. J. Environ. Res. Public Health 2018, 15(1), 166; https://doi.org/10.3390/ijerph15010166
Received: 18 December 2017 / Revised: 10 January 2018 / Accepted: 18 January 2018 / Published: 21 January 2018
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Abstract
Background: Traditionally, workers employed in police forces have been found to be exposed to a high risk of distress. Several studies reported that the main stressors were associated more with organizational aspects, whilst other researchers underlined that the main stressor were associated
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Background: Traditionally, workers employed in police forces have been found to be exposed to a high risk of distress. Several studies reported that the main stressors were associated more with organizational aspects, whilst other researchers underlined that the main stressor were associated more with operational issues. The aim of this research was to investigate operational and organizational stressors, their consequences also in terms of anxiety and the coping strategies adopted. Methods: We compared Patrol Police Officers working in the Operational Service (Outdoor Patrol Officers) and those in the Interior Department (Indoor Patrol Officers) in the same Municipal Police force. Results: The results revealed that both Outdoor Patrol Officers and Interior Patrol Officers suffered from organizational and occupational stressor. Outdoor Patrol Officers appeared more willing to use different coping strategies, whereas Indoor Patrol Officers used avoidance strategies. This allows Outdoor Patrol Officers to explore new responses and approaches to deal with situations which—owing to the type of work—it is impossible to change. Outdoor Patrol Officers appeared better equipped to change their attitude to work than Indoor Patrol Officers. Conclusion: Interventions on both organizational and operational stressors would improve the quality of Patrol Police Officers’ working life and have positive repercussions on the service offered to the general public. Full article
(This article belongs to the Special Issue Stress and Health)
Open AccessArticle Feasibility of e-Health Interventions on Smoking Cessation among Vietnamese Active Internet Users
Int. J. Environ. Res. Public Health 2018, 15(1), 165; https://doi.org/10.3390/ijerph15010165
Received: 13 November 2017 / Revised: 2 January 2018 / Accepted: 19 January 2018 / Published: 20 January 2018
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Abstract
Introduction: Although e-health interventions are widely implemented as a supportive measure to smoking cessation, there is a lack of evidence in the feasibility of its application among Vietnamese youths, which is considered to be one of the most frequent internet using populations. This
[...] Read more.
Introduction: Although e-health interventions are widely implemented as a supportive measure to smoking cessation, there is a lack of evidence in the feasibility of its application among Vietnamese youths, which is considered to be one of the most frequent internet using populations. This study assessed the quitting attempts among smokers and their preference and willingness to pay for smartphone-based cessation supporting applications in a sample of active internet users approached. Methods: A total of 1082 participants were recruited for the online-based survey from August to October 2015 in Vietnam. Information on sociodemographic characteristics, health information seeking behaviors on the internet, smoking status, quitting attempts and willingness to pay for smartphone-based cessation supporting applications were collected. Multivariate logistic regression was used to determine the associated factors with current smoking and willingness to pay for the smoking cessation application. Results: About 11% of participants were current smokers while 73.4% had attempted to quit smoking. Only 26.8% of the individuals indicated that they were willing to utilize a smartphone application to assist them in quitting. Participants who were male, had partners/spouse and lived at other places were more likely to smoke cigarette. Meanwhile, people who spent 50–70% of their online time to read health information were less likely to smoke. Results also show that living with family and never sharing health information on the internet were negatively associated with a participant’s willingness to pay for the smartphone application. Meanwhile, people who highly trusted health information were more likely to be willing to pay for the application. Conclusions: This prevalence of smoking and associated factors can provide potential indicators for creating several public health interventions in the new environment with the increasing development of information technology. This study implies that in order to expand the coverage of smoking cessation interventions, we recommend the integration of e-health interventions with clinical- or telephone-based conventional models by providing smartphone applications and information on the internet from reliable sources. Full article
(This article belongs to the Special Issue eHealth: The Impact of Technology on Healthcare)
Open AccessArticle Fate of Fecal Indicators in Resource-Oriented Sanitation Systems Using Nitrifying Bio-Treatment
Int. J. Environ. Res. Public Health 2018, 15(1), 164; https://doi.org/10.3390/ijerph15010164
Received: 26 December 2017 / Revised: 16 January 2018 / Accepted: 16 January 2018 / Published: 20 January 2018
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Abstract
Hygienic fecal treatment in resource-oriented sanitation (ROS) systems is an important concern. Although the addition of nitrifying microorganisms is a sustainable fecal treatment method in ROS systems, it is essential to examine the cleanliness of this method. In this study, we investigated the
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Hygienic fecal treatment in resource-oriented sanitation (ROS) systems is an important concern. Although the addition of nitrifying microorganisms is a sustainable fecal treatment method in ROS systems, it is essential to examine the cleanliness of this method. In this study, we investigated the fate of fecal indicators in source-separated fecal samples through tracking Escherichia coli and total coliforms. The effects of adding different amounts of Nitrosomonas europaea bio-seed, along with a constant amount of Nitrobacter winogradskyi bio-seed, were studied. In intact feces samples, the pathogen population underwent an initial increase, followed by a slight decrease, and eventually became constant. Although the addition of nitrifying microorganisms initially enhanced the pathogen growth rate, it caused the reduction process to become more efficient in the long-term. In addition to a constant concentration of 10,000 cells of N. winogradskyi per 1 g feces, a minimum amount of 3000 and 7000 cells of N. europaea per 1 g feces could completely remove E. coli and total coliforms, respectively, in less than 25 days. Increasing the amount of bio-seeds added can further reduce the time required for total pathogen removal. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Implications of Combined Exposure to Household Air Pollution and HIV on Neurocognition in Children
Int. J. Environ. Res. Public Health 2018, 15(1), 163; https://doi.org/10.3390/ijerph15010163
Received: 18 November 2017 / Revised: 16 January 2018 / Accepted: 17 January 2018 / Published: 20 January 2018
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Abstract
Air pollution exposure and HIV infection can each cause neurocognitive insult in children. The purpose of this study was to test whether children with combined high air pollution exposure and perinatal HIV infection have even greater risk of neurocognitive impairment. This was a
[...] Read more.
Air pollution exposure and HIV infection can each cause neurocognitive insult in children. The purpose of this study was to test whether children with combined high air pollution exposure and perinatal HIV infection have even greater risk of neurocognitive impairment. This was a cross-sectional study of HIV-uninfected unexposed (HUU) and HIV-infected children and their caregivers in Nairobi, Kenya. We used a detailed neuropsychological battery to evaluate neurocognitive functioning in several domains. We measured caregiver 24-h personal CO exposure as a proxy for child CO exposure and child urinary 1-hydroxypyrene (1-OHP), a biomarker for exposure to polycyclic aromatic hydrocarbons (PAHs). Median 24-h caregiver CO exposure was 6.1 and 3.7 ppm for 45 HIV-infected (mean age 6.6 years) and 49 HUU (mean age 6.7 years), respectively; 48.5% of HIV-infected and 38.6% of HUU had caregiver 24-h CO levels exceeding the WHO recommended level. Median 1-OHP exposure was 0.6 and 0.7 µmol/mol creatinine among HIV-infected and HUU children, respectively. HIV-infected children with high urinary 1-OHP (exceeding 0.68 µmol/mol creatinine) had significantly lower global cognition (p = 0.04), delayed memory (p = 0.01), and attention scores (p = 0.003). Among HUU children, urinary 1-OHP and caregiver 24-h caregiver CO were not significantly associated with neurocognitive function. Our findings suggest that combined chronic exposure to air pollutants and perinatal HIV infection may be associated with poorer neurocognitive outcomes. High prevalence of air pollution exposure highlights the need to reduce these exposures. Full article
(This article belongs to the Special Issue Global Children’s Environmental Health)
Open AccessArticle Examining Public Perceptions about Lead in School Drinking Water: A Mixed-Methods Analysis of Twitter Response to an Environmental Health Hazard
Int. J. Environ. Res. Public Health 2018, 15(1), 162; https://doi.org/10.3390/ijerph15010162
Received: 21 November 2017 / Revised: 9 January 2018 / Accepted: 17 January 2018 / Published: 20 January 2018
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Abstract
Exposure to lead has long been a community health concern in St. Louis, Missouri. The objective of this study was to examine public response to reports of elevated lead levels in school drinking water in St. Louis, Missouri via Twitter, a microblogging platform
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Exposure to lead has long been a community health concern in St. Louis, Missouri. The objective of this study was to examine public response to reports of elevated lead levels in school drinking water in St. Louis, Missouri via Twitter, a microblogging platform with over 320 million active users. We used a mixed-methods design to examine Twitter user status updates, known as “tweets,” from 18 August to 31 December 2016. The number of tweets each day was recorded, and Twitter users were classified into five user types (General Public, Journalist/News, Health Professional/Academic, Politician/Government Official, and Non-Governmental Organization). A total of 492 tweets were identified during the study period. The majority of discourse on Twitter occurred during the two-week period after initial media reports and was driven by members of the General Public. Thematic analysis of tweets revealed four themes: Information Sharing, Health Concerns, Sociodemographic Disparities, and Outrage. Twitter users characterized lead in school drinking water as an issue of environmental inequity. The findings of this study provide evidence that social media platforms can be utilized as valuable tools for public health researchers and practitioners to gauge public sentiment about environmental health issues, identify emerging community concerns, and inform future communication and research strategies regarding environmental health hazards. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Prevalence and Factors Associated with Fixed-Dose Combination Antiretroviral Drugs Adherence among HIV-Positive Pregnant Women on Option B Treatment in Mpumalanga Province, South Africa
Int. J. Environ. Res. Public Health 2018, 15(1), 161; https://doi.org/10.3390/ijerph15010161
Received: 30 November 2017 / Revised: 12 January 2018 / Accepted: 19 January 2018 / Published: 20 January 2018
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Abstract
The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers’ adherence to their antiretroviral medication is one of the crucial factors to achieve this target. Cross-sectional data were collected
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The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers’ adherence to their antiretroviral medication is one of the crucial factors to achieve this target. Cross-sectional data were collected at 12 community health centres, over 12 months (2014–2015), from 673 HIV-positive women, less than 6 months pregnant, attending antenatal care, and on Option B treatment. Adherence measures included the Adults AIDS Clinical Trials Group (AACTG) four-day measure, as well as the Visual Analog Scale (VAS) seven-day measure. Bivariate analyses and multivariate logistic regressions are presented. 78.8% of respondents were adherent on AACTG, while 68.8% reported VAS adherence. Bivariate analyses for increased adherence show significant associations with older age, less/no alcohol usage, disclosure of HIV status, higher HIV knowledge, no desire to avoid ARV side effects, low stigma, and low depression. AACTG showed a negative association with intimate partner violence. Multivariable logistic regression on AACTG and VAS adherence rates resulted in unique contributions to increased adherence of older age, less/no alcohol usage, higher HIV knowledge, lack of depression, and non-disclosure. Programs targeting closer side effect monitoring, HIV disclosure, pre-natal depression, alcohol intake, and HIV knowledge need consideration. Full article
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