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Int. J. Environ. Res. Public Health, Volume 15, Issue 2 (February 2018)

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Open AccessArticle Demographic and Urbanization Disparities of Liver Transplantation in Taiwan
Int. J. Environ. Res. Public Health 2018, 15(2), 177; doi:10.3390/ijerph15020177
Received: 13 December 2017 / Revised: 10 January 2018 / Accepted: 18 January 2018 / Published: 23 January 2018
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Abstract
Limited access to or receipt of liver transplantation (LT) may jeopardize survival of patients with end-stage liver diseases. Taiwan launched its National Health Insurance (NHI) program in 1995, which essentially removes financial barriers to health care. This study aims to investigate where there
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Limited access to or receipt of liver transplantation (LT) may jeopardize survival of patients with end-stage liver diseases. Taiwan launched its National Health Insurance (NHI) program in 1995, which essentially removes financial barriers to health care. This study aims to investigate where there are still demographic and urbanization disparities of LT after 15 years of NHI program implementation. Data analyzed in this study were retrieved from Taiwan’s NHI inpatient claims. A total of 3020 people aged ≥18 years received LT between 2000 and 2013. We calculated crude and adjusted prevalence rate of LT according to secular year, age, sex, and urbanization. The multiple Poisson regression model was further employed to assess the independent effects of demographics and urbanization on prevalence of LT. The biennial number of people receiving LT substantially increased from 56 in 2000–2001 to 880 in 2012–2013, representing a prevalence rate of 1.63 and 18.58 per 106, respectively. Such increasing secular trend was independent of sex. The prevalence was consistently higher in men than in women. The prevalence also increased with age in people <65 years, but dropped sharply in the elderly (≥65 years) people. We noted a significant disparity of LT in areas with different levels of urbanization. Compared to urban areas, satellite (prevalence rate ratio (PRR), 0.63, 95% confidence interval (CI), 0.57–0.69) and rural (PRR, 0.76, 95% CI, 0.69–0.83) areas were both associated with a significantly lower prevalence of LT. There are still significant demographic and urbanization disparities in LT after 15 years of NHI program implementation. Given the predominance of living donor liver transplantation in Taiwan, further studies should be conducted to investigate factors associated with having a potential living donor for LT. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China
Int. J. Environ. Res. Public Health 2018, 15(2), 178; doi:10.3390/ijerph15020178
Received: 18 November 2017 / Revised: 18 December 2017 / Accepted: 17 January 2018 / Published: 23 January 2018
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Abstract
Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to
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Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to analyze associations between six air pollutants (namely SO2, CO, NO2, O3, PM10, and PM2.5) and daily outpatient and inpatient visits after adjusting confounding meteorological factors, time and day of the week effects. Significant associations between air pollutants and two types of hospital visits were observed. The estimated increase in overall outpatient visits associated with each 10 µg/m3 increase in air pollutant concentration ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average). Our results also suggested a heterogeneity of the health effects across different outcomes and in different populations. The findings in present study indicate that even in Shenzhen, a less polluted area in China, significant associations exist between air pollution and daily number of overall outpatient and inpatient visits. Full article
(This article belongs to the Special Issue Ambient Air Pollution and Health Vulnerability)
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Open AccessFeature PaperArticle System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics
Int. J. Environ. Res. Public Health 2018, 15(2), 179; doi:10.3390/ijerph15020179
Received: 9 October 2017 / Revised: 16 December 2017 / Accepted: 17 January 2018 / Published: 23 January 2018
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Abstract
Efficient patient-centred quality improvement requires an understanding of the system-wide areas of dissatisfaction along with evidence to identify the programs which can be strategically targeted according to specific patient characteristics and preferences. This cross-sectional study reports the proportion of chronic disease outpatients selecting
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Efficient patient-centred quality improvement requires an understanding of the system-wide areas of dissatisfaction along with evidence to identify the programs which can be strategically targeted according to specific patient characteristics and preferences. This cross-sectional study reports the proportion of chronic disease outpatients selecting 23 patient-centred improvement initiatives. Using univariate tests and multivariable logistic regressions, this multi-site study also identifies initiatives differentially selected by outpatients according to clinical and demographic characteristics. A total of 475 outpatients participated (49% response). Commonly selected initiatives included: reducing wait-times (22.3%); convenient appointment scheduling (16.0%); and receiving up-to-date treatment information (16.0%). Within univariate tests, preferences for information and service accessibility initiatives were not significantly associated with specific subgroups. However, seven initiatives were preferred according to age, gender, diagnosis status, and chronic disease type within multivariate models. For example, neurology outpatients were more likely to select assistance to manage psychological symptoms when compared to oncology outpatients (OR: 2.89). Study findings suggest that system-wide programs to enhance information provision are strategic approaches to improve experiences across patient characteristics. Furthermore, a few initiatives can be targeted to specific groups and emphasized the importance of detailed scoping analyses and tailored implementation plans when designing patient-centred quality improvement programs. Full article
(This article belongs to the Special Issue Quality of Patient-Centered Care)
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Open AccessArticle Faecal Pathogen Flows and Their Public Health Risks in Urban Environments: A Proposed Approach to Inform Sanitation Planning
Int. J. Environ. Res. Public Health 2018, 15(2), 181; doi:10.3390/ijerph15020181
Received: 8 December 2017 / Revised: 11 January 2018 / Accepted: 16 January 2018 / Published: 23 January 2018
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Abstract
Public health benefits are often a key political driver of urban sanitation investment in developing countries, however, pathogen flows are rarely taken systematically into account in sanitation investment choices. While several tools and approaches on sanitation and health risks have recently been developed,
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Public health benefits are often a key political driver of urban sanitation investment in developing countries, however, pathogen flows are rarely taken systematically into account in sanitation investment choices. While several tools and approaches on sanitation and health risks have recently been developed, this research identified gaps in their ability to predict faecal pathogen flows, to relate exposure risks to the existing sanitation services, and to compare expected impacts of improvements. This paper outlines a conceptual approach that links faecal waste discharge patterns with potential pathogen exposure pathways to quantitatively compare urban sanitation improvement options. An illustrative application of the approach is presented, using a spreadsheet-based model to compare the relative effect on disability-adjusted life years of six sanitation improvement options for a hypothetical urban situation. The approach includes consideration of the persistence or removal of different pathogen classes in different environments; recognition of multiple interconnected sludge and effluent pathways, and of multiple potential sites for exposure; and use of quantitative microbial risk assessment to support prediction of relative health risks for each option. This research provides a step forward in applying current knowledge to better consider public health, alongside environmental and other objectives, in urban sanitation decision making. Further empirical research in specific locations is now required to refine the approach and address data gaps. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Economic Conditions May Contribute to Increased Violence toward Children: A Nationwide Population-Based Analysis of Pediatric Injuries in Taiwanese Emergency Departments
Int. J. Environ. Res. Public Health 2018, 15(2), 182; doi:10.3390/ijerph15020182
Received: 2 December 2017 / Revised: 21 January 2018 / Accepted: 22 January 2018 / Published: 23 January 2018
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Abstract
Childhood injuries are unfortunately common. Analysis procedures may assist professionals who work with children with developing preventive measures for protecting children’s wellness. This study explores the causes of pediatric injuries presenting to an emergency department in Taiwan. This nationwide, population-based study was conducted
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Childhood injuries are unfortunately common. Analysis procedures may assist professionals who work with children with developing preventive measures for protecting children’s wellness. This study explores the causes of pediatric injuries presenting to an emergency department in Taiwan. This nationwide, population-based study was conducted using data from the National Health Insurance Research Database of Taiwan (NHIRD). Patients aged <18 years were identified from approximately one million individuals listed in the NHIRD. We followed up with these patients for nine years and analyzed the causes of injuries requiring presentation to an emergency department. Variables of interest were age, sex, injury mechanisms, and temporal trends. A total of 274,028 children were identified in our study. Between 2001 and 2009, the leading causes of pediatric injuries treated in emergency departments were motor vehicle injuries, falls, and homicide. The overall incidence of injuries declined over the course of the study because of reductions in motor vehicle accidents and falls. The incidence of homicide increased during the study period, particularly between 2007 and 2009. A moderately inverse correlation between homicide rate and economic growth was observed (correlation coefficient: −0.613, p = 0.041). There was a general decline in pediatric injuries between 2001 and 2009. Public policy changes, including motorcycle helmet laws and increases in alcohol taxes, may have contributed to this decline. Unfortunately, the incidence of homicide increased over the course of the study. Ongoing financial crises may have contributed to this increase. Multidisciplinary efforts are required to reduce homicide and reinforce the importance of measures that protect children against violence. Full article
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Open AccessFeature PaperArticle Vertical Geochemical Variations and Speciation Studies of As, Fe, Mn, Zn, and Cu in the Sediments of the Central Gangetic Basin: Sequential Extraction and Statistical Approach
Int. J. Environ. Res. Public Health 2018, 15(2), 183; doi:10.3390/ijerph15020183
Received: 15 December 2017 / Revised: 18 January 2018 / Accepted: 20 January 2018 / Published: 23 January 2018
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Abstract
A geochemical and speciation study of As, Fe, Mn, Zn, and Cu was performed using sequential extraction and statistical approaches in the core sediments taken at two locations—Rigni Chhapra and Chaube Chhapra—of the central Gangetic basin (India). A gradual increase in the grain
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A geochemical and speciation study of As, Fe, Mn, Zn, and Cu was performed using sequential extraction and statistical approaches in the core sediments taken at two locations—Rigni Chhapra and Chaube Chhapra—of the central Gangetic basin (India). A gradual increase in the grain size (varying from clay to coarse sands) was observed in both the core profiles up to 30.5 m depth. The concentrations of analyzed elements ranged as follows: 6.9–14.2 mg/kg for As, 13,849–31,088 mg/kg for Fe, 267–711 mg/kg for Mn, 45–164 mg/kg for Cu for Rigni Chhapra while for Chaube Chhapra the range was 7.5–13.2 mg/kg for As, 10,936–37,052 mg/kg for Fe, 267–1052 mg/kg for Mn, 60–198 mg/kg for Zn and 60–108 mg/kg for Cu. Significant amounts (53–95%) of all the fractionated elemental concentrations were bound within the crystal structure of the minerals as a residual fraction. The reducible fraction was the second most dominant fraction for As (7% and 8%), Fe (3%), Mn (20% and 26%), and Cu (7% and 6%) respectively for both the cores. It may be released when aquifers subjected to changing redox conditions. The acid soluble fraction was of most interest because it could quickly mobilize into the water system which formed the third most dominating among all three fractions. Four color code of sediments showed an association with total As concentration and did not show a relation with any fraction of all elements analyzed. The core sediment was observed enriched with As and other elements (Cu, Fe, Mn, and Zn). However, it fell under uncontaminated to moderately contaminate which might exhibit a low risk in prevailing natural conditions. X-ray diffraction analyses indicated the availability of siderite and magnetite minerals in the core sediments in a section of dark grey with micaceous medium sand with organic matter (black). Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessFeature PaperArticle Exploring Facilitators and Barriers to Initiation and Completion of the Human Papillomavirus (HPV) Vaccine Series among Parents of Girls in a Safety Net System
Int. J. Environ. Res. Public Health 2018, 15(2), 185; doi:10.3390/ijerph15020185
Received: 21 December 2017 / Revised: 13 January 2018 / Accepted: 15 January 2018 / Published: 23 January 2018
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Abstract
Objective: To assess, among parents of predominantly minority, low-income adolescent girls who had either not initiated (NI) or not completed (NC) the HPV vaccine series, attitudes and other factors important in promoting the series, and whether attitudes differed by language preference. Design/Methods: From
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Objective: To assess, among parents of predominantly minority, low-income adolescent girls who had either not initiated (NI) or not completed (NC) the HPV vaccine series, attitudes and other factors important in promoting the series, and whether attitudes differed by language preference. Design/Methods: From August 2013–October 2013, we conducted a mail survey among parents of girls aged 12–15 years randomly selected from administrative data in a Denver safety net system; 400 parents from each group (NI and NC) were targeted. Surveys were in English or Spanish. Results: The response rate was 37% (244/660; 140 moved or gone elsewhere; 66% English-speaking, 34% Spanish-speaking). Safety attitudes of NIs and NCs differed, with 40% NIs vs. 14% NCs reporting they thought HPV vaccine was unsafe (p < 0.0001) and 43% NIs vs. 21% NCs that it may cause long-term health problems (p < 0.001). Among NCs, 42% reported they did not know their daughter needed more shots (English-speaking, 20%, Spanish-speaking 52%) and 39% reported that “I wasn’t worried about the safety of the HPV vaccine before, but now I am” (English-speaking, 23%, Spanish-speaking, 50%). Items rated as very important among NIs in the decision regarding vaccination included: more information about safety (74%), more information saying it prevents cancer (70%), and if they knew HPV was spread mainly by sexual contact (61%). Conclusions: Safety concerns, being unaware of the need for multiple doses, and low perceived risk of infection remain significant barriers to HPV vaccination for at-risk adolescents. Some parents’ safety concerns do not appear until initial vaccination. Full article
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Open AccessArticle Study on Urban Heat Island Intensity Level Identification Based on an Improved Restricted Boltzmann Machine
Int. J. Environ. Res. Public Health 2018, 15(2), 186; doi:10.3390/ijerph15020186
Received: 5 December 2017 / Revised: 15 January 2018 / Accepted: 16 January 2018 / Published: 23 January 2018
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Abstract
Thermal infrared remote sensing has become one of the main technology methods used for urban heat island research. When applying urban land surface temperature inversion of the thermal infrared band, problems with intensity level division arise because the method is subjective. However, this
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Thermal infrared remote sensing has become one of the main technology methods used for urban heat island research. When applying urban land surface temperature inversion of the thermal infrared band, problems with intensity level division arise because the method is subjective. However, this method is one of the few that performs heat island intensity level identification. This paper will build an intensity level identifier for an urban heat island, by using weak supervision and thought-based learning in an improved, restricted Boltzmann machine (RBM) model. The identifier automatically initializes the annotation and optimizes the model parameters sequentially until the target identifier is completed. The algorithm needs very little information about the weak labeling of the target training sample and generates an urban heat island intensity spatial distribution map. This study can provide reliable decision-making support for urban ecological planning and effective protection of urban ecological security. The experimental results showed the following: (1) The heat island effect in Wuhan is existent and intense. Heat island areas are widely distributed. The largest heat island area is in Wuhan, followed by the sub-green island. The total area encompassed by heat island and strong island levels accounts for 54.16% of the land in Wuhan. (2) Partially based on improved RBM identification, this method meets the research demands of determining the spatial distribution characteristics of the internal heat island effect; its identification accuracy is superior to that of comparable methods. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Present and Future of Dengue Fever in Nepal: Mapping Climatic Suitability by Ecological Niche Model
Int. J. Environ. Res. Public Health 2018, 15(2), 187; doi:10.3390/ijerph15020187
Received: 15 November 2017 / Revised: 12 January 2018 / Accepted: 17 January 2018 / Published: 23 January 2018
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Abstract
Both the number of cases of dengue fever and the areas of outbreaks within Nepal have increased significantly in recent years. Further expansion and range shift is expected in the future due to global climate change and other associated factors. However, due to
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Both the number of cases of dengue fever and the areas of outbreaks within Nepal have increased significantly in recent years. Further expansion and range shift is expected in the future due to global climate change and other associated factors. However, due to limited spatially-explicit research in Nepal, there is poor understanding about the present spatial distribution patterns of dengue risk areas and the potential range shift due to future climate change. In this context, it is crucial to assess and map dengue fever risk areas in Nepal. Here, we used reported dengue cases and a set of bioclimatic variables on the MaxEnt ecological niche modeling approach to model the climatic niche and map present and future (2050s and 2070s) climatically suitable areas under different representative concentration pathways (RCP2.6, RCP6.0 and RCP8.5). Simulation-based estimates suggest that climatically suitable areas for dengue fever are presently distributed throughout the lowland Tarai from east to west and in river valleys at lower elevations. Under the different climate change scenarios, these areas will be slightly shifted towards higher elevation with varied magnitude and spatial patterns. Population exposed to climatically suitable areas of dengue fever in Nepal is anticipated to further increase in both 2050s and 2070s on all the assumed emission scenarios. These findings could be instrumental to plan and execute the strategic interventions for controlling dengue fever in Nepal. 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 AccessFeature PaperArticle Parental Attitudes, Behaviors, and Barriers to School Readiness among Parents of Low-Income Latino Children
Int. J. Environ. Res. Public Health 2018, 15(2), 188; doi:10.3390/ijerph15020188
Received: 18 December 2017 / Revised: 14 January 2018 / Accepted: 20 January 2018 / Published: 24 January 2018
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Abstract
We sought to explore parental attitudes, behaviors, and barriers regarding school readiness in a county clinic serving low income, Latino children. Between December 2013–September 2014, we conducted a cross sectional survey of parents during 3–6 years well-child appointments about school readiness (SR) across:
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We sought to explore parental attitudes, behaviors, and barriers regarding school readiness in a county clinic serving low income, Latino children. Between December 2013–September 2014, we conducted a cross sectional survey of parents during 3–6 years well-child appointments about school readiness (SR) across: (1) attitudes/behaviors; (2) barriers; and (3) awareness; and (4) use of local resources. Most parents (n = 210, response rate 95.6%) find it very important/important for their child to know specific skills prior to school: take turns and share (98.5%), use a pencil and count (97.6%), know letters (99.1%), colors (97.1%), and shapes (96.1%). Over 80% of parents find education important and engage in positive SR behaviors: singing, practicing letters, or reading. Major barriers to SR were lack of knowledge for kindergarten readiness, language barriers, access to books at home, constraints on nightly reading, difficulty completing school forms, and limited free time with child. Awareness of local resources such as preschool programs was higher than actual utilization. These low-income, Latino parents value SR but lack knowledge to prepare their child for school and underutilize community resources such as free preschool programs. Pediatricians are uniquely positioned to address these needs, but more evidence-based interventions are needed. Full article
(This article belongs to the Special Issue The Health Needs of Vulnerable Children: Challenges and Solutions)
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Open AccessArticle A Cross-Sectional Study of Viral Hepatitis Perception among Residents from Southeast and North Regions of Brazil
Int. J. Environ. Res. Public Health 2018, 15(2), 189; doi:10.3390/ijerph15020189
Received: 15 December 2017 / Revised: 2 January 2018 / Accepted: 2 January 2018 / Published: 24 January 2018
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Abstract
Few data are available regarding viral hepatitis perception among the general global population. The present study aims to estimate the perception of viral hepatitis in a cohort of individuals living in two geographical regions of Brazil: North (Manaus city (MA)) and Southeast (Rio
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Few data are available regarding viral hepatitis perception among the general global population. The present study aims to estimate the perception of viral hepatitis in a cohort of individuals living in two geographical regions of Brazil: North (Manaus city (MA)) and Southeast (Rio de Janeiro city (RJ)). A cross-sectional, descriptive study was carried out among 287 subjects recruited in MA (134) and RJ (153). All individuals answered a questionnaire assessing socio-demographic characteristics and viral hepatitis awareness. Participants’ responses were scored and divided using interquartile values. Associations between socio-demographic characteristics and knowledge were also evaluated. Interquartile analysis scored 0–21 correct answers as “Very Weak”; 22–27 as “Weak”; 28–31 as “Intermediate”; and 32–47 as “Desirable”. Mean ± standard deviations (SD) of correct responses were weak in both MA (24.1 ± 7.0) and RJ (26.3 ± 7.3). Bivariate analysis showed an association between viral hepatitis awareness and both education level (p < 0.001) and family income (p < 0.01). Desirable scores were more common in female participants (61%), those aged between 21–30 years (40%), those with a secondary education (51.7%), those who received high income (31.6%), and those from RJ (70.0%). Health education campaigns in these cities are recommended to increase knowledge and reduce the transmission of these viruses. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessFeature PaperArticle What Works? Toward a New Classification System for Mental Health Supported Accommodation Services: The Simple Taxonomy for Supported Accommodation (STAX-SA)
Int. J. Environ. Res. Public Health 2018, 15(2), 190; doi:10.3390/ijerph15020190
Received: 5 December 2017 / Revised: 15 January 2018 / Accepted: 19 January 2018 / Published: 24 January 2018
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Abstract
Inconsistent terminology and variation in service models have made synthesis of the supported accommodation literature challenging. To overcome this, we developed a brief, categorical taxonomy that aimed to capture the defining features of different supported accommodation models: the simple taxonomy for supported accommodation
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Inconsistent terminology and variation in service models have made synthesis of the supported accommodation literature challenging. To overcome this, we developed a brief, categorical taxonomy that aimed to capture the defining features of different supported accommodation models: the simple taxonomy for supported accommodation (STAX-SA). Data from a previous review of existing classification systems were used to develop the taxonomy structure. After initial testing and amendments, the STAX-SA and an existing taxonomy were applied to 132 supported accommodation service descriptions drawn from two systematic reviews and their performance compared. To assess external validity, the STAX-SA was distributed to a sample of supported accommodation managers in England and they were asked to use it to classify their services. The final version of the STAX-SA comprised of five supported accommodation ‘types’, based on four domains; Staffing location; Level of support; Emphasis on move-on; and Physical setting. The STAX-SA accurately categorized 71.1% (n = 94) of service descriptions, outperforming the comparison tool, and was not affected by publication date or research design. The STAX-SA effectively discriminated between ‘real world’ service models in England and 53.2% (n = 17) of service managers indicated that the taxonomy was ‘Very effective’ or ‘Extremely effective’ in capturing key characteristics of their service. The STAX-SA is an effective tool for classifying supported accommodation models and represents a promising approach to synthesizing the extant effectiveness literature. The authors recommend the development of reporting guidelines for future supported accommodation publications to facilitate comparison between models. Full article
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
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Open AccessFeature PaperArticle Allostatic Load and Effort-Reward Imbalance: Associations over the Working-Career
Int. J. Environ. Res. Public Health 2018, 15(2), 191; doi:10.3390/ijerph15020191
Received: 30 November 2017 / Revised: 15 January 2018 / Accepted: 15 January 2018 / Published: 24 January 2018
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Abstract
Although associations between work stressors and stress-related biomarkers have been reported in cross-sectional studies, the use of single time measurements of work stressors could be one of the reasons for inconsistent associations. This study examines whether repeated reports of work stress towards the
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Although associations between work stressors and stress-related biomarkers have been reported in cross-sectional studies, the use of single time measurements of work stressors could be one of the reasons for inconsistent associations. This study examines whether repeated reports of work stress towards the end of the working career predicts allostatic load, a measure of chronic stress related physiological processes. Data from waves 2 to 6 of the English Longitudinal Study of Ageing (ELSA) were analysed, with a main analytical sample of 2663 older adults (aged 50+) who had at least one measurement of effort-reward imbalance between waves 2–6 and a measurement of allostatic load at wave 6. Cumulative work stress over waves 2–6 were measured by the effort-reward imbalance model. ELSA respondents who had reported two or more occasions of imbalance had a higher (0.3) estimate of the allostatic load index than those who did not report any imbalance, controlling for a range of health and socio-demographic factors, as well as allostatic load at baseline. More recent reports of imbalance were significantly associated with a higher allostatic load index, whereas reports of imbalance from earlier waves of ELSA were not. The accumulation of work related stressors could have adverse effects on chronic stress biological processes. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
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Open AccessArticle Oral Contact Events and Caregiver Hand Hygiene: Implications for Fecal-Oral Exposure to Enteric Pathogens among Infants 3–9 Months Living in Informal, Peri-Urban Communities in Kisumu, Kenya
Int. J. Environ. Res. Public Health 2018, 15(2), 192; doi:10.3390/ijerph15020192
Received: 11 December 2017 / Revised: 18 January 2018 / Accepted: 22 January 2018 / Published: 24 January 2018
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Abstract
Childhood diarrhea is one of the leading causes of morbidity and mortality in children under five in low and middle-income countries, second only to respiratory illness. The mouthing behavior that is common in children exposes them to fecal-orally transmitted pathogens that can result
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Childhood diarrhea is one of the leading causes of morbidity and mortality in children under five in low and middle-income countries, second only to respiratory illness. The mouthing behavior that is common in children exposes them to fecal-orally transmitted pathogens that can result in diarrhea; however, there is a need for further evidence on specific exposure routes. This study describes the frequency and diversity of two important routes of enteric pathogen exposure among infants 3–9 months of age: infant oral contact behavior and caregiver handwashing behavior. Data were collected through structured observations of 25 index infants for the oral contact data and 25 households for the caregiver handwashing data in a peri-urban setting in Kisumu (Obunga), Kenya. Breast was the most common type of oral contact event with an average of 3.00 per observation period and 0.5 events per hour. This was followed by a range of physical objects with an average of 2.49 per observation and 0.4 events per hour. The “infant’s own hands” was the third most common oral contact, with an average of 2.16 events per hour, and 0.4 oral contact events per hour. Food and liquids were the 4th and 5th most common oral contact events with an average of 1.64 food contacts and 0.52 liquid oral contact events per observation period. Feeding events, including breastfeeding, were the most commonly observed key juncture—71% of total junctures observed were caregivers feeding children. This was followed by child cleaning (23%), caregiver toilet uses at (4%), and lastly food preparation at 2%. HWWS was observed only once before a feeding event (1%), twice after cleaning a child (9%), and twice after caregiver toilet use (40%). The combined implication of data from observing oral contact behavior in children and hand hygiene of caregivers suggests that caregiver hand hygiene prior to feeding events and after cleaning a child are priority interventions. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle “Girls Have More Challenges; They Need to Be Locked Up”: A Qualitative Study of Gender Norms and the Sexuality of Young Adolescents in Uganda
Int. J. Environ. Res. Public Health 2018, 15(2), 193; doi:10.3390/ijerph15020193
Received: 15 December 2017 / Revised: 15 January 2018 / Accepted: 19 January 2018 / Published: 24 January 2018
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Abstract
Unequal power and gender norms expose adolescent girls to higher risks of HIV, early marriages, pregnancies and coerced sex. In Uganda, almost half of the girls below the age of 18 are already married or pregnant, which poses a danger to the lives
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Unequal power and gender norms expose adolescent girls to higher risks of HIV, early marriages, pregnancies and coerced sex. In Uganda, almost half of the girls below the age of 18 are already married or pregnant, which poses a danger to the lives of young girls. This study explores the social construction of gender norms from early childhood, and how it influences adolescents’ agency. Contrary to the mainstream theory of agency, which focuses on the ability to make informed choices, adolescents’ agency appears constrained by context-specific obstacles. This study adopted qualitative research approaches involving 132 participants. Of these, 44 were in-depth interviews and 11 were focus group discussions, parcelled out into separate groups of adolescents (12–14 years), teachers, and parents (n = 88), in Western Uganda. Data were analysed manually using open and axial codes, and conclusions were inductive. Results show that gender norms are established early in life, and have a very substantial impact on the agency of young adolescents. There were stereotypical gender norms depicting boys as sexually active and girls as restrained; girls’ movements were restricted; their sexual agency constrained; and prevention of pregnancy was perceived as a girl’s responsibility. Programs targeting behavioural change need to begin early in the lives of young children. They should target teachers and parents about the values of gender equality and strengthen the legal system to create an enabling environment to address the health and wellbeing of adolescents. Full article
Open AccessArticle Multiple Attribute Group Decision-Making Methods Based on Trapezoidal Fuzzy Two-Dimensional Linguistic Partitioned Bonferroni Mean Aggregation Operators
Int. J. Environ. Res. Public Health 2018, 15(2), 194; doi:10.3390/ijerph15020194
Received: 25 November 2017 / Revised: 29 December 2017 / Accepted: 9 January 2018 / Published: 24 January 2018
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Abstract
In this paper, we investigate multiple attribute group decision making (MAGDM) problems where decision makers represent their evaluation of alternatives by trapezoidal fuzzy two-dimensional uncertain linguistic variable. To begin with, we introduce the definition, properties, expectation, operational laws of trapezoidal fuzzy two-dimensional linguistic
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In this paper, we investigate multiple attribute group decision making (MAGDM) problems where decision makers represent their evaluation of alternatives by trapezoidal fuzzy two-dimensional uncertain linguistic variable. To begin with, we introduce the definition, properties, expectation, operational laws of trapezoidal fuzzy two-dimensional linguistic information. Then, to improve the accuracy of decision making in some case where there are a sort of interrelationship among the attributes, we analyze partition Bonferroni mean (PBM) operator in trapezoidal fuzzy two-dimensional variable environment and develop two operators: trapezoidal fuzzy two-dimensional linguistic partitioned Bonferroni mean (TF2DLPBM) aggregation operator and trapezoidal fuzzy two-dimensional linguistic weighted partitioned Bonferroni mean (TF2DLWPBM) aggregation operator. Furthermore, we develop a novel method to solve MAGDM problems based on TF2DLWPBM aggregation operator. Finally, a practical example is presented to illustrate the effectiveness of this method and analyses the impact of different parameters on the results of decision-making. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Optimum Water Quality Monitoring Network Design for Bidirectional River Systems
Int. J. Environ. Res. Public Health 2018, 15(2), 195; doi:10.3390/ijerph15020195
Received: 28 November 2017 / Revised: 15 January 2018 / Accepted: 19 January 2018 / Published: 24 January 2018
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Abstract
Affected by regular tides, bidirectional water flows play a crucial role in surface river systems. Using optimization theory to design a water quality monitoring network can reduce the redundant monitoring nodes as well as save the costs for building and running a monitoring
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Affected by regular tides, bidirectional water flows play a crucial role in surface river systems. Using optimization theory to design a water quality monitoring network can reduce the redundant monitoring nodes as well as save the costs for building and running a monitoring network. A novel algorithm is proposed to design an optimum water quality monitoring network for tidal rivers with bidirectional water flows. Two optimization objectives of minimum pollution detection time and maximum pollution detection probability are used in our optimization algorithm. We modify the Multi-Objective Particle Swarm Optimization (MOPSO) algorithm and develop new fitness functions to calculate pollution detection time and pollution detection probability in a discrete manner. In addition, the Storm Water Management Model (SWMM) is used to simulate hydraulic characteristics and pollution events based on a hypothetical river system studied in the literature. Experimental results show that our algorithm can obtain a better Pareto frontier. The influence of bidirectional water flows to the network design is also identified, which has not been studied in the literature. Besides that, we also find that the probability of bidirectional water flows has no effect on the optimum monitoring network design but slightly changes the mean pollution detection time. Full article
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Open AccessArticle Examining the Impact of Maternal Individual Features on Children’s Behavioral Problems in Adoptive Families: The Role of Maternal Temperament and Neurobiological Markers
Int. J. Environ. Res. Public Health 2018, 15(2), 196; doi:10.3390/ijerph15020196
Received: 3 January 2018 / Revised: 21 January 2018 / Accepted: 22 January 2018 / Published: 24 January 2018
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Abstract
The first year after adoption constitutes a sensitive period for both strengthening the new emotional bond in the family and checking its appropriate development by adoption services. A key variable for children’s catch-up are adoptive parents’ socioemotional and individual features. The aim of
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The first year after adoption constitutes a sensitive period for both strengthening the new emotional bond in the family and checking its appropriate development by adoption services. A key variable for children’s catch-up are adoptive parents’ socioemotional and individual features. The aim of this study is to investigate links between adoptive mothers’ individual features and behavioral problems in their children in the first year after adoption placement, by testing the moderating role of both age at adoption and maternal genetic polymorphisms. Seventy-eight adoptive mothers completed temperament and genetic measures. Mothers showed a specific pattern of interaction between basic temperament traits and genetic markers in their assessment of children’s behavioral problems; dopamine D4 receptor gene and children’s age at adoption are two moderators in the association in which mothers’ temperament was affecting the evaluation of their children’s behavioral problems. Findings highlight a still undervalued area of parenting resources in the process of post-institutionalized children’s catch-up after adoption placement, by showing how individual features count in the commonly measured variable of children’s behavioral and emotional problems. This could help in orienting identification and choice of key variables for family assessment after adoption placement, thus contributing in fostering children’s healthy development. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle Managing Exposure to Benzene and Total Petroleum Hydrocarbons at Two Oil Refineries 1977–2014
Int. J. Environ. Res. Public Health 2018, 15(2), 197; doi:10.3390/ijerph15020197
Received: 15 December 2017 / Revised: 15 January 2018 / Accepted: 18 January 2018 / Published: 24 January 2018
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Abstract
Air concentrations of and inhalation exposure to total petroleum hydrocarbons (TPH) and benzene was monitored separately at two oil refineries from 1977 to 2014. Prevention policies and control measures that may explain changes were surveyed. The aim was to evaluate how the application
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Air concentrations of and inhalation exposure to total petroleum hydrocarbons (TPH) and benzene was monitored separately at two oil refineries from 1977 to 2014. Prevention policies and control measures that may explain changes were surveyed. The aim was to evaluate how the application of of Occupational Health and Safety Assessment Series OHSAS 18001.04 principles as well as Environmental protection Agency EPA and European Oil Company Organisation for Environment, Health and Safety CONCAWE practices have influenced air concentrations. Benzene air concentrations declined in 11 of 17 units, six of which were associated with declining exposures. Benzene air concentrations declined across all units on average by 46%. This amounts to an average yearly decline of 1.7%. TPH air concentrations declined in 10 of 17 units, seven of which were associated with declining exposures. The average decline in TPH air concentrations was 49%, corresponding to 1.3% per year. As a result, average working day exposure in 10 of 17 units have declined significantly and today, benzene and TPH exposure in most units are well below 10% of the current Occupational Exposure Limit (OEL8h:s). A decline in air concentrations have coincided with consistent implementation of control measures. Such measures include on-line monitoring of leaks; benzene recovery; floating container roofs; improved valves and seals; hermetic pumps; recovery of loading gases and instalment of torches in terminals; cutback in coke combustion; a new production line spanning directly from the dock to aromatics production; and recovery of loading gases in the doc. Other tools in exposure management include personal leak monitors, on-line measurements, monitoring campaigns, risk assessment, and availability and user training of protective equipment. However, improvements are still needed. Hydrocarbon or benzene air concentrations have not declined in 8 of 17 units, in some of which concentrations exceed 10% of the relevant OEL8h value. In addition, for benzene even 10% of the current OEL, 0.1 ppm, might still possess a risk. With this in mind, methods to estimate exposure at the refineries need to be improved to enable measuring benzene concentrations <0.1 ppm. Shut downs of the refinery have been associated with peaks in exposure concentrations. Consequently, effort should be placed on safe working methods pertaining to shutdowns. Also, the connection and detachment of hoses continues to be problematic from the point of view of controlling exposure. Full article
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Open AccessArticle The Asbestos Ban in Korea from a Grassroots Perspective: Why Did It Occur?
Int. J. Environ. Res. Public Health 2018, 15(2), 198; doi:10.3390/ijerph15020198
Received: 16 December 2017 / Revised: 17 January 2018 / Accepted: 19 January 2018 / Published: 25 January 2018
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Abstract
In 2009, asbestos was finally banned in Korea, about 70 years after the first opening of asbestos mines under Japanese control. After having presented the history of asbestos industry, together with its regulations and health effects over time, we constructed narrative analyses of
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In 2009, asbestos was finally banned in Korea, about 70 years after the first opening of asbestos mines under Japanese control. After having presented the history of asbestos industry, together with its regulations and health effects over time, we constructed narrative analyses of how the asbestos issue under the prevailing risk system was managed by whom and for what purpose, to provide context for the change. We could identify five different phases: laissez-faire, politico-technical, economic–managerial, health-oriented cultural, and human rights-based post-cultural risk systems. The changes leading to the asbestos ban evolved over different phases, and each phase change was necessary to reach the final ban, in that, without resolving the previous issues by examining different categories of potential alternatives, either the final ban was not possible or, even if instituted, could not be sustained. An asbestos ban could be introduced when all the alternatives to these issues, including legitimate political windows, economic rationalizations, health risk protections, and human rights sensitivities, were available. We think the alternatives that we had were not in perfect shape, but in more or less loosely connected forms, and hence we had to know how to build solidarities between different stakeholders to compensate for the imperfections. Full article
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Open AccessArticle Analysis and Assessment of Exposure to Selected Phthalates Found in Children’s Toys in Christchurch, New Zealand
Int. J. Environ. Res. Public Health 2018, 15(2), 200; doi:10.3390/ijerph15020200
Received: 28 November 2017 / Revised: 11 January 2018 / Accepted: 16 January 2018 / Published: 25 January 2018
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Abstract
Internationally several phthalates are subject to regulatory control regarding maximum allowable concentrations in children’s toys. Such regulation is not in place in New Zealand. Phthalates have been associated with developmental toxicity and endocrine disruption. We determined the concentration of seven phthalates in children’s
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Internationally several phthalates are subject to regulatory control regarding maximum allowable concentrations in children’s toys. Such regulation is not in place in New Zealand. Phthalates have been associated with developmental toxicity and endocrine disruption. We determined the concentration of seven phthalates in children’s toys purchased in Christchurch, New Zealand. These results provided data for an exposure assessment deriving Hazard Indices (HI) for oral and dermal exposure routes in children, based on the concentration of mixtures of phthalates shown by the EU to produce either reproductive/developmental or hepatotoxic effects. Of the 49 toys analyzed, 65% contained at least one phthalate at a concentration of >0.1% by mass; and 35% contained multiple-phthalates at individual concentrations of >0.1%. A HI of 3.4 was derived for the combined exposures to the four phthalates associated with reproductive and developmental effects. A HI of 0.3 was derived for the group of phthalates associated with hepatotoxic effects. Five phthalates were detected at levels exceeding the EU regulatory limit of 0.1% by mass. Risk assessment calculations indicate that, using realistic exposure scenarios, the worst-case combined exposure to phthalates associated with developmental toxicity exceeded a HI of 1 so may cause adverse developmental effects. Full article
Open AccessArticle Urinary Metabolite Levels of Flame Retardants in Electronic Cigarette Users: A Study Using the Data from NHANES 2013–2014
Int. J. Environ. Res. Public Health 2018, 15(2), 201; doi:10.3390/ijerph15020201
Received: 6 December 2017 / Revised: 22 January 2018 / Accepted: 22 January 2018 / Published: 25 January 2018
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Abstract
Evaluating the safety of e-cigarettes and making informed judgement about developing potential standards require sufficient scientific evidence. Since e-cigarettes are highly engineered products containing plastic, glass and metal parts, and e-liquids are largely different matrices, many toxic compounds which are not typical hazards
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Evaluating the safety of e-cigarettes and making informed judgement about developing potential standards require sufficient scientific evidence. Since e-cigarettes are highly engineered products containing plastic, glass and metal parts, and e-liquids are largely different matrices, many toxic compounds which are not typical hazards for the users of combustible tobacco products (e.g., cigarettes), could exist in e-liquids, and consequently, posing potential health risk to e-cigarette users. We combined the measurements of urinary metabolites of organophosphate flame retardants (OPFRs) with questionnaire data collected in the National Health and Nutrition Examination Surveys (NHANES) from 2013 to 2014, and we compared adjusted geometric means (GM) for each biomarker in e-cigarette users with levels in non-users and users of various tobacco products using multiple regression analyses to adjust for potential confounders. We found diphenyl phosphate (DPhP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), bis(2-chloroethyl) phosphate (BCEP), and dibutyl phosphate (DBUP) were detected in all e-cigarette users. The adjusted GM of BCEP, the metabolite of tris(2-chloroethyl) phosphate (TCEP), was 81% higher than nonusers (p = 0.0124) and significantly higher than those for both cigarette and cigar users (p < 0.05). The findings in this pilot study suggest that certain OPFRs may present in e-cigarettes as contaminants, and consequently, resulting in higher exposure levels in e-cigarette users compared to nonusers. As we only identified 14 e-cigarette users in the survey, the findings in this study need to be confirmed in future study at a larger scale. A better examination of the types and levels of FRs and their potential contamination sources in e-cigarettes is also needed. Full article
Open AccessArticle Trace Elements in Soils and Selected Agricultural Plants in the Tongling Mining Area of China
Int. J. Environ. Res. Public Health 2018, 15(2), 202; doi:10.3390/ijerph15020202
Received: 24 November 2017 / Revised: 9 January 2018 / Accepted: 11 January 2018 / Published: 25 January 2018
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Abstract
The quality and safety of agricultural products from metal mining areas are of wide concern. In order to investigate the contents and health risks of trace elements in fruit vegetables planted in metal mining areas, 440 samples of fruit vegetables from 117 vegetable
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The quality and safety of agricultural products from metal mining areas are of wide concern. In order to investigate the contents and health risks of trace elements in fruit vegetables planted in metal mining areas, 440 samples of fruit vegetables from 117 vegetable plots were collected from Tongling mining area. Trace element contents in fruit vegetables and soil were measured. The results indicated that the total concentration of trace elements in some of the soil samples exceeded the Grade II national standard in China. Transfer factor (TF) of Cd was the highest (8.360), followed by Zn, Cu, As, and Pb. Estimated daily intake (EDI) of the trace elements, except Cd, were generally below the maximum tolerable daily intake (MTDI). The target hazard quotient (THQ) of Zn for children was more than 1 in some vegetables, suggesting potential health hazards for child population. Total target hazard quotient (TTHQ) of Cu and Zn were also more than 1 through consumption of all vegetables, indicating significant health risks. For both adults and children, hazard index (HI) was more than 1 for the consumption of vegetables. The findings reveal the health risks associated with the consumption of trace elements through the intake of selected vegetables in the population of Tongling. Full article
(This article belongs to the collection Environmental Risk Assessment)
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Open AccessArticle Assessment of Tomato (Solanum lycopersicum L.) Producers’ Exposure Level to Pesticides, in Kouka and Toussiana (Burkina Faso)
Int. J. Environ. Res. Public Health 2018, 15(2), 204; doi:10.3390/ijerph15020204
Received: 29 December 2017 / Revised: 15 January 2018 / Accepted: 23 January 2018 / Published: 25 January 2018
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Abstract
To assess producers’ exposure level to pesticides in vegetable production in Burkina Faso, a study was carried out in 2016 and 2017 among 30 tomato producers in the municipalities of Kouka and Toussiana. Eighteen (18) commercial formulations were identified, with more than 50%
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To assess producers’ exposure level to pesticides in vegetable production in Burkina Faso, a study was carried out in 2016 and 2017 among 30 tomato producers in the municipalities of Kouka and Toussiana. Eighteen (18) commercial formulations were identified, with more than 50% of pesticides destined for cotton production. Eleven active substances have been identified and the most frequently used are λ-cyhalothrin (35%), acetamiprid (22%) and profenofos (13%). The most commonly used chemical families are pyrethroids (28%) and organophosphates (18%). The study revealed a low level of training for producers, a high use of pesticides according to the Frequency Treatment Indicator, and a very low level of protection used by producers. The Health Risk Index shows that active substances such as methomyl, λ-cyhalothrin and profenofos present very high risk to operators’ health. Based on the UK-POEM model, the predictive exposure levels obtained varied from 0.0105 mg/kg body weight/day to 1.7855 mg/kg body weight/day, which is several times higher than the Acceptable Operator Exposure Level. However, the study also shows that exposure can be greatly reduced if the required Personal Protective Equipment is worn. Producers’ awareness and training on integrated pest management are necessary to reduce the risks linked to the pesticides use in Burkina Faso. Full article
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Open AccessArticle Impact of an Outdoor Smoking Ban at Secondary Schools on Cigarettes, E-Cigarettes and Water Pipe Use among Adolescents: An 18-Month Follow-Up
Int. J. Environ. Res. Public Health 2018, 15(2), 205; doi:10.3390/ijerph15020205
Received: 10 November 2017 / Revised: 19 January 2018 / Accepted: 23 January 2018 / Published: 25 January 2018
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Abstract
The effectiveness of outdoor smoking bans on smoking behavior among adolescents remains inconclusive. This study evaluates the long-term impact of outdoor school ground smoking bans among adolescents at secondary schools on the use of conventional cigarettes, e-cigarettes (with/without nicotine) and water pipes. Outdoor
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The effectiveness of outdoor smoking bans on smoking behavior among adolescents remains inconclusive. This study evaluates the long-term impact of outdoor school ground smoking bans among adolescents at secondary schools on the use of conventional cigarettes, e-cigarettes (with/without nicotine) and water pipes. Outdoor smoking bans at 19 Dutch secondary schools were evaluated using a quasi-experimental design. Data on 7733 adolescents were obtained at baseline, and at 6 and 18-month follow-up. The impact of outdoor smoking bans on ‘ever use of conventional cigarettes’, ‘smoking onset’, ‘ever use of e-cigarette with nicotine’, ‘e-cigarette without nicotine’, and ‘water pipe’ was measured. Multilevel logistic regression analysis was used. At schools with a ban, implementation fidelity was checked. At schools where a ban was implemented, at 18-month follow-up more adolescents had started smoking compared to the control condition. No effect of implementation of the ban was found for smoking prevalence, e-cigarettes with/without nicotine, and water pipe use. Implementation fidelity was sufficient. No long-term effects were found of an outdoor smoking ban, except for smoking onset. The ban might cause a reversal effect when schools encounter difficulties with its enforcement or when adolescents still see others smoking. Additional research is required with a longer follow-up than 18 months. Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
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Open AccessArticle Spatial Distribution, Chemical Fraction and Fuzzy Comprehensive Risk Assessment of Heavy Metals in Surface Sediments from the Honghu Lake, China
Int. J. Environ. Res. Public Health 2018, 15(2), 207; doi:10.3390/ijerph15020207
Received: 4 December 2017 / Revised: 22 January 2018 / Accepted: 22 January 2018 / Published: 26 January 2018
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Abstract
Spatial concentrations and chemical fractions of heavy metals (Cr, Cu, Pb, Zn and Cd) in 16 sampling sites from the Honghu Lake were investigated using an atomic absorption spectrophotometer and optimized BCR (the European Community Bureau of Reference) three-stage extraction procedure. Compared with
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Spatial concentrations and chemical fractions of heavy metals (Cr, Cu, Pb, Zn and Cd) in 16 sampling sites from the Honghu Lake were investigated using an atomic absorption spectrophotometer and optimized BCR (the European Community Bureau of Reference) three-stage extraction procedure. Compared with the corresponding probable effect levels (PELs), adverse biological effects of the studied five sediment metals decreased in the sequence of Cr > Cu > Zn > Pb > Cd. Geo-accumulation index (Igeo) values for Cr, Cu, Pb and Zn in each sampling site were at un-contamination level, while the values for Cd varied from un-contamination level to moderate contamination level. Spatially, the enrichment degree of Cd in lower part of the South Lake, the west part of the North Lake and the outlet were higher than the other parts of Honghu Lake. For metal chemical fractions, the proportions of the acid-extractable fraction of five metal contents were in the descending order: Cd, Cu, Zn, Pb and Cr. Cd had the highest bioaccessibility. Being the above indexes focused always on heavy metals’ total content or chemical fraction in deterministic assessment system, which may confuse decision makers, the fuzzy comprehensive risk assessment method was established based on PEI (Potential ecological risk index), RAC (Risk assessment code) and fuzzy theory. Average comprehensive risks of heavy metals in sediments revealed the following orders: Cd (considerable risk) > Cu (moderate risk) > Zn (low risk) > Pb > Cr. Thus, Cd and Cu were determined as the pollutants of most concern. The central part of South Honghu Lake (S4, S5, S6, S9, S12 and S14), east part of the North Honghu Lake (S1) and outlet of outlet of the Honghu Lake (S10) were recommended as the priority control areas. Specifically, it is necessary to pay more attention to S1, S4, S5, S6, S9 and S16 when decision making for their calculated membership values (probabilities) of adjacent risk levels quite close. Full article
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Open AccessArticle Annoyance Judgment and Measurements of Environmental Noise: A Focus on Italian Secondary Schools
Int. J. Environ. Res. Public Health 2018, 15(2), 208; doi:10.3390/ijerph15020208
Received: 4 December 2017 / Revised: 22 January 2018 / Accepted: 24 January 2018 / Published: 26 January 2018
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Abstract
The effects of noise on students’ health, well-being, and learning are of growing concern among both the general public and policy-makers in Europe. Several studies have highlighted the consequences of noise on children’s learning and performance at school. This study investigates the relationship
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The effects of noise on students’ health, well-being, and learning are of growing concern among both the general public and policy-makers in Europe. Several studies have highlighted the consequences of noise on children’s learning and performance at school. This study investigates the relationship between noise judgment in school goers aged 11–18 and noise measurements aimed at evaluating their exposure at school. For this purpose, a questionnaire was administered to 521 individuals in 28 classrooms in eight schools of four cities in Italy, with different environmental characteristics. Using a Likert-type scale, a selected set of responses related to noise generated an Annoyance Index (AI) score for each student and a classroom median score (MAI). From the noise data acquired, a global noise score (GNS) was assigned to each classroom. A higher AI was found in industrialized areas and among younger students. No significant differences in noise judgment were found by gender. A significant inverse correlation was described between MAI and GNS, thus the better the acoustic quality of the classrooms, the less the perceived noise and annoyance. The results show that noise perception and consequent disturbance are highly correlated with classroom acoustics, and confirm that annoyance represents the most widespread subjective response to noise. Full article
(This article belongs to the Special Issue Noise-Related Annoyance)
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Open AccessArticle Self-Harm among Young People Detained in the Youth Justice System in Sri Lanka
Int. J. Environ. Res. Public Health 2018, 15(2), 209; doi:10.3390/ijerph15020209
Received: 12 December 2017 / Revised: 17 January 2018 / Accepted: 18 January 2018 / Published: 26 January 2018
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Abstract
Self-harm is prevalent in incarcerated adults, yet comparatively few studies of self-harm in detained youth (and even fewer in low- and middle-income countries) have been published. We examined the prevalence and correlates of self-harm in a sample of 181 young people (mean age
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Self-harm is prevalent in incarcerated adults, yet comparatively few studies of self-harm in detained youth (and even fewer in low- and middle-income countries) have been published. We examined the prevalence and correlates of self-harm in a sample of 181 young people (mean age 15.0 years, SD = 2.3) detained in the youth justice system in Sri Lanka. Structured face-to-face questionnaires assessed demographic characteristics, family and social background, substance use, self-harm history (including frequency, method, and intention), bullying victimization, physical and sexual abuse (victimization and perpetration), and exposure to self-harm/suicide by others. Seventy-seven participants (43%) reported a lifetime history of self-harm, 19 of whom (25%) who reported doing so with suicidal intent. Fifty participants (65% of those with a history of self-harm) reported engaging in self-harm impulsively, with no prior planning. A history of self-harm was associated with being female, prior sexual abuse victimization, prior exposure to self-harm by friends, and a lifetime history of self-harm ideation. High rates of substance use, bullying victimization, parental incarceration, and exposure to suicide were reported across the sample. Young people detained in the youth justice system in Sri Lanka are a vulnerable group with high rates of self-harm, substance use, and psychosocial risk factors. Strategies for identifying and preventing self-harm, and targeted psychological interventions designed specifically to address impulsivity, may contribute to more positive outcomes in this marginalised population. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle Depression in Intimate Partner Violence Victims in Slovenia: A Crippling Pattern of Factors Identified in Family Practice Attendees
Int. J. Environ. Res. Public Health 2018, 15(2), 210; doi:10.3390/ijerph15020210
Received: 22 November 2017 / Revised: 19 January 2018 / Accepted: 24 January 2018 / Published: 26 January 2018
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Abstract
This multi-centre cross-sectional study explored associations between prevalence of depression and exposure to intimate partner violence (IPV) at any time in patients’ adult life in 471 participants of a previous IPV study. In 2016, 174 interviews were performed, using the Short Form Domestic
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This multi-centre cross-sectional study explored associations between prevalence of depression and exposure to intimate partner violence (IPV) at any time in patients’ adult life in 471 participants of a previous IPV study. In 2016, 174 interviews were performed, using the Short Form Domestic Violence Exposure Questionnaire, the Zung Scale and questions about behavioural patterns of exposure to IPV. Family doctors reviewed patients’ medical charts for period from 2012 to 2016, using the Domestic Violence Exposure Medical Chart Check List, for conditions which persisted for at least three years. Depression was found to be associated with any exposure to IPV in adult life and was more likely to affect women. In multivariable logistic regression modelling, factors associated with self-rated depression were identified (p < 0.05). Exposure to emotional and physical violence was identified as a risk factor in the first model, explaining 23% of the variance. The second model explained 66% of the variance; past divorce, dysfunctional family relationships and a history of incapacity to work increased the likelihood of depression in patients. Family doctors should consider IPV exposure when detecting depression, since lifetime IPV exposure was found to be 40.4% and 36.9% of depressed revealed it. Full article
(This article belongs to the Special Issue Mental Health and Environmental Exposures)
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Open AccessArticle Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter?
Int. J. Environ. Res. Public Health 2018, 15(2), 211; doi:10.3390/ijerph15020211
Received: 1 August 2017 / Revised: 27 October 2017 / Accepted: 29 October 2017 / Published: 26 January 2018
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Abstract
This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and
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This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person’s home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m2, p < 0.001), 18 months (0.069 kg/m2, p < 0.001), and 24 months (0.067 kg/m2, p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m2 at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes. Full article
(This article belongs to the Special Issue Food Environment, Diet, and Health)
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Open AccessArticle The Effect of Childhood Health Status on Adult Health in China
Int. J. Environ. Res. Public Health 2018, 15(2), 212; doi:10.3390/ijerph15020212
Received: 5 December 2017 / Revised: 20 January 2018 / Accepted: 22 January 2018 / Published: 26 January 2018
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Abstract
Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good
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Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects’ fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13–18%), 13% (95% CI: 10–15%), and 14% (95% CI: 12–17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote childhood health will have long-term benefits in China and that health-care policies should consider their long-term impacts over the life cycle in addition to their effects on specific age groups. Full article
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Open AccessArticle Physiological Effects of Visual Stimulation with Forest Imagery
Int. J. Environ. Res. Public Health 2018, 15(2), 213; doi:10.3390/ijerph15020213
Received: 15 November 2017 / Revised: 10 January 2018 / Accepted: 24 January 2018 / Published: 26 January 2018
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Abstract
This study was aimed to clarify the physiological effects of visual stimulation using forest imagery on activity of the brain and autonomic nervous system. Seventeen female university students (mean age, 21.1 ± 1.0 years) participated in the study. As an indicator of brain
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This study was aimed to clarify the physiological effects of visual stimulation using forest imagery on activity of the brain and autonomic nervous system. Seventeen female university students (mean age, 21.1 ± 1.0 years) participated in the study. As an indicator of brain activity, oxyhemoglobin (oxy-Hb) concentrations were measured in the left and right prefrontal cortex using near-infrared time-resolved spectroscopy. Heart rate variability (HRV) was used as an indicator of autonomic nervous activity. The high-frequency (HF) component of HRV, which reflected parasympathetic nervous activity, and the ratio of low-frequency (LF) and high-frequency components (LF/HF), which reflected sympathetic nervous activity, were measured. Forest and city (control) images were used as visual stimuli using a large plasma display window. After sitting at rest viewing a gray background for 60 s, participants viewed two images for 90 s. During rest and visual stimulation, HRV and oxy-Hb concentration in the prefrontal cortex were continuously measured. Immediately thereafter, subjective evaluation of feelings was performed using a modified semantic differential (SD) method. The results showed that visual stimulation with forest imagery induced (1) a significant decrease in oxy-Hb concentrations in the right prefrontal cortex and (2) a significant increase in perceptions of feeling “comfortable,” “relaxed,” and “natural.” Full article
(This article belongs to the Special Issue Evidence-Based Nature Therapy: Advances in Physiological Evaluation)
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Open AccessArticle Sex-Specific Associations in Nutrition and Activity-Related Risk Factors for Chronic Disease: Australian Evidence from Childhood to Emerging Adulthood
Int. J. Environ. Res. Public Health 2018, 15(2), 214; doi:10.3390/ijerph15020214
Received: 18 December 2017 / Revised: 17 January 2018 / Accepted: 23 January 2018 / Published: 26 January 2018
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Abstract
Global assessments of burden of disease suggests there are sex differences in risk factors for chronic disease, including overweight/obesity, dietary patterns and habitual physical activity. Given that prevention efforts aim to target such factors to reduce disease risk, the age at which sex
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Global assessments of burden of disease suggests there are sex differences in risk factors for chronic disease, including overweight/obesity, dietary patterns and habitual physical activity. Given that prevention efforts aim to target such factors to reduce disease risk, the age at which sex differences may occur is of particular interest. Early life to young adulthood is the optimal time for intervention, with lifestyle habits typically forming during this period. This study aimed to identify the sex differences in risk factors for chronic disease during childhood (5–9 years), adolescence (10–17 years) and emerging adulthood (18–25 years) in a large population-representative Australian sample. Among children in this study (n = 739), no sex-related differences were observed. Among adolescents (n = 1304), females were more likely than males to meet daily fruit and vegetable recommendations (12.9% vs. 7.5%; OR = 1.84, 95% CI = 1.16, 2.93, p < 0.05). Among emerging adults (n = 909), females were less likely to be overweight/obese (30.1% vs. 39.8%; OR = 0.65, 95% CI = 0.44, 0.95, p < 0.05) and more likely to meet physical activity recommendations (52.1% vs. 42.3%; OR = 1.44, 95% CI = 1.01, 2.06, p < 0.05). These findings suggest that sex differences for risk factors of chronic disease occur during adolescence and emerging adulthood, although the differences are not consistent across age periods. From adolescence onwards, it appears that females exhibit lower risk factors than males and a life span approach to risk factor monitoring is warranted. Full article
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
Open AccessArticle Study of Stroke Incidence in the Aseer Region, Southwestern Saudi Arabia
Int. J. Environ. Res. Public Health 2018, 15(2), 215; doi:10.3390/ijerph15020215
Received: 17 December 2017 / Revised: 12 January 2018 / Accepted: 22 January 2018 / Published: 26 January 2018
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Abstract
Recent data regarding first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of this work was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia. All first-stroke
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Recent data regarding first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of this work was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia. All first-stroke patients admitted to all hospitals in the Aseer region over a one-year period (January through December 2016) were included. Stroke patients outside the Aseer region were excluded from the study. The incidence per 100,000 patients and the concomitant 95% CI (Confidence Intervals) were computed. The present study included 1249 first-time stroke patients and calculated an overall minimal incidence rate of hospitalized first-time stroke of 57.64 per 100,000 persons per year (95% CI: 57.57–57.70). A steady increase was noticed depending on the patients' age, reaching a figure of 851.81 (95% CI: 849.2–854.5) for those patients aged 70 years and more. Overall, the incidence rate for females (48.14; 95% CI: 48.04–48.24) was lower compared to males (65.52; 95% CI: 65.1–66.0). Taking into consideration the expected rise of the elderly because of the prominent medical services provided by the Saudi government, leading to a subsequent change in the horizontal and vertical age distribution structure of the population, an increase in the number of stroke patients is expected. It is suggested to establish a nationwide stroke surveillance system in the Kingdom, with the objective to report, analyze, and maintain an updated overview of the stroke status in Saudi Arabia. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Intention for Car Use Reduction: Applying a Stage-Based Model
Int. J. Environ. Res. Public Health 2018, 15(2), 216; doi:10.3390/ijerph15020216
Received: 30 October 2017 / Revised: 22 January 2018 / Accepted: 22 January 2018 / Published: 26 January 2018
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Abstract
This study investigates which variables drive intention to reduce car use by modelling a stage of change construct with mechanisms in the Theory of Planned Behavior (TPB) and Norm Activation Model (NAM). Web questionnaires (n = 794) were collected via 11 workplaces.
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This study investigates which variables drive intention to reduce car use by modelling a stage of change construct with mechanisms in the Theory of Planned Behavior (TPB) and Norm Activation Model (NAM). Web questionnaires (n = 794) were collected via 11 workplaces. The socio-demographics, work commute, stage of change, attitudes to sustainable travel modes, social norms, perceived behavioral control, and personal norm were assessed. An initial descriptive analysis revealed that 19% of the employees saw no reason to reduce their car use; 35% would like to reduce their car use but felt it was impossible; 12% were thinking about reducing their car use but were unsure of how or when to do this; 12% had an aim to reduce current car use, and knew which journeys to replace and which modes to use; and 23% try to use modes other than a car for most journeys, and will maintain or reduce their already low car use in the coming months. A series of Ordered Logit Models showed that socio-demographic variables did not explain the stage of change. Instead, personal norms, instrumental and affective attitudes, and perceived behavioral control toward sustainable travel modes were all significant and explained 43% of the variance in stage of change. Furthermore, it was found that the significant relationships were not linear in nature. The analysis also showed an indirect effect of social norms on the stage of change through personal norms. Implications are discussed regarding the design of interventions aimed at influencing a sustainable work commute. Full article
(This article belongs to the Special Issue Sustainable Transportation and Health)
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Open AccessArticle Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults
Int. J. Environ. Res. Public Health 2018, 15(2), 218; doi:10.3390/ijerph15020218
Received: 7 December 2017 / Revised: 13 January 2018 / Accepted: 24 January 2018 / Published: 26 January 2018
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Abstract
While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460) on sexually
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While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460) on sexually active homeless adults from a cross-sectional study of participants (n = 610) recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s), and multiple sexual partners (≥4 sexual partners) in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness. Full article
(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)
Open AccessArticle Quality of Life (QoL) Survey in Hong Kong: Understanding the Importance of Housing Environment and Needs of Residents from Different Housing Sectors
Int. J. Environ. Res. Public Health 2018, 15(2), 219; doi:10.3390/ijerph15020219
Received: 30 December 2017 / Revised: 24 January 2018 / Accepted: 25 January 2018 / Published: 27 January 2018
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Abstract
This study presents a Quality of Life (QoL) survey to understand the influence of the housing environment and needs of residents from different housing sectors. The research focuses on Hong Kong where living conditions have become the main affect for people’s QoL. Through
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This study presents a Quality of Life (QoL) survey to understand the influence of the housing environment and needs of residents from different housing sectors. The research focuses on Hong Kong where living conditions have become the main affect for people’s QoL. Through a household survey using a standard instrument “Word Health Organisation (WHO) Quality of Life-BREF”, the article found that among the four WHO QoL domains (Physical Health, Psychological Health, Social Relations And Environment), Environment, particularly its constitute aspect housing environment was the most influential factor for overall quality of life for the public rental housing sector where low-income people live. This research also found that different groups of people have differing needs of their housing environments: the low-income group needs better location and privacy while the medium and high-income groups need better architectural quality. Based on differentiating their needs and wants, this research argues for prioritizing the low-income group’s needs for effectively improving their QoL. Full article
Open AccessArticle Environmental Regulation, Foreign Direct Investment and Green Technological Progress—Evidence from Chinese Manufacturing Industries
Int. J. Environ. Res. Public Health 2018, 15(2), 221; doi:10.3390/ijerph15020221
Received: 25 December 2017 / Revised: 21 January 2018 / Accepted: 23 January 2018 / Published: 29 January 2018
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Abstract
This study examines the spillover effects of foreign direct investment (FDI) on green technology progress rate (as measured by the green total factor productivity). The analysis utilizes two measures of FDI, labor-based FDI and capital-based FDI, and separately investigates four sets of industry
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This study examines the spillover effects of foreign direct investment (FDI) on green technology progress rate (as measured by the green total factor productivity). The analysis utilizes two measures of FDI, labor-based FDI and capital-based FDI, and separately investigates four sets of industry classifications—high/low discharge regulation and high/low emission standard regulation. The results indicate that in the low discharge regulation and low emission standard regulation industry, labor-based FDI has a significant negative spillover effect, and capital-based FDI has a significant positive spillover effect. However, in the high-intensity environmental regulation industry, the negative influence of labor-based FDI is completely restrained, and capital-based FDI continues to play a significant positive green technological spillover effects. These findings have clear policy implications: the government should be gradually reducing the labor-based FDI inflow or increasing stringency of environmental regulation in order to reduce or eliminate the negative spillover effect of the labor-based FDI. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle An Online Survey of New Zealand Vapers
Int. J. Environ. Res. Public Health 2018, 15(2), 222; doi:10.3390/ijerph15020222
Received: 6 December 2017 / Revised: 22 January 2018 / Accepted: 24 January 2018 / Published: 29 January 2018
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Abstract
Using electronic cigarettes (vaping) is controversial, but is increasingly widespread. This paper reports the results of an electronic survey of vapers in New Zealand, a country where the sale and supply of e-liquids containing nicotine is illegal, although vapers can legally access e-liquids
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Using electronic cigarettes (vaping) is controversial, but is increasingly widespread. This paper reports the results of an electronic survey of vapers in New Zealand, a country where the sale and supply of e-liquids containing nicotine is illegal, although vapers can legally access e-liquids from overseas. An on-line survey was conducted, using vaper and smoking cessation networks for recruitment, with follow up surveys conducted 1 and 2 months after the initial survey. 218 participants were recruited. Almost all had been smokers, but three quarters no longer smoked, with the remainder having significantly reduced their tobacco use. Three participants were non-smokers before starting to vape, but none had gone on to become smokers. The overriding motivation to begin and continue vaping was to stop or to reduce smoking. The results were consistent with a progression from initially both vaping and smoking using less effective electronic cigarette types, then moving to more powerful devices, experimentation with flavors and nicotine strengths—all resulting in reducing or stopping tobacco use. Lack of access to nicotine and lack of support for their chosen cessation method were the main problems reported. Vaping had resulted in effective smoking cessation for the majority of participants. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
Open AccessArticle Factors Associated with Cigarette Smoking and Motivation to Quit among Street Food Sellers in Vietnam
Int. J. Environ. Res. Public Health 2018, 15(2), 223; doi:10.3390/ijerph15020223
Received: 17 November 2017 / Revised: 18 January 2018 / Accepted: 24 January 2018 / Published: 29 January 2018
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Abstract
Since 2013, smoke-free signs in public places, including in restaurants and food stores, have been introduced in Vietnam, aiming to prevent passive smoking. Although extensive research has been carried out on second-hand smoking among clients in public places (e.g., hospitals, restaurants) in Vietnam,
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Since 2013, smoke-free signs in public places, including in restaurants and food stores, have been introduced in Vietnam, aiming to prevent passive smoking. Although extensive research has been carried out on second-hand smoking among clients in public places (e.g., hospitals, restaurants) in Vietnam, no single study exists which captures the current practice of smoking among street food outlets. This study aims to estimate the prevalence of smoking and identify factors associated with smoking status and cessation motivation amongst food sellers in Vietnam. A cross-sectional study involving 1733 food providers at outlets was conducted in 29 districts in Hanoi capital, Vietnam, in 2015. The prevalence of smoking amongst food sellers was determined to be 8.5% (25% for men and 0.8% for women). The enforcement of the smoke-free policy remains modest, since only 7.9% observed outlets complied with the law, providing a room designated for smokers. Although approximately 80% of the participants were aware of the indoor smoke-free regulations in public places, such as restaurants and food stores, 40.2% of smokers reported no intention of quitting smoking. A percentage of 37.6% of current smokers reported that despite having intentions to quit, they did not receive any form of support for smoking cessation. Being male and having hazardous drinking habits and a poor quality of life were all factors that were significantly associated with smoking status. Additionally, having awareness of smoking’s adverse effects and being frequently supervised by the authority were associated with a greater motivation to quit. This study highlights the importance of an accompanying education and smoking cessation program in addition to the frequent inspection and reinforcement of smoke-free policy in food stores. This research extends on our knowledge of smoking prevalence and its factors related to smoking events and motivation to quit among street food outlets. Overall, this study strengthens the idea that more government efforts towards preventing passive smoking and smoking cessation education are necessary in restaurants and other street food outlets. Full article
Open AccessArticle Are Perceived and Objective Distances to Fresh Food and Physical Activity Resources Associated with Cardiometabolic Risk?
Int. J. Environ. Res. Public Health 2018, 15(2), 224; doi:10.3390/ijerph15020224
Received: 18 December 2017 / Revised: 19 January 2018 / Accepted: 25 January 2018 / Published: 29 January 2018
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Abstract
Perceived and objective measures of neighbourhood features have shown limited correspondence. Few studies have examined whether discordance between objective measures and individual perceptions of neighbourhood environments relates to individual health. Individuals with mismatched perceptions may benefit from initiatives to improve understandings of resource
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Perceived and objective measures of neighbourhood features have shown limited correspondence. Few studies have examined whether discordance between objective measures and individual perceptions of neighbourhood environments relates to individual health. Individuals with mismatched perceptions may benefit from initiatives to improve understandings of resource availability. This study utilised data from n = 1491 adult participants in a biomedical cohort to evaluate cross-sectional associations between measures of access (perceived, objective, and perceived-objective mismatch) to fruit and vegetable retailers (FVR) and public open space (POS), and clinically-measured metabolic syndrome and its component risk factors: central obesity, dyslipidaemia, hypertension and pre-diabetes/diabetes. Access measures included perceived distances from home to the nearest FVR and POS, corresponding objectively-assessed road network distances, and the discordance between perceived and objective distances (overestimated (i.e., mismatched) distances versus matched perceived-objective distances). Individual and neighbourhood measures were spatially joined using a geographic information system. Associations were evaluated using multilevel logistic regression, accounting for individual and area-level covariates. Hypertension was positively associated with perceived distances to FVR (odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.02, 1.28) and POS (OR = 1.19, 95% CI = 1.05, 1.34), after accounting for covariates and objective distances. Hypertension was positively associated with overestimating distances to FVR (OR = 1.36, 95% CI = 1.02, 1.80). Overestimating distances to POS was positively associated with both hypertension (OR = 1.42, 95% CI = 1.11, 1.83) and dyslipidaemia (OR = 1.25, 95% CI = 1.00, 1.57). Results provide new evidence for specific associations between perceived and overestimated distances from home to nearby resources and cardiometabolic risk factors. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Exploring the Impacts of Housing Condition on Migrants’ Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach
Int. J. Environ. Res. Public Health 2018, 15(2), 225; doi:10.3390/ijerph15020225
Received: 2 December 2017 / Revised: 6 January 2018 / Accepted: 24 January 2018 / Published: 29 January 2018
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Abstract
Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers’ mental health. The links between housing conditions and mental health are well-established in healthy city
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Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers’ mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities. Full article
(This article belongs to the Special Issue Mental Health and Environmental Exposures)
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Open AccessArticle Association between Drug Usage and Constipation in the Elderly Population of Greater Western Sydney Australia
Int. J. Environ. Res. Public Health 2018, 15(2), 226; doi:10.3390/ijerph15020226
Received: 22 November 2017 / Revised: 15 January 2018 / Accepted: 24 January 2018 / Published: 29 January 2018
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Abstract
The low socioeconomic region of Greater Western Sydney (GWS) has higher than average rates of gastrointestinal symptoms. The relationship between prescription drug usage and constipation has not been explored. The aim of this study was to investigate the impact of drug use on
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The low socioeconomic region of Greater Western Sydney (GWS) has higher than average rates of gastrointestinal symptoms. The relationship between prescription drug usage and constipation has not been explored. The aim of this study was to investigate the impact of drug use on constipation in the elderly population of GWS (NSW, Australia). A random selection of elderly residents completed a postal questionnaire for constipation and drug use (response 30.7%). Bivariate associations between constipation and number of drug use and number of drug use with constipation adverse effect were compared. For multivariate analysis multiple logistic regression was performed for constipation with the number of drugs, use of drugs with known constipation side effects, and each drug class (Anatomical Therapeutic Chemical Classification System (ATC) level 4) as independent variables. The prevalence of constipation was 33.9%. There was a dose–response relationship between constipation and the number of drugs used (odds ratio 1.24, p < 0.001) and the usage of drugs with known constipation adverse effects (odds ratio 2.21, p = 0.009). These findings suggest that constipation is associated with the number of drugs used, particularly those with constipation adverse-effects, in the elderly of GWS. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Do Working Conditions of Patients in Psychotherapeutic Consultation in the Workplace Differ from Those in Outpatient Care? Results from an Observational Study
Int. J. Environ. Res. Public Health 2018, 15(2), 227; doi:10.3390/ijerph15020227
Received: 30 November 2017 / Revised: 24 January 2018 / Accepted: 25 January 2018 / Published: 30 January 2018
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Abstract
In previous studies, it was found that patients treated at a psychosomatic outpatient clinic (PSOC) for common mental disorders showed more severe symptoms than those who used a psychotherapeutic consultation service at the workplace (PSIW). This study examines whether the higher symptom severity
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In previous studies, it was found that patients treated at a psychosomatic outpatient clinic (PSOC) for common mental disorders showed more severe symptoms than those who used a psychotherapeutic consultation service at the workplace (PSIW). This study examines whether the higher symptom severity of the PSOC patients in comparison to their PSIW counterparts is also related to higher levels of occupational stress as measured by the demand-control-support model (DCS). N = 253 participants (PSIW n = 100; PSOC n = 153) provided self-reported data on demands, decision latitude, social support, and health before consultation. The association between mental health care setting, symptom level and demands, decision latitude, and social support was assessed by means of a path model. Results of the path model indicated that the higher level of depression in PSOC patients was related to higher levels of demands and lower levels of social support. Demands and social support were found to be indirectly associated with treatment setting. No interaction effect between demands, decision latitude, social support, and depression was found. Results of this study reveal that the working conditions influenced the pathway to care process via symptom severity. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
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Open AccessArticle The Effect of the eHealth Intervention ‘MyPlan 1.0’ on Physical Activity in Adults Who Visit General Practice: A Quasi-Experimental Trial
Int. J. Environ. Res. Public Health 2018, 15(2), 228; doi:10.3390/ijerph15020228
Received: 8 December 2017 / Revised: 23 January 2018 / Accepted: 26 January 2018 / Published: 30 January 2018
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Abstract
Physical inactivity is one of the major risk factors for poor health in the world. Therefore, effective interventions that promote physical activity are needed. Hence, we developed an eHealth intervention for adults, i.e., ‘MyPlan 1.0’, which includes self-regulation techniques for behaviour change. This
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Physical inactivity is one of the major risk factors for poor health in the world. Therefore, effective interventions that promote physical activity are needed. Hence, we developed an eHealth intervention for adults, i.e., ‘MyPlan 1.0’, which includes self-regulation techniques for behaviour change. This study examined the effect of ‘MyPlan 1.0’ on physical activity (PA) levels in general practice. 615 adults (≥18 years) were recruited in 19 Flemish general practices, for the intervention group (n = 328) or for the wait-list control group (n = 183). Participants in the intervention group received the web-based intervention ‘MyPlan 1.0’ and were prompted to discuss their personal advice/action plan with their general practitioner. Participants in the wait-list control group only received general advice from the website. Self-reported physical activity was assessed with the International Physical Activity Questionnaire (IPAQ) at baseline and after one month. A three-level (general practice, adults, time) regression analysis was conducted in MLwiN. Significant intervention effects were found for total PA and moderate to vigorous PA with an increase for the intervention group compared to a decrease in the control condition. However, there was a high dropout rate in the intervention group (76%) and the wait-list control group (57%). Our self-regulation intervention was effective in increasing physical activity levels in adults. Future studies should consider strategies to prevent the large dropout from participants. Full article
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Open AccessArticle Factors Associated with Pregnancy among Married Adolescents in Nepal: Secondary Analysis of the National Demographic and Health Surveys from 2001 to 2011
Int. J. Environ. Res. Public Health 2018, 15(2), 229; doi:10.3390/ijerph15020229
Received: 12 December 2017 / Revised: 16 January 2018 / Accepted: 23 January 2018 / Published: 30 January 2018
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Abstract
Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence,
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Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, and identify factors associated with pregnancy among adolescents in Nepal between 2001 and 2011. Secondary analyses of Nepal Demographic Health Surveys (NDHS) data from 2001, 2006, and 2011 were completed. The outcome was any pregnancy or birth among married adolescents; prevalence was calculated for each survey year. Although the rate of marriage among adolescent women in Nepal decreased significantly from 2001 to 2011, prevalence of pregnancy and birth among married adolescent women in Nepal remains high (average 56%) in Nepal, and increased significantly between 2001 and 2011. Regression analyses of this outcome indicate higher risk was associated with living in the least resourced region, early sexual debut, and older husband. Despite national efforts to reduce pregnancies among married adolescent women in Nepal, prevalence remains high. Integrated, cross-sectoral prevention efforts are required. Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy. Full article
Open AccessArticle Ventilation Positive Pressure Intervention Effect on Indoor Air Quality in a School Building with Moisture Problems
Int. J. Environ. Res. Public Health 2018, 15(2), 230; doi:10.3390/ijerph15020230
Received: 30 November 2017 / Revised: 26 January 2018 / Accepted: 27 January 2018 / Published: 30 January 2018
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Abstract
This case study investigates the effects of ventilation intervention on measured and perceived indoor air quality (IAQ) in a repaired school where occupants reported IAQ problems. Occupants’ symptoms were suspected to be related to the impurities leaked indoors through the building envelope. The
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This case study investigates the effects of ventilation intervention on measured and perceived indoor air quality (IAQ) in a repaired school where occupants reported IAQ problems. Occupants’ symptoms were suspected to be related to the impurities leaked indoors through the building envelope. The study’s aim was to determine whether a positive pressure of 5–7 Pa prevents the infiltration of harmful chemical and microbiological agents from structures, thus decreasing symptoms and discomfort. Ventilation intervention was conducted in a building section comprising 12 classrooms and was completed with IAQ measurements and occupants’ questionnaires. After intervention, the concentration of total volatile organic compounds (TVOC) and fine particulate matter (PM2.5) decreased, and occupants’ negative perceptions became more moderate compared to those for other parts of the building. The indoor mycobiota differed in species composition from the outdoor mycobiota, and changed remarkably with the intervention, indicating that some species may have emanated from an indoor source before the intervention. Full article
(This article belongs to the Special Issue Air Quality and Health)
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Open AccessArticle Association between Social Activities and Cognitive Function among the Elderly in China: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2018, 15(2), 231; doi:10.3390/ijerph15020231
Received: 20 December 2017 / Revised: 15 January 2018 / Accepted: 29 January 2018 / Published: 30 January 2018
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Abstract
Participation in social activities is one of important factors for older adults’ health. The present study aims to examine the cross-sectional association between social activities and cognitive function among Chinese elderly. A total of 8966 individuals aged 60 and older from the 2015
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Participation in social activities is one of important factors for older adults’ health. The present study aims to examine the cross-sectional association between social activities and cognitive function among Chinese elderly. A total of 8966 individuals aged 60 and older from the 2015 China Health and Retirement Longitudinal Study were obtained for this study. Telephone interviews of cognitive status, episodic memory, and visuospatial abilities were assessed by questionnaire. We used the sum of all three of the above measures to represent the respondent’s cognitive status as a whole. Types and frequencies of participation in social groups were used to measure social activities. Multiple linear regression analysis was used to explore the relationship between social activities and cognitive function. After adjustment for demographics, smoking, drinking, depression, hypertension, diabetes, basic activities of daily living, instrumental activities of daily living, and self-rated health, multiple linear regression analysis revealed that interaction with friends, participating in hobby groups, and sports groups were associated with better cognitive function among both men and women (p < 0.05); doing volunteer work was associated with better cognitive function among women but not among men (p < 0.05). These findings suggest that there is a cross-sectional association between participation in social activities and cognitive function among Chinese elderly. Longitudinal studies are needed to examine the effects of social activities on cognitive function. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
Open AccessArticle Determining Exposure Factors of Anti-Fogging, Dye, Disinfectant, Repellent, and Preservative Products in Korea
Int. J. Environ. Res. Public Health 2018, 15(2), 232; doi:10.3390/ijerph15020232
Received: 28 December 2017 / Revised: 23 January 2018 / Accepted: 26 January 2018 / Published: 30 January 2018
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Abstract
Reliable exposure factors are essential to determine health risks posed by chemicals in consumer products. We analyzed five risk-concerned product categories (anti-fogging, dye, disinfectant, repellent, and preservative products) for 13 products (three car anti-fogging products, a lens anti-fogging product, two car dye products,
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Reliable exposure factors are essential to determine health risks posed by chemicals in consumer products. We analyzed five risk-concerned product categories (anti-fogging, dye, disinfectant, repellent, and preservative products) for 13 products (three car anti-fogging products, a lens anti-fogging product, two car dye products, two drain disinfectants, an air conditioner disinfectant, a chlorine-based disinfectant, a fabric repellent, an insect repellent for food, and a wood preservative) considered to be of high risk in order to determine exposure factors via web surveys and estimation of amount of product. Among the 3000 participants (1482 (49%) men) aged ≥19 years, drain disinfectants were used most frequently (38.2%); the rate of usage of the other products ranged between 1.1–24.0%. The usage rates for the consumer products differed by sex, age, income, and education. Some consumer products such as car and lens anti-fogging products, chlorine-based disinfectants, fabric repellents, and drain disinfectants were regularly used more than once a month, while car dye products, air conditioner disinfectants, insect repellents for food, and wood preservatives were not regularly used owing to the specific product purposes and seasonal needs. Our results could be used for managing or controlling chemical substances in consumer products and conducting accurate exposure assessments. Full article
(This article belongs to the collection Environmental Risk Assessment)
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Open AccessArticle Patient Satisfaction with Pre-Hospital Emergency Services. A Qualitative Study Comparing Professionals’ and Patients’ Views
Int. J. Environ. Res. Public Health 2018, 15(2), 233; doi:10.3390/ijerph15020233
Received: 22 December 2017 / Revised: 23 January 2018 / Accepted: 26 January 2018 / Published: 30 January 2018
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Abstract
Objective: To describe patient satisfaction with pre-hospital emergency knowledge and determine if patients and professionals share a common vision on the satisfaction predictors. Methods: A qualitative study was conducted in two phases. First, a systematic review following the PRISMA protocol was carried
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Objective: To describe patient satisfaction with pre-hospital emergency knowledge and determine if patients and professionals share a common vision on the satisfaction predictors. Methods: A qualitative study was conducted in two phases. First, a systematic review following the PRISMA protocol was carried out searching publications between January 2000 and July 2016 in Medline, Scopus, and Cochrane. Second, three focus groups involving professionals (advisers and healthcare providers) and a total of 79 semi-structured interviews involving patients were conducted to obtain information about what dimensions of care were a priority for patients. Results: Thirty-three relevant studies were identified, with a majority conducted in Europe using questionnaires. They pointed out a very high level of satisfaction of callers and patients. Delay with the assistance and the ability for resolution of the case are the elements that overlap in fostering satisfaction. The published studies reviewed with satisfaction neither the overall care process nor related the measurement of the real time in responding to an emergency. The patients and professionals concurred in their assessments about the most relevant elements for patient satisfaction, although safety was not a predictive factor for patients. Response capacity and perceived capacity for resolving the situation were crucial factors for satisfaction. Conclusions: Published studies have assessed similar dimensions of satisfaction and have shown high patient satisfaction. Expanded services resolving a wide number of issues that can concern citizens are also positively assessed. Delays and resolution capacity are crucial for satisfaction. Furthermore, despite the fact that few explanations may be given due to a lack of face-to-face attention, finding the patient’s location, taking into account the caller’s emotional needs, and maintaining phone contact until the emergency services arrive are high predictors of satisfaction. Full article
(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)
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Open AccessArticle Effectiveness of a Lifestyle Intervention on Social Support, Self-Efficacy, and Physical Activity among Older Adults: Evaluation of Texercise Select
Int. J. Environ. Res. Public Health 2018, 15(2), 234; doi:10.3390/ijerph15020234
Received: 4 December 2017 / Revised: 9 January 2018 / Accepted: 23 January 2018 / Published: 30 January 2018
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Abstract
Despite the well-recognized benefits of physical activity across the life course, older adults are more inactive than other age groups. The current study examines the effects of Texercise Select participation on self-reported sedentary, light, moderate, and vigorous physical activity. Secondarily, this study examined
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Despite the well-recognized benefits of physical activity across the life course, older adults are more inactive than other age groups. The current study examines the effects of Texercise Select participation on self-reported sedentary, light, moderate, and vigorous physical activity. Secondarily, this study examined intervention effects on two potential facilitators of physical activity: (1) self-efficacy for being more physically active and (2) social support received for physical activity. This study used a non-equivalent group design with self-reported surveys administered at baseline, three-month (immediate post for cases) and six-month follow-ups for the intervention (n = 163) and a comparison group (n = 267). Multivariable mixed model analyses were conducted controlling for age, sex, race, ethnicity, education, comorbid conditions, and site. Among the intervention group, the program had significant immediate effects on most primary outcomes (p < 0.05) at three months. Furthermore, significant improvements were observed for all physical activity intensity levels at six months (p < 0.05). The reduction in sedentary behavior and increases in all physical activity intensity levels were significantly greater from baseline to three-month and baseline to six-month follow-ups among intervention group participants relative to those in the comparison group. This study confirms the effectiveness of Texercise Select to reduce sedentary behavior and improve physicality, supporting the intervention’s robustness as a scalable and sustainable evidence-based program. It also counters negative stereotypes that older adults are not interested in attending multi-modal lifestyle intervention programs nor able to make health behavior changes that can improve health and overall functioning. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Patterns of Signs That Telephone Crisis Support Workers Associate with Suicide Risk in Telephone Crisis Line Callers
Int. J. Environ. Res. Public Health 2018, 15(2), 235; doi:10.3390/ijerph15020235
Received: 15 December 2017 / Revised: 11 January 2018 / Accepted: 22 January 2018 / Published: 30 January 2018
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Abstract
Signs of suicide are commonly used in suicide intervention training to assist the identification of those at imminent risk for suicide. Signs of suicide may be particularly important to telephone crisis-line workers (TCWs), who have little background information to identify the presence of
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Signs of suicide are commonly used in suicide intervention training to assist the identification of those at imminent risk for suicide. Signs of suicide may be particularly important to telephone crisis-line workers (TCWs), who have little background information to identify the presence of suicidality if the caller is unable or unwilling to express suicidal intent. Although signs of suicide are argued to be only meaningful as a pattern, there is a paucity of research that has examined whether TCWs use patterns of signs to decide whether a caller might be suicidal, and whether these are influenced by caller characteristics such as gender. The current study explored both possibilities. Data were collected using an online self-report survey in a Australian sample of 137 TCWs. Exploratory factor analysis uncovered three patterns of suicide signs that TCWs may use to identify if a caller might be at risk for suicide (mood, hopelessness, and anger), which were qualitatively different for male and female callers. These findings suggest that TCWs may recognise specific patterns of signs to identify suicide risk, which appear to be influenced to some extent by the callers’ inferred gender. Implications for the training of telephone crisis workers and others including mental-health and medical professionals, as well as and future research in suicide prevention are discussed. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
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Open AccessArticle The External Performance Appraisal of China Energy Regulation: An Empirical Study Using a TOPSIS Method Based on Entropy Weight and Mahalanobis Distance
Int. J. Environ. Res. Public Health 2018, 15(2), 236; doi:10.3390/ijerph15020236
Received: 11 January 2018 / Revised: 28 January 2018 / Accepted: 29 January 2018 / Published: 30 January 2018
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Abstract
In China’s industrialization process, the effective regulation of energy and environment can promote the positive externality of energy consumption while reducing negative externality, which is an important means for realizing the sustainable development of an economic society. The study puts forward an improved
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In China’s industrialization process, the effective regulation of energy and environment can promote the positive externality of energy consumption while reducing negative externality, which is an important means for realizing the sustainable development of an economic society. The study puts forward an improved technique for order preference by similarity to an ideal solution based on entropy weight and Mahalanobis distance (briefly referred as E-M-TOPSIS). The performance of the approach was verified to be satisfactory. By separately using traditional and improved TOPSIS methods, the study carried out the empirical appraisals on the external performance of China’s energy regulation during 1999~2015. The results show that the correlation between the performance indexes causes the significant difference between the appraisal results of E-M-TOPSIS and traditional TOPSIS. The E-M-TOPSIS takes the correlation between indexes into account and generally softens the closeness degree compared with traditional TOPSIS. Moreover, it makes the relative closeness degree fluctuate within a small-amplitude. The results conform to the practical condition of China’s energy regulation and therefore the E-M-TOPSIS is favorably applicable for the external performance appraisal of energy regulation. Additionally, the external economic performance and social responsibility performance (including environmental and energy safety performances) based on the E-M-TOPSIS exhibit significantly different fluctuation trends. The external economic performance dramatically fluctuates with a larger fluctuation amplitude, while the social responsibility performance exhibits a relatively stable interval fluctuation. This indicates that compared to the social responsibility performance, the fluctuation of external economic performance is more sensitive to energy regulation. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Use of an Integrated Research-Practice Partnership to Improve Outcomes of a Community-Based Strength-Training Program for Older Adults: Reach and Effect of Lifelong Improvements through Fitness Together (LIFT)
Int. J. Environ. Res. Public Health 2018, 15(2), 237; doi:10.3390/ijerph15020237
Received: 30 December 2017 / Revised: 25 January 2018 / Accepted: 25 January 2018 / Published: 31 January 2018
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Abstract
Only 17% of older adults meet the recommendations for two days of full body strength training that is associated with improved functional fitness; reduced risk of falls; and reduced morbidity and mortality rates. Community-based interventions are recommended as they provide supportive infrastructure to
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Only 17% of older adults meet the recommendations for two days of full body strength training that is associated with improved functional fitness; reduced risk of falls; and reduced morbidity and mortality rates. Community-based interventions are recommended as they provide supportive infrastructure to reach older adults and impact strength training behaviors. Scalability and sustainability of these interventions is directly linked with setting-level buy-in. Adapting an intervention through an integrated research–practice partnership may improve individual and setting-level outcomes. The purpose of this study was to evaluate the initial reach and effect of a locally adapted, health educator-led strength-training intervention; Lifelong Improvements through Fitness Together (LIFT). LIFT was compared to an evidence-based exercise program, Stay Strong; Stay Healthy (SSSH). Intervention dose and mode were the same for LIFT and SSSH, but LIFT included behavioral change strategies. Older adult functional fitness was assessed before and after the 8-week strength training intervention. Health educators who delivered LIFT and SSSH were able to reach 80 and 33 participants, respectively. Participants in LIFT were able to significantly improve in all functional fitness measures whereas SSSH participants were only able to significantly improve in 5 of the 7 functional fitness measures. In conclusion, this study provides preliminary evidence that the locally adapted program reached more individuals and had improvements in functional fitness. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Microwave-Hydrothermal Treated Grape Peel as an Efficient Biosorbent for Methylene Blue Removal
Int. J. Environ. Res. Public Health 2018, 15(2), 239; doi:10.3390/ijerph15020239
Received: 28 December 2017 / Revised: 24 January 2018 / Accepted: 25 January 2018 / Published: 31 January 2018
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Abstract
Biosorption using agricultural wastes has been proven as a low cost and efficient way for wastewater treatment. Herein, grape peel treated by microwave- and conventional-hydrothermal processes was used as low cost biosorbent to remove methylene blue (MB) from aqueous solutions. The adsorption parameters
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Biosorption using agricultural wastes has been proven as a low cost and efficient way for wastewater treatment. Herein, grape peel treated by microwave- and conventional-hydrothermal processes was used as low cost biosorbent to remove methylene blue (MB) from aqueous solutions. The adsorption parameters including the initial pH value, dosage of biosorbents, contact time, and initial MB concentration were investigated to find the optimum adsorption conditions. The biosorbent obtained by microwave-hydrothermal treatment only for 3 min at 180 °C (microwave-hydrothermal treated grape peel, MGP) showed faster kinetics and higher adsorption capability than that produced by a conventional-hydrothermal process (hydrothermal treated grape peel, HGP) with a duration time of 16 h. The maximum adsorption capability of MGP under the optimum conditions (pH = 11, a dosage of 2.50 g/L) as determined with the Langmuir model reached 215.7 mg/g, which was among the best values achieved so far on biosorbents. These results demonstrated that the grape peel treated by a quick microwave-hydrothermal process can be a very promising low cost and efficient biosorbent for organic dye removal from aqueous solutions. Full article
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Open AccessArticle The Influence of Supportive and Ethical Work Environments on Work-Related Accidents, Injuries, and Serious Psychological Distress among Hospital Nurses
Int. J. Environ. Res. Public Health 2018, 15(2), 240; doi:10.3390/ijerph15020240
Received: 13 December 2017 / Revised: 28 January 2018 / Accepted: 29 January 2018 / Published: 31 January 2018
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Abstract
The healthcare industry in Japan has experienced many cases of work-related injuries, accidents, and workers’ compensation claims because of mental illness. This study examined the influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses.
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The healthcare industry in Japan has experienced many cases of work-related injuries, accidents, and workers’ compensation claims because of mental illness. This study examined the influence of supportive and ethical work environments on work-related accidents, injuries, and serious psychological distress among hospital nurses. Self-reported questionnaires were distributed to nurses (n = 1114) from 11 hospitals. Valid responses (n = 822, 93% women, mean age = 38.49 ± 10.09 years) were used for analyses. The questionnaire included items addressing basic attributes, work and organizational characteristics, social capital and ethical climate at the workplace, psychological distress, and experience of work-related accidents or injuries in the last half year. The final model of a multivariate logistic regression analysis revealed that those who work less than 4 h of overtime per week (OR = 0.313), those who work on days off more than once per month (OR = 0.424), and an exclusive workplace climate (OR = 1.314) were significantly associated with work-related accidents or injuries. Additionally, an exclusive workplace climate (OR = 1.696) elevated the risk of serious psychological distress. To prevent work-related compensation cases, which are caused by these variables, strengthening hospitals’ occupational health and safety is necessary. Full article
(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)
Open AccessFeature PaperArticle Prevalence of Mental Disorders and Addictions among Homeless People in the Greater Paris Area, France
Int. J. Environ. Res. Public Health 2018, 15(2), 241; doi:10.3390/ijerph15020241
Received: 13 December 2017 / Revised: 16 January 2018 / Accepted: 23 January 2018 / Published: 31 January 2018
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Abstract
The Samenta study was conducted in 2009 in the Greater Paris area to estimate the prevalence of psychiatric disorders in homeless people. A cross-sectional survey was performed with a three-stage random sample of homeless people (n = 859), including users of day
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The Samenta study was conducted in 2009 in the Greater Paris area to estimate the prevalence of psychiatric disorders in homeless people. A cross-sectional survey was performed with a three-stage random sample of homeless people (n = 859), including users of day services, emergency shelters, hot meal distribution, long-term rehabilitation centres, and social hotels. Information was collected by a lay interviewer, using the Mini International Neuropsychiatric Interview, and completed by a psychologist through an open clinical interview. In the end, a psychiatrist assessed the psychiatric diagnosis according to the International Statistical Classification of Diseases and Related Health Problems (ICD, 10th revision). One third of homeless people in the Paris area had at least one severe psychiatric disorder (SPD): psychotic disorders (13%), anxiety disorders (12%), or severe mood disorders (7%). One in five was alcohol-dependent and 18% were drug users. Homeless women had significantly higher prevalence of anxiety disorders and depression compared to men, who were more likely to suffer from psychotic disorders. Homeless people of French origin were at higher risk of SPD, as well as people who experienced various adverse life events before the age of 18 (running away, sexual violence, parental disputes, and/or addictions) and those who experienced homelessness for the first time before the age of 26. The prevalence rates of the main psychiatric disorders within the homeless population of our study are consistent with those reported in other Western cities. Our results advocate for an improvement in the detection, housing, and care of psychiatric homeless people. Full article
(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)
Open AccessArticle Adverse Selection in Community Based Health Insurance among Informal Workers in Bangladesh: An EQ-5D Assessment
Int. J. Environ. Res. Public Health 2018, 15(2), 242; doi:10.3390/ijerph15020242
Received: 15 November 2017 / Revised: 4 January 2018 / Accepted: 29 January 2018 / Published: 31 January 2018
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Abstract
Community-based Health Insurance (CBHI) schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured) respondents were
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Community-based Health Insurance (CBHI) schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured) respondents were surveyed using the Bengali version of the EuroQuol-5 dimensions (EQ-5D) questionnaire for assessing their health status. The EQ-5D scores were estimated using available regional tariffs. Multiple logistic regression was applied for predicting the association between health status and CBHI scheme enrolment. A higher number of insured reported problems in mobility (7.3%; p = 0.002); self-care (7.1%; p = 0.000) and pain and discomfort (7.7%; p = 0.005) than uninsured. The average EQ-5D score was significantly lower among the insured (0.704) compared to the uninsured (0.749). The regression analysis showed that those who had a problem in mobility (m 1.25–2.17); self-care (OR = 2.29; 95% CI: 1.62–3.25) and pain and discomfort (OR = 1.43; 95% CI: 1.13–1.81) were more likely to join the scheme. Individuals with higher EQ-5D scores (OR = 0.46; 95% CI: 0.31–0.69) were less likely to enroll in the scheme. Given that adverse selection was evident in the pilot CBHI scheme, there should be consideration of this problem when planning scale-up of these kind of schemes. Full article
(This article belongs to the Special Issue Insurance and Health)
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Open AccessArticle Landslide Susceptibility Assessment Using Spatial Multi-Criteria Evaluation Model in Rwanda
Int. J. Environ. Res. Public Health 2018, 15(2), 243; doi:10.3390/ijerph15020243
Received: 27 November 2017 / Revised: 11 January 2018 / Accepted: 16 January 2018 / Published: 31 January 2018
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Abstract
Landslides susceptibility assessment has to be conducted to identify prone areas and guide risk management. Landslides in Rwanda are very deadly disasters. The current research aimed to conduct landslide susceptibility assessment by applying Spatial Multi-Criteria Evaluation Model with eight layers of causal factors
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Landslides susceptibility assessment has to be conducted to identify prone areas and guide risk management. Landslides in Rwanda are very deadly disasters. The current research aimed to conduct landslide susceptibility assessment by applying Spatial Multi-Criteria Evaluation Model with eight layers of causal factors including: slope, distance to roads, lithology, precipitation, soil texture, soil depth, altitude and land cover. In total, 980 past landslide locations were mapped. The relationship between landslide factors and inventory map was calculated using the Spatial Multi-Criteria Evaluation. The results revealed that susceptibility is spatially distributed countrywide with 42.3% of the region classified from moderate to very high susceptibility, and this is inhabited by 49.3% of the total population. In addition, Provinces with high to very high susceptibility are West, North and South (40.4%, 22.8% and 21.5%, respectively). Subsequently, the Eastern Province becomes the peak under low susceptibility category (87.8%) with no very high susceptibility (0%). Based on these findings, the employed model produced accurate and reliable outcome in terms of susceptibility, since 49.5% of past landslides fell within the very high susceptibility category, which confirms the model’s performance. The outcomes of this study will be useful for future initiatives related to landslide risk reduction and management. Full article
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Open AccessArticle The Role of Motivation to Reduce Obesity among Elderly People: Response to Priming Temptation in Obese Individuals
Int. J. Environ. Res. Public Health 2018, 15(2), 244; doi:10.3390/ijerph15020244
Received: 19 December 2017 / Revised: 26 January 2018 / Accepted: 29 January 2018 / Published: 1 February 2018
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Abstract
The risk of obesity-related disorders is increased among the elderly, so changing eating habits can be an important element of prevention. The main aim of this article is to consider whether looking at pictures that present either fattening food or healthy food may
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The risk of obesity-related disorders is increased among the elderly, so changing eating habits can be an important element of prevention. The main aim of this article is to consider whether looking at pictures that present either fattening food or healthy food may motivate elderly people to change their nutrition habits. Might priming different kinds of food influence the attractiveness of the food for people in late adulthood undergoing obesity therapy? Based on priming theories, we analysed the effects of the conscious processing of stimuli associated with dietary habits in individuals aged with BMI ≥ 30 kg/m2. Our experiments confirmed the influence of a higher-priority goal of “slimming” on the perception and internalization of nutrition-related stimuli. In response to such stimuli, individuals who are actively involved in weight reduction and health-oriented programs use strategies for resisting temptation and to effectively “slim”. We present our findings in the context of their theoretical background and practical application. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Empowering Retailers to Refuse to Sell Tobacco Products to Minors
Int. J. Environ. Res. Public Health 2018, 15(2), 245; doi:10.3390/ijerph15020245
Received: 3 January 2018 / Revised: 29 January 2018 / Accepted: 29 January 2018 / Published: 1 February 2018
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Abstract
Tobacco smoking and exposure to secondhand smoke are major environmental risk factors that negatively influence health. It is recommended that tobacco product manufacturers and retailers receive empowerment counseling programs to achieve adolescent health targets. The present study conducted an empowerment counseling session to
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Tobacco smoking and exposure to secondhand smoke are major environmental risk factors that negatively influence health. It is recommended that tobacco product manufacturers and retailers receive empowerment counseling programs to achieve adolescent health targets. The present study conducted an empowerment counseling session to counsel tobacco product retailers in refusing to sell tobacco products to minors. The three stages of this study were conducted from March 2015 to February 2017. The results revealed that 74% of retailers were selling tobacco products to minors at baseline, 40% at stage two and 15% at stage three. These represent significant reductions in selling tobacco products to minors (all stage differences p < 0.001). However, experimental design studies could be used to examine the empowerment counseling program for preventing tobacco sales to minors in the future. Moreover, health care providers should collaborate with tobacco product retailers to design unique empowerment counseling sessions for specific regions to improve retailers’ capabilities for self-management in terms of tobacco hazard prevention. Full article
Open AccessArticle Spatio-Temporal Dynamic Analysis of Sustainable Development in China Based on the Footprint Family
Int. J. Environ. Res. Public Health 2018, 15(2), 246; doi:10.3390/ijerph15020246
Received: 4 November 2017 / Revised: 22 January 2018 / Accepted: 24 January 2018 / Published: 1 February 2018
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Abstract
The existing index systems on sustainable evaluation are mostly based on a multi index comprehensive evaluation method. The main disadvantage of this approach is that the selection and assignment of evaluation indexes are greatly influenced by subjective factors, which can result in poor
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The existing index systems on sustainable evaluation are mostly based on a multi index comprehensive evaluation method. The main disadvantage of this approach is that the selection and assignment of evaluation indexes are greatly influenced by subjective factors, which can result in poor comparability of results. By contrast, the Footprint Family (including ecological footprint, carbon footprint, and water footprint) is not affected by subjective factors. The Footprint Family also covers the basic tenets of sustainable development. This paper proposes use of a sustainable development evaluation index system based on the principle of the Footprint Family, and including the ecological pressure index (EPI), the ecological occupancy index (EOI), the ecological economic coordination index (EECI), the GHG (Greenhouse Gas) emission index (CEI), the water resources stress index (WSI), and the sustainable development index (SDI). Furthermore, a standard for grading the evaluated results based on global benchmarks is formulated. The results of an empirical study in China were the following. The development situation deteriorated from 1990 to 2015. The results showed that the SDI decreased from a medium level (grade 5) to a lower-medium level (grade 4). The results of this empirical study also showed that the method of evaluation can avoid the influence of subjective factors and can be used in the evaluation of sustainable development for various temporal and spatial conditions. Full article
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Open AccessArticle Assessing Heat Stress and Health among Construction Workers in a Changing Climate: A Review
Int. J. Environ. Res. Public Health 2018, 15(2), 247; doi:10.3390/ijerph15020247
Received: 9 November 2017 / Revised: 15 January 2018 / Accepted: 25 January 2018 / Published: 1 February 2018
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Abstract
Construction workers are at an elevated risk of heat stress, due to the strenuous nature of the work, high temperature work condition, and a changing climate. An increasing number of workers are at risk, as the industry’s growth has been fueled by high
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Construction workers are at an elevated risk of heat stress, due to the strenuous nature of the work, high temperature work condition, and a changing climate. An increasing number of workers are at risk, as the industry’s growth has been fueled by high demand and vast numbers of immigrant workers entering into the U.S., the Middle East and Asia to meet the demand. The risk of heat-related illnesses is increased by the fact that little to no regulations are present and/or enforced to protect these workers. This review recognizes the issues by summarizing epidemiological studies both in the U.S. and internationally. These studies have assessed the severity with which construction workers are affected by heat stress, risk factors and co-morbidities associated with heat-related illnesses in the construction industry, vulnerable populations, and efforts in implementing preventive measures. Full article
(This article belongs to the Section Occupational Safety and Health)
Open AccessArticle Women’s Ideas about the Health Effects of Household Air Pollution, Developed through Focus Group Discussions and Artwork in Southern Nepal
Int. J. Environ. Res. Public Health 2018, 15(2), 248; doi:10.3390/ijerph15020248
Received: 18 November 2017 / Revised: 22 January 2018 / Accepted: 29 January 2018 / Published: 1 February 2018
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Abstract
Household air pollution is a major cause of ill health, but few solutions have been effective to date. While many quantitative studies have been conducted, few have explored the lived experiences and perceptions of women who do the cooking, and as a result
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Household air pollution is a major cause of ill health, but few solutions have been effective to date. While many quantitative studies have been conducted, few have explored the lived experiences and perceptions of women who do the cooking, and as a result are those most exposed to household air pollution. In this study, we worked with groups of home cooks, and sought to use art as a means of engaging them in discussions of how household air pollution from cooking affects their lives. In the Terai district of southern Nepal, we held four focus groups that included 26 local women from urban and peri-urban areas, as well as six local artists. The women then met approximately weekly over four months, and produced images related to air pollution. Transcripts from the focus groups were reviewed independently by two authors, who initially categorised data deductively to pre-defined nodes, and subsequently inductively reviewed emergent themes. Women identified a number of health effects from air pollution. The main physical effects related to the eye and the respiratory system, and women and young children were seen as most vulnerable. The psychosocial effects of air pollution included reduced food intake by women and lethargy. Suggested solutions included modifications to the cooking process, changing the location of stoves, and increasing ventilation. The main barriers were financial. The lived experiences of women in southern Nepal around the problem of air pollution offers a more nuanced and context-specific understanding of the perceptions and challenges of addressing air pollution, which can be used to inform future interventions. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Risk Factors for Obesity and Overfat among Primary School Children in Mashonaland West Province, Zimbabwe
Int. J. Environ. Res. Public Health 2018, 15(2), 249; doi:10.3390/ijerph15020249
Received: 2 January 2018 / Revised: 26 January 2018 / Accepted: 29 January 2018 / Published: 2 February 2018
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Abstract
Associated childhood obesity risk factors are not well established in developing countries such as Zimbabwe and this information is essential for tailored intervention development. This study aimed to identify prominent risk factors for overweight/obese and overfat/obese among primary school children of Mashonaland West
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Associated childhood obesity risk factors are not well established in developing countries such as Zimbabwe and this information is essential for tailored intervention development. This study aimed to identify prominent risk factors for overweight/obese and overfat/obese among primary school children of Mashonaland West Province in Zimbabwe. A school-based cross-sectional study was conducted using multi-stage random cluster sampling approach (30 × 30). Bivariate and multivariable logistic regression was employed and identified the risk factors for overweight/obese and overfat/obese. A total of 974 participants were enrolled in the study. Prominent significant risk factors of overweight/obese after multivariable adjustment were higher socio-economic households; parental diabetes status; and living in Makonde, Zvimba, Sanyati or Mhondoro-Ngezi district as opposed to Hurungwe district. Risk factors for overfat/obese that remained statically significant were children in urban areas (aOR = 3.19, 95% CI: 2.18−4.66, p = 0.000), being one child in a household, and parents who have diabetes mellitus. Living in Makonde, Sanyati, and Zvimba district remained associated with overfat/obese compared to Hurungwe district. This study has identified prominent proximal determinants of overweight/obese and overfat/obese among primary school children in Zimbabwe, to better assist policy guidance. Aggressive education on good nutrition activities should be tailored and targeted to most affected urban areas within high-risk districts. Full article
Open AccessArticle Using Twitter to Better Understand the Spatiotemporal Patterns of Public Sentiment: A Case Study in Massachusetts, USA
Int. J. Environ. Res. Public Health 2018, 15(2), 250; doi:10.3390/ijerph15020250
Received: 6 December 2017 / Revised: 29 January 2018 / Accepted: 30 January 2018 / Published: 2 February 2018
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Abstract
Twitter provides a rich database of spatiotemporal information about users who broadcast their real-time opinions, sentiment, and activities. In this paper, we sought to investigate the holistic influence of land use and time period on public sentiment. A total of 880,937 tweets posted
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Twitter provides a rich database of spatiotemporal information about users who broadcast their real-time opinions, sentiment, and activities. In this paper, we sought to investigate the holistic influence of land use and time period on public sentiment. A total of 880,937 tweets posted by 26,060 active users were collected across Massachusetts (MA), USA, through 31 November 2012 to 3 June 2013. The IBM Watson Alchemy API (application program interface) was employed to quantify the sentiment scores conveyed by tweets on a large scale. Then we statistically analyzed the sentiment scores across different spaces and times. A multivariate linear mixed-effects model was used to quantify the fixed effects of land use and the time period on the variations in sentiment scores, considering the clustering effect of users. The results exposed clear spatiotemporal patterns of users’ sentiment. Higher sentiment scores were mainly observed in the commercial and public areas, during the noon/evening and on weekends. Our findings suggest that social media outputs can be used to better understand the spatial and temporal patterns of public happiness and well-being in cities and regions. Full article
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Open AccessArticle A Community-Based Study to Estimate the Seroprevalence of Trichinellosis and Echinococcosis in the Roma and Non-Roma Population of Slovakia
Int. J. Environ. Res. Public Health 2018, 15(2), 251; doi:10.3390/ijerph15020251
Received: 13 December 2017 / Revised: 25 January 2018 / Accepted: 30 January 2018 / Published: 2 February 2018
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Abstract
Trichinellosis and cystic and alveolar echinococcosis are serious parasitic diseases transmissible between animals and humans. Moreover, alveolar echinococcosis is considered one of the most dangerous of human helminthoses. Roma communities are particularly numerous in Central and Eastern Europe. They are often concentrated in
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Trichinellosis and cystic and alveolar echinococcosis are serious parasitic diseases transmissible between animals and humans. Moreover, alveolar echinococcosis is considered one of the most dangerous of human helminthoses. Roma communities are particularly numerous in Central and Eastern Europe. They are often concentrated in economically undeveloped regions and live in segregated localities with unsatisfactory housing and sanitary conditions. The study aimed to find out the seroprevalence of Trichinella and Echinococcus infections in the Roma population of segregated settlements and to compare it with the seropositivity of the non-Roma population of eastern Slovakia. Out of 823 samples, three sera showed seropositivity to Trichinella in the ELISA (Enzyme-linked immunosorbent assay) test. Subsequent Western blot reaction (WB) confirmed seropositivity in two Roma women. ELISA seropositivity to E. multilocularis was recorded in six persons (0.73%), and five (0.61%) respondents were seropositive to E. granulosus, but WB confirmed the presence of antibodies to Echinococcus spp. in one Roma participant. Positive persons suffered from unspecific clinical symptoms; Trichinella-positive persons reported headache, cough, fatigue, and muscle pain. The Echinococcus-positive participant suffered from headache and back pain. The study showed that the worse living conditions of the Roma community did not significantly influence the occurrence of Trichinella and Echinococcus infections in this minority. Full article
(This article belongs to the Special Issue Roma Health)
Open AccessArticle Residents’ Self-Reported Health Effects and Annoyance in Relation to Air Pollution Exposure in an Industrial Area in Eastern-Estonia
Int. J. Environ. Res. Public Health 2018, 15(2), 252; doi:10.3390/ijerph15020252
Received: 30 November 2017 / Revised: 22 January 2018 / Accepted: 31 January 2018 / Published: 2 February 2018
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Abstract
Eastern Estonia has large oil shale mines and industrial facilities mainly focused on electricity generation from oil shale and shale oil extraction, which produce high air pollution emissions. The “Study of the health impact of the oil shale sector—SOHOS” was aimed at identifying
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Eastern Estonia has large oil shale mines and industrial facilities mainly focused on electricity generation from oil shale and shale oil extraction, which produce high air pollution emissions. The “Study of the health impact of the oil shale sector—SOHOS” was aimed at identifying the impacts on residents’ health and annoyance due to the industrial processing. First, a population-wide survey about health effects and annoyance was carried out. Second, the total and oil shale sectors’ emitted concentrations of benzene, phenol, and PM2.5 were modelled. Third, the differences between groups were tested and relationships between health effects and environmental pollution studied using multiple regression analysis. Compared to the control groups from non-industrial areas in Tartu or Lääne-Viru, residents of Ida-Viru more frequently (p < 0.05) reported wheezing, chest tightness, shortness of breath, asthma attacks, a long-term cough, hypertension, heart diseases, myocardial infarction, stroke, and diabetes. All health effects except asthma were reported more frequently among non-Estonians. People living in regions with higher levels of PM2.5, had significantly higher odds (p < 0.05) of experiencing chest tightness (OR = 1.13, 95% CI 1.02–1.26), shortness of breath (1.16, 1.03–1.31) or an asthma attack (1.22, 1.04–1.42) during the previous year. People living in regions with higher levels of benzene had higher odds of experiencing myocardial infarction (1.98, 1.11–3.53) and with higher levels of phenol chest tightness (1.44, 1.03–2.00), long-term cough (1.48, 1.06–2.07) and myocardial infarction (2.17, 1.23–3.83). The prevalence of adverse health effects was also higher among those who had been working in the oil shale sector. Next to direct health effects, up to a quarter of the residents of Ida-Viru County were highly annoyed about air pollution. Perceived health risk from air pollution increased the odds of being annoyed. Annoyed people in Ida-Viru had significantly higher odds of experiencing respiratory symptoms during the last 12 months, e.g., wheezing (2.30, 1.31–4.04), chest tightness (2.88, 1.91–4.33 or attack of coughing (1.99, 1.34–2.95). Full article
(This article belongs to the Special Issue Air Quality and Health)
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Open AccessArticle Long-Term Effectiveness of Stress Management at Work: Effects of the Changes in Perceived Stress Reactivity on Mental Health and Sleep Problems Seven Years Later
Int. J. Environ. Res. Public Health 2018, 15(2), 255; doi:10.3390/ijerph15020255
Received: 8 December 2017 / Revised: 25 January 2018 / Accepted: 30 January 2018 / Published: 3 February 2018
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Abstract
The reduction of stress reactivity resulting from stress management interventions prevents disorders and improves mental health, however, its long-term sustainability has been little examined. The objective of this study was, therefore, to determine the effectiveness of a stress management intervention, designed to improve
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The reduction of stress reactivity resulting from stress management interventions prevents disorders and improves mental health, however, its long-term sustainability has been little examined. The objective of this study was, therefore, to determine the effectiveness of a stress management intervention, designed to improve stress reactivity, for mental health and sleep problems seven years later, using longitudinal data from 101 male industrial workers. Linear regressions estimated the adjusted effects of the changes in stress reactivity in general as well as in its six subdimensions (work overload, social conflict, social stress, failure at work, and anticipatory and prolonged reactivity) on depression, anxiety, and sleep problems seven years later. The improvement of the prolonged reactivity had positive effects on depression, anxiety, and sleep problems (unstandardized regression coefficients [Bs] ≥ 0.35, all p-values ≤ 0.01). Depression and sleep problems were further improved by a reduction of the reactivity to social conflicts (Bs ≥ 0.29, p-values < 0.05), and an improvement in the overall reactivity score positively influenced sleep problems (B = 0.07, p = 0.017). In conclusion, the improvement of stress reactivity resulting from a work stress intervention was effective and generally long-lasting in preventing mental health and sleep problems. The reduction of the prolonged reactivity seems of particular importance and efficient in inhibiting negative stress manifestations. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
Open AccessArticle Relative Contributions of Different Lifestyle Factors to Health-Related Quality of Life in the Elderly
Int. J. Environ. Res. Public Health 2018, 15(2), 256; doi:10.3390/ijerph15020256
Received: 28 December 2017 / Revised: 28 January 2018 / Accepted: 1 February 2018 / Published: 3 February 2018
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Abstract
Much of the previous literature has studied the relationship between individual lifestyle factors and the health-related quality of life (HRQOL). However, only a few studies combined them to explore their relative importance to the HRQOL in the elderly. This study assesses the HRQOL
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Much of the previous literature has studied the relationship between individual lifestyle factors and the health-related quality of life (HRQOL). However, only a few studies combined them to explore their relative importance to the HRQOL in the elderly. This study assesses the HRQOL of the urban, rural, and institutionalized Chinese elderly and explores the relative contributions of different lifestyle factors to their HRQOL. The SF-36v2 Health Survey, the WHOQOL-OLD module, and the socio-demographic and lifestyle questionnaire were utilized in this study. Hierarchical regression was performed in order to analyze the results. The physical and mental component scores of the SF-36v2 survey were 47.05 ± 9.95 and 54.92 ± 9.92, respectively. The total score for the WHOQOL-OLD module was 73.01 ± 11.99, with institutionalized persons reporting lower scores. For the physical component of the elderly participants’ HRQOL, the R2 value changed the most (0.116) when exercise-and-labor-related factors were added in. For the mental component, sleep-related (0.054), and leisure-time-activity-related factors (0.053) caused the largest change of the R2 value. For the elderly-specific HRQOL, measured by the WHOQOL-OLD module, the leisure-time-activity-related factors caused the largest change in the R2 value (0.119), followed by exercise-and-labor-related factors (0.078). Heterogeneity was present among the three subgroups. In sum, compared with their community-dwelling counterparts, the HRQOL of institutionalized older people was relatively poor and different lifestyle factors contributed to the HRQOL differently. Full article
Open AccessArticle Predicting Effects of the Self and Contextual Factors on Violence: A Comparison between School Students and Youth Offenders in Macau
Int. J. Environ. Res. Public Health 2018, 15(2), 258; doi:10.3390/ijerph15020258
Received: 17 January 2018 / Revised: 28 January 2018 / Accepted: 29 January 2018 / Published: 3 February 2018
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Abstract
This study was designed to explore the self and contextual factors for violence in two samples of school students and youth offenders in Macau. There were 3085 participants who were between 12 and 20 years old; 48.3% of them were male and 51.7%
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This study was designed to explore the self and contextual factors for violence in two samples of school students and youth offenders in Macau. There were 3085 participants who were between 12 and 20 years old; 48.3% of them were male and 51.7% female. Findings revealed that youth offenders exhibited more violence than school students. For the self factors, while lower self-esteem and higher self-efficacy of school students were associated with more violent behavior, these two variables had no significant effects for youth offenders. For the contextual factors, family conflict was the strongest predictor of violence, and school commitment/attachment was the weakest predictor for both samples. For youth offenders, family conflict had the largest direct effect, followed by susceptibility to negative peer influence and influence of the Triad gangs, while school commitment/attachment had a significant though mild direct effect. For school students, family conflict mediated the effect of self-esteem and self-efficacy on violence. While Triad gangs’ influence was the second strongest predictor of violence, being exposed to Triad gangs’ influence also mediated the effect of self-esteem and self-efficacy on violence. It is recommended that youth outreach services with a focus on family support and gang detachment for at-risk youth be strengthened. Full article
(This article belongs to the Special Issue Youth Violence as a Public Health Issue)
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Open AccessArticle Interactive Cumulative Burden Assessment: Engaging Stakeholders in an Adaptive, Participatory and Transdisciplinary Approach
Int. J. Environ. Res. Public Health 2018, 15(2), 260; doi:10.3390/ijerph15020260
Received: 21 December 2017 / Revised: 21 January 2018 / Accepted: 1 February 2018 / Published: 3 February 2018
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Abstract
Cumulative burden assessment (CuBA) has the potential to inform planning and decision-making on health disparities related to multiple environmental burdens. However, scholars have raised concerns about the social complexity to be dealt with while conducting CuBA, suggesting that it should be addressed in
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Cumulative burden assessment (CuBA) has the potential to inform planning and decision-making on health disparities related to multiple environmental burdens. However, scholars have raised concerns about the social complexity to be dealt with while conducting CuBA, suggesting that it should be addressed in an adaptive, participatory and transdisciplinary (APT) approach. APT calls for deliberation among stakeholders by engaging them in a process of social learning and knowledge co-production. We propose an interactive stakeholder-based approach that facilitates a science-based stakeholder dialogue as an interface for combining different knowledge domains and engendering social learning in CuBA processes. Our approach allows participants to interact with each other using a flexible and auditable CuBA model implemented within a shared workspace. In two workshops we explored the usefulness and practicality of the approach. Results show that stakeholders were enabled to deliberate on cumulative burdens collaboratively, to learn about the technical uncertainties and social challenges associated with CuBA, and to co-produce knowledge in a realm of both technical and societal challenges. The paper identifies potential benefits relevant for responding to social complexity in the CuBA and further recommends exploration of how our approach can enable or constraint social learning and knowledge co-production in CuBA processes under various institutional, social and political contexts. Full article
(This article belongs to the Special Issue Environmental Health Indicators for Policy Support)
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Open AccessFeature PaperArticle Adverse Pregnancy Outcomes among Adolescents in Northwest Russia: A Population Registry-Based Study
Int. J. Environ. Res. Public Health 2018, 15(2), 261; doi:10.3390/ijerph15020261
Received: 14 December 2017 / Revised: 29 January 2018 / Accepted: 30 January 2018 / Published: 3 February 2018
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Abstract
This study aimed to assess whether adolescents have an increased risk of adverse pregnancy outcomes (APO) compared to adult women. We used data on 43,327 births from the population-based Arkhangelsk County Birth Registry, Northwest Russia, for 2012–2014. The perinatal outcomes included stillbirth, preterm
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This study aimed to assess whether adolescents have an increased risk of adverse pregnancy outcomes (APO) compared to adult women. We used data on 43,327 births from the population-based Arkhangelsk County Birth Registry, Northwest Russia, for 2012–2014. The perinatal outcomes included stillbirth, preterm birth (<37 and <32 weeks), low and very low birthweight, 5 min Apgar score <7 and <4, perinatal infections, and the need for neonatal transfer to a higher-level hospital. Multivariable logistic regression was applied to assess the associations between age and APO. Altogether, 4.7% of deliveries occurred in adolescents. Both folic acid intake and multivitamin intake during pregnancy were more prevalent in adults. Adolescents were more likely to be underweight, to smoke, and to have infections of the kidney and the genital tract compared to adult women. Compared to adults, adolescents were at lower risk of low birthweight, a 5 min Apgar score <7, and need for neonatal transfer. Adolescents had no increased risk of other APO studied in the adjusted analysis, suggesting that a constellation of other factors, but not young age per se, is associated with APO in the study setting. Full article
Open AccessArticle Stepping It Up: Walking Behaviors in Children Transitioning from 5th to 7th Grade
Int. J. Environ. Res. Public Health 2018, 15(2), 262; doi:10.3390/ijerph15020262
Received: 15 December 2017 / Revised: 18 January 2018 / Accepted: 29 January 2018 / Published: 3 February 2018
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Abstract
The purpose of this study was to (1) describe children’s walking behaviors in 5th to 7th grade and change over time and (2) examine associations between walking behaviors and Walk Score®. Participants consisted of n = 586 students from the Transitions
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The purpose of this study was to (1) describe children’s walking behaviors in 5th to 7th grade and change over time and (2) examine associations between walking behaviors and Walk Score®. Participants consisted of n = 586 students from the Transitions and Activity Changes in Kids (TRACK) Study. Children reported any walking behavior (e.g., exercise and transportation) over the past five days. Walk Score was calculated based on children’s home address. Descriptive statistics summarized walking behaviors by gender and time, and repeated measure mixed models examined the relationship between walking behaviors and Walk Score. Approximately 46.8% and 19.2% of 5th grade children reported walking for exercise and transportation, respectively, and these percentages declined through 7th grade. Girls reported higher levels of total walking behavior and walking for exercise than boys (p < 0.001). Girls with a higher Walk Score had 63% higher odds of reporting walking for transportation than girls with a lower Walk Score (OR = 1.63, 95% CI = 1.02, 2.62). Walking behaviors among children were infrequent with significant declines over time, and of the nine associations examined with Walk Score, only one was significant. Efforts should prioritize frequent walking behavior and community design to increase children’s physical activity. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Fat Mass Index and Body Mass Index Affect Peak Metabolic Equivalent Negatively during Exercise Test among Children and Adolescents in Taiwan
Int. J. Environ. Res. Public Health 2018, 15(2), 263; doi:10.3390/ijerph15020263
Received: 28 December 2017 / Revised: 19 January 2018 / Accepted: 1 February 2018 / Published: 4 February 2018
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Abstract
Peak metabolic equivalent (MET) is the most reliable indicator of cardiorespiratory fitness (CRF). The aim of this study was to examine the association between CRF indicated by peak MET and body mass index (BMI) or fat mass index (FMI) in Taiwanese children and
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Peak metabolic equivalent (MET) is the most reliable indicator of cardiorespiratory fitness (CRF). The aim of this study was to examine the association between CRF indicated by peak MET and body mass index (BMI) or fat mass index (FMI) in Taiwanese children and adolescents (C-A). Data of 638 C-A aged 10–18 that received symptom-limited treadmill exercise testing was analyzed. Anthropometry-body composition was measured by vector bioelectrical impedance analysis. BMI was defined as body weight (kg)/body height (m)2 and FMI was defined as fat mass (kg)/body height (m)2. BMI was grouped by Taiwanese obesity cut-off points. FMI Class-I was categorized by percentage of body fat. FMI Class-II used the reference values from Korean C-A. Excess adiposity was defined as (1) “overweight” and “obesity” by BMI, (2) greater than the sex- and age-specific 75th percentile of whole subjects by FMI Class-I, and (3) greater than 95th percentiles of reference value by FMI Class-II. Boys had significantly higher fat mass and FMI, and had more excess adiposity than girls (all p < 0.05). Both boys and girls with excess adiposity (by any definition) had lower MET at anaerobic threshold (AT MET) and peak MET (all p < 0.001). BMI and FMI were significantly negatively associated with both AT MET and peak MET significantly (all p < 0.001). FMI (95% CI: −0.411~−0.548) correlated with peak MET more than BMI (95% CI: −0.134~ −0.372) did. Excess adiposity affected CRF negatively. It is concluded that weight management should start early in childhood. Full article
(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)
Open AccessArticle The Effect of a Leisure Time Physical Activity Intervention Delivered via a Workplace: 15-Month Follow-Up Study
Int. J. Environ. Res. Public Health 2018, 15(2), 264; doi:10.3390/ijerph15020264
Received: 17 November 2017 / Revised: 24 January 2018 / Accepted: 31 January 2018 / Published: 4 February 2018
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Abstract
In line with recommendations from both the World Health Organization and the European Union some employers encourage workplace health promotion through physical activity (PA) facilities and leisure time PA-initiatives. The current study describes a 15-month follow-up after an 8-week workplace delivered PA-initiative, investigates
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In line with recommendations from both the World Health Organization and the European Union some employers encourage workplace health promotion through physical activity (PA) facilities and leisure time PA-initiatives. The current study describes a 15-month follow-up after an 8-week workplace delivered PA-initiative, investigates if improvements in cardiovascular risk status are sustainable, and elucidates differences according to educational level. One hundred and twenty one employees (43 women) were examined before and after the 8-week PA-initiative and 94 at the 15-month follow-up. PA-levels, blood pressure, resting heart rate, lipids, glycosylated hemoglobin (HbA1c), C-reactive protein (CRP), and selected markers of inflammation were registered at baseline, immediately after the 8-week PA-initiative, and 15 months after baseline. At the end of follow-up (15-month), PA-levels—increased during the 8-week intervention—had returned to baseline values. None of the five improvements in cardiovascular markers (total cholesterol, low density lipoprotein (LDL), P-selectin, CD40Ligand (CD40L) and Monocyte chemoattractant protein-1 (MCP-1)) seen at the 8-week follow-up were sustained. At the 15-month follow-up as compared to baseline HbA1c, CRP (log) and interleukin-6 (IL-6) were reduced by 0.06 mmol/L (95% CI −0.11,−0.01), 0.25 mg/L (95% CI −0.46,−0.04) and 0.39 pg/mL (95% CI −0.75, −0.04), respectively. At baseline, there were differences in cardiovascular risk factors comparing men with low versus high levels of education. No differences in changes in outcomes between these groups of men were found during follow-up. In this study highly educated men generally have lower levels of cardiovascular risk factors, but the effect of PA on such markers in this group do not differ from the effects seen in less educated men. Full article
(This article belongs to the Special Issue Occupational Sedentary Behaviour)
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Open AccessFeature PaperArticle Prevalence of and Factors Associated with Work-Related Musculoskeletal Symptoms in Nursing Assistants Working in Nursing Homes
Int. J. Environ. Res. Public Health 2018, 15(2), 265; doi:10.3390/ijerph15020265
Received: 13 November 2017 / Revised: 21 January 2018 / Accepted: 1 February 2018 / Published: 4 February 2018
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Abstract
The prevalence of work-related musculoskeletal symptoms (WRMSs) in different body parts for nursing assistants (NAs) working in nursing homes is currently unknown. The aim of this study was to determine the extent of WRMSs in nursing assistants and the factors associated with them.
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The prevalence of work-related musculoskeletal symptoms (WRMSs) in different body parts for nursing assistants (NAs) working in nursing homes is currently unknown. The aim of this study was to determine the extent of WRMSs in nursing assistants and the factors associated with them. Four hundred and forty NAs from 52 nursing homes, recruited by convenience sampling, participated in this cross-sectional study in 2014–2015. A valid and reliable study questionnaire was used to collect data. The results of our study found that 88.4% of NAs reported at least one body part with WRMSs. These NAs reported more symptoms in the shoulders than lower back. Adverse workstyle (OR = 1.04, 95% CI = 1.01–1.08) was the only factor associated with WRMSs after adjustment for potential confounders using multivariable logistic regression. This adverse workstyle could be developed because of physical and psychological work demands. Efforts should be directed at integrating “workstyle intervention” into lifestyle physical activity training to this group of healthcare workers. Full article
(This article belongs to the Special Issue Musculoskeletal Disorders)
Open AccessArticle Do Authoritarian Governments Respond to Public Opinion on the Environment? Evidence from China
Int. J. Environ. Res. Public Health 2018, 15(2), 266; doi:10.3390/ijerph15020266
Received: 15 December 2017 / Revised: 31 January 2018 / Accepted: 1 February 2018 / Published: 4 February 2018
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Abstract
Given its serious impacts on the public’s health, air pollution in China is a matter of strong public concern, particularly in reference to malodorous waste gas. Petition letters related to atmospheric pollution accounted for about 40% of the total petition cases. However, scholarly
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Given its serious impacts on the public’s health, air pollution in China is a matter of strong public concern, particularly in reference to malodorous waste gas. Petition letters related to atmospheric pollution accounted for about 40% of the total petition cases. However, scholarly views differ on whether the Chinese government responds to public opinion on the environment and seeks to improve its environmental governance behavior. For this study, data from national surveys on the public’s environmental satisfaction administered during the period 2011–2015 were analyzed to determine whether the public’s dissatisfaction with the state of the environment in a given year resulted in increased investments by provincial governments in pollution governance during the following year. The study’s findings revealed that governmental behavior in response to public opinion on the environment was selective within the field of environmental governance, with provincial governments being inclined to invest more in waste gas pollution control than in water pollution control. Furthermore, results from this study show that the Chinese government tends to put more efforts into the environmental field where it could more easily achieve short-term benefits. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
Open AccessArticle Conceptualizing and Managing Medical Emergencies Where No Formal Paramedical System Exists: Perspectives from a Remote Indigenous Community in Canada
Int. J. Environ. Res. Public Health 2018, 15(2), 267; doi:10.3390/ijerph15020267
Received: 8 December 2017 / Revised: 18 January 2018 / Accepted: 29 January 2018 / Published: 4 February 2018
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Abstract
(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts.
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(1) Background: Remote communities in Canada lack an equitable emergency medical response capacity compared to other communities. Community-based emergency care (CBEC) training for laypeople is a model that has the potential to enhance the medical emergency response capacity in isolated and resource-limited contexts. The purpose of this study was to understand the characteristics of medical emergencies and to conceptualize and present a framework for what a medical emergency is for one remote Indigenous community in northwestern Ontario, in order to inform the development of CBEC training. (2) Methods: This study adhered to the principles of community-based participatory research and realist evaluation; it was an integrated component of the formative evaluation of the second Sachigo Lake Wilderness Emergency Response Education Initiative (SLWEREI) training course in 2012. Twelve members of Sachigo Lake First Nation participated in the training course, along with local nursing staff, police officers, community Elders, and course instructors (n = 24 total), who participated in interviews, focus groups, and a collaborative discussion of local health issues in the development of the SLWEREI. (3) Results: The qualitative results are organized into sections that describe the types of local health emergencies and the informal response system of community members in addressing these emergencies. Prominent themes of health adversity that emerged were an inability to manage chronic conditions and fears of exacerbations, the lack of capacity for addressing mental illness, and the high prevalence of injury for community members. (4) Discussion: A three-point framework of what constitutes local perceptions of an emergency emerged from the findings in this study: (1) a sense of isolation; (2) a condition with a potentially adverse outcome; and (3) a need for help. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
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Open AccessArticle Will Green CSR Enhance Innovation? A Perspective of Public Visibility and Firm Transparency
Int. J. Environ. Res. Public Health 2018, 15(2), 268; doi:10.3390/ijerph15020268
Received: 16 October 2017 / Revised: 2 January 2018 / Accepted: 29 January 2018 / Published: 4 February 2018
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Abstract
In response to the asking and requiring of stakeholders to be more environmentally responsible, firms must commit to green corporate social responsibility (CSR). Firms being green and responsible always can acquire intangible resources that are important for firm innovation. Given the scarcity of
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In response to the asking and requiring of stakeholders to be more environmentally responsible, firms must commit to green corporate social responsibility (CSR). Firms being green and responsible always can acquire intangible resources that are important for firm innovation. Given the scarcity of existing research addressing relevant issues in depth, this paper expands our understanding of green CSR by revealing its antecedent effects on firm innovation performance. We also include public visibility and firm transparency as contingency factors to explore the relationship between green CSR and firm innovation performance. Using data collected from publicly listed firms in China, we find that greater innovation performance is associated with an increase in firm green CSR, and the positive relationship between green CSR and innovation performance is moderated by public visibility and firm transparency. Based on the results, theoretical contributions and practical implications are outlined. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Removal of Pharmaceutical and Personal Care Products (PPCPs) from Municipal Waste Water with Integrated Membrane Systems, MBR-RO/NF
Int. J. Environ. Res. Public Health 2018, 15(2), 269; doi:10.3390/ijerph15020269
Received: 21 November 2017 / Revised: 15 January 2018 / Accepted: 22 January 2018 / Published: 5 February 2018
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Abstract
This study focuses on the application of combining membrane bioreactor (MBR) treatment with reverse osmosis (RO) or nanofiltration (NF) membrane treatment for removal of pharmaceuticals and personal care products (PPCPs) in municipal wastewater. Twenty-seven PPCPs were measured in real influent with lowest average
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This study focuses on the application of combining membrane bioreactor (MBR) treatment with reverse osmosis (RO) or nanofiltration (NF) membrane treatment for removal of pharmaceuticals and personal care products (PPCPs) in municipal wastewater. Twenty-seven PPCPs were measured in real influent with lowest average concentration being trimethoprim (7.12 ng/L) and the highest being caffeine (18.4 ng/L). The results suggest that the MBR system effectively removes the PPCPs with an efficiency of between 41.08% and 95.41%, and that the integrated membrane systems, MBR-RO/NF, can achieve even higher removal rates of above 95% for most of them. The results also suggest that, due to the differences in removal mechanisms of NF/RO membrane, differences of removal rates exist. In this study, the combination of MBR-NF resulted in the removal of 13 compounds to below detection limits and MBR-RO achieved even better results with removal of 20 compounds to below detection limits. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Epidemiological Characteristics and Spatial-Temporal Distribution of Hand, Foot, and Mouth Disease in Chongqing, China, 2009–2016
Int. J. Environ. Res. Public Health 2018, 15(2), 270; doi:10.3390/ijerph15020270
Received: 22 December 2017 / Revised: 22 January 2018 / Accepted: 24 January 2018 / Published: 5 February 2018
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Abstract
(1) Objective: Even with licensed vaccine for enterovirus 71 (EV71) put into market in 2016 in China, hand, foot, and mouth disease (HFMD) is still a threat for children’s health in Chongqing. We described the epidemiological characteristics and spatial–temporal patterns of HFMD
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(1) Objective: Even with licensed vaccine for enterovirus 71 (EV71) put into market in 2016 in China, hand, foot, and mouth disease (HFMD) is still a threat for children’s health in Chongqing. We described the epidemiological characteristics and spatial–temporal patterns of HFMD in Chongqing from 2009 to 2016, in order to provide information and evidence for guiding public health response and intervention. (2) Methods: We retrieved the HFMD surveillance data from January 2009 to December 2016 from “National Disease Reporting Information System”, and then analyzed demographic and geographical information integrally. Descriptive analysis was conducted to evaluate the epidemic features of HFMD in Chongqing. The spatial–temporal methods were performed to explore the clusters at district/county level. (3) Results: A total of 276,207 HFMD cases were reported during the study period (total population incidence: 114.8 per 100,000 per year), including 641 severe cases (129 deaths). The annual incidence of HFMD sharply increased in even-numbered years, but remained stable or decreased in odd-numbered years. A semiannual seasonality was observed during April to July, and October to December in each year. The male-to-female ratios of the mild and severe cases were 1.4:1 and 1.5:1, with the median age of 2.3 years and 1.9 years, respectively. More than 90% of the cases were children equal to and less than 5 years old. High-incidence clustered regions included the main urban districts and northeast regions according to incidence rates comparison or space–time cluster analysis. A total of 19,482 specimen were collected from the reported cases and 13,277 (68.2%) were positive for enterovirus. EV71 was the major causative agent for severe cases, while other enteroviruses were the predominant serotype for mild cases. (4) Conclusions: The characteristics of HFMD in Chongqing exhibited a phenomenon of increasing incidence in two-year cycles and semiannual seasonality in time distribution. Children ≤5 years old, especially boys, were more affected by HFMD. EV71 was the major causative agent for severe cases. We suggest initiating mass EV71 vaccination campaigns among children aged 6 months to 5 years in Chongqing, especially in the main urban districts and northern regions, in order to reduce case fatality, and take integrated measurements for controlling and preventing HFMD attributed to other enteroviruses. Full article
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Open AccessArticle Empirical Study on the Sustainability of China’s Grain Quality Improvement: The Role of Transportation, Labor, and Agricultural Machinery
Int. J. Environ. Res. Public Health 2018, 15(2), 271; doi:10.3390/ijerph15020271
Received: 13 December 2017 / Revised: 25 January 2018 / Accepted: 26 January 2018 / Published: 5 February 2018
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Abstract
As a major part of farming sustainability, the issues of grain production and its quality improvement have been important in many countries. This paper aims to address these issues in China. Based on the data from the main production provinces and by applying
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As a major part of farming sustainability, the issues of grain production and its quality improvement have been important in many countries. This paper aims to address these issues in China. Based on the data from the main production provinces and by applying the stochastic frontier analysis methodology, we find that the improvement of transportation and the use of agricultural machinery have become the main driving forces for grain quality improvement in China. After further studying different provinces’ potentials of grain quality improvement, we show that grain quality has increased steadily. Therefore, we can conclude China’s grain quality improvement is indeed sustainable. Furthermore, different grains like rice, wheat, and corn share similar characteristics in terms of quality improvement, but the improvement rate for rice is relatively low, while those of corn and wheat are relatively high. Moreover, the overall change of efficiency gain of grain quality improvement is not significant for different provinces. The efficiency gains of the quality improvements for rice and wheat even decrease slightly. In addition, we find that only expanding grain quality improvement potential can simultaneously achieve the dual objectives of improving grain quality and increasing yield. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessFeature PaperArticle Primary Care Comprehensiveness Can Reduce Emergency Department Visits and Hospitalization in People with Hypertension in South Korea
Int. J. Environ. Res. Public Health 2018, 15(2), 272; doi:10.3390/ijerph15020272
Received: 28 December 2017 / Revised: 1 February 2018 / Accepted: 4 February 2018 / Published: 5 February 2018
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Abstract
Hypertension has been the leading risk factor contributing to cardiovascular morbidity and mortality, which needs comprehensive measures to manage and can be controlled effectively in primary care. In the health care context of South Korea, where specialists can see patients directly at their
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Hypertension has been the leading risk factor contributing to cardiovascular morbidity and mortality, which needs comprehensive measures to manage and can be controlled effectively in primary care. In the health care context of South Korea, where specialists can see patients directly at their own community clinics and there has been no consensus on the definition of primary care, the authors used the nationally representative 2013 Korea Health Panel data, categorized adults (≥18 years) with hypertension by types of usual source of care (USC), and analyzed the association of having a comprehensive community clinic (i.e., primary care) physician as a USC with experience of emergency department (ED) visits and hospitalization within a year. After adjusting for cofounding variables including Charlson comorbidity index scores, those having a primary care physician as a USC remained associated with a decrease in an experience of ED visits (OR: 0.61, 95% CI: 0.40–0.93) and hospitalization (OR: 0.69, 95% CI: 0.49–0.96), compared to those not having a usual physician. Health policies that promote having a primary care physician as a USC could decrease unnecessary experience of ED visits and hospitalization by adults with hypertension. This can partly reduce ED overcrowding and avoidable hospitalization in Korea. Full article
(This article belongs to the Special Issue Chronic Diseases and Multimorbidity in Primary Care)
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Open AccessArticle Evaluating the Hydrologic Performance of Low Impact Development Scenarios in a Micro Urban Catchment
Int. J. Environ. Res. Public Health 2018, 15(2), 273; doi:10.3390/ijerph15020273
Received: 9 January 2018 / Revised: 30 January 2018 / Accepted: 31 January 2018 / Published: 5 February 2018
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Abstract
As urbanization progresses, increasingly impervious surfaces have changed the hydrological processes in cities and resulted in a major challenge for urban stormwater control. This study uses the urban stormwater model to evaluate the performance and costs of low impact development (LID) scenarios in
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As urbanization progresses, increasingly impervious surfaces have changed the hydrological processes in cities and resulted in a major challenge for urban stormwater control. This study uses the urban stormwater model to evaluate the performance and costs of low impact development (LID) scenarios in a micro urban catchment. Rainfall-runoff data of three rainfall events were used for model calibration and validation. The pre-developed (PreDev) scenario, post-developed (PostDev) scenario, and three LID scenarios were used to evaluate the hydrologic performance of LID measures. Using reduction in annual runoff as the goal, the best solutions for each LID scenario were selected using cost-effectiveness curves. The simulation results indicated that the three designed LID scenarios could effectively reduce annual runoff volumes and pollutant loads compared with the PostDev scenario. The most effective scenario (MaxPerf) reduced annual runoff by 53.4%, followed by the sponge city (SpoPerf, 51.5%) and economy scenarios (EcoPerf, 43.1%). The runoff control efficiency of the MaxPerf and SpoPerf scenarios increased by 23.9% and 19.5%, respectively, when compared with the EcoPerf scenario; however, the costs increased by 104% and 83.6%. The reduction rates of four pollutants (TSS, TN, TP, and COD) under the MaxPerf scenario were 59.8–61.1%, followed by SpoPerf (53.9–58.3%) and EcoPerf (42.3–45.4%), and the costs of the three scenarios were 3.74, 3.47 and 1.83 million yuan, respectively. These results can provide guidance to urban stormwater managers in future urban planning to improve urban water security. Full article
(This article belongs to the Special Issue Stormwater Management in Urban Areas)
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Open AccessArticle Prevalence and Correlates of Cyberbullying Perpetration. Findings from a German Representative Student Survey
Int. J. Environ. Res. Public Health 2018, 15(2), 274; doi:10.3390/ijerph15020274
Received: 31 October 2017 / Revised: 25 January 2018 / Accepted: 1 February 2018 / Published: 6 February 2018
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Abstract
Based on a survey of 9512 ninth-grade students conducted in Lower Saxony in 2013, this paper examines the prevalence of cyberbullying perpetration and the correlates of this behavior. Binary logistic multilevel regression was used in order to analyze correlates of sexual and psychological
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Based on a survey of 9512 ninth-grade students conducted in Lower Saxony in 2013, this paper examines the prevalence of cyberbullying perpetration and the correlates of this behavior. Binary logistic multilevel regression was used in order to analyze correlates of sexual and psychological cyberbully perpetration. In the preceding semester, 2.4% of the adolescents were perpetrators of psychological cyberbullying and 0.4% bullied someone online sexually. Low levels of empathy, frequent consumption of violent media, and being victims of aggressive online behaviors are correlated with the risk that a child will become a bully. Female adolescents are less likely than boys to engage in sexual cyberbullying perpetration, but they are more likely to engage in psychological cyberbullying perpetration. Only a small share of adolescents engage in sexual and psychological cyberbullying perpetration. Both behaviors differ in their correlates, however being a victim of aggressive online behaviors increase the risk for perpetration of both behaviors, respectively. Full article
Open AccessArticle Does Walkability Contribute to Geographic Variation in Psychosocial Distress? A Spatial Analysis of 91,142 Members of the 45 and Up Study in Sydney, Australia
Int. J. Environ. Res. Public Health 2018, 15(2), 275; doi:10.3390/ijerph15020275
Received: 27 December 2017 / Revised: 31 January 2018 / Accepted: 1 February 2018 / Published: 6 February 2018
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Abstract
Walkability describes the capacity of the built environment to promote walking, and has been proposed as a potential focus for community-level mental health planning. We evaluated this possibility by examining the contribution of area-level walkability to variation in psychosocial distress in a population
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Walkability describes the capacity of the built environment to promote walking, and has been proposed as a potential focus for community-level mental health planning. We evaluated this possibility by examining the contribution of area-level walkability to variation in psychosocial distress in a population cohort at spatial scales comparable to those used for regional planning in Sydney, Australia. Data on psychosocial distress were analysed for 91,142 respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. We fit conditional auto regression models at the postal area level to obtain smoothed “disease maps” for psychosocial distress, and assess its association with area-level walkability after adjusting for individual- and area-level factors. Prevalence of psychosocial distress was 7.8%; similar for low (7.9%), low-medium (7.9%), medium-high (8.0%), and high (7.4%) walkability areas; and decreased with reducing postal area socioeconomic disadvantage: 12.2% (most), 9.3%, 7.5%, 5.9%, and 4.7% (least). Unadjusted disease maps indicated strong geographic clustering of psychosocial distress with 99.0% of excess prevalence due to unobserved and spatially structured factors, which was reduced to 55.3% in fully adjusted maps. Spatial and unstructured variance decreased by 97.3% and 39.8% after adjusting for individual-level factors, and another 2.3% and 4.2% with the inclusions of area-level factors. Excess prevalence of psychosocial distress in postal areas was attenuated in adjusted models but remained spatially structured. Postal area prevalence of high psychosocial distress is geographically clustered in Sydney, but is unrelated to postal area walkability. Area-level socioeconomic disadvantage makes a small contribution to this spatial structure; however, community-level mental health planning will likely deliver greatest benefits by focusing on individual-level contributors to disease burden and inequality associated with psychosocial distress. Full article
(This article belongs to the Special Issue Mental Health and Environmental Exposures)
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Open AccessArticle Identification of Pancreatic Injury in Patients with Elevated Amylase or Lipase Level Using a Decision Tree Classifier: A Cross-Sectional Retrospective Analysis in a Level I Trauma Center
Int. J. Environ. Res. Public Health 2018, 15(2), 277; doi:10.3390/ijerph15020277
Received: 24 November 2017 / Revised: 31 January 2018 / Accepted: 4 February 2018 / Published: 6 February 2018
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Abstract
Background: In trauma patients, pancreatic injury is rare; however, if undiagnosed, it is associated with high morbidity and mortality rates. Few predictive models are available for the identification of pancreatic injury in trauma patients with elevated serum pancreatic enzymes. In this study, we
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Background: In trauma patients, pancreatic injury is rare; however, if undiagnosed, it is associated with high morbidity and mortality rates. Few predictive models are available for the identification of pancreatic injury in trauma patients with elevated serum pancreatic enzymes. In this study, we aimed to construct a model for predicting pancreatic injury using a decision tree (DT) algorithm, along with data obtained from a population-based trauma registry in a Level I trauma center. Methods: A total of 991 patients with elevated serum levels of amylase (>137 U/L) or lipase (>51 U/L), including 46 patients with pancreatic injury and 865 without pancreatic injury between January 2009 and December 2016, were allocated in a ratio of 7:3 to training (n = 642) or test (n = 269) sets. Using the data on patient and injury characteristics as well as laboratory data, the DT algorithm with Classification and Regression Tree (CART) analysis was performed based on the Gini impurity index, using the rpart function in the rpart package in R. Results: Among the trauma patients with elevated amylase or lipase levels, three groups of patients were identified as having a high risk of pancreatic injury, using the DT model. These included (1) 69% of the patients with lipase level ≥306 U/L; (2) 79% of the patients with lipase level between 154 U/L and 305 U/L and shock index (SI) ≥ 0.72; and (3) 80% of the patients with lipase level <154 U/L with abdomen injury, glucose level <158 mg/dL, amylase level <90 U/L, and neutrophil percentage ≥76%; they had all sustained pancreatic injury. With all variables in the model, the DT achieved an accuracy of 97.9% (sensitivity of 91.4% and specificity of 98.3%) for the training set. In the test set, the DT achieved an accuracy of 93.3%, sensitivity of 72.7%, and specificity of 94.2%. Conclusions: We established a DT model using lipase, SI, and additional conditions (injury to the abdomen, glucose level <158 mg/dL, amylase level <90 U/L, and neutrophils ≥76%) as important nodes to predict three groups of patients with a high risk of pancreatic injury. The proposed decision-making algorithm may help in identifying pancreatic injury among trauma patients with elevated serum amylase or lipase levels. Full article
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Open AccessArticle Prevention of Common Mental Disorders in Employees. Perspectives on Collaboration from Three Health Care Professions
Int. J. Environ. Res. Public Health 2018, 15(2), 278; doi:10.3390/ijerph15020278
Received: 30 November 2017 / Revised: 1 February 2018 / Accepted: 4 February 2018 / Published: 6 February 2018
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Abstract
Collaboration among occupational health physicians, primary care physicians and psychotherapists in the prevention and treatment of common mental disorders in employees has been scarcely researched. To identify potential for improvement, these professions were surveyed in Baden-Württemberg (Germany). Four hundred and fifty occupational health
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Collaboration among occupational health physicians, primary care physicians and psychotherapists in the prevention and treatment of common mental disorders in employees has been scarcely researched. To identify potential for improvement, these professions were surveyed in Baden-Württemberg (Germany). Four hundred and fifty occupational health physicians, 1000 primary care physicians and 700 resident medical and psychological psychotherapists received a standardized questionnaire about their experiences, attitudes and wishes regarding activities for primary, secondary and tertiary prevention of common mental disorders in employees. The response rate of the questionnaire was 30% (n = 133) among occupational health physicians, 14% (n = 136) among primary care physicians and 27% (n = 186) among psychotherapists. Forty percent of primary care physicians and 33% of psychotherapists had never had contact with an occupational health physician. Psychotherapists indicated more frequent contact with primary care physicians than vice versa (73% and 49%, respectively). Better cooperation and profession-specific training on mental disorders and better knowledge about work-related stress were endorsed. For potentially involved stakeholders, the importance of interdisciplinary collaboration for better prevention and care of employees with common mental disorders is very high. Nevertheless, there is only little collaboration in practice. To establish quality-assured cooperation structures in practice, participants need applicable frameworks on an organizational and legal level. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Seasonal and Spatial Variability of Anthropogenic and Natural Factors Influencing Groundwater Quality Based on Source Apportionment
Int. J. Environ. Res. Public Health 2018, 15(2), 279; doi:10.3390/ijerph15020279
Received: 5 January 2018 / Revised: 28 January 2018 / Accepted: 2 February 2018 / Published: 6 February 2018
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Abstract
Globally, groundwater resources are being deteriorated by rapid social development. Thus, there is an urgent need to assess the combined impacts of natural and enhanced anthropogenic sources on groundwater chemistry. The aim of this study was to identify seasonal characteristics and spatial variations
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Globally, groundwater resources are being deteriorated by rapid social development. Thus, there is an urgent need to assess the combined impacts of natural and enhanced anthropogenic sources on groundwater chemistry. The aim of this study was to identify seasonal characteristics and spatial variations in anthropogenic and natural effects, to improve the understanding of major hydrogeochemical processes based on source apportionment. 34 groundwater points located in a riverside groundwater resource area in northeast China were sampled during the wet and dry seasons in 2015. Using principal component analysis and factor analysis, 4 principal components (PCs) were extracted from 16 groundwater parameters. Three of the PCs were water-rock interaction (PC1), geogenic Fe and Mn (PC2), and agricultural pollution (PC3). A remarkable difference (PC4) was organic pollution originating from negative anthropogenic effects during the wet season, and geogenic F enrichment during the dry season. Groundwater exploitation resulted in dramatic depression cone with higher hydraulic gradient around the water source area. It not only intensified dissolution of calcite, dolomite, gypsum, Fe, Mn and fluorine minerals, but also induced more surface water recharge for the water source area. The spatial distribution of the PCs also suggested the center of the study area was extremely vulnerable to contamination by Fe, Mn, COD, and F. Full article
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Open AccessArticle Microplastics Reduce Short-Term Effects of Environmental Contaminants. Part I: Effects of Bisphenol A on Freshwater Zooplankton Are Lower in Presence of Polyamide Particles
Int. J. Environ. Res. Public Health 2018, 15(2), 280; doi:10.3390/ijerph15020280
Received: 15 November 2017 / Revised: 12 January 2018 / Accepted: 1 February 2018 / Published: 6 February 2018
Cited by 1 | PDF Full-text (1206 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Microplastics can have direct physical effects on organisms in freshwater systems, and are considered as vectors for absorbed environmental pollutants. It is still under discussion if microplastics are relevant pollutant vectors for uptake into aquatic organisms in comparison to further uptake pathways, e.g.,
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Microplastics can have direct physical effects on organisms in freshwater systems, and are considered as vectors for absorbed environmental pollutants. It is still under discussion if microplastics are relevant pollutant vectors for uptake into aquatic organisms in comparison to further uptake pathways, e.g., via water or sediment particles. We analyzed how the presence of microplastics (polyamide particles, PA) modifies acute effects of the environmental pollutant bisphenol A (BPA) on freshwater zooplankton (Daphnia magna). Daphnids were exposed to PA particles and BPA alone, before combining them in the next step with one concentration of PA and varying concentrations of BPA. The PA particles themselves did not induce negative effects, while the effects of BPA alone followed a typical dose-dependent manner. Sorption of BPA to PA particles prior to exposure led to a reduction of BPA in the aqueous phase. The combination of BPA and PA led to decreased immobilization, although PA particles loaded with BPA were ingested by the daphnids. Calculations based on physiochemistry and equilibrium assumptions indicated lower BPA body burden of daphnids in the presence of PA particles. These results confirm model-based studies, and show that investigated microplastic concentrations are negligible for the overall pollutant uptake of daphnids with water as additional uptake pathway. Full article
(This article belongs to the Special Issue Microplastics: Hazards to Environmental and Human Health)
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Open AccessArticle Stakeholders Opinions on Multi-Use Deep Water Offshore Platform in Hsiao-Liu-Chiu, Taiwan
Int. J. Environ. Res. Public Health 2018, 15(2), 281; doi:10.3390/ijerph15020281
Received: 30 November 2017 / Revised: 11 January 2018 / Accepted: 23 January 2018 / Published: 6 February 2018
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Abstract
This paper describes a group model building activity designed to elicit the potential effects a projected multi-use deep water offshore platform may have on its local environment, including ecological and socio-economic issues. As such a platform is proposed for construction around the island
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This paper describes a group model building activity designed to elicit the potential effects a projected multi-use deep water offshore platform may have on its local environment, including ecological and socio-economic issues. As such a platform is proposed for construction around the island of Hsiao-Liu-Chiu, Taiwan, we organized several meetings with the local stakeholders and structured the debates using group modeling methods to promote consensus. During the process, the participants iteratively built and revised a causal-loop diagram that summarizes their opinions. Overall, local stakeholders concluded that a multi-use deep water offshore marine platform might have beneficial effects for Hsiao-Liu-Chiu because more tourists and fish could be attracted by the structure, but they also raised some potential problems regarding the law in Taiwan and the design of the offshore platform, especially its resistance to extreme weather. We report the method used and the main results and insights gained during the process. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessFeature PaperArticle Testing Cessation Messages for Cigarette Package Inserts: Findings from a Best/Worst Discrete Choice Experiment
Int. J. Environ. Res. Public Health 2018, 15(2), 282; doi:10.3390/ijerph15020282
Received: 9 December 2017 / Revised: 20 January 2018 / Accepted: 1 February 2018 / Published: 6 February 2018
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Abstract
This study assessed smokers’ responses to different smoking cessation topics and imagery for cigarette package inserts. Adult smokers from Canada (n = 1000) participated in three discrete choice experiments (DCEs): DCE 1 assessed five cessation benefit topics and five imagery types; DCE
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This study assessed smokers’ responses to different smoking cessation topics and imagery for cigarette package inserts. Adult smokers from Canada (n = 1000) participated in three discrete choice experiments (DCEs): DCE 1 assessed five cessation benefit topics and five imagery types; DCE 2 assessed five messages with tips to improve cessation success and five imagery types; DCE 3 assessed four reproductive health benefits of cessation topics and four imagery types. In each DCE, participants evaluated four or five sets of four inserts, selecting the most and least motivating (DCEs 1 & 3) or helpful (DCE 2) for quitting. Linear mixed models regressed choices on insert and smoker characteristics. For DCE 1, the most motivating messages involved novel disease topics and imagery of younger women. For DCE 2, topics of social support, stress reduction and nicotine replacement therapy were selected as most helpful, with no differences by imagery type. For DCE 3, imagery influenced choices more than topic, with imagery of a family or a mom and baby selected as most motivating. Statistically significant interactions for all three experiments indicated that the influence of imagery type on choices depended on the message topic. Messages to promote smoking cessation through cigarette pack inserts should consider specific combinations of message topic and imagery. Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
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Open AccessArticle Depressive Symptoms of Chinese Children: Prevalence and Correlated Factors among Subgroups
Int. J. Environ. Res. Public Health 2018, 15(2), 283; doi:10.3390/ijerph15020283
Received: 25 December 2017 / Revised: 27 January 2018 / Accepted: 4 February 2018 / Published: 7 February 2018
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Abstract
Economic growth and socioeconomic changes have transformed nearly every aspect of childhood in China, and many are worried by the increasing prevalence of mental health issues among children, particularly depression. To provide insight into the distribution of depressive symptoms among children in China
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Economic growth and socioeconomic changes have transformed nearly every aspect of childhood in China, and many are worried by the increasing prevalence of mental health issues among children, particularly depression. To provide insight into the distribution of depressive symptoms among children in China and identify vulnerable groups, we use data from the 2012 China Family Panel Survey (CFPS), a survey that collected data from a large, nationally representative sample of the Chinese population. Using the CFPS data, we construct a sample of 2679 children aged 10–15 years old from 25 provinces in China. According to our results, the incidence of depression varies by geographic area. Specifically, we find that rates of depressive symptoms are significantly lower in urban areas (14% of sample children) than in rural areas (23% of sample children). Our results also show that children from ethnic minorities, from poorer families, and whose parents are depressed are more likely to be depressed than other children. In contrast, we find that depressive symptoms do not vary by gender. Full article
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Open AccessArticle Degradation Investigation of Selected Taste and Odor Compounds by a UV/Chlorine Advanced Oxidation Process
Int. J. Environ. Res. Public Health 2018, 15(2), 284; doi:10.3390/ijerph15020284
Received: 14 January 2018 / Revised: 27 January 2018 / Accepted: 4 February 2018 / Published: 7 February 2018
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Abstract
Taste- and odor-causing (T&O) compounds are a major concern in drinking water treatment plants due to their negative impacts on the safety and palatability of water supply. This study explored the degradation kinetics and radical chemistry of four often-detected T&O compounds, geosmin (GSM),
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Taste- and odor-causing (T&O) compounds are a major concern in drinking water treatment plants due to their negative impacts on the safety and palatability of water supply. This study explored the degradation kinetics and radical chemistry of four often-detected T&O compounds, geosmin (GSM), 2-methylisoborneol (MIB), benzothiazole (BT), and 2-isobutyl-3-methoxypyrazine (IBMP), in the ultraviolet/chlorine (UV/chlorine) advanced oxidation process. All experiments were carried out in a 700 mL photoreactor and the process effectively degraded the investigated T&O compounds in a slightly acidic environment. The degradation of T&O decreased with increasing pH but slightly with decreasing chlorine dosage. When the pH increased from 6 to 8, the pseudo-first-order rate constants of GSM, MIB, BT, and IBMP dropped from 2.84 × 10−3, 2.29 × 10−3, 3.64 × 10−3, and 2.76 × 10−3 s−1 to 3.77 × 10−4, 2.64 × 10−4, 6.48 × 10−4, and 6.40 × 10−4 s−1, respectively. Increasing the chlorine dosage slightly accelerated the degradation of the investigated T&O compounds, but excessive hypochlorous acid and hypochlorite scavenged the HO• radicals and reactive chlorine species (RCS). Generally, HO• primarily contributed to the degradation of all of the investigated T&O compounds as compared to RCS. The degradation by RCS was found to be structurally selective. RCS could not degrade GSM, but contributed to the degradation of MIB, BT, and IBMP. The results confirmed that the proposed oxidation process effectively degraded typical T&O compounds in aqueous phase. Full article
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Open AccessArticle Clinical Aspects of Foot Health in Individuals with Alzheimer’s Disease
Int. J. Environ. Res. Public Health 2018, 15(2), 286; doi:10.3390/ijerph15020286
Received: 10 January 2018 / Revised: 1 February 2018 / Accepted: 4 February 2018 / Published: 7 February 2018
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Abstract
Alzheimer’s disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined
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Alzheimer’s disease (AD) shows a marked presence of physiologic changes and the start or aggravation of underlying diseases such as physical frailty in diverse anatomical regions. It is believed to have a particularly harmful effect on the health of the foot. We examined the foot health status in older persons with AD, with a specific focus on the extent to which people with AD may be using inadequate footwear in old age. Seventy-three community-dwelling people with probable, mild to moderate AD aged 65–95 years were recruited from a center of excellence for AD. A single trained physician evaluated health status and foot conditions. Current shoe and foot length and width measurements were taken using a calibrated Brannock device. The results indicate that sixty-five participants (89.04%) suffered from feet problems. Also, only twenty-two subjects (30.14%) used the correct shoes in width and size related with the morphology of their feet. Fifty-one participants (69.86%) were using incorrect shoes in length or width. The present study revealed that peoples with AD had a high presence of foot health problems. Also, the use of inappropriate shoes revealed measurable differences of association between shoe size and the morphology of the foot. Full article
Open AccessArticle Microplastics Reduce Short-Term Effects of Environmental Contaminants. Part II: Polyethylene Particles Decrease the Effect of Polycyclic Aromatic Hydrocarbons on Microorganisms
Int. J. Environ. Res. Public Health 2018, 15(2), 287; doi:10.3390/ijerph15020287
Received: 30 November 2017 / Revised: 8 January 2018 / Accepted: 8 January 2018 / Published: 7 February 2018
PDF Full-text (2450 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Microplastic particles in terrestrial and aquatic ecosystems are currently discussed as an emerging persistent organic pollutant and as acting as a vector for hydrophobic chemicals. Microplastic particles may ultimately deposit and accumulate in soil as well as marine and freshwater sediments where they
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Microplastic particles in terrestrial and aquatic ecosystems are currently discussed as an emerging persistent organic pollutant and as acting as a vector for hydrophobic chemicals. Microplastic particles may ultimately deposit and accumulate in soil as well as marine and freshwater sediments where they can be harmful to organisms. In this study, we tested the sensitivity of natural freshwater sediment bacterial communities (by genetic fingerprint) to exposure to microplastics (polyethylene, 2 and 20 mg/g sediment) and microplastics loaded with polycyclic aromatic hydrocarbons (PAHs, phenanthrene and anthracene), using a laboratory-based approach. After two weeks of incubation, the bacterial community composition from an unpolluted river section was altered by high concentrations of microplastics, whereas the community downstream of a wastewater treatment plant remained unchanged. Low microplastic concentrations loaded with phenanthrene or anthracene induced a less pronounced response in the sediment communities compared to the same total amount of phenanthrene or anthracene alone. In addition, biodegradation of the PAHs was reduced. This study shows, that microplastic can affect bacterial community composition in unpolluted freshwater sediments. Moreover, the results indicate that microplastics can serve as a vehicle for hydrophobic pollutants but bioavailability of the latter is reduced by the sorption to microplastics. Full article
(This article belongs to the Special Issue Microplastics: Hazards to Environmental and Human Health)
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Open AccessArticle Smokers’ Views on Personal Carbon Monoxide Monitors, Associated Apps, and Their Use: An Interview and Think-Aloud Study
Int. J. Environ. Res. Public Health 2018, 15(2), 288; doi:10.3390/ijerph15020288
Received: 14 December 2017 / Revised: 31 January 2018 / Accepted: 2 February 2018 / Published: 7 February 2018
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Abstract
Smartphone-based personal carbon monoxide (CO) monitors and associated apps, or “CO Smartphone Systems” (CSSs) for short, could enable smokers to independently monitor their smoking and quitting. This study explored views and preferences regarding CSSs and their use among 16 adult, UK-based smokers. First,
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Smartphone-based personal carbon monoxide (CO) monitors and associated apps, or “CO Smartphone Systems” (CSSs) for short, could enable smokers to independently monitor their smoking and quitting. This study explored views and preferences regarding CSSs and their use among 16 adult, UK-based smokers. First, semi-structured interviews explored participants’ expectations of CSSs. Secondly, a think-aloud study identified participants’ reactions to a personal CO monitor and to existing or prototype apps. Framework Analysis identified five themes: (1) General views, needs, and motivation to use CSSs; (2) Views on the personal CO monitor; (3) Practicalities of CSS use; (4) Desired features in associated apps; and (5) Factors affecting preferences for CSSs and their use. Participants had high expectations of CSSs and their potential to increase motivation. Priority app features included: easy CO testing journeys, relevant and motivating feedback, and recording of contextual data. Appearance and usability of the personal CO monitor, and accuracy and relevance of CO testing were considered important for engagement. Participants differed in their motivation to use and preferences for CSSs features and use, which might have non-trivial impact on evaluation efforts. Personal CO monitors and associated apps may be attractive tools for smokers, but making CSSs easy to use and evaluating these among different groups of smokers may be challenging. Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
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Open AccessFeature PaperArticle Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents
Int. J. Environ. Res. Public Health 2018, 15(2), 289; doi:10.3390/ijerph15020289
Received: 25 December 2017 / Revised: 1 February 2018 / Accepted: 4 February 2018 / Published: 7 February 2018
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Abstract
Little is known about hip fracture rates and post-fracture mortality among nursing home residents. This retrospective cohort study examined incidence rates (IR) of and mortality after hip fracture in this population focusing on sex differences. A cohort of >127,000 residents ≥65 years, newly
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Little is known about hip fracture rates and post-fracture mortality among nursing home residents. This retrospective cohort study examined incidence rates (IR) of and mortality after hip fracture in this population focusing on sex differences. A cohort of >127,000 residents ≥65 years, newly admitted to German nursing homes between 2010 and 2014 were used to calculate age-, sex-, care-need- and time after admission-specific IR. To determine mortality, the Kaplan-Meier-method was applied. Using Cox regression, we studied mortality and estimated time-dependent hazard ratios (HRs). For this purpose, to each person with a hip fracture, one resident without a hip fracture was matched by sex, age and care-need using risk-set sampling. 75% were women (mean age: 84.0 years). During 168,588 person-years (PY), 8537 residents with at least one hip fracture were observed. The IR for women and men were 52.9 and 42.5/1000 PY. For both sexes, IR increased with rising age and decreased with increasing care-level. IR were highest in the first months after admission and subsequently declined afterwards. The impact of hip fractures on mortality was time-dependent. Mortality of residents with hip fracture was highest in the first two months after fracture compared to those without (HR): 2.82; 95% CI 2.57–3.11) and after six months, no differences were found (HR: 1.10; 95% CI 0.98–1.22) Further research should always include analyses stratified by sex, age and time period after admission. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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Open AccessArticle Characteristics of Stress and Suicidal Ideation in the Disclosure of Sexual Orientation among Young French LGB Adults
Int. J. Environ. Res. Public Health 2018, 15(2), 290; doi:10.3390/ijerph15020290
Received: 16 January 2018 / Revised: 2 February 2018 / Accepted: 4 February 2018 / Published: 7 February 2018
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Abstract
Background: Lesbians, gays, and bisexual people (LGB) present high levels of suicidal ideation. The disclosure of sexual orientation is a stressful experience which presents a high suicide risk. Research has not paid sufficient attention to stress during this disclosure in order to understand
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Background: Lesbians, gays, and bisexual people (LGB) present high levels of suicidal ideation. The disclosure of sexual orientation is a stressful experience which presents a high suicide risk. Research has not paid sufficient attention to stress during this disclosure in order to understand suicide among LGB people. The aims of this study were to investigate: (1) the characteristics of stress during this revelation, more precisely cognitive appraisal, emotions, and coping; and (2) associations between these characteristics and suicidal ideation. Method: A total of 200 LGB young adults answered the “Stressful situation assessment questionnaire”, focusing on the most stressful disclosure of sexual orientation they have ever experienced. Results: Avoidance coping is a good predictor of suicidal ideation, and mediates the association between primary appraisal (risk “Harm myself and others”) and suicidal ideation. Conclusions: Our study illustrates the need to better understand stress during the disclosure of sexual orientation to prevent and care for suicide risk among LGB young adults. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
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Open AccessArticle Daily Patterns of Preschoolers’ Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study
Int. J. Environ. Res. Public Health 2018, 15(2), 291; doi:10.3390/ijerph15020291
Received: 10 November 2017 / Revised: 15 January 2018 / Accepted: 23 January 2018 / Published: 7 February 2018
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Abstract
This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current
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This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers’ step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs (p < 0.01) and clearly reflected the kindergartens’ daily schedules, except for Germany. For example, low numbers of steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school) policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers. Full article
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
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Open AccessArticle Influential Effects of Intrinsic-Extrinsic Incentive Factors on Management Performance in New Energy Enterprises
Int. J. Environ. Res. Public Health 2018, 15(2), 292; doi:10.3390/ijerph15020292
Received: 11 December 2017 / Revised: 1 February 2018 / Accepted: 3 February 2018 / Published: 8 February 2018
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Abstract
Background: New energy has become a key trend for global energy industry development. Talent plays a very critical role in the enhancement of new energy enterprise competitiveness. As a key component of talent, managers have been attracting more and more attention. The
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Background: New energy has become a key trend for global energy industry development. Talent plays a very critical role in the enhancement of new energy enterprise competitiveness. As a key component of talent, managers have been attracting more and more attention. The increase in job performance relies on, to a certain extent, incentive mechanism. Based on the Two-factor Theory, differences in influences and effects of different incentives on management performance have been checked in this paper from an empirical perspective. Methods: This paper selects the middle and low level managers in new energy enterprises as research samples and classifies the managers’ performance into task performance, contextual performance and innovation performance. It uses manager performance questionnaires and intrinsic-extrinsic incentive factor questionnaires to investigate and study the effects and then uses Amos software to analyze the inner link between the intrinsic-extrinsic incentives and job performance. Results: Extrinsic incentives affect task performance and innovation performance positively. Intrinsic incentives impose active significant effects on task performance, contextual performance, and innovation performance. The intrinsic incentive plays a more important role than the extrinsic incentive. Conclusions: Both the intrinsic-extrinsic incentives affect manager performance positively and the intrinsic incentive plays a more important role than the extrinsic incentive. Several suggestions to management should be given based on these results. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Environmental Intolerance, Symptoms and Disability Among Fertile-Aged Women
Int. J. Environ. Res. Public Health 2018, 15(2), 293; doi:10.3390/ijerph15020293
Received: 23 January 2018 / Revised: 4 February 2018 / Accepted: 6 February 2018 / Published: 8 February 2018
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Abstract
The purpose was to study the prevalence of environmental intolerance (EI) and its different manifestations, including behavioral changes and disability. Fertile-aged women (n = 680) of the Kuopio Birth Cohort Study were asked about annoyance to 12 environmental factors, symptoms and behavioral
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The purpose was to study the prevalence of environmental intolerance (EI) and its different manifestations, including behavioral changes and disability. Fertile-aged women (n = 680) of the Kuopio Birth Cohort Study were asked about annoyance to 12 environmental factors, symptoms and behavioral changes. We asked how much the intolerance had disrupted their work, household responsibilities or social life. We chose intolerance attributed to chemicals, indoor molds, and electromagnetic fields to represent typical intolerance entities. Of the respondents, 46% reported annoyance to chemicals, molds, or electromagnetic fields. Thirty-three percent reported symptoms relating to at least one of these three EIs, 18% reported symptoms that included central nervous system symptoms, and 15% reported behavioral changes. Indicating disability, 8.4% reported their experience relating to any of the three EIs as at least “somewhat difficult”, 2.2% “very difficult” or “extremely difficult”, and 0.9% “extremely difficult”. Of the latter 2.2%, all attributed their intolerance to indoor molds, and two thirds also to chemicals. As the number of difficulties increased, the number of organ systems, behavioral changes and overlaps of the three EIs also grew. EI is a heterogeneous phenomenon and its prevalence depends on its definition. The manifestations of EI form a continuum, ranging from annoyance to severe disability. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Disease and Economic Burden of Hospitalizations Attributable to Diabetes Mellitus and Its Complications: A Nationwide Study in Brazil
Int. J. Environ. Res. Public Health 2018, 15(2), 294; doi:10.3390/ijerph15020294
Received: 16 November 2017 / Revised: 20 January 2018 / Accepted: 1 February 2018 / Published: 8 February 2018
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Abstract
Diabetes is associated with a significant burden globally. The costs of diabetes-related hospitalizations are unknown in most developing countries. The aim of this study was to estimate the total number and economic burden of hospitalizations attributable to diabetes mellitus (DM) and its complications
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Diabetes is associated with a significant burden globally. The costs of diabetes-related hospitalizations are unknown in most developing countries. The aim of this study was to estimate the total number and economic burden of hospitalizations attributable to diabetes mellitus (DM) and its complications in adults from the perspective of the Brazilian Public Health System in 2014. Data sources included the National Health Survey (NHS) and National database of Hospitalizations (SIH). We considered diabetes, its microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular complications (coronary heart disease, cerebrovascular disease, and peripheral arterial disease), respiratory and urinary tract infections, as well as selected cancers. Assuming that DM patients are hospitalized for these conditions more frequently that non-DM individuals, we estimated the etiological fraction of each condition related to DM, using the attributable risk methodology. We present number, average cost per case, and overall costs of hospitalizations attributable to DM in Brazil in 2014, stratified by condition, state of the country, gender and age group. In 2014, a total of 313,273 hospitalizations due to diabetes in adults were reported in Brazil (4.6% of total adult hospitalization), totaling (international dollar) Int$264.9 million. The average cost of an adult hospitalization due to diabetes was Int$845, 19% higher than hospitalization without DM. Hospitalizations due to cardiovascular diseases related to diabetes accounted for the higher proportion of costs (47.9%), followed by microvascular complications (25.4%) and DM per se (18.1%). Understanding the costs of diabetes and its major complications is crucial to raise awareness and to support the decision-making process on policy implementation, also allowing the assessment of prevention and control strategies. Full article
Open AccessArticle The Impact of Sustainable Development Technology on a Small Economy—The Case of Energy-Saving Technology
Int. J. Environ. Res. Public Health 2018, 15(2), 295; doi:10.3390/ijerph15020295
Received: 13 December 2017 / Revised: 1 February 2018 / Accepted: 5 February 2018 / Published: 8 February 2018
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Abstract
We investigated the impact of a sustainable development technology on the macroeconomic variables in a small economy utilizing a case study with a stochastically improving energy saving technology and a stochastically increasing energy price. The results show the technological displacement effects of energy
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We investigated the impact of a sustainable development technology on the macroeconomic variables in a small economy utilizing a case study with a stochastically improving energy saving technology and a stochastically increasing energy price. The results show the technological displacement effects of energy saving technology are stronger, but there are more ambiguous instantaneous returns to physical capital. However, the energy saving technology’s displacement effects might not affect the conditions under which the Harberger-Laursen-Metzler (HLM) effect holds. The effects of rising energy prices on bonds are stronger, and there are more ambiguous instantaneous returns, but the conditions under which the HLM effect holds are different. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle The Roles of Three Types of Knowledge and Perceived Uncertainty in Explaining Risk Perception, Acceptability, and Self-Protective Response—A Case Study on Endocrine Disrupting Surfactants
Int. J. Environ. Res. Public Health 2018, 15(2), 296; doi:10.3390/ijerph15020296
Received: 3 December 2017 / Revised: 22 January 2018 / Accepted: 6 February 2018 / Published: 8 February 2018
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Abstract
The ubiquitous surfactants nonylphenol (NP) and its ethoxylates (NPEOs), which are known as endocrine disrupters, have appeared in the lists of restricted chemical substances, monitoring programs, and environmental quality standards of many countries due to their adverse effects. Recent studies have reported alarming
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The ubiquitous surfactants nonylphenol (NP) and its ethoxylates (NPEOs), which are known as endocrine disrupters, have appeared in the lists of restricted chemical substances, monitoring programs, and environmental quality standards of many countries due to their adverse effects. Recent studies have reported alarming levels of NP, as the final metabolite of NPEOs, in Vietnamese urban waters, whilst response to this issue is negligible. With the aim of addressing how the public perceives and expects to avoid the risk of endocrine disrupting surfactants (EDSs), the study tested the hypothesized roles of specific knowledge, general knowledge, and perceived uncertainty using structural equation modelling. The findings revealed that different types of knowledge played certain roles in explaining risk perception, risk acceptability, and self-protective response, which are distinguished by experience amongst the public. Evidence of the mediating role that perceived uncertainty may play in the decrease of risk perception and the increase of risk unacceptance has been provided. The insights gained from the study may help answer why the public are in favor of taking non-diet-related self-protective measures rather than changing their dietary habits, which illustrates a comparison with the basis of health belief model. The needs for building cognitive capacity amongst the public, particularly pregnant women and young mothers, and risk communication concerning endocrine disrupting contamination linked to reproductive health are highlighted. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle A Qualitative Exploration of the Role of Vape Shop Environments in Supporting Smoking Abstinence
Int. J. Environ. Res. Public Health 2018, 15(2), 297; doi:10.3390/ijerph15020297
Received: 15 December 2017 / Revised: 19 January 2018 / Accepted: 27 January 2018 / Published: 9 February 2018
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E-cigarettes are the most popular method of quitting smoking in England and most are purchased in specialist vape shops. This qualitative study explores how the vape shop environment is experienced by quitters to support smoking abstinence. Semi-structured qualitative interviews were conducted to elicit
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E-cigarettes are the most popular method of quitting smoking in England and most are purchased in specialist vape shops. This qualitative study explores how the vape shop environment is experienced by quitters to support smoking abstinence. Semi-structured qualitative interviews were conducted to elicit experiences of e-cigarette use, including experiences of vape shops, in 40 people who had used e-cigarettes in a quit attempt. Observations of six shops in a range of locations were also undertaken. Interview and observation data were analysed using inductive thematic analysis and triangulated. At an individual level, smoking abstinence was supported through shop assistants’ attempts to understand customers’ smoking preferences in order to: (i) tailor advice about the most appropriate product; and (ii) offer an ongoing point of contact for practical help. At an interpersonal level, shops offered opportunity to socialise and reinforce a vaping identity, although the environment was perceived as intimidating for some (e.g., new and female users). At a structural level, shops ensured easy access to products perceived to be good value by customers and had adapted to legislative changes. Vape shops can provide effective behavioural support to quitters to maintain smoking abstinence. Health professionals could capitalise on this through partnership working with shops, to ensure best outcomes for clients wanting to use e-cigarettes to quit smoking. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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Open AccessArticle Suicidal Ideation among Youth Living in the Slums of Kampala, Uganda
Int. J. Environ. Res. Public Health 2018, 15(2), 298; doi:10.3390/ijerph15020298
Received: 16 January 2018 / Revised: 4 February 2018 / Accepted: 5 February 2018 / Published: 9 February 2018
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Abstract
The purpose of this study is to examine the factors associated with suicidal ideation among youth living in the slums of Kampala, Uganda. Analyses are based on cross-sectional survey data, collected in 2014, of a convenience sample (n = 1134) of urban
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The purpose of this study is to examine the factors associated with suicidal ideation among youth living in the slums of Kampala, Uganda. Analyses are based on cross-sectional survey data, collected in 2014, of a convenience sample (n = 1134) of urban service-seeking youth participating in a Uganda Youth Development Link drop-in center. Logistic regression analyses were computed to determine the psychosocial factors associated with suicidal ideation. Among youth participants, 23.54% (n = 266) reported suicidal ideation in the past year. In the multivariable analysis, suicidal ideation was associated with being female (OR: 1.61; 95% CI: 1.15, 2.25), reporting one (OR: 1.51; 95% CI: 1.05, 2.18) or two deceased parents (OR: 1.55; 95% CI: 1.03, 2.35), ever living on the streets (OR: 2.65; 95% CI: 1.86, 3.79), problem drinking (OR: 1.83; 95% CI: 1.19, 2.80), sexually transmitted infection (OR: 1.59; 95% CI: 1.14, 2.21), ever being raped (OR: 1.49; 95% CI: 1.01, 2.20), and experiencing physical child abuse (OR: 2.40; 95% CI: 1.75, 3.27). Our findings underscore many unmet needs in this vulnerable population. However, strategies that specifically seek to address problem drinking—a modifiable risk factor for suicidal ideation—may be particularly warranted in this low-resource setting. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle Urinary Arsenic in Human Samples from Areas Characterized by Natural or Anthropogenic Pollution in Italy
Int. J. Environ. Res. Public Health 2018, 15(2), 299; doi:10.3390/ijerph15020299
Received: 19 December 2017 / Revised: 30 January 2018 / Accepted: 7 February 2018 / Published: 9 February 2018
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Abstract
Arsenic is ubiquitous and has a potentially adverse impact on human health. We compared the distribution of concentrations of urinary inorganic arsenic plus methylated forms (uc(iAs+MMA+DMA)) in four Italian areas with other international studies, and we assessed the relationship between uc(iAs+MMA+DMA) and various
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Arsenic is ubiquitous and has a potentially adverse impact on human health. We compared the distribution of concentrations of urinary inorganic arsenic plus methylated forms (uc(iAs+MMA+DMA)) in four Italian areas with other international studies, and we assessed the relationship between uc(iAs+MMA+DMA) and various exposure factors. We conducted a human biomonitoring study on 271 subjects (132 men) aged 20–44, randomly sampled and stratified by area, gender, and age. Data on environmental and occupational exposure and dietary habits were collected through a questionnaire. Arsenic was speciated using chromatographic separation and inductively coupled mass spectrometry. Associations between uc(iAs+MMA+DMA) and exposure factors were evaluated using the geometric mean ratio (GMR) with a 90% confidence interval by stepwise multiple regression analysis. The 95th percentile value of uc(iAs+MMA+DMA) for the whole sample (86.28 µg/L) was higher than other national studies worldwide. A statistical significant correlation was found between uc(iAs+MMA+DMA) and occupational exposure (GMR: 2.68 [1.79–4.00]), GSTT gene (GMR: 0.68 [0.52–0.80]), consumption of tap water (GMR: 1.35 [1.02–1.77]), seafood (GMR: 1.44 [1.11–1.88]), whole milk (GMR: 1.34 [1.04–1.73]), and fruit/vegetables (GMR: 1.37 [1.03–1.82]). This study demonstrated the utility of uc(iAs+MMA+DMA) as a biomarker to assess environmental exposure. In a public health context, this information could be used to support remedial action, to prevent individuals from being further exposed to environmental arsenic sources. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessFeature PaperArticle An Experimental Exploration of the Effects of Exposure to Images of Nature on Rumination
Int. J. Environ. Res. Public Health 2018, 15(2), 300; doi:10.3390/ijerph15020300
Received: 23 December 2017 / Revised: 29 January 2018 / Accepted: 5 February 2018 / Published: 9 February 2018
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Abstract
Exposure to natural environments has been shown to have beneficial effects on mood. Rumination is a thinking style associated with negative mood, and sometimes depression, and is characterized by repetitive, intrusive thoughts, often with a negative emotional element. This study investigated whether exposure
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Exposure to natural environments has been shown to have beneficial effects on mood. Rumination is a thinking style associated with negative mood, and sometimes depression, and is characterized by repetitive, intrusive thoughts, often with a negative emotional element. This study investigated whether exposure to nature, operationalized using photographs presented as a slideshow, could aid reduction in levels of state rumination. An experimental, within-between (Time x Condition) participant design was used; participants (n = 58) undertook a presentation task designed to induce rumination and influence mood. Participants were then randomly allocated to either: watch a slideshow of a natural environment, watch a slideshow of an urban environment, or wait patiently with no distractions. Data were collected at baseline, after the presentation, and after the slideshow. Environmental exposure had no effect on levels of rumination or negative mood, but did have a significant effect on levels of positive mood, ‘being away’, and ‘fascination’. Positive mood declined in those who saw the urban slideshow, but remained the same in those who saw the nature slideshow, whilst levels of being away and fascination were highest in those who saw the nature slideshow. This study extends previous restorative environment research by exploring the effects of nature on rumination. Full article
(This article belongs to the Special Issue Stress and Health)
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Open AccessArticle Perceived Environmental Factors Associated with Obesity in Libyan Men and Women
Int. J. Environ. Res. Public Health 2018, 15(2), 301; doi:10.3390/ijerph15020301
Received: 14 December 2017 / Revised: 29 January 2018 / Accepted: 6 February 2018 / Published: 9 February 2018
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Abstract
Background: There is a lack of research pertaining to the links between built environment attributes and obesity in adults in the Eastern Mediterranean Region. In the Libyan context, no previous studies have been conducted to investigate this relationship. Therefore, the aim of
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Background: There is a lack of research pertaining to the links between built environment attributes and obesity in adults in the Eastern Mediterranean Region. In the Libyan context, no previous studies have been conducted to investigate this relationship. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and obesity among Libyan men and women. The prevalence of overweight and obesity was also assessed. Methods: A cross-sectional study design was used for the population-based survey in Benghazi, Libya. A multi-stage cluster sampling technique was used to select Libyan adults from the Benghazi electoral register. The Physical Activity Neighbourhood Environment Scale (PANES) was used to measure participants’ perception of neighbourhood environmental factors. Using the Tanita BC-601 Segmental Body Composition Monitor and a portable stadiometer, anthropometric measurements were taken at a mutually agreeable place by qualified nurses. Results: Four hundred and one Libyan adults were recruited (78% response rate). Participants were aged 20–65 years, 63% were female, and all had lived in Benghazi for over 10 years. The prevalence of obesity and overweight was 42.4% and 32.9% respectively. A significant association was found between BMI and 6 neighbourhood environment attributes, specifically: street connectivity, unsafe environment and committing crimes at night, and neighbourhood aesthetics. For men only, these were: access to public transport, access to recreational facilities, and unsafe environment and committing crimes during the day. The attribute ‘residential density zones’ was only significant for women. Conclusions: The study suggests that Libyan people are at risk of living in neighbourhoods with unsupportive environmental features of physical activity, which are likely to promote obesity of both genders. The findings of this study could inform Libyan health policies about interventions in the obesogenic environments that might slow the obesity epidemic and contain the public health crisis. This study suggests that further research is needed, within the Libyan context, to explore the impact of the neighbourhood environment attributes on contributing to increased obesity. Full article
Open AccessArticle “I Was Relieved to Know That My Baby Was Safe”: Women’s Attitudes and Perceptions on Using a New Electronic Fetal Heart Rate Monitor during Labor in Tanzania
Int. J. Environ. Res. Public Health 2018, 15(2), 302; doi:10.3390/ijerph15020302
Received: 15 December 2017 / Revised: 5 February 2018 / Accepted: 7 February 2018 / Published: 9 February 2018
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Abstract
To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this
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To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively. We carried out 20 semi-structured individual interviews post-labor at two hospitals in Tanzania. A thematic content analysis was used to analyze the data. Our results indicated that the use of the monitor positively affected the women’s birth experience. It provided much-needed reassurance about the wellbeing of the child. The women considered that wearing Moyo improved care due to an increase in communication and attention from birth attendants. However, the women did not fully understand the purpose and function of the device and overestimated its capabilities. This highlights the need to improve how and when information is conveyed to women in labor. Full article
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Open AccessArticle Walking Outdoors during Seminars Improved Perceived Seminar Quality and Sense of Well-Being among Participants
Int. J. Environ. Res. Public Health 2018, 15(2), 303; doi:10.3390/ijerph15020303
Received: 18 December 2017 / Revised: 18 January 2018 / Accepted: 7 February 2018 / Published: 9 February 2018
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Abstract
Low levels of physical activity and sedentary behaviour are a growing health problem globally. Physical inactivity is associated with increased risk of numerous ailments, cardiovascular disease and mortality. Our primary aim was to perform a feasibility study on how to incorporate physical activity
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Low levels of physical activity and sedentary behaviour are a growing health problem globally. Physical inactivity is associated with increased risk of numerous ailments, cardiovascular disease and mortality. Our primary aim was to perform a feasibility study on how to incorporate physical activity among students and teachers in regular teaching activities. The second aim was to investigate how students and teachers perceived the differences between outdoor walking seminars and regular indoor seminars. By transforming an on-campus course into a blended course, we were able to conduct seminars outdoors in nearby nature while walking. These walking seminars were evaluated among 131 students and nine teachers leading the walking seminars. The responses to the student survey and teacher interviews indicate that discussions, sense of well-being and the general quality of the seminar improved, regardless of how physically active participants were the rest of the time. The study shows one way to increase physical activity with small means; in our case, a reorganization of how we prepared for the seminars which allowed for walking discussions. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Solid Particle Number Emission Factors of Euro VI Heavy-Duty Vehicles on the Road and in the Laboratory
Int. J. Environ. Res. Public Health 2018, 15(2), 304; doi:10.3390/ijerph15020304
Received: 22 December 2017 / Revised: 2 February 2018 / Accepted: 5 February 2018 / Published: 9 February 2018
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Abstract
Particulate matter (PM), and in particular ultrafine particles, have a negative impact on human health. The contribution of vehicle PM emissions to air pollution is typically quantified with emission inventories, which need vehicle emission factors as input. Heavy-duty vehicles, although they represent a
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Particulate matter (PM), and in particular ultrafine particles, have a negative impact on human health. The contribution of vehicle PM emissions to air pollution is typically quantified with emission inventories, which need vehicle emission factors as input. Heavy-duty vehicles, although they represent a small percentage of the vehicle population in nearly every major country, contribute the majority of the on-road PM emissions. However, the published data of modern heavy-duty vehicle emissions are scarce, and for the newest Euro VI technologies, almost non-existent. The main objective of this paper is to present Solid Particle Number (SPN) emission factors from Euro VI heavy-duty vehicles using diesel, Compressed Natural Gas (CNG), or Liquefied Natural Gas (LNG). Urban, rural and motorway (highway) emissions were determined on the road at various European cities using SPN Portable Emission Measurement Systems (PEMS). Additional tests on a heavy-duty chassis dynamometer showed that the solid sub-23 nm fraction, which is not covered at the moment in the European regulation, is high, especially for CNG engines. The significant contribution of regeneration events and the effect of ambient temperature and engine cold-start on particle emissions were also discussed. Full article
(This article belongs to the Special Issue Air Quality and Health)
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Open AccessArticle A Longitudinal Study of Predictors for Adolescent Electronic Cigarette Experimentation and Comparison with Conventional Smoking
Int. J. Environ. Res. Public Health 2018, 15(2), 305; doi:10.3390/ijerph15020305
Received: 14 December 2017 / Revised: 1 February 2018 / Accepted: 6 February 2018 / Published: 9 February 2018
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Abstract
Little is known of the predictors of electronic cigarette (e-cigarette) use among adolescents, even though the use is increasing. We studied here the predictors for e-cigarette experimentation (tried and tried more than twice) and compared them with predictors for conventional smoking. A baseline
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Little is known of the predictors of electronic cigarette (e-cigarette) use among adolescents, even though the use is increasing. We studied here the predictors for e-cigarette experimentation (tried and tried more than twice) and compared them with predictors for conventional smoking. A baseline school survey was conducted in the Helsinki metropolitan area, Finland, in 2011 for seventh graders (12 to 13-year-olds). Response rate was 73%. The same students were followed up in 2014 (9th grade, 15 to 16-year-olds), N = 5742. Generalized linear mixed models controlling for school clustering were used. In the follow-up, 43.3% of boys and 25.6% of girls had tried e-cigarettes and 21.9% and 8.1% correspondingly more than twice. The strongest predictors for both genders were conventional smoking, drunkenness and energy drink use. Furthermore, poor academic achievement predicted e-cigarette experimentation for both genders, and for boys, participation in team sports was a predictor. The predictors for experimenting and for experimenting more than twice were very similar, except for boys’ participation in team sports. They were also similar compared to the predictors of conventional smoking but the associations were weaker. To conclude, smoking and other addictive behaviors predict adolescents’ experimentation with e-cigarettes. Family’s socioeconomic background had little significance. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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Open AccessArticle Taking Action on Air Pollution Control in the Beijing-Tianjin-Hebei (BTH) Region: Progress, Challenges and Opportunities
Int. J. Environ. Res. Public Health 2018, 15(2), 306; doi:10.3390/ijerph15020306
Received: 1 January 2018 / Revised: 23 January 2018 / Accepted: 29 January 2018 / Published: 9 February 2018
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Abstract
Due to rapid urbanization, industrialization and motorization, a large number of Chinese cities are affected by heavy air pollution. In order to explore progress, remaining challenges, and sustainability of air pollution control in the Beijing-Tianjin-Hebei (BTH) region after 2013, a mixed method analysis
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Due to rapid urbanization, industrialization and motorization, a large number of Chinese cities are affected by heavy air pollution. In order to explore progress, remaining challenges, and sustainability of air pollution control in the Beijing-Tianjin-Hebei (BTH) region after 2013, a mixed method analysis was undertaken. The quantitative analysis comprised an overview of air quality management in the BTH region. Semi-structured expert interviews were conducted with 12 stakeholders from various levels of government and research institutions who played substantial roles either in decision-making or in research and advising on air pollution control in the BTH region. The results indicated that with the stringent air pollution control policies, the air quality in BTH meets the targets of the Air Pollution Prevention and Control Action Plan. However, improvements vary across the region and for different pollutants. Although implementation has been decisive and was at least in parts effectively enforced, significant challenges remained with regard to industrial and traffic emission control, and national air quality limits continued to be significantly exceeded and competing development interests remained mainly unsolved. There were also concerns about the sustainability of the current air pollution control measures especially for industries due to the top-down enforcement, and the associated large burden of social cost including unemployment and social inequity resulting industrial restructuring. Better mechanisms for ensuring cross-sectoral coordination and for improved central-local government communication were suggested. Further suggestions were provided to improve the conceptual design and effective implementation of respective air pollution control strategies in BTH. Our study highlights some of the major hurdles that need to be addressed to succeed with a comprehensive air pollution control management for the Chinese mega-urban agglomerations. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Acute Effects of Ambient PM2.5 on All-Cause and Cause-Specific Emergency Ambulance Dispatches in Japan
Int. J. Environ. Res. Public Health 2018, 15(2), 307; doi:10.3390/ijerph15020307
Received: 19 December 2017 / Revised: 7 February 2018 / Accepted: 9 February 2018 / Published: 9 February 2018
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Abstract
Short-term health effects of ambient PM2.5 have been established with numerous studies, but evidence in Asian countries is limited. This study aimed to investigate the short-term effects of PM2.5 on acute health outcomes, particularly all-cause, cardiovascular, respiratory, cerebrovascular and neuropsychological outcomes.
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Short-term health effects of ambient PM2.5 have been established with numerous studies, but evidence in Asian countries is limited. This study aimed to investigate the short-term effects of PM2.5 on acute health outcomes, particularly all-cause, cardiovascular, respiratory, cerebrovascular and neuropsychological outcomes. We utilized daily emergency ambulance dispatches (EAD) data from eight Japanese cities (2007–2011). Statistical analyses included two stages: (1) City-level generalized linear model with Poisson distribution; (2) Random-effects meta-analysis in pooling city-specific effect estimates. Lag patterns were explored using (1) unconstrained-distributed lags (lag 0 to lag 7) and (2) average lags (lag: 0–1, 0–3, 0–5, 0–7). In all-cause EAD, significant increases were observed in both shorter lag (lag 0: 1.24% (95% CI: 0.92, 1.56)) and average lag 0–1 (0.64% (95% CI: 0.23, 1.06)). Increases of 1.88% and 1.48% in respiratory and neuropsychological EAD outcomes, respectively, were observed at lag 0 per 10 µg/m3 increase in PM2.5. While respiratory outcomes demonstrated significant average effects, no significant effect was observed for cardiovascular outcomes. Meanwhile, an inverse association was observed in cerebrovascular outcomes. In this study, we observed that effects of PM2.5 on all-cause, respiratory and neuropsychological EAD were acute, with average effects not exceeding 3 days prior to EAD onset. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle The Uncertain Geographic Context Problem in the Analysis of the Relationships between Obesity and the Built Environment in Guangzhou
Int. J. Environ. Res. Public Health 2018, 15(2), 308; doi:10.3390/ijerph15020308
Received: 28 December 2017 / Revised: 3 February 2018 / Accepted: 5 February 2018 / Published: 10 February 2018
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Abstract
Traditionally, static units of analysis such as administrative units are used when studying obesity. However, using these fixed contextual units ignores environmental influences experienced by individuals in areas beyond their residential neighborhood and may render the results unreliable. This problem has been articulated
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Traditionally, static units of analysis such as administrative units are used when studying obesity. However, using these fixed contextual units ignores environmental influences experienced by individuals in areas beyond their residential neighborhood and may render the results unreliable. This problem has been articulated as the uncertain geographic context problem (UGCoP). This study investigates the UGCoP through exploring the relationships between the built environment and obesity based on individuals’ activity space. First, a survey was conducted to collect individuals’ daily activity and weight information in Guangzhou in January 2016. Then, the data were used to calculate and compare the values of several built environment variables based on seven activity space delineations, including home buffers, workplace buffers (WPB), fitness place buffers (FPB), the standard deviational ellipse at two standard deviations (SDE2), the weighted standard deviational ellipse at two standard deviations (WSDE2), the minimum convex polygon (MCP), and road network buffers (RNB). Lastly, we conducted comparative analysis and regression analysis based on different activity space measures. The results indicate that significant differences exist between variables obtained with different activity space delineations. Further, regression analyses show that the activity space delineations used in the analysis have a significant influence on the results concerning the relationships between the built environment and obesity. The study sheds light on the UGCoP in analyzing the relationships between obesity and the built environment. Full article
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Open AccessArticle Gender Difference and Spatial Heterogeneity in Local Obesity
Int. J. Environ. Res. Public Health 2018, 15(2), 311; doi:10.3390/ijerph15020311
Received: 30 January 2018 / Revised: 5 February 2018 / Accepted: 9 February 2018 / Published: 10 February 2018
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Abstract
This study asks if there is gender-specific spatial heterogeneity in local obesity. By using the 2015 Korea Community Health Survey and employing spatial analyses, this study found that there is considerable gender-specific spatial heterogeneity in local obesity rates. More specifically, we found that:
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This study asks if there is gender-specific spatial heterogeneity in local obesity. By using the 2015 Korea Community Health Survey and employing spatial analyses, this study found that there is considerable gender-specific spatial heterogeneity in local obesity rates. More specifically, we found that: (1) local obesity rates are more spatially dependent for women than for men; (2) environmental factors, in general, have stronger effects on local obesity rates for women than for men; (3) environmental factors have more spatially varying effects on local obesity rates for women than for men. Based on these findings, we suggest that policies for obesity prevention should not be based on the assumption of spatial homogeneity and gender indifference, but rather should be refined based on gender-specific spatial heterogeneity in local obesity. Full article
(This article belongs to the Special Issue Obesity and Urban Environments)
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Open AccessArticle Rapid Screening of Cadmium in Rice and Identification of Geographical Origins by Spectral Method
Int. J. Environ. Res. Public Health 2018, 15(2), 312; doi:10.3390/ijerph15020312
Received: 7 January 2018 / Revised: 26 January 2018 / Accepted: 6 February 2018 / Published: 11 February 2018
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Abstract
The accuracy, repeatability and detection limits of the energy-dispersive X-ray fluorescence (XRF) spectrometer used in this study were tested to verify its suitability for rapid screening of cadmium in samples. Concentrations of cadmium in rice grain samples were tested by the XRF spectrometer.
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The accuracy, repeatability and detection limits of the energy-dispersive X-ray fluorescence (XRF) spectrometer used in this study were tested to verify its suitability for rapid screening of cadmium in samples. Concentrations of cadmium in rice grain samples were tested by the XRF spectrometer. The results showed that the apparatus had good precision around the national limit value (0.2 mg/kg). Raman spectroscopy has been analyzed in the discrimination of rice grain samples from different geographical origins within China. Scanning time has been discussed in order to obtain better Raman features of rice samples. A total of 31 rice samples were analyzed. After spectral data pre-treatment, principal component analysis (PCA), K-means clustering (KMC), hierarchical clustering (HC) and support vector machine (SVM) were performed to discriminate origins of rice samples. The results showed that the geographical origins of rice could be classified using Raman spectroscopy combined with multivariate analysis. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle A Descriptive Longitudinal Study of Changes in Vape Shop Characteristics and Store Policies in Anticipation of the 2016 FDA Regulations of Tobacco Products, Including E-Cigarettes
Int. J. Environ. Res. Public Health 2018, 15(2), 313; doi:10.3390/ijerph15020313
Received: 5 December 2017 / Revised: 27 January 2018 / Accepted: 6 February 2018 / Published: 11 February 2018
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Abstract
After proposing the “Deeming Rule” in 2014, the U.S. Food and Drug Administration (FDA) began regulating the manufacturing, marketing, and sales of electronic cigarette (e-cigarette) products as tobacco products in 2016. The current study conducted vape shop store observations and surveyed Los Angeles–area
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After proposing the “Deeming Rule” in 2014, the U.S. Food and Drug Administration (FDA) began regulating the manufacturing, marketing, and sales of electronic cigarette (e-cigarette) products as tobacco products in 2016. The current study conducted vape shop store observations and surveyed Los Angeles–area shop employees (assessing their beliefs, awareness, and perceptions of e-cigarettes and related FDA regulations) at two time points one year apart to better understand what vape shop retailers would do given FDA’s soon-to-be-enacted Deeming Rule. The study also compared retailer beliefs/awareness/actions and store characteristics immediately after the Deeming Rule proposal versus a year after the Rule had been proposed, right before its enactment. Two data collection waves occurred before the Deeming Rule enactment, with Year 1 surveying 77 shops (2014) and Year 2 surveying 61 shops (2015–2016). Between the data collection points, 16 shops had closed. Among the shops that were open at both time points, the majority (95% in Year 1; 74% in Year 2) were aware of some FDA regulations or other policies applying to vape shops. However, overall awareness of FDA regulations and state/local policies governing e-cigarettes significantly decreased from Year 1 to Year 2. At both time points, all shops offered customers free puffs of nicotine-containing e-liquids (prohibited by the then upcoming Deeming Rule). Perceptions of e-cigarette safety also significantly decreased between the years. Exploring vape shop retailer perceptions and store policies (i.e., free puffs/samples displays, perceptions of e-cigarette safety, etc.) over time will help the FDA assess the needs of the vape shop community and develop more effective retailer education campaigns and materials targeted to increase compliance with the newly enacted regulations. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
Open AccessArticle Biosorption of Cadmium by Non-Toxic Extracellular Polymeric Substances (EPS) Synthesized by Bacteria from Marine Intertidal Biofilms
Int. J. Environ. Res. Public Health 2018, 15(2), 314; doi:10.3390/ijerph15020314
Received: 10 January 2018 / Revised: 4 February 2018 / Accepted: 7 February 2018 / Published: 11 February 2018
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Abstract
Cadmium is a major hea