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Int. J. Environ. Res. Public Health, Volume 15, Issue 4 (April 2018)

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Editorial

Jump to: Research, Review, Other

Open AccessEditorial Why Are New Tobacco Control Interventions Needed?
Int. J. Environ. Res. Public Health 2018, 15(4), 658; doi:10.3390/ijerph15040658
Received: 23 March 2018 / Revised: 26 March 2018 / Accepted: 27 March 2018 / Published: 2 April 2018
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Abstract
It has been known for years which policies and interventions work to decrease tobacco use in the population[...] Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
Open AccessEditorial Emerging Trends in Health Promotion for People with Disabilities
Int. J. Environ. Res. Public Health 2018, 15(4), 742; doi:10.3390/ijerph15040742
Received: 10 April 2018 / Revised: 10 April 2018 / Accepted: 10 April 2018 / Published: 13 April 2018
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Abstract
The need among people with disabilities to improve their own health and prevent/manage secondary conditions requires a better balance between reactive and anticipatory care. Full article
(This article belongs to the Special Issue Health Promotion Interventions for People with Disabilities)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Cycling for Transportation in Sao Paulo City: Associations with Bike Paths, Train and Subway Stations
Int. J. Environ. Res. Public Health 2018, 15(4), 562; doi:10.3390/ijerph15040562
Received: 8 December 2017 / Revised: 28 February 2018 / Accepted: 2 March 2018 / Published: 21 March 2018
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Abstract
Cities that support cycling for transportation reap many public health benefits. However, the prevalence of this mode of transportation is low in Latin American countries and the association with facilities such as bike paths and train/subway stations have not been clarified. We conducted
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Cities that support cycling for transportation reap many public health benefits. However, the prevalence of this mode of transportation is low in Latin American countries and the association with facilities such as bike paths and train/subway stations have not been clarified. We conducted a cross-sectional analysis of the relationship between bike paths, train/subway stations and cycling for transportation in adults from the city of Sao Paulo. We used data from the Sao Paulo Health Survey (n = 3145). Cycling for transportation was evaluated by a questionnaire and bike paths and train/subway stations were geocoded using the geographic coordinates of the adults’ residential addresses in 1500-m buffers. We used multilevel logistic regression, taking account of clustering by census tract and households. The prevalence of cycling for transportation was low (5.1%), and was more prevalent in males, singles, those active in leisure time, and in people with bicycle ownership in their family. Cycling for transportation was associated with bike paths up to a distance of 500 m from residences (OR (Odds Ratio) = 2.54, 95% CI (Confidence interval) 1.16–5.54) and with the presence of train/subway stations for distances >500 m from residences (OR = 2.07, 95% CI 1.10–3.86). These results are important to support policies to improve cycling for transportation in megacities such as Sao Paulo. Full article
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Open AccessArticle Towards the Identification of an In Vitro Tool for Assessing the Biological Behavior of Aerosol Supplied Nanomaterials
Int. J. Environ. Res. Public Health 2018, 15(4), 563; doi:10.3390/ijerph15040563
Received: 27 February 2018 / Revised: 16 March 2018 / Accepted: 19 March 2018 / Published: 21 March 2018
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Abstract
Nanoparticles (NP)-based inhalation systems for drug delivery can be administered in liquid form, by nebulization or using pressurized metered dose inhalers, and in solid form by means of dry powder inhalers. However, NP delivery to the lungs has many challenges including the formulation
[...] Read more.
Nanoparticles (NP)-based inhalation systems for drug delivery can be administered in liquid form, by nebulization or using pressurized metered dose inhalers, and in solid form by means of dry powder inhalers. However, NP delivery to the lungs has many challenges including the formulation instability due to particle-particle interactions and subsequent aggregation, causing poor deposition in the small distal airways and subsequent alveolar macrophages activity, which could lead to inflammation. This work aims at providing an in vitro experimental design for investigating the correlation between the physico-chemical properties of NP, and their biological behavior, when they are used as NP-based inhalation treatments, comparing two different exposure systems. By means of an aerosol drug delivery nebulizer, human lung cells cultured at air–liquid interface (ALI) were exposed to two titanium dioxide NP (NM-100 and NM-101), obtained from the JRC repository. In parallel, ALI cultures were exposed to NP suspension by direct inoculation, i.e., by adding the NP suspensions on the apical side of the cell cultures with a pipette. The formulation stability of NP, measured as hydrodynamic size distributions, the cell viability, cell monolayer integrity, cell morphology and pro-inflammatory cytokines secretion were investigated. Our results demonstrated that the formulation stability of NM-100 and NM-101 was strongly dependent on the aggregation phenomena that occur in the conditions adopted for the biological experiments. Interestingly, comparable biological data between the two exposure methods used were observed, suggesting that the conventional exposure coupled to ALI culturing conditions offers a relevant in vitro tool for assessing the correlation between the physico-chemical properties of NP and their biological behavior, when NP are used as drug delivery systems. Full article
(This article belongs to the Special Issue Nano-Bio Interactions: Nanomedicine and Nanotoxicology)
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Open AccessArticle Black–White Differences in Housing Type and Sleep Duration as Well as Sleep Difficulties in the United States
Int. J. Environ. Res. Public Health 2018, 15(4), 564; doi:10.3390/ijerph15040564
Received: 11 December 2017 / Revised: 10 March 2018 / Accepted: 16 March 2018 / Published: 21 March 2018
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Abstract
Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health.
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Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004–2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02–1.08)) and women (PR = 1.07 (95% CI: 1.04–1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21–1.30)) and women (PR = 1.24 (95% CI: 1.20–1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race–sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities. Full article
(This article belongs to the Special Issue Sleep Health)
Open AccessArticle Modelling a Compensation Standard for a Regional Forest Ecosystem: A Case Study in Yanqing District, Beijing, China
Int. J. Environ. Res. Public Health 2018, 15(4), 565; doi:10.3390/ijerph15040565
Received: 22 January 2018 / Revised: 16 March 2018 / Accepted: 19 March 2018 / Published: 21 March 2018
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Abstract
The assessment of forest ecosystem services can quantify the impact of these services on human life and is the main basis for formulating a standard of compensation for these services. Moreover, the calculation of the indirect value of forest ecosystem services should not
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The assessment of forest ecosystem services can quantify the impact of these services on human life and is the main basis for formulating a standard of compensation for these services. Moreover, the calculation of the indirect value of forest ecosystem services should not be ignored, as has been the case in some previous publications. A low compensation standard and the lack of a dynamic coordination mechanism are the main problems existing in compensation implementation. Using comparison and analysis, this paper employed accounting for both the costs and benefits of various alternatives. The analytic hierarchy process (AHP) method and the Pearl growth-curve method were used to adjust the results. This research analyzed the contribution of each service value from the aspects of forest produce services, ecology services, and society services. We also conducted separate accounting for cost and benefit, made a comparison of accounting and evaluation methods, and estimated the implementation period of the compensation standard. The main conclusions of this research include the fact that any compensation standard should be determined from the points of view of both benefit and cost in a region. The results presented here allow the range between the benefit and cost compensation to be laid out more reasonably. The practical implications of this research include the proposal that regional decision-makers should consider a dynamic compensation method to meet with the local economic level by using diversified ways to raise the compensation standard, and that compensation channels should offer a mixed mode involving both the market and government. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Estimating Vehicle Fuel Consumption and Emissions Using GPS Big Data
Int. J. Environ. Res. Public Health 2018, 15(4), 566; doi:10.3390/ijerph15040566
Received: 14 February 2018 / Revised: 12 March 2018 / Accepted: 20 March 2018 / Published: 21 March 2018
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Abstract
The energy consumption and emissions from vehicles adversely affect human health and urban sustainability. Analysis of GPS big data collected from vehicles can provide useful insights about the quantity and distribution of such energy consumption and emissions. Previous studies, which estimated fuel consumption/emissions
[...] Read more.
The energy consumption and emissions from vehicles adversely affect human health and urban sustainability. Analysis of GPS big data collected from vehicles can provide useful insights about the quantity and distribution of such energy consumption and emissions. Previous studies, which estimated fuel consumption/emissions from traffic based on GPS sampled data, have not sufficiently considered vehicle activities and may have led to erroneous estimations. By adopting the analytical construct of the space-time path in time geography, this study proposes methods that more accurately estimate and visualize vehicle energy consumption/emissions based on analysis of vehicles’ mobile activities (MA) and stationary activities (SA). First, we build space-time paths of individual vehicles, extract moving parameters, and identify MA and SA from each space-time path segment (STPS). Then we present an N-Dimensional framework for estimating and visualizing fuel consumption/emissions. For each STPS, fuel consumption, hot emissions, and cold start emissions are estimated based on activity type, i.e., MA, SA with engine-on and SA with engine-off. In the case study, fuel consumption and emissions of a single vehicle and a road network are estimated and visualized with GPS data. The estimation accuracy of the proposed approach is 88.6%. We also analyze the types of activities that produced fuel consumption on each road segment to explore the patterns and mechanisms of fuel consumption in the study area. The results not only show the effectiveness of the proposed approaches in estimating fuel consumption/emissions but also indicate their advantages for uncovering the relationships between fuel consumption and vehicles’ activities in road networks. Full article
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Open AccessCommunication Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA
Int. J. Environ. Res. Public Health 2018, 15(4), 567; doi:10.3390/ijerph15040567
Received: 9 February 2018 / Revised: 13 March 2018 / Accepted: 17 March 2018 / Published: 21 March 2018
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Abstract
Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with
[...] Read more.
Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle A Qualitative Study of Airborne Minerals and Associated Organic Compounds in Southeast of Cairo, Egypt
Int. J. Environ. Res. Public Health 2018, 15(4), 568; doi:10.3390/ijerph15040568
Received: 3 February 2018 / Revised: 24 February 2018 / Accepted: 27 February 2018 / Published: 21 March 2018
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Abstract
This study is concerned with the identification of the mineralogical composition of dust fall samples collected from southeast of Cairo, Egypt. The mineralogical identification was conducted by means of the polarizing microscope, infra-red spectroscopy (IR), and X-ray diffraction (XRD). The relationship between the
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This study is concerned with the identification of the mineralogical composition of dust fall samples collected from southeast of Cairo, Egypt. The mineralogical identification was conducted by means of the polarizing microscope, infra-red spectroscopy (IR), and X-ray diffraction (XRD). The relationship between the mineralogical composition of dust fall samples and 10 rock samples from the surrounding terrains were investigated. The major mineralogical species existing in the atmosphere of the study area are: carbonates mainly in the form of calcite in addition to the appearance of the dolomite form in traces overall the study area, but with considerable observation in the southern region; quartz which is less than calcite in its abundance; sulphates in the form of gypsum which may also be present as traces in the anhydrite form. Trace constitution of feldspars; clay minerals in the form of kaolinite, illite, and montimorillonite; and halite are also observable in the same samples. Organic compounds are present in the atmosphere of the area mainly as alkanes with presence of traces of phosphines. This study qualitatively shows the mineralogy of air particulate over rock processing area and the obtained results indicates that the main pollution source in the study area is the industrial activities with minor contribution of the natural sources, especially erosion and dust carried by winds from the surrounding terrains Cairo in the southern direction. This study provides useful results for the contribution of rock processing activities to the mineral composition of atmospheric particulates. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle A Stratified Meta-Analysis of the Association between Exposure to Environmental Tobacco Smoke during Childhood and Adulthood and Urothelial Bladder Cancer Risk
Int. J. Environ. Res. Public Health 2018, 15(4), 569; doi:10.3390/ijerph15040569
Received: 22 February 2018 / Revised: 17 March 2018 / Accepted: 19 March 2018 / Published: 22 March 2018
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Abstract
Background: Active smoking is a major risk factor for urothelial bladder cancer (UBC). However, the evidence that exposure to environmental tobacco smoke (ETS) either in childhood or adult life is also associated with UBC risk is ambiguous. With this meta-analysis, we aim
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Background: Active smoking is a major risk factor for urothelial bladder cancer (UBC). However, the evidence that exposure to environmental tobacco smoke (ETS) either in childhood or adult life is also associated with UBC risk is ambiguous. With this meta-analysis, we aim to summarise how exposure to ETS is associated with UBC risk. Methods: In total, 11 studies (3 cohort studies, 8 case-control studies) were included in this meta-analysis and summary odds ratios (SORs) for UBC risk were calculated for never smokers who were exposed to ETS during childhood at home, during adulthood at home, or during adulthood in a work environment compared to never smokers who were never exposed to ETS. Sensitivity analyses were conducted to test the robustness of findings. Results: Never smokers exposed to ETS during childhood (SOR = 1.04, 95% confidence interval (CI) = 0.82–1.26), during adulthood at work (SOR = 0.98, 95% CI = 0.78–1.18) or at home (SOR = 0.99, 95% CI = 0.83–1.15) were at a similar risk of UBC compared to never smokers who were never exposed to ETS. Results for males and females were similar. Also, when pooling all estimates during both childhood and adulthood, no effect was observed (SOR = 1.00, 95% CI = 0.89–1.10). Conclusions: Although measurement of exposure to ETS was imprecise, there does not seem to be an association between UBC risk and exposure to ETS during childhood or adulthood. However, the current body of evidence mostly overlooks the duration and intensity of exposure to ETS. Full article
(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)
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Open AccessArticle Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos
Int. J. Environ. Res. Public Health 2018, 15(4), 570; doi:10.3390/ijerph15040570
Received: 15 February 2018 / Revised: 12 March 2018 / Accepted: 12 March 2018 / Published: 22 March 2018
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Abstract
Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or
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Evidence of the impact of water, sanitation, and hygiene (WASH) in schools (WinS) interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS) study was a randomized controlled trial designed to measure the impact of the United Nations Children’s Fund (UNICEF) Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils’ school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times. Full article
(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)
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Open AccessArticle Horizontal and Vertical Distributions of Chromium in a Chromate Production District of South Central China
Int. J. Environ. Res. Public Health 2018, 15(4), 571; doi:10.3390/ijerph15040571
Received: 24 February 2018 / Revised: 13 March 2018 / Accepted: 19 March 2018 / Published: 22 March 2018
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Abstract
To study the horizontal and vertical distribution of chromium (Cr) in the soil of a chromate production site (CPS) and its nearby area (NA-CPS) in south central China, 61 profiles (depth: 14 m) in the CPS and 69 samples (topsoil) were excavated following
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To study the horizontal and vertical distribution of chromium (Cr) in the soil of a chromate production site (CPS) and its nearby area (NA-CPS) in south central China, 61 profiles (depth: 14 m) in the CPS and 69 samples (topsoil) were excavated following a grid-sampling method. The geographic coordinates, elevation, and types of soil layers were recorded, and the total Cr in the soil and the total Cr and Cr(VI) in the leachate of the soil and in the groundwater were determined. Migration of Cr in surface soils may be represented in terms of a multiple linear regression equation (R2adj = 0.632). Distance, elevation, and pH are the primary factors that influence the horizontal distribution of Cr content in the surface soils, while the Cr concentration in different soil profiles mostly obeys the positive or negative binomial distributions. For a positive distribution, the Cr concentration decreases with increasing depth in the 0.0–8.0 m soil layer, under the fixing effect of soil. However, it shows an upward trend with a depth in the 8–14 m soil layer under the influence of Cr-polluted phreatic water. Under a negative distribution, Cr content is stable in the 0–6 m layer because of the influence of chromite ore processing residue mixed with miscellaneous fills, but it decreases obviously in the 6–14 m layer under the fixing effect of soil. Similar vertical distributions were observed for pH, LCr, LCr6+, and PCr6+. The decreasing amplitude of the Cr concentration for binomial distributions is mainly affected by the Cr concentration, pH, and LRCr of the soil. Moreover, PCr6+ of soil increases with pH, and the type of soil layer is the primary factor influencing LRCr in the soil profiles. Our results of the horizontal and vertical distributions of Cr could be used to guide investigations that are focused on reducing the number of samples in the horizontal and vertical directions at CPSs, and to improve risk assessments of CPSs and nearby areas. Full article
(This article belongs to the Special Issue Soil Pollution and Remediation)
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Open AccessArticle Assessing the Effectiveness and Cost-Benefit of Test-and-Vaccinate Policy for Supplementary Vaccination against Rubella with Limited Doses
Int. J. Environ. Res. Public Health 2018, 15(4), 572; doi:10.3390/ijerph15040572
Received: 23 February 2018 / Revised: 18 March 2018 / Accepted: 21 March 2018 / Published: 22 March 2018
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Abstract
Elevating herd immunity level against rubella is essential to prevent congenital rubella syndrome (CRS). Insufficient vaccination coverage left susceptible pockets among adults in Japan, and the outbreak of rubella from 2012 to 2013 resulted in 45 observed CRS cases. Given a limited stock
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Elevating herd immunity level against rubella is essential to prevent congenital rubella syndrome (CRS). Insufficient vaccination coverage left susceptible pockets among adults in Japan, and the outbreak of rubella from 2012 to 2013 resulted in 45 observed CRS cases. Given a limited stock of rubella-containing vaccine (RCV) available, the Japanese government recommended healthcare providers to prioritize vaccination to those confirmed with low level of immunity, or to those likely to transmit to pregnant women. Although a test-and-vaccinate policy could potentially help reduce the use of the limited stockpile of vaccines, by selectively elevating herd immunity, the cost of serological testing is generally high and comparable to the vaccine itself. Here, we aimed to examine whether random vaccination would be more cost-beneficial than the test-and-vaccinate strategy. A mathematical model was employed to evaluate the vaccination policy implemented in 2012–2013, quantifying the benefit-to-cost ratio to achieve herd immunity. The modelling exercise demonstrated that, while the test-and-vaccinate strategy can efficiently achieve herd immunity when stockpiles of RCV are limited, random vaccination would be a more cost-beneficial strategy. As long as the herd immunity acts as the goal of vaccination, our findings apply to future supplementary immunization strategy. Full article
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Open AccessArticle Real-Time Estimation of Population Exposure to PM2.5 Using Mobile- and Station-Based Big Data
Int. J. Environ. Res. Public Health 2018, 15(4), 573; doi:10.3390/ijerph15040573
Received: 5 March 2018 / Revised: 16 March 2018 / Accepted: 16 March 2018 / Published: 23 March 2018
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Abstract
Extremely high fine particulate matter (PM2.5) concentration has been a topic of special concern in recent years because of its important and sensitive relation with health risks. However, many previous PM2.5 exposure assessments have practical limitations, due to the assumption
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Extremely high fine particulate matter (PM2.5) concentration has been a topic of special concern in recent years because of its important and sensitive relation with health risks. However, many previous PM2.5 exposure assessments have practical limitations, due to the assumption that population distribution or air pollution levels are spatially stationary and temporally constant and people move within regions of generally the same air quality throughout a day or other time periods. To deal with this challenge, we propose a novel method to achieve the real-time estimation of population exposure to PM2.5 in China by integrating mobile-phone locating-request (MPL) big data and station-based PM2.5 observations. Nationwide experiments show that the proposed method can yield the estimation of population exposure to PM2.5 concentrations and cumulative inhaled PM2.5 masses with a 3-h updating frequency. Compared with the census-based method, it introduced the dynamics of population distribution into the exposure estimation, thereby providing an improved way to better assess the population exposure to PM2.5 at different temporal scales. Additionally, the proposed method and dataset can be easily extended to estimate other ambient pollutant exposures such as PM10, O3, SO2, and NO2, and may hold potential utilities in supporting the environmental exposure assessment and related policy-driven environmental actions. Full article
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Open AccessArticle The Association between Potential Exposure to Magazine Ads with Voluntary Health Warnings and the Perceived Harmfulness of Electronic Nicotine Delivery Systems (ENDS)
Int. J. Environ. Res. Public Health 2018, 15(4), 575; doi:10.3390/ijerph15040575
Received: 8 January 2018 / Revised: 20 March 2018 / Accepted: 21 March 2018 / Published: 23 March 2018
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Abstract
(1) Background: Several brands of electronic nicotine delivery systems (ENDS) carry voluntary health warning messages. This study examined how potential exposure to ENDS magazine ads with these voluntary health warnings were associated with the perceived harmfulness of ENDS. (2) Methods: Risk perception measures
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(1) Background: Several brands of electronic nicotine delivery systems (ENDS) carry voluntary health warning messages. This study examined how potential exposure to ENDS magazine ads with these voluntary health warnings were associated with the perceived harmfulness of ENDS. (2) Methods: Risk perception measures and self-reported exposure to ENDS ads were obtained from the 2014 Georgia State University (GSU) Tobacco Products and Risk Perceptions Survey of a nationally representative sample of U.S. adults. We examined the association between potential exposure to magazine ads with warnings and the perceived harms of ENDS relative to cigarettes, using binary logistic regressions and controlling for general ENDS ad exposure and socio-demographic characteristics. (3) Results: Potential exposure to ENDS magazine ads with warnings was associated with a lower probability of considering ENDS to be more or equally harmful compared to cigarettes, particularly among non-smokers (OR = 0.16; 95% CI: 0.04–0.77). In addition, ad exposure, ENDS use history, race/ethnicity, gender, education, and income were also associated with harm perceptions. (4) Conclusions: This study did not find evidence that magazine ads with warnings increased misperceptions that ENDS are equally or more harmful than cigarettes. With more ENDS advertisements carrying warnings, more research is needed to determine how the warnings in advertisements convey relative harm information to consumers and the public. Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
Open AccessArticle Assessment of Potentially Toxic Elements as Non-Point Sources of Contamination in the Upper Crocodile Catchment Area, North-West Province, South Africa
Int. J. Environ. Res. Public Health 2018, 15(4), 576; doi:10.3390/ijerph15040576
Received: 28 February 2018 / Revised: 15 March 2018 / Accepted: 22 March 2018 / Published: 23 March 2018
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Abstract
The concentration of potential toxic elements (PTEs) in the Upper Crocodile river catchment area in North-west Province, South Africa, was investigated. Water and sediment samples were collected among different land uses in the upper Crocodile River catchment area and analysed using inductively-coupled plasma–mass
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The concentration of potential toxic elements (PTEs) in the Upper Crocodile river catchment area in North-west Province, South Africa, was investigated. Water and sediment samples were collected among different land uses in the upper Crocodile River catchment area and analysed using inductively-coupled plasma–mass spectrometry (ICP–MS). Several guidelines were used to gauge the level of contamination and possible toxic effect of PTEs. The physicochemical analysis showed that electrical conductivity (EC), pH, and total dissolved solids (TDS) values complied with the recommended values of Department of Water and Forestry (DWAF) guidelines for South Africa. The average concentration of Cu, Pb, Cd, Zn, As, Cr, Al, and Mn in the water samples were lower than the recommended levels for water-quality guidelines for aquatic environments except for Fe, which exceeded the recommended values of DWAF of 0.1 mg/L and EPA (US) of 0.3 mg/L. The level of contamination was measured using the enrichment factor, contamination factor, and geoaccumulation index. The level of Cr was above the stipulated threshold limit of the sediment quality guideline for adverse biological effects, suggesting an ecotoxicology risk of anthropogenic origin, which was confirmed by statistical analysis. The non-point sources of PTEs are spatially distributed according to land-use types and are strongly correlated to land use. Full article
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Open AccessArticle How Long Are Cancer Patients Waiting for Oncological Therapy in Poland?
Int. J. Environ. Res. Public Health 2018, 15(4), 577; doi:10.3390/ijerph15040577
Received: 23 February 2018 / Revised: 19 March 2018 / Accepted: 20 March 2018 / Published: 23 March 2018
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Abstract
Background: The five-year relative survival rate in Poland is approximately 10% lower compared with the average for Europe. One of the factors that may contribute to the inferior treatment results in Poland could be the long time between cancer suspicion and the beginning
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Background: The five-year relative survival rate in Poland is approximately 10% lower compared with the average for Europe. One of the factors that may contribute to the inferior treatment results in Poland could be the long time between cancer suspicion and the beginning of treatment. The aim of the study was to determine the real waiting time for cancer diagnosis and treatment in Poland. Methods: The study was carried out in six cancer centers on a group of 1373 patients, using a questionnaire to interview patients. The median waiting time was estimated as follows: (A) from suspicion (the date of the first visit, with symptoms, to a doctor or a preventive or screening test) until histopathological diagnosis; (B) from suspicion until initial treatment; and (C) from diagnosis until initial treatment. Results: The median times from suspicion to treatment, from suspicion to diagnosis, and from diagnosis to treatment, were 10.6, 5.6, and 5.0 weeks, respectively. Using multivariate analysis, the strongest influence was estimated, in a case of tumor localization, to be the method of initial treatment and facilities. Conclusion: The waiting time for cancer treatment in Poland is too long. The highest influence on waiting time was determined, in the case of tumors, as the type of cancer and factors related to the health care system. Full article
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Open AccessArticle Investigating the Effect of Personality, Internet Literacy, and Use Expectancies in Internet-Use Disorder: A Comparative Study between China and Germany
Int. J. Environ. Res. Public Health 2018, 15(4), 579; doi:10.3390/ijerph15040579
Received: 18 January 2018 / Revised: 13 March 2018 / Accepted: 19 March 2018 / Published: 23 March 2018
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Abstract
Research on Internet-use Disorder (IUD) has increased rapidly, indicating its clinical and global importance. Past studies suggested cultural diversity regarding the prevalence of an IUD, e.g., between Asian and European countries. Additionally, it was found that personality factors, Internet-related cognitions and specific competences
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Research on Internet-use Disorder (IUD) has increased rapidly, indicating its clinical and global importance. Past studies suggested cultural diversity regarding the prevalence of an IUD, e.g., between Asian and European countries. Additionally, it was found that personality factors, Internet-related cognitions and specific competences seem to influence IUD tendencies, but research lacks in cultural comparative studies regarding these mechanisms. This study focuses on differences between Germany and China regarding the above-mentioned characteristics. German (n = 411; M = 20.70 years, SD = 3.34 years) and Chinese participants (n = 410; M = 20.72 years, SD = 2.65 years) answered the short Internet Addiction Test, Big Five Inventories, the Internet-use Expectancies Scale, as well as the Internet Literacy Questionnaire. The results revealed higher occurrence of IUD symptoms in China. Furthermore, Chinese participants scored significantly higher on neuroticism and agreeableness, whereas German participants scored higher on extraversion and openness. Compared to German participants, Chinese showed higher expectancies to avoid negative feelings online and to be positively reinforced. Regarding Internet literacy, German participants indicated higher skills concerning the reflection and critical analysis of online content, whereas Chinese showed higher expertise in producing and interacting online. Further, simple slope analyses indicated that certain Internet literacy domains were related differentially to IUD symptoms in Germany and China. While Chinese participants with higher reflective skills indicated highest IUD symptoms, reflective skills revealed no effect in Germany. Additionally, higher self-regulative skills correlated with lower IUD symptoms in the German, but not in the Chinese sample. The results give a hint to potential cultural differences regarding IUD, especially on the predictive and protective role of Internet literacy domains. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
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Open AccessArticle Mortality and Morbidity during Extreme Heat Events and Prevalence of Outdoor Work: An Analysis of Community-Level Data from Los Angeles County, California
Int. J. Environ. Res. Public Health 2018, 15(4), 580; doi:10.3390/ijerph15040580
Received: 16 February 2018 / Revised: 20 March 2018 / Accepted: 20 March 2018 / Published: 23 March 2018
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Abstract
Heat is a well-recognized hazard for workers in many outdoor settings, yet few investigations have compared the prevalence of outdoor work at the community level and rates of heat-related mortality and morbidity. This analysis examines whether heat-related health outcomes occur more frequently in
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Heat is a well-recognized hazard for workers in many outdoor settings, yet few investigations have compared the prevalence of outdoor work at the community level and rates of heat-related mortality and morbidity. This analysis examines whether heat-related health outcomes occur more frequently in communities with higher proportions of residents working in construction, agriculture, and other outdoor industries. Using 2005–2010 data from Los Angeles County, California, we analyze associations between community-level rates of deaths, emergency department (ED) visits, and hospitalizations during summer heat events and the prevalence of outdoor work. We find generally higher rates of heat-related ED visits and hospitalizations during summer heat events in communities with more residents working outdoors. Specifically, each percentage increase in residents working in construction resulted in an 8.1 percent increase in heat-related ED visits and a 7.9 percent increase in heat-related hospitalizations, while each percentage increase in residents working in agriculture and related sectors resulted in a 10.9 percent increase in heat-related ED visits. The findings suggest that outdoor work may significantly influence the overall burden of heat-related morbidity at the community level. Public health professionals and healthcare providers should recognize work and employment as significant heat risk factors when preparing for and responding to extreme heat events. Full article
(This article belongs to the Special Issue Public Health and Disasters)
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Open AccessArticle Lack of Substantial Post-Cessation Weight Increase in Electronic Cigarettes Users
Int. J. Environ. Res. Public Health 2018, 15(4), 581; doi:10.3390/ijerph15040581
Received: 23 January 2018 / Revised: 20 March 2018 / Accepted: 21 March 2018 / Published: 23 March 2018
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Abstract
Minimization of post-cessation weight gain in quitters is important, but existing approaches (e.g., antismoking medications) shows only limited success. We investigated changes in body weight in smokers who quit or reduced substantially their cigarette consumption by switching to electronic cigarettes (ECs) use. Body
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Minimization of post-cessation weight gain in quitters is important, but existing approaches (e.g., antismoking medications) shows only limited success. We investigated changes in body weight in smokers who quit or reduced substantially their cigarette consumption by switching to electronic cigarettes (ECs) use. Body weight and smoking/vaping history were extracted from medical records of smokers and ex-smokers to match three study groups: (1) regular EC users on at least two consecutive follow-up visits; (2) regular smokers (and not using ECs); (3) subjects who reported sustained smoking abstinence after completing a cessation program. Review of their medical records was conducted at two follow-up visits at 6- (F/U 6m) and 12-months (F/U 12m). A total of 86 EC users, 93 regular smokers, and 44 quitters were studied. In the EC users study group, cigarettes/day use decreased from 21.1 at baseline to 1.8 at F/U 12m (p < 0.0001). Dual usage was reported by approximately 50% of EC users. Both within factor (time, p < 0.0001) and between factor (study groups, p < 0.0001) produced significant effect on weight (% change from baseline), with a significant 4.8% weight gain from baseline in the quitters study group at F/U 12m. For the EC users, weight gain at F/U 12m was only 1.5% of baseline. There was no evidence of post-cessation weight increase in those who reduced substantially cigarette consumption by switching to ECs (i.e., dual users) and only modest post-cessation weight increase was reported in exclusive EC users at F/U 12m. By reducing weight gain and tobacco consumption, EC-based interventions may promote an overall improvement in quality of life. Full article
(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)
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Open AccessArticle Spatiotemporal Characteristics and Health Risk Assessment of Heavy Metals in PM2.5 in Zhejiang Province
Int. J. Environ. Res. Public Health 2018, 15(4), 583; doi:10.3390/ijerph15040583
Received: 12 February 2018 / Revised: 9 March 2018 / Accepted: 23 March 2018 / Published: 24 March 2018
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Abstract
The spatiotemporal characteristics and human health risks of 12 heavy metals (Al, As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sb, Se, and Tl) in fine particulate matter (PM2.5) in Zhejiang Province were investigated. The annual average PM2.5 concentration was
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The spatiotemporal characteristics and human health risks of 12 heavy metals (Al, As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sb, Se, and Tl) in fine particulate matter (PM2.5) in Zhejiang Province were investigated. The annual average PM2.5 concentration was 58.83 µg/m3 in 2015 in Zhejiang. Element contents in PM2.5 varied greatly with the season and locations. Al, Pb, and Mn were the most abundant elements among the studied metal(loid)s in PM2.5. The non-carcinogenic risks of the 12 elements through inhalation and dermal contact exposure were lower than the safe level for children and adults. However, there were potential non-carcinogenic risks of Tl, As, and Sb for children and Tl for adults through ingestion exposure. The carcinogenic risks from As, Be, Cd, Cr, Pb, and Ni through inhalation exposure were less than the acceptable level (1 × 10−4) for children and adults. Pb may carry a potential carcinogenic risk for both children and adults through ingestion. More attention should be paid to alleviate non-carcinogenic and carcinogenic health risks posed by particle-bound toxic elements through ingestion exposure. Full article
(This article belongs to the Special Issue Climate Change, Extreme Temperatures, Air Pollution, and Health)
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Open AccessArticle Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution
Int. J. Environ. Res. Public Health 2018, 15(4), 584; doi:10.3390/ijerph15040584
Received: 16 February 2018 / Revised: 21 March 2018 / Accepted: 22 March 2018 / Published: 24 March 2018
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Abstract
Few studies have focused on the relation between the use and characteristics of footwear and the presence of foot lesions in people with psychiatric disorders. This work analyzes the influence of different footwear habits on the presence of deformities and ungueal and dermal
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Few studies have focused on the relation between the use and characteristics of footwear and the presence of foot lesions in people with psychiatric disorders. This work analyzes the influence of different footwear habits on the presence of deformities and ungueal and dermal pathologies of the foot of institutionalized people with psychiatric disorders compared to people without these disorders. A transversal and observational study was conducted on 107 participants, divided into two groups who have used different types of shoes throughout their lives. The control group comprised 63 autonomous people who mainly use leather footwear and a study group of 44 institutionalized people with intellectual disabilities and psychiatric disorders who mainly use textile footwear. There were significant differences between populations. The group with psychiatric disorders presented more xerosis and hyperkeratosis. Footwear with inappropriate characteristics is a possible causal agent of skin alterations. Wearing footwear with quality textile uppers, e.g., fabric or felt, could influence the appearance of these alterations. Leather footwear is recommended for institutionalized people to reduce symptoms of xerosis and improve their quality of life. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
Open AccessArticle Influence of Algae Age and Population on the Response to TiO2 Nanoparticles
Int. J. Environ. Res. Public Health 2018, 15(4), 585; doi:10.3390/ijerph15040585
Received: 2 February 2018 / Revised: 21 March 2018 / Accepted: 21 March 2018 / Published: 25 March 2018
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Abstract
This work shows the influence of algae age (at the time of the exposure) and the initial algae population on the response of green algae Raphidocelis subcapitata to titanium dioxide nanoparticles (TiO2 NPs). The different algae age was obtained by changes in
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This work shows the influence of algae age (at the time of the exposure) and the initial algae population on the response of green algae Raphidocelis subcapitata to titanium dioxide nanoparticles (TiO2 NPs). The different algae age was obtained by changes in flow rate of continually stirred tank reactors prior to NP exposure. Increased algae age led to a decreased growth, variations in chlorophyll content, and an increased lipid peroxidation. Increased initial algae population (0.3−4.2 × 106 cells/mL) at a constant NP concentration (100 mg/L) caused a decline in the growth of algae. With increased initial algae population, the lipid peroxidation and chlorophyll both initially decreased and then increased. Lipid peroxidation had 4× the amount of the control at high and low initial population but, at mid-ranged initial population, had approximately half the control value. Chlorophyll a results also showed a similar trend. These results indicate that the physiological state of the algae is important for the toxicological effect of TiO2 NPs. The condition of algae and exposure regime must be considered in detail when assessing the toxicological response of NPs to algae. Full article
(This article belongs to the Special Issue Nano-Bio Interactions: Nanomedicine and Nanotoxicology)
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Open AccessArticle Association between Cervical Spondylosis and Migraine: A Nationwide Retrospective Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(4), 587; doi:10.3390/ijerph15040587
Received: 6 February 2018 / Revised: 22 March 2018 / Accepted: 22 March 2018 / Published: 25 March 2018
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Abstract
Background: Few studies have investigated the longitudinal association between cervical spondylosis (CS) and migraine by using a nationwide population-based database. Methods: We conducted a retrospective cohort study from 2000 to 2011 identifying 27,930 cases of cervical spondylosis and 111,720 control subjects (those without
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Background: Few studies have investigated the longitudinal association between cervical spondylosis (CS) and migraine by using a nationwide population-based database. Methods: We conducted a retrospective cohort study from 2000 to 2011 identifying 27,930 cases of cervical spondylosis and 111,720 control subjects (those without cervical spondylosis) from a single database. The subjects were frequency-matched on the basis of sex, age, and diagnosis date. The non- cervical spondylosis cohort was four times the size of the cervical spondylosis cohort. To quantify the effects of cervical spondylosis on the risk of migraine, univariate and multivariate Cox proportional hazard regression analyses were used to calculate the hazard ratio (HR), and 95% confidence interval (CI). Results: After a 10-year follow-up controlling for potential confounding factors, overall migraine incidence was higher in the cervical spondylosis cohort than in the non-cervical spondylosis cohort (5.16 and 2.09 per 1000 people per year, respectively; crude hazard ratio = 2.48, 95% confidence interval = 2.28–2.69), with an adjusted hazard ratio of 2.03 (95% confidence interval = 1.86–2.22) after accounting for sex, age, comorbidities, and medication. Individuals with myelopathy in the cervical spondylosis cohort had a 2.19 times (95% confidence interval = 1.80–2.66) higher incidence of migraine when compared than did those in the non- cervical spondylosis cohort. Conclusions: Individuals with cervical spondylosis exhibited a higher risk of migraine than those without cervical spondylosis. The migraine incidence rate was even higher among individuals with cervical spondylotic myelopathy. Full article
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Open AccessArticle Roma Housing and Eating in 1775 and 2013: A Comparison
Int. J. Environ. Res. Public Health 2018, 15(4), 588; doi:10.3390/ijerph15040588
Received: 15 February 2018 / Revised: 14 March 2018 / Accepted: 22 March 2018 / Published: 25 March 2018
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Abstract
We compared housing and the eating habits of Roma. Contemporary findings (2013) were compared with those from the first monothematic work on Roma (1775), which depicts their housing and eating habits, especially regarding the differences between social classes. Data were obtained from a
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We compared housing and the eating habits of Roma. Contemporary findings (2013) were compared with those from the first monothematic work on Roma (1775), which depicts their housing and eating habits, especially regarding the differences between social classes. Data were obtained from a journal (1775) and from semi-structured interviews (2013) with more than 70 Roma women and men who live in segregated and excluded settlements at the edges of villages or scattered among the majority. Data were collected in two villages and one district town in the Tatra region, where the data from the 1775 measurements originated. We used classical sociological theory to interpret the obtained data. The main findings showed differences between specific social classes then and now regarding housing, as well as the eating habits related to both conditions among the Roma in the Tatra region. The houses of rich Roma families did not differ from the houses of the majority population. The huts of the poorest inhabitants of settlements did not meet any hygiene standards. Typical Roma foods such as gója or marikľa were the traditional foods of Slovak peasants living in poverty in the country. We concluded that the housing and eating habits of the citizens of poor settlements located in the eastern parts of Slovakia are still similar to those of two centuries ago. The existing social exclusion may be explained partly from this finding. Full article
(This article belongs to the Special Issue Roma Health)
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Open AccessArticle Concentrations of 2,4-Dichlorophenol and 2,5-Dichlorophenol in Urine of Korean Adults
Int. J. Environ. Res. Public Health 2018, 15(4), 589; doi:10.3390/ijerph15040589
Received: 14 February 2018 / Revised: 20 March 2018 / Accepted: 20 March 2018 / Published: 25 March 2018
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Abstract
Humans are exposed to the environmental pollutants 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) through air, the use of water and the consumption of products. In this study, we evaluated the urinary concentrations of these compounds in Korean people between the ages of 18 to
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Humans are exposed to the environmental pollutants 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) through air, the use of water and the consumption of products. In this study, we evaluated the urinary concentrations of these compounds in Korean people between the ages of 18 to 69 years, by making use of data from the Korean National Human Biomonitoring Survey that was completed in 2009. Of 1865 representative Koreans, 63.4% and 97.9% were found to have concentrations of 2,4-DCP and 2,5-DCP > 0.05 μg/L (limit of detection) in their urine, respectively. The geometric mean of urinary concentrations was 0.14 μg/L (confidence interval of 95% = 0.13–0.16) and 0.44 μg/L (confidence interval = 0.41–0.48), respectively. It was found that the adjusted proportional changes in 2,4-DCP concentrations were significantly associated with body mass index, whereas those of 2,5-DCP concentrations were influenced by place of residence. From these findings, it is evident that most adults in Korea have levels of 2,4-DCP and 2,5-DCP that are detectable in their urine and the burden of these compounds on their bodies varies depending on numerous demographic factors. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Trauma and Depression among North Korean Refugees: The Mediating Effect of Negative Cognition
Int. J. Environ. Res. Public Health 2018, 15(4), 591; doi:10.3390/ijerph15040591
Received: 24 January 2018 / Revised: 16 March 2018 / Accepted: 19 March 2018 / Published: 25 March 2018
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Abstract
North Korean refugees experience adaptation difficulties, along with a wide range of psychological problems. Accordingly, this study examined the associations between early traumatic experiences, negative automatic thoughts, and depression among young North Korean refugees living in South Korea. Specifically, we examined how different
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North Korean refugees experience adaptation difficulties, along with a wide range of psychological problems. Accordingly, this study examined the associations between early traumatic experiences, negative automatic thoughts, and depression among young North Korean refugees living in South Korea. Specifically, we examined how different factors of negative automatic thoughts would mediate the relationship between early trauma and depressive symptoms. A total of 109 North Korean refugees aged 13–29 years were recruited from two alternative schools. Our path analysis indicated that early trauma was positively linked with thoughts of personal failure, physical threat, and hostility, but not with thoughts of social threat. The link with depressive symptoms was only significant for thoughts of personal failure. After removing all non-significant pathways, the model revealed that early traumatic experiences were positively associated with depressive symptoms (ß = 0.61, 95% CI = 0.48–0.73) via thoughts of personal failure (ß = 0.17, 95% CI = 0.08–0.28), as well as directly (ß = 0.44, 95% CI = 0.27–0.59). Interventions that target negative cognitions of personal failure may be helpful for North Korean refugees at risk of depression. Full article
(This article belongs to the Special Issue Refugee, Migrant and Ethnic Minority Health)
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Open AccessArticle Exploring Geographic Variation of Mental Health Risk and Service Utilization of Doctors and Hospitals in Toronto: A Shared Component Spatial Modeling Approach
Int. J. Environ. Res. Public Health 2018, 15(4), 593; doi:10.3390/ijerph15040593
Received: 27 January 2018 / Revised: 6 March 2018 / Accepted: 20 March 2018 / Published: 26 March 2018
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Abstract
Mental Health has been known to vary geographically. Different rates of utilization of mental health services in local areas reflect geographic variation of mental health and complexity of health care. Variations and inequalities in how the health care system addresses risks are two
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Mental Health has been known to vary geographically. Different rates of utilization of mental health services in local areas reflect geographic variation of mental health and complexity of health care. Variations and inequalities in how the health care system addresses risks are two critical issues for addressing population mental health. This study examines these issues by analyzing the utilization of mental health services in Toronto at the neighbourhood level. We adopted a shared component spatial modeling approach that allows simultaneous analysis of two main health service utilizations: doctor visits and hospitalizations related to mental health conditions. Our results reflect a geographic variation of both types of mental health service utilization across neighbourhoods in Toronto. We identified hot and cold spots of mental health risks that are common to both or specific to only one type of health service utilization. Based on the evidence found, we discuss intervention strategies, focusing on the hotspots and provision of health services about doctors and hospitals, to improve mental health for the neighbourhoods. Limitations of the study and further research directions are also discussed. Full article
(This article belongs to the Special Issue Health Systems and Services)
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Open AccessArticle Classification Accuracy of a Wearable Activity Tracker for Assessing Sedentary Behavior and Physical Activity in 3–5-Year-Old Children
Int. J. Environ. Res. Public Health 2018, 15(4), 594; doi:10.3390/ijerph15040594
Received: 21 February 2018 / Revised: 19 March 2018 / Accepted: 23 March 2018 / Published: 26 March 2018
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Abstract
This study examined the accuracy of the Fitbit activity tracker (FF) for quantifying sedentary behavior (SB) and varying intensities of physical activity (PA) in 3–5-year-old children. Twenty-eight healthy preschool-aged children (Girls: 46%, Mean age: 4.8 ± 1.0 years) wore the FF and were
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This study examined the accuracy of the Fitbit activity tracker (FF) for quantifying sedentary behavior (SB) and varying intensities of physical activity (PA) in 3–5-year-old children. Twenty-eight healthy preschool-aged children (Girls: 46%, Mean age: 4.8 ± 1.0 years) wore the FF and were directly observed while performing a set of various unstructured and structured free-living activities from sedentary to vigorous intensity. The classification accuracy of the FF for measuring SB, light PA (LPA), moderate-to-vigorous PA (MVPA), and total PA (TPA) was examined calculating Pearson correlation coefficients (r), mean absolute percent error (MAPE), Cohen’s kappa (k), sensitivity (Se), specificity (Sp), and area under the receiver operating curve (ROC-AUC). The classification accuracies of the FF (ROC-AUC) were 0.92, 0.63, 0.77 and 0.92 for SB, LPA, MVPA and TPA, respectively. Similarly, values of kappa, Se, Sp and percentage of correct classification were consistently high for SB and TPA, but low for LPA and MVPA. The FF demonstrated excellent classification accuracy for assessing SB and TPA, but lower accuracy for classifying LPA and MVPA. Our findings suggest that the FF should be considered as a valid instrument for assessing time spent sedentary and overall physical activity in preschool-aged children. Full article
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
Open AccessArticle What Persons with Chronic Health Conditions Need to Maintain or Return to Work—Results of an Online-Survey in Seven European Countries
Int. J. Environ. Res. Public Health 2018, 15(4), 595; doi:10.3390/ijerph15040595
Received: 11 January 2018 / Revised: 19 March 2018 / Accepted: 22 March 2018 / Published: 26 March 2018
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Abstract
Chronic health conditions represent the major share of the disease burden in Europe and have a significant impact on work. This study aims to: (1) identify factors that have a negative or positive impact on the work lives of persons with chronic health
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Chronic health conditions represent the major share of the disease burden in Europe and have a significant impact on work. This study aims to: (1) identify factors that have a negative or positive impact on the work lives of persons with chronic health conditions; (2) explore the needs of these persons to maintain a job or return to work and (3) compare these results with respect to these persons’ occupational status. An online survey was performed in seven European countries. Open-ended survey questions were analyzed using qualitative methods. In total, 487 participants with six chronic health conditions participated. The majority of participants named work-related aspects (such as career development, stress at the workplace, work structure and schedule as well as workload), support of others and attitudes of others as being the factors positively and negatively impact their work lives the most. Our study shed light on the importance of changing the attitudes of supervisors and co-workers to counteract stigmatization of persons with chronic health conditions in the workplace. In conclusion, this study provides a basis for developing new strategies of integration and reintegration at work for persons with chronic health conditions in European countries. Full article
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Open AccessArticle Physical Activity Environment and Japanese Adults’ Body Mass Index
Int. J. Environ. Res. Public Health 2018, 15(4), 596; doi:10.3390/ijerph15040596
Received: 14 February 2018 / Revised: 15 March 2018 / Accepted: 20 March 2018 / Published: 26 March 2018
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Abstract
Evidence about the impacts of the physical activity environment on adults’ weight in the context of Asian countries is scarce. Likewise, no study exists in Asia examining whether Walk Score®—a free online walkability tool—is related to obesity. This study aimed to
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Evidence about the impacts of the physical activity environment on adults’ weight in the context of Asian countries is scarce. Likewise, no study exists in Asia examining whether Walk Score®—a free online walkability tool—is related to obesity. This study aimed to examine associations between multiple physical activity environment measures and Walk Score® ratings with Japanese adults’ body mass index (BMI). Data from 1073 adults in the Healthy Built Environment in Japan study were used. In 2011, participants reported their height and weight. Environmental attributes, including population density, intersection density, density of physical activity facilities, access to public transportation, and availability of sidewalks, were calculated using Geographic Information Systems. Walk Scores® ratings were obtained from the website. Multiple linear regression analysis was conducted to examine the association between each environmental attribute and BMI. Adjusting for covariates, all physical activity environmental attributes were negatively associated with BMI. Similarly, an increase of one standard deviation of Walk Score® was associated with a 0.29 (95% confidence interval (CI) of −0.49–−0.09) decrease in BMI. An activity-friendly built environment was associated with lower adults’ BMI in Japan. Investing in healthy community design may positively impact weight status in non-Western contexts. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Microplastic Contamination of Wild and Captive Flathead Grey Mullet (Mugil cephalus)
Int. J. Environ. Res. Public Health 2018, 15(4), 597; doi:10.3390/ijerph15040597
Received: 2 February 2018 / Revised: 20 March 2018 / Accepted: 23 March 2018 / Published: 26 March 2018
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Abstract
A total of 60 flathead grey mullets were examined for microplastic ingestion. Thirty wild mullets were captured from the eastern coast of Hong Kong and 30 captive mullets were obtained from fish farms. Microplastic ingestion was detected in 60% of the wild mullets,
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A total of 60 flathead grey mullets were examined for microplastic ingestion. Thirty wild mullets were captured from the eastern coast of Hong Kong and 30 captive mullets were obtained from fish farms. Microplastic ingestion was detected in 60% of the wild mullets, with an average of 4.3 plastic items per mullet, while only 16.7% of captive mullets were found to have ingested microplastics, with an average of 0.2 items per mullet. The results suggested that wild mullets have a higher risk of microplastic ingestion than their captive counterparts. The most common plastic items were fibres that were green in colour and small in size (<2 mm). Polypropylene was the most common polymer (42%), followed by polyethylene (25%). In addition, the abundance of microplastics was positively correlated with larger body size among the mullets. Full article
(This article belongs to the Special Issue Microplastics: Hazards to Environmental and Human Health)
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Open AccessArticle Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels
Int. J. Environ. Res. Public Health 2018, 15(4), 598; doi:10.3390/ijerph15040598
Received: 7 February 2018 / Revised: 22 March 2018 / Accepted: 22 March 2018 / Published: 26 March 2018
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Abstract
Several Travel-associated Legionnaires’ disease (TALD) cases occur annually in Europe. Except from the most obvious sites (cooling towers and hot water systems), infections can also be associated with recreational, water feature, and garden areas of hotels. This argument is of great interest to
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Several Travel-associated Legionnaires’ disease (TALD) cases occur annually in Europe. Except from the most obvious sites (cooling towers and hot water systems), infections can also be associated with recreational, water feature, and garden areas of hotels. This argument is of great interest to better comprehend the colonization and to calculate the risk to human health of these sites. From July 2000–November 2017, the public health authorities of the Island of Crete (Greece) inspected 119 hotels associated with TALD, as reported through the European Legionnaires’ Disease Surveillance Network. Five hundred and eighteen samples were collected from decorative fountain ponds, showers near pools and spas, swimming pools, spa pools, garden sprinklers, drip irrigation systems (reclaimed water) and soil. Of those, 67 (12.93%), originating from 43 (35.83%) hotels, tested positive for Legionella (Legionella pneumophila serogroups 1, 2, 3, 6, 7, 8, 13, 14, 15 and non-pneumophila species (L. anisa, L. erythra, L. taurinensis, L. birminghamensis, L. rubrilucens). A Relative Risk (R.R.) > 1 (p < 0.0001) was calculated for chlorine concentrations of less than 0.2 mg/L (R.R.: 54.78), star classification (<4) (R.R.: 4.75) and absence of Water Safety Plan implementation (R.R.: 3.96). High risk (≥104 CFU/L) was estimated for pool showers (16.42%), garden sprinklers (7.46%) and pool water (5.97%). Full article
(This article belongs to the Special Issue Recreational Water Illnesses)
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Open AccessFeature PaperArticle Duration of Breastfeeding, but Not Timing of Solid Food, Reduces the Risk of Overweight and Obesity in Children Aged 24 to 36 Months: Findings from an Australian Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(4), 599; doi:10.3390/ijerph15040599
Received: 9 February 2018 / Revised: 12 March 2018 / Accepted: 22 March 2018 / Published: 26 March 2018
PDF Full-text (367 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This study aimed to determine whether breastfeeding duration and the timing of solid food were independently associated with being overweight or obese in early childhood. Subjects were 953 children participating in the Study of Mothers and Infants Life Events Affecting Oral Health (SMILE)
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This study aimed to determine whether breastfeeding duration and the timing of solid food were independently associated with being overweight or obese in early childhood. Subjects were 953 children participating in the Study of Mothers and Infants Life Events Affecting Oral Health (SMILE) birth cohort study, based in Adelaide, Australia. Socio-demographic information and data on breastfeeding duration and age of introduction of solid food were collected at birth, 3, 4, 6, 12, and 24 months via mailed or online questionnaires completed by mothers. The weight and height of children were measured at a dental examination when children were aged between 24 and 36 months. Body mass index was calculated, and children were categorised into weight groups according to the World Health Organization growth standards. Multivariable logistic regression analysis was conducted, adjusting for maternal age at birth, education, socio-economic status, pre-pregnancy weight, smoking in pregnancy, method of delivery, and child’s birthweight. Risk of overweight/obesity was independently associated with maternal pre-pregnancy BMI, smoking in pregnancy, and birthweight. Children that were breastfed for 12 months or more had a significantly lower risk of being overweight/obese than those breastfed for less than 17 weeks (AOR 0.49; 95%CI 0.27, 0.90; p for trend =0.009). Age of introduction of solid food, however, was not associated with the risk of being overweight/obese at 24 to 36 months. This study provides further evidence of an inverse relationship between breastfeeding and risk of overweight/obesity, however, no association with the timing of solid food was detected. Full article
(This article belongs to the Special Issue Nutrition in the First 1000 Days)
Open AccessArticle Association of Overcrowding and Turnover with Self-Harm in a Swiss Pre-Trial Prison
Int. J. Environ. Res. Public Health 2018, 15(4), 601; doi:10.3390/ijerph15040601
Received: 28 February 2018 / Revised: 22 March 2018 / Accepted: 22 March 2018 / Published: 27 March 2018
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Abstract
Self-harm is a common issue in detention and includes both suicidal and non-suicidal behaviours. Beyond well-known individual risk factors, institutional factors such as overcrowding (i.e., when the prison population exceeds its capacity) and turnover (i.e., the rate at which the prison population is
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Self-harm is a common issue in detention and includes both suicidal and non-suicidal behaviours. Beyond well-known individual risk factors, institutional factors such as overcrowding (i.e., when the prison population exceeds its capacity) and turnover (i.e., the rate at which the prison population is renewed), may also increase the risk of self-harm. However, these factors are understudied or previous studies reported inconsistent findings. This study investigated the association of self-harm with overcrowding and turnover in the largest pre-trial Swiss prison in Geneva. Data were collected yearly between 2011 and 2017. Measures included self-harm (all kinds of self-injuring acts requiring medical attention, including self-strangulations and self-hangings). We performed meta-regressions to analyse the relationships between self-harm and institutional factors. Self-harm events were frequent, with a prevalence estimate of 26.4%. Overcrowding and turnover were high (average occupation rate of 177% and average turnover of 73%, respectively). Overcrowding and turnover were significantly associated with self-harm (respectively b = 0.068, p < 0.001 and (b = 1.257, p < 0.001). In both cases, self-harm was higher when overcrowding and turnover increased. Overcrowding and turnover raise important human rights concerns and have damaging effects on the health of people living in detention. Identification of and care for this vulnerable population at risk of self-harm are needed and institutional factors should be addressed. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
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Open AccessArticle Characterization of Fine Particulate Matter and Associated Health Burden in Nanjing
Int. J. Environ. Res. Public Health 2018, 15(4), 602; doi:10.3390/ijerph15040602
Received: 7 February 2018 / Revised: 15 March 2018 / Accepted: 15 March 2018 / Published: 27 March 2018
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Abstract
Particulate matter (PM) air pollution has become a serious environmental problem in Nanjing and poses great health risks to local residents. In this study, characteristics of particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) over Nanjing were analyzed
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Particulate matter (PM) air pollution has become a serious environmental problem in Nanjing and poses great health risks to local residents. In this study, characteristics of particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) over Nanjing were analyzed using hourly and daily averaged PM2.5 concentrations and meteorological parameters collected from nine national monitoring sites during the period of March 2014 to February 2017. Then, the integrated exposure-response (IER) model was applied to assess premature mortality, years of life lost (YLL) attributable to PM2.5, and mortality benefits due to PM2.5 reductions. The concentrations of PM2.5 varied among hours, seasons and years, which can be explained by differences in emission sources, secondary formations and meteorological conditions. The decreased ratio of PM2.5 to CO suggested that secondary contributions decreased while the relative contributions of vehicle exhaust increased from increased CO data. According to the values of attributable fractions (AF), stroke was the major cause of death, followed by ischemic heart disease (IHD), lung cancer (LC) and chronic obstructive pulmonary disease (COPD). The estimated total deaths in Nanjing due to PM2.5 were 12,055 and 10,771, leading to 98,802 and 87,647 years of life lost in 2014 and 2015, respectively. The elderly and males had higher health risks than youngsters and females. When the PM2.5 concentrations meet the World Health Organization (WHO) Air Quality Guidelines (AQG) of 10 μg/m3, 84% of the premature deaths would be avoided, indicating that the Nanjing government needs to adopt more stringent measure to reduce PM pollution and enhance the health benefits. Full article
(This article belongs to the Special Issue Air Quality and Health)
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Open AccessFeature PaperArticle Multi-Scale Clustering of Lyme Disease Risk at the Expanding Leading Edge of the Range of Ixodes scapularis in Canada
Int. J. Environ. Res. Public Health 2018, 15(4), 603; doi:10.3390/ijerph15040603
Received: 27 February 2018 / Revised: 17 March 2018 / Accepted: 21 March 2018 / Published: 27 March 2018
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Abstract
Since its detection in Canada in the early 1990s, Ixodes scapularis, the primary tick vector of Lyme disease in eastern North America, has continued to expand northward. Estimates of the tick’s broad-scale distribution are useful for tracking the extent of the Lyme
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Since its detection in Canada in the early 1990s, Ixodes scapularis, the primary tick vector of Lyme disease in eastern North America, has continued to expand northward. Estimates of the tick’s broad-scale distribution are useful for tracking the extent of the Lyme disease risk zone; however, tick distribution may vary widely within this zone. Here, we investigated I. scapularis nymph distribution at three spatial scales across the Lyme disease emergence zone in southern Quebec, Canada. We collected ticks and compared the nymph densities among different woodlands and different plots and transects within the same woodland. Hot spot analysis highlighted significant nymph clustering at each spatial scale. In regression models, nymph abundance was associated with litter depth, humidity, and elevation, which contribute to a suitable habitat for ticks, but also with the distance from the trail and the type of trail, which could be linked to host distribution and human disturbance. Accounting for this heterogeneous nymph distribution at a fine spatial scale could help improve Lyme disease management strategies but also help people to understand the risk variation around them and to adopt appropriate behaviors, such as staying on the trail in infested parks to limit their exposure to the vector and associated pathogens. Full article
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Open AccessArticle Evaluation of Loss Due to Storm Surge Disasters in China Based on Econometric Model Groups
Int. J. Environ. Res. Public Health 2018, 15(4), 604; doi:10.3390/ijerph15040604
Received: 29 December 2017 / Revised: 22 February 2018 / Accepted: 28 February 2018 / Published: 27 March 2018
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Abstract
Storm surge has become an important factor restricting the economic and social development of China’s coastal regions. In order to improve the scientific judgment of future storm surge damage, a method of model groups is proposed to refine the evaluation of the loss
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Storm surge has become an important factor restricting the economic and social development of China’s coastal regions. In order to improve the scientific judgment of future storm surge damage, a method of model groups is proposed to refine the evaluation of the loss due to storm surges. Due to the relative dispersion and poor regularity of the natural property data (login center air pressure, maximum wind speed, maximum storm water, super warning water level, etc.), storm surge disaster is divided based on eight kinds of storm surge disaster grade division methods combined with storm surge water, hypervigilance tide level, and disaster loss. The storm surge disaster loss measurement model groups consist of eight equations, and six major modules are constructed: storm surge disaster in agricultural loss, fishery loss, human resource loss, engineering facility loss, living facility loss, and direct economic loss. Finally, the support vector machine (SVM) model is used to evaluate the loss and the intra-sample prediction. It is indicated that the equations of the model groups can reflect in detail the relationship between the damage of storm surges and other related variables. Based on a comparison of the original value and the predicted value error, the model groups pass the test, providing scientific support and a decision basis for the early layout of disaster prevention and mitigation. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Future Orientation among Students Exposed to School Bullying and Cyberbullying Victimization
Int. J. Environ. Res. Public Health 2018, 15(4), 605; doi:10.3390/ijerph15040605
Received: 30 January 2018 / Revised: 9 March 2018 / Accepted: 21 March 2018 / Published: 27 March 2018
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Abstract
Future orientation can be defined as an individual’s thoughts, beliefs, plans, and hopes for the future. Earlier research has shown adolescents’ future orientation to predict outcomes later in life, which makes it relevant to analyze differences in future orientation among youth. The aim
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Future orientation can be defined as an individual’s thoughts, beliefs, plans, and hopes for the future. Earlier research has shown adolescents’ future orientation to predict outcomes later in life, which makes it relevant to analyze differences in future orientation among youth. The aim of the present study was to analyze if bullying victimization was associated with an increased likelihood of reporting a pessimistic future orientation among school youth. To be able to distinguish between victims and bully-victims (i.e., students who are both bullies and victims), we also took perpetration into account. The data were derived from the Stockholm School Survey performed in 2016 among ninth grade students (ages 15–16 years) (n = 5144). Future orientation and involvement in school bullying and in cyberbullying were based on self-reports. The statistical method used was binary logistic regression. The results demonstrated that victims and bully-victims of school bullying and of cyberbullying were more likely to report a pessimistic future orientation compared with students not involved in bullying. These associations were shown also when involvement in school bullying and cyberbullying were mutually adjusted. The findings underline the importance of anti-bullying measures that target both school bullying and cyberbullying. Full article
(This article belongs to the Special Issue Cyber Pathology: Cyber Victimization and Cyber Bullying)
Open AccessArticle Antibacterial Activity of Orthodontic Cement Containing Quaternary Ammonium Polyethylenimine Nanoparticles Adjacent to Orthodontic Brackets
Int. J. Environ. Res. Public Health 2018, 15(4), 606; doi:10.3390/ijerph15040606
Received: 5 March 2018 / Revised: 21 March 2018 / Accepted: 22 March 2018 / Published: 27 March 2018
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Abstract
Enamel demineralization is a common problem found in patients using orthodontic devices, such as orthodontic braces. It was found that Streptoccocus mutans growth increases adjacent to orthodontic devices, which may result in caries development. Incorporated antibacterial quaternary ammonium polyethylenimine (QPEI) nanoparticles were previously
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Enamel demineralization is a common problem found in patients using orthodontic devices, such as orthodontic braces. It was found that Streptoccocus mutans growth increases adjacent to orthodontic devices, which may result in caries development. Incorporated antibacterial quaternary ammonium polyethylenimine (QPEI) nanoparticles were previously shown to be highly efficacious against various bacteria. Combining antibacterial materials in orthodontic cement may be advantageous to prevent bacterial outgrowth adjacent to orthodontic brackets. The aim was to evaluate the efficiency of orthodontic cement containing QPEI nanoparticles in reducing S. mutans and Lactobacillus casei outgrowth adjacent to orthodontic brackets. Orthodontic brackets were bonded to the buccal surfaces of extracted lower incisors. The antibacterial effect on S. mutans and L. casei outgrowth of Neobond bracket adhesive orthodontic cement with and without QPEI nanoparticles was compared. The antibacterial effect was evaluated using crystal violet staining and bacterial count (CFU/mL). The teeth in the experimental group, with the QPEI nanoparticles cement, showed significantly lower optical density (OD) values and CFU counts of S. mutans and L. casei than the teeth in the control group (p < 0.05). Based on the results, it can be concluded that orthodontic cement containing QPEI nanoparticles significantly inhibits S. mutans and L. casei growth around orthodontic brackets. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Concentration and Risk Evaluation of Polycyclic Aromatic Hydrocarbons in Urban Soil in the Typical Semi-Arid City of Xi’an in Northwest China
Int. J. Environ. Res. Public Health 2018, 15(4), 607; doi:10.3390/ijerph15040607
Received: 11 February 2018 / Revised: 15 March 2018 / Accepted: 20 March 2018 / Published: 27 March 2018
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Abstract
Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental pollutants, presenting potential threats to the ecological environment and human health. Sixty-two urban soil samples were collected in the typical semi-arid city of Xi’an in Northwest China. They were analyzed for concentration, pollution, and ecological and
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Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental pollutants, presenting potential threats to the ecological environment and human health. Sixty-two urban soil samples were collected in the typical semi-arid city of Xi’an in Northwest China. They were analyzed for concentration, pollution, and ecological and health risk of sixteen U.S. Environmental Protection Agency priority PAHs. The total concentrations of the sixteen PAHs (Σ16PAHs) in the urban soil ranged from 390.6 to 10,652.8 µg/kg with an average of 2052.6 µg/kg. The concentrations of some individual PAHs in the urban soil exceeded Dutch Target Values of Soil Quality and the Σ16PAHs represented heavy pollution. Pyrene and dibenz[a,h]anthracene had high ecological risk to aquatic/soil organisms, while other individual PAHs showed low ecological risk. The total ecological risk of PAHs to aquatic/soil organisms is classified as moderate. Toxic equivalency quantities (TEQs) of the sixteen PAHs varied between 21.16 and 1625.78 µg/kg, with an average of 423.86 µg/kg, indicating a relatively high toxicity potential. Ingestion and dermal adsorption of soil dust were major pathways of human exposure to PAHs from urban soil. Incremental lifetime cancer risks (ILCRs) of human exposure to PAHs were 2.86 × 10−5 for children and 2.53 × 10−5 for adults, suggesting that the cancer risk of human exposure to PAHs from urban soil is acceptable. Full article
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Open AccessArticle How Socio-Environmental Factors Are Associated with Japanese Encephalitis in Shaanxi, China—A Bayesian Spatial Analysis
Int. J. Environ. Res. Public Health 2018, 15(4), 608; doi:10.3390/ijerph15040608
Received: 11 February 2018 / Revised: 21 March 2018 / Accepted: 22 March 2018 / Published: 27 March 2018
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Abstract
Evidence indicated that socio-environmental factors were associated with occurrence of Japanese encephalitis (JE). This study explored the association of climate and socioeconomic factors with JE (2006–2014) in Shaanxi, China. JE data at the county level in Shaanxi were supplied by Shaanxi Center for
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Evidence indicated that socio-environmental factors were associated with occurrence of Japanese encephalitis (JE). This study explored the association of climate and socioeconomic factors with JE (2006–2014) in Shaanxi, China. JE data at the county level in Shaanxi were supplied by Shaanxi Center for Disease Control and Prevention. Population and socioeconomic data were obtained from the China Population Census in 2010 and statistical yearbooks. Meteorological data were acquired from the China Meteorological Administration. A Bayesian conditional autoregressive model was used to examine the association of meteorological and socioeconomic factors with JE. A total of 1197 JE cases were included in this study. Urbanization rate was inversely associated with JE incidence during the whole study period. Meteorological variables were significantly associated with JE incidence between 2012 and 2014. The excessive precipitation at lag of 1–2 months in the north of Shaanxi in June 2013 had an impact on the increase of local JE incidence. The spatial residual variations indicated that the whole study area had more stable risk (0.80–1.19 across all the counties) between 2012 and 2014 than earlier years. Public health interventions need to be implemented to reduce JE incidence, especially in rural areas and after extreme weather. Full article
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Open AccessArticle An Extended Chemical Plant Environmental Protection Game on Addressing Uncertainties of Human Adversaries
Int. J. Environ. Res. Public Health 2018, 15(4), 609; doi:10.3390/ijerph15040609
Received: 31 January 2018 / Revised: 18 March 2018 / Accepted: 20 March 2018 / Published: 27 March 2018
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Abstract
Chemical production activities in industrial districts pose great threats to the surrounding atmospheric environment and human health. Therefore, developing appropriate and intelligent pollution controlling strategies for the management team to monitor chemical production processes is significantly essential in a chemical industrial district. The
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Chemical production activities in industrial districts pose great threats to the surrounding atmospheric environment and human health. Therefore, developing appropriate and intelligent pollution controlling strategies for the management team to monitor chemical production processes is significantly essential in a chemical industrial district. The literature shows that playing a chemical plant environmental protection (CPEP) game can force the chemical plants to be more compliant with environmental protection authorities and reduce the potential risks of hazardous gas dispersion accidents. However, results of the current literature strictly rely on several perfect assumptions which rarely hold in real-world domains, especially when dealing with human adversaries. To address bounded rationality and limited observability in human cognition, the CPEP game is extended to generate robust schedules of inspection resources for inspection agencies. The present paper is innovative on the following contributions: (i) The CPEP model is extended by taking observation frequency and observation cost of adversaries into account, and thus better reflects the industrial reality; (ii) Uncertainties such as attackers with bounded rationality, attackers with limited observation and incomplete information (i.e., the attacker’s parameters) are integrated into the extended CPEP model; (iii) Learning curve theory is employed to determine the attacker’s observability in the game solver. Results in the case study imply that this work improves the decision-making process for environmental protection authorities in practical fields by bringing more rewards to the inspection agencies and by acquiring more compliance from chemical plants. Full article
(This article belongs to the collection Environmental Risk Assessment)
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Open AccessFeature PaperArticle Evaluating Community Partnerships Addressing Community Resilience in Los Angeles, California
Int. J. Environ. Res. Public Health 2018, 15(4), 610; doi:10.3390/ijerph15040610
Received: 20 February 2018 / Revised: 19 March 2018 / Accepted: 23 March 2018 / Published: 27 March 2018
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Abstract
Community resilience has grown in importance in national disaster response and recovery efforts. However, measurement of community resilience, particularly the content and quality of relationships aimed at improving resilience, is lacking. To address this gap, we used a social network survey to measure
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Community resilience has grown in importance in national disaster response and recovery efforts. However, measurement of community resilience, particularly the content and quality of relationships aimed at improving resilience, is lacking. To address this gap, we used a social network survey to measure the number, type, and quality of relationships among organizations participating in 16 coalitions brought together to address community resilience in the Los Angeles Community Disaster Resilience project. These coalitions were randomized to one of two approaches (community resilience or preparedness). Resilience coalitions received training and support to develop these partnerships and implement new activities. Both coalition types received expert facilitation by a public health nurse or community educator. We also measured the activities each coalition engaged in and the extent to which partners participated in these activities at two time points. We found that the community resilience coalitions were initially larger and had lower trust among members than the preparedness communities. Over time, these trust differences dissipated. While both coalitions grew, the resilience community coalitions maintained their size difference throughout the project. We also found differences in the types of activities implemented by the resilience communities; these differences were directly related to the trainings provided. This information is useful to organizations seeking guidance on expanding the network of community-based organizations that participate in community resilience activities. Full article
(This article belongs to the Special Issue Public Health and Disasters)
Open AccessArticle In-Cabin Air Quality during Driving and Engine Idling in Air-Conditioned Private Vehicles in Hong Kong
Int. J. Environ. Res. Public Health 2018, 15(4), 611; doi:10.3390/ijerph15040611
Received: 9 February 2018 / Revised: 13 March 2018 / Accepted: 23 March 2018 / Published: 27 March 2018
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Abstract
Many people spend lengthy periods each day in enclosed vehicles in Hong Kong. However, comparably limited data is available about in-cabin air quality in air-conditioned private vehicles, and the car usage that may affect the air quality. Fifty-one vehicles were tested for particulate
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Many people spend lengthy periods each day in enclosed vehicles in Hong Kong. However, comparably limited data is available about in-cabin air quality in air-conditioned private vehicles, and the car usage that may affect the air quality. Fifty-one vehicles were tested for particulate matter (PM0.3 and PM2.5), total volatile organic compounds (TVOCs), carbon monoxide (CO), carbon dioxide (CO2), airborne bacteria, and fungi levels during their routine travel journey. Ten of these vehicles were further examined for PM0.3, PM2.5, TVOCs, CO, and CO2 during engine idling. In general, during driving PM2.5 levels in-cabin reduced overtime, but not PM0.3. For TVOCs, 24% vehicles exceeded the recommended Indoor Air Quality (IAQ) level in offices and public places set by the Hong Kong Environmental Protection Department. The total volatile organic compounds (TVOC) concentration positively correlated with the age of the vehicle. Carbon monoxide (CO) levels in all of the vehicles were lower than the IAQ recommendation, while 96% vehicles exceeded the recommended CO2 level of 1000 ppmv; 16% vehicles >5000 ppmv. Microbial counts were relatively low. TVOCs levels at idle engine were higher than that during driving. Although the time we spend in vehicles is short, the potential exposure to high levels of pollutants should not be overlooked. Full article
(This article belongs to the Special Issue Environmental Hygiene)
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Open AccessArticle Evaluation of an Agricultural Meteorological Disaster Based on Multiple Criterion Decision Making and Evolutionary Algorithm
Int. J. Environ. Res. Public Health 2018, 15(4), 612; doi:10.3390/ijerph15040612
Received: 25 January 2018 / Revised: 11 March 2018 / Accepted: 20 March 2018 / Published: 28 March 2018
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Abstract
The evaluation of a meteorological disaster can be regarded as a multiple-criteria decision making problem because it involves many indexes. Firstly, a comprehensive indexing system for an agricultural meteorological disaster is proposed, which includes the disaster rate, the inundated rate, and the complete
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The evaluation of a meteorological disaster can be regarded as a multiple-criteria decision making problem because it involves many indexes. Firstly, a comprehensive indexing system for an agricultural meteorological disaster is proposed, which includes the disaster rate, the inundated rate, and the complete loss rate. Following this, the relative weights of the three criteria are acquired using a novel proposed evolutionary algorithm. The proposed algorithm consists of a differential evolution algorithm and an evolution strategy. Finally, a novel evaluation model, based on the proposed algorithm and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), is presented to estimate the agricultural meteorological disaster of 2008 in China. The geographic information system (GIS) technique is employed to depict the disaster. The experimental results demonstrated that the agricultural meteorological disaster of 2008 was very serious, especially in Hunan and Hubei provinces. Some useful suggestions are provided to relieve agriculture meteorological disasters. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Fractionation, Bioaccessibility, and Risk Assessment of Heavy Metals in the Soil of an Urban Recreational Area Amended with Composted Sewage Sludge
Int. J. Environ. Res. Public Health 2018, 15(4), 613; doi:10.3390/ijerph15040613
Received: 9 February 2018 / Revised: 20 March 2018 / Accepted: 21 March 2018 / Published: 28 March 2018
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Abstract
A composted sewage sludge (CSS) was added to the soil of an urban garden at 5%, 10%, and 25% (w/w soil) and stabilised for 180 days. Samples were then collected and analysed for total heavy metal concentrations, chemical fractions, and
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A composted sewage sludge (CSS) was added to the soil of an urban garden at 5%, 10%, and 25% (w/w soil) and stabilised for 180 days. Samples were then collected and analysed for total heavy metal concentrations, chemical fractions, and bioaccessibility, together with some physicochemical properties. The results showed that the total chromium (Cr), copper (Cu), lead (Pb), and zinc (Zn) concentrations were increased with CSS addition rate. The CSS addition decreased the residual fractions of these four elements. The exchangeable Cr, Cu, and Pb fractions were very small or not detected, while Zn exhibited an increasing trend in its exchangeable fraction with CSS addition rate. The bioaccessibility of these four elements was increased with the CSS addition rate. Moreover, the Cr, Cu, and Zn bioaccessibility correlated positively with the total concentration, while the bioaccessibility of these four elements exhibited a negative correlation with the residual fraction. The fractionation and bioaccessibility of heavy metals may have also been influenced by pH, cation exchange capacity, and organic matter. The risk assessment code reflected the amended soil showed no or low environmental risks for Cr, Cu, and Pb and a medium risk for Zn. The hazardous index values and cancer risk levels indicated that the heavy metals in the soil amended with 25% CSS posed negligible potential noncarcinogenic and carcinogenic risks to children and adults via incidental ingestion. Full article
(This article belongs to the Special Issue Soil Pollution and Remediation)
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Open AccessArticle Geospatial Analysis and Seasonal Distribution of West Nile Virus Vectors (Diptera: Culicidae) in Southern Ontario, Canada
Int. J. Environ. Res. Public Health 2018, 15(4), 614; doi:10.3390/ijerph15040614
Received: 3 February 2018 / Revised: 17 March 2018 / Accepted: 26 March 2018 / Published: 28 March 2018
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Abstract
The purpose of this study was to establish geospatial and seasonal distributions of West Nile virus vectors in southern Ontario, Canada using historical surveillance data from 2002 to 2014. We set out to produce mosquito abundance prediction surfaces for each of Ontario’s thirteen
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The purpose of this study was to establish geospatial and seasonal distributions of West Nile virus vectors in southern Ontario, Canada using historical surveillance data from 2002 to 2014. We set out to produce mosquito abundance prediction surfaces for each of Ontario’s thirteen West Nile virus vectors. We also set out to determine whether elevation and proximity to conservation areas and provincial parks, wetlands, and population centres could be used to improve our model. Our results indicated that the data sets for Anopheles quadrimaculatus, Anopheles punctipennis, Anopheles walkeri, Culex salinarius, Culex tarsalis, Ochlerotatus stimulans, and Ochlerotatus triseriatus were not suitable for geospatial modelling because they are randomly distributed throughout Ontario. Spatial prediction surfaces were created for Aedes japonicus and proximity to wetlands, Aedes vexans and proximity to population centres, Culex pipiens/restuans and proximity to population centres, Ochlerotatus canadensis and elevation, and Ochlerotatus trivittatus and proximity to population centres using kriging. Seasonal distributions are presented for all thirteen species. We have identified both when and where vector species are most abundant in southern Ontario. These data have the potential to contribute to a more efficient and focused larvicide program and West Nile virus awareness campaigns. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Nutrition-Related Knowledge, Attitudes, and Practices (KAP) among Kindergarten Teachers in Chongqing, China: A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2018, 15(4), 615; doi:10.3390/ijerph15040615
Received: 8 February 2018 / Revised: 19 March 2018 / Accepted: 23 March 2018 / Published: 28 March 2018
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Abstract
Kindergarten teachers play an important role in providing kindergarten children with education on nutrition. However, few studies have been published on nutrition-related knowledge, attitudes, and practices (KAP) of Chinese kindergarten teachers. This study aimed to assess the nutrition-related knowledge, attitudes, and practices (KAP)
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Kindergarten teachers play an important role in providing kindergarten children with education on nutrition. However, few studies have been published on nutrition-related knowledge, attitudes, and practices (KAP) of Chinese kindergarten teachers. This study aimed to assess the nutrition-related knowledge, attitudes, and practices (KAP) of kindergarten teachers in Chongqing, China. Thus, a cross-sectional survey was conducted using a structured KAP model questionnaire administered to 222 kindergarten teachers, who were senior teachers from 80 kindergartens in 19 districts and 20 counties in Chongqing. Multiple regression analysis was used to analyze the influential factors. Among the participants, 54.2% were familiar with simple nutrition-related knowledge; only 9.9% of them were satisfied with their knowledge of childhood nutrition; and 97.7% of them had a positive attitude to learn nutrition-related knowledge. Only 38.7% of the participants had attended pediatric nutrition knowledge courses or training. Multiple regression analysis confirmed significant independent effects on the nutrition knowledge score (p < 0.0001) of respondents on age, type of residence, type of kindergarten, body mass index(BMI), professional training of kindergarten teachers, behavior of having ever participated in childhood nutrition education knowledge courses or training, and behavior of having ever paid attention to children’s nutrition knowledge. The model indicated that independent variables explained 45.4% (adjusted R2) of the variance found in the knowledge scores of respondents. While there were low levels of nutrition knowledge and training, it was still encouraging to note that there were positive attitudes towards acquiring nutrition-related knowledge among kindergarten teachers in Chongqing, China. These findings provide some implications that necessary training measures need to be carried out to improve the nutrition-related knowledge level among kindergarten teachers in China. Full article
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
Open AccessArticle The Epidemiology of Unintentional and Violence-Related Injury Morbidity and Mortality among Children and Adolescents in the United States
Int. J. Environ. Res. Public Health 2018, 15(4), 616; doi:10.3390/ijerph15040616
Received: 6 February 2018 / Revised: 20 March 2018 / Accepted: 21 March 2018 / Published: 28 March 2018
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Abstract
Injuries and violence among young people have a substantial emotional, physical, and economic toll on society. Understanding the epidemiology of this public health problem can guide prevention efforts, help identify and reduce risk factors, and promote protective factors. We examined fatal and nonfatal
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Injuries and violence among young people have a substantial emotional, physical, and economic toll on society. Understanding the epidemiology of this public health problem can guide prevention efforts, help identify and reduce risk factors, and promote protective factors. We examined fatal and nonfatal unintentional injuries, injuries intentionally inflicted by other (i.e., assaults and homicides) among children ages 0–19, and intentionally self-inflicted injuries (i.e., self-harm and suicides) among children ages 10–19. We accessed deaths (1999–2015) and visits to emergency departments (2001–2015) for these age groups through the Centers for Disease Control and Prevention’s (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS), and examined trends and differences by age, sex, race/ethnicity, rural/urban status, and injury mechanism. Almost 13,000 children and adolescents age 0–19 years died in 2015 from injury and violence compared to over 17,000 in 1999. While the overall number of deaths has decreased over time, there were increases in death rates among certain age groups for some categories of unintentional injury and for suicides. The leading causes of injury varied by age group. Our results indicate that efforts to reduce injuries to children and adolescents should consider cause, intent, age, sex, race, and regional factors to assure that prevention resources are directed at those at greatest risk. Full article
(This article belongs to the Special Issue Child Injury Prevention 2017)
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Open AccessArticle Comparison of Commensal Escherichia coli Isolates from Adults and Young Children in Lubuskie Province, Poland: Virulence Potential, Phylogeny and Antimicrobial Resistance
Int. J. Environ. Res. Public Health 2018, 15(4), 617; doi:10.3390/ijerph15040617
Received: 6 March 2018 / Revised: 22 March 2018 / Accepted: 23 March 2018 / Published: 28 March 2018
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Abstract
Commensal Escherichia coli population is a dynamic structure which may be important in the pathogenesis of extraintestinal infections. The aim of this study was the comparison of genetic diversity of commensal E. coli isolates from two age group—adults and young children. E. coli
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Commensal Escherichia coli population is a dynamic structure which may be important in the pathogenesis of extraintestinal infections. The aim of this study was the comparison of genetic diversity of commensal E. coli isolates from two age group—adults and young children. E. coli strains were isolated on MacConkey agar and identified by biochemical tests. Determination of four major phylogenetic groups, identification of virulence genes and antimicrobial resistance determinants were performed by using multiplex or simplex PCR. Phenotypic analysis of resistance was based on disc-diffusion method. The prevalence of virulence genes was significantly higher among isolates from adults than from young children. Phylogroup B2 predominated among E. coli from adults, whereas phylogroup A was the most common in isolates from young children. The analyses of antimicrobial resistance revealed that resistance to at least one antimicrobial agent and multidrug-resistance were detected significantly more frequent in the isolates from adults than from young children. This study documented that the commensal E. coli isolates from adults showed greater genetic diversity than from young children and constitutes a substantial reservoir of the virulence genes typical for extraintestinal pathogenic E. coli. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Parents’ Experiences of Suicide-Bereavement: A Qualitative Study at 6 and 12 Months after Loss
Int. J. Environ. Res. Public Health 2018, 15(4), 618; doi:10.3390/ijerph15040618
Received: 28 February 2018 / Revised: 22 March 2018 / Accepted: 24 March 2018 / Published: 28 March 2018
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Abstract
The death of a child by suicide is a severe trauma, placing parents at greater risk of psychological morbidity and physical health problems compared to other causes of death. However, few studies have examined the aftermath and bereavement experience for parents following the
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The death of a child by suicide is a severe trauma, placing parents at greater risk of psychological morbidity and physical health problems compared to other causes of death. However, few studies have examined the aftermath and bereavement experience for parents following the death of a child to suicide, limiting the ability to guide effective postvention services through empirical research. The current study, which was part of a larger longitudinal investigation of suicide bereavement in Queensland, Australia, examined the individual experiences of both mothers and fathers bereaved by suicide over time, specifically at the six month and 12 month time points after their loss. Bereaved parents who had provided written consent to be contacted for research purposes were identified through the Queensland Suicide Register, and took part in individual, semi-structured interviews. Generic qualitative analysis identified three key themes: searching for answers and sense-making, coping strategies and support, and finding meaning and purpose. Some participants showed indications of meaning-making and post-traumatic growth at 12 months after the suicide. According to the dual process model of bereavement, it is likely that participants were still oscillating between sense-making and meaning making, indicating that adapting to bereavement is a dynamic and fluctuating process. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle ‘Obesogenic’ School Food Environments? An Urban Case Study in The Netherlands
Int. J. Environ. Res. Public Health 2018, 15(4), 619; doi:10.3390/ijerph15040619
Received: 13 February 2018 / Revised: 16 March 2018 / Accepted: 23 March 2018 / Published: 28 March 2018
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Abstract
(1) Background: This study aimed to explore and define socio-economic (SES) differences in urban school food environments in The Netherlands. (2) Methods: Retail food outlets, ready-to-eat products, in-store food promotions and food advertisements in public space were determined within 400 m walking distance
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(1) Background: This study aimed to explore and define socio-economic (SES) differences in urban school food environments in The Netherlands. (2) Methods: Retail food outlets, ready-to-eat products, in-store food promotions and food advertisements in public space were determined within 400 m walking distance of all secondary schools in the 4th largest city of The Netherlands. Fisher’s exact tests were conducted. (3) Results: In total, 115 retail outlets sold ready-to-eat food and drink products during school hours. Fast food outlets were more often in the vicinity of schools in lower SES (28.6%) than in higher SES areas (11.5%). In general, unhealthy options (e.g., fried snacks, sugar-sweetened beverages (SSB)) were more often for sale, in-store promoted or advertised in comparison with healthy options (e.g., fruit, vegetables, bottled water). Sport/energy drinks were more often for sale, and fried snacks/fries, hamburgers/kebab and SSB were more often promoted or advertised in lower SES areas than in higher SES-areas. (4) Conclusion: In general, unhealthy food options were more often presented than the healthy options, but only a few SES differences were observed. The results, however, imply that efforts in all school areas are needed to make the healthy option the default option during school time. Full article
(This article belongs to the Special Issue Obesity and Urban Environments)
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Open AccessArticle Beliefs about Vaccinations: Comparing a Sample from a Medical School to That from the General Population
Int. J. Environ. Res. Public Health 2018, 15(4), 620; doi:10.3390/ijerph15040620
Received: 17 January 2018 / Revised: 13 March 2018 / Accepted: 20 March 2018 / Published: 28 March 2018
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Abstract
The current study compares health care professionals’ beliefs about vaccination statements with the beliefs of a sample of individuals from the general population. Students and faculty within a medical school (n = 58) and a sample from the general population in the
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The current study compares health care professionals’ beliefs about vaccination statements with the beliefs of a sample of individuals from the general population. Students and faculty within a medical school (n = 58) and a sample from the general population in the United States (n = 177) were surveyed regarding their beliefs about vaccinations. Participants evaluated statements about vaccinations (both supporting and opposing), and indicated whether they thought the general population would agree with them. Overall, it was found that subjects in both populations agreed with statements supporting vaccination over opposing statements, but the general population was more likely to categorize the supporting statements as beliefs rather than facts. Additionally, there was little consensus within each population as to which statements were considered facts versus beliefs. Both groups underestimated the number of people that would agree with them; however, the medical affiliates showed the effect significantly more. Implications for medical education and health communication are discussed. Full article
(This article belongs to the Special Issue Vaccination and Health Outcomes)
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Open AccessArticle Water Quality in Surface Water: A Preliminary Assessment of Heavy Metal Contamination of the Mashavera River, Georgia
Int. J. Environ. Res. Public Health 2018, 15(4), 621; doi:10.3390/ijerph15040621
Received: 4 February 2018 / Revised: 14 March 2018 / Accepted: 20 March 2018 / Published: 28 March 2018
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Abstract
Water quality contamination by heavy metal pollution has severe effects on public health. In the Mashavera River Basin, an important agricultural area for the national food system in Georgia (e.g., vegetable, dairy and wine production), water contamination has multiple influences on the regional
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Water quality contamination by heavy metal pollution has severe effects on public health. In the Mashavera River Basin, an important agricultural area for the national food system in Georgia (e.g., vegetable, dairy and wine production), water contamination has multiple influences on the regional and country-wide health. With new industrial activities in the region, sediment extraction, and discharge of untreated wastewater into the river, its tributaries and irrigation canals, a comprehensive study of water quality was greatly needed. This study examined sediment and water samples from 17 sampling sites in the Mashavera River Basin during the high and low precipitation seasons. The results were characterized utilizing the Geo-accumulation Index (Igeo), Enrichment Factor (EF), Pollution Load index (PLI), Contamination Factor (CF) and Metal Index (MI). According to the CFs, Cu > Cd > Zn > Pb > Fe > Mn > Ni > Cr > Hg is the descending order for the content of all observed heavy metals in sediments collected in both seasons. Fe and As were additionally examined in water samples. Overall, As, Cd and Pb, all highly toxic elements, were found in high concentrations in downstream sample sites. According to these results, comprehensive monitoring with narrow intervals between sampling dates, more sample sites along all waterways, and proximate observation of multiple trace metal elements are highly recommended. Moreover, as the part of the water quality governance system, an immediate and sustainable collective action by all stakeholders to control the pollution level is highly recommended, as this issue is linked to the security of the national food system and poses a local public health risk. Full article
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Open AccessArticle Parents’ Experience and Views of Vaccinating Their Child against Influenza at Primary School and at the General Practice
Int. J. Environ. Res. Public Health 2018, 15(4), 622; doi:10.3390/ijerph15040622
Received: 27 February 2018 / Revised: 23 March 2018 / Accepted: 25 March 2018 / Published: 28 March 2018
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Abstract
The purpose of this study was to gain an in-depth understanding of parents’ experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP). A cross-sectional qualitative study was conducted between March–June 2016 with
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The purpose of this study was to gain an in-depth understanding of parents’ experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP). A cross-sectional qualitative study was conducted between March–June 2016 with parents of children in Reception and Year 1 in four randomly selected schools in Bury, Leicestershire, and Surrey, England. Twenty-five outreach forms were completed and returned, and seven interviews were conducted. Interview transcripts were coded by theme in NVivo (version 11, QSR International Pty Ltd., Melbourne, Australia). The primary reason parents gave for vaccinating their child was to prevent their child from contracting influenza. Parents’ perceived benefits of vaccinating in schools were to avoid the inconvenience of having to take their child to the GP, and that their child would behave better at school. Parents viewed that accompanying their child for the vaccination at school would undermine the convenience and peer-pressure advantages of the school as a venue. No parents expressed concern about their child being too young to be vaccinated in school. This research suggests that the school is a desirable venue for childhood influenza vaccination, both from the parents’ view and given that influenza vaccination coverage is higher when delivered through schools than GPs. Full article
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Open AccessArticle Physical Activity as a Determinant of Quality of Life in Working-Age People in Wrocław, Poland
Int. J. Environ. Res. Public Health 2018, 15(4), 623; doi:10.3390/ijerph15040623
Received: 11 February 2018 / Revised: 23 March 2018 / Accepted: 27 March 2018 / Published: 29 March 2018
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Abstract
Regular physical activity can greatly contribute to the improvement of physical fitness and performance, reduction of the incidence risk of some occupational diseases, and as a consequence, to a general improvement of quality of life in terms of health status. The aim of
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Regular physical activity can greatly contribute to the improvement of physical fitness and performance, reduction of the incidence risk of some occupational diseases, and as a consequence, to a general improvement of quality of life in terms of health status. The aim of the article was to assess relationships between the quality of life and physical activity of a working-age population. The study material comprised 4460 residents of the city of Wrocław, Poland (2129 men, 2331 women) aged 18–64 years. The study was a questionnaire survey using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and The World Health Organization Quality of Life (WHOQOL-BREF) questionnaires. The highest levels of overall quality of life and its four particular domains (physical, psychological, social, and environmental), as well as perceived health conditions were found among the most physically active respondents. Furthermore, the odds of high assessment of perceived overall quality of life were shown to increase with the increasing levels of physical activity. Activities aimed at the improvement of the quality of life of working-age people should involve programs enhancing the development of physical activity. Full article
Open AccessArticle Patient as a Partner in Healthcare-Associated Infection Prevention
Int. J. Environ. Res. Public Health 2018, 15(4), 624; doi:10.3390/ijerph15040624
Received: 15 February 2018 / Revised: 24 March 2018 / Accepted: 28 March 2018 / Published: 29 March 2018
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Abstract
Objectives: The objective of the study was getting to know the knowledge and attitudes towards hand hygiene (HH) among Polish patients and healthcare workers (HCWs). Methods: 459 respondents replied to the survey: 173 (37.6%) patients and 286 (62.3%) HCWs; 57 HCWs were additionally
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Objectives: The objective of the study was getting to know the knowledge and attitudes towards hand hygiene (HH) among Polish patients and healthcare workers (HCWs). Methods: 459 respondents replied to the survey: 173 (37.6%) patients and 286 (62.3%) HCWs; 57 HCWs were additionally interviewed. Results: Few HCWs knew and used the “5 moments for HH” in the required situations. Both patients and HCWs rated HH of other HCWs poorly: only 75% of patients and 54% of HCWs noticed the application of HH before blood sample collection, but 1/2 of interviewed HCWs did not encounter a request for HH from a patient. According to interviews, 23 (40%) HCWs did not admonish others when they did not use HH. Seventy-five percent of patients and HCWs claimed that, in the past, in schools the toilets were poorly stocked, but the situation improved with the passage of time. Conclusions: There are barriers with resspect to treating patients as partners in HH in Polish hospitals and HCWs’ lack of compliance with the “5 moments for HH” significantly reduces patients’ safety. Practice implications: Education regarding HH should be conducted for the whole society from an early age: lack of proper supplies in school bathrooms impedes the development of positive HH habits. Full article
Open AccessArticle Farmers’ Willingness to Pay for Health Risk Reductions of Pesticide Use in China: A Contingent Valuation Study
Int. J. Environ. Res. Public Health 2018, 15(4), 625; doi:10.3390/ijerph15040625
Received: 3 February 2018 / Revised: 4 March 2018 / Accepted: 26 March 2018 / Published: 29 March 2018
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Abstract
This study aimed to estimate farmers’ willingness to pay (WTP) for health risk reductions of pesticide use by applying the contingent valuation method (CVM) and to explore the factors that influence farmers’ WTP in China. In total, 244 farmers were randomly selected and
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This study aimed to estimate farmers’ willingness to pay (WTP) for health risk reductions of pesticide use by applying the contingent valuation method (CVM) and to explore the factors that influence farmers’ WTP in China. In total, 244 farmers were randomly selected and interviewed. The mean WTP was estimated to be $65.38 (0.94% of total household income) per household per year for a 5/10,000 reduction in morbidity risk. This study shows that farmers’ socioeconomic and attitudinal factors that significantly affect their WTP include farmers’ farming income, education, household size and risk perceptions. In particular, the results demonstrate that respondents’ social trust, social reciprocity and social networks have significant impacts on their WTP. The findings of this study can provide useful insights for policy makers to design effective policies to address health problems related to pesticide use in the developing world. Full article
(This article belongs to the Special Issue Economic Evaluation of Environmental Policies and Interventions)
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Open AccessArticle Health Impacts and Economic Costs of Air Pollution in the Metropolitan Area of Skopje
Int. J. Environ. Res. Public Health 2018, 15(4), 626; doi:10.3390/ijerph15040626
Received: 26 January 2018 / Revised: 19 March 2018 / Accepted: 27 March 2018 / Published: 29 March 2018
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Abstract
Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is
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Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. Methods: we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. Results: In 2012, long-term exposure to PM2.5 (49.2 μg/m3) caused an estimated 1199 premature deaths (CI95% 821–1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104–977) from cardiovascular diseases, and 937 admissions (CI95% 937–1869) for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m3) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m3) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Conclusions: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city. Full article
(This article belongs to the Special Issue Climate Change, Extreme Temperatures, Air Pollution, and Health)
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Open AccessArticle Temporal and Spatial Variation in, and Population Exposure to, Summertime Ground-Level Ozone in Beijing
Int. J. Environ. Res. Public Health 2018, 15(4), 628; doi:10.3390/ijerph15040628
Received: 7 February 2018 / Revised: 15 March 2018 / Accepted: 26 March 2018 / Published: 29 March 2018
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Abstract
Ground-level ozone pollution in Beijing has been causing concern among the public due to the risks posed to human health. This study analyzed the temporal and spatial distribution of, and investigated population exposure to, ground-level ozone. We analyzed hourly ground-level ozone data from
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Ground-level ozone pollution in Beijing has been causing concern among the public due to the risks posed to human health. This study analyzed the temporal and spatial distribution of, and investigated population exposure to, ground-level ozone. We analyzed hourly ground-level ozone data from 35 ambient air quality monitoring sites, including urban, suburban, background, and traffic monitoring sites, during the summer in Beijing from 2014 to 2017. The results showed that the four-year mean ozone concentrations for urban, suburban, background, and traffic monitoring sites were 95.1, 99.8, 95.9, and 74.2 μg/m3, respectively. A total of 44, 43, 45, and 43 days exceeded the Chinese National Ambient Air Quality Standards (NAAQS) threshold for ground-level ozone in 2014, 2015, 2016, and 2017, respectively. The mean ozone concentration was higher in suburban sites than in urban sites, and the traffic monitoring sites had the lowest concentration. The diurnal variation in ground-level ozone concentration at the four types of monitoring sites displayed a single-peak curve. The peak and valley values occurred at 3:00–4:00 p.m. and 7:00 a.m., respectively. Spatially, ground-level ozone concentrations decreased in gradient from the north to the south. Population exposure levels were calculated based on ground-level ozone concentrations and population data. Approximately 50.38%, 44.85%, and 48.49% of the total population of Beijing were exposed to ground-level ozone concentrations exceeding the Chinese NAAQS threshold in 2014, 2015, and 2016, respectively. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Reconsidering the Relationship between Air Pollution and Deprivation
Int. J. Environ. Res. Public Health 2018, 15(4), 629; doi:10.3390/ijerph15040629
Received: 16 February 2018 / Revised: 17 March 2018 / Accepted: 27 March 2018 / Published: 29 March 2018
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Abstract
This paper critically examines the relationship between air pollution and deprivation. We argue that focusing on a particular economic or social model of urban development might lead one to erroneously expect all cities to converge towards a particular universal norm. A naive market
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This paper critically examines the relationship between air pollution and deprivation. We argue that focusing on a particular economic or social model of urban development might lead one to erroneously expect all cities to converge towards a particular universal norm. A naive market sorting model, for example, would predict that poor households will eventually be sorted into high pollution areas, leading to a positive relationship between air pollution and deprivation. If, however, one considers a wider set of theoretical perspectives, the anticipated relationship between air pollution and deprivation becomes more complex and idiosyncratic. Specifically, we argue the relationship between pollution and deprivation can only be made sense of by considering processes of risk perception, path dependency, gentrification and urbanization. Rather than expecting all areas to eventually converge to some universal norm, we should expect the differences in the relationship between air pollution and deprivation across localities to persist. Mindful of these insights, we propose an approach to modeling which does not impose a geographically fixed relationship. Results for Scotland reveal substantial variations in the observed relationships over space and time, supporting our argument. Full article
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Open AccessArticle Cigarette Waste in Popular Beaches in Thailand: High Densities that Demand Environmental Action
Int. J. Environ. Res. Public Health 2018, 15(4), 630; doi:10.3390/ijerph15040630
Received: 12 February 2018 / Revised: 18 March 2018 / Accepted: 23 March 2018 / Published: 29 March 2018
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Abstract
Thailand, like all nations, has a responsibility to initiate environmental actions to preserve marine environments. Low- and middle-income countries face difficulties implementing feasible strategies to fulfill this ambitious goal. To contribute to the revitalization of Thailand’s marine ecosystems, we investigated the level of
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Thailand, like all nations, has a responsibility to initiate environmental actions to preserve marine environments. Low- and middle-income countries face difficulties implementing feasible strategies to fulfill this ambitious goal. To contribute to the revitalization of Thailand’s marine ecosystems, we investigated the level of tobacco product waste (TPW) on Thailand’s public beaches. We conducted a cross-sectional observational survey at two popular public beaches. Research staff collected cigarette butts over two eight-hour days walking over a one-kilometer stretch of beach. We also compiled and analyzed data on butts collected from sieved sand at 11 popular beaches throughout Thailand’s coast, with 10 samples of sieved sand collected per beach. Our survey at two beaches yielded 3067 butts in lounge areas, resulting in a mean butt density of 0.44/m2. At the 11 beaches, sieved sand samples yielded butt densities ranging from 0.25 to 13.3/m2, with a mean butt density of 2.26/m2 (SD = 3.78). These densities show that TPW has become a serious problem along Thailand’s coastline. Our findings are comparable with those in other countries. We report on government and civil society initiatives in Thailand that are beginning to address marine TPW. The solution will only happen when responsible parties, especially and primarily tobacco companies, undertake actions to eliminate TPW. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Association between Short-Term Exposure to Air Pollution and Dyslipidemias among Type 2 Diabetic Patients in Northwest China: A Population-Based Study
Int. J. Environ. Res. Public Health 2018, 15(4), 631; doi:10.3390/ijerph15040631
Received: 25 February 2018 / Revised: 15 March 2018 / Accepted: 26 March 2018 / Published: 30 March 2018
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Abstract
Air pollution exposure may play an adverse role in diabetes. However, little data are available directly evaluating the effects of air pollution exposure in blood lipids of which dysfunction has been linked to diabetes or its complications. We aimed to evaluate the association
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Air pollution exposure may play an adverse role in diabetes. However, little data are available directly evaluating the effects of air pollution exposure in blood lipids of which dysfunction has been linked to diabetes or its complications. We aimed to evaluate the association between air pollution and lipids level among type 2 diabetic patients in Northwest China. We performed a population-based study of 3912 type 2 diabetes patients in an ongoing cohort study in China. Both spline and multiple linear regressions analysis were used to examine the association between short-term exposure to PM10, SO2, NO2 and total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). By spline analyses, we observed that the relationship between SO2 and HDL-C and LDL-C was shown to be non-linear (p_non-lin-association = 0.0162 and 0.000). An inverted U-shaped non-linear relationship between NO2 and LDL-C was found (p_non-lin-association < 0.0001). A J-shaped non-linear relationship between PM10 and TC, HDL-C (p_non-lin-association = 0.0173, 0.0367) was also revealed. In linear regression analyses, a 10 μg/m3 increment in SO2 was associated with 1.31% (95% CI: 0.40–2.12%), 3.52% (95% CI: 1.07–6.03%) and 7.53% (95% CI: 5.98–9.09%) increase in TC, TG and LDL-C, respectively. A 10 μg/m3 increment in PM10 was associated with 0.45% (95% CI: 0.08–0.82%), 0.29% (95% CI: 0.10–0.49%) and 0.83% (95% CI: 0.21–1.45%) increase in TC, HDL-C and LDL-C, respectively. For NO2, an increment of 10 μg/m3 was statistically associated with −3.55% (95% CI: −6.40–0.61%) and 39.01% (95% CI: 31.43–47.03%) increase in HDL-C and LDL-C. The adverse effects of air pollutants on lipid levels were greater in female and elder people. Further, we found SO2 and NO2 played a more evident role in lipid levels in warm season, while PM10 appeared stronger in cold season. The findings suggest that exposure to air pollution has adverse effects on lipid levels among type 2 diabetes patients, and vulnerable people may pay more attention on severe air pollution days. Full article
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Open AccessArticle Burden and Risk Factors for Cold-Related Illness and Death in New York City
Int. J. Environ. Res. Public Health 2018, 15(4), 632; doi:10.3390/ijerph15040632
Received: 13 February 2018 / Revised: 23 March 2018 / Accepted: 27 March 2018 / Published: 30 March 2018
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Abstract
Exposure to cold weather can cause cold-related illness and death, which are preventable. To understand the current burden, risk factors, and circumstances of exposure for illness and death directly attributed to cold, we examined hospital discharge, death certificate, and medical examiner data during
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Exposure to cold weather can cause cold-related illness and death, which are preventable. To understand the current burden, risk factors, and circumstances of exposure for illness and death directly attributed to cold, we examined hospital discharge, death certificate, and medical examiner data during the cold season from 2005 to 2014 in New York City (NYC), the largest city in the United States. On average each year, there were 180 treat-and-release emergency department visits (average annual rate of 21.6 per million) and 240 hospital admissions (29.6 per million) for cold-related illness, and 15 cold-related deaths (1.8 per million). Seventy-five percent of decedents were exposed outdoors. About half of those exposed outdoors were homeless or suspected to be homeless. Of the 25% of decedents exposed indoors, none had home heat and nearly all were living in single-family or row homes. The majority of deaths and illnesses occurred outside of periods of extreme cold. Unsheltered homeless individuals, people who use substances and become incapacitated outdoors, and older adults with medical and psychiatric conditions without home heat are most at risk. This information can inform public health prevention strategies and interventions. Full article
(This article belongs to the Section Climate Change and Health)
Open AccessArticle The Relationship between Sleep Time and Mental Health Problems According to the Strengths and Difficulties Questionnaire in Children after an Earthquake Disaster: The Fukushima Health Management Survey
Int. J. Environ. Res. Public Health 2018, 15(4), 633; doi:10.3390/ijerph15040633
Received: 23 February 2018 / Revised: 18 March 2018 / Accepted: 28 March 2018 / Published: 30 March 2018
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Abstract
A cross-sectional study was performed on the adverse effects of sleep time on the mental health of children after the Great East Japan Earthquake and subsequent nuclear reactor accident in March 2011. The target participants were children aged 4–15 years living inside the
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A cross-sectional study was performed on the adverse effects of sleep time on the mental health of children after the Great East Japan Earthquake and subsequent nuclear reactor accident in March 2011. The target participants were children aged 4–15 years living inside the government-designated evacuation zone as of 11 March 2011 (n = 29,585). The participants’ parents/guardians completed the Strengths and Difficulties Questionnaire (SDQ) and sleep time data were obtained from the 2011 Fukushima Health Management Survey. A total of 18,745 valid responses were returned. We excluded questionnaires with incomplete answers leaving 13,272 responses for the final analysis. First, we divided the children into three age groups for analysis. Second, we divided each age group into four or five groups based on sleep time per day. We used SDQ scores ≥16 to indicate a high risk of mental health problems. In the 4–6-year-old group, those with a sleep time of <9 h had a higher risk. In the 7–12-year-old group, those with ≥10 h of sleep time had a higher risk. In the 13–15-year-old group, those with ≥9 h of sleep time had a higher risk. Shorter sleep time was associated with a higher risk of mental health in 4–6-year-olds. On the other hand, oversleeping was associated with a high risk of mental health in 7–15-year-olds. Full article
(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)
Open AccessArticle Demographics and Psychological Factors Associated with Adiposity in Nurses
Int. J. Environ. Res. Public Health 2018, 15(4), 634; doi:10.3390/ijerph15040634
Received: 22 January 2018 / Revised: 24 February 2018 / Accepted: 10 March 2018 / Published: 30 March 2018
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Abstract
Adiposity-based chronic disease (ABCD), overweight-Ow- or obesity-Ob-) in health personnel is as frequent as in the general population, even though they understand well the importance of maintaining a healthy weight. Thus, it is highly likely that certain demographic and psychological conditions, independently of
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Adiposity-based chronic disease (ABCD), overweight-Ow- or obesity-Ob-) in health personnel is as frequent as in the general population, even though they understand well the importance of maintaining a healthy weight. Thus, it is highly likely that certain demographic and psychological conditions, independently of knowledge, are contributing to develop ABCD. The aim of this study was to examine the association between these factors and ABCD in nurses. Data were collected from a cross-sectional study conducted in a tertiary level institute in Mexico City from 2012 to 2013. All the nurses of the institute of any age, shift, service area and seniority were invited to participate and 55% (265) accepted. We found that ABCD was present in 79.6%, and low self-esteem and emotional distress in 26% and 10%, respectively. Working in the night shift (p = 0.031), labor seniority ≥15 years (p = 0.006), having 1 or more children (p = 0.021) and sessions of physical activity <30 min (p = 0.03) were associated with ABCD. Low self-esteem (OR = 2, 95% CI 1.150–3.07, p = 0.023) and emotional distress (OR = 4, 95% CI 1.472–13.078, p = 0.012) were associated with unhealthy lifestyle (less of 3 days per week and/or less of 30 min per session of physical activity and poor dietary habits). Therefore, strategies to prevent and treat ABCD must consider each context among nurses and psychological disorders need be identified to avoid an unhealthy lifestyle. Full article
Open AccessArticle A Community-Driven Approach to Generate Urban Policy Recommendations for Obesity Prevention
Int. J. Environ. Res. Public Health 2018, 15(4), 635; doi:10.3390/ijerph15040635
Received: 12 February 2018 / Revised: 21 March 2018 / Accepted: 28 March 2018 / Published: 30 March 2018
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Abstract
There is an increasing research interest in targeting interventions at the neighborhood level to prevent obesity. Healthy urban environments require including residents’ perspectives to help understanding how urban environments relate to residents’ food choices and physical activity levels. We describe an innovative community-driven
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There is an increasing research interest in targeting interventions at the neighborhood level to prevent obesity. Healthy urban environments require including residents’ perspectives to help understanding how urban environments relate to residents’ food choices and physical activity levels. We describe an innovative community-driven process aimed to develop environmental recommendations for obesity prevention. We conducted this study in a low-income area in Madrid (Spain), using a collaborative citizen science approach. First, 36 participants of two previous Photovoice projects translated their findings into policy recommendations, using an adapted logical framework approach. Second, the research team grouped these recommendations into strategies for obesity prevention, using the deductive analytical strategy of successive approximation. Third, through a nominal group session including participants, researchers, public health practitioners and local policy-makers, we discussed and prioritized the obesity prevention recommendations. Participants identified 12 policy recommendations related to their food choices and 18 related to their physical activity. The research team grouped these into 11 concrete recommendations for obesity prevention. The ‘top-three’ ranked recommendations were: (1) to adequate and increase the number of public open spaces; (2) to improve the access and cost of existing sports facilities and (3) to reduce the cost of gluten-free and diabetic products. Full article
(This article belongs to the Special Issue Obesity and Urban Environments)
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Open AccessFeature PaperArticle The Function of Personality in Suicidal Ideation from the Perspective of the Interpersonal-Psychological Theory of Suicide
Int. J. Environ. Res. Public Health 2018, 15(4), 636; doi:10.3390/ijerph15040636
Received: 15 February 2018 / Revised: 27 March 2018 / Accepted: 29 March 2018 / Published: 30 March 2018
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Abstract
The Interpersonal-Psychological Theory of Suicide (IPTS) has been increasingly studied over the last years, responding to the demand for a valid framework addressing suicidality. Yet, only a few studies have explored the function of personality in the IPTS and none with clinical patients.
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The Interpersonal-Psychological Theory of Suicide (IPTS) has been increasingly studied over the last years, responding to the demand for a valid framework addressing suicidality. Yet, only a few studies have explored the function of personality in the IPTS and none with clinical patients. We aimed to contribute to fill this gap in investigating the relationship between personality as conceptualized by the Five-Factor Model, the IPTS constructs, and a dimensional measure of current suicidal ideation. We conducted correlation, multiple linear regression, and path analyses based on a trait-interpersonal framework in a sample of 201 individuals visiting the psychiatric emergency room of a general hospital with current suicidal ideation. Neuroticism (positively) and openness (negatively) predicted perceived burdensomeness, while neuroticism (positively) and extraversion (negatively) predicted thwarted belongingness. Higher conscientiousness and lower extraversion were both predictors of the acquired capability for suicide. However, none of the models involving path analyses with IPTS variables as mediators of the relationship between personality traits and suicidal ideation was adequately adjusted to the data. Thus, it appears that personality plays a significant albeit modest role in suicidality when considered from an IPTS perspective. As personality is frequently assessed in the clinical routine, health professionals should consider it as complementary to detect individuals at risk of or presenting suicidal ideation. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle The Mental Health Status and Intellectual Ability of Unwed Mothers Dwelling in Korean Shelter Homes
Int. J. Environ. Res. Public Health 2018, 15(4), 637; doi:10.3390/ijerph15040637
Received: 21 February 2018 / Revised: 26 March 2018 / Accepted: 27 March 2018 / Published: 30 March 2018
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Abstract
Although many unwed mothers have issues concerning mental health and intellectual ability, little research has focused on their mental and cognitive status. Due to the public stigma attached to unwed mothers in South Korea, they tend to conceal their status and are less
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Although many unwed mothers have issues concerning mental health and intellectual ability, little research has focused on their mental and cognitive status. Due to the public stigma attached to unwed mothers in South Korea, they tend to conceal their status and are less likely to seek psychiatric and psychological help. In this context, this study aims to assess the current status of their mental health and intellectual characteristics. A total of 48 unwed mothers from two shelter homes in South Korea agreed to participate in the study. We compared the mental health status of these unwed mothers with that of the general female population. Unwed mothers were more likely than those of the general female population to have mood disorders, post traumatic stress disorder (PTSD), alcohol and nicotine use disorders, and attention-deficit hyperactivity disorder (ADHD). Among the 48 unwed mothers, 20 (41.7%) had an IQ of less than 70, and the mean IQ (78.31) was significantly lower than the normalized mean IQ of the general female population. This study confirmed that unwed mothers dwelling in Korean shelter homes are more likely than the general female population to have mental disorders. Full article
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Open AccessArticle Can Periodical Examinations of Employees Be Useful in Detection of Glycaemia Impairment and Improving Patients’ Adherence to Medical Recommendations?
Int. J. Environ. Res. Public Health 2018, 15(4), 638; doi:10.3390/ijerph15040638
Received: 3 March 2018 / Revised: 27 March 2018 / Accepted: 27 March 2018 / Published: 30 March 2018
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Abstract
Worldwide epidemiological data indicates insufficient diagnosis of diabetes as an increasing public health problem. In the search for solutions to this disadvantageous situation, occupational medicine health services seem to open up a unique opportunity to recognize some abnormalities in the early stages, especially
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Worldwide epidemiological data indicates insufficient diagnosis of diabetes as an increasing public health problem. In the search for solutions to this disadvantageous situation, occupational medicine health services seem to open up a unique opportunity to recognize some abnormalities in the early stages, especially among the asymptomatic working-age population. 316 workers underwent obligatory prophylactic examinations. In patients with twice assayed FGL ≥ 126 mg/dL (7.0 mmol/L) an additional intervention was implemented, including further diagnostic processes and therapy in General Practice (GP), followed by examination by an occupational health specialist within 3 months. The diagnosis of previously unknown diabetes was established among 2.5% of examined workers. All patients referred to the GP due to detected glycaemia impairment visited their doctor and finished the diagnostic process, took up therapy constrained by the occupational health physician to show the effects of intervention within 3 months. Prophylactic medical check-ups allow improved compliance and medical surveillance over glycaemia impairment in patients with prediabetes states, unknown diabetes or uncontrolled clinical course of diabetes. Considering fasting glucose level during mandatory prophylactic examination helps effective prevention of diabetes and its complications and thus provides public health system benefits. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
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Open AccessArticle Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management
Int. J. Environ. Res. Public Health 2018, 15(4), 639; doi:10.3390/ijerph15040639
Received: 12 December 2017 / Revised: 12 March 2018 / Accepted: 24 March 2018 / Published: 30 March 2018
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Abstract
Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore,
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Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls. Full article
(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)
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Open AccessArticle Assessing Vulnerability to Urban Heat: A Study of Disproportionate Heat Exposure and Access to Refuge by Socio-Demographic Status in Portland, Oregon
Int. J. Environ. Res. Public Health 2018, 15(4), 640; doi:10.3390/ijerph15040640
Received: 14 December 2017 / Revised: 13 March 2018 / Accepted: 14 March 2018 / Published: 30 March 2018
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Abstract
Extreme urban heat is a powerful environmental stressor which poses a significant threat to human health and well-being. Exacerbated by the urban heat island phenomenon, heat events are expected to become more intense and frequent as climate change progresses, though we have limited
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Extreme urban heat is a powerful environmental stressor which poses a significant threat to human health and well-being. Exacerbated by the urban heat island phenomenon, heat events are expected to become more intense and frequent as climate change progresses, though we have limited understanding of the impact of such events on vulnerable populations at a neighborhood or census block group level. Focusing on the City of Portland, Oregon, this study aimed to determine which socio-demographic populations experience disproportionate exposure to extreme heat, as well as the level of access to refuge in the form of public cooling centers or residential central air conditioning. During a 2014 heat wave, temperature data were recorded using a vehicle-traverse collection method, then extrapolated to determine average temperature at the census block group level. Socio-demographic factors including income, race, education, age, and English speaking ability were tested using statistical assessments to identify significant relationships with heat exposure and access to refuge from extreme heat. Results indicate that groups with limited adaptive capacity, including those in poverty and non-white populations, are at higher risk for heat exposure, suggesting an emerging concern of environmental justice as it relates to climate change. The paper concludes by emphasizing the importance of cultural sensitivity and inclusion, in combination with effectively distributing cooling centers in areas where the greatest burden befalls vulnerable populations. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
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Open AccessArticle Cooking Fuels in Lagos, Nigeria: Factors Associated with Household Choice of Kerosene or Liquefied Petroleum Gas (LPG)
Int. J. Environ. Res. Public Health 2018, 15(4), 641; doi:10.3390/ijerph15040641
Received: 4 March 2018 / Revised: 26 March 2018 / Accepted: 28 March 2018 / Published: 31 March 2018
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Abstract
Cooking with dirty-burning fuels is associated with health risk from household air pollution. We assessed the prevalence of and factors associated with the use of cooking fuels, and attitudes and barriers towards use of liquefied petroleum gas (LPG). This was a cross-sectional, population-based
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Cooking with dirty-burning fuels is associated with health risk from household air pollution. We assessed the prevalence of and factors associated with the use of cooking fuels, and attitudes and barriers towards use of liquefied petroleum gas (LPG). This was a cross-sectional, population-based survey conducted in 519 households in Lagos, Nigeria. We used a structured questionnaire to obtain information regarding choice of household cooking fuel and the attitudes towards the use of LPG. Kerosene was the most frequently used cooking fuel (n = 475, 91.5%; primary use n = 364, 70.1%) followed by charcoal (n = 159, 30.6%; primary use n = 88, 17%) and LPG (n = 86, 16.6%; primary use n = 63, 12.1%). Higher level of education, higher income and younger age were associated with LPG vs. kerosene use. Fuel expenditure on LPG was significantly lower than for kerosene ( N (Naira) 2169.0 ± 1507.0 vs. N 2581.6 ± 1407.5). Over 90% of non-LPG users were willing to switch to LPG but cited safety issues and high cost as potential barriers to switching. Our findings suggest that misinformation and beliefs regarding benefits, safety and cost of LPG are important barriers to LPG use. An educational intervention program could be a cost-effective approach to improve LPG adoption and should be formally addressed through a well-designed community-based intervention study. Full article
Open AccessArticle Extremely Low Frequency-Magnetic Field (ELF-MF) Exposure Characteristics among Semiconductor Workers
Int. J. Environ. Res. Public Health 2018, 15(4), 642; doi:10.3390/ijerph15040642
Received: 8 March 2018 / Revised: 27 March 2018 / Accepted: 28 March 2018 / Published: 31 March 2018
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Abstract
We assessed the exposure of semiconductor workers to extremely low frequency-magnetic fields (ELF-MF) and identified job characteristics affecting ELF-MF exposure. These were demonstrated by assessing the exposure of 117 workers involved in wafer fabrication (fab) and chip packaging wearing personal dosimeters for a
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We assessed the exposure of semiconductor workers to extremely low frequency-magnetic fields (ELF-MF) and identified job characteristics affecting ELF-MF exposure. These were demonstrated by assessing the exposure of 117 workers involved in wafer fabrication (fab) and chip packaging wearing personal dosimeters for a full shift. A portable device was used to monitor ELF-MF in high temporal resolution. All measurements were categorized by operation, job and working activity during working time. ELF-MF exposure of workers were classified based on the quartiles of ELF-MF distribution. The average levels of ELF-MF exposure were 0.56 µT for fab workers, 0.59 µT for chip packaging workers and 0.89 µT for electrical engineers, respectively. Exposure to ELF-MF differed among types of factory, operation, job and activity. Workers engaged in the diffusion and chip testing activities showed the highest ELF-MF exposure. The ELF-MF exposures of process operators were found to be higher than those of maintenance engineers, although peak exposure and/or patterns varied. The groups with the highest quartile ELF-MF exposure level are operators in diffusion, ion implantation, module and testing operations, and maintenance engineers in diffusion, module and testing operations. In conclusion, ELF-MF exposure among workers can be substantially affected by the type of operation and job, and the activity or location. Full article
(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)
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Open AccessArticle The Impact of Suicide Bereavement on Educational and Occupational Functioning: A Qualitative Study of 460 Bereaved Adults
Int. J. Environ. Res. Public Health 2018, 15(4), 643; doi:10.3390/ijerph15040643
Received: 1 March 2018 / Revised: 28 March 2018 / Accepted: 29 March 2018 / Published: 31 March 2018
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Abstract
People bereaved by suicide are at an increased risk of suicide and of dropping out of education or work. Explanations for these associations are unclear, and more research is needed to understand how improving support in educational or work settings for people bereaved
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People bereaved by suicide are at an increased risk of suicide and of dropping out of education or work. Explanations for these associations are unclear, and more research is needed to understand how improving support in educational or work settings for people bereaved by suicide might contribute to reducing suicide risk. Our objective was to explore the impact of suicide on occupational functioning. We conducted a cross-sectional online study of bereaved adults aged 18–40, recruited from staff and students of British higher educational institutions in 2010. We used thematic analysis to analyse free text responses to two questions probing the impact of suicide bereavement on work and education. Our analysis of responses from 460 adults bereaved by suicide identified three main themes: (i) specific aspects of grief that impacted on work performance, cognitive and emotional domains, and social confidence; (ii) structural challenges in work or educational settings including a lack of institutional support, the impact of taking time off, and changes to caring roles; and (iii) new perspectives on the role of work, including determination to achieve. Institutional support should be tailored to take account of the difficulties and experiences described. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle Determinants of Child Health Behaviors in a Disadvantaged Area from a Community Perspective: A Participatory Needs Assessment
Int. J. Environ. Res. Public Health 2018, 15(4), 644; doi:10.3390/ijerph15040644
Received: 2 February 2018 / Revised: 24 March 2018 / Accepted: 29 March 2018 / Published: 31 March 2018
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Abstract
Children from disadvantaged areas are hard to reach for interventions aimed at promoting healthy lifestyles. We conducted a participatory needs assessment, in which researchers collaborated with a community in a disadvantaged area in Amsterdam to gain an understanding of the health-related issues of
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Children from disadvantaged areas are hard to reach for interventions aimed at promoting healthy lifestyles. We conducted a participatory needs assessment, in which researchers collaborated with a community in a disadvantaged area in Amsterdam to gain an understanding of the health-related issues of children within this community. Qualitative data was collected through: three to four participatory group meetings with three groups of 9–12-year-old children (n = 5–9 per group); nine interviews with professionals working with youth; two interviews with parents and their children; and informal meetings including 31 parents. All transcriptions or summaries were coded and analyzed. Childhood overweight/obesity was indicated as the main health issue. A lack of physical activity and unhealthy dietary behavior were identified as the main risk factors, with underlying determinants such as culture, habits, finances, and social norms. Identified needs included more supervised, low-priced sports activities at a nearby location and more education on adopting a healthy diet. Our participatory health needs assessment resulted in a comprehensive overview of the most relevant risk factors and determinants of childhood overweight/obesity and needs from the community’s perspective. This knowledge aids in the development of better tailored, and thereby potentially more effective, interventions. Full article
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
Open AccessArticle Factors that Predict Parental Willingness to Have Their Children Vaccinated against HPV in a Country with Low HPV Vaccination Coverage
Int. J. Environ. Res. Public Health 2018, 15(4), 645; doi:10.3390/ijerph15040645
Received: 20 January 2018 / Revised: 27 March 2018 / Accepted: 29 March 2018 / Published: 31 March 2018
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Abstract
Background: Adolescent HPV (Human Papilloma Virus) vaccination is yet to be introduced as a mandatory program in Poland. Polish literature on factors associated with adolescent HPV vaccination is scant, despite the fact that uptake is one of the poorest in the European Union.
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Background: Adolescent HPV (Human Papilloma Virus) vaccination is yet to be introduced as a mandatory program in Poland. Polish literature on factors associated with adolescent HPV vaccination is scant, despite the fact that uptake is one of the poorest in the European Union. Objectives: To assess HPV awareness and identify independent predictors for parental willingness to have their children vaccinated against HPV. Methods: All parents of first grade students from three selected high schools in Zgorzelec, Poland, who participated in parent–teacher meetings at the time the study was conducted, had their children unvaccinated regarding HPV, and who gave informed consent to participate were included. There were 600 first grade students; 9 were vaccinated against HPV. This left 591 parents who met the eligibility criteria; the response rate was 76.1%. Results: Awareness of HPV was reported by 55.3% of 450 parents (mean age 42 years, 70.9% females); 85.1% expressed their willingness to vaccinate their children against HPV; 31.3% identified HPV as a sexually transmitted pathogen, and 36.2% identified it as a risk factor of cervical cancer. Multivariable logistic regression analyses indicated that being employed (OR 2.09; 95% CI: 1.10–3.86), having positive attitudes toward vaccines (OR 3.02; 95% CI: 1.34–6.49), previous information about HPV (OR 2.02; 95% CI: 1.17–3.51), and concerns about the side effects of the HPV vaccine (OR 0.60; 95% CI: 0.35–0.99) were independent predictors of parents’ willingness to vaccinate. Conclusions: Attitudes regarding their child being vaccinated against HPV were positive among Polish parents, even though awareness and knowledge of HPV in this group were low. Most of the significant factors that influenced their willingness were modifiable, such as being informed about HPV and having positive attitudes toward vaccines. Future interventions should focus specifically on vulnerable subgroups, such as unemployed parents. Full article
Open AccessArticle Children and Caregivers’ Exposure to Adverse Childhood Experiences (ACES): Association with Children’s and Caregivers’ Psychological Outcomes in a Therapeutic Preschool Program
Int. J. Environ. Res. Public Health 2018, 15(4), 646; doi:10.3390/ijerph15040646
Received: 15 February 2018 / Revised: 15 March 2018 / Accepted: 29 March 2018 / Published: 31 March 2018
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Abstract
Exposure to adverse childhood experiences (ACE) has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing
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Exposure to adverse childhood experiences (ACE) has been found to have a profound negative impact on multiple child outcomes, including academic achievement, social cognition patterns, and behavioral adjustment. However, these links have yet to be examined in preschool children that are already experiencing behavior or social-emotional problems. Thus, the present study examined the links between the caregiver’s and the child’s exposure to ACE and multiple child and caregiver’s outcomes in a sample of 30 preschool children enrolled in a Therapeutic Nursery Program (TNP). Children are typically referred to this TNP due to significant delays in their social emotional development that often result in difficulty functioning in typical childcare, home, and community settings. Analyses revealed some contradictory patterns that may be specific to this clinical sample. Children with higher exposure to ACE showed more biased social information processing patterns and their caregivers reported lower child social skills than caregivers of children with less exposure, however their inhibitory control levels were higher (better control) and staff reported that these children exhibited better social skills as well as better approaches to learning than children with less exposure. No such contradictions were found in relation to the caregiver’s exposure to ACE, as it was positively associated with a number of negative child and caregiver outcomes. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data
Int. J. Environ. Res. Public Health 2018, 15(4), 647; doi:10.3390/ijerph15040647
Received: 9 February 2018 / Revised: 27 March 2018 / Accepted: 28 March 2018 / Published: 31 March 2018
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Abstract
Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma
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Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM2.5, PM10, O3, SO2, and NO2) in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O3 in spring in Taipei. In children aged 0–6 years, asthma was associated with O3 in Taipei and SO2 in Kaohsiung, after controlling for the daily mean temperature and relative humidity. Full article
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Open AccessArticle Preventing Opioid Use Disorders among Fishing Industry Workers
Int. J. Environ. Res. Public Health 2018, 15(4), 648; doi:10.3390/ijerph15040648
Received: 21 February 2018 / Revised: 26 March 2018 / Accepted: 28 March 2018 / Published: 31 March 2018
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Abstract
Fishing industry workers are at high risk for work-related musculoskeletal disorders (MSDs) and injuries. Prescription opioids used to treat pain injuries may put these workers at increased risk for developing substance disorders. Using a Community-Based Participatory Research approach, formative research was conducted to
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Fishing industry workers are at high risk for work-related musculoskeletal disorders (MSDs) and injuries. Prescription opioids used to treat pain injuries may put these workers at increased risk for developing substance disorders. Using a Community-Based Participatory Research approach, formative research was conducted to inform the eventual development of relevant interventions to prevent and reduce opioid use disorders among fishing industry workers. Qualitative interviews (n = 21) were conducted to assess: knowledge and attitudes about opioid use disorders; features of fishing work that might affect use and/or access to treatment; and community and organizational capacity for prevention and treatment. Participants reported numerous pathways connecting commercial fishing with opioid use. The combination of high stress and physically tasking job duties requires comprehensive workplace interventions to prevent chronic pain and MSDs, in addition to tailored and culturally responsive treatment options to address opioid use disorders in this population. Public health programs must integrate workplace health and safety protection along with evidence-based primary, secondary, and tertiary interventions in order to address opioid use disorders, particularly among workers in strenuous jobs. Full article
(This article belongs to the Special Issue Drug Abuse, Environment and Public Health)
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Open AccessArticle Robust Economic Control Decision Method of Uncertain System on Urban Domestic Water Supply
Int. J. Environ. Res. Public Health 2018, 15(4), 649; doi:10.3390/ijerph15040649
Received: 22 January 2018 / Revised: 26 March 2018 / Accepted: 29 March 2018 / Published: 31 March 2018
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Abstract
As China quickly urbanizes, urban domestic water generally presents the circumstances of both rising tendency and seasonal cycle fluctuation. A robust economic control decision method for dynamic uncertain systems is proposed in this paper. It is developed based on the internal model principle
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As China quickly urbanizes, urban domestic water generally presents the circumstances of both rising tendency and seasonal cycle fluctuation. A robust economic control decision method for dynamic uncertain systems is proposed in this paper. It is developed based on the internal model principle and pole allocation method, and it is applied to an urban domestic water supply system with rising tendency and seasonal cycle fluctuation. To achieve this goal, first a multiplicative model is used to describe the urban domestic water demand. Then, a capital stock and a labor stock are selected as the state vector, and the investment and labor are designed as the control vector. Next, the compensator subsystem is devised in light of the internal model principle. Finally, by using the state feedback control strategy and pole allocation method, the multivariable robust economic control decision method is implemented. The implementation with this model can accomplish the urban domestic water supply control goal, with the robustness for the variation of parameters. The methodology presented in this study may be applied to the water management system in other parts of the world, provided all data used in this study are available. The robust control decision method in this paper is also applicable to deal with tracking control problems as well as stabilization control problems of other general dynamic uncertain systems. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
Open AccessArticle The Effectiveness of International Non-Governmental Organizations’ Response Operations during Public Health Emergency: Lessons Learned from the 2014 Ebola Outbreak in Sierra Leone
Int. J. Environ. Res. Public Health 2018, 15(4), 650; doi:10.3390/ijerph15040650
Received: 20 February 2018 / Revised: 18 March 2018 / Accepted: 20 March 2018 / Published: 1 April 2018
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Abstract
International Nongovernmental Organizations (INGOs) have played critical roles in improving the quality of primary health care in ordinary time and, indeed, responding to epidemic crises in developing countries. Due to a lack of empirical research for effectiveness of their responding activities, the legitimacy
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International Nongovernmental Organizations (INGOs) have played critical roles in improving the quality of primary health care in ordinary time and, indeed, responding to epidemic crises in developing countries. Due to a lack of empirical research for effectiveness of their responding activities, the legitimacy and accountability of nonprofits’ engagement in the health crisis as a critical responder is doubted. This paper aims to examine the effectiveness of INGOs in a context of managing a fatal epidemic outbreak of Ebola in Sierra Leone during May–November, 2014; building healthcare infrastructures, providing medical supplies, educating local residents, and training response staffs. The analysis results show that development of healthcare infrastructures and provision of medical supplies have been significantly effective in terms of decreasing the severity of the crisis in chiefdoms. The findings imply that policy tools, which allow INGOs to enter to the field in a timely manner, can improve the effectiveness of INGOs’ responses in current and future epidemic outbreaks in developing countries where people suffer from a lack of health infrastructures. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Pediatric Age Palm Oil Consumption
Int. J. Environ. Res. Public Health 2018, 15(4), 651; doi:10.3390/ijerph15040651
Received: 12 February 2018 / Revised: 25 March 2018 / Accepted: 27 March 2018 / Published: 1 April 2018
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Abstract
Palm oil is widely used in the food industry for its chemical/physical properties, low cost and wide availability. Its widespread use has provoked an intense debate about whether it is a potential danger to human health. In a careful review of the scientific
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Palm oil is widely used in the food industry for its chemical/physical properties, low cost and wide availability. Its widespread use has provoked an intense debate about whether it is a potential danger to human health. In a careful review of the scientific literature, we focused on nutritional characteristics and health effects of the use of palm oil with regards to children, seeking to determine whether there is evidence that justifies fears about the health effects of palm oil. Our review showed that palm oil represents a significant source of saturated fatty acids, to which scientific evidence attributes negative health effects when used in excess, especially with regards to cardiovascular diseases. However, to date, there is no evidence about the harmful effects of palm oil on the health of children. Nevertheless, palm oil has possible ill health effects linked to its composition of fatty acids: its consumption is not correlated to risk factors for cardiovascular diseases in young people with a normal weight and cholesterol level; the elderly and patients with dyslipidaemia or previous cardiovascular events or hypertension are at a greater risk. Therefore, the matter is not palm oil itself but the fatty-acid-rich food group to which it belongs. The most important thing is to consume no more than 10% of saturated fatty acids, regardless of their origin and regardless of one’s age. Correct information based on a careful analysis of the scientific evidence, rather than a focus on a singular presumed culprit substance, should encourage better lifestyles. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Is a Water Content of 60% Maximum Water Holding Capacity Suitable for Folsomia candida Reproduction Tests? A Study with Silver Nanoparticles and AgNO3
Int. J. Environ. Res. Public Health 2018, 15(4), 652; doi:10.3390/ijerph15040652
Received: 28 February 2018 / Revised: 29 March 2018 / Accepted: 30 March 2018 / Published: 1 April 2018
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Abstract
Silver nanoparticles (AgNP) are increasingly emitted to the environment due to a rise in application in various products; therefore, assessment of their potential risks for biota is important. In this study the effects of AgNP at environmentally relevant concentrations (0.6–375 µg kg−1
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Silver nanoparticles (AgNP) are increasingly emitted to the environment due to a rise in application in various products; therefore, assessment of their potential risks for biota is important. In this study the effects of AgNP at environmentally relevant concentrations (0.6–375 µg kg−1 soil) on the soil invertebrate Folsomia candida in OECD (Organisation for Economic Co-operation and Development) soil was examined at different soil water contents. Animals were retrieved by heat extraction, which had an efficiency of about 90% compared with the floatation method. The tested water content range is set by OECD Guideline 232 (40–60% of the maximum water holding capacity, WHC), and we detected significant differences in toxicity due to these. With AgNO3, used as an ionic control, the number of juveniles significantly decreased only at 40% WHC, which might be due to dilution of the toxicant at higher soil water content. In turn, at 60% WHC, the reproduction of F. candida significantly increased in the presence of AgNP compared with in the control. However, at this water content, the required number of juveniles in the control treatment was not reached in three independent tests. The fact that the OECD validity criterion is not met indicates that the soil conditions are not suitable for reproduction at 60% WHC. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Electrode Modified by Reduced Graphene Oxide for Monitoring of Total Thallium in Grain Products
Int. J. Environ. Res. Public Health 2018, 15(4), 653; doi:10.3390/ijerph15040653
Received: 5 March 2018 / Revised: 27 March 2018 / Accepted: 30 March 2018 / Published: 1 April 2018
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Abstract
Grain products and the associated industry have a notable economic and social impact all over the world. The toxicological safety of grain products is a nutritional prerogative. This study focused on the determination of thallium content in grain product samples collected from a
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Grain products and the associated industry have a notable economic and social impact all over the world. The toxicological safety of grain products is a nutritional prerogative. This study focused on the determination of thallium content in grain product samples collected from a commercial brand commonly available in Poland. The samples were analyzed with the use of differential pulse anodic stripping voltammetry (DPASV) with graphene oxide based on glassy carbon. The stripping anodic peak current of thallium was linear over its concentration range from 9.78 × 10−9 to 97.8 × 10−9 M. The limit of detection (LOD) was calculated according to the formula LOD = (κ × SDa)/b, where κ is 3.3, SDa is the standard deviation of the intercept, and b is the slope. The determined value of LOD was 1.229 µg L−1 (6.01 × 10−9 M). The proposed method was successfully applied for the determination of thallium ions in samples of actual grain products. The obtained results confirmed that thallium was present in the studied cereal samples (average content at 0.0268 ± 0.0798 mg/kg). Thallium has a half-life of 60 days; therefore, the consumption of foods with thallium content of approximately 0.08 mg/kg has the potential for harmful bioaccumulation in the body. Thallium contamination in cereal products should be a critical parameter for health environmental regulations. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle The Effect of Leisure Activity Diversity and Exercise Time on the Prevention of Depression in the Middle-Aged and Elderly Residents of Taiwan
Int. J. Environ. Res. Public Health 2018, 15(4), 654; doi:10.3390/ijerph15040654
Received: 16 February 2018 / Revised: 22 March 2018 / Accepted: 29 March 2018 / Published: 1 April 2018
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Abstract
Previous studies have confirmed that activity participation is beneficial to mental health, but few studies focus on older adults’ depression. Based on the theory of social integration, this study examined the effects of leisure activity diversity and exercise time on depression in late
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Previous studies have confirmed that activity participation is beneficial to mental health, but few studies focus on older adults’ depression. Based on the theory of social integration, this study examined the effects of leisure activity diversity and exercise time on depression in late adulthood. Subjects in the 2011 Survey of Health and Living Status of the Middle-Aged and Elderly in Taiwan were extracted. A series of logistic regressions were conducted to discern factors related to the odds of having depression. Among study subjects (N = 3727; age ≥ 58), 20.9% indicated an inclination of having depression (CESD-10 score ≥ 8). This study found that participating in diverse leisure activities and longer exercise time decreases older adults’ risk of having depression. Additionally, the results confirmed that depression is positively correlated with chronic diseases. Consequently, efforts should be continually spent on encouraging older adults’ participation in activities to reduce the prevalence of depression. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
Open AccessArticle A Comparative Study of Behavior Problems among Left-Behind Children, Migrant Children and Local Children
Int. J. Environ. Res. Public Health 2018, 15(4), 655; doi:10.3390/ijerph15040655
Received: 29 November 2017 / Revised: 16 March 2018 / Accepted: 27 March 2018 / Published: 1 April 2018
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Abstract
This study aims to estimate the prevalence of behavioral problems among left-behind children, migrant children and local children in China, and to compare the risks of behavioral problems among the three types of children. Data on 4479 children aged 6–16 used in this
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This study aims to estimate the prevalence of behavioral problems among left-behind children, migrant children and local children in China, and to compare the risks of behavioral problems among the three types of children. Data on 4479 children aged 6–16 used in this study were from a survey conducted in China in 2017. The school-age version of the Children Behavior Checklist was used to measure children’s behavioral problems. Descriptive analysis, correlation analysis, and logistic regressions were conducted. The prevalence of behavioral problems was 18.80% and 13.59% for left-behind children and migrant children, respectively, both of which were higher than that of local children. Logistic regression analysis showed that after adjustments for individual and environmental variables, the likelihood of total, internalizing and externalizing behavior problems for left-behind children and migrant children were higher than those for local children; left-behind children had a higher likelihood of internalizing problems than externalizing problems, while migrant children had a higher prevalence of externalizing problems. Left-behind children had a higher prevalence of each specific syndrome than migrant and local children. Both individual and environmental factors were associated with child behavioral problems, and family migration may contribute to the increased risks. Left-behind and migrant children were more vulnerable than local children to behavioral problems. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle Influence of Vehicle Speed on the Characteristics of Driver’s Eye Movement at a Highway Tunnel Entrance during Day and Night Conditions: A Pilot Study
Int. J. Environ. Res. Public Health 2018, 15(4), 656; doi:10.3390/ijerph15040656
Received: 4 February 2018 / Revised: 29 March 2018 / Accepted: 30 March 2018 / Published: 2 April 2018
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Abstract
The aim of this study was to investigate how vehicle speed influences the characteristics of driver’s eye movement at highway tunnel entrances during day and night. In this study, six drivers’ eye movement data (from 200 m before tunnel entrance to 200 m
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The aim of this study was to investigate how vehicle speed influences the characteristics of driver’s eye movement at highway tunnel entrances during day and night. In this study, six drivers’ eye movement data (from 200 m before tunnel entrance to 200 m inside tunnel entrance) under five predetermined vehicle speeds (40, 50, 60, 70 and 80 km/h) in the daytime and three predetermined vehicle speeds (40, 60 and 80 km/h) in the nighttime were recorded using the non-intrusive Dikablis Professional eye-tracking system. Pupil size, the average fixation duration time and the average number of fixation were analyzed and then the influence of the vehicle speed on these parameters was evaluated by means of IBM SPSS Statistics 20.0. The results for pupil size in daytime increased when approaching the tunnel entrance, while as for nighttime, pupil size decreased when approaching the tunnel entrance and then increased after entering the tunnel. The pupil size in daytime has a significant negative correlation with vehicle speed, while the pupil size in nighttime did not show a significant association with vehicle speed. Furthermore, the average fixation duration in daytime increased when entering the tunnel, and had a significant negative correlation with vehicle speed. Also, the average number of fixations in daytime decreased when entering the tunnel and has a significant negative correlation with vehicle speed. However, the average fixation duration and the average number of fixations in nighttime did not show any significant association with vehicle speed. Moreover, limitations and future directions of the study are discussed for the further investigation. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Associations between Job Strain and Arterial Stiffness: A Large Survey among Enterprise Employees from Thailand
Int. J. Environ. Res. Public Health 2018, 15(4), 659; doi:10.3390/ijerph15040659
Received: 31 January 2018 / Revised: 25 March 2018 / Accepted: 27 March 2018 / Published: 2 April 2018
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Abstract
As an intermediate endpoint to cardiovascular disease, arterial stiffness has received much attention recently. So far, the research on work stress and arterial stiffness is still sparse and inconsistent, and no investigations on work stress and cardiovascular health among the Thai working population
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As an intermediate endpoint to cardiovascular disease, arterial stiffness has received much attention recently. So far, the research on work stress and arterial stiffness is still sparse and inconsistent, and no investigations on work stress and cardiovascular health among the Thai working population have been reported. Therefore, we conducted an epidemiological study among 2141 Thai enterprise employees (858 men and 1283 women) who were free from any diagnosed cardiovascular disease. Work stress was measured using Karasek’s Job Demand–Control model for job strain (a combination of high demand and low control). Arterial stiffness was evaluated by a non-invasive approach using pulse-wave analysis based on a finger photoplethysmogram. Multivariable linear regression was applied to examine associations between job strain and arterial stiffness. In men, job strain was significantly associated with arterial stiffness (β  =  0.078, 95% confidence interval  =  0.026 to 0.130), after accounting for sociodemographic, behavioral, dietary and biomedical factors. However, the association in women was not significant. As the first study in Thailand on work stress and cardiovascular risk, we found that job strain might be an important risk factor for cardiovascular disease among Thai working men. Further studies with longitudinal design are warranted. Full article
(This article belongs to the Section Occupational Safety and Health)
Open AccessArticle Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching
Int. J. Environ. Res. Public Health 2018, 15(4), 660; doi:10.3390/ijerph15040660
Received: 23 February 2018 / Revised: 22 March 2018 / Accepted: 29 March 2018 / Published: 2 April 2018
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Abstract
The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS) through the use of volunteers. The study’s priority population consistently experiences
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The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS) through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition) were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19). The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care. Full article
(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)
Open AccessArticle Spatio-Temporal Epidemiology of Viral Hepatitis in China (2003–2015): Implications for Prevention and Control Policies
Int. J. Environ. Res. Public Health 2018, 15(4), 661; doi:10.3390/ijerph15040661
Received: 13 February 2018 / Revised: 19 March 2018 / Accepted: 30 March 2018 / Published: 2 April 2018
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Abstract
Viral hepatitis, as one of the most serious notifiable infectious diseases in China, takes heavy tolls from the infected and causes a severe economic burden to society, yet few studies have systematically explored the spatio-temporal epidemiology of viral hepatitis in China. This study
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Viral hepatitis, as one of the most serious notifiable infectious diseases in China, takes heavy tolls from the infected and causes a severe economic burden to society, yet few studies have systematically explored the spatio-temporal epidemiology of viral hepatitis in China. This study aims to explore, visualize and compare the epidemiologic trends and spatial changing patterns of different types of viral hepatitis (A, B, C, E and unspecified, based on the classification of CDC) at the provincial level in China. The growth rates of incidence are used and converted to box plots to visualize the epidemiologic trends, with the linear trend being tested by chi-square linear by linear association test. Two complementary spatial cluster methods are used to explore the overall agglomeration level and identify spatial clusters: spatial autocorrelation analysis (measured by global and local Moran’s I) and space-time scan analysis. Based on the spatial autocorrelation analysis, the hotspots of hepatitis A remain relatively stable and gradually shrunk, with Yunnan and Sichuan successively moving out the high-high (HH) cluster area. The HH clustering feature of hepatitis B in China gradually disappeared with time. However, the HH cluster area of hepatitis C has gradually moved towards the west, while for hepatitis E, the provincial units around the Yangtze River Delta region have been revealing HH cluster features since 2005. The space-time scan analysis also indicates the distinct spatial changing patterns of different types of viral hepatitis in China. It is easy to conclude that there is no one-size-fits-all plan for the prevention and control of viral hepatitis in all the provincial units. An effective response requires a package of coordinated actions, which should vary across localities regarding the spatial-temporal epidemic dynamics of each type of virus and the specific conditions of each provincial unit. Full article
(This article belongs to the Special Issue Spatio-Temporal Analysis of Infectious Diseases)
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Open AccessArticle Medical Surveillance, Continuous Health Promotion and a Participatory Intervention in a Small Company
Int. J. Environ. Res. Public Health 2018, 15(4), 662; doi:10.3390/ijerph15040662
Received: 11 February 2018 / Revised: 29 March 2018 / Accepted: 30 March 2018 / Published: 2 April 2018
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Abstract
The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers’ wellbeing
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The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers’ wellbeing using a holistic approach during medical surveillance enables us to promptly identify problems in work organisation and the company climate. Problems of this kind can be adequately managed by using a participatory approach. The aim of this paper is twofold: to signal this way of proceeding with medical surveillance, and to describe an organisational development intervention. Participatory groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the Effort/Reward Imbalance questionnaire, and an improvement in psychological wellbeing assessed by means of the Goldberg Anxiety/Depression scale. Although the limited size of the sample and the lack of a control group call for a cautious evaluation of this study, the participatory strategy proved to be a useful tool due to its cost-effectiveness. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
Open AccessArticle The Elderly Perceived Meanings and Values of Virtual Reality Leisure Activities: A Means-End Chain Approach
Int. J. Environ. Res. Public Health 2018, 15(4), 663; doi:10.3390/ijerph15040663
Received: 15 January 2018 / Revised: 26 March 2018 / Accepted: 2 April 2018 / Published: 3 April 2018
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Abstract
This study uses means-end chain (MEC) techniques to examine the awareness, decision-making procedure, and personal values of the elderly with regard to virtual reality leisure activities. The results of the study show that elderly respondents value virtual reality leisure activities that are fun,
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This study uses means-end chain (MEC) techniques to examine the awareness, decision-making procedure, and personal values of the elderly with regard to virtual reality leisure activities. The results of the study show that elderly respondents value virtual reality leisure activities that are fun, safe, and easy. In terms of outcome benefits, elderly respondents value feeling physically and mentally healthy, firsthand experience, and satisfied curiosity. In value terms, elderly respondents hope that their chosen virtual reality leisure activities improve not only their relationships with others, but also their enjoyment, quality of life, and sense of belonging. The results show that, while consumers with different awarenesses of virtual reality leisure activities have different decision-making processes, they share creating “good memories” as the terminal value with the most significant effect. This presents a potential opportunity to promote virtual reality leisure activities. Relevant bodies or enterprises can seek to create good memories in consumers by developing activities that are safe and fun, promote good health, and provide good service, thereby attracting the interest of elderly consumers. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Hesitant Fuzzy Linguistic Preference Utility Set and Its Application in Selection of Fire Rescue Plans
Int. J. Environ. Res. Public Health 2018, 15(4), 664; doi:10.3390/ijerph15040664
Received: 16 March 2018 / Revised: 26 March 2018 / Accepted: 27 March 2018 / Published: 3 April 2018
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Abstract
Hesitant fuzzy linguistic term set provides an effective tool to represent uncertain decision information. However, the semantics corresponding to the linguistic terms in it cannot accurately reflect the decision-makers’ subjective cognition. In general, different decision-makers’ sensitivities towards the semantics are different. Such sensitivities
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Hesitant fuzzy linguistic term set provides an effective tool to represent uncertain decision information. However, the semantics corresponding to the linguistic terms in it cannot accurately reflect the decision-makers’ subjective cognition. In general, different decision-makers’ sensitivities towards the semantics are different. Such sensitivities can be represented by the cumulative prospect theory value function. Inspired by this, we propose a linguistic scale function to transform the semantics corresponding to linguistic terms into the linguistic preference values. Furthermore, we propose the hesitant fuzzy linguistic preference utility set, based on which, the decision-makers can flexibly express their distinct semantics and obtain the decision results that are consistent with their cognition. For calculations and comparisons over the hesitant fuzzy linguistic preference utility sets, we introduce some distance measures and comparison laws. Afterwards, to apply the hesitant fuzzy linguistic preference utility sets in emergency management, we develop a method to obtain objective weights of attributes and then propose a hesitant fuzzy linguistic preference utility-TOPSIS method to select the best fire rescue plan. Finally, the validity of the proposed method is verified by some comparisons of the method with other two representative methods including the hesitant fuzzy linguistic-TOPSIS method and the hesitant fuzzy linguistic-VIKOR method. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle The Effect of Seasonal Floods on Health: Analysis of Six Years of National Health Data and Flood Maps
Int. J. Environ. Res. Public Health 2018, 15(4), 665; doi:10.3390/ijerph15040665
Received: 15 February 2018 / Revised: 21 March 2018 / Accepted: 29 March 2018 / Published: 3 April 2018
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Abstract
There is limited knowledge on the effect of seasonal flooding on health over time. We quantified the short- and long-term effects of floods on selected health indicators at public healthcare facilities in 11 districts in Cambodia, a flood-prone setting. Counts of inpatient discharge
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There is limited knowledge on the effect of seasonal flooding on health over time. We quantified the short- and long-term effects of floods on selected health indicators at public healthcare facilities in 11 districts in Cambodia, a flood-prone setting. Counts of inpatient discharge diagnoses and outpatient consultations for diarrhea, acute respiratory infections, skin infections, injuries, noncommunicable diseases and vector-borne diseases were retrieved from public healthcare facilities for each month between January 2008 and December 2013. Flood water was mapped by month, in square kilometers, from satellite data. Poisson regression models with three lag months were constructed for the health problems in each district, controlled for seasonality and long-term trends. During times of flooding and three months after, there were small to moderate increases in visits to healthcare facilities for skin infections, acute respiratory infections, and diarrhea, while no association was seen at one to two months. The associations were small to moderate, and a few of our results were significant. We observed increases in care seeking for diarrhea, skin infections, and acute respiratory infections following floods, but the associations are uncertain. Additional research on previous exposure to flooding, using community- and facility-based data, would help identify expected health risks after floods in flood-prone settings. Full article
(This article belongs to the Special Issue Public Health and Disasters)
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Open AccessArticle Support Needs and Experiences of People Bereaved by Suicide: Qualitative Findings from a Cross-Sectional British Study of Bereaved Young Adults
Int. J. Environ. Res. Public Health 2018, 15(4), 666; doi:10.3390/ijerph15040666
Received: 1 March 2018 / Revised: 29 March 2018 / Accepted: 29 March 2018 / Published: 3 April 2018
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Abstract
People bereaved by suicide are at increased risk of suicide, but evidence is lacking that available interventions reduce suicide risk. Few large-scale studies have described the views of suicide-bereaved people regarding their needs for support. Our objective was to explore the nature of
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People bereaved by suicide are at increased risk of suicide, but evidence is lacking that available interventions reduce suicide risk. Few large-scale studies have described the views of suicide-bereaved people regarding their needs for support. Our objective was to explore the nature of young adults’ experiences of support after bereavement by suicide and their views on valued and unhelpful aspects. We conducted a cross-sectional study of staff and students aged 18–40 at 37 United Kingdom (UK) higher educational institutions in 2010, eliciting qualitative responses to two questions probing experiences of support and unmet needs after the suicide of a close contact. We conducted thematic analysis of responses from 420 adults bereaved by suicide, of whom 75% had received support after the loss. We identified three broad descriptive areas corresponding to important aspects of support: value and experiences of the support received; views on specific support needs; and reasons for not seeking support. We found that needs for emotional support exist throughout the social networks of people who die by suicide but are often hidden. Our findings suggest a need for proactive offers of support from family, friends, and professionals after suicide, repeated regularly in case a bereaved person does not feel ready for support early on. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle ‘We All Work Together to Vaccinate the Child’: A Formative Evaluation of a Community-Engagement Strategy Aimed at Closing the Immunization Gap in North-West Ethiopia
Int. J. Environ. Res. Public Health 2018, 15(4), 667; doi:10.3390/ijerph15040667
Received: 26 February 2018 / Revised: 27 March 2018 / Accepted: 28 March 2018 / Published: 3 April 2018
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Abstract
The role of community engagement (CE) in improving demand for immunization merits investigation. The International Rescue Committee developed a CE strategy to implement a vaccine defaulter-tracing tool and a color-coded health calendar aimed at increasing uptake of immunization services in north-west Ethiopia (
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The role of community engagement (CE) in improving demand for immunization merits investigation. The International Rescue Committee developed a CE strategy to implement a vaccine defaulter-tracing tool and a color-coded health calendar aimed at increasing uptake of immunization services in north-west Ethiopia (‘The Fifth Child Project’). We report findings from a formative evaluation of this project. In May/June 2016 we conducted 18 participant observations of project activities, 46 semi-structured interviews and 6 focus groups with caregivers, health workers, community members/leaders. Audio-recordings and fieldnotes were transcribed, anonymized, translated and analyzed thematically using inductive and deductive coding. Additional data was collected in November 2016 to verify findings. The project was suitably integrated within the health extension program and established a practical system for defaulter-tracing. The calendar facilitated personalized interactions between health workers and caregivers and was a catalyst for health discussions within homes. At the community level, a regulation exercise of sanctions was observed, which served as a deterrent against vaccine default. Pre-existing community accountability mechanisms supported the CE, although varying levels of engagement between leaders and health workers were observed. The benefits of shared responsibility for immunization were evident; however, more transparency was required about community self-regulatory measures to ensure health-related discussions remain positive. Full article
Open AccessArticle Toxicity Thresholds Based on EDTA Extractable Nickel and Barley Root Elongation in Chinese Soils
Int. J. Environ. Res. Public Health 2018, 15(4), 669; doi:10.3390/ijerph15040669
Received: 8 February 2018 / Revised: 22 March 2018 / Accepted: 30 March 2018 / Published: 4 April 2018
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Abstract
The uncertainty in the risk assessment of trace metal elements in soils when total metal contents are used can be decreased by assessing their availability and/or extractability when the soils have a high background value or different sources of trace metal elements. In
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The uncertainty in the risk assessment of trace metal elements in soils when total metal contents are used can be decreased by assessing their availability and/or extractability when the soils have a high background value or different sources of trace metal elements. In this study, the added water-soluble nickel (Ni) toxicity to barley root elongation was studied in 17 representative Chinese soil samples with and without artificial rainwater leaching. The extractability of added Ni in soils was estimated by three sequential extractions with ethylenediaminetetraacetic acid (EDTA). The results showed that the effective concentration of EDTA extractable Ni (EC50), which caused 50% inhibition of barley root elongation, ranged from 46 to 1019 mg/kg in unleached soils and 24 to 1563 mg/kg in leached soils. Regression models for EDTA extractable Ni and total Ni added to soils against soil properties indicated that EDTA extractable Ni was significantly correlated with the total Ni added to soils and that pH was the most important control factor. Regression models for toxicity thresholds based on EDTA extractable Ni against soil properties showed that soil citrate dithionate extractable Fe was more important than soil pH in predicting Ni toxicity. These results can be used to accurately assess the risk of contaminated soils with high background values and/or different Ni sources. Full article
(This article belongs to the Special Issue Soil Pollution and Remediation)
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Open AccessArticle Effect of Potassium Chlorate on the Treatment of Domestic Sewage by Achieving Shortcut Nitrification in a Constructed Rapid Infiltration System
Int. J. Environ. Res. Public Health 2018, 15(4), 670; doi:10.3390/ijerph15040670
Received: 6 February 2018 / Revised: 8 March 2018 / Accepted: 28 March 2018 / Published: 4 April 2018
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Abstract
A constructed rapid infiltration (CRI) system is a new type of sewage biofilm treatment technology, but due to its anaerobic zone it lacks the carbon sources and the conditions for nitrate retention, and its nitrogen removal performance is very poor. However, a shortcut
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A constructed rapid infiltration (CRI) system is a new type of sewage biofilm treatment technology, but due to its anaerobic zone it lacks the carbon sources and the conditions for nitrate retention, and its nitrogen removal performance is very poor. However, a shortcut nitrification–denitrification process presents distinctive advantages, as it saves oxygen, requires less organic matter, and requires less time for denitrification compared to conventional nitrogen removal methods. Thus, if the shortcut nitrification–denitrification process could be applied to the CRI system properly, a simpler, more economic, and efficient nitrogen removal method will be obtained. However, as its reaction process shows that the first and the most important step of achieving shortcut nitrification–denitrification is to achieve shortcut nitrification, in this study we explored the feasibility to achieve shortcut nitrification, which produces nitrite as the dominant nitrogen species in effluent, by the addition of potassium chlorate (KClO3) to the influent. In an experimental CRI test system, the effects on nitrogen removal, nitrate inhibition, and nitrite accumulation were studied, and the advantages of achieving a shortcut nitrification–denitrification process were also analysed. The results showed that shortcut nitrification was successfully achieved and maintained in a CRI system by adding 5 mM KClO3 to the influent at a constant pH of 8.4. Under these conditions, the nitrite accumulation percentage was increased, while a lower concentration of 3 mM KClO3 had no obvious effect. The addition of 5mM KClO3 in influent presumably inhibited the activity of ammonia-oxidizing bacteria (AOB) and nitrite-oxidizing bacteria (NOB), but inhibition of nitrite-oxidizing bacteria (NOB) was so strong that it resulted in a maximum nitrite accumulation percentage of up to over 80%. As a result, nitrite became the dominant nitrogen product in the effluent. Moreover, if the shortcut denitrification process will be achieved in the subsequent research, it could save 60.27 mg CH3OH per litre of sewage in the CRI system compared with the full denitrification process. Full article
(This article belongs to the Special Issue Municipal Wastewater Treatment)
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Open AccessArticle An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States
Int. J. Environ. Res. Public Health 2018, 15(4), 671; doi:10.3390/ijerph15040671
Received: 8 February 2018 / Revised: 28 March 2018 / Accepted: 1 April 2018 / Published: 4 April 2018
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Abstract
Suicide is a serious but preventable public health issue. Several previous studies have revealed a positive association between altitude and suicide rates at the county level in the contiguous United States. We assessed the association between suicide rates and altitude using a cross-county
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Suicide is a serious but preventable public health issue. Several previous studies have revealed a positive association between altitude and suicide rates at the county level in the contiguous United States. We assessed the association between suicide rates and altitude using a cross-county ecological study design. Data on suicide rates were obtained from a Web-based Injury Statistics Query and Reporting System (WISQARS), maintained by the U.S. National Center for Injury Prevention and Control (NCIPC). Altitude data were collected from the United States Geological Survey (USGS). We employed an ordinary least square (OLS) regression to model the association between altitude and suicide rates in 3064 counties in the contiguous U.S. We conducted a geographically weighted regression (GWR) to examine the spatially varying relationship between suicide rates and altitude after controlling for several well-established covariates. A significant positive association between altitude and suicide rates (average county rates between 2008 and 2014) was found in the dataset in the OLS model (R2 = 0.483, p < 0.001). Our GWR model fitted the data better, as indicated by an improved R2 (average: 0.62; range: 0.21–0.64) and a lower Akaike Information Criteria (AIC) value (13,593.68 vs. 14,432.14 in the OLS model). The GWR model also significantly reduced the spatial autocorrelation, as indicated by Moran’s I test statistic (Moran’s I = 0.171; z = 33.656; p < 0.001 vs. Moran’s I = 0.323; z = 63.526; p < 0.001 in the OLS model). In addition, a stronger positive relationship was detected in areas of the northern regions, northern plain regions, and southeastern regions in the U.S. Our study confirmed a varying overall positive relationship between altitude and suicide. Future research may consider controlling more predictor variables in regression models, such as firearm ownership, religion, and access to mental health services. Full article
(This article belongs to the Special Issue Mental Health and Environmental Exposures)
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Open AccessArticle The Cost of Youth Suicide in Australia
Int. J. Environ. Res. Public Health 2018, 15(4), 672; doi:10.3390/ijerph15040672
Received: 24 February 2018 / Revised: 29 March 2018 / Accepted: 3 April 2018 / Published: 4 April 2018
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Abstract
Suicide is the leading cause of death among Australians between 15 and 24 years of age. This study seeks to estimate the economic cost of youth suicide (15–24 years old) for Australia using 2014 as a reference year. The main outcome measure is
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Suicide is the leading cause of death among Australians between 15 and 24 years of age. This study seeks to estimate the economic cost of youth suicide (15–24 years old) for Australia using 2014 as a reference year. The main outcome measure is monetized burden of youth suicide. Costs, in 2014 AU$, are measured and valued as direct costs, such as coronial inquiry, police, ambulance, and funeral expenses; indirect costs, such as lost economic productivity; and intangible costs, such as bereavement. In 2014, 307 young Australians lost their lives to suicide (82 females and 225 males). The average age at time of death was 20.4 years, representing an average loss of 62 years of life and close to 46 years of productive capacity. The average cost per youth suicide is valued at $2,884,426, including $9721 in direct costs, $2,788,245 as the value of lost productivity, and $86,460 as the cost of bereavement. The total economic loss of youth suicide in Australia is estimated at $22 billion a year (equivalent to US$ 17 billion), ranging from $20 to $25 billion. These findings can assist decision-makers understand the magnitude of adverse outcomes associated with youth suicide and the potential benefits to be achieved by investing in effective suicide prevention strategies. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle The Relationship of Health Beliefs with Information Sources and HPV Vaccine Acceptance among Young Adults in Korea
Int. J. Environ. Res. Public Health 2018, 15(4), 673; doi:10.3390/ijerph15040673
Received: 24 February 2018 / Revised: 1 April 2018 / Accepted: 2 April 2018 / Published: 4 April 2018
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Abstract
Despite the HPV vaccine’s efficacy in preventing cervical cancer, its coverage rates among Asians are very low. To increase immunization coverage among these populations, understanding the psychological factors that affect HPV acceptability is critical. To this end, this study examined the relationships between
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Despite the HPV vaccine’s efficacy in preventing cervical cancer, its coverage rates among Asians are very low. To increase immunization coverage among these populations, understanding the psychological factors that affect HPV acceptability is critical. To this end, this study examined the relationships between multidimensional health beliefs and HPV vaccine acceptance, and what information sources effectively foster HPV vaccination-related health beliefs. Data were collected using a survey of 323 undergraduate students in Korea. Results showed that perceived susceptibility, perceived severity, perceived benefits, and perceived vaccine safety concerns predicted vaccine acceptance. Multiple dimensions of perceived barriers showed differing impacts on vaccine acceptance. In addition, interpersonal information sources were effective in boosting various health beliefs for HPV vaccination. The Internet also was effective in reducing social barriers, but the effects were opposite to those of social media. Theoretical and practical implications are discussed. Full article
Open AccessArticle The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda
Int. J. Environ. Res. Public Health 2018, 15(4), 674; doi:10.3390/ijerph15040674
Received: 31 January 2018 / Revised: 14 March 2018 / Accepted: 29 March 2018 / Published: 4 April 2018
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Abstract
A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the
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A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate change, the science–policy interface and power in policy-making, to identify additional barriers to the meaningful incorporation of health co-benefits into climate change mitigation policy development. Specifically, we identify four key interrelated areas where barriers may exist in relation to health co-benefits: discourse, efficiency, vested interests and structural challenges. With these insights in mind, we argue that the current politico-economic paradigm in which climate change is situated and the processes used to develop climate change mitigation policies do not adequately support accounting for health co-benefits. We present approaches for enhancing the role of health co-benefits in the development of climate change mitigation policies to ensure that health is embedded in the broader climate change agenda. Full article
(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)
Open AccessArticle Public Health and Unconventional Oil and Gas Extraction Including Fracking: Global Lessons from a Scottish Government Review
Int. J. Environ. Res. Public Health 2018, 15(4), 675; doi:10.3390/ijerph15040675
Received: 28 November 2017 / Revised: 22 February 2018 / Accepted: 29 March 2018 / Published: 4 April 2018
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Abstract
Unconventional oil and gas extraction (UOGE) including fracking for shale gas is underway in North America on a large scale, and in Australia and some other countries. It is viewed as a major source of global energy needs by proponents. Critics consider fracking
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Unconventional oil and gas extraction (UOGE) including fracking for shale gas is underway in North America on a large scale, and in Australia and some other countries. It is viewed as a major source of global energy needs by proponents. Critics consider fracking and UOGE an immediate and long-term threat to global, national, and regional public health and climate. Rarely have governments brought together relatively detailed assessments of direct and indirect public health risks associated with fracking and weighed these against potential benefits to inform a national debate on whether to pursue this energy route. The Scottish government has now done so in a wide-ranging consultation underpinned by a variety of reports on unconventional gas extraction including fracking. This paper analyses the Scottish government approach from inception to conclusion, and from procedures to outcomes. The reports commissioned by the Scottish government include a comprehensive review dedicated specifically to public health as well as reports on climate change, economic impacts, transport, geology, and decommissioning. All these reports are relevant to public health, and taken together offer a comprehensive review of existing evidence. The approach is unique globally when compared with UOGE assessments conducted in the USA, Australia, Canada, and England. The review process builds a useful evidence base although it is not without flaws. The process approach, if not the content, offers a framework that may have merits globally. Full article
(This article belongs to the Special Issue Environmental Health Impacts of Hydraulic Fracturing)
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Open AccessArticle A Predictive Model Has Identified Tick-Borne Encephalitis High-Risk Areas in Regions Where No Cases Were Reported Previously, Poland, 1999–2012
Int. J. Environ. Res. Public Health 2018, 15(4), 677; doi:10.3390/ijerph15040677
Received: 27 February 2018 / Revised: 24 March 2018 / Accepted: 2 April 2018 / Published: 4 April 2018
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Abstract
During 1999–2012, 77% of the cases of tick-borne encephalitis (TBE) were recorded in two out of 16 Polish provinces. However, historical data, mostly from national serosurveys, suggest that the disease could be undetected in many areas. The aim of this study was to
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During 1999–2012, 77% of the cases of tick-borne encephalitis (TBE) were recorded in two out of 16 Polish provinces. However, historical data, mostly from national serosurveys, suggest that the disease could be undetected in many areas. The aim of this study was to identify which routinely-measured meteorological, environmental, and socio-economic factors are associated to TBE human risk across Poland, with a particular focus on areas reporting few cases, but where serosurveys suggest higher incidence. We fitted a zero-inflated Poisson model using data on TBE incidence recorded in 108 NUTS-5 administrative units in high-risk areas over the period 1999–2012. Subsequently we applied the best fitting model to all Polish municipalities. Keeping the remaining variables constant, the predicted rate increased with the increase of air temperature over the previous 10–20 days, precipitation over the previous 20–30 days, in forestation, forest edge density, forest road density, and unemployment. The predicted rate decreased with increasing distance from forests. The map of predicted rates was consistent with the established risk areas. It predicted, however, high rates in provinces considered TBE-free. We recommend raising awareness among physicians working in the predicted high-risk areas and considering routine use of household animal surveys for risk mapping. Full article
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Open AccessArticle Decision-Making and Environmental Implications under Cap-and-Trade and Take-Back Regulations
Int. J. Environ. Res. Public Health 2018, 15(4), 678; doi:10.3390/ijerph15040678
Received: 30 January 2018 / Revised: 30 March 2018 / Accepted: 1 April 2018 / Published: 4 April 2018
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Abstract
To reduce carbon emissions during production and realize the recycling of resources, the government has promulgated carbon cap-and-trade regulation and take-back regulation separately. This paper firstly analyses the manufacturing, remanufacturing and collection decisions of a monopoly manufacturer under cap-and-trade regulation and take-back regulation
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To reduce carbon emissions during production and realize the recycling of resources, the government has promulgated carbon cap-and-trade regulation and take-back regulation separately. This paper firstly analyses the manufacturing, remanufacturing and collection decisions of a monopoly manufacturer under cap-and-trade regulation and take-back regulation conditions, and then explores the environmental impact (i.e., carbon emissions) of both carbon regulation and more stringent take-back regulation. Finally, numerical examples are provided to illustrate the theoretical results. The results indicate that it will do good for the environment once the cap-and-trade regulation is carried out. We also conclude that government’s supervision of carbon trading price plays an important role in reducing the environmental impact. Furthermore, unexpectedly, we prove that if emissions intensity of a remanufactured (vis-á-vis new) product is sufficiently high, the improvement of collection and remanufacturing targets might lead to the deterioration of environment. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Association between Four-Level Categorisation of Indoor Exposure and Perceived Indoor Air Quality
Int. J. Environ. Res. Public Health 2018, 15(4), 679; doi:10.3390/ijerph15040679
Received: 14 February 2018 / Revised: 16 March 2018 / Accepted: 31 March 2018 / Published: 4 April 2018
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Abstract
The aim of this study was to develop and test a tool for assessing urgency of indoor air quality (IAQ) measures. The condition of the 27 buildings were investigated and results were categorized. Statistical test studied the differences between the categories and the
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The aim of this study was to develop and test a tool for assessing urgency of indoor air quality (IAQ) measures. The condition of the 27 buildings were investigated and results were categorized. Statistical test studied the differences between the categories and the employees’ complaints about their work environment. To study the employees’ experiences of the work premises, a validated indoor air (IA) questionnaire was used. This study reveals a multifaceted problem: many factors affecting IAQ may also affect perceived IAQ, making it difficult to separate the impurity sources and ventilation system deficiencies affecting to employee experiences. An examination of the relationship between the categories and perceived IAQ revealed an association between the mould odour perceived by employees and mould detected by the researcher. A weak link was also found between the assessed categories and environmental complaints. However, we cannot make far-reaching conclusions regarding the assessed probability of abnormal IA exposure in the building on the basis of employee experiences. According to the results, categorising tool can partly support the assessment of the urgency for repairs when several factors that affect IAQ are taken into account. Full article
(This article belongs to the Special Issue Indoor Environmental Quality)
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Open AccessArticle The Coaching on Lifestyle (CooL) Intervention for Overweight and Obesity: A Longitudinal Study into Participants’ Lifestyle Changes
Int. J. Environ. Res. Public Health 2018, 15(4), 680; doi:10.3390/ijerph15040680
Received: 6 February 2018 / Revised: 30 March 2018 / Accepted: 2 April 2018 / Published: 4 April 2018
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Abstract
Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in
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Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents) at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, motivation, perceived barriers, lifestyle behaviours, quality of life and weight. Among children and their parents, few improvements were found regarding behaviours and quality of life. CooL has been successful in coaching adult participants towards sustained behavioural change during the intervention period. Mixed results and smaller effect sizes were found for children and their parents. Full article
(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)
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Open AccessArticle Environmental Sustainability and Mold Hygiene in Buildings
Int. J. Environ. Res. Public Health 2018, 15(4), 681; doi:10.3390/ijerph15040681
Received: 14 March 2018 / Revised: 30 March 2018 / Accepted: 3 April 2018 / Published: 4 April 2018
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Abstract
Environmental sustainability is one of the key issues in building management. In Hong Kong, one of the initiatives is to reduce the operation hours of air-conditioning in buildings to cut down energy consumption. In this study, we reported a mold contamination case in
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Environmental sustainability is one of the key issues in building management. In Hong Kong, one of the initiatives is to reduce the operation hours of air-conditioning in buildings to cut down energy consumption. In this study, we reported a mold contamination case in a newly refurbished laboratory, in which the air-conditioner was switched from 24- to 18-h mode after refurbishment. In order to prevent mold recurrence, the air-conditioner was switched back to 24-h mode in the laboratory. During the mold investigation, visible mold patches in the laboratory were searched and then cultured, counted and identified. Building and environmental conditions were recorded, and used to deduce different causes of mold contamination. Eight contaminated sites including a wall, a bench, some metal and plastic surfaces and seven types of molds including two Cladosporium spp., two Aspergillus spp., one Rhizopus sp., one Trichoderma sp., and one Tritirachium sp. were identified. Cladosporium spp. were the most abundant and frequently found molds in the laboratory. The contaminated areas could have one to five different species on them. Based on the mold and environmental conditions, several scenarios causing the mold contamination were deduced, and different mold control measures were discussed to compare them with the current solution of using 24-h air-conditioning to control mold growth. This study highlights the importance of mold hygiene in sustainable building management. Full article
(This article belongs to the Special Issue Environmental Hygiene)
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Open AccessArticle Toenail Chromium Concentration and Metabolic Syndrome among Korean Adults
Int. J. Environ. Res. Public Health 2018, 15(4), 682; doi:10.3390/ijerph15040682
Received: 7 March 2018 / Revised: 29 March 2018 / Accepted: 3 April 2018 / Published: 4 April 2018
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Abstract
Although in vivo and in vitro studies have shown that chromium has protective effects against metabolic diseases, few studies have examined this association in humans. The present study examined chronic chromium (Cr) exposure among Koreans based on the measurement of toenail Cr concentrations,
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Although in vivo and in vitro studies have shown that chromium has protective effects against metabolic diseases, few studies have examined this association in humans. The present study examined chronic chromium (Cr) exposure among Koreans based on the measurement of toenail Cr concentrations, and analyzed the associations between toenail Cr concentrations and metabolic syndrome (MetS) and its components. We conducted a cross-sectional analysis using baseline data from the prospective cohort study in the Yeungnam area of South Korea that included 232 men and 268 women. Toenail Cr concentration was quantified by neutron activation analysis, and metabolic biomarker levels were obtained through medical examinations. The odd ratios (OR) of prevalent MetS and its components in correlation with Cr concentrations were calculated using multivariable logistic regression. After multiple confounding variables were adjusted for, participants with higher concentrations of Cr had a prevalence rate of MetS similar to those with lower concentrations (OR, 1.84; 95% confidence interval, 0.65–5.23). Our results do not support an association between long-term exposure to Cr and a lower prevalence of MetS in Koreans, whose Cr concentrations are relatively low compared to those of populations in Europe and the United States. Full article
Open AccessArticle Arsenic, Cadmium and Lead Exposure and Immunologic Function in Workers in Taiwan
Int. J. Environ. Res. Public Health 2018, 15(4), 683; doi:10.3390/ijerph15040683
Received: 7 March 2018 / Revised: 2 April 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
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Abstract
There has been growing concern over the impact of environmental exposure to heavy metals and other trace elements on immunologic functions. This study investigated men’s arsenic (As), cadmium (Cd) and lead (Pb) contents in hair samples and their associations with immunological indicators, including
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There has been growing concern over the impact of environmental exposure to heavy metals and other trace elements on immunologic functions. This study investigated men’s arsenic (As), cadmium (Cd) and lead (Pb) contents in hair samples and their associations with immunological indicators, including white blood cell (WBC), lymphocyte and monocyte counts, and the immunoglobulin (Ig) levels including IgA, IgG and IgE. We recruited 133 men from one antimony trioxide manufacturing plant, two glass manufacturing plants and two plastics manufacturing plants. The mean concentration of Cd [0.16 (SD = 0.03) ug/g] was lower than means of As [0.86 (SD = 0.16) ug/g] and Pb [0.91 (SD = 0.22) ug/g] in hair samples, exerting no relationship with immunologic functions for Cd. The Spearman’s correlation analysis showed a positive relationship between monocyte counts and hair Pb levels, but negative relations between As and IgG and between As and IgE. In conclusion, findings from these industry workers suggest that As levels in hair may have a stronger relation with immunologic function than Cd and PB have. Further research is needed to confirm the negative relationship. Full article
(This article belongs to the Section Occupational Safety and Health)
Open AccessArticle Toxic Effects of Bisphenol A, Propyl Paraben, and Triclosan on Caenorhabditis elegans
Int. J. Environ. Res. Public Health 2018, 15(4), 684; doi:10.3390/ijerph15040684
Received: 20 February 2018 / Revised: 28 March 2018 / Accepted: 30 March 2018 / Published: 5 April 2018
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Abstract
Bisphenol A (BPA) is a ubiquitous plasticizer which is absorbed by ingestion and dermal contact; propyl paraben (PPB) inhibits the microbiome and extends the shelf life of many personal care products, whereas triclosan (TCS) is commonly found in antiseptics, disinfectants, or additives. In
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Bisphenol A (BPA) is a ubiquitous plasticizer which is absorbed by ingestion and dermal contact; propyl paraben (PPB) inhibits the microbiome and extends the shelf life of many personal care products, whereas triclosan (TCS) is commonly found in antiseptics, disinfectants, or additives. In this work, Caenorhabditis elegans was used as a biological model to assess the toxic effects of BPA, PPB, and TCS. The wild type strain, Bristol N2, was used in bioassays with the endpoints of lethality, growth, and reproduction; green fluorescent protein (GFP) transgenic strains with the hsp-3, hsp-4, hsp-16.2, hsp-70, sod-1, sod-4, cyp-35A4, cyp-29A2, and skn-1 genes were evaluated for their mRNA expression through fluorescence measurement; and quick Oil Red O (q ORO) was utilized to stain lipid deposits. Lethality was concentration-dependent, while TCS and PPB showed more toxicity than BPA. BPA augmented worm length, while PPB reduced it. All toxicants moderately increased the width and the width–length ratio. BPA and PPB promoted reproduction, in contrast to TCS, which diminished it. All toxicants affected the mRNA expression of genes related to cellular stress, control of reactive oxygen species, and nuclear receptor activation. Lipid accumulation occurred in exposed worms. In conclusion, BPA, PPB, and TCS alter the physiology of growth, lipid accumulation, and reproduction in C. elegans, most likely through oxidative stress mechanisms. Full article
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Open AccessArticle Development, Implementation and Evaluation of an Educational Intervention to Prevent Low Speed Vehicle Run-Over Events: Lessons Learned
Int. J. Environ. Res. Public Health 2018, 15(4), 685; doi:10.3390/ijerph15040685
Received: 9 March 2018 / Revised: 1 April 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
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Abstract
There is a growing body of literature regarding low speed vehicle runover (LSVRO) events among children. To date, no literature exists on evaluation of interventions to address this serious childhood injury. Knowledge, attitudes, and behaviour regarding LSVROs were assessed via survey at a
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There is a growing body of literature regarding low speed vehicle runover (LSVRO) events among children. To date, no literature exists on evaluation of interventions to address this serious childhood injury. Knowledge, attitudes, and behaviour regarding LSVROs were assessed via survey at a shopping centre (pre-intervention), then five months later (post-intervention), to investigate the effect of a population level educational intervention in Queensland, Australia. Participants’ knowledge regarding frequency of LSVRO events was poor. No participant demonstrated ‘adequate behaviour’ in relation to four safe driveway behaviours pre-intervention; this increased at post-intervention (p < 0.05). Most of the sample perceived other’s driveway behaviour as inadequate, and this reduced significantly (<0.05). Perceived effectiveness of LSVRO prevention strategies increased from pre- to post-intervention, but not significantly. TV was the greatest source of knowledge regarding LSVROs pre- and post-intervention. This study provides some evidence that the educational campaign and opportunistic media engagement were successful in increasing awareness and improving behaviour regarding LSVROs. While there are several limitations to this study, our experience reflects the ‘real-world’ challenges associated with implementing prevention strategies. We suggest a multi-faceted approach involving media (including social media), legislative changes, subsidies (for reversing cameras), and education to prevent LSVROs. Full article
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Open AccessFeature PaperArticle Source Apportionment and Influencing Factor Analysis of Residential Indoor PM2.5 in Beijing
Int. J. Environ. Res. Public Health 2018, 15(4), 686; doi:10.3390/ijerph15040686
Received: 28 February 2018 / Revised: 24 March 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
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Abstract
In order to identify the sources of indoor PM2.5 and to check which factors influence the concentration of indoor PM2.5 and chemical elements, indoor concentrations of PM2.5 and its related elements in residential houses in Beijing were explored. Indoor and
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In order to identify the sources of indoor PM2.5 and to check which factors influence the concentration of indoor PM2.5 and chemical elements, indoor concentrations of PM2.5 and its related elements in residential houses in Beijing were explored. Indoor and outdoor PM2.5 samples that were monitored continuously for one week were collected. Indoor and outdoor concentrations of PM2.5 and 15 elements (Al, As, Ca, Cd, Cu, Fe, K, Mg, Mn, Na, Pb, Se, Tl, V, Zn) were calculated and compared. The median indoor concentration of PM2.5 was 57.64 μg/m3. For elements in indoor PM2.5, Cd and As may be sensitive to indoor smoking, Zn, Ca and Al may be related to indoor sources other than smoking, Pb, V and Se may mainly come from outdoor. Five factors were extracted for indoor PM2.5 by factor analysis, explained 76.8% of total variance, outdoor sources contributed more than indoor sources. Multiple linear regression analysis for indoor PM2.5, Cd and Pb was performed. Indoor PM2.5 was influenced by factors including outdoor PM2.5, smoking during sampling, outdoor temperature and time of air conditioner use. Indoor Cd was affected by factors including smoking during sampling, outdoor Cd and building age. Indoor Pb concentration was associated with factors including outdoor Pb and time of window open per day, building age and RH. In conclusion, indoor PM2.5 mainly comes from outdoor sources, and the contributions of indoor sources also cannot be ignored. Factors associated indoor and outdoor air exchange can influence the concentrations of indoor PM2.5 and its constituents. Full article
(This article belongs to the Special Issue Indoor Environmental Quality)
Open AccessArticle Keeping Antibiotics at Home Promotes Self-Medication with Antibiotics among Chinese University Students
Int. J. Environ. Res. Public Health 2018, 15(4), 687; doi:10.3390/ijerph15040687
Received: 16 February 2018 / Revised: 2 April 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
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Abstract
Background: Inappropriate use of antibiotics has caused antimicrobial resistance, presenting a major health challenge to the world population. Self-medication with antibiotics (SMA) is currently at an alarming level in China. Objectives: To determine the sources of antibiotics leftover at home, the risk factors
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Background: Inappropriate use of antibiotics has caused antimicrobial resistance, presenting a major health challenge to the world population. Self-medication with antibiotics (SMA) is currently at an alarming level in China. Objectives: To determine the sources of antibiotics leftover at home, the risk factors of keeping antibiotics at home, and the associations between keeping antibiotics at home and SMA among Chinese university students. Methods: Six provinces were purposely selected from six regions of China, and one multi-disciplinary university was selected from each chosen province. A total of 11,192 university students were selected using cluster random sampling from the selected universities. Logistic regression was conducted to examine the relationship between keeping antibiotics at home and SMA. Results: Out of the 11,192 students surveyed, 7057 (63.1%) reported keeping antibiotics at home at the time they were surveyed. Of those who kept antibiotics in their home, 1965 (27.8%) reported that these antibiotics were left over from a previous prescription by a doctor and 4893 (69.3%), purchased antibiotics over the counter. Additionally, 29.6% (507/1711) of students self-medicated with antibiotics when ill during the month before the survey. Students keeping antibiotics at home were five times (95% CI 3.53, 7.05) more likely to engage in SMA when ill and 2.6 times (95% CI 2.34, 2.89) more likely to self-medicating with antibiotics for prophylaxis than the other students. Female students, those with a family background of higher education, and those who had a parent working in the medical field had a significantly higher chance of keeping antibiotics at home. Conclusions: The high prevalence of keeping antibiotics at home and SMA among young adults is a serious concern. Professional regulations and population-tailored health education are needed. Full article
(This article belongs to the Special Issue Drug Abuse, Environment and Public Health)
Open AccessArticle Subclinical Enteric Parasitic Infections and Growth Faltering in Infants in São Tomé, Africa: A Birth Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(4), 688; doi:10.3390/ijerph15040688
Received: 29 January 2018 / Revised: 2 April 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
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Abstract
The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and
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The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric assessments included: z-scores for weight-for-length (WLZ), length-for-age (LAZ), weight (WAVZ) and length velocities (LAVZ), length-for-age difference (LAD), and wasting and stunting risk (≤−1 SD). Generalized additive mixed effects regression models were used to explore the associations between anthropometric parameters and enteric parasitic infections and cofactors. A total of 475 infants were enrolled, and 282 completed the study. The great majority of infants were asymptomatic. Giardia lamblia was detected in 35.1% of infants in at least one stool sample, helminths in 30.4%, and Cryptosporidium spp. in 14.7%. Giardia lamblia and helminth infections were significantly associated with mean decreases of 0.10 in LAZ and 0.32 in LAD, and of 0.16 in LAZ and 0.48 in LAD, respectively. Cryptosporidium spp. infection was significantly associated with a mean decrease of 0.43 in WAVZ and 0.55 in LAVZ. The underestimated association between subclinical parasitic enteric infections and mild growth faltering in infants should be addressed in public health policies. Full article
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Open AccessArticle Underestimation of Self-Reported Smoking Prevalence in Korean Adolescents: Evidence from Gold Standard by Combined Method
Int. J. Environ. Res. Public Health 2018, 15(4), 689; doi:10.3390/ijerph15040689
Received: 2 March 2018 / Revised: 31 March 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
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Abstract
The objective of this study was to evaluate the validity of self-reported smoking prevalence in Korean adolescents by using an improved gold standard by a combined method. Using a stratified sampling method, we selected 13 schools from among 397 high schools that participated
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The objective of this study was to evaluate the validity of self-reported smoking prevalence in Korean adolescents by using an improved gold standard by a combined method. Using a stratified sampling method, we selected 13 schools from among 397 high schools that participated in the 2015 Korean Youth Health Risk Behavior Web-Based Survey (KYRBS). A second survey (repeated self-reporting questionnaire and urinary cotinine test) was conducted on 1058 students who completed the KYRBS. The gold standard of current smoker was defined as those either self-reporting as a smoker in the second survey or having a urinary cotinine concentration ≥50 ng/mL. The current smoking prevalence in the first survey (KYRBS) was 7.9% (boys 16.5% and girls 1.8%), which was lower than the results based on gold standard (11.3% total, boys 21.9% and girls 3.7%). The sensitivity and specificity of self-reported smoking status was 62.5% and 99.0%, respectively. In particular, the sensitivity of girls (43.5%) was lower than that of boys (67.0%). The self-reported smoking prevalence in Korean adolescents was underestimated, particularly among girls. Careful attention should be paid to interpreting adolescents’ smoking prevalence, and supplementary surveys or periodic validity tests need to be considered in Asian countries. Full article
Open AccessArticle Using a Counting Process Method to Impute Censored Follow-Up Time Data
Int. J. Environ. Res. Public Health 2018, 15(4), 690; doi:10.3390/ijerph15040690
Received: 17 March 2018 / Revised: 1 April 2018 / Accepted: 3 April 2018 / Published: 5 April 2018
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Abstract
Censoring occurs when complete follow-up time information is unavailable for patients enrolled in a clinical study. The process is considered to be informative (non-ignorable) if the likelihood function for the model cannot be partitioned into a set of response parameters that are independent
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Censoring occurs when complete follow-up time information is unavailable for patients enrolled in a clinical study. The process is considered to be informative (non-ignorable) if the likelihood function for the model cannot be partitioned into a set of response parameters that are independent of the censoring parameters. In such cases, estimated survival time probabilities may be biased, prompting the need for special statistical methods to remedy the situation. The problem is especially salient when censoring occurs early in a study. In this paper, we describe a method to impute censored follow-up times using a counting process method. Full article
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Open AccessArticle Suicide Precipitants Differ Across the Lifespan but Are Not Significant in Predicting Medically Severe Attempts
Int. J. Environ. Res. Public Health 2018, 15(4), 691; doi:10.3390/ijerph15040691
Received: 8 March 2018 / Revised: 3 April 2018 / Accepted: 4 April 2018 / Published: 5 April 2018
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Abstract
An important risk factor for suicide assessment is the suicide precipitant. This study explores suicide attempt precipitants across the lifespan. Three years of medical records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore
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An important risk factor for suicide assessment is the suicide precipitant. This study explores suicide attempt precipitants across the lifespan. Three years of medical records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. These cases were divided into three age groups: Adolescence, Early Adulthood, and Middle Adulthood. A total of 540 cases were examined (70.9% females; 63.7% Chinese, 13.7% Malays, 15.9% Indians), whose ages ranged from 12 to 62. There were eight cases above the age of 65 years which were excluded from the analysis. Significant differences were found in precipitants for suicide attempts across the lifespan. Middle adults had relatively fewer relationship problems, and adolescents had comparatively fewer financial and medical problems. The models to predict medically severe attempts across the age groups using suicide precipitants were not significant. The findings were discussed in regards to implications in suicide assessment and primary prevention in Singapore, as well as limitations and recommendations for future research. Full article
(This article belongs to the Special Issue Adult Psychiatry)
Open AccessArticle Decision Tree Approach to the Impact of Parents’ Oral Health on Dental Caries Experience in Children: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2018, 15(4), 692; doi:10.3390/ijerph15040692
Received: 21 March 2018 / Revised: 21 March 2018 / Accepted: 3 April 2018 / Published: 6 April 2018
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Abstract
Decision tree (DT) analysis was applied in this cross-sectional study to investigate caries experience in children by using clinical and microbiological data obtained from parent–child pairs. Thirty pairs of parents and children were recruited from periodontal and pediatric dental clinics. All participants were
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Decision tree (DT) analysis was applied in this cross-sectional study to investigate caries experience in children by using clinical and microbiological data obtained from parent–child pairs. Thirty pairs of parents and children were recruited from periodontal and pediatric dental clinics. All participants were clinically examined for caries and periodontitis by a calibrated examiner. Cariogenic and periodontopathic bacteria examinations were conducted. The Kendall rank correlation coefficient was used to measure the association between data variables obtained through clinical and microbiological examinations. A classificatory inductive decision tree was generated using the C4.5 algorithm with the top-down approach. The C4.5 DT analysis was applied to classify major influential factors for children dental caries experience. The DT identified parents’ periodontal health classification, decayed, missing, filled permanent teeth (DMFT) index, periodontopathic test (PerioCheck) result, and periodontal pocket depth as the classification factors for children caries experience. 13.3% of children were identified with a low decayed, missing, filled primary teeth (dmft) index (dmft < 3) whose parents had a periodontal pocket depth ≤3.7, PerioCheck score >1, DMFT index <13.5, and periodontal classification >2. The DT model for this study sample had an accuracy of 93.33%. Here, parental periodontal status and parents’ DMFT were the factors forming the DT for children’s caries experience. Full article
(This article belongs to the Special Issue Maternal and Child Health 2018)
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Open AccessArticle Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia
Int. J. Environ. Res. Public Health 2018, 15(4), 693; doi:10.3390/ijerph15040693
Received: 22 February 2018 / Revised: 30 March 2018 / Accepted: 4 April 2018 / Published: 6 April 2018
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Abstract
Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years
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Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew “rat-urine disease” as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively (p-values < 0.05). As for attitudes, ethnicity, income and education type were significantly associated (p-values < 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222–0.680) and preventive practices (AOR = 1.81, 95% CI = 1.204–2.734). Ethnicity (AOR = 0.40, 95% CI = 0.239–0.665), income (AOR = 1.58, 95% CI = 1.041–2.385) and education type (AOR = 3.69, 95% CI = 1.237–10.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613–7.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Radon Levels in Indoor Environments of the University Hospital in Bari-Apulia Region Southern Italy
Int. J. Environ. Res. Public Health 2018, 15(4), 694; doi:10.3390/ijerph15040694
Received: 14 February 2018 / Revised: 3 April 2018 / Accepted: 3 April 2018 / Published: 7 April 2018
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Abstract
Since 1988, the International Agency for Research on Cancer (IARC) has classified radon among the compounds for which there is scientific evidence of carcinogenicity for humans (group 1). The World Health Organization (WHO) recommends a reference radon level between 100 and 300 Bq/m
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Since 1988, the International Agency for Research on Cancer (IARC) has classified radon among the compounds for which there is scientific evidence of carcinogenicity for humans (group 1). The World Health Organization (WHO) recommends a reference radon level between 100 and 300 Bq/m3 for homes. The objective of this study is to measure the radon concentrations in 401 workplaces, different from the patient rooms, in 28 different buildings of the university hospital in Bari (Apulia region, Southern Italy) to evaluate the exposure of health care workers. Radon environmental sampling is performed over two consecutive six-month periods via the use of passive dosimeters of the CR-39 type. We find an average annual radon concentration expressed as median value of 48.0 Bq/m3 (range 6.5–388.0 Bq/m3) with a significant difference between the two six-month periods (median value: February/July 41.0 Bq/m3 vs. August/January 55.0 Bq/m3). An average concentration of radon lower than the WHO reference level (100 Bq/m3) is detected in 76.1% of monitored environments, while higher than 300 Bq/m3 only in the 0.9%. Most workplaces report radon concentrations within the WHO reference level, therefore, the risk to workers’ health deriving from occupational exposure to radon can be considered to be low. Nevertheless, the goal is to achieve near-zero exposures to protect workers’ health. Full article
(This article belongs to the Special Issue Urban Geochemistry and Human Health)
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Open AccessArticle Turning the Co-Production Corner: Methodological Reflections from an Action Research Project to Promote LGBT Inclusion in Care Homes for Older People
Int. J. Environ. Res. Public Health 2018, 15(4), 695; doi:10.3390/ijerph15040695
Received: 22 December 2017 / Revised: 19 March 2018 / Accepted: 29 March 2018 / Published: 7 April 2018
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Abstract
Background: Older lesbian, gay, bisexual and trans (LGBT) residents are often invisible in long-term care settings. This article presents findings from a community-based action research project, which attempted to address this invisibility through co-produced research with LGBT community members. Particular Question:
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Background: Older lesbian, gay, bisexual and trans (LGBT) residents are often invisible in long-term care settings. This article presents findings from a community-based action research project, which attempted to address this invisibility through co-produced research with LGBT community members. Particular Question: What conditions enable co-produced research to emerge in long-term residential care settings for older people? Aims of Project: To analyse outcomes and challenges of action-oriented, co-produced research in the given context. In particular, we explore how co-production as a collaborative approach to action-orientated research can emerge during the research/fieldwork process; and reflect critically on the ethics and effectiveness of this approach in advancing inclusion in context. Methods: The project was implemented across six residential care homes in England. Reflections are based on qualitative evaluation data gathered pre- and post-project, which includes 37 interviews with care home staff, managers and community advisors (two of whom are co-authors). Results and Conclusions: We discuss how the co-production turn emerged during research and evaluate how the politics of this approach helped advance inclusion—itself crucial to well-being. We argue for the value of co-produced research in instigating organizational change in older people’s care environments and of non-didactic storytelling in LGBT awareness-raising amongst staff. Full article
(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)
Open AccessArticle German Public Support for Tobacco Control Policy Measures: Results from the German Study on Tobacco Use (DEBRA), a Representative National Survey
Int. J. Environ. Res. Public Health 2018, 15(4), 696; doi:10.3390/ijerph15040696
Received: 15 February 2018 / Revised: 15 March 2018 / Accepted: 29 March 2018 / Published: 7 April 2018
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Abstract
Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”):
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Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”): a nationally representative, face-to-face household survey. Public support was measured on total ban of sale, raising the minimum age for sales, taxation of tobacco industry sales, research into e-cigarettes, and ban of smoking in cars when children are present. Associations were assessed with multivariate logistic regression. Over 50% of the German population support taxing industry profits (57.3%) and assessing e-cigarettes as an aid to quit smoking (55.5%). Over 40% support raising the legal age of sale (43.1%), and 22.9% support a total ban on tobacco sales. A smoking ban in cars when children are present was most popular (71.5%), even among current smokers (67.0%). There is public support for stricter tobacco control measures in Germany. A smoking ban in cars when children are present could be a feasible policy to implement. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle Relationship between the Manner of Mobile Phone Use and Depression, Anxiety, and Stress in University Students
Int. J. Environ. Res. Public Health 2018, 15(4), 697; doi:10.3390/ijerph15040697
Received: 23 January 2018 / Revised: 24 March 2018 / Accepted: 4 April 2018 / Published: 8 April 2018
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Abstract
Objectives: There is insufficient evidence regarding the potential risk of mobile phone use on mental health. Therefore, the aim of this research was to examine the relationship between mobile phone use and mental health by measuring the levels of depression, anxiety, and
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Objectives: There is insufficient evidence regarding the potential risk of mobile phone use on mental health. Therefore, the aim of this research was to examine the relationship between mobile phone use and mental health by measuring the levels of depression, anxiety, and stress among university students in Serbia and Italy. Methods: This cross-sectional study was carried out at two distinguished universities in Serbia and Italy from March to May of the 2015/2016 academic year and included 785 students of both genders. The questionnaire was compiled and developed from different published sources regarding the manner and intensity of mobile phone use, along with the Depression Anxiety Stress Scale (DASS 42) for measuring psychological health. The statistical analysis of the data included the application of binary logistic regression and correlation tests. Results: Statistical analysis indicates that anxiety symptoms are somewhat more present in younger students (odds ratio (OR) = 0.86, 95% confidence interval (CI): 0.76–0.96), in those who send more text messages SMSs (OR = 1.15, 95% CI: 1.11–1.31), and in those who browse the internet less frequently (OR = 0.84, 95% CI: 0.73–0.95). Stress is more common in students who make fewer calls a day (OR = 0.79, 95% CI: 0.64–0.97), as well in those who spend more time talking on the mobile phone per day (OR = 1.28, 95% CI: 1.12–1.56). The strongest predictor of high stress levels was keeping the mobile phone less than 1 m away during sleeping (OR = 1.48, 95% CI: 1.12–2.08). Conclusions: The results indicated that the intensity and modality of mobile phone use could be a factor that can influence causal pathways leading to mental health problems in the university student population. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle Effects of Co-Processing Sewage Sludge in the Cement Kiln on PAHs, Heavy Metals Emissions and the Surrounding Environment
Int. J. Environ. Res. Public Health 2018, 15(4), 698; doi:10.3390/ijerph15040698
Received: 14 February 2018 / Revised: 29 March 2018 / Accepted: 6 April 2018 / Published: 8 April 2018
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Abstract
To understand the effects of co-processing sewage sludge in the cement kiln on non-criterion pollutants emissions and its surrounding environment, the flue gas from a cement kiln stack, ambient air and soil from the background/downwind sites were collected in the cement plant. Polycyclic
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To understand the effects of co-processing sewage sludge in the cement kiln on non-criterion pollutants emissions and its surrounding environment, the flue gas from a cement kiln stack, ambient air and soil from the background/downwind sites were collected in the cement plant. Polycyclic aromatic hydrocarbons (PAHs) and heavy metals of the samples were analyzed. The results show that PAHs in flue gas mainly exist in the gas phase and the low molecular weight PAHs are the predominant congener. The co-processing sewage sludge results in the increase in PAHs and heavy metals emissions, especially high molecular weight PAHs and low-volatile heavy metals such as Cd and Pb in the particle phase, while it does not change their compositions and distribution patterns significantly. The concentrations and their distributions of the PAHs and heavy metals between the emissions and ambient air have a positive correlation and the co-processing sewage sludge results in the increase of PAHs and heavy metals concentrations in the ambient air. The PAHs concentration level and their distribution in soil are proportional to those in the particle phase of flue gas, and the co-processing sewage sludge can accelerate the accumulation of the PAHs and heavy metals in the surrounding soil, especially high/middle molecular weight PAHs and low-volatile heavy metals. Full article
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