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Int. J. Environ. Res. Public Health, Volume 15, Issue 5 (May 2018)

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Cover Story (view full-size image) Food safety is a signifcant issue all over the world and should be treated as a priority. Every [...] Read more.
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Editorial

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Open AccessEditorial Health and Health Care for Homeless People in Various Contexts
Int. J. Environ. Res. Public Health 2018, 15(5), 948; https://doi.org/10.3390/ijerph15050948
Received: 2 May 2018 / Revised: 4 May 2018 / Accepted: 5 May 2018 / Published: 10 May 2018
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Abstract
Although there is some uncertainty about the exact number of homeless people at any given time in different countries, it is undeniable that this number has steadily and dramatically grown in the recent years [...] Full article
(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Evaluating the Implementation of a Twitter-Based Foodborne Illness Reporting Tool in the City of St. Louis Department of Health
Int. J. Environ. Res. Public Health 2018, 15(5), 833; https://doi.org/10.3390/ijerph15050833
Received: 3 April 2018 / Revised: 19 April 2018 / Accepted: 22 April 2018 / Published: 24 April 2018
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Abstract
Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City
[...] Read more.
Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City of St. Louis Department of Health adopted the HealthMap Foodborne Dashboard (Dashboard), a tool that monitors Twitter for tweets about food poisoning in a geographic area and allows the health department to respond. We evaluated the implementation by interviewing employees of the City of St. Louis Department of Health involved in food safety. We interviewed epidemiologists, environmental health specialists, health services specialists, food inspectors, and public information officers. Participants viewed engaging innovation participants and executing the innovation as challenges while they felt the Dashboard had relative advantage over existing reporting methods and was not complex once in place. This study is the first to examine practitioner perceptions of the implementation of a new technology in a local health department. Similar implementation projects should focus more on process by developing clear and comprehensive plans to educate and involve stakeholders prior to implementation. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Effects of Environmental Air Pollution on Pulmonary Function Level of Residents in Korean Industrial Complexes
Int. J. Environ. Res. Public Health 2018, 15(5), 834; https://doi.org/10.3390/ijerph15050834
Received: 27 February 2018 / Revised: 11 April 2018 / Accepted: 21 April 2018 / Published: 24 April 2018
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Abstract
This study aims to identify environmental air pollution adversely affecting pulmonary function among a community-based general population living in Korean industrial complexes. A total of 1963 residents participated in a pulmonary function test (PFT). The sample population consisted of an exposed group (
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This study aims to identify environmental air pollution adversely affecting pulmonary function among a community-based general population living in Korean industrial complexes. A total of 1963 residents participated in a pulmonary function test (PFT). The sample population consisted of an exposed group (n = 1487) living within a radius of 5 km of industrial complexes and a control group (n = 476) living over a radius of 10 km from the industrial complexes in Gwangyang and Yeosu cities. PFT results were calculated for each resident of the study population. On-site questionnaire surveys with face-to-face interviews were also conducted to collect more detailed information on personal lifestyles, medical history, exposure to air pollution, and respiratory disease and related symptoms. A total of 486 measured samples were collected by eight automated air-monitoring stations installed in four counties of Gwangyang and four counties of Yeosu in South Korea from January 2006 to February 2007. Mean levels of SO2 (0.012 ppm), CO (0.648 ppm), NO2 (0.02 ppm), O3 (0.034 ppm), and PM10 (43.07 μg/m3), collected within a radius of 5 km, were significantly higher than those collected over a radius of 10 km from Gwangyang and Yeosu industrial complexes. Prevalence odds ratio (OR) of abnormal pulmonary function in the exposed group of residents (<5 km) was elevated at 1.24 (95% CI 0.71–1.96), but not statistically significant (p > 0.05). In multiple linear regression analysis, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) levels significantly declined as SO2, CO, and O3 levels increased when adjusting for age, sex, body mass index (BMI), alcohol, smoking, secondhand smoke, and respiratory disease and related symptoms (n = 1963) (p < 0.05). These results suggest that exposure to air pollution affects pulmonary function levels of residents living in Korean industrial complexes. Full article
(This article belongs to the Special Issue Lung Diseases Associated with Environmental Pollutants)
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Open AccessArticle Mobile Exergaming in Adolescents’ Everyday Life—Contextual Design of Where, When, with Whom, and How: The SmartLife Case
Int. J. Environ. Res. Public Health 2018, 15(5), 835; https://doi.org/10.3390/ijerph15050835
Received: 28 March 2018 / Revised: 16 April 2018 / Accepted: 20 April 2018 / Published: 24 April 2018
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Abstract
Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential
[...] Read more.
Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential playing time, but need to be engaging and integrated in everyday life. The goal of the present study was to examine the context of gameplay for mobile exergaming in adolescents’ everyday life to inform game design and the integration of gameplay into everyday life. Eight focus groups were conducted with 49 Flemish adolescents (11 to 17 years of age). The focus groups were audiotaped, transcribed, and analyzed by means of thematic analysis via Nvivo 11 software (QSR International Pty Ltd., Victoria, Australia). The adolescents indicated leisure time and travel time to and from school as suitable timeframes for playing a mobile exergame. Outdoor gameplay should be restricted to the personal living environment of adolescents. Besides outdoor locations, the game should also be adaptable to at-home activities. Activities could vary from running outside to fitness exercises inside. Furthermore, the social context of the game was important, e.g., playing in teams or meeting at (virtual) meeting points. Physical activity tracking via smart clothing was identified as a motivator for gameplay. By means of this study, game developers may be better equipped to develop mobile exergames that embed gameplay in adolescents’ everyday life. Full article
(This article belongs to the Special Issue Advances in Technology Enabled Health and Care)
Open AccessArticle The Relationship between Urbanization, the Built Environment, and Physical Activity among Older Adults in Taiwan
Int. J. Environ. Res. Public Health 2018, 15(5), 836; https://doi.org/10.3390/ijerph15050836
Received: 15 March 2018 / Revised: 20 April 2018 / Accepted: 22 April 2018 / Published: 24 April 2018
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Abstract
Urbanization and ageing are global phenomena and offer unique challenges in different countries. A supportive environment plays a critical role in addressing the issue of behavioral change and health promotion among older adults. Many studies in the U.S., EU, and Australia have considered
[...] Read more.
Urbanization and ageing are global phenomena and offer unique challenges in different countries. A supportive environment plays a critical role in addressing the issue of behavioral change and health promotion among older adults. Many studies in the U.S., EU, and Australia have considered promoting physical activity in the community based on ecological models, whereas very few Asian studies have examined the relationships among urbanization, the built environment and physical activity in elderly at the ecological level, especially from a multi-level perspective. Due to the prevalence of post-war baby boomers and a very low birth-rate, the older population (aged 65 years old and older) in Taiwan has increased rapidly since 2011 and has exceeded the younger generation (0–14 years old) in 2017. Hence, the purpose of this study was first to examine the degree of urbanization in townships and the status of related built environments in Taiwan and then to investigate whether the built environment is associated with recommended amounts of physical activity among older adults. Three national datasets and a multi-level design were used in this research. Data at the individual level was obtained from the 2009 National Health Interview Survey (NHIS) which was taken from June 2009 to February 2010. Ecological data was obtained from the 2006 National Land Use Investigation of the National Geographic Information System and the 2010 Population and Housing Census. The analyses included a descriptive analysis, a bivariate analysis, a multiple logistic regression, and a multi-level analysis, utilizing a mostly hierarchical linear model (HLM). The results showed a significant relationship between factors at the environmental levels and physical activity in older adults. Urbanization, the built environment, and the median income of townships were positively correlated to the physical activity of the older adults. After controlling for individual-level factors, urbanization still exhibited this correlation. Parks and green spaces were associated with achieving the recommended amount of physical activity. However, there was no relationship after controlling for factors at the individual level. Detailed discussions were provided. Full article
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Open AccessArticle Social Network Analysis Applied to a Historical Ethnographic Study Surrounding Home Birth
Int. J. Environ. Res. Public Health 2018, 15(5), 837; https://doi.org/10.3390/ijerph15050837
Received: 1 March 2018 / Revised: 4 April 2018 / Accepted: 4 April 2018 / Published: 24 April 2018
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Abstract
Safety during birth has improved since hospital delivery became standard practice, but the process has also become increasingly medicalised. Hence, recent years have witnessed a growing interest in home births due to the advantages it offers to mothers and their newborn infants. The
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Safety during birth has improved since hospital delivery became standard practice, but the process has also become increasingly medicalised. Hence, recent years have witnessed a growing interest in home births due to the advantages it offers to mothers and their newborn infants. The aims of the present study were to confirm the transition from a home birth model of care to a scenario in which deliveries began to occur almost exclusively in a hospital setting; to define the social networks surrounding home births; and to determine whether geography exerted any influence on the social networks surrounding home births. Adopting a qualitative approach, we recruited 19 women who had given birth at home in the mid 20th century in a rural area in Spain. We employed a social network analysis method. Our results revealed three essential aspects that remain relevant today: the importance of health professionals in home delivery care, the importance of the mother’s primary network, and the influence of the geographical location of the actors involved in childbirth. All of these factors must be taken into consideration when developing strategies for maternal health. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Effect of Drought on Agronomic Traits of Rice and Wheat: A Meta-Analysis
Int. J. Environ. Res. Public Health 2018, 15(5), 839; https://doi.org/10.3390/ijerph15050839
Received: 20 March 2018 / Revised: 14 April 2018 / Accepted: 17 April 2018 / Published: 24 April 2018
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Abstract
Drought has been one of the most important limiting factors for crop production, which deleteriously affects food security worldwide. The main objective of the present study was to quantitatively assess the effect of drought on the agronomic traits (e.g., plant height, biomass, yield,
[...] Read more.
Drought has been one of the most important limiting factors for crop production, which deleteriously affects food security worldwide. The main objective of the present study was to quantitatively assess the effect of drought on the agronomic traits (e.g., plant height, biomass, yield, and yield components) of rice and wheat in combination with several moderators (e.g., drought stress intensity, rooting environment, and growth stage) using a meta-analysis study. The database was created from 55 published studies on rice and 60 published studies on wheat. The results demonstrated that drought decreased the agronomic traits differently between rice and wheat among varying growth stages. Wheat and rice yields decreased by 27.5% and 25.4%, respectively. Wheat grown in pots showed greater decreases in agronomic traits than those grown in the field. Rice showed opposite growing patterns when compared to wheat in rooting environments. The effect of drought on rice increased with plant growth and drought had larger detrimental influences during the reproductive phase (e.g., blooming stage, filling stage, and maturity). However, an exception was found in wheat, which had similar decreased performance during the complete growth cycle. Based on these results, future droughts could produce lower yields of rice and wheat when compared to the current drought. Full article
(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)
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Open AccessArticle Do Low Income Youth of Color See “The Bigger Picture” When Discussing Type 2 Diabetes: A Qualitative Evaluation of a Public Health Literacy Campaign
Int. J. Environ. Res. Public Health 2018, 15(5), 840; https://doi.org/10.3390/ijerph15050840
Received: 3 February 2018 / Revised: 19 April 2018 / Accepted: 20 April 2018 / Published: 24 April 2018
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Abstract
As Type 2 diabetes spikes among minority and low-income youth, there is an urgent need to tackle the drivers of this preventable disease. The Bigger Picture (TBP) is a counter-marketing campaign using youth-created, spoken-word public service announcements (PSAs) to reframe the epidemic as
[...] Read more.
As Type 2 diabetes spikes among minority and low-income youth, there is an urgent need to tackle the drivers of this preventable disease. The Bigger Picture (TBP) is a counter-marketing campaign using youth-created, spoken-word public service announcements (PSAs) to reframe the epidemic as a socio-environmental phenomenon requiring communal action, civic engagement and norm change. Methods: We examined whether and how TBP PSAs advance health literacy among low-income, minority youth. We showed nine PSAs, asking individuals open-ended questions via questionnaire, then facilitating a focus group to reflect upon the PSAs. Results: Questionnaire responses revealed a balance between individual vs. public health literacy. Some focused on individual responsibility and behaviors, while others described socio-environmental forces underlying risk. The focus group generated a preponderance of public health literacy responses, emphasizing future action. Striking sociopolitical themes emerged, reflecting tensions minority and low-income youth experience, such as entrapment vs. liberation. Conclusion: Our findings speak to the structural barriers and complexities underlying diabetes risk, and the ability of spoken word medium to make these challenges visible and motivate action. Practice Implications: Delivering TBP content to promote interactive reflection has potential to change behavioral norms and build capacity to confront the social, economic and structural factors that influence behaviors. Full article
(This article belongs to the Special Issue Health Literacy in Context—Settings, Media, and Populations)
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Open AccessArticle Seasonal Influenza Vaccination in Health Care Workers. A Pre-Post Intervention Study in an Italian Paediatric Hospital
Int. J. Environ. Res. Public Health 2018, 15(5), 841; https://doi.org/10.3390/ijerph15050841
Received: 3 March 2018 / Revised: 13 April 2018 / Accepted: 21 April 2018 / Published: 24 April 2018
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Abstract
Despite relevant recommendations and evidences on the efficacy of influenza vaccination in health care workers (HCWs), vaccination coverage rates in Europe and Italy currently do not exceed 25%. Aim of the study is to measure the variations in vaccination coverage rates in an
[...] Read more.
Despite relevant recommendations and evidences on the efficacy of influenza vaccination in health care workers (HCWs), vaccination coverage rates in Europe and Italy currently do not exceed 25%. Aim of the study is to measure the variations in vaccination coverage rates in an Italian pediatric hospital after a promotion campaign performed in the period October–December 2017. The design is a pre-post intervention study. The intervention is based on a wide communication campaign and an expanded offer of easy vaccination on site. The study was carried out at Bambino Gesù Children’s hospital in Rome, Italy, on the whole population of HCWs. Univariate and multivariate statistical analyses were performed. Vaccination coverage rate increased in 2017/18 campaign compared with the 2016/17 one (+95 HCWs vaccinated; +4.4%). The highest increases were detected in males (+45.7%), youngest employees (+142.9%), mean age of employment (+175%), other HCWs (+209.1%), Emergency Area (+151.6%) and Imaging Diagnostic Department (+200.0%). At multivariate logistic regression, working in some departments and being nurses represents a higher risk of being unvaccinated. Although the vaccination coverage rate remained low, a continuous increase of the coverage rate and development of a different consciousness in HCWs was highlighted. The study significantly identified the target for future campaigns. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
Open AccessArticle The Status of Musculoskeletal Disorders and Its Influence on the Working Ability of Oil Workers in Xinjiang, China
Int. J. Environ. Res. Public Health 2018, 15(5), 842; https://doi.org/10.3390/ijerph15050842
Received: 24 March 2018 / Revised: 17 April 2018 / Accepted: 20 April 2018 / Published: 24 April 2018
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Abstract
The purpose of this study was to investigate the status of musculoskeletal disorders (MSDs) and its influence on the working ability of oil workers, and to provide a theoretical basis for helping lessen the burden of MSDs and improve the man-machine environment of
[...] Read more.
The purpose of this study was to investigate the status of musculoskeletal disorders (MSDs) and its influence on the working ability of oil workers, and to provide a theoretical basis for helping lessen the burden of MSDs and improve the man-machine environment of oil workers. The cluster sampling method was used to study 2000 workers who had been employed for more than 1 year in this field. We investigated the prevalence rate and the work ability index (WAI). A total of 1935 valid questionnaires were collected, a response rate of 96.75%. There were 1639 people who had suffered from MSDs in the past year, a prevalence rate of 84.7%. The damage detection rate in female oil workers was higher than in males, and the damage detection rate in workers aged 30 to 45 years was higher than that in the other two age groups. The detection rate in less highly-educated oil workers was higher than that in more highly-educated workers. The detection rate in divorced workers was higher than that in other groups. The detection rate in workers between the number of working years of 18 to 25 years was higher than in the other two groups. The detection rate in workers with a high professional title was significantly higher than that in lower-titled workers (p < 0.05). The results showed that the WAI scores of the subjects with MSDs were significantly lower than for subjects without MSDs (p < 0.05). In a logistic regression analysis, sex, number of working years and WAI index all had an impact on MSDs. We concluded that due to the demands of their role, the oil workers had serious MSDs that influenced their working ability. Full article
(This article belongs to the Special Issue Musculoskeletal Disorders)
Open AccessArticle General Practitioners’ Perceptions of Heat Health Impacts on the Elderly in the Face of Climate Change—A Qualitative Study in Baden-Württemberg, Germany
Int. J. Environ. Res. Public Health 2018, 15(5), 843; https://doi.org/10.3390/ijerph15050843
Received: 28 February 2018 / Revised: 11 April 2018 / Accepted: 16 April 2018 / Published: 24 April 2018
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Abstract
Heat health impacts (HHI) on the elderly are a growing concern in the face of climate change and aging populations. General practitioners (GPs) have an important role in health care for the elderly. To inform the development of effective prevention measures, it is
[...] Read more.
Heat health impacts (HHI) on the elderly are a growing concern in the face of climate change and aging populations. General practitioners (GPs) have an important role in health care for the elderly. To inform the development of effective prevention measures, it is important to investigate GPs’ perceptions of HHI. Twenty four qualitative expert interviews were conducted with GPs and analyzed using the framework approach. GPs were generally aware of heat health impacts, focusing on cardiovascular morbidity and volume imbalances. Perceptions of mortality and for instance impacts on respiratory diseases or potentially risky drugs in heat waves partly diverged from findings in literature. GPs judged the current relevance of HHI differently depending on their attitudes towards: (i) sensitivity of the elderly, (ii) status of nursing care and (iii) heat exposure in Baden-Württemberg. Future relevance of HHI was perceived to be increasing by most GPs. The main cause identified for this was population aging, while impacts of climate change were judged as uncertain by many. GPs’ perceptions, partly diverging from literature, show that GPs’ knowledge and awareness on HHI and climate change needs to be strengthened. However, they also emphasize the need for more research on HHI in the ambulant health care setting. Furthermore, GPs perceptions suggest that strong nursing care and social networks for elderly are major elements of a climate resilient health system. Full article
(This article belongs to the Section Climate Change and Health)
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Open AccessArticle Integration of a Copper-Containing Biohybrid (CuHARS) with Cellulose for Subsequent Degradation and Biomedical Control
Int. J. Environ. Res. Public Health 2018, 15(5), 844; https://doi.org/10.3390/ijerph15050844
Received: 13 March 2018 / Revised: 17 April 2018 / Accepted: 20 April 2018 / Published: 25 April 2018
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Abstract
We previously described the novel synthesis of a copper high-aspect ratio structure (CuHARS) biohybrid material using cystine. While extremely stable in water, CuHARS is completely (but slowly) degradable in cellular media. Here, integration of the CuHARS into cellulose matrices was carried out to
[...] Read more.
We previously described the novel synthesis of a copper high-aspect ratio structure (CuHARS) biohybrid material using cystine. While extremely stable in water, CuHARS is completely (but slowly) degradable in cellular media. Here, integration of the CuHARS into cellulose matrices was carried out to provide added control for CuHARS degradation. Synthesized CuHARS was concentrated by centrifugation and then dried. The weighed mass was re-suspended in water. CuHARS was stable in water for months without degradation. In contrast, 25 μg/mL of the CuHARS in complete cell culture media was completely degraded (slowly) in 18 days under physiological conditions. Stable integration of CuHARS into cellulose matrices was achieved through assembly by mixing cellulose micro- and nano-fibers and CuHARS in an aqueous (pulp mixture) phase, followed by drying. Additional materials were integrated to make the hybrids magnetically susceptible. The cellulose-CuHARS composite films could be transferred, weighed, and cut into usable pieces; they maintained their form after rehydration in water for at least 7 days and were compatible with cell culture studies using brain tumor (glioma) cells. These studies demonstrate utility of a CuHARS-cellulose biohybrid for applied applications including: (1) a platform for biomedical tracking and (2) integration into a 2D/3D matrix using natural products (cellulose). Full article
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Open AccessArticle Influence of Latitude on the Prevalence of Kawasaki Disease: A Retrospective Cohort Study from the Taiwan National Health Insurance Database and Review of the Literature
Int. J. Environ. Res. Public Health 2018, 15(5), 845; https://doi.org/10.3390/ijerph15050845
Received: 20 March 2018 / Revised: 14 April 2018 / Accepted: 23 April 2018 / Published: 25 April 2018
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Abstract
Background: Countries at higher latitudes have higher incidence rates of Kawasaki disease (KD) than do countries at lower latitudes in the Asian and West Pacific area. However, the precise influence of latitude on KD incidence rates requires further clarification. Methods: We searched the
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Background: Countries at higher latitudes have higher incidence rates of Kawasaki disease (KD) than do countries at lower latitudes in the Asian and West Pacific area. However, the precise influence of latitude on KD incidence rates requires further clarification. Methods: We searched the Longitudinal Health Insurance Database 2005 to retrieve patients’ medical records from 1996 to 2009. The patients with KD were categorized as living in northern, middle, and southern Taiwan; the period prevalence of KD for each area was determined. Climate variables, including temperature, sunshine duration, precipitation, and relative humidity, were collected from the Taiwan Central Weather Bureau. The effect of latitude on the period KD prevalence and the correlation between climate variables and KD prevalence were calculated. Results: After patients without complete data excluded, a total of 61,830 children up to 10 years old were retrieved, from which 404 patients with KD were recognized. The period prevalence of KD increased significantly with latitude (p = 0.0004). Climate variables associated with high temperature demonstrated a connection with KD prevalence; however, this correlation was not statistically significant. Conclusions: Our study demonstrated that higher latitude is associated with a higher KD prevalence in Taiwan. Full article
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Open AccessArticle Suicidal Ideation and Healthy Immigrant Effect in the Canadian Population: A Cross-Sectional Population Based Study
Int. J. Environ. Res. Public Health 2018, 15(5), 848; https://doi.org/10.3390/ijerph15050848
Received: 9 March 2018 / Revised: 22 April 2018 / Accepted: 23 April 2018 / Published: 25 April 2018
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Abstract
Understanding suicidal ideation is crucial for preventing suicide. Although “healthy immigrant effect” is a phenomenon that has been well documented across a multitude of epidemiological and social studies—where immigrants are, on average, healthier than the native-born, little research has examined the presence of
[...] Read more.
Understanding suicidal ideation is crucial for preventing suicide. Although “healthy immigrant effect” is a phenomenon that has been well documented across a multitude of epidemiological and social studies—where immigrants are, on average, healthier than the native-born, little research has examined the presence of such effect on suicidal ideation. The objective of this study is to investigate if there is a differential effect of immigration identity on suicidal ideation and how the effect varies by socio-demographic characteristics in the Canadian population. Data from the Canadian Community Health Survey in year 2014 were used. Multivariate logistic regression was employed. Our findings indicated that recent immigrants (lived in Canada for 9 or less years) were significantly less likely to report suicidal ideation compared with non-immigrants. However, for established immigrants (10 years and above of living in Canada), the risk of suicidal ideation converged to Canadian-born population. Moreover, male immigrants were at significantly lower risk of having suicidal ideation than Canadian-born counterparts; whereas, female immigrants did not benefit from the “healthy immigrant effect”. Our findings suggest the need for targeted intervention strategies on suicidal ideation among established immigrants and female immigrants. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
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Open AccessArticle Measurement of Pesticide Residues from Chemical Control of the Invasive Spodoptera frugiperda (Lepidoptera: Noctuidae) in a Maize Experimental Field in Mokwa, Nigeria
Int. J. Environ. Res. Public Health 2018, 15(5), 849; https://doi.org/10.3390/ijerph15050849
Received: 8 March 2018 / Revised: 14 April 2018 / Accepted: 16 April 2018 / Published: 25 April 2018
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Abstract
The management of the fall armyworm Spodoptera frugiperda in maize field necessitates the use a big quantities of insecticides and sometimes the use of multiple types and formulations of chemicals. The use of insecticides in crops is associated with environmental risks and health
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The management of the fall armyworm Spodoptera frugiperda in maize field necessitates the use a big quantities of insecticides and sometimes the use of multiple types and formulations of chemicals. The use of insecticides in crops is associated with environmental risks and health hazards to both producers and consumers. This study was designed to evaluate the residue of 11 insecticides that were used to control high population of the fall armyworm in maize field in Mokwa, Nigeria. Maize and soil samples were collected from an experimental field to investigate the residue level using high performance liquid chromatography (HPLC, Agilent Technologies, Santa Clara, CA, USA) analysis techniques. Results revealed the presence of five insecticide compounds (Cypermethrin, Deltamethrin, Lambda-Cyhalothrin, Permethrin, and Chorpyrifos) in soil samples with possible adverse effects on soil born organisms and other non-targeted species. In contrast, no residue was found in maize stems and seeds. From these results, we conclude that the treated maize remains safe for consumption and the producers may not get any serious risk of contamination from the chemical control of the fall armyworm. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle University Students’ Willingness to Assist Fellow Students Who Experience Alcohol-Related Facial Flushing to Reduce Their Drinking
Int. J. Environ. Res. Public Health 2018, 15(5), 850; https://doi.org/10.3390/ijerph15050850
Received: 23 March 2018 / Revised: 20 April 2018 / Accepted: 23 April 2018 / Published: 25 April 2018
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Abstract
This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive
[...] Read more.
This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive cancers. Individuals who flush should reduce their alcohol exposure, but they may continue to drink if social pressures and rules of etiquette make not drinking socially risky. The analysis used data from 2912 undergraduate students from 13 universities in southwestern, central and northeastern China from a survey asking how they respond to someone’s flushing in various scenarios. Latent class analysis grouped students by similar responses to flushing. A multinomial logistic regression explored how class membership was associated with knowledge, drinking status, and reactions to one’s own flushing. Five classes were derived from the latent class analysis, ranging from always intervene to mostly hesitate to help; in between were classes of students who were willing to help in some scenarios and hesitant in other scenarios. Only 11.6% students knew the connection between facial flushing and impaired alcohol metabolism, and knowledgeable students were somewhat more likely to assist when they saw someone flushing. In the absence of knowledge, other factors—such as drinking status, the gender of the bystander, the gender of the person who flushed, and degree of friendship with the person who flushed—determined how willing a person was to help someone reduce or stop drinking. Class membership was predicted by knowledge, gender, drinking status, and reactions to one’s own flushing. Of these 4 factors, knowledge and reactions to one’s own flushing could be influenced through alcohol education programs. It will take some time for alcohol education to catch up to and change social and cultural patterns of drinking. Meanwhile, motivational strategies should be developed to increase the willingness of bystanders to assist friends and to create a social expectation that flushers should stop or reduce their drinking. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessFeature PaperArticle Impact of a Translated Disease Self-Management Program on Employee Health and Productivity: Six-Month Findings from a Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2018, 15(5), 851; https://doi.org/10.3390/ijerph15050851
Received: 20 March 2018 / Revised: 9 April 2018 / Accepted: 19 April 2018 / Published: 25 April 2018
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Abstract
Disease management is gaining importance in workplace health promotion given the aging workforce and rising chronic disease prevalence. The Chronic Disease Self-Management Program (CDSMP) is an effective intervention widely offered in diverse community settings; however, adoption remains low in workplace settings. As part
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Disease management is gaining importance in workplace health promotion given the aging workforce and rising chronic disease prevalence. The Chronic Disease Self-Management Program (CDSMP) is an effective intervention widely offered in diverse community settings; however, adoption remains low in workplace settings. As part of a larger NIH-funded randomized controlled trial, this study examines the effectiveness of a worksite-tailored version of CDSMP (wCDSMP [n = 72]) relative to CDSMP (‘Usual Care’ [n = 109]) to improve health and work performance among employees with one or more chronic conditions. Multiple-group latent-difference score models with sandwich estimators were fitted to identify changes from baseline to 6-month follow-up. Overall, participants were primarily female (87%), non-Hispanic white (62%), and obese (73%). On average, participants were age 48 (range: 23–72) and self-reported 3.25 chronic conditions (range: 1–16). The most commonly reported conditions were high cholesterol (45%), high blood pressure (45%), anxiety/emotional/mental health condition (26%), and diabetes (25%). Among wCDSMP participants, significant improvements were observed for physically unhealthy days (uΔ = −2.07, p = 0.018), fatigue (uΔ = −2.88, p = 0.002), sedentary behavior (uΔ = −4.49, p = 0.018), soda/sugar beverage consumption (uΔ = −0.78, p = 0.028), and fast food intake (uΔ = −0.76, p = 0.009) from baseline to follow-up. Significant improvements in patient–provider communication (uΔ = 0.46, p = 0.031) and mental work limitations (uΔ = −8.89, p = 0.010) were also observed from baseline to follow-up. Relative to Usual Care, wCDSMP participants reported significantly larger improvements in fatigue, physical activity, soda/sugar beverage consumption, and mental work limitations (p < 0.05). The translation of Usual Care (content and format) has potential to improve health among employees with chronic conditions and increase uptake in workplace settings. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Gender and Body-Fat Status as Predictors of Parental Feeding Styles and Children’s Nutritional Knowledge, Eating Habits and Behaviours
Int. J. Environ. Res. Public Health 2018, 15(5), 852; https://doi.org/10.3390/ijerph15050852
Received: 27 February 2018 / Revised: 14 April 2018 / Accepted: 24 April 2018 / Published: 25 April 2018
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Abstract
The home food environment is critically important for the development of children’s health-related practices. By managing dietary restrictions, providing nutritional knowledge and demonstrating eating behaviours, parents contribute to children’s food preferences and eating patterns. The present study examined nutritional knowledge, eating habits and
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The home food environment is critically important for the development of children’s health-related practices. By managing dietary restrictions, providing nutritional knowledge and demonstrating eating behaviours, parents contribute to children’s food preferences and eating patterns. The present study examined nutritional knowledge, eating habits and appetite traits among 387 Polish five-year-old healthy and overfat boys and girls in the context of parental feeding styles and body-fat status. We observed that girls presented healthier eating habits than boys; however, overfat boys had better nutritional knowledge. Children’s body-fat percentage (%BF) was found to be linked with eating behaviours such as low satiety responsiveness and increased food responsiveness in girls as well as low emotional undereating and increased emotional overeating in boys. Our results revealed that overfat mothers, who were more prone to use the encouragement feeding style, rarely had daughters with increased %BF. Parents of overfat girls, however, were less likely to apply encouragement and instrumental feeding styles. Contrary to popular belief and previous studies, overfat women do not necessarily transmit unhealthy eating patterns to their children. Parents’ greater emphasis on managing the weight and eating habits of daughters (rather than sons) probably results from their awareness of standards of female physical attractiveness. Full article
(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)
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Open AccessArticle Observance of Sterilization Protocol Guideline Procedures of Critical Instruments for Preventing Iatrogenic Transmission of Creutzfeldt-Jakob Disease in Dental Practice in France, 2017
Int. J. Environ. Res. Public Health 2018, 15(5), 853; https://doi.org/10.3390/ijerph15050853
Received: 18 March 2018 / Revised: 13 April 2018 / Accepted: 14 April 2018 / Published: 25 April 2018
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Abstract
Effective sterilization of reusable instruments contaminated by Creutzfeldt–Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental
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Effective sterilization of reusable instruments contaminated by Creutzfeldt–Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33) were classified into 4 groups: (1) Pre-sterilization cleaning of reusable instruments; (2) Biological verification of sterilization cycles—Monitoring steam sterilization procedures; (3) Autoclave performance and practitioner knowledge of autoclave use; (4) Monitoring and documentation of sterilization procedures—Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed). Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%). Dental practices ≥ 3 dental units performed significantly better (>80%) procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively), while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their non-compliance are needed. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Association between Sleep Duration and Overweight/Obesity at Age 7–18 in Shenyang, China in 2010 and 2014
Int. J. Environ. Res. Public Health 2018, 15(5), 854; https://doi.org/10.3390/ijerph15050854
Received: 13 March 2018 / Revised: 12 April 2018 / Accepted: 24 April 2018 / Published: 25 April 2018
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Abstract
This study was designed to examine the association between sleep duration and being overweight/obese in primary, middle, and high school students. This was a multiple cross-sectional study using data from the 2010 and 2014 National Survey on Students’ Constitution and Health (CNSSCH). A
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This study was designed to examine the association between sleep duration and being overweight/obese in primary, middle, and high school students. This was a multiple cross-sectional study using data from the 2010 and 2014 National Survey on Students’ Constitution and Health (CNSSCH). A total of 23,602 students aged 7–18 years were enrolled in this study. The prevalence of being overweight and obese—stratified by age, gender, and sleep duration—in 2010 and 2014 were compared. Sleep duration was categorized as <7 h, ≥7 to 8 h, ≥8 to 9 h, and ≥9 h. Overweight and obesity were defined according to the cut-point criteria in China. Multivariable logistic regression results in 2010 and 2014 revealed that students sleeping <7 h and aged 7–12 years had an increased risk of becoming overweight/obese. In 2010, the adjusted prevalence ratios of overweight for 7–12-year-old students sleeping <9 h was 1.196 (95%CI: 1.004–1.424) and 13–15-year-old students sleeping <8 h was 1.265 (95%CI: 1.023–1.565). In 2014, the adjusted prevalence ratios of overweight and obesity for 7–12-year-old students sleeping <9 h were 1.295 (95%CI: 1.091–1.537) and 1.231 (95%CI: 1.045–1.449); 16–18-year-old students sleeping <7 h were 1.530 (95%CI: 1.239–1.888) and 1.585 (95%CI: 1.270–2.081). Our study revealed that different levels of sleep curtailment increased the risk of becoming overweight/obesity in different age groups of students. Full article
(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)
Open AccessArticle Ecological Vulnerability Assessment Based on Fuzzy Analytical Method and Analytic Hierarchy Process in Yellow River Delta
Int. J. Environ. Res. Public Health 2018, 15(5), 855; https://doi.org/10.3390/ijerph15050855
Received: 19 March 2018 / Revised: 17 April 2018 / Accepted: 21 April 2018 / Published: 25 April 2018
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Abstract
The Yellow River Delta (YRD), located in Yellow River estuary, is characterized by rich ecological system types, and provides habitats or migration stations for wild birds, all of which makes the delta an ecological barrier or ecotone for inland areas. Nevertheless, the abundant
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The Yellow River Delta (YRD), located in Yellow River estuary, is characterized by rich ecological system types, and provides habitats or migration stations for wild birds, all of which makes the delta an ecological barrier or ecotone for inland areas. Nevertheless, the abundant natural resources of YRD have brought huge challenges to the area, and frequent human activities and natural disasters have damaged the ecological systems seriously, and certain ecological functions have been threatened. Therefore, it is necessary to determine the status of the ecological environment based on scientific methods, which can provide scientifically robust data for the managers or stakeholders to adopt timely ecological protection measures. The aim of this study was to obtain the spatial distribution of the ecological vulnerability (EV) in YRD based on 21 indicators selected from underwater status, soil condition, land use, landform, vegetation cover, meteorological conditions, ocean influence, and social economy. In addition, the fuzzy analytic hierarchy process (FAHP) method was used to obtain the weights of the selected indicators, and a fuzzy logic model was constructed to obtain the result. The result showed that the spatial distribution of the EV grades was regular, while the fuzzy membership of EV decreased gradually from the coastline to inland area, especially around the river crossing, where it had the lowest EV. Along the coastline, the dikes had an obviously protective effect for the inner area, while the EV was higher in the area where no dikes were built. This result also showed that the soil condition and groundwater status were highly related to the EV spatially, with the correlation coefficients −0.55 and −0.74 respectively, and human activities had exerted considerable pressure on the ecological environment. Full article
(This article belongs to the collection Environmental Risk Assessment)
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Open AccessArticle Impact of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany
Int. J. Environ. Res. Public Health 2018, 15(5), 856; https://doi.org/10.3390/ijerph15050856
Received: 17 March 2018 / Revised: 18 April 2018 / Accepted: 23 April 2018 / Published: 25 April 2018
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Abstract
Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons,
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Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence regarding its actual impact on the use of medical services. The aim of the study is to examine this impact on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). Study Design: For this purpose, a standardized survey was conducted with 260 asylum seekers in different municipalities, some of which have introduced the EHIC for asylum seekers, while others have not. Methods: The period prevalence was compared between the groups “with EHIC” and “without EHIC” using a two-sided t-test. Multivariate analysis was done using a linear OLS regression model. Results: Asylum seekers in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Conclusions: The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers. Full article
(This article belongs to the Special Issue Refugee, Migrant and Ethnic Minority Health)
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Open AccessArticle The Preschool-Aged and School-Aged Children Present Different Odds of Mortality than Adults in Southern Taiwan: A Cross-Sectional Retrospective Analysis
Int. J. Environ. Res. Public Health 2018, 15(5), 858; https://doi.org/10.3390/ijerph15050858
Received: 26 March 2018 / Revised: 18 April 2018 / Accepted: 21 April 2018 / Published: 25 April 2018
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Abstract
Background: This study aimed to profile the epidemiology of injury among preschool-aged and school-aged children in comparison to those in adults. Methods: According to the Trauma Registry System of a level I trauma center, the medical data were retrieved from 938
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Background: This study aimed to profile the epidemiology of injury among preschool-aged and school-aged children in comparison to those in adults. Methods: According to the Trauma Registry System of a level I trauma center, the medical data were retrieved from 938 preschool-aged children (aged less than seven years), 670 school-aged children (aged 7–12 years), and 16,800 adults (aged 20–64 years) between 1 January 2009 and 31 December 2016. Two-sided Pearson’s, chi-squared, and Fisher’s exact tests were used to compare categorical data. A one-way analysis of variance (ANOVA) with the Games-Howell post-hoc test was used to assess the differences in continuous variables among different groups of patients. The mortality outcomes of different subgroups were assessed by a multivariable regression model under the adjustment of sex, injury mechanisms, and injury severity. Results: InFsupppjury mechanisms in preschool-aged and school-aged children were remarkably different from that in adults; in preschool-aged children, burns were the most common cause of injury requiring hospitalization (37.4%), followed by falls (35.1%) and being struck by/against objects (11.6%). In school-aged children, injuries were most commonly sustained from falls (47.8%), followed by bicycle accidents (14%) and being struck by/against objects (12.5%). Compared to adults, there was no significant difference of the adjusted mortality of the preschool-aged children (AOR = 0.9; 95% CI 0.38–2.12; p = 0.792) but there were lower adjusted odds of mortality of the school-aged children (AOR = 0.4; 95% CI 0.10–0.85; p = 0.039). The school-aged children had lower odds of mortality than adults (OR, 0.2; 95% CI, 0.06–0.74; p = 0.012), but such lower odds of risk of mortality were not found in preschool-aged children (OR, 0.7; 95% CI, 0.29–1.81; p = 0.646). Conclusions: This study suggests that specific types of injuries from different injury mechanisms are predominant among preschool-aged and school-aged children. The school-aged children had lower odds of mortality than adults; nonetheless there was no difference in mortality rates of preschool-aged children than adults, with or without controlling for sex, injury mechanisms and ISS. These results highlight the importance of injury prevention, particularly for preschool-aged children in Southern Taiwan. Full article
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Open AccessArticle Effects of Internet and Smartphone Addictions on Depression and Anxiety Based on Propensity Score Matching Analysis
Int. J. Environ. Res. Public Health 2018, 15(5), 859; https://doi.org/10.3390/ijerph15050859
Received: 23 February 2018 / Revised: 11 April 2018 / Accepted: 21 April 2018 / Published: 25 April 2018
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Abstract
The associations of Internet addiction (IA) and smartphone addiction (SA) with mental health problems have been widely studied. We investigated the effects of IA and SA on depression and anxiety while adjusting for sociodemographic variables. In this study, 4854 participants completed a cross-sectional
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The associations of Internet addiction (IA) and smartphone addiction (SA) with mental health problems have been widely studied. We investigated the effects of IA and SA on depression and anxiety while adjusting for sociodemographic variables. In this study, 4854 participants completed a cross-sectional web-based survey including socio-demographic items, the Korean Scale for Internet Addiction, the Smartphone Addiction Proneness Scale, and the subscales of the Symptom Checklist 90 Items-Revised. The participants were classified into IA, SA, and normal use (NU) groups. To reduce sampling bias, we applied the propensity score matching method based on genetics matching. The IA group showed an increased risk of depression (relative risk 1.207; p < 0.001) and anxiety (relative risk 1.264; p < 0.001) compared to NUs. The SA group also showed an increased risk of depression (relative risk 1.337; p < 0.001) and anxiety (relative risk 1.402; p < 0.001) compared to NCs. These findings show that both, IA and SA, exerted significant effects on depression and anxiety. Moreover, our findings showed that SA has a stronger relationship with depression and anxiety, stronger than IA, and emphasized the need for prevention and management policy of the excessive smartphone use. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
Open AccessArticle Associations between Urban Sprawl and Life Expectancy in the United States
Int. J. Environ. Res. Public Health 2018, 15(5), 861; https://doi.org/10.3390/ijerph15050861
Received: 25 March 2018 / Revised: 21 April 2018 / Accepted: 23 April 2018 / Published: 26 April 2018
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Abstract
In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study
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In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study investigated cross-sectional associations between sprawl and life expectancy for metropolitan counties in the United States in 2010. In this study, the measure of life expectancy in 2010 came from a recently released dataset of life expectancies by county. This study modeled average life expectancy with a structural equation model that included five mediators: annual vehicle miles traveled (VMT) per household, average body mass index, crime rate, and air quality index as mediators of sprawl, as well as percentage of smokers as a mediator of socioeconomic status. After controlling for sociodemographic characteristics, this study found that life expectancy was significantly higher in compact counties than in sprawling counties. Compactness affects mortality directly, but the causal mechanism is unclear. For example, it may be that sprawling areas have higher traffic speeds and longer emergency response times, lower quality and less accessible health care facilities, or less availability of healthy foods. Compactness affects mortality indirectly through vehicle miles traveled, which is a contributor to traffic fatalities, and through body mass index, which is a contributor to many chronic diseases. This study identified significant direct and indirect associations between urban sprawl and life expectancy. These findings support further research and practice aimed at identifying and implementing changes to urban planning designed to support health and healthy behaviors. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle The Comprehensive Snack Parenting Questionnaire (CSPQ): Development and Test-Retest Reliability
Int. J. Environ. Res. Public Health 2018, 15(5), 862; https://doi.org/10.3390/ijerph15050862
Received: 14 March 2018 / Revised: 19 April 2018 / Accepted: 24 April 2018 / Published: 26 April 2018
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Abstract
The narrow focus of existing food parenting instruments led us to develop a food parenting practices instrument measuring the full range of food practices constructs with a focus on snacking behavior. We present the development of the questionnaire and our research on the
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The narrow focus of existing food parenting instruments led us to develop a food parenting practices instrument measuring the full range of food practices constructs with a focus on snacking behavior. We present the development of the questionnaire and our research on the test-retest reliability. The developed Comprehensive Snack Parenting Questionnaire (CSPQ) covers 21 constructs. Test-retest reliability was assessed by calculating intra class correlation coefficients and percentage agreement after two administrations of the CSPQ among a sample of 66 Dutch parents. Test-retest reliability analysis revealed acceptable intra class correlation coefficients (≥0.41) or agreement scores (≥0.60) for all items. These results, together with earlier work, suggest sufficient psychometric characteristics. The comprehensive, but brief CSPQ opens up chances for highly essential but unstudied research questions to understand and predict children’s snack intake. Example applications include studying the interactional nature of food parenting practices or interactions of food parenting with general parenting or child characteristics. Full article
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
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Open AccessArticle Disability-Adjusted Life Years for Cancer in 2010–2014: A Regional Approach in Mexico
Int. J. Environ. Res. Public Health 2018, 15(5), 864; https://doi.org/10.3390/ijerph15050864
Received: 15 March 2018 / Revised: 18 April 2018 / Accepted: 21 April 2018 / Published: 26 April 2018
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Abstract
The disability-adjusted life years (DALYs) were used to estimate the regional (state of Colima, Mexico) cancer burden in 2010–2014. The years of life lost (YLL) were estimated with mortality data and years lived with disability (YLD) using incidence data. The DALYs were calculated
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The disability-adjusted life years (DALYs) were used to estimate the regional (state of Colima, Mexico) cancer burden in 2010–2014. The years of life lost (YLL) were estimated with mortality data and years lived with disability (YLD) using incidence data. The DALYs were calculated as the arithmetic addition of YLL and YLD. Sex and cancer site-specific estimations were made and DALY rates were used to identify the leading causes of disease burden. Data from 2532 deaths were analyzed and, for all malignant tumors combined, 18,712.9 DALYs and 20,243.3 DALYs were estimated in males and females respectively. The overall contribution of YLL in DALY estimates was higher among females (93.7% vs. 87.4%). Age-standardized DALY rates (and 95% confidence intervals, CI) per 100,000 inhabitants were used to rank the leading causes of disease burden and, among males, malignant tumors from the prostate, lower respiratory tract, and colon and rectum accounted the highest rates (45.7, 95% CI 32.7–59.3; 37.6, 95% CI 25.7–49.9; and 25.9, 95% CI 16.0–36.1 DALYs). Breast, cervix uteri, and lower respiratory tract cancer showed the highest burden in females (66.0, 95% CI 50.3–82.4; 44.4, 95% CI 31.5–57.7; and 20.9, 95% CI 12.0–30.0 DALYs). The present study provides an indication of the burden of cancer at the regional level, underscoring the need to expand cancer prevention, screening, and awareness programs, as well as to improve early diagnosis and medical treatment. Full article
(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)
Open AccessArticle Differentiating Medicated Patients Suffering from Major Depressive Disorder from Healthy Controls by Spot Urine Measurement of Monoamines and Steroid Hormones
Int. J. Environ. Res. Public Health 2018, 15(5), 865; https://doi.org/10.3390/ijerph15050865
Received: 7 February 2018 / Revised: 22 April 2018 / Accepted: 23 April 2018 / Published: 26 April 2018
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Abstract
Introduction: Major Depressive Disorder (MDD) is a common psychiatric disorder. Currently, there is no objective, cost-effective and non-invasive method to measure biological markers related to the pathogenesis of MDD. Previous studies primarily focused on urinary metabolite markers which are not proximal to
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Introduction: Major Depressive Disorder (MDD) is a common psychiatric disorder. Currently, there is no objective, cost-effective and non-invasive method to measure biological markers related to the pathogenesis of MDD. Previous studies primarily focused on urinary metabolite markers which are not proximal to the pathogenesis of MDD. Herein, we compare urinary monoamines, steroid hormones and the derived ratios amongst MDD when compared to healthy controls. Methods: Morning urine samples of medicated patients suffering from MDD (n = 47) and healthy controls (n = 41) were collected. Enzyme-linked immunosorbent assay (ELISA) was performed to measure five biomarkers: cortisol, dopamine, noradrenaline, serotonin and sulphate derivative of dehydroepiandrosterone (DHEAS). The mean urinary levels and derived ratios of monoamines and steroid hormones were compared between patients and controls to identify potential biomarkers. The receiver operative characteristic curve (ROC) analysis was conducted to evaluate the diagnostic performance of potential biomarkers. Results: Medicated patients with MDD showed significantly higher spot urine ratio of DHEAS/serotonin (1.56 vs. 1.19, p = 0.004) and lower ratio of serotonin/dopamine (599.71 vs. 888.60, p = 0.008) than healthy controls. A spot urine serotonin/dopamine ratio cut-off of >667.38 had a sensitivity of 73.2% and specificity of 51.1%. Conclusions: Our results suggest that spot urine serotonin/dopamine ratio can be used as an objective diagnostic method for adults with MDD. Full article
(This article belongs to the Special Issue Adult Psychiatry)
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Open AccessArticle Biomethanation of Harmful Macroalgal Biomass in Leach-Bed Reactor Coupled to Anaerobic Filter: Effect of Water Regime and Filter Media
Int. J. Environ. Res. Public Health 2018, 15(5), 866; https://doi.org/10.3390/ijerph15050866
Received: 21 March 2018 / Revised: 23 April 2018 / Accepted: 24 April 2018 / Published: 26 April 2018
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Abstract
Ulva is a marine macroalgal genus which causes serious green tides in coastal areas worldwide. This study investigated anaerobic digestion as a way to manage Ulva waste in a leach-bed reactor coupled to an anaerobic filter (LBR-AF). Two LBR-AF systems with different filter
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Ulva is a marine macroalgal genus which causes serious green tides in coastal areas worldwide. This study investigated anaerobic digestion as a way to manage Ulva waste in a leach-bed reactor coupled to an anaerobic filter (LBR-AF). Two LBR-AF systems with different filter media, blast furnace slag grains for R1, and polyvinyl chloride rings for R2, were run at increasing water replacement rates (WRRs). Both achieved efficient volatile solids reduction (68.4–87.1%) and methane yield (148–309 mL/g VS fed) at all WRRs, with the optimal WRR for maximum methane production being 100 mL/d. R1 maintained more stable methanation performance than R2, possibly due to the different surface properties (i.e., biomass retention capacity) of the filter media. Such an effect was also noted in the different behaviors of the LBR and AF between R1 and R2. The molecular analysis results revealed that the development of the microbial community structure in the reactors was primarily determined by the fermentation type, i.e., dry (LBR) or wet (AF). Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines
Int. J. Environ. Res. Public Health 2018, 15(5), 868; https://doi.org/10.3390/ijerph15050868
Received: 8 March 2018 / Revised: 17 April 2018 / Accepted: 23 April 2018 / Published: 26 April 2018
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This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.;
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This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Sufficient Social Support as a Possible Preventive Factor against Fighting and Bullying in School Children
Int. J. Environ. Res. Public Health 2018, 15(5), 870; https://doi.org/10.3390/ijerph15050870
Received: 23 March 2018 / Revised: 19 April 2018 / Accepted: 20 April 2018 / Published: 26 April 2018
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Abstract
Background: This study aims to explore how sufficient social support can act as a possible preventive factor against fighting and bullying in school-aged children in 9 European countries. Methods: Data for this study were collected during the 2013/2014 Health Behaviour in School-aged
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Background: This study aims to explore how sufficient social support can act as a possible preventive factor against fighting and bullying in school-aged children in 9 European countries. Methods: Data for this study were collected during the 2013/2014 Health Behaviour in School-aged Children (HBSC) survey. The sample consisted of 9 European countries, involving 43,667 school children in total, aged 11, 13 and 15 years. The analysed data focus on social context (relations with family, peers, and school) as well as risk behaviours such as smoking, drunkenness, fighting and bullying in adolescents. The relationships between social support and violent behaviour variables were estimated using multiple regression models and multivariate analyses. Results: Bullying, across 9 countries, was more prevalent than fighting, except for Armenia, Israel, and Poland. The prevalence among countries differed considerably, with fighting being most expressed in Armenia and bullying—in Latvia and Lithuania. The strongest risk factors for bullying and fighting were male gender (less expressed for bullying), smoking and alcohol consumption. In addition, for bullying the social support was similarly strong factor like above-mentioned factors, while for fighting—less significant, but still independent. All forms of social support were significantly relate with lower violent behaviour of school children, and family support was associated most strongly. Regardless the socioeconomic, historical, and cultural differences among selected countries, the enhancement and reinforcement of the social support from possible many different resources should be taken into consideration in prevention programs against school violence behaviours. Full article
Open AccessArticle Self-Reported Environmental Tobacco Smoke Exposure and Avoidance Compared with Cotinine Confirmed Tobacco Smoke Exposure among Pregnant Women and Their Infants
Int. J. Environ. Res. Public Health 2018, 15(5), 871; https://doi.org/10.3390/ijerph15050871
Received: 29 March 2018 / Revised: 23 April 2018 / Accepted: 24 April 2018 / Published: 27 April 2018
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Abstract
Background: Exposure to environmental tobacco smoke (ETS) presents substantial health risks for pregnant women and newborn infants. Measurements of ETS include invasive and expensive biochemical tests, as well as less invasive and lower-cost, self-reported exposure and avoidance measures. Better understanding of self-report measures
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Background: Exposure to environmental tobacco smoke (ETS) presents substantial health risks for pregnant women and newborn infants. Measurements of ETS include invasive and expensive biochemical tests, as well as less invasive and lower-cost, self-reported exposure and avoidance measures. Better understanding of self-report measures will help to select ETS assessments for evaluation. Methods: This analysis was conducted within the context of a tailored video intervention to reduce tobacco smoking and ETS exposure during pregnancy and after delivery in the control group sample of 147 nonsmoking women. Measurements of salivary cotinine concentration, self-reported ETS exposure, and avoidance behaviors were captured at 32 weeks’ gestation and 6 months postpartum. Results: Salivary cotinine concentration was significantly related to ETS avoidance among pregnant nonsmokers at 32 weeks’ gestation, but not ETS exposure. At 6 months postpartum, both the reported ETS exposure of the infant and maternal avoidance behaviors to reduce her infant’s exposure were associated with the infant’s salivary cotinine concentration. At 32 weeks’ gestation and 6 months postpartum, avoidance behaviors decreased as exposure increased. Discussion: This study suggests that for nonsmoking women during pregnancy, reports of tobacco smoke avoidance are more valid than reports of exposure. After delivery, self-reported ETS exposure or avoidance are associated with each other and the biochemical measurement of salivary cotinine. These results provide researchers and clinicians with evidence to support the inclusion of avoidance behaviors in the selection of ETS measures. Full article
(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)
Open AccessArticle Dechlorination of Hexachlorobenzene in Contaminated Soils Using a Nanometallic Al/CaO Dispersion Mixture: Optimization through Response Surface Methodology
Int. J. Environ. Res. Public Health 2018, 15(5), 872; https://doi.org/10.3390/ijerph15050872
Received: 29 March 2018 / Revised: 18 April 2018 / Accepted: 18 April 2018 / Published: 27 April 2018
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Abstract
Hexachlorobenzene (HCB) contamination of soils remains a significant environmental challenge all over the world. Reductive stabilization is a developing technology that can decompose the HCB with a dechlorination process. A nanometallic Al/CaO (n-Al/CaO) dispersion mixture was developed utilizing ball-milling technology in this study.
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Hexachlorobenzene (HCB) contamination of soils remains a significant environmental challenge all over the world. Reductive stabilization is a developing technology that can decompose the HCB with a dechlorination process. A nanometallic Al/CaO (n-Al/CaO) dispersion mixture was developed utilizing ball-milling technology in this study. The dechlorination efficiency of HCB in contaminated soils by the n-Al/CaO grinding treatment was evaluated. Response surface methodology (RSM) was employed to investigate the effects of three variables (soil moisture content, n-Al/CaO dosage and grinding time) and the interactions between these variables under the Box-Behnken Design (BBD). A high regression coefficient value (R2 = 0.9807) and low p value (<0.0001) of the quadratic model indicated that the model was accurate in predicting the experimental results. The optimal soil moisture content, n-Al/CaO dosage, and grinding time were found to be 7% (m/m), 17.7% (m/m), and 24 h, respectively, in the experimental ranges and levels. Under optimal conditions, the dechlorination efficiency was 80%. The intermediate product analysis indicated that dechlorination was the process by stepwise loss of chloride atoms. The main pathway observed within 24 h was HCB → pentachlorobenzene (PeCB) → 1,2,3,4-tetrachlorobenzene (TeCB) and 1,2,4,5-TeCB. The results indicated that the moderate soil moisture content was crucial for the hydrodechlorination of HCB. A probable mechanism was proposed wherein water acted like a hydrogen donor and promoted the hydrodechlorination process. The potential application of n-Al/CaO is an environmentally-friendly and cost-effective option for decontamination of HCB-contaminated soils. Full article
(This article belongs to the Special Issue Soil Pollution and Remediation)
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Open AccessArticle Health Risk Behavior Patterns in a National Adult Population Survey
Int. J. Environ. Res. Public Health 2018, 15(5), 873; https://doi.org/10.3390/ijerph15050873
Received: 9 March 2018 / Revised: 6 April 2018 / Accepted: 24 April 2018 / Published: 27 April 2018
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Abstract
Background: The aim of this paper is to analyze the co-occurrence of health risk behaviors (HRBs), namely, tobacco smoking, alcohol risk drinking, overeating, and physical inactivity, as well as their 16 combinations (patterns), which are stratified by age and gender. Methods:
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Background: The aim of this paper is to analyze the co-occurrence of health risk behaviors (HRBs), namely, tobacco smoking, alcohol risk drinking, overeating, and physical inactivity, as well as their 16 combinations (patterns), which are stratified by age and gender. Methods: The data of 19,294 study participants, from a telephone survey among the adult general population of Germany that was conducted in 2012, were analyzed. Results: In adults, two or more of the four HBRs were found among 51.5% of females and 61.9% of males. The single most prevalent HRB pattern among all of the female (20.7, 19.6–21.8%) and male participants (18.2, 17.1–19.3%) was being overweight combined with a lack of physical activity, and its prevalence increased by 4% with each year of life. A multinomial regression analysis revealed that education was inversely associated with 11 of the 15 HRB patterns. The risk of having four, compared to zero, HRBs was 3.3 (2.5–4.4) for males relative to females. Conclusion: Similar to the findings from other western countries, the majority of the participants in this adult national sample from Germany had two or more HRBs. The most common of all possible HRB patterns was overweight and inactivity. The data confirm inverse relations between education and most HRB patterns. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle A Prospective Study on the Influence of Scholastic Factors on the Prevalence and Initiation of Illicit Drug Misuse in Adolescence
Int. J. Environ. Res. Public Health 2018, 15(5), 874; https://doi.org/10.3390/ijerph15050874
Received: 21 March 2018 / Revised: 13 April 2018 / Accepted: 24 April 2018 / Published: 27 April 2018
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Abstract
Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia and Herzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of
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Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia and Herzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of 16 years old at the beginning of the study (baseline). The participants were tested at baseline and follow-up (20 months later). The predictors included variables of scholastic-achievement (grade point average, school absences, unexcused absences and behavioral grade). The criteria were: (i) IDM at baseline; (ii) IDM at follow-up; and (iii) initiation of IDM over the study course. Results: Logistic regression indicated increased odds of IDM in adolescents who were more frequent absent from school (baseline: Odds Ratio (OR): 3.73, 95% Confidence Interval (CI): 2.12–6.57; follow-up: OR: 2.91, 95% CI: 1.90–4.65). The lower grade point average and more unexcused absences were evidenced for adolescents who consumed drugs on follow-up (OR: 1.67, 95% CI: 1.11–2.51; OR: 1.74, 95% CI: 1.30–2.32 for grade point average and unexcused absences, respectively). Initiation of IDM was predicted by frequent absences from school (OR: 2.2, 95% CI: 1.3–3.8), and lower behavioral grades (OR: 1.9, 95% CI: 1.2–3.3). Conclusions: The findings confirmed strong correlations between scholastic failure and IDM. Absences from school and lower behavioral grades at baseline were predictive of the initiation of IDM in older adolescents. Full article
(This article belongs to the Special Issue Drug Abuse, Environment and Public Health)
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Open AccessArticle How Well Do COP22 Attendees Understand Graphs on Climate Change Health Impacts from the Fifth IPCC Assessment Report?
Int. J. Environ. Res. Public Health 2018, 15(5), 875; https://doi.org/10.3390/ijerph15050875
Received: 22 February 2018 / Revised: 23 April 2018 / Accepted: 25 April 2018 / Published: 27 April 2018
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Abstract
Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put
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Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put the understandability of three graphs taken from the Health chapter of the Fifth Assessment Report to an empirical test. We present a pilot study where we evaluate objective understanding (mean accuracy in multiple-choice questions) and subjective understanding (self-assessed confidence in accuracy) in a sample of attendees of the United Nations Climate Change Conference in Marrakesh, 2016 (COP22), and a student sample. Results show a mean objective understanding of M = 0.33 for the COP sample, and M = 0.38 for the student sample. Subjective and objective understanding were unrelated for the COP22 sample, but associated for the student sample. These results suggest that (i) understandability of the IPCC health chapter graphs is insufficient, and that (ii) particularly COP22 attendees lacked insight into which graphs they did, and which they did not understand. Implications for the construction of graphs to communicate health impacts of climate change to decision-makers are discussed. Full article
(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)
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Open AccessCommunication Glucose Gel as a Potential Alternative Treatment to Infant Formula for Neonatal Hypoglycaemia in Australia
Int. J. Environ. Res. Public Health 2018, 15(5), 876; https://doi.org/10.3390/ijerph15050876
Received: 14 February 2018 / Revised: 5 April 2018 / Accepted: 17 April 2018 / Published: 27 April 2018
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Abstract
Infant formula is often used as a treatment for neonatal hypoglycaemia in Australia; however, there are concerns that this may jeopardise mother-baby bonding and breastfeeding. Successful use of glucose gel as an alternative treatment for hypoglycaemia has been reported. We wanted to investigate
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Infant formula is often used as a treatment for neonatal hypoglycaemia in Australia; however, there are concerns that this may jeopardise mother-baby bonding and breastfeeding. Successful use of glucose gel as an alternative treatment for hypoglycaemia has been reported. We wanted to investigate in a pilot study whether the use of glucose gel has the potential to quickly and safely restore normoglycaemia in the infants of diabetic mothers in an Australian setting. Infants with asymptomatic hypoglycaemia were treated with glucose gel (n = 36) and compared to a historical group of infants which had been treated with infant formula (n = 24). Within 15 min of the first treatment, the gel group had a mean blood glucose level (BGL) of 2.6 mmol/L, and 2.7 mmol/L 30 min after the second treatment. This was lower than the BGL after the first treatment for the formula group, which rose to a mean of 2.8 then to 3.2 mmol/L after the second treatment (p = 0.003). In successfully treated infants, administration of the gel resulted in normoglycaemia within 30 min. The likelihood of special care nursery admission was not significantly different between the groups, although we had a small sample size, and our findings should be interpreted with caution. These pilot results provide support for further investigations into the use of glucose gel as an alternative treatment to infant formula. Full article
(This article belongs to the Special Issue Nutrition in the First 1000 Days)
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Open AccessArticle Dust at Various Workplaces—Microbiological and Toxicological Threats
Int. J. Environ. Res. Public Health 2018, 15(5), 877; https://doi.org/10.3390/ijerph15050877
Received: 26 March 2018 / Revised: 20 April 2018 / Accepted: 25 April 2018 / Published: 27 April 2018
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Abstract
The aim of the present study was to evaluate the relation between the chemical (analysis of elements and pH) and microbiological composition (culture and metagenomics analysis) of the dust at various workplaces (cement plant, composting plant, poultry farm, and cultivated area) and the
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The aim of the present study was to evaluate the relation between the chemical (analysis of elements and pH) and microbiological composition (culture and metagenomics analysis) of the dust at various workplaces (cement plant, composting plant, poultry farm, and cultivated area) and the cytotoxicity effect on the human adenocarcinoma lung epithelial adherent cell line A-549 (MTT assay test). Analysis of the Particulate Matter (PM) fraction showed that the dust concentration in cultivated areas exceeded the OELs. For the remaining workplaces examined, the dust concentration was lower than OELs limits. The number of microorganisms in the dust samples was 3.8 × 102–1.6 × 108 CFU/g bacteria and 1.5 × 102–6.5 × 106 CFU/g fungi. The highest number of microorganisms was noted for dust from cultivated areas (total number of bacteria, actinomycetes, P. fluorescens) and composting plants (xerophilic fungi and staphylococci), while the least number of microorganisms was observed for dust from cement plants. Many types of potentially pathogenic microorganisms have been identified, including bacteria, such as Bacillus, Actinomyces, Corynebacterium, Prevotella, Clostridium, and Rickettsia, and fungi, such as Alternaria, Cladosporium, Penicillium, and Aspergillus. The most cytotoxic to the human lung cell line A-549 was dust from cultivated areas (IC50 = 3.8 mg/mL after 72 h). The cytotoxicity of the tested dust samples depends on the PM concentration, the number of microorganisms, including potentially pathogenic genera, and the exposure time. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Occurrence of Aflatoxin M1 in Raw Milk from Manufacturers of Infant Milk Powder in China
Int. J. Environ. Res. Public Health 2018, 15(5), 879; https://doi.org/10.3390/ijerph15050879
Received: 3 March 2018 / Revised: 2 April 2018 / Accepted: 20 April 2018 / Published: 28 April 2018
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Abstract
This survey was performed to investigate the occurrence of aflatoxin M1 (AFM1) contamination of raw milk from manufacturers of infant milk powder in China. A total of 1207 raw milk samples were collected overall from four seasons of 2016 in Northeast China, Northwest
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This survey was performed to investigate the occurrence of aflatoxin M1 (AFM1) contamination of raw milk from manufacturers of infant milk powder in China. A total of 1207 raw milk samples were collected overall from four seasons of 2016 in Northeast China, Northwest China, Northern China, and Central China (11 provinces and one municipality). Results showed that 56 of the 1207 raw milk samples (4.64%) were positive for AFM1, which were obtained from Heilongjiang (two samples), Gansu (one sample), Shaanxi (46 samples), Beijing (one sample), and Hunan (six samples) provinces. None of the raw milk samples from manufacturers of infant milk powder exceeded the Chinese limit (62.5 ng/L) in 2016. Only a few raw milk samples were not suitable for use in infant milk according to EU (European Union) or U.S. infant milk limits. Furthermore, based on this survey and previous studies, it is particularly important to avoid AFM1 contamination in raw milk during the winter. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Evaluating Health Co-Benefits of Climate Change Mitigation in Urban Mobility
Int. J. Environ. Res. Public Health 2018, 15(5), 880; https://doi.org/10.3390/ijerph15050880
Received: 27 February 2018 / Revised: 10 April 2018 / Accepted: 23 April 2018 / Published: 28 April 2018
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Abstract
There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they
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There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they are not easy to capture. In an interdisciplinary multi-model approach we address this gap, investigating the co-benefits resulting from increased physical activity and improved air quality due to climate mitigation policies for three urban areas. Additionally we take a (macro-)economic perspective, since that is the ultimate interest of policy-makers. Methodologically, we link a transport modelling tool, a transport emission model, an emission dispersion model, a health model and a macroeconomic Computable General Equilibrium (CGE) model to analyze three climate change mitigation scenarios. We show that higher levels of physical exercise and reduced exposure to pollutants due to mitigation measures substantially decrease morbidity and mortality. Expenditures are mainly born by the public sector but are mostly offset by the emerging co-benefits. Our macroeconomic results indicate a strong positive welfare effect, yet with slightly negative GDP and employment effects. We conclude that considering economic co-benefits of climate change mitigation policies in urban mobility can be put forward as a forceful argument for policy makers to take action. Full article
(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)
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Open AccessArticle Employee Perceptions of Workplace Health Promotion Programs: Comparison of a Tailored, Semi-Tailored, and Standardized Approach
Int. J. Environ. Res. Public Health 2018, 15(5), 881; https://doi.org/10.3390/ijerph15050881
Received: 21 March 2018 / Revised: 19 April 2018 / Accepted: 23 April 2018 / Published: 28 April 2018
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In the design of workplace health promotion programs (WHPPs), employee perceptions represent an integral variable which is predicted to translate into rate of user engagement (i.e., participation) and program loyalty. This study evaluated employee perceptions of three workplace health programs promoting nutritional consumption
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In the design of workplace health promotion programs (WHPPs), employee perceptions represent an integral variable which is predicted to translate into rate of user engagement (i.e., participation) and program loyalty. This study evaluated employee perceptions of three workplace health programs promoting nutritional consumption and physical activity. Programs included: (1) an individually tailored consultation with an exercise physiologist and dietitian; (2) a semi-tailored 12-week SMS health message program; and (3) a standardized group workshop delivered by an expert. Participating employees from a transport company completed program evaluation surveys rating the overall program, affect, and utility of: consultations (n = 19); SMS program (n = 234); and workshops (n = 86). Overall, participants’ affect and utility evaluations were positive for all programs, with the greatest satisfaction being reported in the tailored individual consultation and standardized group workshop conditions. Furthermore, mode of delivery and the physical presence of an expert health practitioner was more influential than the degree to which the information was tailored to the individual. Thus, the synergy in ratings between individually tailored consultations and standardized group workshops indicates that low-cost delivery health programs may be as appealing to employees as tailored, and comparatively high-cost, program options. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
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Open AccessArticle Health Seeking Behavior among Rural Left-Behind Children: Evidence from Shaanxi and Gansu Provinces in China
Int. J. Environ. Res. Public Health 2018, 15(5), 883; https://doi.org/10.3390/ijerph15050883
Received: 16 February 2018 / Revised: 30 March 2018 / Accepted: 26 April 2018 / Published: 28 April 2018
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Abstract
More than 60 million children in rural China are “left-behind”—both parents live and work far from their rural homes and leave their children behind. This paper explores differences in how left-behind and non-left-behind children seek health remediation in China’s vast but understudied rural
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More than 60 million children in rural China are “left-behind”—both parents live and work far from their rural homes and leave their children behind. This paper explores differences in how left-behind and non-left-behind children seek health remediation in China’s vast but understudied rural areas. This study examines this question in the context of a program to provide vision health care to myopic rural students. The data come from a randomized controlled trial of 13,100 students in Gansu and Shaanxi provinces in China. The results show that without a subsidy, uptake of health care services is low, even if individuals are provided with evidence of a potential problem (an eyeglasses prescription). Uptake rises two to three times when this information is paired with a subsidy voucher redeemable for a free pair of prescription eyeglasses. In fact, left-behind children who receive an eyeglasses voucher are not only more likely to redeem it, but also more likely to use the eyeglasses both in the short term and long term. In other words, in terms of uptake of care and compliance with treatment, the voucher program benefitted left-behind students more than non-left-behind students. The results provide a scientific understanding of differential impacts for guiding effective implementation of health policy to all groups in need in developing countries. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Electrocardiographic and Electrooculographic Responses to External Emotions and Their Transitions in Bipolar I and II Disorders
Int. J. Environ. Res. Public Health 2018, 15(5), 884; https://doi.org/10.3390/ijerph15050884
Received: 23 February 2018 / Revised: 11 April 2018 / Accepted: 27 April 2018 / Published: 28 April 2018
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Abstract
Bipolar disorder has two main types, bipolar I (BD I) and II (BD II), which present different affective states and personality characteristics, they might present different modes of emotional regulation. We hypothesized that the electrocardiogram and electrooculogram to external emotions are different in
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Bipolar disorder has two main types, bipolar I (BD I) and II (BD II), which present different affective states and personality characteristics, they might present different modes of emotional regulation. We hypothesized that the electrocardiogram and electrooculogram to external emotions are different in BD I and BD II. We asked 69 BD I and 54 BD II patients, and 139 healthy volunteers to undergo these tests in response to disgust, erotica, fear, happiness, neutral, and sadness, and their transitions. Their affective states were also measured. The heart rate in BD I was significantly higher under background fear after target neutral. The eyeball movement was quicker in BD I under target happiness after background disgust; in BD I under target sadness after background disgust; and in BD I under background disgust after target neutral. Some electrocardiographic and electrooculographic changes were correlated with affective states in patients. BD I and BD II had different physiological responses to external emotions and their transitions, indicating different pathophysiologies and suggesting different emotional-therapies for BD I and BD II. Full article
(This article belongs to the Special Issue Adult Psychiatry)
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Open AccessArticle Frequency Analysis of Failure Scenarios from Shale Gas Development
Int. J. Environ. Res. Public Health 2018, 15(5), 885; https://doi.org/10.3390/ijerph15050885
Received: 27 February 2018 / Revised: 27 April 2018 / Accepted: 27 April 2018 / Published: 29 April 2018
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This study identified and prioritized potential failure scenarios for natural gas drilling operations through an elicitation of people who work in the industry. A list of twelve failure scenarios of concern was developed focusing on specific events that may occur during the shale
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This study identified and prioritized potential failure scenarios for natural gas drilling operations through an elicitation of people who work in the industry. A list of twelve failure scenarios of concern was developed focusing on specific events that may occur during the shale gas extraction process involving an operational failure or a violation of regulations. Participants prioritized the twelve scenarios based on their potential impact on the health and welfare of the general public, potential impact on worker safety, how well safety guidelines protect against their occurrence, and how frequently they occur. Illegal dumping of flowback water, while rated as the least frequently occurring scenario, was considered the scenario least protected by safety controls and the one of most concern to the general public. In terms of worker safety, the highest concern came from improper or inadequate use of personal protective equipment (PPE). While safety guidelines appear to be highly protective regarding PPE usage, inadequate PPE is the most directly witnessed failure scenario. Spills of flowback water due to equipment failure are of concern both with regards to the welfare of the general public and worker safety as they occur more frequently than any other scenario examined in this study. Full article
(This article belongs to the Special Issue Environmental Health Impacts of Hydraulic Fracturing)
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Open AccessArticle Risk Analysis of Earth-Rock Dam Failures Based on Fuzzy Event Tree Method
Int. J. Environ. Res. Public Health 2018, 15(5), 886; https://doi.org/10.3390/ijerph15050886
Received: 12 March 2018 / Revised: 8 April 2018 / Accepted: 26 April 2018 / Published: 29 April 2018
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Earth-rock dams make up a large proportion of the dams in China, and their failures can induce great risks. In this paper, the risks associated with earth-rock dam failure are analyzed from two aspects: the probability of a dam failure and the resulting
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Earth-rock dams make up a large proportion of the dams in China, and their failures can induce great risks. In this paper, the risks associated with earth-rock dam failure are analyzed from two aspects: the probability of a dam failure and the resulting life loss. An event tree analysis method based on fuzzy set theory is proposed to calculate the dam failure probability. The life loss associated with dam failure is summarized and refined to be suitable for Chinese dams from previous studies. The proposed method and model are applied to one reservoir dam in Jiangxi province. Both engineering and non-engineering measures are proposed to reduce the risk. The risk analysis of the dam failure has essential significance for reducing dam failure probability and improving dam risk management level. Full article
(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)
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Open AccessArticle Groundwater Flow Processes and Human Impact along the Arid US-Mexican Border, Evidenced by Environmental Tracers: The Case of Tecate, Baja California
Int. J. Environ. Res. Public Health 2018, 15(5), 887; https://doi.org/10.3390/ijerph15050887
Received: 19 March 2018 / Revised: 26 April 2018 / Accepted: 27 April 2018 / Published: 30 April 2018
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With the increasing population, urbanization and industry in the arid area of Tecate, there is a concomitant increase in contaminants being introduced into the Tecate River and its aquifer. This contamination is damaging the usable groundwater supply and making local residents and commercial
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With the increasing population, urbanization and industry in the arid area of Tecate, there is a concomitant increase in contaminants being introduced into the Tecate River and its aquifer. This contamination is damaging the usable groundwater supply and making local residents and commercial enterprises increasingly dependent on imported water from the Colorado River basin. In this study we apply a suite of chemical and isotopic tracers in order to evaluate groundwater flow and assess contamination trends. Groundwater recharge occurs through mountain-block and mountain-front recharge at higher elevations of the ranges. Groundwater from the unconfined, alluvial aquifer indicates recent recharge and little evolution. The increase in salinity along the flow path is due to interaction with weathering rock-forming silicate minerals and anthropogenic sources such as urban wastewater, residual solids and agricultural runoff from fertilizers, livestock manure and/or septic tanks and latrines. A spatial analysis shows local differences and the impact of the infiltration of imported waters from the Colorado River basin. The general trend of impaired water quality has scarcely been documented in the last decades, but it is expected to continue. Since the groundwater system is highly vulnerable, it is necessary to protect groundwater sources. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle A Pooled Data Analysis to Determine the Relationship between Selected Metals and Arsenic Bioavailability in Soil
Int. J. Environ. Res. Public Health 2018, 15(5), 888; https://doi.org/10.3390/ijerph15050888
Received: 24 March 2018 / Revised: 23 April 2018 / Accepted: 26 April 2018 / Published: 30 April 2018
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Abstract
Chronic exposure to arsenic (As) is a global concern due to worldwide exposure and adverse effects, and the importance of incorporating bioavailability in the exposure assessment and risk assessment of As is increasing acknowledged. The bioavailability of As is impacted by a number
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Chronic exposure to arsenic (As) is a global concern due to worldwide exposure and adverse effects, and the importance of incorporating bioavailability in the exposure assessment and risk assessment of As is increasing acknowledged. The bioavailability of As is impacted by a number of soil properties, such as pH, clay and metal concentrations. By retrieving 485 data from 32 publications, the aim of this study was to determine the relationship between selected metals (Fe and Al) and As bioavailability. In present study, the bioaccessibility (BAC) data measured by in vitro approaches were converted into bioavailability data based on the previously determined relationship between BAC and bioavailability. The As relative bioavailability (RBA) was summarized to be 24.36 ± 18.49%, which is in the range previously reported. A significant association between Fe concentration and the bioavailability of As was observed while this association varied for different types of RBA data. This disparity may suggest a non-reliable association between Fe and As bioavailability. The correlations between logarithmically transformed total content of Fe + Al and As bioavailability is then outlined: RBA = (−8.40 ± 1.02) × Ln(Fe + Al) + (58.25 ± 4.09), R2 = 0.25, p < 0.001, n = 212. Jackknife resampling was also applied to validate the relation between total content of (Fe + Al) and As bioavailability, which suggested that the relation is robust. This is the first pooled study to address the relations between selected metal concentrations and As bioavailability, which may provide some implications to establish soil properties-based RBA prediction for As. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessArticle Association of Insulin Resistance with Bone Strength and Bone Turnover in Menopausal Chinese-Singaporean Women without Diabetes
Int. J. Environ. Res. Public Health 2018, 15(5), 889; https://doi.org/10.3390/ijerph15050889
Received: 27 February 2018 / Revised: 20 April 2018 / Accepted: 25 April 2018 / Published: 30 April 2018
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Insulin resistance (IR) is accompanied by increased areal or volumetric bone mineral density (aBMD or vBMD), but also higher fracture risk. Meanwhile, imbalances in bone health biomarkers affect insulin production. This study investigates the effect of IR on proximal femur and lumbar spine
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Insulin resistance (IR) is accompanied by increased areal or volumetric bone mineral density (aBMD or vBMD), but also higher fracture risk. Meanwhile, imbalances in bone health biomarkers affect insulin production. This study investigates the effect of IR on proximal femur and lumbar spine BMD, femoral neck bending, compressive and impact strength indices (Composite Strength Indices) and circulating levels of parathyroid hormone (PTH), C-telopeptide of Type I collagen (CTx-1) and 25(OH) Vitamin D3, in a cohort of 97 healthy, non-obese, menopausal Chinese-Singaporean women. Lumbar spine aBMD was inversely associated with IR and dependent on lean body mass (LBM) and age. No such associations were found for vBMD of the third lumbar vertebra, aBMD and vBMD of the proximal femur, or circulating levels of PTH, CTx-1 and 25(OH) Vitamin D3. Composite Strength Indices were inversely associated with IR and independent of LBM, but after adjusting for fat mass and age, this association remained valid only for the impact strength index. Composite Strength Indices were significantly lower in participants with a high degree of IR. Our findings on IR and Composite Strength Indices relationships were in agreement with previous studies on different cohorts, but those on IR and BMD associations were not. Full article
(This article belongs to the Special Issue New Concepts in Women’s Bone Health)
Open AccessArticle Expressed Emotion, Shame, and Non-Suicidal Self-Injury
Int. J. Environ. Res. Public Health 2018, 15(5), 890; https://doi.org/10.3390/ijerph15050890
Received: 14 March 2018 / Revised: 15 April 2018 / Accepted: 26 April 2018 / Published: 30 April 2018
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Abstract
A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed
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A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed Emotion (EE) than non-injurers (t(254) = −3.24, p = 0.001), linear contrasts explaining 6% of between-groups variability (F(2, 254) = 7.36, p = 0.001, η2 = 0.06). Differences in EE between current and past self-injurers were not significant. Overall shame accounted for 33% of between-groups variance (F(2, 252) = 61.99, p < 0.001, η2 = 0.33), with linear contrasts indicating self-injurers experienced higher levels compared to non-injurers (t(252) = −8.23, p < 0.001). Current self-injurers reported higher overall shame than past self-injurers (t(252) = 6.78, p < 0.001). In further logistic regression, emotional involvement and overall shame were the only significant predictors of self-injury status. With every one-unit increase in emotional involvement, odds of currently engaging in self-injury decreased by a factor of 0.860. Conversely, a one-unit increase in overall shame was associated with an increase in the odds of being a current self-injurer by a factor of 1.05. The findings have important treatment implications for engaging key family members in intervention and prevention efforts. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle Weight Shame, Social Connection, and Depressive Symptoms in Late Adolescence
Int. J. Environ. Res. Public Health 2018, 15(5), 891; https://doi.org/10.3390/ijerph15050891
Received: 4 April 2018 / Revised: 18 April 2018 / Accepted: 28 April 2018 / Published: 1 May 2018
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Abstract
Child and adolescent obesity is increasingly the focus of interventions, because it predicts serious disease morbidity later in life. However, social environments that permit weight-related stigma and body shame may make weight control and loss more difficult. Rarely do youth obesity interventions address
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Child and adolescent obesity is increasingly the focus of interventions, because it predicts serious disease morbidity later in life. However, social environments that permit weight-related stigma and body shame may make weight control and loss more difficult. Rarely do youth obesity interventions address these complexities. Drawing on repeated measures in a large sample (N = 1443) of first-year (freshman), campus-resident university students across a nine-month period, we model how weight-related shame predicts depressive symptom levels, how being overweight (assessed by anthropometric measures) shapes that risk, and how social connection (openness to friendship) might mediate/moderate. Body shame directly, clearly, and repeatedly predicts depression symptom levels across the whole school year for all students, but overweight youth have significantly elevated risk. Social connections mediate earlier in the school year, and in all phases moderate, body shame effects on depression. Youth obesity interventions would be well-served recognizing and incorporating the influential roles of social-environmental factors like weight stigma and friendship in program design. Full article
(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)
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Open AccessArticle Antibiotic-Resistant Pathogenic Escherichia Coli Isolated from Rooftop Rainwater-Harvesting Tanks in the Eastern Cape, South Africa
Int. J. Environ. Res. Public Health 2018, 15(5), 892; https://doi.org/10.3390/ijerph15050892
Received: 26 March 2018 / Revised: 25 April 2018 / Accepted: 27 April 2018 / Published: 1 May 2018
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Abstract
Although many developing countries use harvested rainwater (HRW) for drinking and other household purposes, its quality is seldom monitored. Continuous assessment of the microbial quality of HRW would ensure the safety of users of such water. The current study investigated the prevalence of
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Although many developing countries use harvested rainwater (HRW) for drinking and other household purposes, its quality is seldom monitored. Continuous assessment of the microbial quality of HRW would ensure the safety of users of such water. The current study investigated the prevalence of pathogenic Escherichia coli strains and their antimicrobial resistance patterns in HRW tanks in the Eastern Cape, South Africa. Rainwater samples were collected weekly between June and September 2016 from 11 tanks in various areas of the province. Enumeration of E. coli was performed using the Colilert®18/Quanti-Tray® 2000 method. E. coli isolates were obtained and screened for their virulence potentials using polymerase chain reaction (PCR), and subsequently tested for antibiotic resistance using the disc-diffusion method against 11 antibiotics. The pathotype most detected was the neonatal meningitis E. coli (NMEC) (ibeA 28%) while pathotype enteroaggregative E. coli (EAEC) was not detected. The highest resistance of the E. coli isolates was observed against Cephalothin (76%). All tested pathotypes were susceptible to Gentamicin, and 52% demonstrated multiple-antibiotic resistance (MAR). The results of the current study are of public health concern since the use of untreated harvested rainwater for potable purposes may pose a risk of transmission of pathogenic and antimicrobial-resistant E. coli. Full article
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
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Open AccessArticle Comparing the Effects of Different Body Armor Systems on the Occupational Performance of Police Officers
Int. J. Environ. Res. Public Health 2018, 15(5), 893; https://doi.org/10.3390/ijerph15050893
Received: 24 April 2018 / Revised: 27 April 2018 / Accepted: 28 April 2018 / Published: 1 May 2018
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Abstract
Policing duties may inherently be dangerous due to stab, blunt trauma and ballistic threats. The addition of individual light armor vests (ILAVs) has been suggested as a means to protect officers. However, the addition of the extra load of the ILAV may affect
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Policing duties may inherently be dangerous due to stab, blunt trauma and ballistic threats. The addition of individual light armor vests (ILAVs) has been suggested as a means to protect officers. However, the addition of the extra load of the ILAV may affect officer ability to conduct occupational tasks. The purpose of this study was to determine if wearing any of three different ILAVs made by different companies with their preferred materials and designs (ILAV A, 4.68 percent body weight, ILAV B, 4.05 percent body weight, & ILAV C, 3.71 percent body weight) affected occupational task performance when compared to that in normal station wear. A prospective, within-subjects repeated measures design was employed, using a counterbalanced randomization in which each ILAV was worn for an entire day while officers completed a variety of occupationally relevant tasks. These tasks included a victim drag, car exit and 5-meter sprint, step down and marksmanship task. To compare the effects of the ILAVs on these tasks, a multivariate repeated measures analysis of variance (ANOVA) was conducted, with post hoc pairwise comparisons using a Bonferroni adjustment. Results showed that performance in each task did not vary between any of the ILAV or normal station wear conditions. There was less variability in the marksmanship task with ILAV B, however. The results suggest that none of the ILAVs used in this study were heavy enough to significantly affect task performance in the assessed tasks when compared to wearing normal station wear. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Emotional Intelligence, Motivational Climate and Levels of Anxiety in Athletes from Different Categories of Sports: Analysis through Structural Equations
Int. J. Environ. Res. Public Health 2018, 15(5), 894; https://doi.org/10.3390/ijerph15050894
Received: 3 April 2018 / Revised: 26 April 2018 / Accepted: 27 April 2018 / Published: 1 May 2018
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Abstract
(1) Background: Psychological factors can strongly affect the athletes’ performance. Therefore, currently the role of the sports psychologist is particularly relevant, being in charge of training the athlete’s psychological factors. This study aims at analysing the connections between motivational climate in sport, anxiety
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(1) Background: Psychological factors can strongly affect the athletes’ performance. Therefore, currently the role of the sports psychologist is particularly relevant, being in charge of training the athlete’s psychological factors. This study aims at analysing the connections between motivational climate in sport, anxiety and emotional intelligence depending on the type of sport practised (individual/team) by means of a multigroup structural equations analysis. (2) 372 semi-professional Spanish athletes took part in this investigation, analysing motivational climate (PMCSQ-2), emotional intelligence (SSRI) and levels of anxiety (STAI). A model of multigroup structural equations was carried out which fitted accordingly (χ2 = 586.77; df = 6.37; p < 0.001; Comparative Fit Index (CFI) = 0.951; Normed Fit Index (NFI) = 0.938; Incremental Fit Index (IFI) = 0.947; Root Mean Square Error of Approximation (RMSEA) = 0.069). (3) Results: A negative and direct connection has been found between ego oriented climate and task oriented climate, which is stronger and more differentiated in team sports. The most influential indicator in ego oriented climate is intra-group rivalry, exerting greater influence in individual sports. For task-oriented climate the strongest indicator is having an important role in individual sports, while in team sports it is cooperative learning. Emotional intelligence dimensions correlate more strongly in team sports than in individual sports. In addition, there was a negative and indirect relation between task oriented climate and trait-anxiety in both categories of sports. (4) Conclusions: This study shows how the task-oriented motivational climate or certain levels of emotional intelligence can act preventively in the face of anxiety states in athletes. Therefore, the development of these psychological factors could prevent anxiety states and improve performance in athletes. Full article
(This article belongs to the Special Issue Effect of Sport Activity on Health Promotion)
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Open AccessArticle Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study
Int. J. Environ. Res. Public Health 2018, 15(5), 896; https://doi.org/10.3390/ijerph15050896
Received: 14 March 2018 / Revised: 17 April 2018 / Accepted: 27 April 2018 / Published: 2 May 2018
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Abstract
Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate
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Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s) within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success. Full article
(This article belongs to the Special Issue Advances in Technology Enabled Health and Care)
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Open AccessArticle Water-Based Automobile Paints Potentially Reduce the Exposure of Refinish Painters to Toxic Metals
Int. J. Environ. Res. Public Health 2018, 15(5), 899; https://doi.org/10.3390/ijerph15050899
Received: 31 March 2018 / Revised: 27 April 2018 / Accepted: 28 April 2018 / Published: 3 May 2018
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Abstract
Exposure to lead-containing dusts is a global public health concern. This work addresses an important issue of whether eco-friendly water-based paints reduce the exposure potential of auto-repainting workers to metals. With this aim, metal levels in automobile paints and worker metal exposure were
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Exposure to lead-containing dusts is a global public health concern. This work addresses an important issue of whether eco-friendly water-based paints reduce the exposure potential of auto-repainting workers to metals. With this aim, metal levels in automobile paints and worker metal exposure were measured using both solvent- and water-based paints. The levels of metals, and particularly Pb, Cr (total), Fe, and Cu, in solvent-based paints varied greatly among colors and brands. Lead concentrations ranged from below the detection limit (~0.25 μg/g) to 107,928 μg/g (dry film) across all samples. In water-based paints, the concentrations of Pb and Cr (total) were generally two to three orders of magnitude lower, but the concentrations of Al and Cu exceeded those in some solvent-based paints. The personal short-term exposure of workers who applied water-based paints of popular colors, such as black and white, were generally low, with Pb levels of less than <4 µg/m3 and Cr (total) levels of less than 1 µg/m3. Conversely, mean short-term exposure to Pb during the painting of a yellow cab using solvent-based paints were 2028 µg/m3, which was ~14 times the Taiwan short-term permissible exposure limit, while the mean level of exposure to Cr (total) was 290 µg/m3, which was well below the exposure limit. This study demonstrates that water-based paints reduce the exposure potential to lead, and highlights the importance of source control in limiting the toxic metals in paints. Full article
Open AccessArticle Will Happiness Improve the Psychological Integration of Migrant Workers?
Int. J. Environ. Res. Public Health 2018, 15(5), 900; https://doi.org/10.3390/ijerph15050900
Received: 13 March 2018 / Revised: 16 April 2018 / Accepted: 17 April 2018 / Published: 3 May 2018
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Abstract
Happiness is a major factor that influences people’s perceptions and behavior. Two-stage least squares regression was applied to investigate the effect of happiness on the psychological integration of migrant workers in China. The data for a total of 1625 individuals were obtained from
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Happiness is a major factor that influences people’s perceptions and behavior. Two-stage least squares regression was applied to investigate the effect of happiness on the psychological integration of migrant workers in China. The data for a total of 1625 individuals were obtained from the 2014 China Labor-force Dynamics Survey (CLDS). This study describes happiness from three main aspects: happiness, life satisfaction, and economic satisfaction. The psychological integration includes two dimensions of settlement willingness, and trust level; these have gone through dimension-reduced processing by using the weighted average method. The empirical evidence shows, first, that happiness has a significantly positive effect on the psychological integration of migrant workers and second, that the sense of life satisfaction in particular plays a more significant role. The acceleration of the social and political integration in migrant workers will enhance their psychological integration. Additionally, social, cultural and economic integration is found to influence migrant workers’ psychological integration by promoting happiness. Happiness between different generations of migrant workers was found to have a noticeably positive impact on their psychological integration; however, the happiness of the younger migrant workers was more perceivable than that of the other generations. Preferential policies should therefore be provided to improve the happiness of migrant workers. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle Evidence for an Association between Macular Degeneration and Thyroid Cancer in the Aged Population
Int. J. Environ. Res. Public Health 2018, 15(5), 902; https://doi.org/10.3390/ijerph15050902
Received: 15 March 2018 / Revised: 30 April 2018 / Accepted: 30 April 2018 / Published: 3 May 2018
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Abstract
Direct evidence of whether thyroid cancer patients have a higher risk of age-related macular degeneration (AMD) has yet to be investigated. Patients older than 50 years-old and newly diagnosed with thyroid cancer between 2000 and 2008 were identified from the national health insurance
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Direct evidence of whether thyroid cancer patients have a higher risk of age-related macular degeneration (AMD) has yet to be investigated. Patients older than 50 years-old and newly diagnosed with thyroid cancer between 2000 and 2008 were identified from the national health insurance research database (NHIRD). We applied time-varying Cox proportional hazard models to assess the association between thyroid cancer and AMD. The multivariable models included conventional cardiovascular risk factors, myopia, vitreous floaters, hypothyroidism, hyperthyroidism, and treatment modality of thyroid cancer. The analysis process was stratified by age, gender, and comorbidity. In this study, 5253 patients were included in a thyroid cancer cohort (men 24.5%; median age 59.1 years (53.7–67.4 years), and 21,012 matched controls were included in a non-thyroid cancer cohort. The AMD incidence was 40.7 per 10,000 person/year in the thyroid cancer cohort. The thyroid cancer cohort had a higher risk (adjusted hazard ratio (aHR) = 1.38, 95% confidence interval, CI = 1.09–1.75) of AMD than the non-thyroid cohort. Thyroid cancer patients had a higher risk of AMD, especially the male patients (aHR = 1.92, 95% CI = 1.38–3.14) and the patients with comorbidities (aHR = 1.38, 95% CI = 1.09–1.74). In conclusion, thyroid cancer patients older than 50 years-old have increased risk of AMD. Full article
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Open AccessArticle Young-Adult Polycystic Kidney Disease is Associated with Major Cardiovascular Complications
Int. J. Environ. Res. Public Health 2018, 15(5), 903; https://doi.org/10.3390/ijerph15050903
Received: 6 April 2018 / Revised: 30 April 2018 / Accepted: 30 April 2018 / Published: 3 May 2018
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Abstract
Background: Patients with polycystic kidney disease (PKD) might have a risk of cardiovascular diseases because several cardiovascular risk factors are occasionally associated with PKD patients. Data on the association between PKD and the risk of cardiovascular events, including acute coronary syndrome (ACS), stroke,
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Background: Patients with polycystic kidney disease (PKD) might have a risk of cardiovascular diseases because several cardiovascular risk factors are occasionally associated with PKD patients. Data on the association between PKD and the risk of cardiovascular events, including acute coronary syndrome (ACS), stroke, and congestive heart failure (CHF), are scant. Methods: Patients aged ≥20 years who were newly diagnosed with PKD (International Classification of Diseases, Ninth Revision, Clinical Modification codes 753.12 and 753.13) between 2000 and 2011 were selected as a PKD cohort (N = 5157). The association between PKD and cardiovascular events was analyzed. Results: We randomly selected a comparison cohort of people without PKD, who were frequency-matched by sex, age, and index date of diagnosis. At the end of 2011, the PKD cohort had a 1.40-fold greater incidence of ACS compared with the comparison cohort (8.59 vs. 6.17 per 1000 person-years), in addition to a 1.40-fold greater incidence of stroke, a 1.49-fold greater incidence of CHF, and a 1.64-fold greater incidence of mortality. Conclusions: This retrospective cohort study shows that patients with PKD have an increased risk of cardiovascular events including ACS, stroke, and CHF as well as mortality, particularly in younger patients. Early identification is necessary to attenuate the risk of cardiovascular complications in patients with PKD. Full article
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Open AccessArticle Seroprevalence of Hepatitis E Virus in Roma Settlements: A Comparison with the General Population in Slovakia
Int. J. Environ. Res. Public Health 2018, 15(5), 904; https://doi.org/10.3390/ijerph15050904
Received: 15 March 2018 / Revised: 25 April 2018 / Accepted: 28 April 2018 / Published: 3 May 2018
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Abstract
Hepatitis E infection is one of the most frequent causes of acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in past
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Hepatitis E infection is one of the most frequent causes of acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in past years. Because the most important risk factors associated with HEV infection include consumption of contaminated pork meat and poor hygienic standards, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the population living in separated and segregated Roma settlements (n = 195), which represent places with increased risk of infection in Slovakia and to compare it with the prevalence in the general population (n = 69). Of 264 respondents included in the study, 47 (17.8%) showed positivity for anti-HEV antibodies, 42 of whom were Roma (21.5%, n = 195) and 5 (7.2%, n = 69) non-Roma. The population living in Roma settlements lives in poorer conditions and are at higher risk of HEV in comparison to the general population. However, differences in living conditions within the settlements do not contributed to lower risk of HEV antibody prevalence between Roma living in settlements. Full article
(This article belongs to the Special Issue Roma Health)
Open AccessArticle The Relationship between Household Sanitation and Women’s Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria
Int. J. Environ. Res. Public Health 2018, 15(5), 905; https://doi.org/10.3390/ijerph15050905
Received: 28 February 2018 / Revised: 27 April 2018 / Accepted: 29 April 2018 / Published: 3 May 2018
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Abstract
Global efforts to improve sanitation have emphasized the needs of women and girls. Managing menstruation is one such need, yet there is scarce research capturing current practices. This study investigated the relationships between household sanitation and women’s experience of menstrual management. Secondary analyses
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Global efforts to improve sanitation have emphasized the needs of women and girls. Managing menstruation is one such need, yet there is scarce research capturing current practices. This study investigated the relationships between household sanitation and women’s experience of menstrual management. Secondary analyses were undertaken on data from 1994 women and girls collected through the Performance Monitoring and Accountability 2020 survey in Kaduna, Nigeria. In multivariable models, women had higher odds of using the main household sanitation facility for menstrual management when they had access to a basic (OR = 1.76 95%CI 1.26–2.46) or limited (OR = 1.63 95%CI 1.08–2.48) sanitation facility, compared to an unimproved facility. Women with no household sanitation facility had higher odds of using their sleeping area (OR = 3.56 95%CI 2.50–5.06) or having no facility for menstrual management (OR = 9.86 95%CI 5.76–16.87) than women with an unimproved sanitation facility. Menstrual management locations were associated with ratings of their characteristics. Safely managed or basic sanitation facilities were not rated more favorably than unimproved facilities in privacy (OR = 1.02 95%CI 0.70–1.48), safety (OR = 1.45 95%CI 0.98–2.15), access to a lock (OR = 0.93 95%CI 0.62–1.37), or soap and water (OR = 1.04 95%CI 0.70–1.56). Women using their sleeping area had more favorable perceptions of their environment. Findings suggest household sanitation influences women’s choices for menstrual management, but that existing indicators for improvement are not sensitive to menstrual needs. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle Exposure to Quartz in Finnish Workplaces Declined during the First Six Years after the Signing of the NEPSI Agreement, but Evened out between 2013 and 2017
Int. J. Environ. Res. Public Health 2018, 15(5), 906; https://doi.org/10.3390/ijerph15050906
Received: 29 March 2018 / Revised: 17 April 2018 / Accepted: 1 May 2018 / Published: 3 May 2018
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Abstract
To reduce the incidence of occupational diseases related to exposure to respirable silica at work, the main industries in the EU associated with respirable silica agreed on measures to improve working conditions through the application of good practices. These practices were included in
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To reduce the incidence of occupational diseases related to exposure to respirable silica at work, the main industries in the EU associated with respirable silica agreed on measures to improve working conditions through the application of good practices. These practices were included in “The Agreement on Workers Health Protection through the Good Handling and Use of Crystalline Silica and Products Containing it” (NEPSI agreement), signed in April 2006. In Finland, we have previously seen a decline in exposure to respirable quartz in relevant industries upon the treaty coming into effect, during the years 2006–2013. The present paper examines trends in exposure to respirable crystalline silica in Finland from 2006 to the end of 2017. In addition, we looked at changes in the number of exposed workers and the prevalence of silicosis and lung cancer associated with the exposure during the same period. The aim was to find out whether the decline in exposure previously recorded had continued, and whether this, in addition to the previously reported descent in exposure, was reflected in the amount and prevalence of occupational diseases associated with inhaling respirable quartz. In the present study, during the period 2013 to 2017 no further improvements were observed. The exposure remained at an average level of 20–50% of the current OEL8h. This is not necessarily sufficient to eliminate silicosis, lung cancer or other health effects associated with exposure to respirable silica in affected workplaces. To bring about further improvements in exposure, we suggest the present OEL8h in Finland (0.05 mg/m3) and particularly in the many EU countries with an OEL8h of 0.1 mg/m3 be lowered to 0.020–0.025 mg/m3. Secondly, branches outside of the NEPSI treaty where the number of exposed workers is increasing in Finland and possibly in some other EU countries as well, namely building and refinery industries, would be advised to sign the treaty. In addition, as a result of signing, good practices should be developed for work tasks where exposure to respirable silica is of concern in these industries. Full article
(This article belongs to the Special Issue Lung Diseases Associated with Environmental Pollutants)
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Open AccessArticle The Relationship between Diabetes Mellitus and Respiratory Function in Patients Eligible for Coronary Artery Bypass Grafting
Int. J. Environ. Res. Public Health 2018, 15(5), 907; https://doi.org/10.3390/ijerph15050907
Received: 12 March 2018 / Revised: 27 April 2018 / Accepted: 30 April 2018 / Published: 3 May 2018
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Abstract
Introduction: Spirometry performed prior to surgery provides information on the types of lung disorders in patients. The purpose of this study was to look for a relationship between the prevalence of diabetes and spirometry parameters. Material and Methods: The study was conducted in
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Introduction: Spirometry performed prior to surgery provides information on the types of lung disorders in patients. The purpose of this study was to look for a relationship between the prevalence of diabetes and spirometry parameters. Material and Methods: The study was conducted in patients with coronary artery disease who were eligible for an isolated coronary artery bypass graft in 2013. The study group included 367 patients (287 men and 80 women) aged 68.7 ± 8.4 years. They were divided into those with diagnosed diabetes (group I, n = 138, 37.6%) and without diabetes (group II, n = 229, 62.4%). Spirometry tests were performed on the day of admission to the hospital. Results: Patients with diabetes (group I) had a significantly higher body mass index than those without diabetes (group II). Spirometry tests also showed that patients with diabetes had statistically significantly lower forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1.0). Both FVC and FEV1.0 were also statistically significantly lower for overweight and obese individuals in group I than those in group II. Conclusion: Patients with diabetes eligible for coronary artery bypass grafting with concurrent overweight or obesity are more likely to have lower spirometry parameters than those without diabetes. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Factors Associated with Physical Activity and Sedentary Behavior in Older Adults from Six Low- and Middle-Income Countries
Int. J. Environ. Res. Public Health 2018, 15(5), 908; https://doi.org/10.3390/ijerph15050908
Received: 20 March 2018 / Revised: 24 April 2018 / Accepted: 27 April 2018 / Published: 3 May 2018
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Abstract
Rising life expectancy in low- and middle-income countries (LMIC), coupled with the increasing burden of non-communicable diseases, accentuates the importance of generating information to support public health strategies. With this aim in mind, the purpose of this study was to identify correlates of
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Rising life expectancy in low- and middle-income countries (LMIC), coupled with the increasing burden of non-communicable diseases, accentuates the importance of generating information to support public health strategies. With this aim in mind, the purpose of this study was to identify correlates of physical activity and sedentary behavior in LMIC. We analyzed Wave 1 data (collected 2007–2010) from the World Health Organization’s longitudinal Study on global AGEing and adult health (SAGE), which focuses on nationally representative samples of adults aged 50 years and older from six countries (China, n = 13,157; India, n = 6560; Mexico, n = 2301; Russian Federation, n = 3763; South Africa, n = 3836; and Ghana, n = 4305). Associations of physical activity (operationalized as meeting physical activity guidelines of ≥150 min/week of moderate-to-vigorous physical activity or not) and sedentary behavior (≥4 h/day versus <4 h/day) with demographic, health and health risk, functional, interpersonal, and environmental factors were assessed using multivariate logistic models. Across the six countries, we found fairly consistent and reasonably strong associations between both physical activity and sedentary behavior and several demographic factors (age and employment, in particular), self-reported health, instrumental activities of daily living, factors relating to socializing, and household location. Correlates of physical activity and sedentary behavior in LMIC appear to be similar to those found in high-income countries. Full article
Open AccessArticle Identification of Depression and Screening for Work Disabilities among Long-Term Unemployed People
Int. J. Environ. Res. Public Health 2018, 15(5), 909; https://doi.org/10.3390/ijerph15050909
Received: 15 April 2018 / Revised: 30 April 2018 / Accepted: 2 May 2018 / Published: 3 May 2018
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Abstract
The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as
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The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as eligible to apply for disability pension. Among them, 188 were diagnosed as clinically depressed. They were classified into those with earlier depression diagnosis (n = 85), those whose depression had not been diagnosed earlier (n = 103), and those without diagnosed depression (n = 176). The association of this ‘Depression identification pattern’ with being granted a disability pension was explored by logistic regression analyses. Compared to those with earlier diagnosis, those whose depression had not been diagnosed earlier were granted disability pension more commonly (72% vs. 54% OR 2.2, p = 0.012). Corresponding figures of the undepressed were 73%, OR 2.3, p = 0.002. The adjustments did not affect the results. Clinical examination of the long-term unemployed people in terms of work disability seems to be worthwhile. In particular, the examination reveals new depression diagnoses, which contribute more to the award of disability pension than depression diagnosed earlier by regular health care. Novel ways to detect depression among the unemployed should be implemented in the health and employment services. Full article
(This article belongs to the Special Issue Mental Health and its Social and Cultural Implications)
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Open AccessArticle Suicide Prevention Guideline Implementation in Specialist Mental Healthcare Institutions in The Netherlands
Int. J. Environ. Res. Public Health 2018, 15(5), 910; https://doi.org/10.3390/ijerph15050910
Received: 16 February 2018 / Revised: 17 April 2018 / Accepted: 21 April 2018 / Published: 3 May 2018
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Abstract
In The Netherlands, on average 40% of all suicides concern patients treated by mental healthcare institutions (MHIs). Recent evidence indicates that implemented guideline recommendations significantly reduce the odds for patients to die by suicide. Implementation of the multidisciplinary guideline for diagnosis and treatment
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In The Netherlands, on average 40% of all suicides concern patients treated by mental healthcare institutions (MHIs). Recent evidence indicates that implemented guideline recommendations significantly reduce the odds for patients to die by suicide. Implementation of the multidisciplinary guideline for diagnosis and treatment of suicidal behaviors is a main objective of the Dutch National Suicide Prevention Strategy. To this end, 24 MHIs that collectively reported 73% of patient suicides in 2015 received an educational outreach intervention offered by the national center of expertise. Aim: To investigate changes in levels of implementation of guideline recommendations; and to assess the degree of variation on suicide prevention policies and practices between MHIs. Methods: Implementation study with a prospective cohort design studying change over time on all domains of a Suicide Prevention Monitor, a guideline-based instrument assessing suicide prevention policies and practices within MHIs. Data were collected in six-month intervals between 2015 and 2017. Results: MHIs improved significantly on four out of ten domains: the development of an organizational suicide prevention policy; monitoring and trend-analysis of suicides numbers; evaluations after suicide; and clinician training. No improvement was measured on the domains pertaining to multi-annual training policies; collaborative care with external partners; recording and evaluation of suicide attempts; routine assessment of suicidality in all patients; safety planning and involving next of kin and carers. Furthermore, marked practice variation between MHIs was found which did not decrease over time. Conclusion: This study shows significant improvement in the implementation of four out of ten guideline-based suicide prevention policies in 24 specialist mental healthcare institutions in The Netherlands. The implementation level of suicide prevention policies and practices still appears to vary significantly between MHIs in The Netherlands. Full article
(This article belongs to the Special Issue Suicide Risk and Mental Disorders)
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Open AccessArticle PCBs and PCDD/Fs in Bluefin Tuna: Occurrence and Dietary Intake
Int. J. Environ. Res. Public Health 2018, 15(5), 911; https://doi.org/10.3390/ijerph15050911
Received: 19 February 2018 / Revised: 27 April 2018 / Accepted: 27 April 2018 / Published: 3 May 2018
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Abstract
Polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-furans (PCDD/Fs) were measured in Mediterranean bluefin tuna (Thunnus thynnus) to verify the compliance with the EU regulations for food commercialization. The estimated intakes were also evaluated. The analyses were performed by gas chromatography-ion trap tandem
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Polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-furans (PCDD/Fs) were measured in Mediterranean bluefin tuna (Thunnus thynnus) to verify the compliance with the EU regulations for food commercialization. The estimated intakes were also evaluated. The analyses were performed by gas chromatography-ion trap tandem mass spectrometry (GC-MS-MS). The PCBs were dominant (1132.0 ng g−1 l.w.), followed by PCDFs (23.2 pg g−1 l.w.) and PCDDs (8.5 pg g−1 l.w.). The pollutant levels (dl-PCBs: 0.7 pg TEQ/g w.w.; PCDD/Fs: 1.9 pg TEQ/g w.w.) and their sum expressed as TEQ values (2.6 pg TEQ/g w.w.) remained below the limits for human consumption proposed by the European Union. On the contrary, the sum of the six indicator non-dioxin-like PCBs (84.2 ng g−1 w.w.) was slightly above the maximum level fixed by the in-force legislation. The estimated dietary intakes for PCDD/Fs plus dl-PCBs were below the toxicological reference values (TRVs) set by various international bodies, while non-cancer and cancer risk assessment revealed a safety concern. Additionally, the estimated intake of ndl-PCBs exceeded the maximum levels set by different European countries. These findings suggest caution in tuna consumption together with an active and frequent surveillance of the chemical quality of its flesh. Full article
(This article belongs to the Special Issue Dietary Exposures)
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Open AccessArticle Association between Peptic Ulcer Disease and Periodontitis: A Nationwide Population-Based Case-Control Study in Taiwan
Int. J. Environ. Res. Public Health 2018, 15(5), 912; https://doi.org/10.3390/ijerph15050912
Received: 12 April 2018 / Revised: 28 April 2018 / Accepted: 29 April 2018 / Published: 4 May 2018
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Abstract
Previous studies have suggested that peptic ulcer disease (PUD) including stomach and duodenal ulcers might be associated with periodontitis (PD); however, no clear conclusions have been reached thus far. In this retrospective case-control study, we aimed to investigate the association between PUD and
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Previous studies have suggested that peptic ulcer disease (PUD) including stomach and duodenal ulcers might be associated with periodontitis (PD); however, no clear conclusions have been reached thus far. In this retrospective case-control study, we aimed to investigate the association between PUD and PD by using a large population-based dataset in Taiwan. A population-based retrospective case control study was conducted using the Longitudinal Health Insurance Database 2010 (LHID2010) derived from the National Health Insurance Research database (NHIRD) in Taiwan from 2000 to 2013. The case and control group were matched with gender, age, urbanization level, socioeconomic status, and Charlson comorbidity index (CCI) by using the propensity score method at a 1:1 ratio. A total of 177,240 cases and 177,240 control patients were included in this study, with an average age of 46.96 ± 11.76 years. The risk of PUD for patients diagnosed with PD was 1.15-fold when compared with those without PD (OR, 1.15; 95% CI, 1.12–1.18). This population-based case control study demonstrated a significantly positive association between PUD and PD in Taiwan. Full article
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Open AccessArticle A Cross-Disciplinary Successful Aging Intervention and Evaluation: Comparison of Person-to-Person and Digital-Assisted Approaches
Int. J. Environ. Res. Public Health 2018, 15(5), 913; https://doi.org/10.3390/ijerph15050913
Received: 14 April 2018 / Revised: 29 April 2018 / Accepted: 2 May 2018 / Published: 4 May 2018
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Abstract
Background: Successful aging has been the paradigm of old-age life. The purpose of this study was to implement and evaluate a cross-disciplinary intervention program using two approaches for community-based older adults in Taichung, Taiwan. Methods: The content of the intervention included
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Background: Successful aging has been the paradigm of old-age life. The purpose of this study was to implement and evaluate a cross-disciplinary intervention program using two approaches for community-based older adults in Taichung, Taiwan. Methods: The content of the intervention included successful aging concepts and preparation, physical activity, chronic disease and health management, dietary and nutrition information, cognitive training, emotional awareness and coping skills, family relationship and resilience, legal concepts regarding financial protection, and Internet use. The traditional person-to-person (P2P) intervention approach was implemented among participants at urban centers, and the personal-and-digital (P&D) intervention approach was implemented among participants at rural centers; before the P&D group received the intervention, participants were assessed as the control group for comparison. Results: Healthy behavior and nutrition improved for the P2P group, although not significantly. Strategies for adapting to old age and reducing ineffective coping were significantly improved in the P2P group. The ability to search for health information improved in the P&D group, and knowledge of finance-related law increased in the P2P group. Conclusion: A continuous, well-designed and evidence-based intervention program is beneficial for improving the health of older adults, or at least delaying its decline. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Changes in Weight, Sedentary Behaviour and Physical Activity during the School Year and Summer Vacation
Int. J. Environ. Res. Public Health 2018, 15(5), 915; https://doi.org/10.3390/ijerph15050915
Received: 18 March 2018 / Revised: 19 April 2018 / Accepted: 2 May 2018 / Published: 4 May 2018
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Abstract
Background: To examine bidirectional associations between body weight and objectively assessed sedentary behaviour (SB) and physical activity (PA) during the school year and summer vacation. Methods: Participants were 209 Japanese boys and girls (9.0 ± 1.8 years at baseline). SB and
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Background: To examine bidirectional associations between body weight and objectively assessed sedentary behaviour (SB) and physical activity (PA) during the school year and summer vacation. Methods: Participants were 209 Japanese boys and girls (9.0 ± 1.8 years at baseline). SB and PA were measured using triaxial accelerometry that discriminated between ambulatory and non-ambulatory PA, screen time measured by questionnaire during the school-term was evaluated in May and the summer vacation, and relative body weight measured in May and just after the end of summer vacation. Results: There were no significant relationships between changes in SB or PA and changes in body weight. However, higher relative body weight at baseline was associated with decreased non-ambulatory moderate PA (p = 0.049), but this association was slightly diminished after adjusting for change in SB (p = 0.056). Longer screen time at baseline was also associated with increased relative body weight (p = 0.033). Conclusions: The present study revealed that body weight might be particularly influential on non-ambulatory moderate PA while SB, PA or changes in these variables did not predict changes in body weight. Moreover, screen time during the school year is a predictor of change in relative body weight during the subsequent summer vacation. Full article
(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)
Open AccessArticle Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community
Int. J. Environ. Res. Public Health 2018, 15(5), 917; https://doi.org/10.3390/ijerph15050917
Received: 1 March 2018 / Revised: 26 April 2018 / Accepted: 30 April 2018 / Published: 4 May 2018
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Abstract
Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a
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Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity. Full article
(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)
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Open AccessArticle Sedentary Behaviour in Swiss Children and Adolescents: Disentangling Associations with the Perceived and Objectively Measured Environment
Int. J. Environ. Res. Public Health 2018, 15(5), 918; https://doi.org/10.3390/ijerph15050918
Received: 13 April 2018 / Revised: 27 April 2018 / Accepted: 3 May 2018 / Published: 4 May 2018
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Abstract
Identifying correlates of sedentary behaviour across all levels of the ecological model and understanding their interrelations is a promising method to plan effective interventions. The present study examined whether the objectively assessed and the perceived neighbourhood are associated with children’s sedentary behaviour time
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Identifying correlates of sedentary behaviour across all levels of the ecological model and understanding their interrelations is a promising method to plan effective interventions. The present study examined whether the objectively assessed and the perceived neighbourhood are associated with children’s sedentary behaviour time (SBT). A comprehensive set of factors at different levels of influence across the ecological model were taken into account and analysed for mediating and modifying effects. Analyses were based on 1306 children and adolescents (6–16 years) participating in the population-based SOPHYA-study. Accelerometers were used to assess SBT, the perceived environment was examined by a validated parental questionnaire, and objective environmental data were allocated using GIS (ArcMap 10.2, Esri, Redlands, CA, USA) for each family’s residential address. A high perceived safety was associated with less SBT. Boys, those whose residential neighbourhood was characterized by dead ends in urban areas, a low main street density in the neighbourhood of children and greenness were less likely to exhibit SBT. The association of the objective environment with the respective parental perceptions was low and no significant mediating effect was found for the perceived environment. We conclude for land-use planning to reduce sedentary behaviour objective environments should be complemented with efforts to increase parental sense of security. Full article
(This article belongs to the Special Issue Sedentary Behaviour and Health)
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Open AccessArticle Arsenic and Other Elemental Concentrations in Mushrooms from Bangladesh: Health Risks
Int. J. Environ. Res. Public Health 2018, 15(5), 919; https://doi.org/10.3390/ijerph15050919
Received: 9 April 2018 / Revised: 2 May 2018 / Accepted: 3 May 2018 / Published: 4 May 2018
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Abstract
Mushroom cultivation has been increasing rapidly in Bangladesh. Arsenic (As) toxicity is widespread in the world and Bangladesh faces the greatest havoc due to this calamity. Rice is the staple food in Bangladesh and among all the crops grown, it is considered to
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Mushroom cultivation has been increasing rapidly in Bangladesh. Arsenic (As) toxicity is widespread in the world and Bangladesh faces the greatest havoc due to this calamity. Rice is the staple food in Bangladesh and among all the crops grown, it is considered to be the main cause of As poisoning to its population after drinking water. Consequently, rice straw, an important growing medium of mushrooms in Bangladesh, is known to have high As content. The objective of this study was, therefore, to determine the concentrations of As in mushrooms cultivated in Bangladesh and to assess the health risk as well. It also considered other elements, including Cd, Cr, Co, Cu, Pb, Mn, Hg, Ni, and Zn concentrations in mushrooms from Bangladesh. The mean concentrations (mg/kg) of As, Cd, Cr, Co, Cu, Pb, Mn, Hg, Ni, and Zn in mushrooms were 0.51, 0.38, 0.28, 0.01, 13.7, 0.31, 11.7, 0.12, 0.28, and 53.5, respectively. Based on the dietary intake of mushrooms, the weekly intakes of As, Cd, Cr, Co, Cu, Pb, Mn, Hg, Ni, and Zn from mushrooms for adults were 0.0042, 0.0030, 0.0024, 0.0001, 0.1125, 0.0019, 0.1116, 0.0011, 0.0023, and 0.4734 mg, respectively. Due to the low concentrations of As and other trace elements observed in mushrooms from Bangladesh, as well as relatively lower consumption of this food in people’s diet, it can be inferred that consumption of the species of mushrooms analysed will cause no toxicological risk. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessArticle Commuting Mode Choice in a High-Density City: Do Land-Use Density and Diversity Matter in Hong Kong?
Int. J. Environ. Res. Public Health 2018, 15(5), 920; https://doi.org/10.3390/ijerph15050920
Received: 13 March 2018 / Revised: 30 April 2018 / Accepted: 2 May 2018 / Published: 4 May 2018
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Abstract
Hong Kong is a densely populated and transit-oriented Chinese city, which provides an ideal urban environment with which to study the various successful facets of land use policy as a model for potential replication to curb increasing car use in other Chinese cities.
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Hong Kong is a densely populated and transit-oriented Chinese city, which provides an ideal urban environment with which to study the various successful facets of land use policy as a model for potential replication to curb increasing car use in other Chinese cities. We examine the commuting mode choice of 203,900 households living in 4768 street blocks in Hong Kong from 2011 census. A street block is the smallest planning unit, made up of one or more housing estates with a homogenous built environment and socioeconomic status. The built environment is measured using the five Ds framework, an international dimensioning framework for classifying and measuring attributes of the built environment for physical activity and travel behaviors. Generalized, multi-level mixed models were applied to detect the associations between travel choice and built environment characteristics, while adjusting for socioeconomic status. Design and destination accessibility had greater effects on the choices to walk and take public transport than on the choice to drive. Density and diversity had only marginal effects on mode choice. Unexpectedly, distance to the urban center had the opposite effect on automobile use to that found in Western studies. Hong Kong residents living close to the urban center were more likely to drive for commuting trips. The contrasting findings between our study and Western studies suggest that the associations between a high-density built environment and travel choice vary with urban context. Full article
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Open AccessArticle Mood Regulation Focused CBT Based on Memory Reconsolidation, Reduced Suicidal Ideation and Depression in Youth in a Randomised Controlled Study
Int. J. Environ. Res. Public Health 2018, 15(5), 921; https://doi.org/10.3390/ijerph15050921
Received: 9 March 2018 / Revised: 25 April 2018 / Accepted: 30 April 2018 / Published: 5 May 2018
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Abstract
Suicide attempts and suicidal ideation in adolescence are considered to be related to suicide and psychiatric adversity later in life. Secondary prevention by improving the treatment of suicidal youth is a distinct possibility. In this study, treatment with a systematised mood-regulation focused cognitive
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Suicide attempts and suicidal ideation in adolescence are considered to be related to suicide and psychiatric adversity later in life. Secondary prevention by improving the treatment of suicidal youth is a distinct possibility. In this study, treatment with a systematised mood-regulation focused cognitive behavioural therapy (MR-CBT) (n = 15) was compared with treatment as usual (TAU) (n = 12) in a group of depressed adolescents in a clinical setting. MR-CBT focuses on mood regulation by means of counter conditioning with memory reconsolidation being the proposed mechanism of change. Subjects practice keeping emotionally positive memories to diminish the emotional impact of negative memories. Symptoms of depression were tested with a short version of the Mood and Feelings Questionnaire (SMFQ), and wellbeing with the World Health Organization 5 Wellbeing Index (WHO-5). Suicidal events were rated according to the clinical interview Columbia Suicide Severity Rating Scale (C-SSRS). Suicidal events at the end of treatment were significantly reduced in the MR-CBT group, but not in the TAU group. Depression and wellbeing improved significantly in both treatment groups. While far from conclusive, the results are encouraging enough to suggest that further studies should be undertaken to examine whether psychotherapy focusing on mood regulation for young individuals at risk might enhance secondary prevention of suicide. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
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Open AccessArticle Trends in the Prevalences of Selected Birth Defects in Korea (2008–2014)
Int. J. Environ. Res. Public Health 2018, 15(5), 923; https://doi.org/10.3390/ijerph15050923
Received: 5 April 2018 / Revised: 30 April 2018 / Accepted: 3 May 2018 / Published: 5 May 2018
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Abstract
Little information is available on the prevalences of birth defects in Korea. The aims of this study were to estimate recent prevalences of selected birth defects and to analyze the prevalence trends of these defects during the period from 2008 to 2014. Prevalences
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Little information is available on the prevalences of birth defects in Korea. The aims of this study were to estimate recent prevalences of selected birth defects and to analyze the prevalence trends of these defects during the period from 2008 to 2014. Prevalences were calculated for 69 major birth defects using health insurance claim data obtained from the Korea National Health Insurance Service (NHIS). Prevalence rate ratios were calculated using Poisson regression to analyze trends over the 7-year study period. The overall prevalence of a major birth defect was 446.3 per 10,000 births (95% CI: 444.0–448.6); 470.9 per 10,000 births (95% CI: 467.6–474.2) for males and 420.2 per 10,000 births (95% CI: 417–423.4) for females. The prevalence rates of the most common birth defects over the study period were; septal defect (138.2 per 10,000; 95% CI: 136.9–139.5), congenital hip dislocation (652 per 10,000; 95% CI: 64.1–65.9), and ventricular septal defect (62.62 per 10,000; 95% CI: 61.7–63.5). During the study period, a significant increase in the prevalence of a major birth defect was observed with a prevalence rate ratio (PRR) of 1.091. The strongest trend was observed for renal dysplasia, which had a PRR of 1.275 (95% CI: 1.211–1.343), and upward trends were observed for urogenital anomalies, such as, renal agenesis (PRR 1.102, 95% CI: 1.067–1.138), undescended testis (PRR 1.082, 95% CI: 1.072–1.093) and hypospadias (PRR 1.067, 95% CI: 1.044–1.090). This study shows an overall increase in the prevalences of birth defects, including hypospadias and undescended testis, which are known to be associated with endocrine factors. In the future, standardized birth defect registries should be established to enable these trends to be monitored. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Risk Factors and Spatial Clusters of Cryptosporidium Infection among School-Age Children in a Rural Region of Eastern China
Int. J. Environ. Res. Public Health 2018, 15(5), 924; https://doi.org/10.3390/ijerph15050924
Received: 12 April 2018 / Revised: 29 April 2018 / Accepted: 3 May 2018 / Published: 6 May 2018
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Abstract
The epidemiological features of Cryptosporidium infection among school-age children in China still remain unclear. Hereby, a cross-sectional study of 1637 children aged 3–9 years was designed to investigate the risk factors and spatial clusters of Cryptosporidium infection in a rural region of Eastern
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The epidemiological features of Cryptosporidium infection among school-age children in China still remain unclear. Hereby, a cross-sectional study of 1637 children aged 3–9 years was designed to investigate the risk factors and spatial clusters of Cryptosporidium infection in a rural region of Eastern China. Stool specimens collected from participants were examined using the auramine-phenol and modified acid-fast staining. Univariable and multivariable analyses were performed to identify the risk factors of Cryptospordium infection. The spatial clusters were analyzed by a discrete Poisson model using SaTScan software. Our results showed that the overall prevalence of Cryptosporidium infection was 11‰ in the research region. At the age of 3–6 years (odds ratios (OR) = 3.072, 95% confidence intervals (CI): 1.001–9.427), not washing hands before eating and after defecation (OR = 3.003, 95% CI: 1.060–8.511) were recognized as risk factors. Furthermore, a high-risk spatial cluster (relative risk = 4.220, p = 0.025) was identified. These findings call for effective sustainable interventions including family and school-based hygienic education to reduce the prevalence of Cryptosporidium infection. Therefore, an early warning system based spatiotemporal models with risk factors is required to further improve the effectiveness and efficiency of cryptosporidiosis control in the future. Full article
(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)
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Open AccessArticle Antibiotic Sensitivity Profiling and Virulence Potential of Campylobacter jejuni Isolates from Estuarine Water in the Eastern Cape Province, South Africa
Int. J. Environ. Res. Public Health 2018, 15(5), 925; https://doi.org/10.3390/ijerph15050925
Received: 10 April 2018 / Revised: 30 April 2018 / Accepted: 3 May 2018 / Published: 6 May 2018
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Abstract
Campylobacter jejuni (CJ) is a zoonotic microbe and a major causative organism of diarrheal infection in humans that often has its functional characteristics inactivated in stressed conditions. The current study assessed the correlation between recovered CJ and water quality parameters and the drug
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Campylobacter jejuni (CJ) is a zoonotic microbe and a major causative organism of diarrheal infection in humans that often has its functional characteristics inactivated in stressed conditions. The current study assessed the correlation between recovered CJ and water quality parameters and the drug sensitivity patterns of the pathogen to frontline antibiotics in human and veterinary medicine. Water samples (n = 244) from rivers/estuarines were collected from April–September 2016, and physicochemical conditions were recorded on-site. CJ was isolated from the samples using standard microbiological methods and subjected to sensitivity testing to 10 antibiotics. Mean CJ counts were between 1 and 5 logs (CFU/mL). Ninety-five isolates confirmed as CJ by PCR showed varying rates of resistance. Sensitivity testing showed resistance to tetracycline (100%), azithromycin (92%), clindamycin (84.2%), clarithromycin and doxycycline (80%), ciprofloxacin (77.8%), vancomycin (70.5%), erythromycin (70%), metronidazole (36.8%) and nalidixic acid (30.5%). Virulence encoding genes were detected in the majority 80/95, 84.2%) of the confirmed isolates from cdtB; 60/95 (63.2%) from cstII; 49/95 (51.6%) from cadF; 45/95 (47.4%) from clpP; 30/95 (31.6%) from htrB, and 0/95 (0%) from csrA. A multiple resistance cmeABC active efflux pump system was present in 69/95 (72.6) isolates. The presence of CJ was positively correlated with temperature (r = 0.17), pH (r = 0.02), dissolved oxygen (r = 0.31), and turbidity (r = 0.23) but negatively correlated with salinity (r = −0.39) and conductivity (r = −0.28). The detection of multidrug resistant CJ strains from estuarine water and the differential gene expressions they possess indicates a potential hazard to humans. Moreover, the negative correlation between the presence of the pathogen and physicochemical parameters such as salinity indicates possible complementary expression of stress tolerance response mechanisms by wild-type CJ strains. Full article
(This article belongs to the Special Issue Recreational Water Illnesses)
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Open AccessArticle The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36–59 Months in Honduras
Int. J. Environ. Res. Public Health 2018, 15(5), 926; https://doi.org/10.3390/ijerph15050926
Received: 10 April 2018 / Revised: 10 April 2018 / Accepted: 2 May 2018 / Published: 7 May 2018
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Abstract
Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to
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Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36–59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011–2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD. Full article
(This article belongs to the Special Issue The Health Needs of Vulnerable Children: Challenges and Solutions)
Open AccessArticle In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia
Int. J. Environ. Res. Public Health 2018, 15(5), 927; https://doi.org/10.3390/ijerph15050927
Received: 10 April 2018 / Revised: 3 May 2018 / Accepted: 5 May 2018 / Published: 7 May 2018
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Abstract
Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time
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Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over one-year period (January through December 2016) were included in the study. Data about personal characteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital complications and survival status were collected. The last reported Aseer region population was used to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios (HR) and concomitant 95% confidence intervals (95% CI) were computed using multivariate Cox regression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted. Results: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall case fatality rate (CFR) of 9.7%. Non-significant difference with gender and age were observed in CFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed a significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke smoking (HR = 2.36), pre-stroke hypertension (HR = 1.77), post-stroke disturbed consciousness (HR = 6.86), poor mobility (HR = 2.60) and developing pulmonary embolism (HR = 2.63) as significant predictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital stroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could be improved by smoking cessation, better control of hypertension and prevention of in hospital complication particularly pulmonary embolism. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle The Challenges of Predicting Suicidal Thoughts and Behaviours in a Sample of Rural Australians with Depression
Int. J. Environ. Res. Public Health 2018, 15(5), 928; https://doi.org/10.3390/ijerph15050928
Received: 29 March 2018 / Revised: 3 May 2018 / Accepted: 3 May 2018 / Published: 7 May 2018
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Abstract
Suicide is a leading cause of death, particularly in rural and remote areas. Although depression is strongly related to both suicidal ideation and attempt, it lacks specificity as a predictor, and little is known about characteristics that increase suicide risk among people with
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Suicide is a leading cause of death, particularly in rural and remote areas. Although depression is strongly related to both suicidal ideation and attempt, it lacks specificity as a predictor, and little is known about characteristics that increase suicide risk among people with depression. A telephone version of the World Mental Health Composite International Diagnostic Interview explored lifetime depression, suicidal ideation, suicide attempt, and related factors among a community-dwelling sample of rural and remote Australians, selected for an interview based on a screener for psychological distress (100% of those with high distress, 75% of those with moderate distress, and 16% of those with low distress). Of 1051 participants interviewed, 364 reported lifetime symptoms of depression; of these, 48% reported lifetime suicidal ideation and 16% reported a lifetime suicide attempt. While depression severity was a significant correlate of suicidality for both males and females, suicide attempt was significantly more common among females with a younger age of depression onset, and a higher number of psychiatric comorbidities. No additional factors were significant for males. Among rural and remote residents with lifetime symptoms of depression, the identification of suicide risk may be enhanced by considering individual and contextual factors beyond depression severity. Further research focusing on risk factors for males would be beneficial. Full article
(This article belongs to the Special Issue Suicide Risk and Mental Disorders)
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Open AccessArticle Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life
Int. J. Environ. Res. Public Health 2018, 15(5), 930; https://doi.org/10.3390/ijerph15050930
Received: 20 March 2018 / Revised: 26 April 2018 / Accepted: 3 May 2018 / Published: 7 May 2018
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Abstract
Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA). We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of
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Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA). We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of 2889 active participants of The North West Adelaide Health Study (response rate = 54%, male n = 704; female n = 856; age 30–100 years) assessed previously diagnosed OSA, OSA symptoms, insomnia, doctor-diagnosed medical conditions, and the SF-36. In weighted analyses, self-reported diagnosed OSA (men: 12.6%, n = 95; women: 3.3%, n = 27) and OSA symptoms (men: 17.1%; women: 9.7%) were more common in men. Diagnosed OSA showed stronger adjusted associations with typical OSA features in women, including obesity (women-odds ratio (OR), 95% CI: 5.7, 1.9–17.1, men: 2.2, 1.2–4.0), daytime sleepiness (women: 6.4, 2.7–15.6, men: 3.3, 2.1–5.4), and loud snoring (women: 25.4, 9.4–69.1, men: 8.7, 5.2–14.4). Diagnosed OSA was independently associated with cardiovascular disease (CVD) in men, and in women with high cholesterol, respiratory disease, insomnia, and reduced SF-36 Physical Component Summary score. In both sexes, OSA symptoms were significantly associated with depression, insomnia, and moderate to severe impairments in SF-36 physical and mental component summary scores. Diagnosed women showed clinical characteristics overtly related to OSA. A higher index of clinical suspicion of OSA may be required in women for a condition regarded as male-predominant to increase equity in health outcomes. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle Association between Organochlorine Pesticide Levels in Breast Milk and Their Effects on Female Reproduction in a Taiwanese Population
Int. J. Environ. Res. Public Health 2018, 15(5), 931; https://doi.org/10.3390/ijerph15050931
Received: 13 April 2018 / Revised: 29 April 2018 / Accepted: 30 April 2018 / Published: 7 May 2018
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Abstract
Only few studies have focused on organochlorine pesticides (OCPs) in breast milk and the related health risks for women in Taiwan. Our goal is to examine breast milk OCPs and their associations with female reproductive function (infertility, gynecological diseases, and menstruation characteristics) as
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Only few studies have focused on organochlorine pesticides (OCPs) in breast milk and the related health risks for women in Taiwan. Our goal is to examine breast milk OCPs and their associations with female reproductive function (infertility, gynecological diseases, and menstruation characteristics) as well as their correlation with sociodemographic parameters (age, pre-pregnant body mass index (BMI), annual incomes, population, birth year, and parity) and dietary habit. The breast milk samples were collected in southern Taiwan (n = 68) from 2013 to 2016 and the OCP residues were analyzed using high resolution gas chromatography with low resolution mass spectrometry (HRGC/LRMS). The results show that the most abundant OCP residues in the breast milk was ΣDDT with the geometric mean ± standard deviation of 9.81 ± 7.52 ng−1 lipid−1 followed by ΣHCH (0.539 ± 0.557 ng−1·lipid−1). In the principal component analysis, cis-chlordane (cis-CHL) and γ-HCH were found to be related to participants who received medical treatment for infertility, and 4,4′-DDT was associated with those who received gynecological surgery. The logistic regression showed that the odds ratio (OR) of log γ-hexachlorocyclohexane (γ-HCH) was higher for mothers who had received medical treatment for infertility than for the normal group (OR = 25.6, p = 0.035) after adjustments for age, pre-pregnant BMI, annual income, population (i.e., native-born Taiwanese), birth year, and parity. Cow milk and beef consumption as well as menstruation characteristics such as average menstrual period (>5 days), shortest menstrual period (<3 days), and women who had taken hormonal drugs were significantly associated to several OCP residues in the breast milk. In addition, ΣHCH including β-HCH and γ-HCH was correlated with annual family income and gravidity as well as cow milk and beef consumptions. Overall, γ-HCH exhibited a probable association with the infertility diseases of Taiwanese women, and dietary habit might play an important role in the female Taiwanese exposure to OCPs. Full article
(This article belongs to the Special Issue Exposure to Endocrine Disruptors in Pregnancy and Early Childhood)
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Open AccessArticle Smelting Remains a Public Health Risk Nearly a Century Later: A Case Study in Pueblo, Colorado, USA
Int. J. Environ. Res. Public Health 2018, 15(5), 932; https://doi.org/10.3390/ijerph15050932
Received: 17 March 2018 / Revised: 25 April 2018 / Accepted: 1 May 2018 / Published: 7 May 2018
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Abstract
Pueblo, Colorado has a long history of smelting activities, and recent studies raised concerns about lead exposure. This study tested 240 children in Pueblo for blood lead levels (BLLs) and found a significant association between distance from old smelters and children BLLs. Around
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Pueblo, Colorado has a long history of smelting activities, and recent studies raised concerns about lead exposure. This study tested 240 children in Pueblo for blood lead levels (BLLs) and found a significant association between distance from old smelters and children BLLs. Around 7.5% of Pueblo children had BLLs above the Centers for Disease Control and Prevention reference level of 5 µg/dL for elevated BLL, and 18.3% had BLLs between 3.3–4.9 µg/dL. Out of the 36 children who lived near former smelters, 13.9% had BLLs above 5 µg/dL vs. 6.37% for children living away from old smelters. The proportion of Pueblo children with elevated BLL was nearly three times the 2007–2010 United States national average (7.5% vs. 2.6%), and this was higher in the immediate vicinity of old smelters (13.9% vs. 2.6%). Genetic polymorphisms for ALAD-1 or ALAD-2 alleles, which play a role in susceptibility to lead toxicity, were not associated with children BBLs. Around 38.5% of houses sampled near the smelters had topsoil lead levels higher than the Environmental Protection Agency’s benchmark of 400 mg/kg. Our study resulted in the addition of areas of Pueblo to the EPA Superfund National Priorities List in December 2014, and cleanup is currently underway to minimize the public health risks. Full article
(This article belongs to the Special Issue Urban Geochemistry and Human Health)
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Open AccessArticle Metabolic Syndrome in First Episode Schizophrenia, Based on the National Mental Health Registry of Schizophrenia (NMHR) in a General Hospital in Malaysia: A 10-Year Retrospective Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(5), 933; https://doi.org/10.3390/ijerph15050933
Received: 18 March 2018 / Revised: 25 April 2018 / Accepted: 26 April 2018 / Published: 7 May 2018
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Abstract
Schizophrenia has been linked with various medical comorbidities, particularly metabolic syndrome. The number of studies on this aspect is lacking in Malaysia. (1) Objective: To investigate metabolic syndrome rates and its associated factors. (2) Method: This is the first 10-year retrospective-outcome study of
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Schizophrenia has been linked with various medical comorbidities, particularly metabolic syndrome. The number of studies on this aspect is lacking in Malaysia. (1) Objective: To investigate metabolic syndrome rates and its associated factors. (2) Method: This is the first 10-year retrospective-outcome study of patients with first episode schizophrenia in Malaysia. Out of 394 patients diagnosed with first episode schizophrenia and registered with the National Mental Health Registry of Schizophrenia (NMHR) in the General Hospital Kuala Lumpur (GHKL) in 2004–2005, 174 patients consented to participate in the study. They were interviewed using a Schizophrenia outcome questionnaire and the International Physical Activity Questionnaire (IPAQ). The diagnosis of metabolic syndrome was made using the National Cholesterol Education Program—Third Adult Treatment Panel (NCEP ATP III). (3) Results: All patients’ weight, body mass index, fasting blood sugar, and blood pressure are significantly increased. Sixty-three subjects (36.2%) developed metabolic syndrome while 36 (23.2%) were hypertensive, and 41 (28.1%) were diabetic. Use of fluphenthixol depot (CI = 1.05–5.09, OR: 0.84, p = 0.039), reduced physical activity (CI = 0.13–1.00, OR: −1.04, p = 0.049), and substance use disorder (CI = 1.40, 13.89, OR: 1.48, p = 0.012) were significantly associated with metabolic syndrome based on univariate analysis. In further multivariate analysis, comorbid substance abuse was the only significant factor associated with metabolic syndrome after adjusting for physical activity and intramuscular depot. (4) Conclusion: Patients with schizophrenia are at high risk of metabolic syndrome. It is important to address substance use problems as an important risk factor of this comorbidity. Full article
(This article belongs to the Special Issue Adult Psychiatry)
Open AccessArticle Teens Implementing a Childhood Obesity Prevention Program in the Community: Feasibility and Perceptions of a Partnership with HSTA and iCook 4-H
Int. J. Environ. Res. Public Health 2018, 15(5), 934; https://doi.org/10.3390/ijerph15050934
Received: 26 March 2018 / Revised: 2 May 2018 / Accepted: 4 May 2018 / Published: 7 May 2018
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Abstract
High school student researchers and teen leaders from the Health Science Technology Academy (HSTA), under the supervision of HSTA teachers, led a childhood obesity prevention (COP) program (iCook 4-H). The objective was to evaluate the feasibility and perceptions of having teen leaders implement
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High school student researchers and teen leaders from the Health Science Technology Academy (HSTA), under the supervision of HSTA teachers, led a childhood obesity prevention (COP) program (iCook 4-H). The objective was to evaluate the feasibility and perceptions of having teen leaders implement a COP program for dyads of youth (9–10 years old) and their primary adult food preparer. Behavior change and perceptions were assessed through surveys and open-ended interviews. Across eight HSTA organizations, 43 teen leaders participated in teaching the iCook 4-H program to 24 dyads. Increased frequency of culinary skills, physical activity and mealtime behavior were reported by youth. Almost all adults (93%) reported that their youth had learned kitchen skills and that the program provided youth-adult quality time and developed culinary skills. Youth echoed adult perceptions with additional themes of food safety and physical activity. HSTA teen leaders perceived the program to be successful and reported the training they received to implement the program was adequate 98% of the time. HSTA teachers found the program to be beneficial for HSTA students in improving leadership, confidence and responsibility. iCook 4-H was feasible to be disseminated through teen leaders in the HSTA program. This teen-led approach could serve as a model for youth health-related programming. Full article
(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)
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Open AccessArticle Removal of Emerging Contaminants and Estrogenic Activity from Wastewater Treatment Plant Effluent with UV/Chlorine and UV/H2O2 Advanced Oxidation Treatment at Pilot Scale
Int. J. Environ. Res. Public Health 2018, 15(5), 935; https://doi.org/10.3390/ijerph15050935
Received: 28 March 2018 / Revised: 20 April 2018 / Accepted: 2 May 2018 / Published: 7 May 2018
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Abstract
Effluent of a municipal wastewater treatment plant (WWTP) was treated on-site with the UV/chlorine (UV/HOCl) advanced oxidation process (AOP) using a pilot plant equipped with a medium pressure UV lamp with an adjustable performance of up to 1 kW. Results obtained from parallel
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Effluent of a municipal wastewater treatment plant (WWTP) was treated on-site with the UV/chlorine (UV/HOCl) advanced oxidation process (AOP) using a pilot plant equipped with a medium pressure UV lamp with an adjustable performance of up to 1 kW. Results obtained from parallel experiments with the same pilot plant, where the state of the art UV/H2O2 AOP was applied, were compared regarding the removal of emerging contaminants (EC) and the formation of adsorbable organohalogens (AOX). Furthermore, the total estrogenic activity was measured in samples treated with the UV/chlorine AOP. At an energy consumption of 0.4 kWh/m3 (0.4 kW, 1 m3/h) and in a range of oxidant concentrations from 1 to 6 mg/L, the UV/chlorine AOP had a significantly higher EC removal yield than the UV/H2O2 AOP. With free available chlorine concentrations (FAC) in the UV chamber influent of at least 5 mg/L (11 mg/L of dosed Cl2), the total estrogenic activity could be reduced by at least 97%. To achieve a certain concentration of FAC in the UV chamber influent, double to triple the amount of dosed Cl2 was needed, resulting in AOX concentrations of up to 520 µg/L. Full article
(This article belongs to the Special Issue Municipal Wastewater Treatment)
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Open AccessArticle Body Weight Misperception and Its Association with Unhealthy Eating Behaviors among Adolescents in China
Int. J. Environ. Res. Public Health 2018, 15(5), 936; https://doi.org/10.3390/ijerph15050936
Received: 5 March 2018 / Revised: 28 April 2018 / Accepted: 4 May 2018 / Published: 8 May 2018
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Abstract
This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students (N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based
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This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students (N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based on the World Health Organization’s Global School-Based Student Health Survey was employed to assess responses. Self-reported data, including weight, height, body weight perception, and eating habits, were collected. Body Mass Index (BMI) for age z-score was calculated from self-reported height and weight using WHO AnthroPlus. We used descriptive, logistic regression analysis and a Kappa test to analyze the data using SPSS. Overall, 56.6% of participants did not correctly categorize their weight status; these were much more likely to be girls. Compared with the correctly-perceived group, those who underestimated their weight tended to report eating late at night, having dinners with family, and checking nutrition labels. In contrast, weight overestimating students were less likely to report eating late at night, having breakfasts with family, having dinners with family, and discussing nutrition topics over meals. Body weight misperception was associated with unhealthy eating behaviors among Chinese adolescents. Full article
(This article belongs to the collection Health Behavior and Public Health)
Open AccessArticle Understanding the Natural and Socioeconomic Factors behind Regional Longevity in Guangxi, China: Is the Centenarian Ratio a Good Enough Indicator for Assessing the Longevity Phenomenon?
Int. J. Environ. Res. Public Health 2018, 15(5), 938; https://doi.org/10.3390/ijerph15050938
Received: 9 February 2018 / Revised: 30 April 2018 / Accepted: 1 May 2018 / Published: 8 May 2018
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Abstract
Despite a number of longevity indicators having been used in previous longevity studies, few studies have critically evaluated whether these indicators are suitable to assess the regional longevity level. In addition, an increasing number of studies have attempted to determine the influence of
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Despite a number of longevity indicators having been used in previous longevity studies, few studies have critically evaluated whether these indicators are suitable to assess the regional longevity level. In addition, an increasing number of studies have attempted to determine the influence of socioeconomic and natural factors on regional longevity, but only certain factors were considered. This study aims to bridge this gap by determining the relationship between the 7 longevity indicators and selecting 24 natural and socioeconomic indicators in 109 selected counties and urban districts in Guangxi, China. This study has applied spatial analysis and geographically weighted regression as the main research methods. The seven longevity indicators here refer to centenarian ratio, longevity index, longevity level, aging tendency, 80+ ratio, 90+ ratio, and 95+ ratio. Natural indicators in this study mainly refer to atmospheric pressure, temperature, difference in temperature, humidity, rainfall, radiation, water vapor, and altitude. Socioeconomic indicators can be categorized into those related to economic status, education, local infrastructure, and health care facilities. The results show that natural factors such as the difference in temperature and altitude, along with socioeconomic factors such as GDP, might be the most significant contributors to the longevity of people aged 60–90 years in Guangxi. The longevity index and longevity level are useful supplementary indexes to the centenarian ratio for assessing the regional longevity. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Factors Associated with Immunization Opinion Leadership among Men Who Have Sex with Men in Los Angeles, California
Int. J. Environ. Res. Public Health 2018, 15(5), 939; https://doi.org/10.3390/ijerph15050939
Received: 20 March 2018 / Revised: 30 April 2018 / Accepted: 30 April 2018 / Published: 8 May 2018
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Abstract
We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled
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We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled MSM living in Los Angeles (N = 520) from December 2016 to February 2017 and evaluated characteristic differences in sociodemographic characteristics, health behaviors, and technology use among those classified as opinion leaders versus those who were not. We also asked respondents about their past receipt of meningococcal serogroups A, C, W, and Y (MenACWY) and meningococcal B (MenB) vaccines, as well as their opinions on the importance of 13 additional vaccines. Multivariable results revealed that non-Hispanic black (aOR = 2.64; 95% CI: 1.17–5.95) and other race/ethnicity (aOR = 2.98; 95% CI: 1.41–6.29) respondents, as well as those with a history of an STI other than HIV (aOR = 1.95; 95% CI: 1.10–3.48), were more likely to be opinion leaders. MenACWY (aOR = 1.92; 95% CI: 1.13–3.25) and MenB (aOR = 3.09; 95% CI: 1.77–5.41) vaccine uptake, and perceived importance for these and seven additional vaccines, were also associated with being an opinion leader. The results suggest that the co-promotion of vaccination and other health promotion initiatives via opinion leaders could be a useful strategy for increasing vaccination among MSM. Full article
Open AccessArticle Temporal Variation and Ecological Risk Assessment of Metals in Soil Nearby a Pb–Zn Mine in Southern China
Int. J. Environ. Res. Public Health 2018, 15(5), 940; https://doi.org/10.3390/ijerph15050940
Received: 8 March 2018 / Revised: 19 April 2018 / Accepted: 30 April 2018 / Published: 9 May 2018
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Abstract
Metal contamination in soil from tailings induces risks for the ecosystem and for humans. In this study, the concentrations and ecological risks of Cd, Cu, Pb, and Zn in soil contaminated by a tailing from Yangshuo (YS) lead and zinc (Pb–Zn) mine, which
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Metal contamination in soil from tailings induces risks for the ecosystem and for humans. In this study, the concentrations and ecological risks of Cd, Cu, Pb, and Zn in soil contaminated by a tailing from Yangshuo (YS) lead and zinc (Pb–Zn) mine, which collapsed for more than 40 years, were determined in 2015. The mean concentrations of Zn, Pb, Cu, and Cd were 1301.79, 768.41, 82.60, and 4.82 mg/kg, respectively, which, with years of remediation activities, decreased by 66.9%, 61.7%, 65.4%, and 65.3% since 1986, but still exceed the national standards. From 1986 to 2015, soil pH increased significantly, with available concentrations of Zn, Pb, Cu and Cd decreasing by 13%, 81%, 77%, and 67%, respectively, and potential ecological risk indexes (Er) of the determined metals decreasing by more than 60%. Horizontally, total contents and percentages of available concentrations of Zn, Pb, Cu, and Cd decreased with the distance from the tailing heap in SD village, while pH values showed the reverse pattern. Vertically, Zn and Cd, Pb, and Cu showed similar vertical distribution patterns in the soil profiles. There was a slight downward migration for the determined metals in soil of M and H area and the mobility was in the order of Cd > Zn > Pb > Cu. It can be concluded that although concentrations and ecological risks of Cd, Cu, Pb, and Zn in soil decreased significantly, SD village is still a high risk area, and the priority pollutant is Cd. Full article
(This article belongs to the collection Environmental Risk Assessment)
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Open AccessArticle The Physical Activity Patterns among Rural Chinese Adults: Data from China National Nutrition and Health Survey in 2010–2012
Int. J. Environ. Res. Public Health 2018, 15(5), 941; https://doi.org/10.3390/ijerph15050941
Received: 31 March 2018 / Revised: 23 April 2018 / Accepted: 4 May 2018 / Published: 9 May 2018
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Abstract
China has experienced a rapid increase in non-communicable diseases (NCDs), especially in rural China. In addition to a dramatic increase in energy intake, the decrease in physical activity (PA) may be a reason. The study described the patterns and factors of physical activity
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China has experienced a rapid increase in non-communicable diseases (NCDs), especially in rural China. In addition to a dramatic increase in energy intake, the decrease in physical activity (PA) may be a reason. The study described the patterns and factors of physical activity and sedentary behaviors of 70,038 adults in rural China, based on data from the Chinese Nutrition and Health Survey (CNNHS) in 2010–2012. The mean working time of the employed subjects was 6.04 ± 1.3 day/week, 8.38 ± 2.2 h/day, of which 3.37 ± 2.8 h was sitting time. The occupational PA intensity was significantly relevant with occupation. The average transportation time of the rural Chinese adults was 57.9 ± 45.4 min, and 60.0% took the active transportation mode. The leisure-time PA (LTPA) participation rate was 3.8%, the LTPA time of those who had LTPA was 234.9 ± 231.3 min/week, lower participation was found in farmers and those in younger age groups, and those with lower educational and economic levels. The average domestic PA time, sedentary leisure-time, and sleeping time was 93.0 ± 72.7 min, 2.5 ± 1.4 h, and 7.9 ± 1.1 h, respectively. PA programs should be implemented in rural China, and the PA guidelines for farmers should be developed separately for the farming and non-farming seasons. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Development of a National Aboriginal and Torres Strait Islander Cancer Framework: A Shared Process to Guide Effective Policy and Practice
Int. J. Environ. Res. Public Health 2018, 15(5), 942; https://doi.org/10.3390/ijerph15050942
Received: 27 March 2018 / Revised: 26 April 2018 / Accepted: 30 April 2018 / Published: 9 May 2018
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Abstract
Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an
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Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an initiative by Cancer Australia and Menzies School of Health Research (Menzies) to develop Australia’s first National Aboriginal and Torres Strait Islander Cancer Framework using a process of co-design with relevant stakeholders. The initiative was guided by three core principles: achieving policy-relevant evidence-based outcomes; engaging and maintaining trust with Indigenous Australians at every phase; and employing best-practice and appropriate research methods. Four components of research comprised the Framework development: evidence review; multifaceted stakeholder consultation and input; triangulation of findings; and direct stakeholder input in drafting and refining the Framework. The evidence review confirmed the increasing burden of cancer on Indigenous Australians, while stakeholder consultations facilitated comprehensive input from those with lived experience. The consultations revealed issues not identified in existing literature, and gave different emphases of priority, thus reinforcing the value of including stakeholder perspectives. This paper focuses primarily on documenting the methods used; findings are presented only in order to illustrate the results of the process. The published Framework is available at www.canceraustralia.gov.au; further description and analyses of findings from the consultations will be published elsewhere. The logistics inherent in large-scale consultation are considerable. However, the quality of data and the foundation for sustained partnership with stakeholders and knowledge translation vastly outweighed the challenges. The process of wide-ranging stakeholder consultation described in this paper offers a model for other areas of national and international Indigenous priority setting and policy and practice development that meets the needs of those most affected. The Framework, through the establishment of an agreed, shared and evidence-based agenda, provides guidance for jurisdictional cancer plans, optimal care pathways, and program and service planning for the multiple players across all levels of the health system. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
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Open AccessArticle Characteristics Associated with Non-Disclosure of Suicidal Ideation in Adults
Int. J. Environ. Res. Public Health 2018, 15(5), 943; https://doi.org/10.3390/ijerph15050943
Received: 30 March 2018 / Revised: 1 May 2018 / Accepted: 7 May 2018 / Published: 9 May 2018
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Abstract
Suicide prevention efforts often depend on the willingness or ability of people to disclose current suicidal behavior. The aim of this study is to identify characteristics that are associated with non-disclosure of suicidal ideation. Data from the Dutch cross-sectional survey Health Monitor 2016
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Suicide prevention efforts often depend on the willingness or ability of people to disclose current suicidal behavior. The aim of this study is to identify characteristics that are associated with non-disclosure of suicidal ideation. Data from the Dutch cross-sectional survey Health Monitor 2016 were used, resulting in 14,322 respondents (age 19+). Multiple logistic regression analyses were conducted to assess the strength of the associations between demographics and health-related characteristics as independent variables, and non-disclosure of suicidal ideation as the dependent variable. The mean age of the respondents was 60 years (SD 16.7) and 45% were male. Of these adults, 5% (n = 719) reported suicidal ideation in the past year, nearly half of which (48%) did not disclose suicidal ideation. Non-disclosure was significantly associated with social loneliness (OR = 1.29). Inverse significant associations were found for age (35–49 years, OR = 0.53), poor health status (OR = 0.63), frequent suicidal ideation (OR = 0.48), and severe psychological distress (OR = 0.63). The accuracy of this model was fair (AUC = 0.73). To conclude, non-disclosure is a substantial problem in adults experiencing suicidal ideation. Adults who do not disclose suicidal ideation are more likely to have few social contacts, while they are less likely to experience poor (mental) health and frequent suicidal thoughts. Full article
(This article belongs to the Special Issue Suicide Risk and Mental Disorders)
Open AccessFeature PaperArticle Patient-Related Factors Associated with Adherence to Recommendations Made by a Fracture Liaison Service: A Mixed-Method Prospective Study
Int. J. Environ. Res. Public Health 2018, 15(5), 944; https://doi.org/10.3390/ijerph15050944
Received: 15 March 2018 / Revised: 2 May 2018 / Accepted: 4 May 2018 / Published: 9 May 2018
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Abstract
A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care for patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone health recommendations from FLS staff is high. This prospective study combined participants’ telephone longitudinal
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A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care for patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone health recommendations from FLS staff is high. This prospective study combined participants’ telephone longitudinal survey data (intervention group, n = 354) and interviews with 16 individuals from FLS in three health regions of the province of Quebec (Canada). Participants were recruited between January 2013 and April 2015. Regression models were fit to examine the relationship between participant-related factors and adherence at 12 months to osteoporosis medication, vitamin D supplementation, and participation in physical activity. Participants acknowledging FF as a consequence of osteoporosis were more likely to adhere to medication (odds ratio (OR) 2.5; p = 0.001) and vitamin D supplementation (OR 2.3; p = 0.01). Paradoxically, the same participants were less prone to engage in physical activity (OR 0.5, p = 0.01). Qualitative interviews suggested that feedback from FLS coordinators helped participants understand the underlying cause of their FF. This study highlighted the key roles of FLS staff in helping patients to recognize FF as a sign of underlying bone disease and encouraging adherence to care recommendations. Full article
(This article belongs to the Special Issue New Concepts in Women’s Bone Health)
Open AccessArticle Lifestyle Health Behaviors of Nurses and Midwives: The ‘Fit for the Future’ Study
Int. J. Environ. Res. Public Health 2018, 15(5), 945; https://doi.org/10.3390/ijerph15050945
Received: 8 April 2018 / Revised: 2 May 2018 / Accepted: 3 May 2018 / Published: 9 May 2018
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Abstract
Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to
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Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014–2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25–34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
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Open AccessArticle Spatial Pattern and Population Structure of Artemisia ordosica Shrub in a Desert Grassland under Enclosure, Northwest China
Int. J. Environ. Res. Public Health 2018, 15(5), 946; https://doi.org/10.3390/ijerph15050946
Received: 4 April 2018 / Revised: 2 May 2018 / Accepted: 2 May 2018 / Published: 9 May 2018
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Abstract
Enclosure is an effective practice for restoring and rehabilitating the degraded grassland ecosystem caused by overgrazing. Shrub species, which are dominant in most desert grasslands in arid and semiarid regions, have some beneficial ecological functions for grassland restoration. However, how the population structure
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Enclosure is an effective practice for restoring and rehabilitating the degraded grassland ecosystem caused by overgrazing. Shrub species, which are dominant in most desert grasslands in arid and semiarid regions, have some beneficial ecological functions for grassland restoration. However, how the population structure and spatial pattern of the Artemisia ordosica shrub changes in a grassland ecosystem under enclosed practice is not well understood. This study, conducted in the Mu Us desert in northwest China, was designed to measure the A. ordosica population according to the chronosequence of enclosure (enclosure periods ranged from 5 years, 10 years, 15 years, and 25 years), contrasting this with an adjacent continuously grazed grassland. The results showed that the enclosed grasslands had a higher number of individuals of different age classes (seedling, adult, aging, and dead group) and greater population coverage, but shrubs had significant lower (p < 0.05) crown diameter and height in comparison with those in continuously grazed grassland. Further, enclosed grasslands had a significantly higher (p < 0.05) Shannon-Wiener index (H) and Evenness index (E), but a significantly lower (p < 0.05) Richness index (R) than continuously grazed grassland. The crown of A. ordosica showed a significant linear positive correlation with height in all plots across succession, indicating that it was feasible to analyze the age structure by crown. The crown-class distribution structure of the A. ordosica population approximated a Gaussian distribution model in all survey plots. Within the population, seedling and adult groups exhibited aggregated spatial distribution at small scales, while aging and dead A. ordosica groups showed random distribution at almost all scales in different plots. The seedling A. ordosica group showed a positive correlation with adults at small scales in all plots except in 10 years of enclosure. However, it showed independent correlation with aging and dead groups at almost all scales. In long-term enclosed plots, the mortality rate of the A. ordosica population increased, therefore assistance management practices, such as fertilization, mowing, interval grazing, and seasonal grazing, must be employed to maintain population stability after long-term enclosure. This study can improve understanding and clarify the effects of enclosures in the desert grasslands of northwest China. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
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Open AccessArticle A New TS Algorithm for Solving Low-Carbon Logistics Vehicle Routing Problem with Split Deliveries by Backpack—From a Green Operation Perspective
Int. J. Environ. Res. Public Health 2018, 15(5), 949; https://doi.org/10.3390/ijerph15050949
Received: 1 March 2018 / Revised: 5 May 2018 / Accepted: 8 May 2018 / Published: 10 May 2018
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Abstract
In order to promote the development of low-carbon logistics and economize logistics distribution costs, the vehicle routing problem with split deliveries by backpack is studied. With the help of the model of classical capacitated vehicle routing problem, in this study, a form of
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In order to promote the development of low-carbon logistics and economize logistics distribution costs, the vehicle routing problem with split deliveries by backpack is studied. With the help of the model of classical capacitated vehicle routing problem, in this study, a form of discrete split deliveries was designed in which the customer demand can be split only by backpack. A double-objective mathematical model and the corresponding adaptive tabu search (TS) algorithm were constructed for solving this problem. By embedding the adaptive penalty mechanism, and adopting the random neighborhood selection strategy and reinitialization principle, the global optimization ability of the new algorithm was enhanced. Comparisons with the results in the literature show the effectiveness of the proposed algorithm. The proposed method can save the costs of low-carbon logistics and reduce carbon emissions, which is conducive to the sustainable development of low-carbon logistics. Full article
(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)
Open AccessArticle SIMPL: A Simplified Model-Based Program for the Analysis and Visualization of Groundwater Rebound in Abandoned Mines to Prevent Contamination of Water and Soils by Acid Mine Drainage
Int. J. Environ. Res. Public Health 2018, 15(5), 951; https://doi.org/10.3390/ijerph15050951
Received: 7 April 2018 / Revised: 5 May 2018 / Accepted: 8 May 2018 / Published: 10 May 2018
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Abstract
Cessation of dewatering following underground mine closure typically results in groundwater rebound, because mine voids and surrounding strata undergo flooding up to the levels of the decant points, such as shafts and drifts. SIMPL (Simplified groundwater program In Mine workings using the Pipe
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Cessation of dewatering following underground mine closure typically results in groundwater rebound, because mine voids and surrounding strata undergo flooding up to the levels of the decant points, such as shafts and drifts. SIMPL (Simplified groundwater program In Mine workings using the Pipe equation and Lumped parameter model), a simplified lumped parameter model-based program for predicting groundwater levels in abandoned mines, is presented herein. The program comprises a simulation engine module, 3D visualization module, and graphical user interface, which aids data processing, analysis, and visualization of results. The 3D viewer facilitates effective visualization of the predicted groundwater level rebound phenomenon together with a topographic map, mine drift, goaf, and geological properties from borehole data. SIMPL is applied to data from the Dongwon coal mine and Dalsung copper mine in Korea, with strong similarities in simulated and observed results. By considering mine workings and interpond connections, SIMPL can thus be used to effectively analyze and visualize groundwater rebound. In addition, the predictions by SIMPL can be utilized to prevent the surrounding environment (water and soil) from being polluted by acid mine drainage. Full article
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Open AccessArticle Current and Potential Future Seasonal Trends of Indoor Dwelling Temperature and Likely Health Risks in Rural Southern Africa
Int. J. Environ. Res. Public Health 2018, 15(5), 952; https://doi.org/10.3390/ijerph15050952
Received: 22 March 2018 / Revised: 24 April 2018 / Accepted: 25 April 2018 / Published: 10 May 2018
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Abstract
Climate change has resulted in rising temperature trends which have been associated with changes in temperature extremes globally. Attendees of Conference of the Parties (COP) 21 agreed to strive to limit the rise in global average temperatures to below 2 °C compared to
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Climate change has resulted in rising temperature trends which have been associated with changes in temperature extremes globally. Attendees of Conference of the Parties (COP) 21 agreed to strive to limit the rise in global average temperatures to below 2 °C compared to industrial conditions, the target being 1.5 °C. However, current research suggests that the African region will be subjected to more intense heat extremes over a shorter time period, with projections predicting increases of 4–6 °C for the period 2071–2100, in annual average maximum temperatures for southern Africa. Increased temperatures may exacerbate existing chronic ill health conditions such as cardiovascular disease, respiratory disease, cerebrovascular disease, and diabetes-related conditions. Exposure to extreme temperatures has also been associated with mortality. This study aimed to consider the relationship between temperatures in indoor and outdoor environments in a rural residential setting in a current climate and warmer predicted future climate. Temperature and humidity measurements were collected hourly in 406 homes in summer and spring and at two-hour intervals in 98 homes in winter. Ambient temperature, humidity and windspeed were obtained from the nearest weather station. Regression models were used to identify predictors of indoor apparent temperature (AT) and to estimate future indoor AT using projected ambient temperatures. Ambient temperatures will increase by a mean of 4.6 °C for the period 2088–2099. Warming in winter was projected to be greater than warming in summer and spring. The number of days during which indoor AT will be categorized as potentially harmful will increase in the future. Understanding current and future heat-related health effects is key in developing an effective surveillance system. The observations of this study can be used to inform the development and implementation of policies and practices around heat and health especially in rural areas of South Africa. Full article
(This article belongs to the Special Issue Health Impacts of Warming of 1.5 °C and 2 °C)
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Open AccessArticle Sport Activity for Health!! The Effects of Karate Participants’ Involvement, Perceived Value, and Leisure Benefits on Recommendation Intention
Int. J. Environ. Res. Public Health 2018, 15(5), 953; https://doi.org/10.3390/ijerph15050953
Received: 7 April 2018 / Revised: 6 May 2018 / Accepted: 7 May 2018 / Published: 10 May 2018
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Abstract
This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that
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This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that karate participants from different places of residence do not display significant differences in involvement, perceived value, leisure benefits, and recommendation intention. Furthermore, “attraction” in the involvement category reveals the highest mean, “paid spirit and energy being worthy” in perceived value appears as the highest mean, and “physiological benefits” in leisure benefits shows the highest mean. The Pearson correlation analysis result presents significant strong positive correlations between involvement, perceived value, leisure benefits, and recommendation intention. Finally, multiple regression analysis reveals that leisure benefits, except “physiological benefits”, show notably positive effects on recommendation intention. According to the research results, suggestions are proposed for the reference of karate teaching business managers, participants, and future research. Full article
(This article belongs to the Special Issue Effect of Sport Activity on Health Promotion)
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Open AccessFeature PaperArticle Experiences and Opinions of Adults with Type 2 Diabetes Regarding a Self-Regulation-Based eHealth Intervention Targeting Physical Activity and Sedentary Behaviour
Int. J. Environ. Res. Public Health 2018, 15(5), 954; https://doi.org/10.3390/ijerph15050954
Received: 13 April 2018 / Revised: 7 May 2018 / Accepted: 7 May 2018 / Published: 10 May 2018
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Abstract
Background: Online interventions targeting a healthy lifestyle in adults with type 2 diabetes are more effective when informed by behaviour change theories. Although these theories provide guidance in developing the content of an intervention, information regarding how to present this content in an
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Background: Online interventions targeting a healthy lifestyle in adults with type 2 diabetes are more effective when informed by behaviour change theories. Although these theories provide guidance in developing the content of an intervention, information regarding how to present this content in an engaging way is often lacking. Consequently, incorporating users’ views in the creation of eHealth interventions has become an important target. Methods: Via a qualitative interview study with 21 adults with type 2 diabetes who had completed an online self-regulation-based intervention (‘MyPlan 2.0’), we assessed participants’ opinions regarding the usefulness of the implemented self-regulation techniques, the design of the programme as well as their knowledge regarding physical activity and sedentary behaviour. A directed content analysis was performed to synthesize the interview data. Results: Participants experienced difficulties completing the coping planning component. The simple design of the website was considered helpful, and most participants were aware of the beneficial effects of an active lifestyle. Conclusions: ‘MyPlan 2.0’ was well-accepted by the majority of participants. However, the coping planning component will need to be adapted. Based on these findings, recommendations on how to tailor eHealth interventions to the population of adults with type 2 diabetes have been formulated. Full article
(This article belongs to the Special Issue Sedentary Behaviour and Health)
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Open AccessArticle Single Mothers’ Experiences with Pregnancy and Child Rearing in Korea: Discrepancy between Social Services/Policies and Single Mothers’ Needs
Int. J. Environ. Res. Public Health 2018, 15(5), 955; https://doi.org/10.3390/ijerph15050955
Received: 12 March 2018 / Revised: 4 May 2018 / Accepted: 8 May 2018 / Published: 10 May 2018
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Abstract
This study aims to explore single mothers’ experiences with social services/policies for their independent living and to identify gaps between these experiences and the needs of single mothers. A focus group discussion was performed to collect data. Seven single mothers discussed their experiences
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This study aims to explore single mothers’ experiences with social services/policies for their independent living and to identify gaps between these experiences and the needs of single mothers. A focus group discussion was performed to collect data. Seven single mothers discussed their experiences in significant periods of their lives: pregnancy, childbirth, and parenting. Findings from the qualitative thematic analysis show discrepancies between the direction of social services/policies and single mothers’ needs, in terms of difficulties in healthcare, childcare, housing, employment, and income security. To the single mothers in this study, the social safety net is not inclusive, compared to that which is available to two-parent families or adoptive families. It is necessary to intervene in current blind spots of services/policies for single mothers, and to provide a social safety net to strengthen single mothers’ self-reliance and their children’s social security in the long term. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle A Case–Control Study of Socio-Economic and Nutritional Characteristics as Determinants of Dental Caries in Different Age Groups, Considered as Public Health Problem: Data from NHANES 2013–2014
Int. J. Environ. Res. Public Health 2018, 15(5), 957; https://doi.org/10.3390/ijerph15050957
Received: 14 April 2018 / Revised: 25 April 2018 / Accepted: 26 April 2018 / Published: 10 May 2018
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Abstract
One of the principal conditions that affects oral health worldwide is dental caries, occurring in about 90% of the global population. This pathology has been considered a challenge because of its high prevalence, besides being a chronic but preventable disease which can be
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One of the principal conditions that affects oral health worldwide is dental caries, occurring in about 90% of the global population. This pathology has been considered a challenge because of its high prevalence, besides being a chronic but preventable disease which can be caused by a series of different demographic, dietary, among others. Based on this problem, in this research a demographic and dietary features analysis is performed for the classification of subjects according to their oral health status based on caries, according to the age group where the population belongs, using as feature selector a technique based on fast backward selection (FBS) approach for the development of three predictive models, one for each age range (group 1: 10–19; group 2: 20–59; group 3: 60 or more years old). As validation, a net reclassification improvement (NRI), AUC, ROC, and OR values are used to evaluate their classification accuracy. We analyzed 189 demographic and dietary features from National Health and Nutrition Examination Survey (NHANES) 2013–2014. Each model obtained statistically significant results for most features and narrow OR confidence intervals. Age group 2 obtained a mean NRI = −0.080 and AUC = 0.933; age group 3 obtained a mean NRI = −0.024 and AUC = 0.787; and age group 4 obtained a mean NRI = −0.129 and AUC = 0.735. Based on these results, it is concluded that these specific demographic and dietary features are significant determinants for estimating the oral health status in patients based on their likelihood of developing caries, and the age group could imply different risk factors for subjects. Full article
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Open AccessArticle Does Type 1 Diabetes Modify Sexuality and Mood of Women and Men?
Int. J. Environ. Res. Public Health 2018, 15(5), 958; https://doi.org/10.3390/ijerph15050958
Received: 6 April 2018 / Revised: 2 May 2018 / Accepted: 8 May 2018 / Published: 11 May 2018
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Abstract
Background: Sexual disorders occurring in women and men with type 1 diabetes have not been sufficiently investigated and described until now. This study attempts to evaluate sexuality in women and men. Methods: Altogether, the study comprised 115 patients with type 1 diabetes and
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Background: Sexual disorders occurring in women and men with type 1 diabetes have not been sufficiently investigated and described until now. This study attempts to evaluate sexuality in women and men. Methods: Altogether, the study comprised 115 patients with type 1 diabetes and 105 healthy people constituting the control group. All the studied persons underwent survey studies determining sexuality using the Female Sexual Function Index (FSFI-19) in women and the International Index of Erectile Function (IIEF-15) in men, and the occurrence of depression using the Beck Depression Inventory. The acceptance of illness among patients with diabetes was examined using the Acceptance of Illness Scale questionnaire. Results: In 35% of the examined women with diabetes, the study demonstrated sexual dysfunction as determined by total FSFI. The point values of all the investigated FSFI domains were significantly lower in women with diabetes than in healthy ones (p < 0.001). Erectile dysfunction occurred in 50% of the studied men with diabetes and in 23% of the control group of men (p = 0.0017). Conclusions: Type 1 diabetes leads to sexual disorders which occur in 1/3 of women and in 1/2 of men. Sexual disorders in patients with diabetes more frequently occur in men, persons with coexisting complications of diabetes, and in those with a concentration of glycated hemoglobin higher than 6.5%. Full article
(This article belongs to the collection Health Care and Diabetes)
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Open AccessArticle Advice and Frequently Asked Questions (FAQs) for Citizen-Science Environmental Health Assessments
Int. J. Environ. Res. Public Health 2018, 15(5), 960; https://doi.org/10.3390/ijerph15050960
Received: 29 March 2018 / Revised: 2 May 2018 / Accepted: 9 May 2018 / Published: 11 May 2018
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Abstract
Citizen science provides quantitative results to support environmental health assessments (EHAs), but standardized approaches do not currently exist to translate findings into actionable solutions. The emergence of low-cost portable sensor technologies and proliferation of publicly available datasets provides unparalleled access to supporting evidence;
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Citizen science provides quantitative results to support environmental health assessments (EHAs), but standardized approaches do not currently exist to translate findings into actionable solutions. The emergence of low-cost portable sensor technologies and proliferation of publicly available datasets provides unparalleled access to supporting evidence; yet data collection, analysis, interpretation, visualization, and communication are subjective approaches that must be tailored to a decision-making audience capable of improving environmental health. A decade of collaborative efforts and two citizen science projects contributed to three lessons learned and a set of frequently asked questions (FAQs) that address the complexities of environmental health and interpersonal relations often encountered in citizen science EHAs. Each project followed a structured step-by-step process in order to compare and contrast methods and approaches. These lessons and FAQs provide advice to translate citizen science research into actionable solutions in the context of a diverse range of environmental health issues and local stakeholders. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Dietary Differences in Male Workers among Smaller Occupational Groups within Large Occupational Categories: Findings from the Japan Environment and Children’s Study (JECS)
Int. J. Environ. Res. Public Health 2018, 15(5), 961; https://doi.org/10.3390/ijerph15050961
Received: 29 March 2018 / Revised: 24 April 2018 / Accepted: 4 May 2018 / Published: 11 May 2018
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Abstract
Studies examining workers’ diet according to smaller occupational groups within “large occupational categories” are sparse. The aim of this study was to examine the potential differences in workers’ diets based on the classification of workers into smaller occupational groups that comprise “large occupational
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Studies examining workers’ diet according to smaller occupational groups within “large occupational categories” are sparse. The aim of this study was to examine the potential differences in workers’ diets based on the classification of workers into smaller occupational groups that comprise “large occupational categories”. The subjects of this study were working fathers who had participated in the Japan Environment and Children’s Study (N = 38,656). Energy and nutrient intake were calculated based on data collected from the Food Frequency Questionnaire. Occupations were classified according to the Japanese Standard Occupational Classification. Logistic regression analyses were performed to examine the adherence to current dietary recommendations within smaller occupational groups. In particular, significant differences were observed among the categorical groups of “professional and engineering workers”, “service workers”, and “agricultural, forestry, and fishery workers”. In “professional and engineering workers”, teachers showed higher odds of adherence to calcium intake recommendations compared with nurses (OR, 2.54; 95% CI, 2.02–3.14; p < 0.001). In “agricultural, forestry, and fishery workers”, agriculture workers showed higher odds of adherence to calcium (OR, 2.15; 95% CI, 1.46–3.15; p < 0.001) and vitamin C (OR 1.90, 95% CI 1.31–2.74, p = 0.001) intake recommendations compared with forestry and fishery workers. These findings may be beneficial from a research perspective as well as in the development of more effective techniques to improve workers’ diet and health. Full article
(This article belongs to the Special Issue Occupational Epidemiology)
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Open AccessArticle A Cost Benefit Analysis of an Active Travel Intervention with Health and Carbon Emission Reduction Benefits
Int. J. Environ. Res. Public Health 2018, 15(5), 962; https://doi.org/10.3390/ijerph15050962
Received: 30 March 2018 / Revised: 6 May 2018 / Accepted: 6 May 2018 / Published: 11 May 2018
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Abstract
Active travel (walking and cycling) is beneficial for people’s health and has many co-benefits, such as reducing motor vehicle congestion and pollution in urban areas. There have been few robust evaluations of active travel, and very few studies have valued health and emissions
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Active travel (walking and cycling) is beneficial for people’s health and has many co-benefits, such as reducing motor vehicle congestion and pollution in urban areas. There have been few robust evaluations of active travel, and very few studies have valued health and emissions outcomes. The ACTIVE before-and-after quasi-experimental study estimated the net benefits of health and other outcomes from New Zealand’s Model Communities Programme using an empirical analysis comparing two intervention cities with two control cities. The Programme funded investment in cycle paths, other walking and cycling facilities, cycle parking, ‘shared spaces’, media campaigns and events, such as ‘Share the Road’, and cycle-skills training. Using the modified Integrated Transport and Health Impacts Model, the Programme’s net economic benefits were estimated from the changes in use of active travel modes. Annual benefits for health in the intervention cities were estimated at 34.4 disability-adjusted life years (DALYs) and two lives saved due to reductions in cardiac disease, diabetes, cancer, and respiratory disease. Reductions in transport-related carbon emissions were also estimated and valued. Using a discount rate of 3.5%, the estimated benefit/cost ratio was 11:1 and was robust to sensitivity testing. It is concluded that when concerted investment is made in active travel in a city, there is likely to be a measurable, positive return on investment. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Biodegradation of Di-(2-ethylhexyl) Phthalate by Rhodococcus ruber YC-YT1 in Contaminated Water and Soil
Int. J. Environ. Res. Public Health 2018, 15(5), 964; https://doi.org/10.3390/ijerph15050964
Received: 6 February 2018 / Revised: 29 April 2018 / Accepted: 3 May 2018 / Published: 11 May 2018
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Abstract
Di-(2-ethylehxyl) phthalate (DEHP) is one of the most broadly representative phthalic acid esters (PAEs) used as a plasticizer in polyvinyl chloride (PVC) production, and is considered to be an endocrine-disrupting chemical. DEHP and its monoester metabolites are responsible for adverse effects on human
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Di-(2-ethylehxyl) phthalate (DEHP) is one of the most broadly representative phthalic acid esters (PAEs) used as a plasticizer in polyvinyl chloride (PVC) production, and is considered to be an endocrine-disrupting chemical. DEHP and its monoester metabolites are responsible for adverse effects on human health. An efficient DEHP-degrading bacterial strain Rhodococcus ruber YC-YT1, with super salt tolerance (0–12% NaCl), is the first DEHP-degrader isolated from marine plastic debris found in coastal saline seawater. Strain YC-YT1 completely degraded 100 mg/L DEHP within three days (pH 7.0, 30 °C). According to high-performance liquid chromatography–mass spectrometry (HPLC-MS) analysis, DEHP was transformed by strain YC-YT1 into phthalate (PA) via mono (2-ethylehxyl) phthalate (MEHP), then PA was used for cell growth. Furthermore, YC-YT1 metabolized initial concentrations of DEHP ranging from 0.5 to 1000 mg/L. Especially, YC-YT1 degraded up to 60% of the 0.5 mg/L initial DEHP concentration. Moreover, compared with previous reports, strain YC-YT1 had the largest substrate spectrum, degrading up to 13 kinds of PAEs as well as diphenyl, p-nitrophenol, PA, benzoic acid, phenol, protocatechuic acid, salicylic acid, catechol, and 1,2,3,3-tetrachlorobenzene. The excellent environmental adaptability of strain YC-YT1 contributed to its ability to adjust its cell surface hydrophobicity (CSH) so that 79.7–95.9% of DEHP-contaminated agricultural soil, river water, coastal sediment, and coastal seawater were remedied. These results demonstrate that R. ruber YC-YT1 has vast potential to bioremediate various DEHP-contaminated environments, especially in saline environments. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Sludge Biochar Amendment and Alfalfa Revegetation Improve Soil Physicochemical Properties and Increase Diversity of Soil Microbes in Soils from a Rare Earth Element Mining Wasteland
Int. J. Environ. Res. Public Health 2018, 15(5), 965; https://doi.org/10.3390/ijerph15050965
Received: 26 March 2018 / Revised: 27 April 2018 / Accepted: 2 May 2018 / Published: 11 May 2018
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Abstract
Long-term unregulated mining of ion-adsorption clays (IAC) in China has resulted in severe ecological destruction and created large areas of wasteland in dire need of rehabilitation. Soil amendment and revegetation are two important means of rehabilitation of IAC mining wasteland. In this study,
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Long-term unregulated mining of ion-adsorption clays (IAC) in China has resulted in severe ecological destruction and created large areas of wasteland in dire need of rehabilitation. Soil amendment and revegetation are two important means of rehabilitation of IAC mining wasteland. In this study, we used sludge biochar prepared by pyrolysis of municipal sewage sludge as a soil ameliorant, selected alfalfa as a revegetation plant, and conducted pot trials in a climate-controlled chamber. We investigated the effects of alfalfa revegetation, sludge biochar amendment, and their combined amendment on soil physicochemical properties in soil from an IAC mining wasteland as well as the impact of sludge biochar on plant growth. At the same time, we also assessed the impacts of these amendments on the soil microbial community by means of the Illumina Miseq sequences method. Results showed that alfalfa revegetation and sludge biochar both improved soil physicochemical properties and microbial community structure. When alfalfa revegetation and sludge biochar amendment were combined, we detected additive effects on the improvement of soil physicochemical properties as well as increases in the richness and diversity of bacterial and fungal communities. Redundancy analyses suggested that alfalfa revegetation and sludge biochar amendment significantly affected soil microbial community structure. Critical environmental factors consisted of soil available K, pH, organic matter, carbon–nitrogen ratio, bulk density, and total porosity. Sludge biochar amendment significantly promoted the growth of alfalfa and changed its root morphology. Combining alfalfa the revegetation with sludge biochar amendment may serve to not only achieve the revegetation of IAC mining wasteland, but also address the challenge of municipal sludge disposal by making the waste profitable. Full article
(This article belongs to the Section Environmental Science and Engineering)
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