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Int. J. Environ. Res. Public Health, Volume 15, Issue 8 (August 2018)

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Open AccessArticle Insight into Patients’ Experiences of Cancer Care in Taiwan: An Instrument Translation and Cross-Cultural Adaptation Study
Int. J. Environ. Res. Public Health 2018, 15(8), 1772; https://doi.org/10.3390/ijerph15081772 (registering DOI)
Received: 18 July 2018 / Revised: 9 August 2018 / Accepted: 14 August 2018 / Published: 17 August 2018
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Abstract
Background: Since Taiwan launched the Cancer Prevention Act in 2003, several prevention strategies and early detection programs have been implemented to reduce the incidence, morbidity and mortality rates of cancer. However, most of the programs have concentrated on healthcare providers. Evaluations from
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Background: Since Taiwan launched the Cancer Prevention Act in 2003, several prevention strategies and early detection programs have been implemented to reduce the incidence, morbidity and mortality rates of cancer. However, most of the programs have concentrated on healthcare providers. Evaluations from the patient’s perspective have been lacking. Thus, in this study a cancer patient experience questionnaire was developed in the Taiwanese context and a preliminary nationwide investigation was conducted on the status of cancer care from the patient’s perspective. Methods: An extensive literature review was first conducted to collect information on the existing instruments used to measure the cancer patient’s experience. Thereafter, a multidisciplinary expert panel was convened to select an optimal instrument based on the IOM’s six domains for evaluating patient-centered care. The European Organisation for Research and Treatment of Cancer (EORTC) translation procedure was applied to the questionnaire for cross-cultural adaptation. A nationwide field test was then implemented at certificated cancer care hospitals. Results: Fifteen questionnaires were collected for the literature review. The expert panel selected the National Cancer Patient Experience Survey based on the IOM’s recommendations. After cross-cultural translation of the questionnaire, a total of 4000 questionnaires were administered in 19 certificated cancer care hospitals and two major cancer patient associations, with 1010 being returned (25.25% response rate). Most of the respondents were middle-aged, and 70% were female. The respondents reported they had a good experience with cancer care, except for “Home care and support” and “Finding out what was wrong with you”. Stratified analysis was conducted, with the results showing that the cancer patients’ experiences varied depending on their sociodemographic and cancer-related characteristics. Conclusions: A Taiwanese version of the cancer patient experience survey questionnaire was developed. Its results showed that the cancer patient’s experiences varied, depending on the patient’s age, cancer type, and cancer history. This study can be used as a basis to establish a patient-centered care model for cancer care in Taiwan. Full article
(This article belongs to the Section Health Services and Health Economics Research)
Open AccessFeature PaperArticle Short-Term Effects of Heat on Mortality and Effect Modification by Air Pollution in 25 Italian Cities
Int. J. Environ. Res. Public Health 2018, 15(8), 1771; https://doi.org/10.3390/ijerph15081771 (registering DOI)
Received: 1 July 2018 / Revised: 13 August 2018 / Accepted: 14 August 2018 / Published: 17 August 2018
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Abstract
Evidence on the health effects of extreme temperatures and air pollution is copious. However few studies focused on their interaction. The aim of this study is to evaluate daily PM10 and ozone as potential effect modifiers of the relationship between temperature and natural
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Evidence on the health effects of extreme temperatures and air pollution is copious. However few studies focused on their interaction. The aim of this study is to evaluate daily PM10 and ozone as potential effect modifiers of the relationship between temperature and natural mortality in 25 Italian cities. Time-series analysis was run for each city. To evaluate interaction, a tensor product between mean air temperature (lag 0–3) and either PM10 or ozone (both lag 0–5) was defined and temperature estimates were extrapolated at low, medium, and high levels of pollutants. Heat effects were estimated as percent change in mortality for increases in temperature between 75th and 99th percentiles. Results were pooled by geographical area. Differential temperature-mortality risks by air pollutants were found. For PM10, estimates ranged from 3.9% (low PM10) to 14.1% (high PM10) in the North, from 3.6% to 24.4% in the Center, and from 7.5% to 21.6% in the South. Temperature-related mortality was similarly modified by ozone in northern and central Italy, while no effect modification was observed in the South. This study underlines the synergistic effects of heat and air pollution on mortality. Considering the predicted increase in heat waves and stagnation events in the Mediterranean countries such as Italy, it is time to enclose air pollution within public health heat prevention plans. Full article
(This article belongs to the Special Issue Climate Change, Extreme Temperatures, Air Pollution, and Health)
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Open AccessArticle Association of Bisphenol A Exposure with LINE-1 Hydroxymethylation in Human Semen
Int. J. Environ. Res. Public Health 2018, 15(8), 1770; https://doi.org/10.3390/ijerph15081770 (registering DOI)
Received: 22 July 2018 / Revised: 11 August 2018 / Accepted: 16 August 2018 / Published: 17 August 2018
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Abstract
Bisphenol A (BPA), an exogenous endocrine-disrupting chemical, has been shown to alter DNA methylation. However, little information is available about the effect of BPA exposure on DNA hydroxymethylation in humans. The objective of the present study was to examine whether BPA exposure was
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Bisphenol A (BPA), an exogenous endocrine-disrupting chemical, has been shown to alter DNA methylation. However, little information is available about the effect of BPA exposure on DNA hydroxymethylation in humans. The objective of the present study was to examine whether BPA exposure was associated with DNA hydroxymethylation in human semen samples. We measured urine BPA levels and LINE-1 hydroxymethylation in 158 male factory workers selected from an occupational cohort study conducted in China between 2004 and 2008. Among them, there were 72 male workers with occupational BPA exposure (BPA-exposed group) and 86 male workers without occupational BPA exposure (unexposed group). Multivariate linear regression models were used to examine the association of exposure to BPA with LINE-1 hydroxymethylation. LINE-1 was more highly hydroxymethylated in the BPA-exposed group than in the unexposed group (median 12.97% vs. 9.68%, respectively; p < 0.05), after adjusting for the potential confounders. The medians of 5-hydroxymethylcytosine (5hmC) generally increased with increasing urine BPA levels: 8.79%, 12.16%, 11.53%, and 13.45%, for undetected BPA and corresponding tertiles for the detected BPA, respectively. After analysis using data at individual level, our findings indicated that BPA exposure was associated with alterations of sperm LINE-1 hydroxymethylation, which might have implications for understanding the mechanisms underlying BPA-induced adverse effects on male reproductive function. Full article
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Open AccessArticle Effect of Hypothermia in the Emergency Department on the Outcome of Trauma Patients: A Cross-Sectional Analysis
Int. J. Environ. Res. Public Health 2018, 15(8), 1769; https://doi.org/10.3390/ijerph15081769 (registering DOI)
Received: 11 June 2018 / Revised: 31 July 2018 / Accepted: 11 August 2018 / Published: 17 August 2018
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Abstract
This study aimed to assess whether hypothermia is an independent predictor of mortality in trauma patients in the condition of defining hypothermia as body temperatures of <36 °C. Data of all hospitalized adult trauma patients recorded in the Trauma Registry System at a
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This study aimed to assess whether hypothermia is an independent predictor of mortality in trauma patients in the condition of defining hypothermia as body temperatures of <36 °C. Data of all hospitalized adult trauma patients recorded in the Trauma Registry System at a level I trauma center between 1 January 2009 and 12 December 2015 were retrospectively reviewed. A multivariate logistic regression analysis was performed in order to identify factors related to mortality. In addition, hypothermia and normothermia were defined as temperatures <36 °C and from 36 °C to 38 °C, respectively. Propensity score-matched study groups of hypothermia and normothermia patients in a 1:1 ratio were grouped for mortality assessment after adjusting for potential confounders such as age, sex, preexisting comorbidities, and injury severity score (ISS). Of 23,705 enrolled patients, a total of 401 hypothermic patients and 13,368 normothermic patients were included in this study. Only 3.0% of patients had hypothermia upon arrival at the emergency department (ED). Compared to normothermic patients, hypothermic patients had a significantly higher rate of abbreviated injury scale (AIS) scores of ≥3 in the head/neck, thorax, and abdomen and higher ISS. The mortality rate in hypothermic patients was significantly higher than that in normothermic patients (13.5% vs. 2.3%, odds ratio (OR): 6.6, 95% confidence interval (CI): 4.86–9.01, p < 0.001). Of the 399 well-balanced propensity score-matched pairs, there was no significant difference in mortality (13.0% vs. 9.3%, OR: 1.5, 95% CI: 0.94–2.29, p = 0.115). However, multivariate logistic regression analysis revealed that patients with low body temperature were significantly associated with the mortality outcome. This study revealed that low body temperature is associated with the mortality outcome in the multivariate logistic regression analysis but not in the propensity score matching (PSM) model that compared patients with hypothermia defined as body temperatures of <36 °C to those who had normothermia. These contradicting observations indicated the limitation of the traditional definition of body temperature for the diagnosis of hypothermia. Prospective randomized control trials are needed to determine the relationship between hypothermia following trauma and the clinical outcome. Full article
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Open AccessConference Report Academic Response to Storm-Related Natural Disasters—Lessons Learned
Int. J. Environ. Res. Public Health 2018, 15(8), 1768; https://doi.org/10.3390/ijerph15081768 (registering DOI)
Received: 5 July 2018 / Revised: 12 August 2018 / Accepted: 14 August 2018 / Published: 17 August 2018
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Abstract
On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in
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On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in Puerto Rico, Florida, and Texas. The presenters reviewed emergency response measures taken by their institutions to maintain community health care access and delivery, the storm-related impact on clinical and research infrastructure, and strategies to retain locally grown clinical expertise and translational science research talent in the aftermath of natural disasters. A longer-term perspective was provided through a comparative review of lessons learned by one New Orleans-based institution (now more than a decade post-storm) in the aftermath of Hurricane Katrina. Caring for the internal and external communities associated with each institution and addressing the health disparities exacerbated by storm-related events is one key strategy that will pay long-term dividends in the survival of the academic institutions and the communities they serve. Full article
Open AccessArticle Ethiopian Orthodox Fasting and Lactating Mothers: Longitudinal Study on Dietary Pattern and Nutritional Status in Rural Tigray, Ethiopia
Int. J. Environ. Res. Public Health 2018, 15(8), 1767; https://doi.org/10.3390/ijerph15081767 (registering DOI)
Received: 29 June 2018 / Revised: 28 July 2018 / Accepted: 10 August 2018 / Published: 17 August 2018
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Abstract
About half of Ethiopians belong to the Orthodox Tewahedo religion. Annually, more than 200 days are dedicated to religious fasting, which includes abstaining from all types of food, animal source foods, and water. However, the association of fasting with undernutrition remains unknown in
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About half of Ethiopians belong to the Orthodox Tewahedo religion. Annually, more than 200 days are dedicated to religious fasting, which includes abstaining from all types of food, animal source foods, and water. However, the association of fasting with undernutrition remains unknown in Ethiopia. Therefore, dietary pattern and nutritional status of lactating women during lent fasting and non-fasting periods were studied, and predictor variables for maternal underweight were identified. To achieve this, lactating mothers in lent fasting (N = 572) and non-fasting (N = 522) periods participated from rural Tigray, Northern Ethiopia. Average minimum diet diversity (MDD-W) was computed from two 24-h recalls, and nutritional status was assessed using body mass index (BMI). Binary logistic regression was used to identify potential predictors of maternal underweight. Wilcoxon signed-rank (WSRT) and McNemar’s tests were used for comparison of the two periods. The prevalence of underweight in fasting mothers was 50.6%. In the multivariate logistic regression model, younger age, sickness in the last four weeks preceding the survey, fasting during pregnancy, lactation periods, grandfathers’ as household decision makers, previous aid experience, non-improved water source, and not owning chicken were positively associated with maternal underweight. In WSRT, there was no significant (p > 0.05) difference on maternal body weight and BMI between periods. The average number of meals, diet diversity, and animal source foods (ASFs), consumption scores were significantly increased in non-fasting compared to fasting periods in both fasting and non-fasting mothers (p < 0.001, p < 0.05, and p < 0.001, respectively). Consumption of dark green leafy vegetables was higher in the fasting period (11%) than non-fasting (3.6%), in the study population. As a conclusion, Ethiopian Orthodox fasting negatively affected maternal nutritional status and dietary pattern in rural Tigray, Northern Ethiopia. To reduce maternal malnutrition in Ethiopia, existing multi-sectoral nutrition intervention strategies, should include religious institutions in a sustainable manner. Full article
Open AccessArticle Food Insecurity among Older Aboriginal and Torres Strait Islanders
Int. J. Environ. Res. Public Health 2018, 15(8), 1766; https://doi.org/10.3390/ijerph15081766 (registering DOI)
Received: 27 June 2018 / Revised: 6 August 2018 / Accepted: 10 August 2018 / Published: 17 August 2018
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Abstract
It is well established that Indigenous populations are at a heightened risk of food insecurity. Yet, although populations (both Indigenous and non-Indigenous) are ageing, little is understood about the levels of food insecurity experienced by older Indigenous peoples. Using Australian data, this study
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It is well established that Indigenous populations are at a heightened risk of food insecurity. Yet, although populations (both Indigenous and non-Indigenous) are ageing, little is understood about the levels of food insecurity experienced by older Indigenous peoples. Using Australian data, this study examined the prevalence and correlates of food insecurity among older Aboriginal and Torres Strait Islanders. Using nationally representative data, we employed ordinal logistic regression models to investigate the association between socio-demographic characteristics and food insecurity. We found that 21% of the older Aboriginal and Torres Strait Islander population were food insecure, with 40% of this group exposed to food insecurity with food depletion and inadequate intake. This places this population at a 5 to 7-fold risk of experiencing food insecurity relative to their older non-Indigenous peers. Measures of geography, language and low socio-economic status were highly associated with exposure to food insecurity. Addressing food insecurity offers one pathway to reduce the disparity in health outcomes between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Policies that consider both remote and non-remote Australia, as well as those that involve Aboriginal people in their design and implementation are needed to reduce food insecurity. Full article
(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)
Open AccessArticle Methylmercury in Industrial Harbor Sediments in Taiwan: First Observations on its Occurrence, Distribution, and Measurement
Int. J. Environ. Res. Public Health 2018, 15(8), 1765; https://doi.org/10.3390/ijerph15081765
Received: 2 August 2018 / Revised: 14 August 2018 / Accepted: 15 August 2018 / Published: 16 August 2018
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Abstract
The distribution of methylmercury (MeHg) and total mercury (T-Hg) in sediments of the estuaries and the basin in Kaohsiung Harbor (Taiwan) is studied. MeHg in the sediment samples was determined using gas chromatography-mass spectrometry. The certified reference material of sediments with respect to
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The distribution of methylmercury (MeHg) and total mercury (T-Hg) in sediments of the estuaries and the basin in Kaohsiung Harbor (Taiwan) is studied. MeHg in the sediment samples was determined using gas chromatography-mass spectrometry. The certified reference material of sediments with respect to the method showed the recovery efficiency between 97.4 and 103.6% which confirmed the applicability of analysis method. The T-Hg and MeHg concentrations were between 149 to 9035 μg/kg and <0.31 to 17.7 μg/kg, respectively. The T-Hg and MeHg concentrations in the estuaries of Kaohsiung Harbor were relatively high. Results suggest that Hg in this studied area was likely contributed from the catchments of the rivers. The MeHg level was <0.01 to 2.66% of the T-Hg in the sediments. A positive correlation is obtained between MeHg, T-Hg, and total organic carbon in the sediments, whereas a negative correlation is observed between pH, oxidation-reduction potential, and MeHg concentration. The results further suggest that sediment characteristics contribute mainly to the distribution of MeHg. Full article
Open AccessReview Moderators of School-Based Physical Activity Interventions on Cardiorespiratory Endurance in Primary School-Aged Children: A Meta-Regression
Int. J. Environ. Res. Public Health 2018, 15(8), 1764; https://doi.org/10.3390/ijerph15081764
Received: 10 July 2018 / Revised: 1 August 2018 / Accepted: 14 August 2018 / Published: 16 August 2018
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Abstract
The purpose of this study was to examine potential moderators of school-based physical activity interventions on cariorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past
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The purpose of this study was to examine potential moderators of school-based physical activity interventions on cariorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past 30 years. Studies were included if there was a control or comparison group, if the study sample included primary school-aged children, if the targeted outcome of cardiorespiratory endurance was objectively assessed, if the intervention was at least partially school-based, and if the effect estimate’s variability was reported. An inverse-variance random effects meta-regression was employed using the primary predictors of component number (single component or multi-component) and intervention length using 20 extracted studies with 23 total effects. The overall pooled effect on cardiorespiratory endurance was statistically significant (Hedges’ g = 0.30, 95% C.I.: 0.19–0.40; p < 0.001). Using random effects meta-regression, neither component number (b = −0.09, 95% C.I.: −0.40–0.23; p = 0.560) or intervention length (b = 0.001, 95% C.I.: −0.002–0.004; p = 0.427) yielded a significant modifying effect on cardiorespiratory endurance. School-based physical activity interventions have a significant pooled effect on cardiorespiratory endurance in primary school-aged children. Component number and intervention length does not modify this effect, suggesting other sources for between-study heterogeneity. Full article
(This article belongs to the collection Physical Activity and Public Health)
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Open AccessArticle Exploring the Relationship between Ridesharing and Public Transit Use in the United States
Int. J. Environ. Res. Public Health 2018, 15(8), 1763; https://doi.org/10.3390/ijerph15081763
Received: 24 July 2018 / Revised: 11 August 2018 / Accepted: 14 August 2018 / Published: 16 August 2018
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Abstract
Car travel accounts for the largest share of transportation-related greenhouse gas emissions in the United States (U.S.), leading to serious air pollution and negative health effects; approximately 76.3% of car trips are single-occupant. To reduce the negative externalities of cars, ridesharing and public
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Car travel accounts for the largest share of transportation-related greenhouse gas emissions in the United States (U.S.), leading to serious air pollution and negative health effects; approximately 76.3% of car trips are single-occupant. To reduce the negative externalities of cars, ridesharing and public transit are advocated as cost-effective and more environmentally sustainable alternatives. A better understanding of individuals’ uses of these two transport modes and their relationship is important for transport operators and policymakers; however, it is not well understood how ridesharing use is associated with public transit use. The objective of this study is to examine the relationships between the frequency and probability of ridesharing use and the frequency of public transit use in the U.S. Zero-inflated negative binomial regression models were employed to investigate the associations between these two modes, utilizing individual-level travel frequency data from the 2017 National Household Travel Survey. The survey data report the number of times the respondent had used ridesharing and public transit in the past 30 days. The results show that, generally, a one-unit increase in public transit use is significantly positively related to a 1.2% increase in the monthly frequency of ridesharing use and a 5.7% increase in the probability of ridesharing use. Additionally, the positive relationship between ridesharing and public transit use was more pronounced for people who live in areas with a high population density or in households with fewer vehicles. These findings highlight the potential for integrating public transit and ridesharing systems to provide easier multimodal transportation, promote the use of both modes, and enhance sustainable mobility, which are beneficial for the environment and public health. Full article
(This article belongs to the Special Issue Transportation-Related Air Pollution and Human Health)
Open AccessArticle Drivers Analysis of CO2 Emissions from the Perspective of Carbon Density: The Case of Shandong Province, China
Int. J. Environ. Res. Public Health 2018, 15(8), 1762; https://doi.org/10.3390/ijerph15081762
Received: 5 July 2018 / Revised: 9 August 2018 / Accepted: 13 August 2018 / Published: 16 August 2018
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Abstract
Against the backgrounds of emission reduction targets promised by China, it is crucial to explore drivers of CO2 emissions comprehensively for policy making. In this study, Shandong Province in China is taken as an example to investigate drivers in carbon density by
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Against the backgrounds of emission reduction targets promised by China, it is crucial to explore drivers of CO2 emissions comprehensively for policy making. In this study, Shandong Province in China is taken as an example to investigate drivers in carbon density by using an extended Kaya identity and a logarithmic mean Divisia index model (LMDI) with two layers. It is concluded that there are eight positive driving factors of carbon density during 2000–2015, including traffic congestion, land urbanization, etc., and seven negative driving factors comprising energy intensity, economic structure, etc. Among these factors, economic growth and energy intensity are the main positive and negative driving factor, respectively. The contribution rate of traffic congestion and land urbanization is gradually increasing. Meanwhile, 15 driving factors are divided into five categories. Economic effect and urbanization effect are the primary positive drivers. Contrarily, energy intensity effect, structural effect, and scale effect contribute negative effects to the changes in carbon density. In the four stages, the contribution of urbanization to carbon density is inverted U. Overall, the results and suggestions can give support to decision maker to draw up relevant government policy. Full article
(This article belongs to the Section Environmental Science and Engineering)
Open AccessArticle Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure
Int. J. Environ. Res. Public Health 2018, 15(8), 1761; https://doi.org/10.3390/ijerph15081761
Received: 17 July 2018 / Revised: 6 August 2018 / Accepted: 14 August 2018 / Published: 16 August 2018
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Abstract
As with all other chronic noncommunicable diseases, adequate health literacy plays a key role in making the right decisions in the treatment of heart failure. Patients with heart failure and a lower health literacy have a reduced quality of life. A cross-sectional study
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As with all other chronic noncommunicable diseases, adequate health literacy plays a key role in making the right decisions in the treatment of heart failure. Patients with heart failure and a lower health literacy have a reduced quality of life. A cross-sectional study among 200 patients with heart failure was conducted at a state university hospital in Belgrade, Serbia. The European Health Literacy Questionnaire, HLS-EU-Q47, was used to assess health literacy. Quality of life was measured with the generic SF-36 and the Minnesota Living with Heart Failure Questionnaire. Descriptive and analytical statistical analysis was applied. More than half of the respondents (64%) had limited health literacy. The lowest mean health literacy index (28.01 ± 9.34) was within the disease prevention dimension, where the largest number of respondents showed limited health literacy (70%). Our patients had a poorer quality of life in the physical dimension, and the best scores were identified in the emotional role and social functioning. Health literacy was highly statistically significant and an independent predictor of quality of life (physical, mental, and total quality of life). Improving health literacy can lead to better decisions in the treatment of disease and quality of life in heart failure patients. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Youth and Adult Visitation and Physical Activity Intensity at Rural and Urban Parks
Int. J. Environ. Res. Public Health 2018, 15(8), 1760; https://doi.org/10.3390/ijerph15081760
Received: 30 July 2018 / Accepted: 15 August 2018 / Published: 16 August 2018
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Abstract
Less physical activity among rural residents may contribute to rural-urban health disparities. Parks can be ideal community resources for promoting physical activity. This study compared park visitation and activity intensity at 15 urban and 15 rural parks matched for acreage and amenities. Parks
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Less physical activity among rural residents may contribute to rural-urban health disparities. Parks can be ideal community resources for promoting physical activity. This study compared park visitation and activity intensity at 15 urban and 15 rural parks matched for acreage and amenities. Parks were observed in the morning, afternoon, and evening on 4 days to determine number of visitors, activity intensity, and amenity use. A total of 5486 visitors were observed with no differences in percentages of males (55.5% vs. 53.9%) and females (44.5% vs. 46.1%) or percentages of weekday (82.4% vs. 81.9%) and weekend (17.6% vs. 18.1%) visitors. The probability of visitors sitting was greater and in moderate intensity activity lower at rural parks. A greater proportion of children (25.0% vs. 14.5%) in rural parks, and teens in urban parks (8.0% vs. 69.6%), were observed on sport fields. A greater proportion of adults in urban areas (12.5% vs. 46.0%) were observed spectating sports. Greater proportions of rural children (10.9% vs. 3.5%), teens (34.1% vs. 12.4%), and adults (38.9% vs. 10.1%) were observed using shelters. Thus, when similar amenities are available, rural and urban parks are used differently, especially by youth. The urban park study results cannot be wholly applied to rural parks. Full article
(This article belongs to the collection Physical Activity and Public Health)
Open AccessArticle Migration and Fate of Acid Mine Drainage Pollutants in Calcareous Soil
Int. J. Environ. Res. Public Health 2018, 15(8), 1759; https://doi.org/10.3390/ijerph15081759
Received: 6 July 2018 / Revised: 2 August 2018 / Accepted: 9 August 2018 / Published: 16 August 2018
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Abstract
As a major province of mineral resources in China, Shanxi currently has 6000 mines of various types, and acid mine drainage (AMD) is a major pollutant from the mining industry. Calcareous soil is dominant in western North China (including the Shanxi Province), therefore,
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As a major province of mineral resources in China, Shanxi currently has 6000 mines of various types, and acid mine drainage (AMD) is a major pollutant from the mining industry. Calcareous soil is dominant in western North China (including the Shanxi Province), therefore, clarifying the migration behavior of the main AMD pollutants (H+, S, Fe, heavy metals) in calcareous soil is essential for remediating AMD-contaminated soil in North China. In this study, the migration behavior of the main pollutants from AMD in calcareous soil was investigated using soil columns containing 20 cm of surficial soil to which different volumes of simulated AMD were added in 20 applications. Filtrate that was discharged from the soil columns and the soil samples from the columns were analyzed. Almost all of the Fe ions (>99%) from the AMD were intercepted in the 0–20 cm depth of the soil. Although >80% of SO42− was retained, the retention efficiency of the soil for SO42− was lower than it was for Fe. Cu, as a representative of heavy metals that are contained in AMD, was nearly totally retained by the calcareous soil. However, Cu had a tendency to migrate downward with the gradual acidification of the upper soil. In addition, CaCO3 was transformed into CaSO4 in AMD-contaminated soil. The outcomes of this study are valuable for understanding the pollution of calcareous soil by AMD and can provide key parameters for remediating AMD-contaminated soil. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Core Symptoms of Major Depressive Disorder among Palliative Care Patients
Int. J. Environ. Res. Public Health 2018, 15(8), 1758; https://doi.org/10.3390/ijerph15081758
Received: 31 May 2018 / Revised: 30 June 2018 / Accepted: 15 July 2018 / Published: 16 August 2018
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Abstract
A valid method to diagnose depression in palliative care has not been established. In this study, we aim to determine the prevalence of depression and the discriminant validity of the items of four sets of diagnostic criteria in palliative care. This is a
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A valid method to diagnose depression in palliative care has not been established. In this study, we aim to determine the prevalence of depression and the discriminant validity of the items of four sets of diagnostic criteria in palliative care. This is a cross-sectional study on 240 palliative care patients where the presence of depression was based on the Diagnostic and Statistical Manual of Mental Disorders, DSM–IV Criteria, Modified DSM–IV Criteria, Cavanaugh Criteria, and Endicott’s Criteria’s. Anxiety, depression, and distress were measured with Hospital Anxiety and Depression Scale and Distress Thermometer. The prevalence of depression among the palliative care patients was highest based on the Modified DSM–IV Criteria (23.3%), followed by the Endicott’s Criteria (13.8%), DSM–IV Criteria (9.2%), and Cavanaugh Criteria (5%). There were significant differences (p < 0.05) in the depressive symptoms showed by DSM–IV item 1 (dysphoric mood), item 2 (loss of interest or pleasure), and Endicott’s criteria item 8 (brooding, self-pity, or pessimism) among the palliative patients, even after adjustment for the anxiety symptoms and distress level. We found that dysphoric mood, loss of interest, and pessimism are the main features of depression in palliative patients. These symptoms should be given more attention in identifying depression in palliative care patients. Full article
(This article belongs to the Special Issue Adult Psychiatry)
Open AccessArticle Protect Your Sleep When Work is Calling: How Work-Related Smartphone Use During Non-Work Time and Sleep Quality Impact Next-Day Self-Control Processes at Work
Int. J. Environ. Res. Public Health 2018, 15(8), 1757; https://doi.org/10.3390/ijerph15081757
Received: 18 July 2018 / Revised: 10 August 2018 / Accepted: 13 August 2018 / Published: 15 August 2018
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Abstract
In view of the rapid development of information and communication technologies, the present study sheds light on how work-related smartphone use during non-work time affects employees’ subsequent working day. Specifically, we examine work-related smartphone use and sleep quality as moderators of next-day self-control
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In view of the rapid development of information and communication technologies, the present study sheds light on how work-related smartphone use during non-work time affects employees’ subsequent working day. Specifically, we examine work-related smartphone use and sleep quality as moderators of next-day self-control processes at work. Theorizing that work-related smartphone use and self-control demands deplete a common limited regulatory resource, we suggest a strengthening two-way interaction between work-related smartphone use during non-work time and next-day self-control demands at work in predicting employees’ ego depletion at work. Moreover, in a three-way interaction, we analyze whether this interaction depends on employees’ sleep quality, assuming that when intensive work-related smartphone use is followed by high-quality sleep, the taxed regulatory resource can replenish overnight. Results from our diary study covering 10 working days (n = 63) indicate that after evenings with high work-related smartphone use, employees experience disproportionate levels of ego depletion when dealing with self-control demands at work. Sleep quality, however, attenuates this interaction. In cases of high sleep quality, next-day self-control processes at work are no longer affected by work-related smartphone use. Based on these findings, we discuss implications for employees and employers regarding work-related smartphone use and the relevance of sleep in replenishing drained resources. Full article
(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)
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Open AccessArticle The Seasonality of Nitrite Concentrations in a Chloraminated Drinking Water Distribution System
Int. J. Environ. Res. Public Health 2018, 15(8), 1756; https://doi.org/10.3390/ijerph15081756
Received: 28 June 2018 / Revised: 6 August 2018 / Accepted: 10 August 2018 / Published: 15 August 2018
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Abstract
We studied the seasonal variation of nitrite exposure in a drinking water distribution system (DWDS) with monochloramine disinfection in the Helsinki Metropolitan Area. In Finland, tap water is the main source of drinking water, and thus the nitrite in tap water increases nitrite
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We studied the seasonal variation of nitrite exposure in a drinking water distribution system (DWDS) with monochloramine disinfection in the Helsinki Metropolitan Area. In Finland, tap water is the main source of drinking water, and thus the nitrite in tap water increases nitrite exposure. Our data included both the obligatory monitoring and a sampling campaign data from a sampling campaign. Seasonality was evaluated by comparing a nitrite time series to temperature and by calculating the seasonal indices of the nitrite time series. The main drivers of nitrite seasonality were the temperature and the water age. We observed that with low water ages (median: 6.7 h) the highest nitrite exposure occurred during the summer months, and with higher water ages (median: 31 h) during the winter months. With the highest water age (190 h), nitrite concentrations were the lowest. At a low temperature, the high nitrite concentrations in the winter were caused by the decelerated ammonium oxidation. The dominant reaction at low water ages was ammonium oxidation into nitrite and, at high water ages, it was nitrite oxidation into nitrate. These results help to direct monitoring appropriately to gain exact knowledge of nitrite exposure. Also, possible future process changes and additional disinfection measures can be designed appropriately to minimize extra nitrite exposure. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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Open AccessArticle Correlation between Non-Polio Acute Flaccid Paralysis Rates with Pulse Polio Frequency in India
Int. J. Environ. Res. Public Health 2018, 15(8), 1755; https://doi.org/10.3390/ijerph15081755
Received: 6 July 2018 / Revised: 4 August 2018 / Accepted: 14 August 2018 / Published: 15 August 2018
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Abstract
The last case of polio from India was reported in 2011. That year, the non-polio acute flaccid paralysis (NPAFP) rate in India was 13.35/100,000, where the expected rate is 1–2/100,000. A previous study of data from 2000 to 2010 has detailed the NPAFP
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The last case of polio from India was reported in 2011. That year, the non-polio acute flaccid paralysis (NPAFP) rate in India was 13.35/100,000, where the expected rate is 1–2/100,000. A previous study of data from 2000 to 2010 has detailed the NPAFP rate in a state correlated with the pulse polio rounds conducted there, and the strongest correlation with the NPAFP rate was found when the number of doses from the previous 4 years were used. However, a simple association being found with regression analysis does not prove a causal relationship. After publication of those findings, as the threat of polio had lessened, the number of rounds of OPV administration was brought down. The present study has been done to look at data till the end of 2017, to see if the incidence of NPAFP declined with this reduction in polio immunization rounds. We used polio surveillance data acquired by the Government of India from 2000–2017. Correlation of the NAFP rate to the number of polio rounds in the state was examined, and the cumulative effect of polio doses administered in previous years was sought. NPAFP rate correlated with the OPV pulse polio rounds in that year (R = 0.46; p < 0.001), and the NPAFP rate started to decrease from 2012 when the number of pulse polio rounds had decreased. NPAFP rates in the states of Uttar Pradesh (UP) and Bihar were the highest in the country. Looking at the high-NPAFP states of UP and Bihar, we found that the correlation coefficient was strongest when doses used over 5 years was considered (R = 0.76; p < 0.001). The response to the reduction in OPV rounds (de-challenging) adds credence to the assumption that OPV was responsible for the change in the NPAFP rate. Now that India has been polio-free for over 6 years, we propose that we may be able to reduce NPAFP by further reducing pulse polio rounds. Full article
(This article belongs to the Special Issue Vaccination and Health Outcomes)
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Open AccessArticle Interaction between Parental Education and Household Wealth on Children’s Obesity Risk
Int. J. Environ. Res. Public Health 2018, 15(8), 1754; https://doi.org/10.3390/ijerph15081754
Received: 12 June 2018 / Revised: 8 August 2018 / Accepted: 10 August 2018 / Published: 15 August 2018
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Abstract
Parents’ education and household wealth cannot be presumed to operate independently of each other. However, in traditional studies on the impact of social inequality on obesity, education and financial wealth tend to be viewed as separable processes. The present study examines the interaction
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Parents’ education and household wealth cannot be presumed to operate independently of each other. However, in traditional studies on the impact of social inequality on obesity, education and financial wealth tend to be viewed as separable processes. The present study examines the interaction of parents’ education and household wealth in relation to childhood obesity. Anthropometric measurement and questionnaire surveys were carried out on 3670 children (aged 9–12 years) and their parents from 26 elementary schools in northeast China. Results showed that the interaction term was significant for household wealth and father’s education (p < 0.01), while no significant interaction between household wealth and mother’s education was found. In a separate analysis, the interaction was statistically significant among girls for obesity risk based on BMI (p = 0.02), and among urban children for both obesity risk based on BMI (p = 0.01) and abdominal obesity risk based on WHR (p = 0.03). Specifically, when household wealth increased from the first quintile to the fifth quintile, OR for father’s education decreased from higher than 1 (OR = 1.95; 95% CI: 1.12–3.38) to non-significant for girl’s obesity risk, from non-significant to lower than 1 for urban children’s obesity risk (OR = 0.52; 95% CI: 0.32–0.86 for the fourth quintile; OR = 0.37; 95% CI: 0.19–0.73 for the fifth quintile) and from higher than 1 (OR = 1.61; 95% CI: 1.04–2.05) to non-significant for urban children’s abdominal obesity risk. These findings indicate that father’s education level interacts with household wealth to influence obesity among girls and urban children in northeast China. Full article
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Open AccessArticle The Trade-Off between Optimizing Flight Patterns and Human Health: A Case Study of Aircraft Noise in Queens, NY, USA
Int. J. Environ. Res. Public Health 2018, 15(8), 1753; https://doi.org/10.3390/ijerph15081753
Received: 24 May 2018 / Revised: 2 July 2018 / Accepted: 27 July 2018 / Published: 15 August 2018
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Abstract
Objectives: Airports in the U.S. have gradually been transitioning to automated flight systems. These systems generate new flight paths over populated areas. While they can improve flight efficiency, the increased noise associated with these novel flight patterns potentially pose serious health threats to
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Objectives: Airports in the U.S. have gradually been transitioning to automated flight systems. These systems generate new flight paths over populated areas. While they can improve flight efficiency, the increased noise associated with these novel flight patterns potentially pose serious health threats to the overflown communities. In this case study, we estimated the monetary benefits relative to health losses associated with one significant change in flight patterns at LaGuardia Airport, year-round use of “TNNIS Climb”, which happened in 2012 as a result of flight automation in New York City. Prior to that, the use of the TNNIS Climb was limited to the U.S. Open tennis matches. Methods: We developed a decision-analytic model using Markov health states to compare the costs and quality-adjusted life years (QALYs) gained associated with the limited use of TNNIS (old status quo) and the year-round use of TNNIS (current status quo). The TNNIS Climb increases airplane noise to above 60 decibels (dB) over some of the most densely populated areas of the city. We used this increased exposure to noise as the basis for estimating ground-level health using data from sound monitors. The total costs (including both direct and indirect costs), QALYs, and the incremental cost-effectiveness ratio (ICER) were estimated for the limited versus the year-round use of the TNNIS Climb. Results: The incremental lifetime costs and QALYs per person exposed to noise associated with the limited versus the year-round use of TNNIS was $11,288, and 1.13, respectively. Therefore, the limited use of TNNIS had an ICER of $10,006/QALY gained relative to the year-round of TNNIS. Our analyses were robust to changes in assumptions and data inputs. Conclusions: Despite increases in efficiency, flight automation systems without a careful assessment of noise might generate flight paths over densely populated areas and cause serious health conditions for the overflown communities. Full article
(This article belongs to the Special Issue Economic Evaluation of Environmental Policies and Interventions)
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Open AccessArticle Variations in Dissolved Nitrate, Chloride, and Sulfate in Precipitation, Reservoir, and Tap Waters, Columbus, Ohio
Int. J. Environ. Res. Public Health 2018, 15(8), 1752; https://doi.org/10.3390/ijerph15081752
Received: 6 July 2018 / Revised: 30 July 2018 / Accepted: 10 August 2018 / Published: 15 August 2018
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Abstract
Urban potable waters can be very susceptible to human activities that can impact water quality and, hence, public health. Columbus, Ohio, is currently the 14th largest city in the United States with an estimated population of ~860,000. Much of the urban population receives
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Urban potable waters can be very susceptible to human activities that can impact water quality and, hence, public health. Columbus, Ohio, is currently the 14th largest city in the United States with an estimated population of ~860,000. Much of the urban population receives its water supply from a series of reservoirs located north of the city proper. These reservoirs are fed by river systems that drain either large agricultural lands, or rapidly growing suburban areas, or both. The agricultural activities introduce dissolved nitrate, and increased usage of de-icing salts on roads and highways within the drainage area introduce chloride into the river/reservoir systems. High nitrate in drinking water poses a potential health risk, particularly to infants, while high chloride, applied as halite, in drinking water can aid in the development of cardiovascular disease. In this work, we present a 19-month time series measuring nitrate, chloride, and sulfate in local precipitation, reservoir and household tap waters in order to better understand the relationship of the hydrologic residence time on the tap water chemistry, as well as to evaluate the anion concentrations. The highest chloride tap water concentration, 6.9 mM, occurred in early February 2011, while increases in nitrate occurred in both early summer and the middle of winter. In general, the anion concentrations in the precipitation are all equal to or lower than the reservoir waters. Similarly, the tap water had concentrations of chloride and sulfate higher than reservoir water, while nitrate was similar to reservoir water. Tap water had higher fluoride and sulfate concentrations, suggesting that they are added during the treatment of the reservoir water prior to residential distribution. These data clearly demonstrate the importance of watershed lands on the quality of water in the human distribution system. Full article
(This article belongs to the Special Issue Urban Geochemistry and Human Health)
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Open AccessArticle Physical and Mental Health Impacts of Household Gardens in an Urban Slum in Lima, Peru
Int. J. Environ. Res. Public Health 2018, 15(8), 1751; https://doi.org/10.3390/ijerph15081751
Received: 17 July 2018 / Revised: 6 August 2018 / Accepted: 10 August 2018 / Published: 15 August 2018
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Abstract
Rural poverty and lack of access to education has led to urban migration and fed the constant growth of urban slums in Lima, Peru. Inhabitants of these informal settlements lack land rights and access to a public water supply, resulting in poor sanitation,
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Rural poverty and lack of access to education has led to urban migration and fed the constant growth of urban slums in Lima, Peru. Inhabitants of these informal settlements lack land rights and access to a public water supply, resulting in poor sanitation, an inability to grow food, and suboptimal health outcomes. A repeated measures longitudinal pilot study utilizing participatory design methods was conducted in Lima between September 2013 and September 2014 to determine the feasibility of implementing household gardens and the subsequent impact of increased green space on well-being. Anthropometric data and a composite of five validated mental health surveys were collected at the baseline, 6-months, and 12-months after garden construction. Significant increases from the baseline in all domains of quality of life, including: physical (p < 0.01), psychological (p = 0.05), social (p = 0.02), environmental (p = 0.02), and overall social capital (p < 0.01) were identified 12 months after garden construction. Life-threatening experiences decreased significantly compared to the baseline (p = 0.02). There were no significant changes in parent or partner empathy (p = 0.21), BMI (p = 0.95), waist circumference (p = 0.18), or blood pressure (p = 0.66) at 6 or 12 months. Improved access to green space in the form of a household garden can significantly improve mental health in an urban slum setting. Full article
Open AccessArticle Wave2Vec: Vectorizing Electroencephalography Bio-Signal for Prediction of Brain Disease
Int. J. Environ. Res. Public Health 2018, 15(8), 1750; https://doi.org/10.3390/ijerph15081750
Received: 4 July 2018 / Revised: 11 August 2018 / Accepted: 13 August 2018 / Published: 15 August 2018
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Abstract
Interest in research involving health-medical information analysis based on artificial intelligence, especially for deep learning techniques, has recently been increasing. Most of the research in this field has been focused on searching for new knowledge for predicting and diagnosing disease by revealing the
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Interest in research involving health-medical information analysis based on artificial intelligence, especially for deep learning techniques, has recently been increasing. Most of the research in this field has been focused on searching for new knowledge for predicting and diagnosing disease by revealing the relation between disease and various information features of data. These features are extracted by analyzing various clinical pathology data, such as EHR (electronic health records), and academic literature using the techniques of data analysis, natural language processing, etc. However, still needed are more research and interest in applying the latest advanced artificial intelligence-based data analysis technique to bio-signal data, which are continuous physiological records, such as EEG (electroencephalography) and ECG (electrocardiogram). Unlike the other types of data, applying deep learning to bio-signal data, which is in the form of time series of real numbers, has many issues that need to be resolved in preprocessing, learning, and analysis. Such issues include leaving feature selection, learning parts that are black boxes, difficulties in recognizing and identifying effective features, high computational complexities, etc. In this paper, to solve these issues, we provide an encoding-based Wave2vec time series classifier model, which combines signal-processing and deep learning-based natural language processing techniques. To demonstrate its advantages, we provide the results of three experiments conducted with EEG data of the University of California Irvine, which are a real-world benchmark bio-signal dataset. After converting the bio-signals (in the form of waves), which are a real number time series, into a sequence of symbols or a sequence of wavelet patterns that are converted into symbols, through encoding, the proposed model vectorizes the symbols by learning the sequence using deep learning-based natural language processing. The models of each class can be constructed through learning from the vectorized wavelet patterns and training data. The implemented models can be used for prediction and diagnosis of diseases by classifying the new data. The proposed method enhanced data readability and intuition of feature selection and learning processes by converting the time series of real number data into sequences of symbols. In addition, it facilitates intuitive and easy recognition, and identification of influential patterns. Furthermore, real-time large-capacity data analysis is facilitated, which is essential in the development of real-time analysis diagnosis systems, by drastically reducing the complexity of calculation without deterioration of analysis performance by data simplification through the encoding process. Full article
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Open AccessArticle Translating Research as an Approach to Enhance Science Engagement
Int. J. Environ. Res. Public Health 2018, 15(8), 1749; https://doi.org/10.3390/ijerph15081749
Received: 14 July 2018 / Revised: 10 August 2018 / Accepted: 12 August 2018 / Published: 15 August 2018
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Abstract
The impact of research depends on the effective communication of discoveries. Scientific writing is the primary tool for the dissemination of research, and is an important skill that biomedical trainees have to develop. Despite its importance, scientific writing is not part of the
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The impact of research depends on the effective communication of discoveries. Scientific writing is the primary tool for the dissemination of research, and is an important skill that biomedical trainees have to develop. Despite its importance, scientific writing is not part of the mainstream curriculum. One strategy used to teach scientific writing is holding a journal club style discussion of primary research literature that the students are asked to read. However, this activity can result in a passive learning experience and limit the development of trainees’ scientific writing skills. In order to improve trainees’ written communication skills, we tested an exercise that involved generating a revised article describing prior research, in essence “translating” the science into basic language. Following the guidelines set out by “Frontiers for Young Minds” and feedback received from “Young Reviewers”, we wrote a revised article with a simpler description of the research. In this article, we describe this scientific writing exercise, which may ultimately serve as a model for scientists to share their research more efficiently in order to promote better public health outcomes. Full article
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Open AccessArticle Association of Oral Health Literacy and Dental Visitation in an Inner-City Emergency Department Population
Int. J. Environ. Res. Public Health 2018, 15(8), 1748; https://doi.org/10.3390/ijerph15081748
Received: 23 July 2018 / Revised: 7 August 2018 / Accepted: 9 August 2018 / Published: 15 August 2018
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Abstract
To examine the association between oral health literacy (OHL) with sociodemographic variables and dental visitation in adults presenting to an urban emergency department (ED). Methods: This was a cross-sectional study of a convenience sample of 556 adults aged 18–90. Interview data from the
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To examine the association between oral health literacy (OHL) with sociodemographic variables and dental visitation in adults presenting to an urban emergency department (ED). Methods: This was a cross-sectional study of a convenience sample of 556 adults aged 18–90. Interview data from the study were used to collect self-reported sociodemographic characteristics and dental visitation history. The OHL of the study participants was measured using the Health Literacy in Dentistry scale (HeLD-14), and the score was dichotomized into low and high OHL. Bivariate associations between sociodemographic variables and OHL were conducted using chi-square tests, and logistic regression was used to examine the association between OHL and dental visitation within the past year. Results: Sixty percent of participants reported having visited a dentist within the past year. Over two-thirds of the sample was classified as having low OHL. Low OHL was more common in non-White races, less-educated, single, unemployed, and lower-income individuals, and those without a primary care physician or dental insurance (p < 0.05). Patients with low oral health literacy were 39% less likely to have visited the dentist in the past year (OR = 0.61; 95% CI 0.38, 0.96). Conclusions: This study highlights significant disparities in OHL. Interventions targeted toward the unique needs of underserved populations should be developed to improve health outcomes. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessReview Breast Cancer and Its Relationship with the Microbiota
Int. J. Environ. Res. Public Health 2018, 15(8), 1747; https://doi.org/10.3390/ijerph15081747
Received: 6 July 2018 / Revised: 8 August 2018 / Accepted: 11 August 2018 / Published: 14 August 2018
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Abstract
The microorganisms that live symbiotically in human beings are increasingly recognized as important players in health and disease. The largest collection of these microorganisms is found in the gastrointestinal tract. Microbial composition reflects both genetic and lifestyle variables of the host. This microbiota
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The microorganisms that live symbiotically in human beings are increasingly recognized as important players in health and disease. The largest collection of these microorganisms is found in the gastrointestinal tract. Microbial composition reflects both genetic and lifestyle variables of the host. This microbiota is in a dynamic balance with the host, exerting local and distant effects. Microbial perturbation (dysbiosis) could contribute to the risk of developing health problems. Various bacterial genes capable of producing estrogen-metabolizing enzymes have been identified. Accordingly, gut microbiota is capable of modulating estrogen serum levels. Conversely, estrogen-like compounds may promote the proliferation of certain species of bacteria. Therefore, a crosstalk between microbiota and both endogenous hormones and estrogen-like compounds might synergize to provide protection from disease but also to increase the risk of developing hormone-related diseases. Recent research suggests that the microbiota of women with breast cancer differs from that of healthy women, indicating that certain bacteria may be associated with cancer development and with different responses to therapy. In this review, we discuss recent knowledge about the microbiome and breast cancer, identifying specific characteristics of the human microbiome that may serve to develop novel approaches for risk assessment, prevention and treatment for this disease. Full article
(This article belongs to the Special Issue Gut Microbiome and Health)
Open AccessArticle SpainUDP: The Spanish Undiagnosed Rare Diseases Program
Int. J. Environ. Res. Public Health 2018, 15(8), 1746; https://doi.org/10.3390/ijerph15081746
Received: 12 June 2018 / Revised: 6 August 2018 / Accepted: 7 August 2018 / Published: 14 August 2018
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Abstract
One of the IRDiRC goals for 2017–2027 is to achieve definitive diagnosis for rare undiagnosed diseases within one year, as delay in diagnosis remains one of the pending issues in the rare diseases field. The Spanish Undiagnosed Rare Diseases Program (SpainUDP) was created
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One of the IRDiRC goals for 2017–2027 is to achieve definitive diagnosis for rare undiagnosed diseases within one year, as delay in diagnosis remains one of the pending issues in the rare diseases field. The Spanish Undiagnosed Rare Diseases Program (SpainUDP) was created in response to this challenging scenario to cover patients’ needs and after seeing the success of the Undiagnosed Diseases Program (UDP) in the USA. SpainUDP offers a multidisciplinary approach to those patients who have long sought a diagnosis without any success. During the first phase of the protocol, undiagnosed cases are sent to SpainUDP by individual patients or families, patient organizations or hospitals. After careful analysis of phenotype, data from sequencing experiments (WES) is processed with a standard pipeline and detailed standardized phenotypic information (mapped to the Human Phenotype Ontology, HPO) is connected to genetic data. In addition, the participation of SpainUDP in international initiatives such as the European projects RD-Connect and Solve RD, the Undiagnosed Diseases Network International (UDNI), and the MatchMaker Exchange (MME) platform, allows the establishment of a global data sharing strategy across multiple projects submitting data to these international initiatives. From the official beginning of the program (at the end of 2015) until early 2018, 147 cases were accepted in SpainUDP. During this time, 37 cases (25%) dropped out the program due to several reasons. The remaining 110 cases are distributed as follows: phenotypic and genotypic (WES) characterization was finished in 30 cases, of which 20 (67%) were diagnosed; 21 cases are pending on variants’ validation by Sanger sequencing; in 25 cases, WES is ongoing and 34 cases are being studied for deep phenotypic characterization. In conclusion, SpainUDP aims to achieve a diagnosis following two recommendations of the IRDiRC: the patients’ diagnosis in as short a time as possible and the promotion of data sharing (especially genomic) at the international level. Full article
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Open AccessCommunication Many Kansas Worksites Offer Few Interventions to Reduce Occupational Sedentary Behavior
Int. J. Environ. Res. Public Health 2018, 15(8), 1745; https://doi.org/10.3390/ijerph15081745
Received: 11 July 2018 / Revised: 3 August 2018 / Accepted: 9 August 2018 / Published: 14 August 2018
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Abstract
The purpose of this study was to identify the extent to which sedentary behavior interventions are being implemented in Kansas worksites. The WorkWell KS Physical Activity Assessment was administered online to 111 worksites across Kansas from October 2016 through April 2018. Each worksite
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The purpose of this study was to identify the extent to which sedentary behavior interventions are being implemented in Kansas worksites. The WorkWell KS Physical Activity Assessment was administered online to 111 worksites across Kansas from October 2016 through April 2018. Each worksite identified a point of contact to complete the worksite-level assessment. Four of the WorkWell KS Physical Activity Assessment’s items assessed interventions that may reduce employees’ sedentary behavior: offering point-of-decision prompts to reduce employees’ sedentary behavior, offering a program for employees to reduce their sedentary time at work, having an organizational norm that allows employees to stand, stretch, and/or move during meetings at least every 30 minutes, and offering standing desks. All 111 worksites that participated in the WorkWell KS Physical Activity Workshop completed the WorkWell KS Physical Activity Assessment, resulting in a 100% response rate. Most worksites (59%, n = 65) reported offering no information, program, policy, or environmental change interventions aimed to reduce sedentary behavior. The most commonly reported intervention offered by worksites to reduce employees’ sedentary behavior was standing desks (32%, n = 35). Overall, participating worksites reported implementing a few interventions that are designed to reduce sedentary behavior. Full article
(This article belongs to the Special Issue Occupational Sedentary Behaviour)
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Open AccessFeature PaperConcept Paper Vape Club: Exploring Non-Profit Regulatory Models for the Supply of Vaporised Nicotine Products
Int. J. Environ. Res. Public Health 2018, 15(8), 1744; https://doi.org/10.3390/ijerph15081744
Received: 18 July 2018 / Revised: 4 August 2018 / Accepted: 7 August 2018 / Published: 14 August 2018
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Abstract
Vaporised nicotine products (VNPs) that are not approved as therapeutic goods are banned in some countries, including Australia, Singapore, and Thailand. We reviewed two non-profit regulatory options, private clubs and the Australian Therapeutic Goods Administration Special Access Scheme (SAS) that have been applied
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Vaporised nicotine products (VNPs) that are not approved as therapeutic goods are banned in some countries, including Australia, Singapore, and Thailand. We reviewed two non-profit regulatory options, private clubs and the Australian Therapeutic Goods Administration Special Access Scheme (SAS) that have been applied to other controlled substances (such as cannabis) as a potential model for regulating VNPs as an alternative to prohibition. The legal status of private cannabis clubs varies between the United States, Canada, Belgium, Spain, and Uruguay. Legal frameworks exist for cannabis clubs in some countries, but most operate in a legal grey area. Kava social clubs existed in the Northern Territory, Australia, until the federal government banned importation of kava. Access to medical cannabis in Australia is allowed as an unapproved therapeutic good via the SAS. In Australia, the SAS Category C appears to be the most feasible option to widen access to VNPs, but it may have limited acceptability to vapers and smokers. The private club model would require new legislation but could be potentially more acceptable if clubs were permitted to operate outside a medical framework. Consumer and regulator support for these models is currently unknown. Without similar restrictions applied to smoked tobacco products, these models may have only a limited impact on smoking prevalence. Further research could explore whether these models could be options for regulating smoked tobacco products. Full article
(This article belongs to the Special Issue Tobacco Harm Reduction)
Open AccessArticle Willingness to Participate in Vaccine-Related Clinical Trials among Older Adults
Int. J. Environ. Res. Public Health 2018, 15(8), 1743; https://doi.org/10.3390/ijerph15081743
Received: 6 July 2018 / Revised: 9 August 2018 / Accepted: 11 August 2018 / Published: 14 August 2018
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Abstract
The purpose of this study is to understand among a convenience sample of 400 adults aged 60 years of age or older (1) reasons for being willing or unwilling to participate in a vaccine clinical research study and (2) overall perceptions about vaccine
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The purpose of this study is to understand among a convenience sample of 400 adults aged 60 years of age or older (1) reasons for being willing or unwilling to participate in a vaccine clinical research study and (2) overall perceptions about vaccine clinical research. A cross-sectional study using a sample of older adults residing in the metro-Atlanta area and surrounding neighborhoods was conducted. The study questionnaire contained 37 questions, including questions about socio-demographics and perceptions about clinical trial processes. Statistical analysis was conducted using logistic regression. The adjusted modeling results indicated that sex, distance to research clinic, and being informed about the research findings played a role in the likelihood of an elderly person participating in a vaccine study. Males were more likely to participate in clinical trials as compared to females (OR: 2.486; CI: 1.042–5.934). Most participants were willing to travel up to 25 miles from the research clinic. Of the respondents, 45% were unlikely to participate if the results of the current trial are not shared. Improving access to clinical trials in terms of distance traveled and ensuring streamlined processes to inform participants about the results of the trial in the future would increase willingness to participate in vaccine clinical trials. The survey could serve as a useful tool for conducting vaccine studies and other clinical trials by understanding the barriers specific to the elderly. Full article
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