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Int. J. Environ. Res. Public Health, Volume 11, Issue 1 (January 2014) , Pages 1-1194

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Open AccessEditorial
International Journal of Environmental Research and Public Health Best Paper Award 2014
Int. J. Environ. Res. Public Health 2014, 11(1), 1192-1194; https://doi.org/10.3390/ijerph110101192 - 22 Jan 2014
Cited by 1 | Viewed by 7028
Abstract
International Journal of Environmental Research and Public Health started to institute an annual award in 2013 to recognize outstanding papers related to environmental health sciences and public health that meet the aims, scope and high standards of this journal. We are pleased to [...] Read more.
International Journal of Environmental Research and Public Health started to institute an annual award in 2013 to recognize outstanding papers related to environmental health sciences and public health that meet the aims, scope and high standards of this journal. We are pleased to announce the second “International Journal of Environmental Research and Public Health Best Paper Award” for 2014. Nominations were solicited from the Editor-in-Chief and Editorial Board members, with all papers published in 2010 eligible for consideration. [...] Full article
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Open AccessArticle
Connectedness to Nature and Public (Skin) Health Perspectives: Results of a Representative, Population-Based Survey among Austrian Residents
Int. J. Environ. Res. Public Health 2014, 11(1), 1176-1191; https://doi.org/10.3390/ijerph110101176 - 20 Jan 2014
Cited by 18 | Viewed by 3445
Abstract
Connectedness to nature (CN) influences motivation to have contact with outdoor natural environments. Spending leisure time in natural environments is beneficial for human health and well-being. Besides these positive effects, health risks of open-air activities are mainly related to unprotected sun light exposure-associated [...] Read more.
Connectedness to nature (CN) influences motivation to have contact with outdoor natural environments. Spending leisure time in natural environments is beneficial for human health and well-being. Besides these positive effects, health risks of open-air activities are mainly related to unprotected sun light exposure-associated acute and chronic skin hazards. Thus, we conducted a cross-sectional, representative telephone survey among Austrian residents to study the association of perceived CN level with sun-exposure knowledge, tanning habits, and sun protective behaviour. In total, 1,500 study subjects (50.5% females) participated in this questionnaire survey. Although knowledge about tanning and motives to tan were similar among genders, females performed more photoprotective measures and were more connected to nature (all p < 0.001) compared to males. Older age and outdoor sport were significant gender-independent predictor variables influencing perceived CN level. Additionally, level of education was relevant in male CN, whereas non-smoking and higher knowledge were predictive of female CN. This survey provides so far unreported empirical data on the relationship between nature connectedness and skin health-relevant recreational habits of Austrian residents. The findings suggest to integrate hitherto neglected gender-specific Public (Skin) Health promotion when counselling on the manifold health advantages of outdoor activities. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
Open AccessArticle
Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care
Int. J. Environ. Res. Public Health 2014, 11(1), 1161-1175; https://doi.org/10.3390/ijerph110101161 - 20 Jan 2014
Cited by 20 | Viewed by 3840
Abstract
The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment [...] Read more.
The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff’s perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment. Full article
Open AccessArticle
Estimating Cyanobacteria Community Dynamics and its Relationship with Environmental Factors
Int. J. Environ. Res. Public Health 2014, 11(1), 1141-1160; https://doi.org/10.3390/ijerph110101141 - 20 Jan 2014
Cited by 5 | Viewed by 2671
Abstract
The cyanobacteria community dynamics in two eutrophic freshwater bodies (Tiegang Reservoir and Shiyan Reservoir) was studied with both a traditional microscopic counting method and a PCR-DGGE genotyping method. Results showed that cyanobacterium Phormidium tenue was the predominant species; twenty-six cyanobacteria species were identified [...] Read more.
The cyanobacteria community dynamics in two eutrophic freshwater bodies (Tiegang Reservoir and Shiyan Reservoir) was studied with both a traditional microscopic counting method and a PCR-DGGE genotyping method. Results showed that cyanobacterium Phormidium tenue was the predominant species; twenty-six cyanobacteria species were identified in water samples collected from the two reservoirs, among which fourteen were identified with the morphological method and sixteen with the PCR-DGGE method. The cyanobacteria community composition analysis showed a seasonal fluctuation from July to December. The cyanobacteria population peaked in August in both reservoirs, with cell abundances of 3.78 × 108 cells L-1 and 1.92 × 108 cells L-1 in the Tiegang and Shiyan reservoirs, respectively. Canonical Correspondence Analysis (CCA) was applied to further investigate the correlation between cyanobacteria community dynamics and environmental factors. The result indicated that the cyanobacteria community dynamics was mostly correlated with pH, temperature and total nitrogen. This study demonstrated that data obtained from PCR-DGGE combined with a traditional morphological method could reflect cyanobacteria community dynamics and its correlation with environmental factors in eutrophic freshwater bodies. Full article
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Open AccessArticle
On Robust Methodologies for Managing Public Health Care Systems
Int. J. Environ. Res. Public Health 2014, 11(1), 1106-1140; https://doi.org/10.3390/ijerph110101106 - 17 Jan 2014
Cited by 6 | Viewed by 2772
Abstract
Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used [...] Read more.
Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used for understanding the ailments, based on gender, age, geography, food-habits and other hereditary event attributes. In addition to rigor on data mining and visualization, an added focus is on values of interpretation of data views, from processed full-bodied diagnosis, subsequent prescription and appropriate medications. The proposed methodology, is a robust back-end application, for web-based patient-doctor consultations and e-Health care management systems through which, billions of dollars spent on medical services, can be saved, in addition to improving quality of life and average life span of a person. Government health departments and agencies, private and government medical practitioners including social welfare organizations are typical users of these systems. Full article
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Open AccessArticle
Biocontrol of Fusarium graminearum Growth and Deoxynivalenol Production in Wheat Kernels with Bacterial Antagonists
Int. J. Environ. Res. Public Health 2014, 11(1), 1094-1105; https://doi.org/10.3390/ijerph110101094 - 16 Jan 2014
Cited by 26 | Viewed by 4098
Abstract
Fusarium graminearum is the main causal pathogen affecting small-grain cereals, and it produces deoxynivalenol, a kind of mycotoxin, which displays a wide range of toxic effects in human and animals. Bacterial strains isolated from peanut shells were investigated for their activities against F. [...] Read more.
Fusarium graminearum is the main causal pathogen affecting small-grain cereals, and it produces deoxynivalenol, a kind of mycotoxin, which displays a wide range of toxic effects in human and animals. Bacterial strains isolated from peanut shells were investigated for their activities against F. graminearum by dual-culture plate and tip-culture assays. Among them, twenty strains exhibited potent inhibition to the growth of F. graminearum, and the inhibition rates ranged from 41.41% to 54.55% in dual-culture plate assay and 92.70% to 100% in tip-culture assay. Furthermore, eighteen strains reduced the production of deoxynivalenol by 16.69% to 90.30% in the wheat kernels assay. Finally, the strains with the strongest inhibitory activity were identified by morphological, physiological, biochemical methods and also 16S rDNA and gyrA gene analysis as Bacillus amyloliquefaciens. The current study highlights the potential application of antagonistic microorganisms and their metabolites in the prevention of fungal growth and mycotoxin production in wheat kernels. As a biological strategy, it might avoid safety problems and nutrition loss which always caused by physical and chemical strategies. Full article
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Open AccessArticle
Does Participation in Physical Education Reduce Sedentary Behaviour in School and throughout the Day among Normal-Weight and Overweight-to-Obese Czech Children Aged 9–11 Years?
Int. J. Environ. Res. Public Health 2014, 11(1), 1076-1093; https://doi.org/10.3390/ijerph110101076 - 16 Jan 2014
Cited by 13 | Viewed by 3113
Abstract
Participation of 9 to 11-year-old children in physical education lessons (PEL) contributes to a significantly higher duration of moderate-to-vigorous physical activity (MVPA) during the school day and, in overweight/obese girls and normal-weight boys, to an increase in overall daily MVPA as shown by [...] Read more.
Participation of 9 to 11-year-old children in physical education lessons (PEL) contributes to a significantly higher duration of moderate-to-vigorous physical activity (MVPA) during the school day and, in overweight/obese girls and normal-weight boys, to an increase in overall daily MVPA as shown by previous research. However, it is not known whether this increase in MVPA is at the expense of light physical activity (LPA) or sedentary behaviour (SED). SED, LPA, and MVPA were assessed in 338 schoolchildren aged 9–11 years (50.3% girls; 29.6% overweight/obese) over two school days (with and without a PEL) using a triaxial accelerometer during various segments of the school day. SED, LPA, and MVPA were quantified based on the duration of the activity (minutes). Participation in PEL led to significantly higher school MVPA in the overweight/obese and normal-weight girls and boys (p < 0.005) compared to MVPA of those children on the school day without PEL. Participation in PEL led to a significantly higher overall daily MVPA duration compared to that during the day without PEL for the overweight/obese girls (p < 0.05), normal-weight girls (p < 0.05) and boys (p < 0.005). Participation in PEL contributed not only to significantly higher LPA in the normal-weight girls and boys (p < 0.01) during the school day but also reduced school-time SED in the overweight/obese children (p < 0.01) and normal-weight girls (p < 0.005). Moreover, participation in PEL significantly reduced the overall daily SED in the normal-weight children and overweight/obese boys (p < 0.05). Adding one PEL to the daily school routine appears to be a promising strategy for effectively reducing SED in children. Full article
Open AccessArticle
An Evaluation of Healthcare Information on the Internet: The Case of Colorectal Cancer Prevention
Int. J. Environ. Res. Public Health 2014, 11(1), 1058-1075; https://doi.org/10.3390/ijerph110101058 - 14 Jan 2014
Cited by 7 | Viewed by 3886
Abstract
Health information, provided through the Internet, has recently received attention from consumers and healthcare providers as an efficient method of motivating people to get screened for colorectal cancer (CRC). In this study, the primary purpose was to investigate the extent to which consumers [...] Read more.
Health information, provided through the Internet, has recently received attention from consumers and healthcare providers as an efficient method of motivating people to get screened for colorectal cancer (CRC). In this study, the primary purpose was to investigate the extent to which consumers were better educated about CRC screening information because of the information available on the Internet. Another purpose was to identify how better-informed consumers, with reliable and trustworthy health information, were enabled to make sound decisions regarding CRC screening. The data used in this study was taken from the 2003 Health Information National Trends Survey. People aged 55 and older were classified based on their compliance with recommended CRC screening. The study applied the PRECEDE-PROCEED model to evaluate the effects of health information taken from the Internet regarding CRC screening. The credibility and reliance of cancer related information on the Internet was significantly associated with patient compliance to be screened for CRC. Experience and knowledge of Internet use had a significant impact on the utilization of CRC screening. This analysis suggests that the design and publishing websites concerning CRC should emphasize credibility and reliance. Websites providing information about CRC must also contain the most current information so that people are able to make educated decisions about CRC screening. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
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Open AccessReview
Setting the Research Agenda on the Health Effects of Chemicals
Int. J. Environ. Res. Public Health 2014, 11(1), 1049-1057; https://doi.org/10.3390/ijerph110101049 - 14 Jan 2014
Cited by 4 | Viewed by 5259
Abstract
In 2011, World Health Organization (WHO) scientists reported that a significant percentage of global deaths and disability-adjusted life years (DALYs) in 2004 could be attributed to chemicals. The 2011 review focused only on certain chemicals, however, and concluded that the global burden of [...] Read more.
In 2011, World Health Organization (WHO) scientists reported that a significant percentage of global deaths and disability-adjusted life years (DALYs) in 2004 could be attributed to chemicals. The 2011 review focused only on certain chemicals, however, and concluded that the global burden of disease was underestimated because of serious data gaps. While various chemical assessment documents have identified research needs for individual chemicals, a systematic review of such documents to identify research themes that could be applied to the multitude of chemicals for which there is little information has not been done. Even for chemicals for which there are considerable data, the information is not sufficient to make an estimate of the chemical’s contribution to the burden of disease. The WHO Environmental Health Criteria (EHC) documents and Concise International Chemical Assessment Documents (CICADs) identify research needs or data gaps in our knowledge of chemicals. We identified several common themes in these documents and in documents prepared by WHO on 10 chemicals of major public health concern. These themes include biomarkers, longitudinal epidemiological studies, mechanisms of disease, reproductive and developmental effects and exposure assessment. Specific examples of data gaps culled from more than 300 WHO documents provide researchers with specific topics for further research. Full article
Open AccessArticle
The Impact of Climate Change on Ozone-Related Mortality in Sydney
Int. J. Environ. Res. Public Health 2014, 11(1), 1034-1048; https://doi.org/10.3390/ijerph110101034 - 13 Jan 2014
Cited by 6 | Viewed by 2899
Abstract
Coupled global, regional and chemical transport models are now being used with relative-risk functions to determine the impact of climate change on human health. Studies have been carried out for global and regional scales, and in our paper we examine the impact of [...] Read more.
Coupled global, regional and chemical transport models are now being used with relative-risk functions to determine the impact of climate change on human health. Studies have been carried out for global and regional scales, and in our paper we examine the impact of climate change on ozone-related mortality at the local scale across an urban metropolis (Sydney, Australia). Using three coupled models, with a grid spacing of 3 km for the chemical transport model (CTM), and a mortality relative risk function of 1.0006 per 1 ppb increase in daily maximum 1-hour ozone concentration, we evaluated the change in ozone concentrations and mortality between decades 1996–2005 and 2051–2060. The global model was run with the A2 emissions scenario. As there is currently uncertainty regarding a threshold concentration below which ozone does not impact on mortality, we calculated mortality estimates for the three daily maximum 1-hr ozone concentration thresholds of 0, 25 and 40 ppb. The mortality increase for 2051–2060 ranges from 2.3% for a 0 ppb threshold to 27.3% for a 40 ppb threshold, although the numerical increases differ little. Our modeling approach is able to identify the variation in ozone-related mortality changes at a suburban scale, estimating that climate change could lead to an additional 55 to 65 deaths across Sydney in the decade 2051–2060. Interestingly, the largest increases do not correspond spatially to the largest ozone increases or the densest population centres. The distribution pattern of changes does not seem to vary with threshold value, while the magnitude only varies slightly. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
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Open AccessArticle
Maize Purple Plant Pigment Protects Against Fluoride-Induced Oxidative Damage of Liver and Kidney in Rats
Int. J. Environ. Res. Public Health 2014, 11(1), 1020-1033; https://doi.org/10.3390/ijerph110101020 - 13 Jan 2014
Cited by 15 | Viewed by 3058
Abstract
Anthocyanins are polyphenols and well known for their biological antioxidative benefits. Maize purple plant pigment (MPPP) extracted and separated from maize purple plant is rich in anthocyanins. In the present study, MPPP was used to alleviate the adverse effects generated by fluoride on [...] Read more.
Anthocyanins are polyphenols and well known for their biological antioxidative benefits. Maize purple plant pigment (MPPP) extracted and separated from maize purple plant is rich in anthocyanins. In the present study, MPPP was used to alleviate the adverse effects generated by fluoride on liver and kidney in rats. The results showed that the ultrastructure of the liver and kidney in fluoride treated rats displayed shrinkage of nuclear and cell volume, swollen mitochondria and endoplasmic reticulum and vacuols formation in the liver and kidney cells. MPPP significantly attenuated these fluoride-induced pathological changes. The MDA levels in serum and liver tissue of fluoride alone treated group were significantly higher than those of the control group (p < 0.05). The presence of 5 g/kg MPPP in the diet reduced the elevation of MDA levels in blood and liver, and increased the SOD and GSH-Px activities in kidney and GSH level in liver and kidney compared with the fluoride alone treated group (p < 0.05). In addition, MPPP alleviated the decrease of Bcl-2 protein expression and the increase of Bax protein expression induced by fluoride. This study demonstrated the protective role of MPPP against fluoride-induced oxidative stress in liver and kidney of rats. Full article
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Open AccessArticle
The Portrayal of Natural Environment in the Evolution of the Ecological Public Health Paradigm
Int. J. Environ. Res. Public Health 2014, 11(1), 1005-1019; https://doi.org/10.3390/ijerph110101005 - 10 Jan 2014
Cited by 18 | Viewed by 5824
Abstract
This paper explores the conceptualization of the natural environment in an evolving ecological public health paradigm. The natural environment has long been recognized as essential to supporting life, health, and wellbeing. Our understanding of the relationship between the natural environment and health has [...] Read more.
This paper explores the conceptualization of the natural environment in an evolving ecological public health paradigm. The natural environment has long been recognized as essential to supporting life, health, and wellbeing. Our understanding of the relationship between the natural environment and health has steadily evolved from one of an undynamic environment to a more sophisticated understanding of ecological interactions. This evolution is reflected in a number of ecological public health models which demonstrate the many external and overlapping determinants of human health. Six models are presented here to demonstrate this evolution, each model reflecting an increasingly ecological appreciation for the fundamental role of the natural environment in supporting human health. We conclude that after decades of public health’s acceptance of the ecological paradigm, we are only now beginning to assemble knowledge of sophisticated ecological interdependencies and apply this knowledge to the conceptualization and study of the relationship between the natural environment and the determinants of human health. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
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Open AccessEditorial
Ninth International Symposium on Recent Advances in Environmental Health Research
Int. J. Environ. Res. Public Health 2014, 11(1), 1001-1004; https://doi.org/10.3390/ijerph110101001 - 10 Jan 2014
Cited by 3 | Viewed by 2259
Abstract
This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from [...] Read more.
This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from 16–19 September, 2012 at the Marriott Hotel in Jackson, Mississippi, USA. It was built upon the overwhelming success of seven previous symposia hosted by JSU. [...] Full article
Open AccessArticle
Geospatial Interpolation and Mapping of Tropospheric Ozone Pollution Using Geostatistics
Int. J. Environ. Res. Public Health 2014, 11(1), 983-1000; https://doi.org/10.3390/ijerph110100983 - 10 Jan 2014
Cited by 8 | Viewed by 3575
Abstract
Tropospheric ozone (O3) pollution is a major problem worldwide, including in the United States of America (USA), particularly during the summer months. Ozone oxidative capacity and its impact on human health have attracted the attention of the scientific community. In the USA, sparse [...] Read more.
Tropospheric ozone (O3) pollution is a major problem worldwide, including in the United States of America (USA), particularly during the summer months. Ozone oxidative capacity and its impact on human health have attracted the attention of the scientific community. In the USA, sparse spatial observations for O3 may not provide a reliable source of data over a geo-environmental region. Geostatistical Analyst in ArcGIS has the capability to interpolate values in unmonitored geo-spaces of interest. In this study of eastern Texas O3 pollution, hourly episodes for spring and summer 2012 were selectively identified. To visualize the O3 distribution, geostatistical techniques were employed in ArcMap. Using ordinary Kriging, geostatistical layers of O3 for all the studied hours were predicted and mapped at a spatial resolution of 1 kilometer. A decent level of prediction accuracy was achieved and was confirmed from cross-validation results. The mean prediction error was close to 0, the root mean-standardized-prediction error was close to 1, and the root mean square and average standard errors were small. O3 pollution map data can be further used in analysis and modeling studies. Kriging results and O3 decadal trends indicate that the populace in Houston-Sugar Land-Baytown, Dallas-Fort Worth-Arlington, Beaumont-Port Arthur, San Antonio, and Longview are repeatedly exposed to high levels of O3-related pollution, and are prone to the corresponding respiratory and cardiovascular health effects. Optimization of the monitoring network proves to be an added advantage for the accurate prediction of exposure levels. Full article
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Open AccessArticle
Human Leptospirosis on Reunion Island: Past and Current Burden
Int. J. Environ. Res. Public Health 2014, 11(1), 968-982; https://doi.org/10.3390/ijerph110100968 - 10 Jan 2014
Cited by 18 | Viewed by 3463
Abstract
Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data [...] Read more.
Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data and the assessment of 9 years of leptospirosis surveillance. From 2004 to 2012, 414 hospitalized cases were reported. Cases of leptospirosis occurred mostly during the rainy season from December to May. Approximately 41% of infections occurred at home, 12% of infections occurred during aquatic leisure and 5% of cases were linked to professional activities. Furthermore, for 41% of cases, the place of infection could not be determined due to the accumulation of residential and non-residential exposure. Most of the cases of leptospirosis were linked to rural areas or traditional, rural occupations. We did not observe a shift to recreational leptospirosis as described in some developed countries. According to the new surveillance system, the number of reported cases has regularly increased since 2004. This situation is in part due to the improvement of the system in the first years but also to a real increase in the number of detected cases due to the introduction of molecular methods and to increased biological investigation into the Dengue-like syndrome by medical practitioners on the island since the Chikungunya crisis in 2006. This increase is probably due to surveillance and diagnosis biases but need to be carefully monitored. Nevertheless, the possibility of an outbreak is always present due to climatic events, such as after the “hyacinth” hurricane in 1980. Full article
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
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Open AccessArticle
Comparison of UTCI with Other Thermal Indices in the Assessment of Heat and Cold Effects on Cardiovascular Mortality in the Czech Republic
Int. J. Environ. Res. Public Health 2014, 11(1), 952-967; https://doi.org/10.3390/ijerph110100952 - 09 Jan 2014
Cited by 42 | Viewed by 3889
Abstract
We compare the recently developed Universal Thermal Climate Index (UTCI) with other thermal indices in analysing heat- and cold-related effects on cardiovascular (CVD) mortality in two different (urban and rural) regions in the Czech Republic during the 16-year period from 1994–2009. Excess mortality [...] Read more.
We compare the recently developed Universal Thermal Climate Index (UTCI) with other thermal indices in analysing heat- and cold-related effects on cardiovascular (CVD) mortality in two different (urban and rural) regions in the Czech Republic during the 16-year period from 1994–2009. Excess mortality is represented by the number of deaths above expected daily values, the latter being adjusted for long-term changes, annual and weekly cycles, and epidemics of influenza/acute respiratory infections. Air temperature, UTCI, Apparent Temperature (AT) and Physiologically Equivalent Temperature (PET) are applied to identify days with heat and cold stress. We found similar heat effects on CVD mortality for air temperature and the examined thermal indices. Responses of CVD mortality to cold effects as characterised by different indices were much more varied. Particularly important is the finding that air temperature provides a weak cold effect in comparison with the thermal indices in both regions, so its application—still widespread in epidemiological studies—may underestimate the magnitude of cold-related mortality. These findings are important when possible climate change effects on heat- and cold-related mortality are estimated. AT and PET appear to be more universal predictors of heat- and cold- related mortality than UTCI when both urban and rural environments are of concern. UTCI tends to select windy rather than freezing days in winter, though these show little effect on mortality in the urban population. By contrast, significant cold-related mortality in the rural region if UTCI is used shows potential for UTCI to become a useful tool in cold exposure assessments. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
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Open AccessArticle
Poultry Farm Vulnerability and Risk of Avian Influenza Re-Emergence in Thailand
Int. J. Environ. Res. Public Health 2014, 11(1), 934-951; https://doi.org/10.3390/ijerph110100934 - 09 Jan 2014
Cited by 5 | Viewed by 3515
Abstract
Highly pathogenic avian influenza (HPAI) remains of concern as a major potential global threat. This article evaluates and discusses the level of vulnerability of medium and small-scale commercial poultry production systems in Thailand related to avian influenza virus re-emergence. We developed a survey [...] Read more.
Highly pathogenic avian influenza (HPAI) remains of concern as a major potential global threat. This article evaluates and discusses the level of vulnerability of medium and small-scale commercial poultry production systems in Thailand related to avian influenza virus re-emergence. We developed a survey on 173 farms in Nakhon Pathom province to identify the global level of vulnerability of farms, and to determine which type of farms appears to be more vulnerable. We used official regulations (the Good Agricultural Practices and Livestock Farm Standards regulations) as a reference to check whether these regulations are respected. The results show that numerous vulnerability factors subsist and could represent, in case of HPAI re-emergence, a significant risk for a large spread of the disease. Bio-security, farm management and agro-commercial practices are particularly significant on that matter: results show that these practices still need a thorough improvement on a majority of farms. Farms producing eggs (especially duck eggs) are more vulnerable than farms producing meat. Those results are consistent with the type of farms that were mostly affected during the 2004–2008 outbreaks in Thailand. Full article
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Open AccessArticle
Toxicity of Gutkha, a Smokeless Tobacco Product Gone Global: Is There More to the Toxicity than Nicotine?
Int. J. Environ. Res. Public Health 2014, 11(1), 919-933; https://doi.org/10.3390/ijerph110100919 - 09 Jan 2014
Cited by 7 | Viewed by 2791
Abstract
The popularity of smokeless tobacco (ST) is growing rapidly and its prevalence of use is rising globally. Consumption of Gutkha, an addictive form of ST, is particularly common amongst South Asian communities throughout the World. This includes within the US, following large-scale immigration [...] Read more.
The popularity of smokeless tobacco (ST) is growing rapidly and its prevalence of use is rising globally. Consumption of Gutkha, an addictive form of ST, is particularly common amongst South Asian communities throughout the World. This includes within the US, following large-scale immigration into the country. However, there exists a lack of knowledge concerning these alternative tobacco products. To this end, a study was carried out to determine the toxicity of gutkha, and what role, if any, nicotine contributes to the effects. Adult male mice were treated daily for 3-week (5 day/week, once/day), via the oral mucosa, with equal volumes (50 μL) of either sterile water (control), a solution of nicotine dissolved in water (0.24 mg of nicotine), or a solution of lyophilized guthka dissolved in water (21 mg lyophilized gutkha). Serum cotinine, measured weekly, was 36 and 48 ng/mL in gutkha- and nicotine-treated mice, respectively. Results demonstrated that exposure to nicotine and gutkha reduced heart weight, while exposure to gutkha, but not nicotine, decreased liver weight, body weight, and serum testosterone levels (compared to controls). These findings suggest that short-term guhtka use adversely impacts growth and circulating testosterone levels, and that gutkha toxicity may be driven by components other than nicotine. As use of guthka increases worldwide, future studies are needed to further delineate toxicological implications such that appropriate policy decisions can be made. Full article
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Open AccessArticle
Rift Valley Fever Outbreaks in Mauritania and Related Environmental Conditions
Int. J. Environ. Res. Public Health 2014, 11(1), 903-918; https://doi.org/10.3390/ijerph110100903 - 09 Jan 2014
Cited by 20 | Viewed by 3021
Abstract
Four large outbreaks of Rift Valley Fever (RVF) occurred in Mauritania in 1998, 2003, 2010 and 2012 which caused lots of animal and several human deaths. We investigated rainfall and vegetation conditions that might have impacted on RVF transmission over the affected regions. [...] Read more.
Four large outbreaks of Rift Valley Fever (RVF) occurred in Mauritania in 1998, 2003, 2010 and 2012 which caused lots of animal and several human deaths. We investigated rainfall and vegetation conditions that might have impacted on RVF transmission over the affected regions. Our results corroborate that RVF transmission generally occurs during the months of September and October in Mauritania, similarly to Senegal. The four outbreaks were preceded by a rainless period lasting at least a week followed by heavy precipitation that took place during the second half of the rainy season. First human infections were generally reported three to five weeks later. By bridging the gap between meteorological forecasting centers and veterinary services, an early warning system might be developed in Senegal and Mauritania to warn decision makers and health services about the upcoming RVF risk. Full article
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Open AccessArticle
Disease Mapping and Regression with Count Data in the Presence of Overdispersion and Spatial Autocorrelation: A Bayesian Model Averaging Approach
Int. J. Environ. Res. Public Health 2014, 11(1), 883-902; https://doi.org/10.3390/ijerph110100883 - 09 Jan 2014
Cited by 9 | Viewed by 3600
Abstract
This paper applies the generalised linear model for modelling geographical variation to esophageal cancer incidence data in the Caspian region of Iran. The data have a complex and hierarchical structure that makes them suitable for hierarchical analysis using Bayesian techniques, but with care [...] Read more.
This paper applies the generalised linear model for modelling geographical variation to esophageal cancer incidence data in the Caspian region of Iran. The data have a complex and hierarchical structure that makes them suitable for hierarchical analysis using Bayesian techniques, but with care required to deal with problems arising from counts of events observed in small geographical areas when overdispersion and residual spatial autocorrelation are present. These considerations lead to nine regression models derived from using three probability distributions for count data: Poisson, generalised Poisson and negative binomial, and three different autocorrelation structures. We employ the framework of Bayesian variable selection and a Gibbs sampling based technique to identify significant cancer risk factors. The framework deals with situations where the number of possible models based on different combinations of candidate explanatory variables is large enough such that calculation of posterior probabilities for all models is difficult or infeasible. The evidence from applying the modelling methodology suggests that modelling strategies based on the use of generalised Poisson and negative binomial with spatial autocorrelation work well and provide a robust basis for inference. Full article
(This article belongs to the Special Issue Spatial Epidemiology)
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Open AccessArticle
Exploring Neighborhood Influences on Small-Area Variations in Intimate Partner Violence Risk: A Bayesian Random-Effects Modeling Approach
Int. J. Environ. Res. Public Health 2014, 11(1), 866-882; https://doi.org/10.3390/ijerph110100866 - 09 Jan 2014
Cited by 32 | Viewed by 4236
Abstract
This paper uses spatial data of cases of intimate partner violence against women (IPVAW) to examine neighborhood-level influences on small-area variations in IPVAW risk in a police district of the city of Valencia (Spain). To analyze area variations in IPVAW risk and its [...] Read more.
This paper uses spatial data of cases of intimate partner violence against women (IPVAW) to examine neighborhood-level influences on small-area variations in IPVAW risk in a police district of the city of Valencia (Spain). To analyze area variations in IPVAW risk and its association with neighborhood-level explanatory variables we use a Bayesian spatial random-effects modeling approach, as well as disease mapping methods to represent risk probabilities in each area. Analyses show that IPVAW cases are more likely in areas of high immigrant concentration, high public disorder and crime, and high physical disorder. Results also show a spatial component indicating remaining variability attributable to spatially structured random effects. Bayesian spatial modeling offers a new perspective to identify IPVAW high and low risk areas, and provides a new avenue for the design of better-informed prevention and intervention strategies. Full article
(This article belongs to the Special Issue Spatial Epidemiology)
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Open AccessArticle
Anthropometric and Health-Related Behavioral Factors in the Explanation of Social Inequalities in Low Birth Weight in Children with Prenatal Alcohol Exposure
Int. J. Environ. Res. Public Health 2014, 11(1), 849-865; https://doi.org/10.3390/ijerph110100849 - 08 Jan 2014
Cited by 3 | Viewed by 3037
Abstract
There is evidence for social inequalities in the health status of children with prenatal alcohol exposure (PAE). This study aimed to describe social inequalities in low birth weight (LBW) in children/adolescents with PAE and to examine the contribution of anthropometric and health-related behavioral [...] Read more.
There is evidence for social inequalities in the health status of children with prenatal alcohol exposure (PAE). This study aimed to describe social inequalities in low birth weight (LBW) in children/adolescents with PAE and to examine the contribution of anthropometric and health-related behavioral factors to the explanation of social inequalities. A total of 2,159 participants with parental self-reported moderate to regular PAE (enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents) were examined. At similar levels of PAE, the risk of LBW was significantly increased in subjects with a low socioeconomic status (SES) (adjusted odds ratio (OR) 2.78, 95% confidence interval (CI) 1.59, 4.86) and middle SES (adjusted OR 2.04, 95% CI 1.28, 3.24). Maternal height, maternal body mass index (BMI) and smoking during pregnancy mediated the association. The mediating effect of maternal height was 12.5% to 33.7%. Maternal BMI explained 7.9% of the socioeconomic difference in LBW between the high and low SES groups in children with PAE. The mediating effect of smoking during pregnancy was 17.3% to 31.5%. Maternal height, maternal BMI and smoking during pregnancy together explained 24.4% to 60.1% of the socioeconomic differences in LBW in children with PAE. A large proportion of the socioeconomic differences in LBW in children with PAE can be attributed to anthropometric and health-related behavioral factors. Full article
(This article belongs to the Special Issue Alcohol Abuse: Newer Approaches to an Old Problem)
Open AccessArticle
Area-Level Socioeconomic Characteristics, Prevalence and Trajectories of Cardiometabolic Risk
Int. J. Environ. Res. Public Health 2014, 11(1), 830-848; https://doi.org/10.3390/ijerph110100830 - 08 Jan 2014
Cited by 6 | Viewed by 2648
Abstract
This study examines the relationships between area-level socioeconomic position (SEP) and the prevalence and trajectories of metabolic syndrome (MetS) and the count of its constituents (i.e., disturbed glucose and insulin metabolism, abdominal obesity, dyslipidemia, and hypertension). A cohort of 4,056 men [...] Read more.
This study examines the relationships between area-level socioeconomic position (SEP) and the prevalence and trajectories of metabolic syndrome (MetS) and the count of its constituents (i.e., disturbed glucose and insulin metabolism, abdominal obesity, dyslipidemia, and hypertension). A cohort of 4,056 men and women aged 18+ living in Adelaide, Australia was established in 2000–2003. MetS was ascertained at baseline, four and eight years via clinical examinations. Baseline area-level median household income, percentage of residents with a high school education, and unemployment rate were derived from the 2001 population Census. Three-level random-intercepts logistic and Poisson regression models were performed to estimate the standardized odds ratio (SOR), prevalence risk ratio (SRR), ratio of SORs/SRRs, and (95% confidence interval (CI)). Interaction between area- and individual-level SEP variables was also tested. The odds of having MetS and the count of its constituents increased over time. This increase did not vary according to baseline area-level SEP (ratios of SORs/SRRs ≈ 1; p ≥ 0.42). However, at baseline, after adjustment for individual SEP and health behaviours, median household income (inversely) and unemployment rate (positively) were significantly associated with MetS prevalence (SOR (95%CI) = 0.76 (0.63–0.90), and 1.48 (1.26–1.74), respectively), and the count of its constituents (SRR (95%CI) = 0.96 (0.93–0.99), and 1.06 (1.04–1.09), respectively). The inverse association with area-level education was statistically significant only in participants with less than post high school education (SOR (95%CI) = 0.58 (0.45–0.73), and SRR (95%CI) = 0.91 (0.88–0.94)). Area-level SEP does not predict an elevated trajectory to developing MetS or an elevated count of its constituents. However, at baseline, area-level SEP was inversely associated with prevalence of MetS and the count of its constituents, with the association of area-level education being modified by individual-level education. Population-level interventions for communities defined by area-level socioeconomic disadvantage are needed to reduce cardiometabolic risks. Full article
Open AccessArticle
The Socioeconomic Determinants of Health: Economic Growth and Health in the OECD Countries during the Last Three Decades
Int. J. Environ. Res. Public Health 2014, 11(1), 815-829; https://doi.org/10.3390/ijerph110100815 - 08 Jan 2014
Cited by 15 | Viewed by 3209
Abstract
In times of economic crisis, most countries face the dual challenge of fighting unemployment while restraining social expenditures and closing budget deficits. The spending cuts and lack of employment affect a large number of decisions that have a direct or indirect impact on [...] Read more.
In times of economic crisis, most countries face the dual challenge of fighting unemployment while restraining social expenditures and closing budget deficits. The spending cuts and lack of employment affect a large number of decisions that have a direct or indirect impact on health. This impact is likely to be unevenly distributed among different groups within the population, and therefore not only health levels may be at risk, but also their distribution. The main purpose of this paper is to explore links between unemployment, economic growth, inequality, and health. We regress a measure of health, the Health Human Development Index (HHDI), against a set of explanatory variables accounting for the countries’ economic performance (GDP growth, unemployment, and income inequality), and some institutional factors related to welfare spending and the nature of the health systems for the past three decades. In addition, we explore the causes for different results obtained using an inequality-adjusted HHDI, vs. the unadjusted HHDI. We describe a panel data model, estimated by random effects, for 32 countries from 1980–2010, in five-year intervals. Our conclusion is that the high economic growth observed in the last decades, together with an increase in the levels of income inequality and/or poverty, explain the observed changes of our index, particularly when this indicator is weighted by health inequality. The remaining institutional variables (the share of social spending, health care expenditure, and the type of health systems) show the expected sign but are not statistically significant. A comment on the methodological pitfalls of the approach completes the analysis. Full article
(This article belongs to the Special Issue Inequalities in Health)
Open AccessArticle
Evaluation of Three Swabbing Devices for Detection of Listeria monocytogenes on Different Types of Food Contact Surfaces
Int. J. Environ. Res. Public Health 2014, 11(1), 804-814; https://doi.org/10.3390/ijerph110100804 - 08 Jan 2014
Cited by 16 | Viewed by 2813
Abstract
Listeria monocytogenes can adhere to different types of food contact surfaces within a food processing environment. Therefore, environmental sampling devices should be capable of detecting unacceptable contamination. In this study, a sponge-stick, foam spatula and an environmental swab were evaluated on their ability [...] Read more.
Listeria monocytogenes can adhere to different types of food contact surfaces within a food processing environment. Therefore, environmental sampling devices should be capable of detecting unacceptable contamination. In this study, a sponge-stick, foam spatula and an environmental swab were evaluated on their ability to detect low concentrations of L. monocytogenes on different types of food contact surfaces. A cocktail of four L. monocytogenes serotypes was inoculated with a concentration of 100 CFU/250 cm2 onto stainless steel (SS), high density polyethylene (HDPE) and rubber surfaces in a 250 cm2 area. Immediately after inoculation and after 1 h exposure, the surfaces were swabbed with the different swabbing devices. The results of the study show only minor differences in the ability of the swabbing devices to detect L. monocytogenes. All devices were capable to detect the contamination immediately after inoculation. However, when the surfaces were allowed to air-dry for 1 h, L. monocytogenes was undetected in 11.1% of the samples (n = 27) with the sponge stick, in 7.4% of the samples (n = 27) with the foam spatula and in 3.7% of the samples (n = 27) with the environmental swab, especially on SS surfaces. The detection ability of the different devices for L. monocytogenes can be concluded to be rather high on different types of food contact surfaces. Full article
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Can Tobacco Control Be Transformative? Reducing Gender Inequity and Tobacco Use among Vulnerable Populations
Int. J. Environ. Res. Public Health 2014, 11(1), 792-803; https://doi.org/10.3390/ijerph110100792 - 07 Jan 2014
Cited by 14 | Viewed by 2998
Abstract
Tobacco use and exposure is unequally distributed across populations and countries and among women and men. These trends and patterns reflect and cause gender and economic inequities along with negative health impacts. Despite a commitment to gender analysis in the preamble to Framework [...] Read more.
Tobacco use and exposure is unequally distributed across populations and countries and among women and men. These trends and patterns reflect and cause gender and economic inequities along with negative health impacts. Despite a commitment to gender analysis in the preamble to Framework Convention on Tobacco Control there is much yet to be done to fully understand how gender operates in tobacco control. Policies, program and research in tobacco control need to not only integrate gender, but rather operationalize gender with the goal of transforming gender and social inequities in the course of tobacco control initiatives. Gender transformative tobacco control goes beyond gender sensitive efforts and challenges policy and program developers to apply gender theory in designing their initiatives, with the goal of changing negative gender and social norms and improving social, economic, health and social indicators along with tobacco reduction. This paper outlines what is needed to progress tobacco control in enhancing the status of gendered and vulnerable groups, with a view to reducing gender and social inequities due to tobacco use and exposure. Full article
(This article belongs to the Special Issue Tobacco Control in Vulnerable Population Groups)
Open AccessArticle
Determinants of Sedentary Behavior, Motivation, Barriers and Strategies to Reduce Sitting Time in Older Women: A Qualitative Investigation
Int. J. Environ. Res. Public Health 2014, 11(1), 773-791; https://doi.org/10.3390/ijerph110100773 - 07 Jan 2014
Cited by 60 | Viewed by 4595
Abstract
Sedentary behavior defined as time spent non-exercising seated or reclining posture has been identified has a health risk and associated with frailty and disablement for older adults. Older adults are the most sedentary segment of society. To date no study has investigated the [...] Read more.
Sedentary behavior defined as time spent non-exercising seated or reclining posture has been identified has a health risk and associated with frailty and disablement for older adults. Older adults are the most sedentary segment of society. To date no study has investigated the determinants of sedentary behavior in older adults. This study reports a qualitative investigation of the determinants of sedentary behavior, strategies and motivator to reduce sitting time by structured interviews in a group of community dwelling older women (N = 11, age 65 and over). Older women expressed the view that their sedentary behavior is mostly determined by pain which acts both as an incentive to sit and a motivator to stand up, lack of energy in the afternoon, pressure from direct social circle to sit and rest, societal and environmental typecasting that older adult are meant to sit, lack of environmental facilities to allow activity pacing. This qualitative investigation highlighted some factors that older adults consider determinants of their sedentary behavior. Some are identical to those affecting physical activity (self-efficacy, functional limitations, ageist stereotyping) but some appear specific to sedentary behavior (locus of control, pain) and should be further investigated and considered during intervention design. Tailored interventions that pay attention to the pattern of sedentary behavior of individuals appear to be supported by the views of older women on their sedentary behavior. Full article
(This article belongs to the Special Issue Health Care for Old People)
Open AccessArticle
Adaptive Tele-Therapies Based on Serious Games for Health for People with Time-Management and Organisational Problems: Preliminary Results
Int. J. Environ. Res. Public Health 2014, 11(1), 749-772; https://doi.org/10.3390/ijerph110100749 - 07 Jan 2014
Cited by 12 | Viewed by 3761
Abstract
Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an [...] Read more.
Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders within the child population today. Inattention problems can lead to greater difficulties in completing assignments, as well as problems with time management and prioritisation of tasks. This article presents an intelligent tele-therapy tool based on Serious Games for Health, aimed at the improvement of time management skills and the prioritisation of tasks. This tele-system is based on the use of decision trees within Django, a high-level Python Web framework. The technologies and techniques used were selected so as to boost user involvement and to enable the system to be easily customised. This article shows the preliminary results of the pilot-phase in an experiment performed to evaluate the use of adaptive tele-therapies within a group of typically developing children and adolescents aged between 12 and 19 years old without ADHD. To do so, we relied on the collection of parameters and the conduct of surveys for assessing time management skills, as well as measuring system usability and availability. The results of a time management survey highlighted that the users involved in the trial did not use any specific or effective time management techniques, scoring 1.98 and 2.30 out of 5 points in this area for ages under 15 and over 16 years old, respectively. The final calculations based on the usability questionnaire resulted in an average score of 78.75 out of 100. The creation of a customisable tool capable of working with different skills, in conjunction with the replication of the current study, may help to understand these users’ needs, as well as boosting time management skills among teenagers with and without ADHD. Full article
(This article belongs to the Special Issue Advances in Telehealthcare)
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Open AccessArticle
Temporal and Spatial Melanoma Trends in Austria: An Ecological Study
Int. J. Environ. Res. Public Health 2014, 11(1), 734-748; https://doi.org/10.3390/ijerph110100734 - 06 Jan 2014
Cited by 18 | Viewed by 3997
Abstract
Annual solar ultraviolet radiation (UVR) is mostly determined by latitude and altitude. Over the last decades, increasing UVR ground levels have been observed. Exposure to UVR is associated with a life-time risk to develop melanoma, a malign skin cancer. Thus, we hypothesized that [...] Read more.
Annual solar ultraviolet radiation (UVR) is mostly determined by latitude and altitude. Over the last decades, increasing UVR ground levels have been observed. Exposure to UVR is associated with a life-time risk to develop melanoma, a malign skin cancer. Thus, we hypothesized that melanoma incidence in Austria is associated with altitude of place of living and time of diagnosis. We investigated this hypothesis in an ecological study by district and year for Austrian melanoma incidence (1990–2010) and mortality (1970–2011) data. As expected, incidence rates increased with altitude (about 2% per 10 m) and year (about 2%). Additionally, melanoma incidence rates were about 50% higher in urban than in rural districts. In contrast, mortality rates decreased with altitude (for males: 0.4% per 10 m, for women: 0.7% per 10 m, respectively). The observed discrepancy between incidence and mortality data could partly be explained by melanoma diagnosis at earlier tumor stage in districts with higher altitude. Possible reasons for this finding include higher awareness of patients, better diagnostic performance of medical professionals working at higher altitudes, or slower tumor growth due to protective effects of sun light-associated vitamin D synthesis. Full article
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Open AccessArticle
Analysis of the Spatial Variation of Hospitalization Admissions for Hypertension Disease in Shenzhen, China
Int. J. Environ. Res. Public Health 2014, 11(1), 713-733; https://doi.org/10.3390/ijerph110100713 - 03 Jan 2014
Cited by 16 | Viewed by 3996
Abstract
In China, awareness about hypertension, the treatment rate and the control rate are low compared to developed countries, even though China’s aging population has grown, especially in those areas with a high degree of urbanization. However, limited epidemiological studies have attempted to describe [...] Read more.
In China, awareness about hypertension, the treatment rate and the control rate are low compared to developed countries, even though China’s aging population has grown, especially in those areas with a high degree of urbanization. However, limited epidemiological studies have attempted to describe the spatial variation of the geo-referenced data on hypertension disease over an urban area of China. In this study, we applied hierarchical Bayesian models to explore the spatial heterogeneity of the relative risk for hypertension admissions throughout Shenzhen in 2011. The final model specification includes an intercept and spatial components (structured and unstructured). Although the road density could be used as a covariate in modeling, it is an indirect factor on the relative risk. In addition, spatial scan statistics and spatial analysis were utilized to identify the spatial pattern and to map the clusters. The results showed that the relative risk for hospital admission for hypertension has high-value clusters in the south and southeastern Shenzhen. This study aimed to identify some specific regions with high relative risk, and this information is useful for the health administrators. Further research should address more-detailed data collection and an explanation of the spatial patterns. Full article
(This article belongs to the Special Issue Spatial Epidemiology)
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