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Int. J. Environ. Res. Public Health, Volume 11, Issue 5 (May 2014), Pages 4555-5566

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Open AccessArticle Public Health Workers and Vaccination Coverage in Eastern China: A Health Economic Analysis
Int. J. Environ. Res. Public Health 2014, 11(5), 5555-5566; https://doi.org/10.3390/ijerph110505555
Received: 21 April 2014 / Revised: 16 May 2014 / Accepted: 16 May 2014 / Published: 22 May 2014
Cited by 1 | PDF Full-text (232 KB) | HTML Full-text | XML Full-text
Abstract
Background: Vaccine-preventable diseases cause more than one million deaths among children under 5 years of age every year. Public Health Workers (PHWs) are needed to provide immunization services, but the role of human resources for public health as a determinant of vaccination
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Background: Vaccine-preventable diseases cause more than one million deaths among children under 5 years of age every year. Public Health Workers (PHWs) are needed to provide immunization services, but the role of human resources for public health as a determinant of vaccination coverage at the population level has not been assessed in China. The objective of this study was to test whether PHW density was positively associated with childhood vaccination coverage in Zhejiang Province, East China. Methods: The vaccination coverage rates of Measles Containing Vaccine (MCV), Diphtheria, Tetanus and Pertussis combined vaccine (DTP), and Poliomyelitis Vaccine (PV) were chosen as the dependent variables. Vaccination coverage data of children aged 13–24 months for each county in Zhejiang Province were taken from the Zhejiang Immunization Information System (ZJIIS). Aggregate PHW density was an independent variable in one set of regressions, and Vaccine Personnel (VP) and other PHW densities were used separately in another set. Data on densities of PHW and VP were taken from a national investigation on EPI launched by Ministry of Health of China in 2013. We controlled other determinants that may influence the vaccination coverage like Gross Domestic Product (GDP) per person, proportion of migrant children aged <7 years, and land area. These data were taken from Zhejiang Provincial Bureau of Statistics and ZJIIS. Results: PHW density was significantly influence the coverage rates of MCV [Adjusted Odds Ratio(AOR) = 4.29], DTP3(AOR = 2.16), and PV3 (AOR = 3.30). However, when the effects of VPs and other PHWs were assessed separately, we found that VP density was significantly associated with coverage of all three vaccinations (MCV AOR = 7.05; DTP3 AOR = 1.82; PV3 AOR = 4.83), while other PHW density was not. Proportion of migrant children < 7 years and Land area were found as negative and significant determinants for vaccination coverage, while GDP per person had no effect on vaccination coverage. Conclusions: A higher density of PHWs (VP) would improve the availability of immunization services over time and space, which may increase the possibility of achieving a higher childhood vaccination coverage rate. It was indicated that the level of GDP per person had no association with the improved vaccination coverage after controlling for other potential factors. Our findings implicated that PHW density was a major constraint on immunization coverage in Zhejiang Province. Full article
Open AccessArticle A Qualitative Investigation of Adolescents’ Perceived Mechanisms of Change from a Universal School-Based Depression Prevention Program
Int. J. Environ. Res. Public Health 2014, 11(5), 5541-5554; https://doi.org/10.3390/ijerph110505541
Received: 24 March 2014 / Revised: 14 May 2014 / Accepted: 15 May 2014 / Published: 22 May 2014
Cited by 12 | PDF Full-text (243 KB) | HTML Full-text | XML Full-text
Abstract
A recent meta-analysis provides evidence supporting the universal application of school-based prevention programs for adolescent depression. The mechanisms underlying such successful interventions, however, are largely unknown. We report on a qualitative analysis of 109 Grade 9 students’ beliefs about what they gained from
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A recent meta-analysis provides evidence supporting the universal application of school-based prevention programs for adolescent depression. The mechanisms underlying such successful interventions, however, are largely unknown. We report on a qualitative analysis of 109 Grade 9 students’ beliefs about what they gained from an evidence-based depression prevention intervention, the Resourceful Adolescent Program (RAP-A). Fifty-four percent of interviewees articulated at least one specific example of program benefit. A thematic analysis of responses revealed two major themes, improved interpersonal relationships and improved self-regulation, both stronger than originally assumed. A more minor theme also emerged—more helpful cognitions. It is postulated that both improved interpersonal relationships and improved self-regulation are likely to enhance one another, and more helpful cognitions may express its contribution through enhanced self-regulation. These findings broaden our understanding of the impact of depression prevention programs, beginning to illuminate how such programs benefit participants. Full article
(This article belongs to the Special Issue Adolescent Depression Prevention)
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Open AccessArticle Assessment of the Microbiological Quality of Groundwater in Three Regions of the Valencian Community (Spain)
Int. J. Environ. Res. Public Health 2014, 11(5), 5527-5540; https://doi.org/10.3390/ijerph110505527
Received: 6 February 2014 / Revised: 16 April 2014 / Accepted: 12 May 2014 / Published: 22 May 2014
Cited by 3 | PDF Full-text (925 KB) | HTML Full-text | XML Full-text
Abstract
Urban groundwater development was traditionally constrained by concerns about its quality. This study was conducted in the regions of La Ribera Alta and Ribera Baja and La Plana de Requena-Utiel of the Valencian Community (Valencia, Spain) where population density, demand for drinking water
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Urban groundwater development was traditionally constrained by concerns about its quality. This study was conducted in the regions of La Ribera Alta and Ribera Baja and La Plana de Requena-Utiel of the Valencian Community (Valencia, Spain) where population density, demand for drinking water and agricultural activities are high. Groundwater bodies (GWBs) are regarded as management areas within each territory, and were used to establish protection policies. This study analyzed eleven GWBs. We used two databases with microbiological measurements from 154 wells over a 7-year period (2004–2011), risk factors and groundwater information. Wells were grouped according to frequency of microbiological contamination using E. coli measurements, category <1, or wells with low-frequency microbiological contamination and high-frequency wells or category 1–100, according to World Health Organization (WHO) quality criteria of drinking water. Of all wells, 18.12% showed high-frequency microbiological contamination with a majority distribution in the Ribera Alta region (26.98%, p < 0.001). No significant differences were found between the two risk categories for flow, static level, well depth and distance from population centres. This paper reveals that the vulnerability classes established by the Geological and Mining Institute of Spain (IGME) do not match the microbiological results, and that only eight wells with high-frequency contamination coincide with the high vulnerability areas. Full article
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Open AccessArticle Use of Segregation Indices, Townsend Index, and Air Toxics Data to Assess Lifetime Cancer Risk Disparities in Metropolitan Charleston, South Carolina, USA
Int. J. Environ. Res. Public Health 2014, 11(5), 5510-5526; https://doi.org/10.3390/ijerph110505510
Received: 4 March 2014 / Revised: 25 April 2014 / Accepted: 12 May 2014 / Published: 21 May 2014
Cited by 15 | PDF Full-text (550 KB) | HTML Full-text | XML Full-text
Abstract
Background: Studies have demonstrated a relationship between segregation and level of education, occupational opportunities, and risk behaviors, yet a paucity of research has elucidated the association between racial residential segregation, socioeconomic deprivation, and lifetime cancer risk. Objectives: We examined estimated lifetime
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Background: Studies have demonstrated a relationship between segregation and level of education, occupational opportunities, and risk behaviors, yet a paucity of research has elucidated the association between racial residential segregation, socioeconomic deprivation, and lifetime cancer risk. Objectives: We examined estimated lifetime cancer risk from air toxics by racial composition, segregation, and deprivation in census tracts in Metropolitan Charleston. Methods: Segregation indices were used to measure the distribution of groups of people from different races within neighborhoods. The Townsend Index was used to measure economic deprivation in the study area. Poisson multivariate regressions were applied to assess the association of lifetime cancer risk with segregation indices and Townsend Index along with several sociodemographic measures. Results: Lifetime cancer risk from all pollution sources was 28 persons/million for half of the census tracts in Metropolitan Charleston. Isolation Index and Townsend Index both showed significant correlation with lifetime cancer risk from different sources. This significance still holds after adjusting for other sociodemographic measures in a Poisson regression, and these two indices have stronger effect on lifetime cancer risk compared to the effects of sociodemographic measures. Conclusions: We found that material deprivation, measured by the Townsend Index and segregation measured by the Isolation index, introduced high impact on lifetime cancer risk by air toxics at the census tract level. Full article
(This article belongs to the Special Issue Eliminating Health Disparities to Achieve Health Equity)
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Open AccessArticle Elevated White Blood Cell Count Is Associated with Higher Risk of Glucose Metabolism Disorders in Middle-Aged and Elderly Chinese People
Int. J. Environ. Res. Public Health 2014, 11(5), 5497-5509; https://doi.org/10.3390/ijerph110505497
Received: 4 April 2014 / Revised: 12 May 2014 / Accepted: 13 May 2014 / Published: 20 May 2014
Cited by 10 | PDF Full-text (265 KB) | HTML Full-text | XML Full-text
Abstract
White blood cell (WBC) count has been associated with diabetic risk, but whether the correlation is independent of other risk factors has hardly been studied. Moreover, very few such studies with large sample sizes have been conducted in Chinese. Therefore, we investigated the
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White blood cell (WBC) count has been associated with diabetic risk, but whether the correlation is independent of other risk factors has hardly been studied. Moreover, very few such studies with large sample sizes have been conducted in Chinese. Therefore, we investigated the relationship between WBC count and glucose metabolism in china. We also examined the relevant variables of WBC count. A total of 9,697 subjects (mean age, 58.0 ± 9.1 years) were recruited. The subjects were classified into four groups, including subjects with normal glucose tolerance, isolated impaired fasting glucose, impaired glucose tolerance and type 2 diabetes mellitus (T2DM). We found that WBC count increased as glucose metabolism disorders exacerbated. WBC count was also positively correlated with waist hip ratio, body mass index, smoking, triglycerides, glycosylated haemoglobin A1c (HbA1c) and 2-h postprandial glucose. In addition, high density lipoprotein and the female gender were inversely correlated with WBC count. In patients with previously diagnosed T2DM, the course of T2DM was not correlated with WBC count. Our findings indicate that elevated WBC count is independently associated with worsening of glucose metabolism in middle-aged and elderly Chinese. In addition, loss of weight, smoking cessation, lipid-modifying therapies, and control of postprandial plasma glucose and HbA1c may ameliorate the chronic low-grade inflammation. Full article
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Open AccessArticle Physical Activity Levels in Women Attending Breast Screening, Receiving Chemotherapy and Post-Breast Cancer Treatment; A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2014, 11(5), 5487-5496; https://doi.org/10.3390/ijerph110505487
Received: 11 March 2014 / Revised: 24 April 2014 / Accepted: 9 May 2014 / Published: 20 May 2014
Cited by 5 | PDF Full-text (425 KB) | HTML Full-text | XML Full-text
Abstract
Background: A lack of physical activity (PA) is a well-recognised risk factor in the development of breast cancer (BC) and evidence-base research on the impact of PA on BC survival is consolidating. However, evidence reveals that BC survivors have low levels of
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Background: A lack of physical activity (PA) is a well-recognised risk factor in the development of breast cancer (BC) and evidence-base research on the impact of PA on BC survival is consolidating. However, evidence reveals that BC survivors have low levels of PA, suggesting the need of targeted interventions to enhance the PA behaviour of BC survivors. Unfortunately, there is lack of data from the UK about the PA behaviours of women at various stages of diagnosis and treatment of BC. Therefore, the aim of the present study was to assess PA levels in women at different stages of BC pathway. Patients and Methods: A convenient sample of patients was selected at various stages of presentation and treatment of BC. Patients attending for breast screening for NHSBSP (n = 188), post-operative patients attending for chemotherapy (n = 41) and BC patients within one year’s post-treatment (n = 80) were invited to take part in this cross-sectional study. Results: Based on the odds ratio, the likelihood of a chemotherapy participant not meeting PA guidelines (i.e., being in the low activity category) were three times higher than the odds of a NHSBPS attendee not meeting PA guidelines, and compared to post-treatment participants, the chemotherapy patient’s odds of not meeting PA guidelines was four times higher. The odds of NHSBPS attendees being in the high activity category compared to the moderate category were three times higher than that of a post-treatment participant. Conclusions: The current study suggests the need to establish robust PA interventions to enhance the PA behaviour of breast cancer survivors. Full article
(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)
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Open AccessArticle Diabetes Prevention in the New York City Sikh Asian Indian Community: A Pilot Study
Int. J. Environ. Res. Public Health 2014, 11(5), 5462-5486; https://doi.org/10.3390/ijerph110505462
Received: 31 January 2014 / Revised: 6 May 2014 / Accepted: 9 May 2014 / Published: 19 May 2014
Cited by 29 | PDF Full-text (267 KB) | HTML Full-text | XML Full-text
Abstract
India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs
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India has one of the highest burdens of diabetes worldwide, and rates of diabetes are also high among Asian Indian immigrants that have migrated into the United States (U.S.). Sikhs represent a significant portion of Asian Indians in the U.S. Diabetes prevention programs have shown the benefits of using lifestyle intervention to reduce diabetes risk, yet there have been no culturally-tailored programs for diabetes prevention in the Sikh community. Using a quasi-experimental two-arm design, 126 Sikh Asian Indians living in New York City were enrolled in a six-workshop intervention led by community health workers. A total of 108 participants completed baseline and 6-month follow-up surveys between March 2012 and October 2013. Main outcome measures included clinical variables (weight, body mass index (BMI), waist circumference, blood pressure, glucose, and cholesterol) and health behaviors (changes in physical activity, food behaviors, and diabetes knowledge). Changes were significant for the treatment group in weight, BMI, waist circumference, blood pressure, glucose, physical activity, food behaviors, and diabetes knowledge, and between group differences were significant for glucose, diabetes knowledge, portion control, and physical activity social interaction. Retention rates were high. Findings demonstrate that a diabetes prevention program in the Sikh community is acceptable, feasible, and efficacious. Full article
(This article belongs to the Special Issue Diabetes Prevention: Challenges and Opportunities)
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Open AccessArticle Green Perspectives for Public Health: A Narrative Review on the Physiological Effects of Experiencing Outdoor Nature
Int. J. Environ. Res. Public Health 2014, 11(5), 5445-5461; https://doi.org/10.3390/ijerph110505445
Received: 1 April 2014 / Revised: 12 May 2014 / Accepted: 14 May 2014 / Published: 19 May 2014
Cited by 48 | PDF Full-text (446 KB) | HTML Full-text | XML Full-text
Abstract
Natural environments offer a high potential for human well-being, restoration and stress recovery in terms of allostatic load. A growing body of literature is investigating psychological and physiological health benefits of contact with Nature. So far, a synthesis of physiological health outcomes of
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Natural environments offer a high potential for human well-being, restoration and stress recovery in terms of allostatic load. A growing body of literature is investigating psychological and physiological health benefits of contact with Nature. So far, a synthesis of physiological health outcomes of direct outdoor nature experiences and its potential for improving Public Health is missing. We were interested in summarizing the outcomes of studies that investigated physiological outcomes of experiencing Nature measuring at least one physiological parameter during the last two decades. Studies on effects of indoor or simulated Nature exposure via videos or photos, animal contact, and wood as building material were excluded from further analysis. As an online literature research delivered heterogeneous data inappropriate for quantitative synthesis approaches, we descriptively summarized and narratively synthesized studies. The procedure started with 1,187 titles. Research articles in English language published in international peer-reviewed journals that investigated the effects of natural outdoor environments on humans by were included. We identified 17 relevant articles reporting on effects of Nature by measuring 20 different physiological parameters. We assigned these parameters to one of the four body systems brain activity, cardiovascular system, endocrine system, and immune function. These studies reported mainly direct and positive effects, however, our analyses revealed heterogeneous outcomes regarding significance of results. Most of the studies were conducted in Japan, based on quite small samples, predominantly with male students as participants in a cross-sectional design. In general, our narrative review provided an ambiguous illustration of the effects outdoor nature exerted on physiological parameters. However, the majority of studies reported significant positive effects. A harmonizing effect of Nature, especially on physiological stress reactions, was found across all body systems. From a Public Health perspective, interdisciplinary work on utilizing benefits of Nature regarding health promotion, disease prevention, and nature-based therapy should be optimized in order to eventually diminish given methodological limitations from mono-disciplinary studies. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
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Open AccessArticle Geographical Distribution Patterns of Iodine in Drinking-Water and Its Associations with Geological Factors in Shandong Province, China
Int. J. Environ. Res. Public Health 2014, 11(5), 5431-5444; https://doi.org/10.3390/ijerph110505431
Received: 7 March 2014 / Revised: 29 April 2014 / Accepted: 4 May 2014 / Published: 19 May 2014
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Abstract
County-based spatial distribution characteristics and the related geological factors for iodine in drinking-water were studied in Shandong Province (China). Spatial autocorrelation analysis and spatial scan statistic were applied to analyze the spatial characteristics. Generalized linear models (GLMs) and geographically weighted regression (GWR) studies
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County-based spatial distribution characteristics and the related geological factors for iodine in drinking-water were studied in Shandong Province (China). Spatial autocorrelation analysis and spatial scan statistic were applied to analyze the spatial characteristics. Generalized linear models (GLMs) and geographically weighted regression (GWR) studies were conducted to explore the relationship between water iodine level and its related geological factors. The spatial distribution of iodine in drinking-water was significantly heterogeneous in Shandong Province (Moran’s I = 0.52, Z = 7.4, p < 0.001). Two clusters for high iodine in drinking-water were identified in the south-western and north-western parts of Shandong Province by the purely spatial scan statistic approach. Both GLMs and GWR indicated a significantly global association between iodine in drinking-water and geological factors. Furthermore, GWR showed obviously spatial variability across the study region. Soil type and distance to Yellow River were statistically significant at most areas of Shandong Province, confirming the hypothesis that the Yellow River causes iodine deposits in Shandong Province. Our results suggested that the more effective regional monitoring plan and water improvement strategies should be strengthened targeting at the cluster areas based on the characteristics of geological factors and the spatial variability of local relationships between iodine in drinking-water and geological factors. Full article
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Open AccessArticle Funding Decisions for Newborn Screening: A Comparative Review of 22 Decision Processes in Europe
Int. J. Environ. Res. Public Health 2014, 11(5), 5403-5430; https://doi.org/10.3390/ijerph110505403
Received: 15 January 2014 / Revised: 29 April 2014 / Accepted: 9 May 2014 / Published: 19 May 2014
Cited by 6 | PDF Full-text (255 KB) | HTML Full-text | XML Full-text
Abstract
Decision-makers need to make choices to improve public health. Population-based newborn screening (NBS) is considered as one strategy to prevent adverse health outcomes and address rare disease patients’ needs. The aim of this study was to describe key characteristics of decisions for funding
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Decision-makers need to make choices to improve public health. Population-based newborn screening (NBS) is considered as one strategy to prevent adverse health outcomes and address rare disease patients’ needs. The aim of this study was to describe key characteristics of decisions for funding new NBS programmes in Europe. We analysed past decisions using a conceptual framework. It incorporates indicators that capture the steps of decision processes by health care payers. Based on an internet survey, we compared 22 decisions for which answers among two respondents were validated for each observation. The frequencies of indicators were calculated to elicit key characteristics. All decisions resulted in positive, mostly unrestricted funding. Stakeholder participation was diverse focusing on information provision or voting. Often, decisions were not fully transparent. Assessment of NBS technologies concentrated on expert opinion, literature review and rough cost estimates. Most important appraisal criteria were effectiveness (i.e., health gain from testing for the children being screened), disease severity and availability of treatments. Some common and diverging key characteristics were identified. Although no evidence of explicit healthcare rationing was found, processes may be improved in respect of transparency and scientific rigour of assessment. Full article
Open AccessArticle Range-Finding Risk Assessment of Inhalation Exposure to Nanodiamonds in a Laboratory Environment
Int. J. Environ. Res. Public Health 2014, 11(5), 5382-5402; https://doi.org/10.3390/ijerph110505382
Received: 13 March 2014 / Revised: 4 May 2014 / Accepted: 8 May 2014 / Published: 16 May 2014
Cited by 16 | PDF Full-text (1096 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This study considers fundamental methods in occupational risk assessment of exposure to airborne engineered nanomaterials. We discuss characterization of particle emissions, exposure assessment, hazard assessment with in vitro studies, and risk range characterization using calculated inhaled doses and dose-response translated to humans from
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This study considers fundamental methods in occupational risk assessment of exposure to airborne engineered nanomaterials. We discuss characterization of particle emissions, exposure assessment, hazard assessment with in vitro studies, and risk range characterization using calculated inhaled doses and dose-response translated to humans from in vitro studies. Here, the methods were utilized to assess workers’ risk range of inhalation exposure to nanodiamonds (NDs) during handling and sieving of ND powder. NDs were agglomerated to over 500 nm particles, and mean exposure levels of different work tasks varied from 0.24 to 4.96 µg·m−3 (0.08 to 0.74 cm−3). In vitro-experiments suggested that ND exposure may cause a risk for activation of inflammatory cascade. However, risk range characterization based on in vitro dose-response was not performed because accurate assessment of delivered (settled) dose on the cells was not possible. Comparison of ND exposure with common pollutants revealed that ND exposure was below 5 μg·m−3, which is one of the proposed exposure limits for diesel particulate matter, and the workers’ calculated dose of NDs during the measurement day was 74 ng which corresponded to 0.02% of the modeled daily (24 h) dose of submicrometer urban air particles. Full article
(This article belongs to the Special Issue Ultrafine Particles and Potential Health Effects)
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Open AccessArticle Decrease of Pirimiphos-Methyl and Deltamethrin Residues in Stored Rice with Post-Harvest Treatment
Int. J. Environ. Res. Public Health 2014, 11(5), 5372-5381; https://doi.org/10.3390/ijerph110505372
Received: 17 March 2014 / Revised: 6 May 2014 / Accepted: 9 May 2014 / Published: 16 May 2014
Cited by 5 | PDF Full-text (394 KB) | HTML Full-text | XML Full-text
Abstract
A modified quick, easy, cheap, effective, rugged (QuEChERS) method with multi-walled carbon nanotubes (MWCNTs) as reversed-dispersive solid phase extraction (r-DSPE) material was applied to the analysis of pirimiphos-methyl and deltamethrin residues in stored rice. Two dustable powder (DP) formulations (2% pirimiphos-methyl and deltamethrin
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A modified quick, easy, cheap, effective, rugged (QuEChERS) method with multi-walled carbon nanotubes (MWCNTs) as reversed-dispersive solid phase extraction (r-DSPE) material was applied to the analysis of pirimiphos-methyl and deltamethrin residues in stored rice. Two dustable powder (DP) formulations (2% pirimiphos-methyl and deltamethrin DP; 5% pirimiphos-methyl DP) were applied in simulated storehouse trials in the lab. The residues and dissipation of the two pesticides in stored rice were investigated. Slow dissipation of both pesticides was observed in stored rice. The half-lives of pirimiphos-methyl were 23.9–28.9 days, and those of deltamethrin were 23.9–24.8 days. Residues of pirimiphos-methyl from application rates of 4.5–6.75 a.i. mg/kg (active ingredient milligram per kilogram) and 10–15 a.i. mg/kg were 1.6–3.8 mg/kg and 3.0–4.5 mg/kg at 60 days Pre-harvest Interval (PHI). Residues of deltamethrin from an application rate of 0.5–0.75 a.i. mg/kg were 0.13–0.14 mg/kg at 60 days PHI. Both pesticides residues were below the Maximum Residue Limits (MRLs) established by the Codex Alimentarius Commission (CAC). Therefore, at the recommended dosages they are safe for use on stored rice. Full article
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Open AccessArticle The Next Generation of Interoperability Agents in Healthcare
Int. J. Environ. Res. Public Health 2014, 11(5), 5349-5371; https://doi.org/10.3390/ijerph110505349
Received: 3 March 2014 / Revised: 24 April 2014 / Accepted: 28 April 2014 / Published: 16 May 2014
Cited by 23 | PDF Full-text (4480 KB) | HTML Full-text | XML Full-text
Abstract
Interoperability in health information systems is increasingly a requirement rather than an option. Standards and technologies, such as multi-agent systems, have proven to be powerful tools in interoperability issues. In the last few years, the authors have worked on developing the Agency for
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Interoperability in health information systems is increasingly a requirement rather than an option. Standards and technologies, such as multi-agent systems, have proven to be powerful tools in interoperability issues. In the last few years, the authors have worked on developing the Agency for Integration, Diffusion and Archive of Medical Information (AIDA), which is an intelligent, agent-based platform to ensure interoperability in healthcare units. It is increasingly important to ensure the high availability and reliability of systems. The functions provided by the systems that treat interoperability cannot fail. This paper shows the importance of monitoring and controlling intelligent agents as a tool to anticipate problems in health information systems. The interaction between humans and agents through an interface that allows the user to create new agents easily and to monitor their activities in real time is also an important feature, as health systems evolve by adopting more features and solving new problems. A module was installed in Centro Hospitalar do Porto, increasing the functionality and the overall usability of AIDA. Full article
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Open AccessArticle Face Validity of the Single Work Ability Item: Comparison with Objectively Measured Heart Rate Reserve over Several Days
Int. J. Environ. Res. Public Health 2014, 11(5), 5333-5348; https://doi.org/10.3390/ijerph110505333
Received: 13 February 2014 / Revised: 14 April 2014 / Accepted: 8 May 2014 / Published: 16 May 2014
Cited by 10 | PDF Full-text (489 KB) | HTML Full-text | XML Full-text
Abstract
Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR) among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male
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Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR) among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male = 74) aged 18–65 years from the cross-sectional “New method for Objective Measurements of physical Activity in Daily living (NOMAD)” study. The workers reported their single item work ability and completed an aerobic capacity cycling test and objective measurements of heart rate reserve monitored with Actiheart for 3–4 days with a total of 5,810 h, including 2,640 working hours. Results: A significant moderate correlation between work ability and %HRR was observed among males (R = −0.33, P = 0.005), but not among females (R = 0.11, P = 0.431). In a gender-stratified multi-adjusted logistic regression analysis, males with high %HRR were more likely to report a reduced work ability compared to males with low %HRR [OR = 4.75, 95% confidence interval (95% CI) = 1.31 to 17.25]. However, this association was not found among females (OR = 0.26, 95% CI 0.03 to 2.16), and a significant interaction between work ability, %HRR and gender was observed (P = 0.03). Conclusions: The observed association between work ability and objectively measured %HRR over several days among male blue-collar workers supports the face validity of the single work ability item. It is a useful and valid measure of the relation between physical work demands and resources among male blue-collar workers. The contrasting association among females needs to be further investigated. Full article
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Open AccessArticle A Randomized Longitudinal Factorial Design to Assess Malaria Vector Control and Disease Management Interventions in Rural Tanzania
Int. J. Environ. Res. Public Health 2014, 11(5), 5317-5332; https://doi.org/10.3390/ijerph110505317
Received: 14 March 2014 / Revised: 9 May 2014 / Accepted: 9 May 2014 / Published: 16 May 2014
Cited by 5 | PDF Full-text (540 KB) | HTML Full-text | XML Full-text | Correction
Abstract
The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed
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The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1) a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2) vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding). The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials. Full article
(This article belongs to the Special Issue Epidemiology, Prevention and Control of Malaria)
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Open AccessArticle Teachers or Psychologists: Who Should Facilitate Depression Prevention Programs in Schools?
Int. J. Environ. Res. Public Health 2014, 11(5), 5294-5316; https://doi.org/10.3390/ijerph110505294
Received: 13 February 2014 / Revised: 14 April 2014 / Accepted: 15 April 2014 / Published: 15 May 2014
Cited by 11 | PDF Full-text (418 KB) | HTML Full-text | XML Full-text
Abstract
The current study evaluates a depression prevention program for adolescents led by psychologists vs. teachers in comparison to a control. The universal school-based prevention program has shown its efficacy in several studies when implemented by psychologists. The current study compares the effects of
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The current study evaluates a depression prevention program for adolescents led by psychologists vs. teachers in comparison to a control. The universal school-based prevention program has shown its efficacy in several studies when implemented by psychologists. The current study compares the effects of the program as implemented by teachers versus that implemented by psychologists under real-life conditions. A total of 646 vocational track 8th grade students from Germany participated either in a universal prevention program, led by teachers (n = 207) or psychologists (n = 213), or a teaching-as-usual control condition (n = 226). The design includes baseline, post-intervention, and follow-up (at 6 and 12 months post-intervention). The cognitive-behavioral program includes 10 sessions held in a regular school setting in same-gender groups and is based on the social information-processing model of social competence. Positive intervention effects were found on the change in girls’ depressive symptoms up to 12 months after program delivery when the program was implemented by psychologists. No such effects were found on boys or when program was delivered by teachers. The prevention program can successfully be implemented for girls by psychologists. Further research is needed for explanations of these effects. Full article
(This article belongs to the Special Issue Adolescent Depression Prevention)
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Open AccessArticle Evaluation of a School-Based Depression Prevention Program among Adolescents from Low-Income Areas: A Randomized Controlled Effectiveness Trial
Int. J. Environ. Res. Public Health 2014, 11(5), 5273-5293; https://doi.org/10.3390/ijerph110505273
Received: 14 February 2014 / Revised: 5 May 2014 / Accepted: 5 May 2014 / Published: 15 May 2014
Cited by 27 | PDF Full-text (561 KB) | HTML Full-text | XML Full-text
Abstract
A randomized controlled trial was conducted among a potential high-risk group of 1,343 adolescents from low-income areas in The Netherlands to test the effectiveness of the depression prevention program Op Volle Kracht (OVK) as provided by teachers in a school setting. The results
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A randomized controlled trial was conducted among a potential high-risk group of 1,343 adolescents from low-income areas in The Netherlands to test the effectiveness of the depression prevention program Op Volle Kracht (OVK) as provided by teachers in a school setting. The results showed no main effect of the program on depressive symptoms at one-year follow-up. A moderation effect was found for parental psychopathology; adolescents who had parents with psychopathology and received the OVK program had less depressive symptoms compared to adolescents with parents with psychopathology in the control condition. No moderating effects on depressive symptoms were found for gender, ethnical background, and level of baseline depressive symptoms. An iatrogenic effect of the intervention was found on the secondary outcome of clinical depressive symptoms. Based on the low level of reported depressive symptoms at baseline, it seems that our sample might not meet the characteristics of a high-risk selective group for depressive symptoms. Therefore, no firm conclusions can be drawn about the selective potential of the OVK depression prevention program. In its current form, the OVK program should not be implemented on a large scale in the natural setting for non-high-risk adolescents. Future research should focus on high-risk participants, such as children of parents with psychopathology. Full article
(This article belongs to the Special Issue Adolescent Depression Prevention)
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Open AccessArticle Monitoring the Presence of 13 Active Compounds in Surface Water Collected from Rural Areas in Northwestern Spain
Int. J. Environ. Res. Public Health 2014, 11(5), 5251-5272; https://doi.org/10.3390/ijerph110505251
Received: 10 February 2014 / Revised: 16 April 2014 / Accepted: 8 May 2014 / Published: 15 May 2014
Cited by 11 | PDF Full-text (504 KB) | HTML Full-text | XML Full-text
Abstract
Drug residues are considered environmental contaminants, and their occurrence has recently become a matter of concern. Analytical methods and monitoring systems are therefore required to control the continuous input of these drug residues into the environment. This article presents a suitable HPLC-ESI-MS/MS method
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Drug residues are considered environmental contaminants, and their occurrence has recently become a matter of concern. Analytical methods and monitoring systems are therefore required to control the continuous input of these drug residues into the environment. This article presents a suitable HPLC-ESI-MS/MS method for the simultaneous extraction, detection and quantification of residues of 13 drugs (antimicrobials, glucocorticosteroids, anti-inflammatories, anti-hypertensives, anti-cancer drugs and triphenylmethane dyes) in surface water. A monitoring study with 549 water samples was carried out in northwestern Spain to detect the presence of drug residues over two sampling periods during 2010, 2011 and 2012. Samples were collected from rural areas with and without farming activity and from urban areas. The 13 analytes were detected, and 18% of the samples collected showed positive results for the presence of at least one analyte. More collection sites were located in rural areas than in urban areas. However, more positive samples with higher concentrations and a larger number of analytes were detected in samples collected from sites located after the discharge of a WWTP. Results indicated that the WWTPs seems to act as a concentration point. Positive samples were also detected at a site located near a drinking water treatment plant. Full article
(This article belongs to the Special Issue Evaluation of Rural Water Systems and Public Health)
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Open AccessArticle Particulate Matter Pollution and Population Exposure Assessment over Mainland China in 2010 with Remote Sensing
Int. J. Environ. Res. Public Health 2014, 11(5), 5241-5250; https://doi.org/10.3390/ijerph110505241
Received: 13 March 2014 / Revised: 7 May 2014 / Accepted: 8 May 2014 / Published: 14 May 2014
Cited by 8 | PDF Full-text (1618 KB) | HTML Full-text | XML Full-text
Abstract
The public is increasingly concerned about particulate matter pollution caused by respirable suspended particles (PM10) and fine particles (PM2.5). In this paper, PM10 and PM2.5 concentration are estimated with remote sensing and individual air quality indexes of
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The public is increasingly concerned about particulate matter pollution caused by respirable suspended particles (PM10) and fine particles (PM2.5). In this paper, PM10 and PM2.5 concentration are estimated with remote sensing and individual air quality indexes of PM10 and PM2.5 (IPM10 and IPM2.5) over mainland China in 2010 are calculated. We find that China suffered more serious PM2.5 than PM10 pollution in 2010, and they presented a spatial differentiation. Consequently, a particulate-based air quality index (PAQI) based on a weighting method is proposed to provide a more objective assessment of the particulate pollution. The study demonstrates that, in 2010, most of mainland China faced a lightly polluted situation in PAQI case; there were three areas obviously under moderate pollution (Hubei, Sichuan-Chongqing border region and Ningxia-Inner Mongolia border region). Simultaneously, two indicators are calculated with the combination of population density gridded data to reveal Chinese population exposure to PM2.5. Comparing per capita PM2.5 concentration with population-weighted PM2.5 concentration, the former shows that the high-level regions are distributed in Guangdong, Shanghai, and Tianjin, while the latter are in Hebei, Chongqing, and Shandong. By comparison, the results demonstrate that population-weighted PM2.5 concentration is more in line with the actual situation. Full article
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Open AccessArticle Assessment of the Health Impacts of Climate Change in Kiribati
Int. J. Environ. Res. Public Health 2014, 11(5), 5224-5240; https://doi.org/10.3390/ijerph110505224
Received: 14 February 2014 / Revised: 5 May 2014 / Accepted: 5 May 2014 / Published: 14 May 2014
Cited by 5 | PDF Full-text (588 KB) | HTML Full-text | XML Full-text
Abstract
Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati
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Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. Full article
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Open AccessArticle Specific Association of Teratogen and Toxicant Metals in Hair of Newborns with Congenital Birth Defects or Developmentally Premature Birth in a Cohort of Couples with Documented Parental Exposure to Military Attacks: Observational Study at Al Shifa Hospital, Gaza, Palestine
Int. J. Environ. Res. Public Health 2014, 11(5), 5208-5223; https://doi.org/10.3390/ijerph110505208
Received: 24 February 2014 / Revised: 25 April 2014 / Accepted: 4 May 2014 / Published: 14 May 2014
Cited by 7 | PDF Full-text (707 KB) | HTML Full-text | XML Full-text
Abstract
This study was undertaken in Gaza, Palestine, in a cohort of babies born in 2011. Hair samples of newborns were analyzed for metal load by DRC-ICP-MS. We report specific level of contamination by teratogen/toxicants metals of newborn babies, environmentally unexposed, according to their
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This study was undertaken in Gaza, Palestine, in a cohort of babies born in 2011. Hair samples of newborns were analyzed for metal load by DRC-ICP-MS. We report specific level of contamination by teratogen/toxicants metals of newborn babies, environmentally unexposed, according to their phenotypes at birth: normal full term babies, birth defects or developmentally premature. The occurrence of birth defects was previously shown to be correlated in this cohort to documented exposure of parents to weapons containing metal contaminants, during attacks in 2009. We detect, in significantly higher amounts than in normal babies, different specific teratogen or toxicant elements, known weapons’ components, characteristic for each of birth defect or premature babies. This is the first attempt to our knowledge to directly link a phenotype at birth with the in utero presence of specific teratogen and/or toxicant metals in a cohort with known episodes of acute exposure of parents to environmental contamination by these same metals, in this case delivered by weaponry The babies were conceived 20–25 months after the major known parental exposure; the specific link of newborn phenotypes to war-remnant metal contaminants, suggests that mothers’ contamination persists in time, and that the exposure may have a long term effect. Full article
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Open AccessReview A Review of Data Quality Assessment Methods for Public Health Information Systems
Int. J. Environ. Res. Public Health 2014, 11(5), 5170-5207; https://doi.org/10.3390/ijerph110505170
Received: 20 January 2014 / Revised: 7 May 2014 / Accepted: 7 May 2014 / Published: 14 May 2014
Cited by 27 | PDF Full-text (620 KB) | HTML Full-text | XML Full-text
Abstract
High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed
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High quality data and effective data quality assessment are required for accurately evaluating the impact of public health interventions and measuring public health outcomes. Data, data use, and data collection process, as the three dimensions of data quality, all need to be assessed for overall data quality assessment. We reviewed current data quality assessment methods. The relevant study was identified in major databases and well-known institutional websites. We found the dimension of data was most frequently assessed. Completeness, accuracy, and timeliness were the three most-used attributes among a total of 49 attributes of data quality. The major quantitative assessment methods were descriptive surveys and data audits, whereas the common qualitative assessment methods were interview and documentation review. The limitations of the reviewed studies included inattentiveness to data use and data collection process, inconsistency in the definition of attributes of data quality, failure to address data users’ concerns and a lack of systematic procedures in data quality assessment. This review study is limited by the coverage of the databases and the breadth of public health information systems. Further research could develop consistent data quality definitions and attributes. More research efforts should be given to assess the quality of data use and the quality of data collection process. Full article
(This article belongs to the Special Issue Public Health Informatics)
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Open AccessArticle Spatio-Temporal Distribution Patterns in Environmental Factors, Chlorophyll-a and Microcystins in a Large Shallow Lake, Lake Taihu, China
Int. J. Environ. Res. Public Health 2014, 11(5), 5155-5169; https://doi.org/10.3390/ijerph110505155
Received: 12 March 2014 / Revised: 4 May 2014 / Accepted: 5 May 2014 / Published: 14 May 2014
Cited by 2 | PDF Full-text (1967 KB) | HTML Full-text | XML Full-text
Abstract
The spatio-temporal distribution of environmental factors, chlorophyll-a (Chl-a), and microcystins (MCs) in a shallow lake, Lake Taihu (China), were investigated from 2009 to 2011 on a monthly basis at nine sampling stations. The annual mean concentration ranges of total nitrogen (TN), total phosphorus
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The spatio-temporal distribution of environmental factors, chlorophyll-a (Chl-a), and microcystins (MCs) in a shallow lake, Lake Taihu (China), were investigated from 2009 to 2011 on a monthly basis at nine sampling stations. The annual mean concentration ranges of total nitrogen (TN), total phosphorus (TP), Chl-a, MC-LR and MC-RR were 0.17–10.53 mg/L, 0.027–0.581 mg/L, 0.10–129.75 µg/L, 0.013–2.019 µg/L and 0.002–0.794 µg/L, respectively. The average TN, ammonium (NH4+) and TP concentrations in Meiliang Bay decreased from 3.54 to 2.26 mg/L, 0.63 to 0.31 mg/L and 0.150 to 0.124 mg/L, respectively, when compared with values from 2006–2008, indicating that water quality has improved in severe cyanobacterial bloom areas in recent years. Additionally, the distribution of MCs was northern lake areas > western lake areas > central lake areas > macrophyte-dominated areas. Correlation analysis revealed that nutrients were the most important variable accounting for the variation of extracellular MC-LR concentration in heavy cyanobacterial bloom areas of Lake Taihu. During the study period, the maximum MCs concentration reached 2.75 ± 0.27 μg/L in the bloom period in the northern lake areas, which is more than two times the safety limit of 1 μg/L MCs required for drinking water. However, microcystins decreased gradually as the water quality improved from 2009 to 2011, indicating that the risk of MCs exposure was slightly decreased in Lake Taihu. Full article
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Open AccessArticle Community Knowledge and Acceptance of Larviciding for Malaria Control in a Rural District of East-Central Tanzania
Int. J. Environ. Res. Public Health 2014, 11(5), 5137-5154; https://doi.org/10.3390/ijerph110505137
Received: 13 March 2014 / Revised: 7 May 2014 / Accepted: 7 May 2014 / Published: 14 May 2014
Cited by 5 | PDF Full-text (285 KB) | HTML Full-text | XML Full-text
Abstract
The use of microbial larvicides, a form of larval source management, is a less commonly used malaria control intervention that nonetheless has significant potential as a component of an integrated vector management strategy. We evaluated community acceptability of larviciding in a rural district
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The use of microbial larvicides, a form of larval source management, is a less commonly used malaria control intervention that nonetheless has significant potential as a component of an integrated vector management strategy. We evaluated community acceptability of larviciding in a rural district in east-central Tanzania using data from 962 household surveys, 12 focus group discussions, and 24 in-depth interviews. Most survey respondents trusted in the safety (73.1%) and efficacy of larviciding, both with regards to mosquito control (92.3%) and to reduce malaria infection risk (91.9%). Probing these perceptions using a Likert scale provides a more detailed picture. Focus group participants and key informants were also receptive to larviciding, but stressed the importance of sensitization before its implementation. Overall, 73.4% of survey respondents expressed a willingness to make a nominal household contribution to a larviciding program, a proportion which decreased as the proposed contribution increased. The lower-bound mean willingness to pay is estimated at 2,934 Tanzanian Shillings (approximately US$1.76) per three month period. We present a multivariate probit regression analysis examining factors associated with willingness to pay. Overall, our findings point to a receptive environment in a rural setting in Tanzania for the use of microbial larvicides in malaria control. Full article
(This article belongs to the Special Issue Epidemiology, Prevention and Control of Malaria)
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Open AccessLetter How Soil Scientists Help Combat Podoconiosis, A Neglected Tropical Disease
Int. J. Environ. Res. Public Health 2014, 11(5), 5133-5136; https://doi.org/10.3390/ijerph110505133
Received: 26 February 2014 / Revised: 5 May 2014 / Accepted: 8 May 2014 / Published: 13 May 2014
Cited by 1 | PDF Full-text (161 KB) | HTML Full-text | XML Full-text
Abstract
Podoconiosis or “endemic non-filarial elephantiasis” is a tropical disease caused by prolonged exposure of bare feet to irritant alkaline clay soils of volcanic origin [1]. The name of the disease is derived from the Greek words for foot: podos, and dust: konos
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Podoconiosis or “endemic non-filarial elephantiasis” is a tropical disease caused by prolonged exposure of bare feet to irritant alkaline clay soils of volcanic origin [1]. The name of the disease is derived from the Greek words for foot: podos, and dust: konos. Small mineral particles from irritant soils penetrate the skin and provoke an inflammatory response leading to fibrosis and blockage of lymphatic vessels, causing lymphoedema [2]. Patients suffer from disabling physical effects, but also stigma [1]. The disease can simply be prevented by avoiding contact with irritant soils (wearing shoes) but this is still an unaffordable “luxury” for many people. Podoconiosis is unique because it is a completely preventable non-communicable tropical disease [1]. In the past few years, podoconiosis has received increased advocacy and is now step by step appearing on the agenda of medical researchers as well as politicians. [...] Full article
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Open AccessArticle Does the Absence of a Supportive Family Environment Influence the Outcome of a Universal Intervention for the Prevention of Depression?
Int. J. Environ. Res. Public Health 2014, 11(5), 5113-5132; https://doi.org/10.3390/ijerph110505113
Received: 21 November 2013 / Revised: 30 April 2014 / Accepted: 5 May 2014 / Published: 13 May 2014
Cited by 9 | PDF Full-text (277 KB) | HTML Full-text | XML Full-text
Abstract
To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis
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To date, universal, school-based interventions have produced limited success in the long-term prevention of depression in young people. This paper examines whether family relationship support moderates the outcomes of a universal, school-based preventive intervention for depression in adolescents. It reports a secondary analysis of data from the beyondblue schools research initiative. Twenty-five matched pairs of secondary schools were randomly assigned to an intervention or control condition (N = 5633 Grade 8 students). The multi-component, school-based intervention was implemented over a 3-year period, with 2 years of follow-up in Grades 11 and 12. For those available at follow-up, small but significantly greater reductions in depressive and anxiety symptoms and improvements in emotional wellbeing were found over time for the intervention group compared to the control among those who experienced low family relationship support in Grade 8. For those who did not experience low family relationship support in Grade 8, no significant effects of the invention were found over the control condition. This pattern of results was also found for the intent-to-treat sample for measures of depression and anxiety. Previous research may have overlooked important moderating variables that influence the outcome of universal approaches to the prevention of depression. The findings raise issues of the relative costs and benefits of universal versus targeted approaches to the prevention of depression. Full article
(This article belongs to the Special Issue Adolescent Depression Prevention)
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Open AccessArticle Evaluation of the Impact of Low Emission Zone and Heavy Traffic Ban in Munich (Germany) on the Reduction of PM10 in Ambient Air
Int. J. Environ. Res. Public Health 2014, 11(5), 5094-5112; https://doi.org/10.3390/ijerph110505094
Received: 31 March 2014 / Revised: 5 May 2014 / Accepted: 5 May 2014 / Published: 13 May 2014
Cited by 15 | PDF Full-text (896 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Concentrations of ambient fine particles (PM10: particles with an aerodynamic diameter ≤ 10 µm) are still exceeding current air quality standards in many European cities. In Munich (Germany), low emission zone and transit bans for heavy-duty vehicles were introduced in 2008
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Concentrations of ambient fine particles (PM10: particles with an aerodynamic diameter ≤ 10 µm) are still exceeding current air quality standards in many European cities. In Munich (Germany), low emission zone and transit bans for heavy-duty vehicles were introduced in 2008 aiming at reduction of traffic emissions contribution to PM10. The effects of those measures on PM10 mass concentrations in Munich were investigated with a semiparametric regression model for modeling PM10 levels adjusted for time, background pollution, public holidays and wind direction. The reduction of PM10 concentration after the introduction of the measures was larger at a traffic monitoring site (13.0 %, 19.6 % in summer, and 6.8 % in winter) and smaller in urban background (4.5 %, 5.7 % in summer, and 3.2 % in winter). The effect was most pronounced on Fridays and on the weekends in summer. Full article
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Open AccessArticle The Effects of Fine Particulate Air Pollution on Daily Mortality: A Case-Crossover Study in a Subtropical City, Taipei, Taiwan
Int. J. Environ. Res. Public Health 2014, 11(5), 5081-5093; https://doi.org/10.3390/ijerph110505081
Received: 12 February 2014 / Revised: 5 May 2014 / Accepted: 5 May 2014 / Published: 12 May 2014
Cited by 10 | PDF Full-text (236 KB) | HTML Full-text | XML Full-text
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This study was undertaken to determine whether there was an association between PM2.5 levels and daily mortality in Taipei, Taiwan, the largest metropolitan city with a subtropical climate. Daily mortality, air pollution, and weather data for Taipei were obtained for the period
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This study was undertaken to determine whether there was an association between PM2.5 levels and daily mortality in Taipei, Taiwan, the largest metropolitan city with a subtropical climate. Daily mortality, air pollution, and weather data for Taipei were obtained for the period from 2006–2008. The relative risk of daily mortality was estimated using a time-stratified case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single pollutant model, PM2.5 showed association with total mortality both on warm (>23 °C) and cool days (<23 °C). There is no indication of an association between PM2.5 and risk of death due to respiratory diseases both on warm and cool days. PM2.5 had effects on the risk of death from cardiovascular diseases only on cool days. In the two-pollutant models, PM2.5 remained effects on the risk of mortality for all cause and cardiovascular disease after the inclusion of SO2 and O3 both on warm and cool days. This study provides evidence that short-term exposure to PM2.5 increased the risk of death for all cause and cardiovascular disease. Full article
Open AccessArticle Improving Protocol Design Feasibility to Drive Drug Development Economics and Performance
Int. J. Environ. Res. Public Health 2014, 11(5), 5069-5080; https://doi.org/10.3390/ijerph110505069
Received: 20 February 2014 / Revised: 29 April 2014 / Accepted: 30 April 2014 / Published: 12 May 2014
Cited by 18 | PDF Full-text (187 KB) | HTML Full-text | XML Full-text
Abstract
Protocol design complexity has increased substantially during the past decade and this in turn has adversely impacted drug development economics and performance. This article reviews the results of two major Tufts Center for the Study of Drug Development studies quantifying the direct cost
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Protocol design complexity has increased substantially during the past decade and this in turn has adversely impacted drug development economics and performance. This article reviews the results of two major Tufts Center for the Study of Drug Development studies quantifying the direct cost of conducting less essential and unnecessary protocol procedures and of implementing amendments to protocol designs. Indirect costs including personnel time, work load and cycle time delays associated with complex protocol designs are also discussed. The author concludes with an overview of steps that research sponsors are taking to improve protocol design feasibility. Full article
(This article belongs to the Special Issue Economics of New Drug Development and Approval)
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Open AccessArticle Simulation of Population-Based Commuter Exposure to NO2 Using Different Air Pollution Models
Int. J. Environ. Res. Public Health 2014, 11(5), 5049-5068; https://doi.org/10.3390/ijerph110505049
Received: 11 February 2014 / Revised: 12 April 2014 / Accepted: 29 April 2014 / Published: 12 May 2014
Cited by 9 | PDF Full-text (592 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
We simulated commuter routes and long-term exposure to traffic-related air pollution during commute in a representative population sample in Basel (Switzerland), and evaluated three air pollution models with different spatial resolution for estimating commute exposures to nitrogen dioxide (NO2) as a
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We simulated commuter routes and long-term exposure to traffic-related air pollution during commute in a representative population sample in Basel (Switzerland), and evaluated three air pollution models with different spatial resolution for estimating commute exposures to nitrogen dioxide (NO2) as a marker of long-term exposure to traffic-related air pollution. Our approach includes spatially and temporally resolved data on actual commuter routes, travel modes and three air pollution models. Annual mean NO2 commuter exposures were similar between models. However, we found more within-city and within-subject variability in annual mean (±SD) NO2 commuter exposure with a high resolution dispersion model (40 ± 7 µg m−3, range: 21–61) than with a dispersion model with a lower resolution (39 ± 5 µg m−3; range: 24–51), and a land use regression model (41 ± 5 µg m−3; range: 24–54). Highest median cumulative exposures were calculated along motorized transport and bicycle routes, and the lowest for walking. For estimating commuter exposure within a city and being interested also in small-scale variability between roads, a model with a high resolution is recommended. For larger scale epidemiological health assessment studies, models with a coarser spatial resolution are likely sufficient, especially when study areas include suburban and rural areas. Full article
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