A pilot study of indoor air pollution produced by biomass cookstoves was conducted in 53 homes in Sri Lanka to assess respiratory conditions associated with stove type (“Anagi” or “Traditional”), kitchen characteristics (e.g., presence of a chimney in the home, indoor cooking area), and concentrations of personal and indoor particulate matter less than 2.5 micrometers in diameter (PM_2.5). Each primary cook reported respiratory conditions for herself (cough, phlegm, wheeze, or asthma) and for children (wheeze or asthma) living in her household. For cooks, the presence of at least one respiratory condition was significantly associated with 48-h log-transformed mean personal PM_2.5 concentration (PR = 1.35; p < 0.001). The prevalence ratio (PR) was significantly elevated for cooks with one or more respiratory conditions if they cooked without a chimney (PR = 1.51, p = 0.025) and non-significantly elevated if they cooked in a separate but poorly ventilated building (PR = 1.51, p = 0.093). The PRs were significantly elevated for children with wheeze or asthma if a traditional stove was used (PR = 2.08, p = 0.014) or if the cooking area was not partitioned from the rest of the home (PR = 2.46, p = 0.012). For the 13 children for whom the cooking area was not partitioned from the rest of the home, having a respiratory condition was significantly associated with log-transformed indoor PM_2.5 concentration (PR = 1.51; p = 0.014). Full article

Reducing exposure to degraded air quality is essential for building healthy cities. Although air quality and population vary at fine spatial scales, current regulatory and public health frameworks assess human exposures using county- or city-scales. We build on a spatial analysis technique, dasymetric mapping, for allocating urban populations that, together with emerging fine-scale measurements of air pollution, addresses three objectives: (1) evaluate the role of spatial scale in estimating exposure; (2) identify urban communities that are disproportionately burdened by poor air quality; and (3) estimate reduction in mobile sources of pollutants due to local tree-planting efforts using nitrogen dioxide. Our results show a maximum value of 197% difference between cadastrally-informed dasymetric system (CIDS) and standard estimations of population exposure to degraded air quality for small spatial extent analyses, and a lack of substantial difference for large spatial extent analyses. These results provide the foundation for improving policies for managing air quality, and targeting mitigation efforts to address challenges of environmental justice. Full article

As illegal e-waste trade has been significantly growing over the course of the last few years, the consequences on human health and the environment demand immediate action on the part of the global community. Though it is argued that e-waste flows from developed to developing countries, this subject seems to be more complex than that, with a variety of studies suggesting that income per capita is not the only factor affecting the choice of regions that e-waste is illegally shipped to. How is a country’s economic and social development associated with illegal e-waste trade? Is legislation an important factor? This paper aims at quantifying macroeconomic (per capita income and openness of economy) and social (human development and social progress) aspects, based on qualitative data on illegal e-waste trade routes, by examining the percentage differences in scorings in selected indicators for all known and suspected routes. The results show that illegal e-waste trade occurs from economically and socially developed regions to countries with significantly lower levels of overall development, with few exceptions, which could be attributed to the fact that several countries have loose regulations on e-waste trade, thus deeming them attractive for potential illegal activities. Full article

The novelty of e-cigarettes and ambiguity about their effects may foster informal sharing of information, such as through social interactions. We aimed to describe smokers’ social interactions about e-cigarettes and their recommendations that others use e-cigarettes. Data were collected from 2149 adult smokers in North Carolina and California who participated in a study of the impact of pictorial cigarette pack warnings. In the previous month, almost half of participants (45%) reported talking to at least one person about e-cigarettes and nearly a third of participants (27%) recommended e-cigarettes to someone else. Smokers recommended e-cigarettes to cut back on smoking (57%), to quit smoking (48%), for health reasons (36%), and for fun (27%). In adjusted analyses, more frequent e-cigarette use, positive views about typical e-cigarette users, and attempting to quit smoking in the past month were associated with recommending e-cigarettes for health reasons (all p < 0.05). Social interactions appear to be a popular method of information-sharing about e-cigarettes among smokers. Health communication campaigns may help to fill in the gaps of smokers’ understanding of e-cigarettes and their long-term effects. Full article

Flood risk analysis is more complex in urban areas than that in rural areas because of their closely packed buildings, different kinds of land uses, and large number of flood control works and drainage systems. The purpose of this paper is to propose a practical framework for flood risk analysis and benefit assessment of flood control measures in urban areas. Based on the concept of disaster risk triangle (hazard, vulnerability and exposure), a comprehensive analysis method and a general procedure were proposed for urban flood risk analysis. Urban Flood Simulation Model (UFSM) and Urban Flood Damage Assessment Model (UFDAM) were integrated to estimate the flood risk in the Pudong flood protection area (Shanghai, China). S-shaped functions were adopted to represent flood return period and damage (R-D) curves. The study results show that flood control works could significantly reduce the flood risk within the 66-year flood return period and the flood risk was reduced by 15.59%. However, the flood risk was only reduced by 7.06% when the flood return period exceeded 66-years. Hence, it is difficult to meet the increasing demands for flood control solely relying on structural measures. The R-D function is suitable to describe the changes of flood control capacity. This frame work can assess the flood risk reduction due to flood control measures, and provide crucial information for strategy development and planning adaptation. Full article

There is limited evidence in Japan regarding the psychosocial determinants of fruit/vegetable intake. We performed a cross-sectional study of people aged 18 years or older in four regions of Japan; 2308 (men: 1012, women: 1296) individuals who completed the questionnaires were included. We found that 24.8% of people were aware of the current recommendations for vegetables and 13.2% for fruit and that “ability to design meals” and “availability when eating outside of the home” were the most important factors related to self-efficacy and barriers to fruit and vegetable intake, respectively. People with high self-efficacy (OR: 3.16; 95% CI: 2.17, 4.60 for fruit; OR: 4.52; 95% CI: 3.08, 6.64 for vegetables) were more likely to consume more fruit and vegetables. People with high scores on attitude (OR: 1.54; 95% CI: 1.06, 2.24) and social support (OR: 1.59; 95% CI: 1.11, 2.27) were more likely to consume more fruit. People with high perceived barriers (OR: 0.69; 95% CI: 0.48, 0.98) were less likely to consume fruit. This study suggests a need to increase the general population’s awareness of the fruit and vegetable intake recommendations; facilitating positive attitudes, self-efficacy, and social support for individuals and strengthening the ability of individuals to design meals with more vegetables and fruit might be useful intervention programs. Full article

Analyzing the dynamics of soil particle-size distributions (PSDs), soil nutrients, and erodibility are very important for understanding the changes of soil structure and quality after long-term land-use conversion. We applied multifractal Rényi spectra (D_q) and singularity spectra (f(α)) to characterize PSDs 35 years after conversions from cropland to shrubland with Caragana microphylla (shrubland I), shrubland with Hippophae rhamnoides (shrubland II), forested land, and grassland on the Loess Plateau of China. Multifractal parameters (capacity dimension (D₀), entropy dimension (D₁), D₁/D₀, correlation dimension (D₂), and Hölder exponent of order zero (α₀)) were used to analyze the changes of PSDs. D_q and f(α) characterized the PSDs well and sensitively represented the changes in PSDs after conversion. All types of land-use conversion significantly improved the properties of the topsoil (0–10 cm), but the effect of shrubland I and even forested land decreased with depth. All types of land-use conversion significantly increased D₁ and D₂ in the topsoil, and D₁ and D₂ in the 10–50 cm layers of shrubland II, forested land, and grassland and D₁ in the 50–100 cm layers of shrubland II were significantly higher relative to the control. Both D₁ and D₂ were positively correlated with the contents of soil nutrients and fine particles and were negatively correlated with soil erosion, indicating that D₁ and D₂ were potential indices for quantifying changes in soil properties and erosion. In conclusion, all types of land-use conversion significantly improved the conditions of the topsoil, but conversion from cropland to shrubland II, forested land, and grassland, especially shrubland II and grassland, were more effective for improving soil conditions in deeper layers. Full article

Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children’s health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools. Full article

Objective: The outbreak of the Ebola epidemic in West Africa in 2014 exerted enormous global public reaction via the Internet and social media. This study aimed to investigate and evaluate the public reaction to Ebola in China and identify the primitive correlation between possible influence factors caused by the outbreak of Ebola in West Africa and Chinese public attention via Internet surveillance. Methods: Baidu Index (BDI) and Sina Micro Index (SMI) were collected from their official websites, and the disease-related data were recorded from the websites of the World Health Organization (WHO), U.S. Centers for Disease Control and Prevention (CDC), and U.S. National Ministries of Health. The average BDI of Internet users in different regions were calculated to identify the public reaction to the Ebola outbreak. Spearman’s rank correlation was used to check the relationship of epidemic trends with BDI and SMI. Additionally, spatio-temporal analysis and autocorrelation analysis were performed to detect the clustered areas with the high attention to the topic of “Ebola”. The related news reports were collected from authoritative websites to identify potential patterns. Results: The BDI and the SMI for “Ebola” showed a similar fluctuating trend with a correlation coefficient = 0.9 (p < 0.05). The average BDI in Beijing, Tibet, and Shanghai was higher than other cities. However, the disease-related indicators did not identify potential correlation with both indices above. A hotspot area was detected in Tibet by local autocorrelation analysis. The most likely cluster identified by spatiotemporal cluster analysis was in the northeast regions of China with the relative risk (RR) of 2.26 (p ≤ 0.01) from 30 July to 14 August in 2014. Qualitative analysis indicated that negative news could lead to a continuous increase of the public’s attention until the appearance of a positive news report. Conclusions: Confronted with the risk of cross-border transmission of the infectious disease, online surveillance might be used as an innovative approach to perform public communication and health education through examining the public’s reaction and attitude. Full article

The aim of this study is to explore the long-term trends of suicide mortality in China. We implemented the age-period-cohort (APC) framework, using data from the Global Burden of Disease Study 2013. Our results showed that the net drift of suicide mortality was −4.727% (95% CI: −4.821% to −4.634%) per year for men and −6.633% (95% CI: −6.751% to −6.515%) per year for women, and the local drift values were below 0 in all age groups (p < 0.01 for all) for both sexes during the period of 1994–2013. Longitudinal age curves indicated that, in the same birth cohort, suicide death risk increased rapidly to peak at the life stage of 20–24 years old and 15–24 years old for men and women, respectively, and then showed a decelerated decline, followed by a rise thereafter after 54 years old for men and a slight one after 69 years old for women. The estimated period and cohort RRs were found to show similar monotonic downward patterns (significantly with p < 0.01 for all) for both sexes, with more quickly decreasing for women than for men during the whole period. The decreasing trend of suicide was likely to be related to the economic rapid growth, improvements in health care, enhancement on the level of education, and increasing awareness of suicide among the public in China. In addition, fast urbanization and the effective control of pesticides and rodenticides might be the special reasons behind these trends we observed in this study. Full article

Ultraviolet (UV) filters are used widely in cosmetics, plastics, adhesives and other industrial products to protect human skin or products against direct exposure to deleterious UV radiation. With growing usage and mis-disposition of UV filters, they currently represent a new class of contaminants of emerging concern with increasingly reported adverse effects to humans and other organisms. Exposure to UV filters induce various endocrine disrupting effects, as revealed by increasing number of toxicological studies performed in recent years. It is necessary to compile a systematic review on the current research status on endocrine disrupting effects of UV filters toward different organisms. We therefore summarized the recent advances on the evaluation of the potential endocrine disruptors and the mechanism of toxicity for many kinds of UV filters such as benzophenones, camphor derivatives and cinnamate derivatives. Full article

Humans have evolved into what they are today after the passage of 6–7 million years. If we define the beginning of urbanization as the rise of the industrial revolution, less than 0.01% of our species’ history has been spent in modern surroundings. Humans have spent over 99.99% of their time living in the natural environment. The gap between the natural setting, for which our physiological functions are adapted, and the highly urbanized and artificial setting that we inhabit is a contributing cause of the “stress state” in modern people. In recent years, scientific evidence supporting the physiological effects of relaxation caused by natural stimuli has accumulated. This review aimed to objectively demonstrate the physiological effects of nature therapy. We have reviewed research in Japan related to the following: (1) the physiological effects of nature therapy, including those of forests, urban green space, plants, and wooden material and (2) the analyses of individual differences that arise therein. The search was conducted in the PubMed database using various keywords. We applied our inclusion/exclusion criteria and reviewed 52 articles. Scientific data assessing physiological indicators, such as brain activity, autonomic nervous activity, endocrine activity, and immune activity, are accumulating from field and laboratory experiments. We believe that nature therapy will play an increasingly important role in preventive medicine in the future. Full article

This study examines the prevalence of depression, anxiety and symptoms of stress among baccalaureate nursing students in Hong Kong. Recent epidemiological data suggest that the prevalence of mild to severe depression, anxiety and stress among qualified nurses in Hong Kong stands at 35.8%, 37.3% and 41.1%, respectively. A total of 661 nursing students were recruited to participate in our cross-sectional mental health survey using the Depression, Anxiety and Stress Scale 21. Multiple logistic regression was used to determine significant relationships between variables. Working in general medicine, being in financial difficulty, having sleep problems, not having leisure activity and perceiving oneself in poor mental health were significant correlates of past-week depression, anxiety and stress. Year of study, physical inactivity and family crisis in the past year correlated significantly with depression. Imbalanced diets significantly correlated with anxiety. Stress was significantly associated with a lack of alone time. This is the first study to confirm empirically that clinical specialty, financial difficulties and lifestyle factors can increase nursing students’ levels of depression and anxiety and symptoms of stress. Prevention, including the early detection and treatment of mental disorder, promises to reduce the prevalence of these indicators among this group. Full article

Textile effluents are highly polluting and have variable and complex compositions. They can be extremely complex, with high salt concentrations and alkaline pHs. A fixed-bed bioreactor was used in the present study to simulate a textile effluent treatment, where the white-rot fungus, Trametes versicolor, efficiently decolourised the azo dye Reactive Black 5 over 28 days. This occurred under high alkaline conditions, which is unusual, but advantageous, for successful decolourisation processes. Active dye decolourisation was maintained by operation in continuous culture. Colour was eliminated during the course of operation and maximum laccase (Lcc) activity (80.2 U∙L⁻¹) was detected after glycerol addition to the bioreactor. Lcc2 gene expression was evaluated with different carbon sources and pH values based on reverse transcriptase-PCR (polymerase chain reaction). Glycerol was shown to promote the highest lcc2 expression at pH 5.5, followed by sucrose and then glucose. The highest levels of expression occurred between three and four days, which corroborate the maximum Lcc activity observed for sucrose and glycerol on the bioreactor. These results give new insights into the use of T. versicolor in textile dye wastewater treatment with high pHs. Full article

This paper intends to assess the effect of a maternity department intervention on improvement of knowledge and use of child safety seats (CSS) among newborn parents. An intervention study included three groups (one education plus free CSS intervention group, one education only group, and one control group). The participants were parents of newborns in the maternity department of two hospitals. Both of the intervention groups received a folded pamphlet of child passenger safety, a height chart and standardized safety education during their hospital stay after giving birth. The education plus free CSS intervention group received an additional free CSS and professional installation training at hospital discharge. The control group received a pamphlet with educational information about nutrition and food safety. Three months after enrollment, a telephone follow-up was conducted among participants in the three groups. Data on child passenger safety knowledge, risky driving behaviors, and use of CSS were evaluated before and after the intervention. A total of 132 newborn parents were enrolled in the study; of those, 52 (39.4%) were assigned into the education plus free CSS intervention group, 44 (33.3%) were in the education intervention only group, and 36 (27.3%) were in the control group. No significant differences existed in demographics among the three groups. There was a significant difference in newborn parents’ child passenger safety knowledge and behaviors in the three groups before and after the intervention. In addition, the CSS use increased significantly in the education plus free CSS group after the intervention compared to parents in the education only or control groups. Education on safety, combined with a free CSS and professional installation training, were effective at increasing newborn parents’ knowledge and use of CSS. Future studies with larger sample sizes and longer follow-up are needed to determine a long-term effect of the intervention. Full article