International Journal of Environmental Research and Public Health

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Open AccessArticle

A Study of The Effect of Demand Uncertainty for Low-Carbon Products Using a Newsvendor Model

by Shaojian Qu^† and Yongyi Zhou^*,†

¹ Business School, University of Shanghai for Science and Technology, Shanghai 200093, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1276; https://doi.org/10.3390/ijerph14111276 - 25 Oct 2017

Cited by 5 | Viewed by 4514

Abstract

This paper studies the effect of uncertain demand on a low-carbon product by using a newsvendor model. With two different kinds of market scales, we examine a game whereby a manufacturer produces and delivers a single new low-carbon product to a single retailer. [...] Read more.

This paper studies the effect of uncertain demand on a low-carbon product by using a newsvendor model. With two different kinds of market scales, we examine a game whereby a manufacturer produces and delivers a single new low-carbon product to a single retailer. The retailer observes the demand information and gives an order before the selling season. We find in the game that if the retailer shares truthful (or in contrast unreal or even does not share) forecast information with the manufacturer, the manufacturer will give a low (high) wholesale price through the sequence of events. In addition, as a policy-maker, the government posts a subsidy by selling the low-carbon product per unit. The manufacturer creates a new contract with a rebate for the retailer. We also take the consumer aversion coefficient and truth coefficient as qualitative variables into our model to study the order, pricing, and expected profit for the members of supply chain. The research shows that uncertain demand causes a the major effect on the new low-carbon product. Thereby, we suggest the retailer should share more truthful information with the manufacturer. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Open AccessEditorial

Indoor Air Quality and Health

by Alessandra Cincinelli^* and Tania Martellini

Department of Chemistry “Ugo Schiff”, University of Florence, via della Lastruccia 3, 50019 Sesto Fiorentino Florence, Italy

Int. J. Environ. Res. Public Health 2017, 14(11), 1286; https://doi.org/10.3390/ijerph14111286 - 25 Oct 2017

Cited by 278 | Viewed by 25197

Abstract

In the last few decades, Indoor Air Quality (IAQ) has received increasing attention from the international scientific community, political institutions, and environmental governances for improving the comfort, health, and wellbeing of building occupants.[...] Full article

(This article belongs to the Special Issue Indoor Air Quality and Health 2016)

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Open AccessFeature PaperArticle

Fatal Pediatric Motor Vehicle Crashes on U.S. Native American Indian Lands Compared to Adjacent Non-Indian Lands: Restraint Use and Injury by Driver, Vehicle, Roadway and Crash Characteristics

by Shin Ah Oh¹, Chang Liu² and Joyce C. Pressley^2,3,4,*

¹ Department of Biostatistics, Columbia University, 722 West 168th Street, New York, NY 10032, USA

² Department of Epidemiology, Columbia University, 722 West 168th Street, New York, NY 10032, USA

³ Department of Health Policy and Management, Columbia University, 722 West 168th Street, New York, NY 10032, USA

⁴ Center for Injury Epidemiology and Prevention, Columbia University, 722 West 168th Street, New York, NY 10032, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1287; https://doi.org/10.3390/ijerph14111287 - 25 Oct 2017

Cited by 4 | Viewed by 4105

Abstract

There are large disparities in American Indian pediatric motor vehicle (MV) mortality with reports that several factors may contribute. The Fatality Analysis Reporting System for 2000–2014 was used to examine restraint use for occupants aged 0–19 years involved in fatal MV crashes on [...] Read more.

There are large disparities in American Indian pediatric motor vehicle (MV) mortality with reports that several factors may contribute. The Fatality Analysis Reporting System for 2000–2014 was used to examine restraint use for occupants aged 0–19 years involved in fatal MV crashes on Indian lands (n = 1667) and non-Indian lands in adjacent states (n = 126,080). SAS GLIMMIX logistic regression with random effects was used to generate odds ratios (OR) with 95% confidence intervals (CI). Restraint use increased in both areas over the study period with restraint use on Indian lands being just over half that of non-Indian lands for drivers (36.8% vs. 67.8%, p < 0.0001) and for pediatric passengers (33.1% vs. 59.3%, p < 0.0001). Driver restraint was the strongest predictor of passenger restraint on both Indian and non-Indian lands exerting a stronger effect in ages 13–19 than in 0–12 year olds. Valid licensed driver was a significant predictor of restraint use in ages 0–12 years. Passengers in non-cars (SUVs, vans and pickup trucks) were less likely to be restrained. Restraint use improved over the study period in both areas, but disparities failed to narrow as restraint use remains lower and driver, vehicle and crash risk factors higher for MV mortality on Indian lands. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

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Open AccessArticle

Health in All Policies in South Australia—Did It Promote and Enact an Equity Perspective?

by Helen Van Eyk^1,*

, Elizabeth Harris², Fran Baum¹, Toni Delany-Crowe¹, Angela Lawless³

and Colin MacDougall^1,4

¹ Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia

² Centre for Primary Health Care and Equity, Level 3, AGSM Building, University of New South Wales, Sydney, NSW 2052, Australia

³ College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia

⁴ College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia

Int. J. Environ. Res. Public Health 2017, 14(11), 1288; https://doi.org/10.3390/ijerph14111288 - 25 Oct 2017

Cited by 35 | Viewed by 5544

Abstract

Mobilising cross-sectoral action is helpful in addressing the range of social determinants that contribute to health inequities. The South Australian Health in All Policies (SA HiAP) approach was implemented from 2007 to stimulate cross-sector policy activity to address the social determinants of health [...] Read more.

Mobilising cross-sectoral action is helpful in addressing the range of social determinants that contribute to health inequities. The South Australian Health in All Policies (SA HiAP) approach was implemented from 2007 to stimulate cross-sector policy activity to address the social determinants of health to improve population wellbeing and reduce health inequities. This paper presents selected findings from a five year multi-methods research study of the SA HiAP approach and draws on data collected during interviews, observation, case studies, and document analysis. The analysis shows that SA HiAP had dual goals of facilitating joined-up government for co-benefits (process focus); and addressing social determinants of health and inequities through cross-sectoral policy activity (outcomes focus). Government agencies readily understood HiAP as providing tools for improving the process of intersectoral policy development, while the more distal outcome-focused intent of improving equity was not well understood and gained less traction. While some early rhetorical support existed for progressing an equity agenda through SA HiAP, subsequent economic pressures resulted in the government narrowing its priorities to economic goals. The paper concludes that SA HiAP’s initial intentions to address equity were only partially enacted and little was done to reduce inequities. Emerging opportunities in SA, and internationally, including the UN Sustainable Development Goals, may revive interest in addressing equity. Full article

(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)

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Open AccessReview

Interdisciplinary eHealth Practice in Cancer Care: A Review of the Literature

by Anna Janssen^1,*, Melissa Brunner^1,2

, Melanie Keep¹

, Monique Hines¹, Srivalli Vilapakkam Nagarajan³, Candice Kielly-Carroll¹, Sarah Dennis^1,4

, Zoe McKeough¹

and Tim Shaw¹

¹ Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia

² Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW 2308, Australia

³ Sydney Medical School, The University of Sydney, Sydney, NSW 2141, Australia

⁴ Ingham Institute of Applied Medical Research, Liverpool, NSW 2170, Australia

Int. J. Environ. Res. Public Health 2017, 14(11), 1289; https://doi.org/10.3390/ijerph14111289 - 25 Oct 2017

Cited by 40 | Viewed by 6786

Abstract

This review aimed to identify research that described how eHealth facilitates interdisciplinary cancer care and to understand the ways in which eHealth innovations are being used in this setting. An integrative review of eHealth interventions used for interdisciplinary care for people with cancer [...] Read more.

This review aimed to identify research that described how eHealth facilitates interdisciplinary cancer care and to understand the ways in which eHealth innovations are being used in this setting. An integrative review of eHealth interventions used for interdisciplinary care for people with cancer was conducted by systematically searching research databases in March 2015, and repeated in September 2016. Searches resulted in 8531 citations, of which 140 were retrieved and scanned in full, with twenty-six studies included in the review. Analysis of data extracted from the included articles revealed five broad themes: (i) data collection and accessibility; (ii) virtual multidisciplinary teams; (iii) communication between individuals involved in the delivery of health services; (iv) communication pathways between patients and cancer care teams; and (v) health professional-led change. Use of eHealth interventions in cancer care was widespread, particularly to support interdisciplinary care. However, research has focused on development and implementation of interventions, rather than on long-term impact. Further research is warranted to explore design, evaluation, and long-term sustainability of eHealth systems and interventions in interdisciplinary cancer care. Technology evolves quickly and researchers need to provide health professionals with timely guidance on how best to respond to new technologies in the health sector. Full article

(This article belongs to the Special Issue eHealth: The Impact of Technology on Healthcare)

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Open AccessArticle

Interplay of Socioeconomic Status and Supermarket Distance Is Associated with Excess Obesity Risk: A UK Cross-Sectional Study

by Thomas Burgoine^1,*

, Joreintje D. Mackenbach², Jeroen Lakerveld², Nita G. Forouhi¹, Simon J. Griffin^1,3, Søren Brage¹

, Nicholas J. Wareham¹ and Pablo Monsivais^1,†

¹ UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK

² Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, P.O. Box 7057, Amsterdam 1007MB, The Netherlands

³ Department of Public Health and Primary Care, Institute of Public Health, Forvie Site, Robinson Way, University of Cambridge, Cambridge CB2 0SR, UK

^† Current address: Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99210, USA.

Int. J. Environ. Res. Public Health 2017, 14(11), 1290; https://doi.org/10.3390/ijerph14111290 - 25 Oct 2017

Cited by 50 | Viewed by 13375

Abstract

U.S. policy initiatives have sought to improve health through attracting neighborhood supermarket investment. Little evidence exists to suggest that these policies will be effective, in particular where there are socioeconomic barriers to healthy eating. We measured the independent associations and combined interplay of [...] Read more.

U.S. policy initiatives have sought to improve health through attracting neighborhood supermarket investment. Little evidence exists to suggest that these policies will be effective, in particular where there are socioeconomic barriers to healthy eating. We measured the independent associations and combined interplay of supermarket access and socioeconomic status with obesity. Using data on 9702 UK adults, we employed adjusted regression analyses to estimate measured BMI (kg/m²), overweight (25 ≥ BMI < 30) and obesity (≥30), across participants’ highest educational attainment (three groups) and tertiles of street network distance (km) from home location to nearest supermarket. Jointly-classified models estimated combined associations of education and supermarket distance, and relative excess risk due to interaction (RERI). Participants farthest away from their nearest supermarket had higher odds of obesity (OR 1.33, 95% CI: 1.11, 1.58), relative to those living closest. Lower education was also associated with higher odds of obesity. Those least-educated and living farthest away had 3.39 (2.46–4.65) times the odds of being obese, compared to those highest-educated and living closest, with an excess obesity risk (RERI = 0.09); results were similar for overweight. Our results suggest that public health can be improved through planning better access to supermarkets, in combination with interventions to address socioeconomic barriers. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Open AccessReply

Reply to the Letter of Terracini B. et al. “Comment on Piscitelli et al. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health”. Int. J. Environ. Res. Public Health 2017, 14, 495

by Prisco Piscitelli^1,*, Immacolata Marino², Andrea Falco¹, Matteo Rivezzi¹, Cosimo Neglia¹, Giulia Della Rosa¹, Giuseppe Militerno³, Adriana Bonifacino⁴, Gaetano Rivezzi⁵, Roberto Romizi⁶, Giuseppe Miserotti⁷, Maurizio Montella⁸, Fabrizio Bianchi⁹, Alessandra Marinelli¹⁰, Antonella De Donno¹¹

, Giovanni De Filippis¹², Giuseppe Serravezza¹², Gianluca Di Tanna¹³, Valerio Gennaro¹⁴, Mario Ascolese¹⁵, Alessandro Distante¹, Ernesto Burgio¹⁶ and Annamaria Colao¹⁷ Show full author list Hide full author list

¹ Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, Via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy

² Department of Economics and Statistics and CSEF, University Federico II, 80131 Naples, Italy

³ Local Health Authority ASL Napoli 3 South, 80100 Naples, Italy

⁴ St. Andrea Hospital, La Sapienza University, 00185 Rome, Italy

⁵ Division of Neonatology, St. Anna & St. Sebastiano Hospital, 81100 Caserta, Italy

⁶ Local Health Authority USL 8, 52100 Arezzo, Italy

⁷ Local Health Authority USL Piacenza, 29121 Piacenza, Italy

⁸ IRCCS G. Pascale Foundation, National Cancer Institute, 80131 Naples, Italy

⁹ National Research Council, CNR-IFC, 56121 Pisa, Italy

¹⁰ Department of Experimental Medicine, Second University of Naples (SUN), 80138 Naples, Italy

¹¹ Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, 73100 Lecce, Italy

¹² Local Health Authority ASL LE, 73100 Lecce, Italy

¹³ AMGEN International, 4057 Basel, Switzerland

¹⁴ IRCCS Policlinico San Martino IST, 16132 Genova, Italy

¹⁵ Division of Pediatric Surgery, Salerno University Hospital “Ruggi D’Aragona”, 84100 Salerno, Italy

¹⁶ European Cancer and Environment Research Institute (ECERI), 21004 Bruxelles, Belgium

¹⁷ Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy

Show full affiliation list Hide full affiliation list

Int. J. Environ. Res. Public Health 2017, 14(11), 1291; https://doi.org/10.3390/ijerph14111291 - 25 Oct 2017

Viewed by 2980

Abstract

A letter to the IJERPH Editor was submitted by Terracini B. et al. as a comment to our latest paper “Hospitalizations in Pediatric and Adult Patients for all Cancer Type in Italy:[...] Full article

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Open AccessArticle

Assessment of SIP Buildings for Sustainable Development in Rural China Using AHP-Grey Correlation Analysis

by Libiao Bai¹

, Hailing Wang¹, Chunming Shi^2,*, Qiang Du¹

and Yi Li³

¹ School of Economics and Management, Chang’an University, Middle Section of South Second Ring Road, Xi’an 710064, China

² Lazaridis School of Business and Economics, Wilfrid Laurier University, Waterloo, ON N2L3C5, Canada

³ School of Civil Engineering, Chang’an University, Middle Section of South Second Ring Road, Xi’an 710064, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1292; https://doi.org/10.3390/ijerph14111292 - 25 Oct 2017

Cited by 24 | Viewed by 4667

Abstract

Traditional rural residential construction has the problems of high energy consumption and severe pollution. In general, with sustainable development in the construction industry, rural residential construction should be aimed towards low energy consumption and low carbon emissions. To help achieve this objective, in [...] Read more.

Traditional rural residential construction has the problems of high energy consumption and severe pollution. In general, with sustainable development in the construction industry, rural residential construction should be aimed towards low energy consumption and low carbon emissions. To help achieve this objective, in this paper, we evaluated four different possible building structures using AHP-Grey Correlation Analysis, which consists of the Analytic Hierarchy Process (AHP) and the Grey Correlation Analysis. The four structures included the traditional and currently widely used brick and concrete structure, as well as structure insulated panels (SIPs). Comparing the performances of economic benefit and carbon emission, the conclusion that SIPs have the best overall performance can be obtained, providing a reference to help builders choose the most appropriate building structure in rural China. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Open AccessArticle

Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program

by Selma Metintaş^1,2,†, Hasan Fevzi Batırel^3,†, Hasan Bayram^4,†, Ülkü Yılmaz^5,†, Mehmet Karadağ^6,†, Güntülü Ak^2,† and Muzaffer Metintaş^2,*,†

¹ Medical Faculty Department of Public Health, Eskisehir Osmangazi University, Eskisehir 26040, Turkey

² Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir 26040, Turkey

³ Medical Faculty Department of Chest Surgery, Marmara University, İstanbul 34722, Turkey

⁴ Medical Faculty Department of Chest Diseases, Koç University, İstanbul 34450, Turkey

⁵ Medical Faculty Department of Chest Diseases, Health Science University, Ankara 06430, Turkey

⁶ Medical Faculty Department of Chest Diseases, Uludağ University, Bursa 16059, Turkey

^† On behalf of the Turkish Mesothelioma Working Group.

Int. J. Environ. Res. Public Health 2017, 14(11), 1293; https://doi.org/10.3390/ijerph14111293 - 25 Oct 2017

Cited by 31 | Viewed by 6709

Abstract

Malignant mesothelioma (MM) is an important health problem due to ongoing asbestos exposure. Environmental asbestos exposure leads to a high risk of MM in Turkey. The Turkish Mesothelioma Working Group and the Turkish Public Health Institute designed and performed the Turkey National Mesothelioma [...] Read more.

Malignant mesothelioma (MM) is an important health problem due to ongoing asbestos exposure. Environmental asbestos exposure leads to a high risk of MM in Turkey. The Turkish Mesothelioma Working Group and the Turkish Public Health Institute designed and performed the Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program (TUNMES-EAECP). The aim of this study was to analyze the results of the TUNMES-EAECP. Patients diagnosed with MM (code C45.0–C45.9) between 2008 and 2012 were identified. The “from case to the field” method was used to determine the villages with current or previous asbestos exposure. Special public health teams took soil samples from these villages, which were then examined using an X-ray diffractometer. Direct Standardized Average Annual Mesothelioma Incidence Rate (AMIR) and relative risk (RR) of MM were calculated. Finally, a projection on the incidence of MM between 2013 and 2033 was made. The number of confirmed MM cases was 5617 with a male to female ratio of 1.36. Mean age was 61.7 ± 13.4 (20–96) years. The median survival was eight (95% CI 7.6–8.4) months. Asbestos exposure continues in 379 villages, with 158,068 people still living in high risk areas. The standardized AMIR was 2.33/100,000 per year. The risk of MM was higher in males, in both sexes over the age of 40, in asbestos-containing provinces, and in those where the TUNMES was organized. Among the population with continuing asbestos exposure in rural areas, the number of MM cases between 2013 and 2033 was estimated as 2511. As such, the incidence of MM in Turkey is as high as in industrialized countries. Asbestos exposure in rural areas continues to be a serious problem in Turkey, which obviates the necessity for effective preventive measures. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Frequency of Loud Snoring and Metabolic Syndrome among Korean Adults: Results from the Health Examinees (HEXA) Study

by Claire E. Kim^1,2, Sangah Shin³, Hwi-Won Lee^1,2, Jiyeon Lim¹, Jong-Koo Lee^4,5

and Daehee Kang^1,2,6,*

¹ Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea

² Department of Biomedical Sciences, College of Medicine, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea

³ Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, Korea

⁴ JW Lee Center for Global Medicine, College of Medicine, Seoul National University, IhwaJang-gil 71 Jongno-gu, Seoul 03087, Korea 03087

⁵ Department of Family Medicine, Seoul National University Hospital, 101 Daehakro, Jongnogu, Seoul 03080, Korea

⁶ Institute of Environmental Medicine, Seoul National University Medical Research Center, 103 Daehakro, Jongnogu, Seoul 03080, Korea

Int. J. Environ. Res. Public Health 2017, 14(11), 1294; https://doi.org/10.3390/ijerph14111294 - 26 Oct 2017

Cited by 9 | Viewed by 4386

Abstract

Studies regarding the association between snoring and metabolic abnormalities have been inconsistent. We examine whether snoring frequency and obstructive sleep apnea markers are associated with metabolic syndrome (MetS) among Koreans aged 40–69 years. A total of 72,885 subjects (24,856 men, 48,029 women) from [...] Read more.

Studies regarding the association between snoring and metabolic abnormalities have been inconsistent. We examine whether snoring frequency and obstructive sleep apnea markers are associated with metabolic syndrome (MetS) among Koreans aged 40–69 years. A total of 72,885 subjects (24,856 men, 48,029 women) from the Health Examinees Gem study between 2009 and 2013 were included. Snoring frequency was grouped into five categories (never, 1–3/month, 1–3/week, 4–5/week, 6+/week). Obstructive sleep apnea markers included breathing interruptions and awakenings. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated through logistic regression. Compared with non-snorers, those who snore 6+/week were associated with increased odds for MetS (OR: 2.07, 95% CI: 1.91–2.25, p-trend < 0.0001 among men; OR: 1.45, CI: 1.33–1.58, p-trend < 0.0001 among women). Snoring frequency is associated with MetS and its components in both men and women. Snoring and obstructive sleep apnea markers are important indicators of sleep quality, which may facilitate early detection of sleep disorders and further complications such as MetS. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessArticle

The Combined Influence of Air Pollution and Home Learning Environment on Early Cognitive Skills in Children

by Elle Lett^1,†

, Jeanette A. Stingone^2,*

and Luz Claudio²

¹ Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA

² Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA

^† Work completed while at Department of Environmental Medicine and Public Health at Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.

Int. J. Environ. Res. Public Health 2017, 14(11), 1295; https://doi.org/10.3390/ijerph14111295 - 26 Oct 2017

Cited by 19 | Viewed by 4632

Abstract

Cognitive skills are one component of school readiness that reflect a child’s neurodevelopment and are influenced by environmental and social factors. Most studies assess the impact of these factors individually, without taking into consideration the complex interactions of multiple factors. The objective of [...] Read more.

Cognitive skills are one component of school readiness that reflect a child’s neurodevelopment and are influenced by environmental and social factors. Most studies assess the impact of these factors individually, without taking into consideration the complex interactions of multiple factors. The objective of this study was to examine the joint association of markers of environmental pollution and of social factors on early cognitive skills in an urban cohort of children. For this, we chose isophorone in ambient air as a marker of industrial air pollution. Low quality home learning environments was chosen as a marker of the social factors contributing to cognitive development. Using a subpopulation from the Early Childhood Longitudinal Study, Birth Cohort (N = 4050), isophorone exposure was assigned using the 2002 National Air Toxics Assessment. Home learning environment was assessed with a modified version of the Home Observation for Measurement of the Environment (HOME) Inventory, and standardized math assessment scores were used as a measure of early cognitive skills. Multiple linear regression was used to estimate the effect of both exposures on math scores. After adjustment for confounders, children living in areas with ambient isophorone in the upper quintile of exposure (>0.49 ng/m³) had math scores that were 1.63 points lower than their less exposed peers [95% CI: −2.91, −0.34], and children with lower HOME scores (at or below 9 out of 12) had math scores that were 1.20 points lower than children with better HOME scores [95% CI: −2.30, −0.10]. In adjusted models accounting for identified confounders and both exposures of interest, both high isophorone exposure and low HOME score remained independently associated with math scores [−1.48, 95% CI: −2.79, −0.18; −1.05, 95% CI: −2.15, 0.05, respectively]. There was no statistical evidence of interaction between the two exposures, although children with both higher isophorone exposure and a low HOME score had a decrement in math scale score beyond the additive effect of each exposure. This was primarily observed among male children. These findings suggest that aspects of both the physical and social environments are independently associated with children’s early cognitive skills. Future research aiming to improve children’s early cognitive skills and subsequent school readiness should address both domains. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Presence of Legionella spp. in Hot Water Networks of Different Italian Residential Buildings: A Three-Year Survey

by Michele Totaro¹, Paola Valentini¹, Anna Laura Costa¹, Lorenzo Frendo¹, Alessia Cappello¹, Beatrice Casini¹, Mario Miccoli², Gaetano Privitera¹ and Angelo Baggiani^1,*

¹ Department of Translational Research N.T.M.S., University of Pisa, 56126 Pisa, Italy

² Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy

Int. J. Environ. Res. Public Health 2017, 14(11), 1296; https://doi.org/10.3390/ijerph14111296 - 26 Oct 2017

Cited by 19 | Viewed by 4226

Abstract

Although the European reports highlight an increase in community-acquired Legionnaires’ disease cases, the risk of Legionella spp. in private houses is underestimated. In Pisa (Italy) we performed a three-year survey on Legionella presence in 121 buildings with an independent hot water production (IB); [...] Read more.

Although the European reports highlight an increase in community-acquired Legionnaires’ disease cases, the risk of Legionella spp. in private houses is underestimated. In Pisa (Italy) we performed a three-year survey on Legionella presence in 121 buildings with an independent hot water production (IB); 64 buildings with a central hot water production (CB); and 35 buildings with a solar thermal system for hot water production (TB). From all the 220 buildings Legionella spp. was researched in two hot water samples collected either at the recirculation point or on the first floor and on the last floor, while the potable water quality was analysed in three cold water samples collected at the inlet from the aqueduct network, at the exit from the autoclave, and at the most remote tap. Legionella pneumophila sg1, Legionella pneumophila sg2–16, and non-pneumophila Legionella species were detected in 26% of the hot water networks, mostly in CB and TB. In these buildings we detected correlations between the presence of Legionella and the total chlorine concentration decrease and/or the increase of the temperature. Cold water resulted free from microbiological hazards, with the exception of Serratia liquefaciens and Enterobacter cloacae isolated at the exit from two different autoclaves. We observed an increase in total microbial counts at 22 °C and 37 °C between the samples collected at the most remote taps compared to the ones collected at the inlet from the aqueduct. The study highlights a condition of potential risk for susceptible categories of population and supports the need for measures of risk assessment and control. Full article

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Open AccessArticle

Environmental Pollution by Benzene and PM₁₀ and Clinical Manifestations of Systemic Sclerosis: A Correlation Study

by Alice Borghini¹, Andrea Poscia¹, Silvia Bosello², Adele Anna Teleman¹, Mario Bocci², Lanfranco Iodice³, Gianfranco Ferraccioli², Daniele Ignazio La Milìa¹ and Umberto Moscato^1,*

¹ Institute of Public Health-Hygiene Section, Università Cattolica del Sacro Cuore, 00168 Roma, Italy

² Department of Rheumatology, Fondazione Policlinico Gemelli, 00168 Rome, Italy

³ Vice Medical Director, San Raffaele Cassino Hospital, 03043 Cassino (FR), Italy

Int. J. Environ. Res. Public Health 2017, 14(11), 1297; https://doi.org/10.3390/ijerph14111297 - 26 Oct 2017

Cited by 19 | Viewed by 3574

Abstract

Atmospheric air pollution has been associated with a range of adverse health effects. The environment plays a causative role in the development of Systemic Sclerosis (SSc). The aim of the present study is to explore the association between particulate (PM₁₀) and [...] Read more.

Atmospheric air pollution has been associated with a range of adverse health effects. The environment plays a causative role in the development of Systemic Sclerosis (SSc). The aim of the present study is to explore the association between particulate (PM₁₀) and benzene (B) exposure in Italian patients with systemic sclerosis and their clinical characteristics of the disease. A correlation study was conducted by enrolling 88 patients who suffer from SSc at the Fondazione Policlinico “A. Gemelli” in Rome (Italy) in the period from January 2013 to January 2014. The average mean concentrations of B (in 11 monitoring sites) and PM₁₀ (in 14 sites) were calculated using data from the Regional Environmental Protection Agency’s monitoring stations located throughout the Lazio region (Italy) and then correlated with the clinical characteristics of the SSc patients. Of the study sample, 92.5% were female. The mean age was 55 ± 12.9 years old and the mean disease duration from the onset of Raynaud’s phenomenon was 13.0 ± 9.4 years. The Spearman’s correlation showed that concentrations of B correlate directly with the skin score (R = 0.3; p ≤ 0.05) and inversely with Diffusing Lung Carbon Monoxide (DLCO) results (R = −0.36; p = 0.04). This study suggests a possible role of B in the development of diffuse skin disease and in a worse progression of the lung manifestations of SSc. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Application of Circular Bubble Plume Diffusers to Restore Water Quality in a Sub-Deep Reservoir

by Chen Lan^1,2

, Jingan Chen^1,*, Jingfu Wang¹, Jianyang Guo¹, Jia Yu^1,2, Pingping Yu³, Haiquan Yang¹ and Yong Liu^1,2

¹ State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, Guiyang 550081, China

² College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China

³ College of Resource and Environmental Engineering, Guizhou University, Guiyang 550025, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1298; https://doi.org/10.3390/ijerph14111298 - 26 Oct 2017

Cited by 9 | Viewed by 3892

Abstract

Circular bubble plume diffusers have been confirmed as an effective technology for the restoration of the deep water system, but have never been applied in sub-deep water system. In this study, circular bubble plume diffusers were used, for the first time, to restore [...] Read more.

Circular bubble plume diffusers have been confirmed as an effective technology for the restoration of the deep water system, but have never been applied in sub-deep water system. In this study, circular bubble plume diffusers were used, for the first time, to restore water quality in the Aha Reservoir, a typical sub-deep reservoir in Southwest China. Axisymmetric intrusive gravity currents were formed with a horizontal radius of 250 m at the equilibrium depth and the intrusion of oxygen-enriched water occurred within the depth of 10–14 m, while thermal stratification remained intact. A total of 95% of the imported oxygen was dissolved, but most was consumed by organic matter and other reduced substances within the hypolimnion. The oxygen consumption of organic matter, NH₄⁺ and remaining reduced materials, accounted for 41.4–52.5%, 25% and 13.3–24.4% of the total imported oxygen, respectively. Compared with the control sites, dissolved oxygen level in the hypolimnion increased 3–4 times, and concentrations of NH₄⁺, total Fe and total Mn were reduced by 15.5%, 45.5% and 48.9%, respectively. A significant decrease in total phosphorus and nitrogen concentrations was observed in the experimental zone (0.04–0.02 mg/L and 1.9–1.7 mg/L, respectively). This indicates that circular bubble plumes have great potential for oxygenation of the hypolimnion and improving water quality in the sub-deep water system. Nevertheless, further efforts are needed to improve the discrete bubble model to elaborate the oxygen transmission dynamics and the plume formation processes in sub-deep water systems, incorporating oxygen consumption processes. Full article

(This article belongs to the Section Environmental Science and Engineering)

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Open AccessArticle

An Integrated Pest Management Intervention Improves Knowledge, Pest Control, and Practices in Family Child Care Homes

by Michelle Stephens^*

, Kimberly Hazard, Debra Moser, Dana Cox, Roberta Rose and Abbey Alkon

School of Nursing, University of California, San Francisco, CA 94143, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1299; https://doi.org/10.3390/ijerph14111299 - 26 Oct 2017

Cited by 6 | Viewed by 6399

Abstract

To reduce young children’s exposure to pesticides when attending family child care homes (FCCHs), we developed an integrated pest management (IPM) intervention for FCCH directors. First, we developed IPM educational materials and resources to provide the foundation for an IPM educational intervention for [...] Read more.

To reduce young children’s exposure to pesticides when attending family child care homes (FCCHs), we developed an integrated pest management (IPM) intervention for FCCH directors. First, we developed IPM educational materials and resources to provide the foundation for an IPM educational intervention for FCCHs. Next, we conducted and evaluated a six-month nurse child care health consultant (CCHC)-led education and consultation IPM intervention to increase IPM knowledge, IPM practices, IPM policies, and decrease the presence or evidence of pests. The pilot intervention study was conducted by three CCHCs in 20 FCCHs in three counties in California. Pre- and post-intervention measures were completed by the FCCH directors and observation measures were completed by the CCHCs. Results indicated significant increases in IPM knowledge, (t-statistic (degrees of freedom), (t(df) = 2.55(10), p < 0.05), increases in IPM practices (t(df) = −6.47(17), p < 0.05), and a 90% reduction in the prevalence of pests. There were no significant differences in changes in IPM practices based on director education, FCCH county, or IPM intervention intensity or duration. A nurse-led IPM education and consultation intervention can reduce exposures of young children attending family child care homes to harmful chemicals. Full article

(This article belongs to the Special Issue Global Children’s Environmental Health)

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Open AccessArticle

Nutrient Content and Nutritional Water Productivity of Selected Grain Legumes in Response to Production Environment

by Tendai Polite Chibarabada^*, Albert Thembinkosi Modi and Tafadzwanashe Mabhaudhi

Crop Science, School of Agricultural, Earth and Environmental Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Private Bag X01, Scottsville 3201 Pietermaritzburg, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1300; https://doi.org/10.3390/ijerph14111300 - 26 Oct 2017

Cited by 21 | Viewed by 4865

Abstract

There is a need to incorporate nutrition into aspects of crop and water productivity to tackle food and nutrition insecurity (FNS). The study determined the nutritional water productivity (NWP) of selected major (groundnut, dry bean) and indigenous (bambara groundnut and cowpea) grain legumes [...] Read more.

There is a need to incorporate nutrition into aspects of crop and water productivity to tackle food and nutrition insecurity (FNS). The study determined the nutritional water productivity (NWP) of selected major (groundnut, dry bean) and indigenous (bambara groundnut and cowpea) grain legumes in response to water regimes and environments. Field trials were conducted during 2015/16 and 2016/17 at three sites in KwaZulu-Natal, South Africa (Ukulinga, Fountainhill and Umbumbulu). Yield and evapotranspiration (ET) data were collected. Grain was analysed for protein, fat, Ca, Fe and Zn nutrient content (NC). Yield, ET and NC were then used to compute NWP. Overall, the major legumes performed better than the indigenous grain legumes. Groundnut had the highest NWP_fat. Groundnut and dry bean had the highest NWP_protein. For NWP_{Fe, Zn and Ca}, dry bean and cowpea were more productive. Yield instability caused fluctuations in NWP. Water treatments were not significant (p > 0.05). While there is scope to improve NWP under rainfed conditions, a lack of crop improvement currently limits the potential of indigenous grain legumes. This provides an initial insight on the nutrient content and NWP of a limited number of selected grain legumes in response to the production environment. There is a need for follow-up research to include cowpea data. Future studies should provide more experimental data and explore effects of additional factors such as management practices (fertiliser levels and plant density), climate and edaphic factors on nutrient content and NWP of crops. Full article

(This article belongs to the Section Global Health)

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Preparation and Application of Carboxylated Graphene Oxide Sponge in Dye Removal

by Lianqin Zhao¹, Sheng-Tao Yang^2,*

, Shicheng Feng², Qiang Ma², Xiaoling Peng² and Deyi Wu^1,*

¹ School of Environmental Science and Engineering, Shanghai Jiao Tong University, No. 800 Dongchuan Road, Shanghai 200240, China

² College of Chemistry and Environment Protection Engineering, Southwest University for Nationalities, Chengdu 610041, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1301; https://doi.org/10.3390/ijerph14111301 - 26 Oct 2017

Cited by 42 | Viewed by 4763

Abstract

Spongy graphene is a newly developed adsorbent of high performance for water treatment. Proper functionalization is an efficient approach to improve the adsorption capacity of graphene adsorbents. In this study, we prepared graphene oxide (GO), functionalized it with carboxyl groups to produce carboxylated [...] Read more.

Spongy graphene is a newly developed adsorbent of high performance for water treatment. Proper functionalization is an efficient approach to improve the adsorption capacity of graphene adsorbents. In this study, we prepared graphene oxide (GO), functionalized it with carboxyl groups to produce carboxylated GO (GO-COOH) dispersion, and lyophilized the GO-COOH dispersion to obtain the GO-COOH sponge. The adsorption isotherm, kinetics, thermodynamics, influencing factors, and regeneration of the adsorption of dye methylene blue (MB) on GO-COOH sponge were evaluated in batch experiments. The adsorption capacity of GO-COOH sponge was measured as 780 mg/g, which was nearly twice that of GO sponge (446 mg/g). The adsorption isotherm could be well described by the Freundlich model with a K_F of 508 (L/mg)^1/n. The adsorption kinetic was nicely fitted by pseudo-first-order model with a k₁ of 0.00157·min⁻¹. In thermodynamics analysis, the negative ΔG indicated the spontaneous nature of adsorption on GO-COOH sponge. The adsorption process was endothermic and was driven by the increase of entropy. Higher pH benefited the removal of MB by GO-COOH sponge and the ionic strength had no meaningful effect. The regeneration was poor due to the strong electrostatic interaction between MB and the GO-COOH sponge. The results collectively suggested that carboxylation increased the adsorption performance of GO sponge. Full article

(This article belongs to the Section Environmental Science and Engineering)

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Open AccessFeature PaperReview

Toward an Asbestos Ban in the United States

by Richard A. Lemen^1,2,3 and Philip J. Landrigan^3,4,5,*

¹ National Institute for Occupational Safety and Health (retired), Washington, DC 20024, USA

² Department of Environmental Health, Rollins School of Public Health of the Emory University, 1518 Clifton Rd., Atlanta, GA 30322, USA

³ Collegium Ramazzini, Castello di Bentivoglio via Saliceto, Bentivoglio, 340010 Bologna, Italy

⁴ Environmental Medicine and Public, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA

⁵ Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, 1090 Tusculum Ave., Cincinnati, OH 45226-1988, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1302; https://doi.org/10.3390/ijerph14111302 - 26 Oct 2017

Cited by 17 | Viewed by 13676

Abstract

Many developed countries have banned the use of asbestos, but not the United States. There have, however, been multiple efforts in the US to establish strict exposure standards, to limit asbestos use, and to seek compensation through the courts for asbestos-injured workers’ In [...] Read more.

Many developed countries have banned the use of asbestos, but not the United States. There have, however, been multiple efforts in the US to establish strict exposure standards, to limit asbestos use, and to seek compensation through the courts for asbestos-injured workers’ In consequence of these efforts, asbestos use has declined dramatically, despite the absence of a legally mandated ban. This manuscript presents a historical review of these efforts. Full article

(This article belongs to the Special Issue Global Panorama of National Experiences in Public Health Actions to Ban Asbestos)

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Exploring Perception of Vibrations from Rail: An Interview Study

by Laura Maclachlan^1,*, Kerstin Persson Waye¹

and Eja Pedersen²

¹ Department of Public Health and Community Medicine, University of Gothenburg, Box 414, 40530 Göteborg, Sweden

² Department of Architecture and the Built Environment, Lund University, Box 118, 22100 Lund, Sweden

Int. J. Environ. Res. Public Health 2017, 14(11), 1303; https://doi.org/10.3390/ijerph14111303 - 26 Oct 2017

Cited by 7 | Viewed by 4071

Abstract

Rail transport is an environmentally responsible approach and traffic is expected to increase in the coming decades. Little is known about the implications for quality of life of populations living close to railways. This study explores the way in which vibrations from rail [...] Read more.

Rail transport is an environmentally responsible approach and traffic is expected to increase in the coming decades. Little is known about the implications for quality of life of populations living close to railways. This study explores the way in which vibrations from rail are perceived and described by these populations. The study took place in the Västra Götaland and Värmland regions of Sweden. A qualitative study approach was undertaken using semi-structured interviews within a framework of predetermined questions in participants’ homes. A 26.3% response rate was achieved and 17 participants were interviewed. The experience of vibrations was described in tangible terms through different senses. Important emerging themes included habituation to and acceptance of vibrations, worry about property damage, worry about family members and general safety. Participants did not reflect on health effects, however, chronic exposure to vibrations through multimodal senses in individual living environments may reduce the possibility for restoration in the home. Lack of empowerment to reduce exposure to vibrations was important. This may alter individual coping strategies, as taking actions to avoid the stressor is not possible. The adoption of other strategies, such as avoidance, may negatively affect an individual’s ability to cope with the stressor and their health. Full article

(This article belongs to the Special Issue Sustainable Transportation and Health)

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Open AccessFeature PaperArticle

Vaccines as Epidemic Insurance

by Mark V. Pauly

Department of Health Care Management, The Wharton School, University of Pennsylvania 208 Colonial Penn Center, 3641 Locust Walk, Philadelphia, PA 19104, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1304; https://doi.org/10.3390/ijerph14111304 - 27 Oct 2017

Cited by 2 | Viewed by 3629

Abstract

This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs [...] Read more.

This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines) in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs) but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage). It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis. Full article

(This article belongs to the Special Issue Insurance and Health)

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Examination of the Relationship between In-Store Environmental Factors and Fruit and Vegetable Purchasing among Hispanics

by Jennifer Sanchez-Flack^1,*, Julie L. Pickrel², George Belch³, Shih-Fan Lin², Cheryl A. M. Anderson⁴, Maria Elena Martinez⁵, Elva M. Arredondo⁶ and Guadalupe X. Ayala⁶

¹ Health Behavior and the Institute for Behavioral and Community Health, San Diego State University, University of California at San Diego Joint Doctoral Program in Public Health, 5500 Campanile Drive, San Diego, CA 92182, USA

² Institute for Behavioral and Community Health, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA

³ Marketing Department, Fowler College of Business, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA

⁴ Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, #0725, La Jolla, CA 92093, USA

⁵ Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, #0901, La Jolla, CA 92093, USA

⁶ Graduate School of Public Health, San Diego State University and the Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1305; https://doi.org/10.3390/ijerph14111305 - 27 Oct 2017

Cited by 4 | Viewed by 4383

Abstract

Retail food environments have received attention for their influence on dietary behaviors and for their nutrition intervention potential. To improve diet-related behaviors, such as fruit and vegetable (FV) purchasing, it is important to examine its relationship with in-store environmental characteristics. This study used [...] Read more.

Retail food environments have received attention for their influence on dietary behaviors and for their nutrition intervention potential. To improve diet-related behaviors, such as fruit and vegetable (FV) purchasing, it is important to examine its relationship with in-store environmental characteristics. This study used baseline data from the “El Valor de Nuestra Salud” study to examine how in-store environmental characteristics, such as product availability, placement and promotion, were associated with FV purchasing among Hispanic customers in San Diego County. Mixed linear regression models indicated that greater availability of fresh FVs was associated with a $0.36 increase in FV purchasing (p = 0.01). Placement variables, specifically each additional square foot of display space dedicated to FVs (p = 0.01) and each additional fresh FV display (p = 0.01), were associated with a $0.02 increase and $0.29 decrease, respectively, in FV purchasing. Introducing FV promotions in the final model was not related to FV purchasing. Exploratory analyses indicated that men reported spending $3.69 fewer dollars on FVs compared to women, controlling for covariates (p = 0.02). These results can help inform interventions targeting in-store environmental characteristics to encourage FV purchasing among Hispanics. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Risk Perception and Anxiety Regarding Radiation after the 2011 Fukushima Nuclear Power Plant Accident: A Systematic Qualitative Review

by Yoshitake Takebayashi^1,2

, Yuliya Lyamzina²

, Yuriko Suzuki³

and Michio Murakami^1,2,*

¹ Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan

² Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan

³ Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan

Int. J. Environ. Res. Public Health 2017, 14(11), 1306; https://doi.org/10.3390/ijerph14111306 - 27 Oct 2017

Cited by 86 | Viewed by 10429

Abstract

The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references [...] Read more.

The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables. Full article

(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)

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Water Pollution Prediction in the Three Gorges Reservoir Area and Countermeasures for Sustainable Development of the Water Environment

by Yinghui Li^1,2,*

, Shuaijin Huang³ and Xuexin Qu⁴

¹ School of Economic Management, Southwest Jiao tong University, Chengdu 610031, China

² Research Center of the Economy of the Upper Reaches of Yangtze River, Chongqing Technology and Business University, Chongqing 400067, China

³ School of Economics, Chongqing Technology and Business University, Chongqing 400067, China

⁴ Chongqing Key Laboratory of Electronic Commerce & Supply Chain System, Chongqing Technology and Business University, Chongqing 400067, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1307; https://doi.org/10.3390/ijerph14111307 - 27 Oct 2017

Cited by 23 | Viewed by 4664

Abstract

The Three Gorges Project was implemented in 1994 to promote sustainable water resource use and development of the water environment in the Three Gorges Reservoir Area (hereafter “Reservoir Area”). However, massive discharge of wastewater along the river threatens these goals; therefore, this study [...] Read more.

The Three Gorges Project was implemented in 1994 to promote sustainable water resource use and development of the water environment in the Three Gorges Reservoir Area (hereafter “Reservoir Area”). However, massive discharge of wastewater along the river threatens these goals; therefore, this study employs a grey prediction model (GM) to predict the annual emissions of primary pollution sources, including industrial wastewater, domestic wastewater, and oily and domestic wastewater from ships, that influence the Three Gorges Reservoir Area water environment. First, we optimize the initial values of a traditional GM (1,1) model, and build a new GM (1,1) model that minimizes the sum of squares of the relative simulation errors. Second, we use the new GM (1,1) model to simulate historical annual emissions data for the four pollution sources and thereby test the effectiveness of the model. Third, we predict the annual emissions of the four pollution sources in the Three Gorges Reservoir Area for a future period. The prediction results reveal the annual emission trends for the major wastewater types, and indicate the primary sources of water pollution in the Three Gorges Reservoir Area. Based on our predictions, we suggest several countermeasures against water pollution and towards the sustainable development of the water environment in the Three Gorges Reservoir Area. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Does Parental Migration Have Negative Impact on the Growth of Left-Behind Children?—New Evidence from Longitudinal Data in Rural China

by Xu Tian¹

, Caicui Ding², Chong Shen³ and Hui Wang^3,*

¹ College of Economics and Management, China Center for Food Security Studies, Nanjing Agricultural University, Nanjing 210095, China

² Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China

³ Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Jiangning District, Nanjing 211166, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1308; https://doi.org/10.3390/ijerph14111308 - 27 Oct 2017

Cited by 31 | Viewed by 4812

Abstract

The soaring number of left-behind children (LBC) in China has raised concerns about whether or not they can receive adequate care. This study investigated the impact of parents’ migration on LBC’s growth. LBC were divided into father-left children (F-LBC) and at least mother [...] Read more.

The soaring number of left-behind children (LBC) in China has raised concerns about whether or not they can receive adequate care. This study investigated the impact of parents’ migration on LBC’s growth. LBC were divided into father-left children (F-LBC) and at least mother left children (M-LBC), both of which were compared with non-left-behind children (non-LBC) in terms of growth indicators. Data of 466 children with two continuous measurements were obtained from the four recent waves of the China Health and Nutrition Survey (CHNS). Anthropometric measures and 24-h recall of three consecutive days of dietary intake were extracted. The disparity of growth and nutrition status were compared by the difference-in-difference (DID) method. Results showed that LBC had significantly worse height and weight than non-LBC at baseline, respectively (p = 0.006, p = 0.003). This disadvantage was improved after parental migration, especially for M-LBC. However, the impact on growth status caused by parents’ migration was statistically insignificant once the pre-treatment disparity was removed. Further analysis on nutrition status indicated that fathers’ migration had a significant negative impact on F-LBC’s calorie intake (p = 0.014), which was mainly caused by the decline of carbohydrates (p = 0.008). This study indicated that the negative impact detected in previous studies might be caused by the retarded growth of LBC before parents’ migration. Full article

(This article belongs to the Section Occupational Safety and Health)

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Using the D-DANP-mV Model to Explore the Continuous System Improvement Strategy for Sustainable Development of Creative Communities

by Lei Xiong¹, Cheng-Lein Teng¹, Bo-Wei Zhu^2,3, Gwo-Hshiung Tzeng^2,* and Shan-Lin Huang^2,4

¹ College of Creative Design, Asia University, Lioufeng Rd. 500, Wufeng, Taichung 41354, Taiwan

² Graduate Institute of Urban Planning, College of Public Affairs, National Taipei University, University Rd. 151, San Shia District, New Taipei City 23741, Taiwan

³ Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa 999078, Macau, China

⁴ Department of Tourism Management, Tourism School, Sanming University, 25, Jingdong Rd., Sanyuan District, Sanming 365004, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1309; https://doi.org/10.3390/ijerph14111309 - 27 Oct 2017

Cited by 22 | Viewed by 5788

Abstract

With globalization, the notion of “creative city” has become a core concept of many cities in the world development policies, with real properties being upgraded or used to change, renewal is being conducted, and creative industries are emerging. This trend has reached its [...] Read more.

With globalization, the notion of “creative city” has become a core concept of many cities in the world development policies, with real properties being upgraded or used to change, renewal is being conducted, and creative industries are emerging. This trend has reached its peak in the past decade, with different forms and scales gathering global development momentum among the creative communities to promote the development of creative economies. In recent years, however, there was still skepticism about the sustainability of the current creative communities. Many scholars have pointed out that signs of unsustainability have begun to appear in many creative communities. To overcome these obstacles, the development of rational and highly effective improvement strategy requires a dynamic thinking process. Therefore, this study employs the DEMATEL-based ANP with modified VIKOR (D-DANP-mV) model in presenting an assessment framework for the sustainability of creative communities. This system is used to assess the sustainability of current creative communities and determine how to solve their problems. Thus, continuous and systemic improvement strategies can be developed to achieve the aim of sustainable development. Two creative communities in Taiwan, Taichung Cultural and Creative Industries Park (TCCIP), and Shen-Ji New Village (SJNV), are used as case studies in this study. Based on the concept of systematic improvement from fundamental issues, the results indicate that the improvement priorities can be determined by applying the D-DANP-mV model. This approach is different from those found by a conventional method with the hypothesis of independent criteria (e.g., diversification of creative talents in TCCIP), and cannot use for performance improvement (e.g., only can be used for ranking and selection among alternatives). Considering these points, unreasonable premises, biased errors, and lack of some real application functions in the process of resource allocation could be more efficient improvement strategies generated in this proposed model. Full article

(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)

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Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

by Patrik Grahn^1,*, Anna María Pálsdóttir¹, Johan Ottosson¹ and Ingibjörg H. Jonsdottir²

¹ Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, P.O. Box 88, SE-230 53 Alnarp, Sweden

² The Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs Gata 22B, SE 413 19 Gothenburg, Sweden

Int. J. Environ. Res. Public Health 2017, 14(11), 1310; https://doi.org/10.3390/ijerph14111310 - 27 Oct 2017

Cited by 45 | Viewed by 10192

Abstract

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard [...] Read more.

The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work. Full article

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Open AccessArticle

An Improved Graph Model for Conflict Resolution Based on Option Prioritization and Its Application

by Kedong Yin^1,2, Li Yu¹

and Xuemei Li^1,2,*

¹ School of Economics, Ocean University of China, Qingdao 266100, China

² Ocean Development Research Institute, Major Research Base of Humanities and Social Sciences of Ministry of Education, Ocean University of China, Qingdao 266100, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1311; https://doi.org/10.3390/ijerph14111311 - 27 Oct 2017

Cited by 11 | Viewed by 4221

Abstract

In order to quantitatively depict differences regarding the preferences of decision makers for different states, a score function is proposed. As a foundation, coalition motivation and real-coalition analysis are discussed when external circumstance or opportunity costs are considering. On the basis of a [...] Read more.

In order to quantitatively depict differences regarding the preferences of decision makers for different states, a score function is proposed. As a foundation, coalition motivation and real-coalition analysis are discussed when external circumstance or opportunity costs are considering. On the basis of a confidence-level function, we establish the score function using a “preference tree”. We not only measure the preference for each state, but we also build a collation improvement function to measure coalition motivation and to construct a coordinate system in which to analyze real-coalition stability. All of these developments enhance the applicability of the graph model for conflict resolution (GMCR). Finally, an improved GMCR is applied in the “Changzhou Conflict” to demonstrate how it can be conveniently utilized in practice. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Open AccessArticle

Long-Lasting Insecticide Net Ownership, Access and Use in Southwest Ethiopia: A Community-Based Cross-Sectional Study

by Dinberu Seyoum^1,2,*, Niko Speybroeck¹, Luc Duchateau³, Patrick Brandt⁴ and Angel Rosas-Aguirre^1,5

¹ Institute of Health and Society (IRSS), Université Catholique de Louvain, 1200 Brussels, Belgium

² Department of Statistics, Natural Science College, Jimma University, Jimma 378, Ethiopia

³ Biometrics Research Group, Faculty of Veterinary Medicine, Ghent University, 9000 Ghent, Belgium

⁴ School of Economic, Political and Policy Sciences, The University of Texas, Dallas, TX 75080, USA

⁵ Institute of Tropical Medicine “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima 31, Peru

Int. J. Environ. Res. Public Health 2017, 14(11), 1312; https://doi.org/10.3390/ijerph14111312 - 27 Oct 2017

Cited by 17 | Viewed by 4640

Abstract

Introduction:A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, [...] Read more.

Introduction:A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, access and use of LLNs in the malaria endemic southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in southwest Ethiopia during October–November 2015, including 836 households from sixteen villages around Gilgel-Gibe dam area. Indicators of ownership, access and use of LLINs were derived following the Roll Back Malaria (RBM) guidelines. Factors associated with failure for both LLIN access and use were analysed at household level using a multivariate logistic regression model. Results: The proportion of households with at least one LLIN was 82.7% (95% CI: 80.0, 85.1). However, only 68.9% (95% CI: 65.6, 71.9) had enough LLINs to cover all family members (with ≥one LLIN for every two persons). While 75.3% (95% CI: 68.4, 83.0) of the population was estimated to have accessed to LLINs, only 63.8% (95% CI: 62.3, 65.2) reported to have used a LLIN the previous night. The intra-household gap (i.e., households owning at least one LLIN, but unable to cover all family members) and the behavioral gap (i.e., household members who did not sleep under a LLIN despite having access to one) were 16.8% and 10.5%, respectively. Age, marital status and education of household heads, as well as household size and cooking using firewood were associated with the access to enough LLINs within households. Decreased access to LLINs at households was the main determinant for not achieving ≥80% household members sleeping under a LLIN the previous night. Other associated factors were household size and education level of household head. Conclusions: LLIN coverage levels in study villages remain below national targets of 100% for ownership and 80% for use. The access to enough LLINs within the households is the main restriction of LLIN use in the study area. Full article

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Open AccessArticle

Diet Quality and Satisfaction with Life, Family Life, and Food-Related Life across Families: A Cross-Sectional Pilot Study with Mother-Father-Adolescent Triads

by Berta Schnettler^1,2,*

, Germán Lobos³, Edgardo Miranda-Zapata⁴, Marianela Denegri^2,5, Gastón Ares⁶ and Clementina Hueche²

¹ Facultad de Ciencias Agropecuarias y Forestales, Universidad de La Frontera, Temuco 4811230, Chile

² Centro de Excelencia en Psicología Económica y del Consumo, Núcleo Científico y Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco 4811230, Chile

³ Facultad de Economía y Negocios, Universidad de Talca, Talca 3460000, Chile

⁴ LICSA, Núcleo Científico y Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco 4811230, Chile

⁵ Facultad de Educación, Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco 4811230, Chile

⁶ Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando 4225, Uruguay

Int. J. Environ. Res. Public Health 2017, 14(11), 1313; https://doi.org/10.3390/ijerph14111313 - 29 Oct 2017

Cited by 53 | Viewed by 7116

Abstract

Family is a major determinant of children’s and adolescents’ eating behavior. The objectives of the present study were to assess diet quality, eating habits, satisfaction with life, family life, and food-related life in mother–father–adolescent triads, and to identify profiles of families according to [...] Read more.

Family is a major determinant of children’s and adolescents’ eating behavior. The objectives of the present study were to assess diet quality, eating habits, satisfaction with life, family life, and food-related life in mother–father–adolescent triads, and to identify profiles of families according to family members’ diet quality. Questionnaires were administered to a sample of 300 two-parent families with one child over the age of 10 in the city of Temuco (Chile), including the Adapted Healthy Eating Index (AHEI), Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWFoL) scale, Satisfaction with Family Life (SWFaL) scales, and questions relating to their eating habits. Positive relationships were found between the diet quality of the family members, particularly between mothers and adolescents. Three family profiles with different diet qualities were identified: “families with an unhealthy diet” (39.3%), “families in which mothers and adolescents have healthy diets, but the fathers’ diets require changes” (14.3%), and “families that require changes in their diet” (46.4%). These findings stress the key role of mothers in determining family diet quality and suggest a positive relationship between diet quality and satisfaction with life. Full article

(This article belongs to the Special Issue Nutrition and Public Health)

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Open AccessReview

Executive Function Capacities, Negative Driving Behavior and Crashes in Young Drivers

by Elizabeth A. Walshe^1,2,*

, Chelsea Ward McIntosh²

, Daniel Romer¹

and Flaura K. Winston²

¹ Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA 19104, USA

² Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1314; https://doi.org/10.3390/ijerph14111314 - 28 Oct 2017

Cited by 72 | Viewed by 9572

Abstract

Motor vehicle crashes remain a leading cause of injury and death in adolescents, with teen drivers three times more likely to be in a fatal crash when compared to adults. One potential contributing risk factor is the ongoing development of executive functioning with [...] Read more.

Motor vehicle crashes remain a leading cause of injury and death in adolescents, with teen drivers three times more likely to be in a fatal crash when compared to adults. One potential contributing risk factor is the ongoing development of executive functioning with maturation of the frontal lobe through adolescence and into early adulthood. Atypical development resulting in poor or impaired executive functioning (as in Attention-Deficit/Hyperactivity Disorder) has been associated with risky driving and crash outcomes. However, executive function broadly encompasses a number of capacities and domains (e.g., working memory, inhibition, set-shifting). In this review, we examine the role of various executive function sub-processes in adolescent driver behavior and crash rates. We summarize the state of methods for measuring executive control and driving outcomes and highlight the great heterogeneity in tools with seemingly contradictory findings. Lastly, we offer some suggestions for improved methods and practical ways to compensate for the effects of poor executive function (such as in-vehicle assisted driving devices). Given the key role that executive function plays in safe driving, this review points to an urgent need for systematic research to inform development of more effective training and interventions for safe driving among adolescents. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

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Open AccessArticle

Who Participates in Running Events? Socio-Demographic Characteristics, Psychosocial Factors and Barriers as Correlates of Non-Participation—A Pilot Study in Belgium

by Delfien Van Dyck^1,2,*

, Greet Cardon²

, Ilse De Bourdeaudhuij²

, Lisa De Ridder³ and Annick Willem²

¹ Research Foundation Flanders (FWO), Egmontstraat 5, 1000 Brussels, Belgium

² Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium

³ Department of Applied Health Sciences, University College West Flanders (Howest), Sint-Jorisstraat 71, 8000 Bruges, Belgium

Int. J. Environ. Res. Public Health 2017, 14(11), 1315; https://doi.org/10.3390/ijerph14111315 - 28 Oct 2017

Cited by 38 | Viewed by 5810

Abstract

In Western countries, the popularity of running events has increased exponentially during the last three decades. However, little is known about the profile of non-participants. This knowledge is crucial to tailor promotional actions towards people who are currently not participating. Therefore, this study [...] Read more.

In Western countries, the popularity of running events has increased exponentially during the last three decades. However, little is known about the profile of non-participants. This knowledge is crucial to tailor promotional actions towards people who are currently not participating. Therefore, this study aimed: (1) to examine which socio-ecological factors are related to participation in running events, (2) to give an overview of the barriers towards participation, and (3) to examine differences in barriers depending on gender, age and educational level. Flemish adults (n = 308) completed an online questionnaire about their socio-demographic and psychosocial characteristics, physical activity levels, participation in running events and barriers towards participation. Results showed that motivation, family social support, knowledge about running events and physical activity levels were associated with participation in running events. Among non-participants, the main barriers were bad physical condition, lack of time and lack of interest. In participants, lack of time, distance to the event and financial barriers were most prevalent. With some exceptions, barriers were relatively similar across socio-demographic subgroups. This study confirmed a democratization among participants of running events and provided evidence about which barriers should be tackled to increase participation among population subgroups that are currently underrepresented in such events. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessArticle

Sensitizing Black Adult and Youth Consumers to Targeted Food Marketing Tactics in Their Environments

by Katherine Isselmann DiSantis¹, Shiriki Kumanyika^2,*, Lori Carter-Edwards³

, Deborah Rohm Young⁴, Sonya A. Grier⁵ and Vikki Lassiter⁶

¹ Department of Public Health, Arcadia University, 450 S. Easton Rd, Glenside, PA 19038, USA

² Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA 19104, USA

³ Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina, 4111 McGavran-Greenberg Hall, CB #7469, Chapel Hill, NC 27599, USA

⁴ Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101, USA

⁵ Kogod School of Business, American University, 4400 Massachusetts Ave, NW Washington, DC 20016, USA

⁶ Social Science Research Council, One Pierrepont Plaza (300 Cadman Plaza West), 15th floor, Brooklyn, NY 11201, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1316; https://doi.org/10.3390/ijerph14111316 - 29 Oct 2017

Cited by 19 | Viewed by 5922

Abstract

Food marketing environments of Black American consumers are heavily affected by ethnically-targeted marketing of sugar sweetened beverages, fast foods, and other products that may contribute to caloric overconsumption. This qualitative study assessed Black consumers’ responses to targeted marketing. Black adults (2 mixed gender [...] Read more.

Food marketing environments of Black American consumers are heavily affected by ethnically-targeted marketing of sugar sweetened beverages, fast foods, and other products that may contribute to caloric overconsumption. This qualitative study assessed Black consumers’ responses to targeted marketing. Black adults (2 mixed gender groups; total n = 30) and youth (2 gender specific groups; total n = 35) from two U.S. communities participated before and after a sensitization procedure—a critical practice used to understand social justice concerns. Pre-sensitization focus groups elicited responses to scenarios about various targeted marketing tactics. Participants were then given an informational booklet about targeted marketing to Black Americans, and all returned for the second (post-sensitization) focus group one week later. Conventional qualitative content analysis of transcripts identified several salient themes: seeing the marketer’s perspective (“it’s about demand”; “consumers choose”), respect for community (“marketers are setting us up for failure”; “making wrong assumptions”), and food environments as a social justice issue (“no one is watching the door”; “I didn’t realize”). Effects of sensitization were reflected in participants’ stated reactions to the information in the booklet, and also in the relative occurrence of marketer-oriented themes and social justice-oriented themes, respectively, less and more after sensitization. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Open AccessArticle

Seasonal Patterns of Japanese Encephalitis and Associated Meteorological Factors in Taiwan

by Che-Liang Lin¹, Hsiao-Ling Chang^2,3, Chuan-Yao Lin⁴ and Kow-Tong Chen^5,6,*

¹ Internal Medicine Chest Division, Chi-Mei Medical Center, Liouying, Tainan 736, Taiwan

² Division of Infection Control and Biosafety, Centers for Disease Control, Ministry of Health and Welfare, Taipei 104, Taiwan

³ School of Public Health, National Defense Medical Center, National Defense University, Taipei 117, Taiwan

⁴ Research Center for Environmental Changes, Academia Sinica, 115, Taiwan

⁵ Department of Occupational Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan 701, Taiwan

⁶ Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan

Int. J. Environ. Res. Public Health 2017, 14(11), 1317; https://doi.org/10.3390/ijerph14111317 - 29 Oct 2017

Cited by 19 | Viewed by 5337

Abstract

The persistent transmission of Japanese encephalitis virus (JEV) in Taiwan necessitates exploring the risk factors of occurrence of Japanese encephalitis (JE). The purpose of this study was to assess the relationship between meteorological factors and the incidence of JE in Taiwan. We collected [...] Read more.

The persistent transmission of Japanese encephalitis virus (JEV) in Taiwan necessitates exploring the risk factors of occurrence of Japanese encephalitis (JE). The purpose of this study was to assess the relationship between meteorological factors and the incidence of JE in Taiwan. We collected data for cases of JE reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2000 to 2014. Meteorological data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of JE in Taiwan were determined via Poisson regression analysis and a case-crossover methodology. During the 15-year study period, a total of 379 cases of JE were reported. The incidence of JE showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, p < 0.001). The number of JE cases started to increase at temperatures of 22 °C (r² = 0.88, p < 0.001). Similarly, the number of JE cases began to increase at a relative humidity of 70–74% (r² = 0.75, p < 0.005). The number of JE cases was positively associated with mean temperature and relative humidity in the period preceding the infection. In conclusion, the occurrence of JE is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures. Full article

(This article belongs to the Special Issue Environmental Determinants of Infectious Disease Transmission)

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Open AccessArticle

Molecular Analysis of the SRD5A1 and SRD5A2 Genes in Patients with Benign Prostatic Hyperplasia with Regard to Metabolic Parameters and Selected Hormone Levels

by Aleksandra Rył¹, Iwona Rotter², Anna Grzywacz³, Iwona Małecka⁴, Karolina Skonieczna-Żydecka⁵

, Katarzyna Grzesiak¹, Marcin Słojewski⁶

, Aleksandra Szylińska^2,*

, Olimpia Sipak-Szmigiel⁷, Małgorzata Piasecka¹, Kinga Walczakiewicz¹ and Maria Laszczyńska¹

¹ Department of Histology and Developmental Biology, Pomeranian Medical University, 70-210 Szczecin, Poland

² Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 70-210 Szczecin, Poland

³ Independent Laboratory of Health Promotion, Pomeranian Medical University, 70-103 Szczecin, Poland

⁴ Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland

⁵ Department of Biochemistry and Human Nutrition, Pomeranian Medical University, 71-460 Szczecin, Poland

⁶ Department of Urology and Urological Oncology, Pomeranian Medical University, 70-111 Szczecin, Poland

⁷ Department of Obstetrics and Gynecology, Pomeranian Medical University, 70-111 Szczecin, Poland

Int. J. Environ. Res. Public Health 2017, 14(11), 1318; https://doi.org/10.3390/ijerph14111318 - 30 Oct 2017

Cited by 17 | Viewed by 4233

Abstract

Introduction: The etiology of benign prostatic hyperplasia (BPH) has not so far been fully explicated. However, it is assumed that changes in the levels of hormones associated with aging can contribute to the development of prostatic hyperplasia. Dihydrotestosterone combines with the androgen [...] Read more.

Introduction: The etiology of benign prostatic hyperplasia (BPH) has not so far been fully explicated. However, it is assumed that changes in the levels of hormones associated with aging can contribute to the development of prostatic hyperplasia. Dihydrotestosterone combines with the androgen receptor (AR) proteins of the prostate gland. Enzyme activity is based on two isoenzymes: type 1 and type 2. 5α-reductase type 1 is encoded by the SRD5A1 gene, and type 2 is encoded by the SRD5A2 gene. The aim of our study was to determine the frequency of the SRD5A1 (rs6884552, rs3797177) and SRD5A2 (rs523349, rs12470143) genes’ polymorphisms, and to assess the relationships between the genotypes of the tested mutations, and the levels of biochemical and hormonal parameters in patients with BPH. Material and Methods: The study involved 299 men with benign prostatic hyperplasia. We determined the serum levels of particular biochemical parameters—fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG)—by the spectrophotometric method, using ready reagent kits. The ELISA method was used to determine the levels of the following hormonal parameters and proteins: total testosterone (TT), free testosterone (FT), insulin (I), luteinizing hormone (LH), and sex hormone binding protein (SHBG). Metabolic syndrome was diagnosed. Genotyping was performed by real-time PCR. Results: We analyzed the relationships between the incidence of particular diseases and the genotypes of the SRD5A1 and SRD5A2 polymorphisms among patients with BPH. The BPH patients with the CC genotype of the SRD5A2 rs523349 and rs12470143 polymorphisms were considerably less frequently diagnosed with metabolic syndrome (MetS) (p = 0.022 and p = 0.023 respectively). Our analysis revealed that homozygotes with the CC of the SDR5A2 rs12470143 polymorphism had visibly higher HDL levels than those with the TT and CT genotypes (p = 0.001). Additionally, we found that the patients with the CC genotype of the SDR5A2 rs12470143 polymorphism had considerably higher FT levels (p = 0.001) than the heterozygotes with the CT and the homozygotes with the TT of the genetic variant analyzed in our study. Furthermore, the patients with at least one G allele of the SRD5A2 rs523349 polymorphism had significantly lower SGBG levels (p = 0.022) compared with the homozygotes with the CC genotype. The presence of at least one A allele (AA + AG genotypes) of the SRD5A1 rs3797177 polymorphism entailed notably lower serum insulin levels than those observed in homozygotes with the GG genotype (p = 0.033). Conclusions: The study described in this article shows that selected SRD5A1 and SRD5A2 polymorphisms can alter the levels of metabolic and hormonal parameters in patients with BPH. Special attention should be paid to the SDR5A2 rs12470143 polymorphism, which is associated with a change in lipid profile, as well as with the inheritance and incidence rate of MetS among these patients. An analysis of the frequency of this polymorphism among BPH patients could be useful in estimating the risk of getting ill, and planning therapies of concomitant diseases for BPH patients. Full article

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Open AccessArticle

New Instrument to Measure Hospital Patient Experiences in Flanders

by Luk Bruyneel^1,*

, Else Tambuyzer², Ellen Coeckelberghs¹, Dirk De Wachter³, Walter Sermeus¹, Dirk De Ridder¹, Dirk Ramaekers¹, Ilse Weeghmans² and Kris Vanhaecht¹

¹ KU Leuven Institute for Healthcare Policy, University of Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium

² Flemish Patient Platform, Groenveldstraat 15, 3001 Heverlee, Belgium

³ Specialised Care Division, Flemish Agency for Care and Health, Flemish public administration, Koning Albert II Laan 35, 1030 Brussels, Belgium

Int. J. Environ. Res. Public Health 2017, 14(11), 1319; https://doi.org/10.3390/ijerph14111319 - 30 Oct 2017

Cited by 10 | Viewed by 5527

Abstract

Implementing a standardized patient experience survey may initiate a process to apply pressure on hospitals to attend to improving patient experiences. In Flanders, Belgium, the Flemish Patient Survey was developed between 2011 and 2015. A preliminary version was developed from a scoping review [...] Read more.

Implementing a standardized patient experience survey may initiate a process to apply pressure on hospitals to attend to improving patient experiences. In Flanders, Belgium, the Flemish Patient Survey was developed between 2011 and 2015. A preliminary version was developed from a scoping review and patient and expert focus groups, and included 27 items for eight hypothesized dimensions: ‘preparing for hospital stay’, ‘information and communication’, ‘coordination’, ‘respect’, ‘privacy’, ‘safe care’, pain management’, and ‘participation’. Exploratory factor analysis for 1076 patients in 17 hospitals found that the data did not fit the dimensions. Adaptations in item wording and response categories were based on the US Hospital Consumer Assessment of Healthcare Providers and Systems. The revised version showed excellent model fit in 22,143 patients in 37 hospitals. Multiple group analysis pointed to evidence of measurement invariance over time across mode of administration, type of nursing unit, and various patient characteristics. Fostering a collaborative approach thus proved successful in implementing a standardized patient experience survey. The most recent findings (2016) illustrate substandard performance and a need for patient-mix adjustment. The Flemish government developed a dedicated website to make findings publicly available and the federal government currently considers patient experiences in devising a pay-for-quality scheme. Full article

(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)

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Open AccessFeature PaperArticle

Maternal Mental Health Disorders and Reports to Child Protective Services: A Birth Cohort Study

by Ivy Hammond¹, Andrea Lane Eastman¹, John M. Leventhal² and Emily Putnam-Hornstein^1,3,*

¹ Children’s Data Network, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA

² School of Medicine, Yale University, New Haven, CT 06510, USA

³ California Child Welfare Indicators Project, University of California at Berkeley, Berkeley, CA 94720, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1320; https://doi.org/10.3390/ijerph14111320 - 30 Oct 2017

Cited by 26 | Viewed by 6651

Abstract

Background. Existing literature has documented a strong relationship between parental mental illness and child maltreatment, but little is known about the prevalence of mental illness among childbearing women. In the present study, linked administrative records were used to identify the prevalence of [...] Read more.

Background. Existing literature has documented a strong relationship between parental mental illness and child maltreatment, but little is known about the prevalence of mental illness among childbearing women. In the present study, linked administrative records were used to identify the prevalence of maternal mental health (MH) disorders documented at birth and determine the associated likelihood of maltreatment reports during infancy. Materials and Methods. Vital records for California’s 2006 birth cohort were linked to hospital discharge and Child Protective Services (CPS) records. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) billing codes from the mother’s delivery hospitalization were used to determine diagnosed maternal MH disorders for 551,232 infants born in 2006, and reports of alleged maltreatment were documented from CPS records. Vital birth records were used to control for sociodemographic factors. Finally, the associated risk of reported maltreatment during the first year of life was examined using generalized linear models. Results. Among infants in this statewide birth cohort, 2.8% were born to a mother with a documented MH disorder, of which 41.3% had documented maternal substance abuse issues versus less than 0.5% of infants born to mothers without a diagnosed MH disorder. Further, 34.6% of infants born to mothers with a MH disorder were reported to CPS within one year, and a majority of those reports were made within the first month of life (77.2%). In contrast, among children born to mothers without a MH disorder, 4.4% were reported to CPS during infancy. After controlling for sociodemographic factors, the rate of CPS reports during infancy for infants born to mothers with a MH disorder but no substance use disorder was 2.6 times that of infants born to mothers without a MH disorder (95% CI = 2.47, 2.73). Among infants born to mothers with MH and substance use disorders, the rate of CPS reports during infancy was 5.69 times that of infants born to mothers without a MH disorder (95% CI = 5.51, 5.87). Conclusions. Administrative records provide a method for identifying infants born to mothers with MH disorders, enabling researchers to track rates over time and generate population-level data to inform policy development and improve service delivery. Full article

(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)

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Open AccessArticle

Spatiotemporal Changes in Fine Particulate Matter Pollution and the Associated Mortality Burden in China between 2015 and 2016

by Luwei Feng^1,†, Bo Ye^2,†, Huan Feng², Fu Ren^1,3,4, Shichun Huang², Xiaotong Zhang², Yunquan Zhang²

, Qingyun Du^1,3,4,5,*

and Lu Ma^2,6,*

¹ School of Resources and Environmental Science, Wuhan University, Wuhan 430079, China

² Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China

³ Key Laboratory of GIS, Ministry of Education, Wuhan University, Wuhan 430079, China

⁴ Key Laboratory of Digital Mapping and Land Information Application Engineering, National Administration of Surveying, Mapping and Geoinformation, Wuhan University, Wuhan 430079, China

⁵ Collaborative Innovation Center of Geospatial Technology, Wuhan University, Wuhan 430079, China

⁶ Global Health Institute, Wuhan University, 8 Donghunan Road, Wuhan 430072, China

^† Luwei Feng and Bo Ye contributed equally to this paper.

Int. J. Environ. Res. Public Health 2017, 14(11), 1321; https://doi.org/10.3390/ijerph14111321 - 30 Oct 2017

Cited by 38 | Viewed by 6494

Abstract

In recent years, research on the spatiotemporal distribution and health effects of fine particulate matter (PM_2.5) has been conducted in China. However, the limitations of different research scopes and methods have led to low comparability between regions regarding the mortality burden [...] Read more.

In recent years, research on the spatiotemporal distribution and health effects of fine particulate matter (PM_2.5) has been conducted in China. However, the limitations of different research scopes and methods have led to low comparability between regions regarding the mortality burden of PM_2.5. A kriging model was used to simulate the distribution of PM_2.5 in 2015 and 2016. Relative risk (RR) at a specified PM_2.5 exposure concentration was estimated with an integrated exposure–response (IER) model for different causes of mortality: lung cancer (LC), ischaemic heart disease (IHD), cerebrovascular disease (stroke) and chronic obstructive pulmonary disease (COPD). The population attributable fraction (PAF) was adopted to estimate deaths attributed to PM_2.5. 72.02% of cities experienced decreases in PM_2.5 from 2015 to 2016. Due to the overall decrease in the PM_2.5 concentration, the total number of deaths decreased by approximately 10,658 per million in 336 cities, including a decrease of 1400, 1836, 6312 and 1110 caused by LC, IHD, stroke and COPD, respectively. Our results suggest that the overall PM_2.5 concentration and PM_2.5-related deaths exhibited decreasing trends in China, although air quality in local areas has deteriorated. To improve air pollution control strategies, regional PM_2.5 concentrations and trends should be fully considered. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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Open AccessArticle

Association between Eating Out and Socio-Demographic Factors of University Students in Chongqing, China

by Ping Hu^1,2,3,4,†, Tingting Wu^1,2,3,†, Fan Zhang^1,2,3, Yan Zhang^1,2,3, Lu Lu^1,2,3, Huan Zeng^1,2,3, Zu-min Shi⁵

, Manoj Sharma⁶

, Lei Xun^1,2,3 and Yong Zhao^1,2,3,*

¹ School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China

² Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China

³ The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China

⁴ Chengdu Blood Center, Chengdu 610041, China

⁵ Adelaide Medical School, University of Adelaide, Adelaide 5005, Australia

⁶ Behavioral & Environmental Health, Jackson State University, Jackson, MS 39213, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1322; https://doi.org/10.3390/ijerph14111322 - 30 Oct 2017

Cited by 16 | Viewed by 4891

Abstract

(1) Objective: We aimed to explore the current situation of eating out and the association with socio-demographic factors of university students in Chongqing, China. (2) Methods: We used self-administered questionnaires to collect information. There are 14 universities in Chongqing; four (Chongqing [...] Read more.

(1) Objective: We aimed to explore the current situation of eating out and the association with socio-demographic factors of university students in Chongqing, China. (2) Methods: We used self-administered questionnaires to collect information. There are 14 universities in Chongqing; four (Chongqing Medical University, Chongqing University, Chongqing Normal University, and Chongqing University of Science & Technology) were randomly selected. In each selected university, two disciplines were randomly selected. (3) Results: 4595 university students participated in the study. The frequency of eating out was relatively high. The frequency of eating out among females was higher than that among males during weekdays. The two main reasons for eating out were having an opportunity to meet friends (56.0%) and improving diet (39.6%). Bistros (61.7%) and hot-pot restaurants (41.1%) were the favorite places for eating out. Only 36.0% of the participants said they considered nutrition and food safety when selecting restaurants. The majority of the participants demonstrated a high demand for nutrition and food safety knowledge when eating out (77.7%). (4) Conclusions: The higher the monthly living expenses were, the higher the frequency of eating out was. An intervention strategy to reduce the frequency or change the behavior of eating out should be formulated by considering the students’ perspectives. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessArticle

Prevalence and Determinants of Current Smoking and Intention to Smoke among Secondary School Students: A Cross-Sectional Survey among Han and Tujia Nationalities in China

by Xianglong Xu^1,2,3

, Dengyuan Liu^1,2,3, Manoj Sharma⁴

and Yong Zhao^1,2,3,*

¹ School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China

² Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China

³ Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China

⁴ Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS 39213, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1323; https://doi.org/10.3390/ijerph14111323 - 30 Oct 2017

Cited by 6 | Viewed by 3858

Abstract

Objectives: This study examined the patterns and determinants of current smoking and intention to smoke among secondary school students of Han and Tujia nationalities in China. Methods: A cross-sectional survey was conducted in three regions, namely, Chongqing, Liaocheng, and Tianjin, of China in [...] Read more.

Objectives: This study examined the patterns and determinants of current smoking and intention to smoke among secondary school students of Han and Tujia nationalities in China. Methods: A cross-sectional survey was conducted in three regions, namely, Chongqing, Liaocheng, and Tianjin, of China in 2015. A structured self-administered questionnaire was used for data collection. Results: Of the total subjects (n = 1805), 78.9% were ethnic Han and 21.1% were ethnic Tujia. Overall 9.4% (Han: 7.7%; Tujia: 15.5%) secondary school students were smokers and 37.28% smoked more than once per day. Of the non-smoker students (n = 1636), 17.4% have an intention to smoke. A total of 81.1% of students reportedly had never been taught throughout school about smoking or tobacco prevention. When compared to the students who were taught in the school about smoking or tobacco prevention (18.90%) students who were never taught were more likely to smoke (OR = 2.39; 95% CI = 1.14–5.01). As compared to Han nationality students who were from Tujia nationality were more likely to smoke (OR = 2.76; 95% CI = 1.88–4.04) and were more likely to have a higher frequency of smoking (95% CI (0.88, 0.88), p = 0.010). Non-smokers who were high school students (OR = 4.29; 95% CI = 2.12–8.66), whose academic performance were situated in the last 25% (OR = 2.23; 95% CI = 1.48–3.34) and lower than 50% (OR = 1.50; 95% CI = 1.02–2.20) were more likely to have an intention of smoking. Conclusions: About one in ten secondary school students was a smoker, one in three smokers smoked more than one time per day, and a quarter of non-smokers had an intention of smoking in China. Smoking rate was higher among students from Tujia than the Han nationality. This study provided some important information for future tobacco control programs among secondary school students in the ethnic minority autonomous region and minority settlements in a multi-ethnic country. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Self-Determination in Health Research: An Alaska Native Example of Tribal Ownership and Research Regulation

by Vanessa Y. Hiratsuka¹

, Julie A. Beans^1,*

, Renee F. Robinson¹, Jennifer L. Shaw¹, Ileen Sylvester² and Denise A. Dillard¹

¹ Southcentral Foundation Research Department, 4085 Tudor Centre Dr., Anchorage, AK 99508, USA

² Southcentral Foundation Executive and Tribal Services, 4501 Diplomacy Drive, Anchorage, AK 99508, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1324; https://doi.org/10.3390/ijerph14111324 - 31 Oct 2017

Cited by 52 | Viewed by 6251

Abstract

Alaska Native (AN) and American Indian (AI) people are underrepresented in health research, yet many decline to participate in studies due to past researcher misconduct. Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and [...] Read more.

Alaska Native (AN) and American Indian (AI) people are underrepresented in health research, yet many decline to participate in studies due to past researcher misconduct. Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and the tribal community by making trust and accountability required features of health research in AN/AI communities. In 1998, SCF assumed ownership from the federal government of health services for AN/AI people in south central Alaska and transformed the health system into a relationship-based model of care. This change reimagines how researchers interact with tribal communities and established community oversight of all health research conducted with AN/AI people in the region. We describe the SCF research review process, which requires tribal approval of the research concept, full proposal, and dissemination products, as well as local institutional review board approval, and a researcher-signed contract. This review evaluates research through the lens of tribal principles, practices, and priorities. The SCF example provides a framework for other tribes and organizations seeking to reshape the future of health research in AN/AI communities. Full article

(This article belongs to the Special Issue Indigenous Health and Wellbeing)

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Chronic Stress in Young German Adults: Who Is Affected? A Prospective Cohort Study

by Ronald Herrera^1,2,*, Ursula Berger², Jon Genuneit³

, Jessica Gerlich¹, Dennis Nowak⁴, Wolff Schlotz⁵, Christian Vogelberg⁶, Erika Von Mutius⁷, Gudrun Weinmayr³, Doris Windstetter¹, Matthias Weigl⁸ and Katja Radon¹

¹ Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital Munich (LMU), 80336 Munich, Germany

² Institute for Medical Informatics, Biometry and Epidemiology-IBE, University of Munich (LMU), 81377 Munich, Germany

³ Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany

⁴ Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine Medical Faculty Ludwig-Maximilians-University Munich, Germany and German Center for Lung Research (DZL), 80336 Munich, Germany

⁵ Max Planck Institute for Empirical Aesthetics, 60322 Frankfurt am Main, Germany

⁶ Department of Pediatrics and Adolescent Medicine, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, 01397 Dresden, Germany

⁷ Dr von Hauner Children’s Hospital, LMU Munich Munich, Germany and German Center for Lung Research (DZL), 80336 Munich, Germany

⁸ Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital Munich (LMU), 80336 Munich, Germany

Int. J. Environ. Res. Public Health 2017, 14(11), 1325; https://doi.org/10.3390/ijerph14111325 - 31 Oct 2017

Cited by 9 | Viewed by 8515

Abstract

We aimed to prospectively assess changes in chronic stress among young adults transitioning from high school to university or working life. A population-based cohort in Munich and Dresden (Germany) was followed from age 16–18 (2002–2003) to age 20–23 (2007–2009) (n = 1688). [...] Read more.

We aimed to prospectively assess changes in chronic stress among young adults transitioning from high school to university or working life. A population-based cohort in Munich and Dresden (Germany) was followed from age 16–18 (2002–2003) to age 20–23 (2007–2009) (n = 1688). Using the Trier Inventory for the Assessment of Chronic Stress, two dimensions of stress at university or work were assessed: work overload and work discontent. In the multiple ordinal generalized estimating equations, socio-demographics, stress outside the workplace, and job history were additionally considered. At follow-up, 52% of the population were university students. Work overload increased statistically significantly from first to second follow-up, while work discontent remained constant at the population level. Students, compared to employees, reported a larger increase in work overload (adjusted odds ratio (OR): 1.33; 95% confidence interval (95% CI): 1.07, 1.67), while work discontent did not differ between the groups. In conclusion, work overload increases when young adults transition from school to university/job life, with university students experiencing the largest increase. Full article

(This article belongs to the Special Issue Stress and Health)

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Geographical Variations in the Environmental Determinants of Physical Inactivity among U.S. Adults

by Ruopeng An¹

, Xinye Li² and Ning Jiang^3,*

¹ Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA

² Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA

³ School of Economics and Resource Management, Beijing Normal University, Beijing 100875, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1326; https://doi.org/10.3390/ijerph14111326 - 31 Oct 2017

Cited by 7 | Viewed by 4623

Abstract

Physical inactivity is a major modifiable risk factor for morbidity, disability and premature mortality worldwide. This study assessed the geographical variations in the impact of environmental quality on physical inactivity among U.S. adults. Data on county-level prevalence of leisure-time physical inactivity came from [...] Read more.

Physical inactivity is a major modifiable risk factor for morbidity, disability and premature mortality worldwide. This study assessed the geographical variations in the impact of environmental quality on physical inactivity among U.S. adults. Data on county-level prevalence of leisure-time physical inactivity came from the Behavioral Risk Factor Surveillance System. County environment was measured by the Environmental Quality Index (EQI), a comprehensive index of environmental conditions that affect human health. The overall EQI consists of five subdomains—air, water, land, social, and built environment. Geographically weighted regressions (GWRs) were performed to estimate and map county-specific impact of overall EQI and its five subdomains on physical inactivity prevalence. The prevalence of leisure-time physical inactivity among U.S. counties was 25% in 2005. On average, one standard deviation decrease in the overall EQI was associated with an increase in county-level prevalence of leisure-time physical inactivity by nearly 1%. However, substantial geographical variations in the estimated environmental determinants of physical inactivity were present. The estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the overall EQI ranged from an increase of over 3% to a decrease of nearly 2% across U.S. counties. Analogous, the estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the EQI air, water, land, social, and built environment subdomains ranged from an increase of 2.6%, 1.5%, 2.9%, 3.3%, and 1.7% to a decrease of 2.9%, 1.4%, 2.4%, 2.4%, and 0.8% across U.S. counties, respectively. Given the substantial heterogeneities in the environmental determinants of physical inactivity, locally customized physical activity interventions are warranted to address the most concerning area-specific environmental issue. Full article

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History of Asbestos Ban in Hong Kong

by Chun-Kwan Wong¹, Sabrina Hei-Man Wan¹ and Ignatius Tak-Sun Yu^1,2,*

¹ Hong Kong Workers’ Health Centre, Room 1429 Beverley Commercial Centre, Tsimshatsui, Hong Kong, China

² Hong Kong Occupational & Environmental Health Academy, Room 1418 Beverley Commercial Centre, Tsimshatsui, Hong Kong, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1327; https://doi.org/10.3390/ijerph14111327 - 31 Oct 2017

Cited by 3 | Viewed by 5185

Abstract

As millions of immigrants moved to Hong Kong (HK) from China in the recent decades, large amount of residential housings were built in the early years and a substantial proportion of those buildings used asbestos-containing materials (ACMs). Since the number of new cases [...] Read more.

As millions of immigrants moved to Hong Kong (HK) from China in the recent decades, large amount of residential housings were built in the early years and a substantial proportion of those buildings used asbestos-containing materials (ACMs). Since the number of new cases of ARDs diagnosed has increased year by year since 1990’s, the remarkable increase of incidences had drawn the attention of the public and most importantly the HK government. It became one of the trigger points leading to asbestos ban in HK history. Comparatively, non-governmental organizations (NGOs), labor unions and patients’ self-help organizations demonstrated a more aggressive and proactive attitude than the HK government and have played a key role in the development of asbestos banning policy in HK. After numerous petitions and meetings with the government representatives by those parties in the past decade, the HK government eventually changed its attitude and started to consider terminating the endless threat from asbestos by amending the policy, and the new clause of legislation for banning of all forms of asbestos was enacted on 4 April 2014. Other than the restriction of asbestos use, the compensation system about ARDs has also made some great moves by the effort of those parties as well. Based on the experience we learnt through the years, efforts from different stakeholders including patients’ self-help organizations, NGOs, legislative councilors, and media power are absolutely essential to the success of progression and development in today’s asbestos banning in HK. Full article

(This article belongs to the Special Issue Global Panorama of National Experiences in Public Health Actions to Ban Asbestos)

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The Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) Study: Self-Reported Health Effects

by Sharon A. Croisant^1,2,*, Yu-li Lin¹, Joseph J. Shearer¹, John Prochaska^1,2, Amanda Phillips-Savoy³, James Gee⁴, Daniel Jackson⁵, Reynold A. Panettieri, Jr.⁶, Marilyn Howarth⁵, John Sullivan^1,2, Bishop James Black⁷, Joi Tate⁷, Dustin Nguyen⁸, Amber Anthony², Asim Khan², Harshica Fernando⁹, G. A. Shakeel Ansari⁹, Gilbert Rowe¹⁰, Bret Howrey¹¹

, Chantele Singleton² and Cornelis Elferink^2,12 Show full author list Hide full author list

¹ Department of Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA

² Sealy Center for Environmental Health and Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA

³ Department of Family Medicine, Louisiana State University at Lafayette, Lafayette, LA 70504, USA

⁴ Department of Family Medicine, Lafayette General Hospital, Lafayette, LA 70503, USA

⁵ Center of Excellence in Environmental Toxicology, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA 19104, USA

⁶ Perelman School of Medicine, Rutgers University, the State University of New Jersey, New Brunswick, NJ 08901, USA

⁷ Center for Environmental and Economic Justice, Biloxi, MS 39531, USA

⁸ Mississippi Vietnamese Fishing Community, Gulfport, MS, USA

⁹ Department of Pathology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA

¹⁰ Texas A&M University at Galveston; Galveston, TX 77554, USA

¹¹ Department of Family Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA

¹² Department of Pharmacology and Toxicology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA

Show full affiliation list Hide full affiliation list

Int. J. Environ. Res. Public Health 2017, 14(11), 1328; https://doi.org/10.3390/ijerph14111328 - 31 Oct 2017

Cited by 14 | Viewed by 5735

Abstract

The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S. history. We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill. This is a report of a cross-sectional [...] Read more.

The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S. history. We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill. This is a report of a cross-sectional cohort study (wave 1) to establish ‘baseline’ findings and meant to provide descriptive information to be used for a multi-wave, longitudinal study. Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS) uses a Community-Based Participatory Research approach, thus including multi-disciplinary, multi-institutional academic partners and representatives of three communities impacted by the spill. Three research sites were selected for human sampling along the Gulf of Mexico coast including two from Mississippi and one from Louisiana, with Galveston, Texas, serving as a comparison site, given that it was not directly impacted by the spill. One hundred participants were selected from each community, representing adults, seniors and children, with approximately equal numbers of males and females in each group. Participants completed initial assessments including completion of a ‘baseline’ survey and, rigorous physical assessments. Results from wave 1 data collection reported herein reveal changes in self-reported physical health and mental health status following the oil spill, disparities in access to healthcare, and associations between mental health and emotional conditions related to displacement/unemployment. Few environmental health studies have been conducted in communities impacted by significant oil spills. Results imply potential prolonged effects on mental health and community vulnerability. Full article

(This article belongs to the Section Environmental Health)

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Cross-Sectional Associations between Home Environmental Factors and Domain-Specific Sedentary Behaviors in Adults: The Moderating Role of Socio-Demographic Variables and BMI

by Sofie Compernolle^1,*

, Cedric Busschaert¹, Ilse De Bourdeaudhuij¹

, Greet Cardon¹

, Sebastien F. M. Chastin^1,2

, Jelle Van Cauwenberg^3,4 and Katrien De Cocker^1,3

¹ Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium

² School of Health and Life Science, Institute of Applied Health Research, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK

³ Research Foundation Flanders (FWO), 1000 Brussels, Belgium

⁴ Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium

Int. J. Environ. Res. Public Health 2017, 14(11), 1329; https://doi.org/10.3390/ijerph14111329 - 31 Oct 2017

Cited by 5 | Viewed by 3796

Abstract

Despite the negative health effects of too much sitting, the majority of adults are too sedentary. To develop effective interventions, insight is needed into home environmental correlates of adults’ sedentary behaviors, and into the susceptibility of population subgroups to these home environmental cues. [...] Read more.

Despite the negative health effects of too much sitting, the majority of adults are too sedentary. To develop effective interventions, insight is needed into home environmental correlates of adults’ sedentary behaviors, and into the susceptibility of population subgroups to these home environmental cues. In total, 559 Flemish adults reported socio-demographics, weight and height, home environmental factors and domain-specific sedentary behaviors. Generalized linear modeling was conducted to examine main associations between home environmental factors and domain-specific sedentary behaviors, and to test the moderating role of socio-demographics and BMI on these associations. In case of significant interactions, stratified analyses were performed. Results showed that, among those who did use a computer/laptop during the last week, a one-unit increase in the number of computers or laptops was associated with 17% (OR = 1.17; 95% CI = 1.02, 1.34) and 24% (OR = 1.24; 95% CI = 1.08, 1.43) more minutes computer time per day, respectively. The proximity of the remote controller (p < 0.001) and the number of televisions (p = 0.03) were positively associated with television time, and the number of motorized vehicles (95% CI = 0.001, 0.12) was positively associated with the odds of participation in transport-related sitting time. The latter two associations were moderated by BMI, with significant positive associations limited to those not overweight. To conclude, home environmental factors were associated with domain-specific sedentary behaviors, especially in healthy weight adults. If confirmed by longitudinal studies, public health professionals should encourage adults to limit the number of indoor entertainment devices and motorized vehicles. Full article

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Research on Storm-Tide Disaster Losses in China Using a New Grey Relational Analysis Model with the Dispersion of Panel Data

by Kedong Yin^1,2, Ya Zhang¹ and Xuemei Li^1,2,*

¹ School of Economics, Ocean University of China, Qingdao 266100, China

² Ocean Development Research Institute, Major Research Base of Humanities and Social Sciences of Ministry of Education, Ocean University of China, Qingdao 266100, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1330; https://doi.org/10.3390/ijerph14111330 - 1 Nov 2017

Cited by 24 | Viewed by 4562

Abstract

Owing to the difference of the sequences’ orders and the surface structure in the current panel grey relational models, research results will not be unique. In addition, individual measurement of indicators and objects and the subjectivity of combined weight would significantly weaken the [...] Read more.

Owing to the difference of the sequences’ orders and the surface structure in the current panel grey relational models, research results will not be unique. In addition, individual measurement of indicators and objects and the subjectivity of combined weight would significantly weaken the effective information of panel data and reduce the reliability and accuracy of research results. Therefore, we propose the concept and calculation method of dispersion of panel data, establish the grey relational model based on dispersion of panel data (DPGRA), and prove that DPGRA exhibits the effective properties of uniqueness, symmetry, and normality. To demonstrate its applicability, the proposed DPGRA model is used to research on storm-tide disaster losses in China’s coastal areas. Comparing research results of three models, which are DPGRA, Euclidean distance grey relational model, and grey grid relational model, it was shown that DPGRA is more effective, feasible, and stable. It is indicated that DPGRA can entirely utilize the effective information of panel data; what’s more, it can not only handle the non-uniqueness of the grey relational model’s results but also improve the reliability and accuracy of research results. The research results are of great significance for coastal areas to focus on monitoring storm–tide disasters hazards, strengthen the protection measures of natural disasters, and improve the ability of disaster prevention and reduction. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Work–Life Imbalance and Musculoskeletal Disorders among South Korean Workers

by Young-Mee Kim

and Sung-il Cho^*

Department of Public Health Science, Graduate School of Public Health, and Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea

Int. J. Environ. Res. Public Health 2017, 14(11), 1331; https://doi.org/10.3390/ijerph14111331 - 1 Nov 2017

Cited by 33 | Viewed by 5909

Abstract

Employed workers often have family responsibilities such as childcare or homemaking. This dual burden may increase work-related health problems, particularly if there are conflicts between work and family responsibilities. This study assessed whether difficulty in work–life balance is associated with musculoskeletal disorders (MSD) [...] Read more.

Employed workers often have family responsibilities such as childcare or homemaking. This dual burden may increase work-related health problems, particularly if there are conflicts between work and family responsibilities. This study assessed whether difficulty in work–life balance is associated with musculoskeletal disorders (MSD) among Korean employees. Data from the population-based Korean Working Conditions Survey of 2011, including 28,640 male and 21,392 female workers, were used. Men and women were analyzed separately to investigate gender differences. MSD were defined as pain in the back, neck, shoulder, or extremities during the past year. Self-assessed difficulty in work–life balance was defined as a work–life conflict (WLC). Adjustments for physical factors, as well as other occupational and socio-demographic variables, were made using multiple logistic regression analysis. Interaction terms including WLCs and key covariates were also incorporated. WLC was significantly associated with increased frequency of MSD in both men (OR: 1.49) and women (OR: 1.50). There were significant interaction effects between WLC and some key covariates (job stress for men and job stress, work hours, physical demand, and frequent overtime work for women). We suggest that having the flexibility to coordinate work and family life is important to prevent MSD among employees. Full article

(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)

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Pricing, Carbon Emission Reduction, Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain under Vertical and Horizontal Cooperation

by Hui Li^1,*, Chuanxu Wang^1,*, Meng Shang² and Wei Ou³

¹ School of Economics and Management, Shanghai Maritime University, No. 1550, Haigang Avenue, Pudong New Area, Shanghai 201306, China

² School of Flight, Anyang Institute of Technology, No. 1 Huanghe Avenue W., Anyang City 455000, China

³ School of Knowledge Science, Japan Advanced Institute of Science and Technology, Asahidai 1-1, Nomi City, Ishikawa 923-1292, Japan

Int. J. Environ. Res. Public Health 2017, 14(11), 1332; https://doi.org/10.3390/ijerph14111332 - 1 Nov 2017

Cited by 45 | Viewed by 5450

Abstract

In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC) with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon [...] Read more.

In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC) with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Factors Associated with Male Partner Involvement in Programs for the Prevention of Mother-to-Child Transmission of HIV in Rural South Africa

by Motlagabo G. Matseke^1,2,*, Robert A. C. Ruiter², Violeta J. Rodriguez^3,4

, Karl Peltzer¹

, Geoffrey Setswe⁵ and Sibusiso Sifunda¹

¹ Human Sciences Research Council, Pretoria 0001, South Africa

² Department of Work and Social Psychology, Maastricht University, 6200 MD Maastricht, The Netherlands

³ Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA

⁴ Department of Psychology, University of Georgia, Athens, GA 30602, USA

⁵ Department of Public Health, University of Venda, Thohoyandou 0950, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1333; https://doi.org/10.3390/ijerph14111333 - 1 Nov 2017

Cited by 24 | Viewed by 4893

Abstract

Male partner involvement (MPI) can contribute to the success of programs aimed at preventing mother-to-child transmission (PMTCT) of HIV. However, the definition and measures of MPI differ according to context. This study utilized secondary cross-sectional data to investigate the prevalence and determinants of [...] Read more.

Male partner involvement (MPI) can contribute to the success of programs aimed at preventing mother-to-child transmission (PMTCT) of HIV. However, the definition and measures of MPI differ according to context. This study utilized secondary cross-sectional data to investigate the prevalence and determinants of MPI among 463 male partners of HIV-infected pregnant women in rural South Africa. Results indicated that 44.1% of male partners reported involvement in most or all specified male partner involvement activities (i.e., scores of 7 to 9). Descriptive, correlation and multiple linear-regression analyses were conducted. Positive predictors of MPI included relationship status, own HIV status, awareness of female partner’s positive HIV status, female partner’s desire to have more children, having family planning discussions with provider, condom use to prevent HIV and sexually transmitted infections (STIs), and partner reasoning skills. Negative predictors included partner verbal aggression. Overall, although MPI is low, the study underlines important information that could be used to develop interventions aimed at improving maternal and infant health in PMTCT programs in South Africa. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Impact of Distance on Mode of Active Commuting in Chilean Children and Adolescents

by Fernando Rodríguez-Rodríguez^1,*

, Carlos Cristi-Montero¹, Carlos Celis-Morales^2,3

, Danica Escobar-Gómez¹ and Palma Chillón⁴

¹ IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaíso 2374631, Chile

² BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow G128TA, UK

³ Centro de Fisiologia y Biomecanica, Universidad Mayor, Santiago 8580000, Chile

⁴ PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Department of Physical Education and Sport, Faculty of Sports Sciences, University of Granada, 18071 Granada, Spain

Int. J. Environ. Res. Public Health 2017, 14(11), 1334; https://doi.org/10.3390/ijerph14111334 - 2 Nov 2017

Cited by 27 | Viewed by 5431

Abstract

Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 [...] Read more.

Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 years were included in this study. Data regarding modes of commuting and commuting distance was collected using a validated questionnaire. Commuting mode was classified as active commuting (walking and/or cycling) or non-active commuting (car, motorcycle and/or bus). Commuting distance expressed in kilometres was categorised into six subgroups (0 to 0.5, 0.6 to 1, 1.1 to 2, 2.1 to 3, 3.1 to 5 and >5 km). Car commuting was the main mode for children (to school 64.9%; from school 51.2%) and adolescents (to school 50.2%; from school 24.7%). Whereas public bus commuting was the main transport used by adolescents to return from school. Only 11.0% and 24.8% of children and adolescents, respectively, walk to school. The proportion of children and adolescents who engage in active commuting was lower in those covering longer distances compared to a short distance. Adolescents walked to and from school more frequently than children. These findings show that non-active commuting was the most common mode of transport and that journey distances may influence commuting modes in children and adolescents. Full article

(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)

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A Cross-Sectional Investigation of the Importance of Park Features for Promoting Regular Physical Activity in Parks

by Sarah A. Costigan^1,*, Jenny Veitch², David Crawford², Alison Carver^1,3 and Anna Timperio²

¹ School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia

² Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong 3220, Australia

³ Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia

Int. J. Environ. Res. Public Health 2017, 14(11), 1335; https://doi.org/10.3390/ijerph14111335 - 2 Nov 2017

Cited by 46 | Viewed by 6628

Abstract

Introduction: Parks in the US and Australia are generally underutilised, and park visitors typically engage in low levels of physical activity (PA). Better understanding park features that may encourage visitors to be active is important. This study examined the perceived importance of park [...] Read more.

Introduction: Parks in the US and Australia are generally underutilised, and park visitors typically engage in low levels of physical activity (PA). Better understanding park features that may encourage visitors to be active is important. This study examined the perceived importance of park features for encouraging park-based PA and examined differences by sex, age, parental-status and participation in PA. Methods: Cross-sectional surveys were completed by local residents (n = 2775) living near two parks (2013/2015). Demographic variables, park visitation and leisure-time PA were self-reported, respondents rated the importance of 20 park features for encouraging park-based PA in the next fortnight. Chi-square tests of independence examined differences in importance of park features for PA among sub-groups of local residents (sex, age, parental-status, PA). Results: Park features ranked most important for park-based PA were: well maintained (96.2%), feel safe (95.4%), relaxing atmosphere (91.2%), easy to get to (91.7%), and shady trees (90.3%). All subgroups ranked ‘well maintained’ as most important. Conclusions: Natural and built environment features of parks are important for promoting adults’ park-based PA, and should be considered in park (re)design. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

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Plant Growth, Antibiotic Uptake, and Prevalence of Antibiotic Resistance in an Endophytic System of Pakchoi under Antibiotic Exposure

by Hao Zhang^1,2,3, Xunan Li², Qingxiang Yang^1,2,3,*, Linlin Sun², Xinxin Yang², Mingming Zhou², Rongzhen Deng² and Linqian Bi²

¹ School of Environment, Henan Normal University, Xinxiang 453007, China

² College of Life Sciences, Henan Normal University, Xinxiang 453007, China

³ Key Laboratory for Microorganisms and Functional Molecules, University of Henan Province, Xinxiang 453007, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1336; https://doi.org/10.3390/ijerph14111336 - 3 Nov 2017

Cited by 86 | Viewed by 7887

Abstract

Antibiotic contamination in agroecosystems may cause serious problems, such as the proliferation of various antibiotic resistant bacteria and the spreading of antibiotic resistance genes (ARGs) in the environment or even to human beings. However, it is unclear whether environmental antibiotics, antibiotic resistant bacteria, [...] Read more.

Antibiotic contamination in agroecosystems may cause serious problems, such as the proliferation of various antibiotic resistant bacteria and the spreading of antibiotic resistance genes (ARGs) in the environment or even to human beings. However, it is unclear whether environmental antibiotics, antibiotic resistant bacteria, and ARGs can directly enter into, or occur in, the endophytic systems of plants exposed to pollutants. In this study, a hydroponic experiment exposing pakchoi (Brassica chinensis L.) to tetracycline, cephalexin, and sulfamethoxazole at 50% minimum inhibitory concentration (MIC) levels and MIC levels, respectively, was conducted to explore plant growth, antibiotic uptake, and the development of antibiotic resistance in endophytic systems. The three antibiotics promoted pakchoi growth at 50% MIC values. Target antibiotics at concentrations ranging from 6.9 to 48.1 µg·kg⁻¹ were detected in the treated vegetables. Additionally, the rates of antibiotic-resistant endophytic bacteria to total cultivable endophytic bacteria significantly increased as the antibiotics accumulated in the plants. The detection and quantification of ARGs indicated that four types, tetX, bla_CTX-M, and sul1 and sul2, which correspond to tetracycline, cephalexin, and sulfamethoxazole resistance, respectively, were present in the pakchoi endophytic system and increased with the antibiotic concentrations. The results highlight a potential risk of the development and spread of antibiotic resistance in vegetable endophytic systems. Full article

(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)

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Open AccessArticle

Reproductive Investment and Health Costs in Roma Women

by Jelena Čvorović^1,* and Kathryn Coe²

¹ Institute of Ethnography, Serbian Academy of Sciences and Arts, 11000 Belgrade, Serbia

² Richard M. Fairbanks School of Public Health, Indiana University–Purdue University Indianapolis, Indianapolis, IN 46202-2872, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1337; https://doi.org/10.3390/ijerph14111337 - 3 Nov 2017

Cited by 8 | Viewed by 4258

Abstract

In this paper, we examine whether variation in reproductive investment affects the health of Roma women using a dataset collected through original anthropological fieldwork among Roma women in Serbia. Data were collected in 2014–2016 in several Roma semi-urban settlements in central Serbia. The [...] Read more.

In this paper, we examine whether variation in reproductive investment affects the health of Roma women using a dataset collected through original anthropological fieldwork among Roma women in Serbia. Data were collected in 2014–2016 in several Roma semi-urban settlements in central Serbia. The sample consisted of 468 Roma women, averaging 44 years of age. We collected demographic data (age, school levels, socioeconomic status), risk behaviors (smoking and alcohol consumption), marital status, and reproductive history variables (the timing of reproduction, the intensity of reproduction, reproductive effort and investment after birth), in addition to self-reported health, height, and weight. Data analyses showed that somatic, short-term costs of reproduction were revealed in this population, while evolutionary, long-term costs were unobservable—contrariwise, Roma women in poor health contributed more to the gene pool of the next generation than their healthy counterparts. Our findings appear to be consistent with simple trade-off models that suggest inverse relationships between reproductive effort and health. Thus, personal sacrifice—poor health as an outcome—seems crucial for greater reproductive success. Full article

(This article belongs to the Special Issue Roma Health)

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Open AccessArticle

Association between Global Life Satisfaction and Self-Rated Oral Health Conditions among Adolescents in Lithuania

by Aistė Kavaliauskienė^1,*, Antanas Šidlauskas¹ and Apolinaras Zaborskis²

¹ Clinic of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, 50106 Kaunas, Lithuania

² Department of Preventive Medicine & Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania

Int. J. Environ. Res. Public Health 2017, 14(11), 1338; https://doi.org/10.3390/ijerph14111338 - 3 Nov 2017

Cited by 11 | Viewed by 3314

Abstract

Background: This study aims to explore the extent to which the perceived oral conditions predict adolescent global life satisfaction (GLS); Methods: The sample in a cross-sectional survey consisted of 1510 Lithuanian adolescents (41.7% boys) aged 11–18. The survey was conducted by [...] Read more.

Background: This study aims to explore the extent to which the perceived oral conditions predict adolescent global life satisfaction (GLS); Methods: The sample in a cross-sectional survey consisted of 1510 Lithuanian adolescents (41.7% boys) aged 11–18. The survey was conducted by means of self-report questionnaires that were administrated in school classrooms ensuring confidentiality and anonymity of the participants. The schoolchildren rated their GLS and answered the questions about perceptions of their oral health. The relationship between GLS and oral health variables was estimated using unadjusted and adjusted binary logistic regression and nonparametric correlation analyses; Results: The research showed that the majority of adolescents rated their GLS highly; however, girls, older adolescents and adolescents from less affluent families were less likely to report high scores. GLS was significantly associated with subjective overall oral health assessment. The odds of reporting low GLS were 50% higher for adolescents with good oral health (OR = 1.51; p < 0.001; 95% CI = 1.18–1.93), and two and half time as higher for adolescents with perceived fair/poor oral health (OR = 2.78; p < 0.001; 95% CI = 1.72–4.50) compared to adolescents with subjectively excellent/very good oral health. Nonparametric correlations indicated lower GLS to be significantly associated with higher scores of Child Perceptions Questionnaire ( Full article

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Open AccessArticle

Prenatal Heavy Metal Exposure and Adverse Birth Outcomes in Myanmar: A Birth-Cohort Study

by Kyi Mar Wai^1,*, Ohn Mar², Satoko Kosaka¹, Mitsutoshi Umemura³ and Chiho Watanabe⁴

¹ Department of Human Ecology, the University of Tokyo, Tokyo, 113-0033, Japan

² Department of Physiology, University of Medicine 1, Yangon 130404, Myanmar

³ Forestry and Forest Products Research Institute, Forest Research and Management Organization, Tsukuba, Ibaraki 305-8687, Japan

⁴ National Institute for Environmental Studies, Tsukuba, Ibaraki 305-8506, Japan

Int. J. Environ. Res. Public Health 2017, 14(11), 1339; https://doi.org/10.3390/ijerph14111339 - 3 Nov 2017

Cited by 84 | Viewed by 7488

Abstract

Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. [...] Read more.

Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR) = 1.10; 95% confidence interval (CI): 1.01–1.21; p = 0.043), gestational age (adjusted OR = 0.83; 95% CI: 0.72–0.95; p = 0.009) and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31–13.65; p = 0.016) were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia, Is Associated with Higher Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population

by Cheng-Shyuan Rau^1,†, Shao-Chun Wu^2,†

, Yi-Chun Chen³, Peng-Chen Chien³, Hsiao-Yun Hsieh³, Pao-Jen Kuo³ and Ching-Hua Hsieh^3,*

¹ Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan

² Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan

³ Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1340; https://doi.org/10.3390/ijerph14111340 - 3 Nov 2017

Cited by 33 | Viewed by 4651

Abstract

Background: Admission hyperglycemia is associated with higher morbidity and mortality in patients with traumatic brain injury (TBI). Stress-induced hyperglycemia (SIH), a form of hyperglycemia induced by the stress response, is associated with increased patient mortality following TBI. However, admission hyperglycemia occurs not [...] Read more.

Background: Admission hyperglycemia is associated with higher morbidity and mortality in patients with traumatic brain injury (TBI). Stress-induced hyperglycemia (SIH), a form of hyperglycemia induced by the stress response, is associated with increased patient mortality following TBI. However, admission hyperglycemia occurs not only in SIH but also in patients with diabetic hyperglycemia (DH). Current information regarding whether trauma patients with SIH represent a distinct group with differential outcomes compared to those with DH remains limited. Methods: Serum glucose concentration ≥200 mg/dL upon arrival at the emergency department was defined as hyperglycemia. Presence of diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6.5%. In the present study, the patient cohort included those with moderate and severe TBI, as defined by an Abbreviated Injury Scale (AIS) score ≥3 points in the head, and excluded those who had additional AIS scores ≥3 points in any other region of the body. A total of 1798 adult patients with isolated moderate to severe TBI were allocated into four groups: SIH (n = 140), DH (n = 187), diabetic normoglycemia (DN, n = 186), and non-diabetic normoglycemia (NDN, n = 1285). Detailed patient information was retrieved from the Trauma Registry System at a level I trauma center between 1 January 2009, and 31 December 2015. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to propensity scores calculated by NCSS software. Logistic regression was used to evaluate the effect of SIH and DH on the adjusted mortality outcome. Results: In patients with isolated moderate to severe TBI, the presence of SIH and DH led to 9.1-fold and 2.3-fold higher odds of mortality, respectively, than patients with NDN. After adjusting for confounding factors, including sex and age, pre-existing co-morbidities, existence of different kinds of intracerebral hemorrhage, and injury severity, patients with SIH still had 6.6-fold higher odds of mortality than those with NDN; however, DH did not present significantly higher adjusted mortality odds. SIH and DH presented different effects on outcomes after TBI. The results also suggested that the pathophysiological effect associated with SIH was different from that of DH. Conclusions: This study demonstrated that patients with SIH and DH had significantly higher mortality than patients with NDN. However, the adjusted mortality was significantly higher only in the selected propensity score-matched patients with SIH and not in those with DH. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessArticle

Genotypic and Epidemiological Trends of Acute Gastroenteritis Associated with Noroviruses in China from 2006 to 2016

by Shu-Wen Qin^1,†, Ta-Chien Chan^2,†

, Jian Cai¹, Na Zhao³, Zi-Ping Miao¹, Yi-Juan Chen¹ and She-Lan Liu^1,*

¹ Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China

² Center for Geographic Information Science, Research Center for Humanities and Social Sciences, Academia Sinica, Taipei 115, Taiwan

³ CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China

^† Shu-Wen Qin and Ta-Chien Chan contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1341; https://doi.org/10.3390/ijerph14111341 - 3 Nov 2017

Cited by 33 | Viewed by 6229

Abstract

There are periodical norovirus-associated acute gastroenteritis outbreaks around the world. This study aimed to analyze the molecular and epidemiological features of norovirus infections in China during 2006–2016. We extracted epidemiological data from 132 norovirus outbreaks and the norovirus genotyping for 1291 sequences in [...] Read more.

There are periodical norovirus-associated acute gastroenteritis outbreaks around the world. This study aimed to analyze the molecular and epidemiological features of norovirus infections in China during 2006–2016. We extracted epidemiological data from 132 norovirus outbreaks and the norovirus genotyping for 1291 sequences in China over the past ten years. A total of 132 norovirus outbreaks (8133 cases) were reported in China, where the east and south regions were most affected [47.7% (63/132)]. The highest number of outbreaks occurred in 2015. A seasonal pattern has been observed, with a peak from November to the following March. Most of the outbreaks occurred in middle and primary schools, accounting for 28.8% (38/132), and 28.0% (37/132) of outbreaks, respectively. The dominant age group was 10 to 19 years old, responsible for 75.7% (933/1232) of cases. Generally, the dominant genotypes was GII, for 81.9% (1058/1291) of sequences. G II.4 was the predominant genotype in China from 2004 to 2014. However, the GII.17 became more prevalent starting in 2014. Norovirus-associated acute gastroenteritis increased sharply in recent years caused by the emergence of GII.17, but epidemiological features have not changed during 2006–2016. Vigilant surveillance should be strengthened to promptly detect any variation. Full article

(This article belongs to the Section Global Health)

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Open AccessFeature PaperReview

Desert Dust and Health: A Central Asian Review and Steppe Case Study

by Troy Sternberg^1,* and Mona Edwards²

¹ School of Geography, University of Oxford, South Parks Road, Oxford OX1 3QY, UK

² Oxford Rock Breakdown Lab, School of Geography, University of Oxford, South Parks Road, Oxford OX1 3QY, UK

Int. J. Environ. Res. Public Health 2017, 14(11), 1342; https://doi.org/10.3390/ijerph14111342 - 3 Nov 2017

Cited by 30 | Viewed by 7881

Abstract

In Asian deserts environmental and anthropomorphic dust is a significant health risk to rural populations. Natural sources in dry landscapes are exacerbated by human activities that increase the vulnerability to dust and dust-borne disease vectors. Today in Central and Inner Asian drylands, agriculture, [...] Read more.

In Asian deserts environmental and anthropomorphic dust is a significant health risk to rural populations. Natural sources in dry landscapes are exacerbated by human activities that increase the vulnerability to dust and dust-borne disease vectors. Today in Central and Inner Asian drylands, agriculture, mining, and rapid development contribute to dust generation and community exposure. Thorough review of limited dust investigation in the region implies but does not quantify health risks. Anthropogenic sources, such as the drying of the Aral Sea, highlight the shifting dust dynamics across the Central EurAsian steppe. In the Gobi Desert, our case study in Khanbogd, Mongolia addressed large-scale mining’s potential dust risk to the health of the local population. Dust traps showed variable exposure to particulates among herder households and town residents; dust density distribution indicated that sources beyond the mine need to be considered when identifying particulate sources. Research suggests that atmospheric dust from multiple causes may enhance human particulate exposure. Greater awareness of dust in greater Central Asia reflects community concern about related health implications. Future human well-being in the region will require more thorough information on dust emissions in the changing environment. Full article

(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)

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Open AccessArticle

In-Class Cycling to Augment College Student Academic Performance and Reduce Physical Inactivity: Results from an RCT

by Lanae Joubert^1,*

, Matthew Kilgas², Alexandrea Riley¹, Yuba Gautam¹, Lars Donath³ and Scott Drum¹

¹ School of Health and Human Performance, Northern Michigan University, Marquette , MI 49855, USA

² Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI 49931, USA

³ Institute of Training and Computer Science in Sport, German Sport University Cologne, 50933 Köln, Germany

Int. J. Environ. Res. Public Health 2017, 14(11), 1343; https://doi.org/10.3390/ijerph14111343 - 4 Nov 2017

Cited by 10 | Viewed by 8419

Abstract

Most college students sit 14 hours per week on average, excluding sedentary study time. Researchers observing workplace and elementary school settings with active workstations to combat sedentary behavior have shown enhanced cognition without distraction. Until now, incorporating active workstations in college classroom settings [...] Read more.

Most college students sit 14 hours per week on average, excluding sedentary study time. Researchers observing workplace and elementary school settings with active workstations to combat sedentary behavior have shown enhanced cognition without distraction. Until now, incorporating active workstations in college classroom settings remained relatively unexplored. This study’s purpose was to assess academic performance using in-class stationary cycle desks during a semester-long lecture course. Twenty-one college students (19–24 years) enrolled in a lecture course volunteered and were split into traditional sit (SIT) and stationary cycle (CYC) groups randomly, matched on a calculated factor equal to a physical activity (PA) score (0–680) multiplied by grade point average (GPA; 4.0 scale). CYC pedaled a prescribed rate of perceived exertion (RPE) of less than 2 out of 10 during a 50-min lecture, 3 × week for 12 weeks. CYC averaged 42 min, 7.9 miles, and 1.7 RPE during class throughout the semester. No significant differences (p > 0.05) were observed between CYC and SIT on in-class test scores or overall course grades. Although statistically insignificant, CYC had higher mean test scores and overall course grades vs. SIT (i.e., B⁺ vs. B, respectively). Low intensity cycling during a college lecture course maintained student academic performance and possibly reduced weekly sedentary behavior time. Full article

(This article belongs to the Special Issue The Impacts of Physical Activity on Chronic Disease Prevention and Population Health)

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Open AccessArticle

Effects of 1.8 GHz Radiofrequency Fields on the Emotional Behavior and Spatial Memory of Adolescent Mice

by Jun-Ping Zhang^1,†, Ke-Ying Zhang^1,†, Ling Guo¹, Qi-Liang Chen¹, Peng Gao², Tian Wang¹, Jing Li¹, Guo-Zhen Guo² and Gui-Rong Ding^1,*

¹ Department of Radiation Biology, Faculty of Preventive Medicine, Fourth Military Medical University, 169# Chang Le West Road, Xi’an 710032, China

² Department of Radiation Medicine, Faculty of Preventive Medicine, Fourth Military Medical University, 169# Chang Le West Road, Xi’an 710032, China

^† These authors contributed equally to the work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1344; https://doi.org/10.3390/ijerph14111344 - 5 Nov 2017

Cited by 39 | Viewed by 5942

Abstract

The increasing use of mobile phones by teenagers has raised concern about the cognitive effects of radiofrequency (RF) fields. In this study, we investigated the effects of 4-week exposure to a 1.8 GHz RF field on the emotional behavior and spatial memory of [...] Read more.

The increasing use of mobile phones by teenagers has raised concern about the cognitive effects of radiofrequency (RF) fields. In this study, we investigated the effects of 4-week exposure to a 1.8 GHz RF field on the emotional behavior and spatial memory of adolescent male mice. Anxiety-like behavior was evaluated by open field test (OFT) and elevated plus maze (EPM) test, while depression-like behavior was evaluated by sucrose preference test (SPT), tail suspension test (TST) and forced swim test (FST). The spatial learning and memory ability were evaluated by Morris water maze (MWM) experiments. The levels of amino acid neurotransmitters were determined by liquid chromatography-mass spectrometry (LC-MS). The histology of the brain was examined by hematoxylin-eosin (HE) staining. It was found that the depression-like behavior, spatial memory ability and histology of the brain did not change obviously after RF exposure. However, the anxiety-like behavior increased in mice, while, the levels of γ-aminobutyric acid (GABA) and aspartic acid (Asp) in cortex and hippocampus significantly decreased after RF exposure. These data suggested that RF exposure under these conditions do not affect the depression-like behavior, spatial memory and brain histology in adolescent male mice, but it may however increase the level of anxiety, and GABA and Asp were probably involved in this effect. Full article

(This article belongs to the Special Issue Electromagnetic Fields and Health—Effects on the Nervous System)

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Open AccessArticle

Electronic Cigarette Use in Students and Its Relation with Tobacco-Smoking: A Cross-Sectional Analysis of the i-Share Study

by Shérazade Kinouani^1,2,*, Edwige Pereira¹ and Christophe Tzourio¹

¹ Team HEALTHY, Bordeaux Population Health Research Center, University of Bordeaux, Inserm, UMR 1219, CHU Bordeaux, F-33000 Bordeaux, France

² Department of General Practice, University of Bordeaux, 146 rue Léo Saignat F-33000 Bordeaux, France

Int. J. Environ. Res. Public Health 2017, 14(11), 1345; https://doi.org/10.3390/ijerph14111345 - 5 Nov 2017

Cited by 28 | Viewed by 8743

Abstract

While young adults often try e-cigarettes, little is known about its use and the reasons for experimentation, particularly in relation with tobacco-smoking. In 2016, data were collected from 2720 French-speaking students participating in a web-based study on students’ health: the internet-based Students Health [...] Read more.

While young adults often try e-cigarettes, little is known about its use and the reasons for experimentation, particularly in relation with tobacco-smoking. In 2016, data were collected from 2720 French-speaking students participating in a web-based study on students’ health: the internet-based Students Health Research Enterprise (i-Share) project. Univariate analyses and multivariable logistic regressions were performed to study the relationship between e-cigarette use and smoking status. Two out of five students declared having tried e-cigarettes and 3.6% were current users. Former smokers were more likely than current smokers to use e-cigarettes currently. Among those who had never smoked, 13.5% had tried e-cigarettes. Very few (0.3%) were current users, alternating e-liquids with and without nicotine. The three main reasons for trying e-cigarettes were curiosity, offer to try by someone, and attractiveness of e-liquid flavors. Among current smokers, previous attempts to quit smoking and a strong desire to stop tobacco were reported more in e-cigarette current users than in former users. In this large sample of French students, findings were consistent with the possibility that e-cigarettes might be used as smoking cessation or reduction aids by some young adults whereas other young never-smokers could be exposed to nicotine. Full article

(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)

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Open AccessArticle

Predicting Physical Activity and Healthy Nutrition Behaviors Using Social Cognitive Theory: Cross-Sectional Survey among Undergraduate Students in Chongqing, China

by Xianglong Xu^1,2,3,†

, Yang Pu^1,2,3,†, Manoj Sharma⁴

, Yunshuang Rao^1,5, Yilin Cai^1,2,3

and Yong Zhao^1,2,3,*

¹ School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China

² Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China

³ The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China

⁴ Department of Behavioral and Environmental Health, Jackson State University, Jackson, MS 39213, USA

⁵ School of Nursing, Chongqing Medical University, Chongqing 400016, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1346; https://doi.org/10.3390/ijerph14111346 - 5 Nov 2017

Cited by 25 | Viewed by 6234

Abstract

(1) Background: Generally suggested public health measures to reduce obesity were to limit television (TV) viewing, enhance daily physical activities, enable the consumption of fruit and vegetables, and reduce sugar-sweetened beverage intake. This study analyzed the extent to which selected social cognitive theory [...] Read more.

(1) Background: Generally suggested public health measures to reduce obesity were to limit television (TV) viewing, enhance daily physical activities, enable the consumption of fruit and vegetables, and reduce sugar-sweetened beverage intake. This study analyzed the extent to which selected social cognitive theory constructs can predict these behaviors among Chinese undergraduate students. (2) Methods: This cross-sectional study included 1976 undergraduate students from six universities in Chongqing, China. A self-administered five-point Likert common physical activity and nutrition behavior scale based on social cognitive theory was utilized. (3) Results: This study included 687 (34.77%) males and 1289 (65.23%) females. A total of 60.14% of the students engaged in exercise for less than 30 min per day. Approximately 16.5% of the participants spent at least 4 h watching TV and sitting in front of a computer daily. Approximately 79% of the participants consumed less than five cups of fruit and vegetables daily. Undergraduate students who had high self-efficacy scores had more leisure time physical activities. Those who have high expectation scores had considerable time watching TV and sitting in front of a computer. Undergraduate students who had high expectation and self-efficacy scores had substantially low consumption of sugar-sweetened beverages. Those who had high self-efficacy scores consumed considerable amounts of fruit and vegetables. Furthermore, the type of university, BMI group, gender, age, lack of siblings, and grade level were associated with the aforementioned four behaviors. (4) Conclusion: Physical inactivity and unhealthy nutrition behaviors are common among undergraduate students. This study used social cognitive theory to provide several implications for limiting the TV viewing, enhancing daily physical activities, consuming fruit and vegetables, and reducing sugar-sweetened beverage intake among undergraduate students. Full article

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Open AccessReview

Sleep, Health and Wellness at Work: A Scoping Review

by Nicola Magnavita^1,*

and Sergio Garbarino^2,3

¹ Occupational Health Unit, Institute of Public Health, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168 Rome, Italy

² Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy

³ Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa, 16132 Genoa, Italy

Int. J. Environ. Res. Public Health 2017, 14(11), 1347; https://doi.org/10.3390/ijerph14111347 - 6 Nov 2017

Cited by 140 | Viewed by 19501

Abstract

Many occupational factors may interfere with sleep. Sleep disturbances can, in turn, endanger the health and safety of workers. This rapid review of the literature identifies the main factors that alter the quantity and quality of sleep, indicates the effects these alterations have [...] Read more.

Many occupational factors may interfere with sleep. Sleep disturbances can, in turn, endanger the health and safety of workers. This rapid review of the literature identifies the main factors that alter the quantity and quality of sleep, indicates the effects these alterations have on the wellbeing of workers and suggests some health promotion measures. Full article

(This article belongs to the Section Occupational Safety and Health)

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Open AccessArticle

A Novel Experimental and Modelling Strategy for Nanoparticle Toxicity Testing Enabling the Use of Small Quantities

by Marinda Van Pomeren^1,*

, Willie J. G. M. Peijnenburg^1,2

, Nadja R. Brun¹

and Martina G. Vijver¹

¹ Institute of Environmental Sciences (CML), Leiden University, P.O. Box 9518, 2300 RA Leiden, The Netherlands

² National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands

Int. J. Environ. Res. Public Health 2017, 14(11), 1348; https://doi.org/10.3390/ijerph14111348 - 6 Nov 2017

Cited by 12 | Viewed by 5054

Abstract

Metallic nanoparticles (NPs) differ from other metal forms with respect to their large surface to volume ratio and subsequent inherent reactivity. Each new modification to a nanoparticle alters the surface to volume ratio, fate and subsequently the toxicity of the particle. Newly-engineered NPs [...] Read more.

Metallic nanoparticles (NPs) differ from other metal forms with respect to their large surface to volume ratio and subsequent inherent reactivity. Each new modification to a nanoparticle alters the surface to volume ratio, fate and subsequently the toxicity of the particle. Newly-engineered NPs are commonly available only in low quantities whereas, in general, rather large amounts are needed for fate characterizations and effect studies. This challenge is especially relevant for those NPs that have low inherent toxicity combined with low bioavailability. Therefore, within our study, we developed new testing strategies that enable working with low quantities of NPs. The experimental testing method was tailor-made for NPs, whereas we also developed translational models based on different dose-metrics allowing to determine dose-response predictions for NPs. Both the experimental method and the predictive models were verified on the basis of experimental effect data collected using zebrafish embryos exposed to metallic NPs in a range of different chemical compositions and shapes. It was found that the variance in the effect data in the dose-response predictions was best explained by the minimal diameter of the NPs, whereas the data confirmed that the predictive model is widely applicable to soluble metallic NPs. The experimental and model approach developed in our study support the development of (eco)toxicity assays tailored to nano-specific features. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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Open AccessFeature PaperArticle

Benefits of Multidimensional Measures of Child Well Being in China

by Shirley Gatenio Gabel^* and Yiwei Zhang

Graduate School of Social Service, Fordham University, New York, NY 10458, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1349; https://doi.org/10.3390/ijerph14111349 - 6 Nov 2017

Cited by 6 | Viewed by 4955

Abstract

In recent decades, measures of child well-being have evolved from single dimension to multidimensional measures. Multi-dimensional measures deepen and broaden our understanding of child well-being and inform us of areas of neglect. Child well-being in China today is measured through proxy measures of [...] Read more.

In recent decades, measures of child well-being have evolved from single dimension to multidimensional measures. Multi-dimensional measures deepen and broaden our understanding of child well-being and inform us of areas of neglect. Child well-being in China today is measured through proxy measures of household need. This paper discusses the evolution of child well-being measures more generally, explores the benefits of positive indicators and multiple dimensions in formulating policy, and then reviews efforts to date by the Chinese government, researchers, and non-governmental and intergovernmental organizations to develop comprehensive multidimensional measures of child well-being in China. The domains and their potential interactions, as well as data sources and availability, are presented. The authors believe that child well-being in China would benefit from the development of a multidimensional index and that there is sufficient data to develop such an index. Full article

(This article belongs to the Special Issue Poverty and Child Well-Being)

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Open AccessArticle

Spatiotemporal Association of Real-Time Concentrations of Black Carbon (BC) with Fine Particulate Matters (PM_2.5) in Urban Hotspots of South Korea

by Sungroul Kim^*, Sol Yu^† and Dongmin Yun

¹ Department of Environment Health Sciences, Soonchunhyang University, Asan 31538, Korea

^† (Currently) Division of Environmental Health Research, National Institute of Environmental Research, Incheon 22689, Korea.

Int. J. Environ. Res. Public Health 2017, 14(11), 1350; https://doi.org/10.3390/ijerph14111350 - 6 Nov 2017

Cited by 4 | Viewed by 4157

Abstract

We evaluated the spatiotemporal distributions of black carbon (BC) and particulate matters with aerodynamic diameters of less than 2.5 m (PM_2.5) concentrations at urban diesel engine emission (DEE) hotspots of South Korea. Concentrations of BC and PM_2.5 were measured at [...] Read more.

We evaluated the spatiotemporal distributions of black carbon (BC) and particulate matters with aerodynamic diameters of less than 2.5 m (PM_2.5) concentrations at urban diesel engine emission (DEE) hotspots of South Korea. Concentrations of BC and PM_2.5 were measured at the entrance gate of two diesel bus terminals and a train station, in 2014. Measurements were conducted simultaneously at the hotspot (Site 1) and at its adjacent, randomly selected, residential areas, apartment complex near major roadways, located with the same direction of 300 m (Site 2) and 500 m (Site 3) away from Site 1 on 4 different days over the season, thrice per day; morning (n = 120 measurements for each day and site), evening (n = 120), and noon (n = 120). The median (interquartile range) PM_2.5 ranged from 12.6 (11.3–14.3) to 60.1 (47.0–76.0) μg/m³ while those of BC concentrations ranged from 2.6 (1.9–3.7) to 6.3 (4.2–10.3) μg/m³. We observed a strong relationship of PM_2.5 concentrations between sites (slopes 0.89–0.9, the coefficient of determination 0.89–0.96) while the relationship for BC concentrations between sites was relatively weak (slopes 0.76–0.85, the coefficient of determination 0.54–0.72). PM_2.5 concentrations were changed from 4% to 140% by unit increase of BC concentration, depending on site and time while likely supporting the necessity of monitoring of BC as well as PM_2.5, especially at urban DEE related hotspot areas. Full article

(This article belongs to the Section Environmental Science and Engineering)

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941 KiB

Open AccessArticle

Effects of Airborne Particulate Matter on Respiratory Health in a Community near a Cement Factory in Chilanga, Zambia: Results from a Panel Study

by Emmy Nkhama^1,3,5,*, Micky Ndhlovu², J. Timothy Dvonch³, Mary Lynam³

, Graciela Mentz⁴, Seter Siziya^5,6 and Kuku Voyi⁷

¹ Department of Environmental Health, Chainama College of Health Sciences, P.O. Box 33991, Lusaka 10101, Zambia

² Department of Clinical Medicine, Chainama College of Health Sciences, P.O. Box 33991, Lusaka 10101, Zambia

³ Department of Environmental Health Science, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA

⁴ Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA

⁵ Public Health Unit, School of Medicine, Copperbelt University, P.O. Box 71191, Ndola 10101, Zambia

⁶ School of Health Sciences, University of Lusaka, P.O. Box 36711, Lusaka 10101, Zambia

⁷ School of Public Health and Health System, Health Sciences Faculty, University of Pretoria, P.O. Box 667, Pretoria 0001, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1351; https://doi.org/10.3390/ijerph14111351 - 6 Nov 2017

Cited by 36 | Viewed by 4772

Abstract

We conducted a panel study to investigate seasonal variations in concentrations of airborne PM_2.5 and PM₁₀ and the effects on respiratory health in a community near a cement factory; in Chilanga; Zambia. A panel of 63 and 55 participants aged 21 [...] Read more.

We conducted a panel study to investigate seasonal variations in concentrations of airborne PM_2.5 and PM₁₀ and the effects on respiratory health in a community near a cement factory; in Chilanga; Zambia. A panel of 63 and 55 participants aged 21 to 59 years from a community located at the edge of the factory within 1 km and a control community located 18 km from the factory respectively; were followed up for three climatic seasons July 2015 to February 2016. Symptom diary questionnaires were completed and lung function measurements taken daily for 14 days in each of the three climatic seasons. Simultaneously, PM_2.5 and PM₁₀ concentrations in ambient air were monitored at a fixed site for each community. Mean seasonal concentrations of PM_2.5and PM₁₀ ranged from 2.39–24.93 μg/m³and 7.03–68.28 μg/m³ respectively in the exposed compared to the control community 1.69–6.03 μg/m³ and 2.26–8.86 μg/m³. The incident rates of reported respiratory symptoms were higher in the exposed compared to the control community: 46.3 vs. 13.8 for cough; 41.2 vs. 9.6 for phlegm; 49.0 vs.12.5 for nose; and 13.9 vs. 3.9 for wheeze per 100 person-days. There was a lower performance on all lung indices in the exposed community compared to the control; overall the mean FEV1 (forced expiratory volume in one second) and FVC (forced vital capacity) predicted percentage for the exposed was six and four percentage points lower than the control. Restriction of industrial emissions coupled with on-going monitoring and regulatory enforcement are needed to ensure that PM (airborne particulate matter) levels in the ambient air are kept within recommended levels to safeguard the respiratory health of nearby community residents. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Measuring the Effect of Housing Quality Interventions: The Case of the New Zealand “Rental Warrant of Fitness”

by Lucy Telfar-Barnard^1,*, Julie Bennett¹, Philippa Howden-Chapman¹, David E. Jacobs^2,3, David Ormandy⁴, Matthew Cutler-Welsh⁵, Nicholas Preval¹, Michael G. Baker¹

and Michael Keall¹

¹ Department of Public Health, University of Otago, Wellington 6021, New Zealand

² School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA

³ National Center for Healthy Housing, Columbia, MD 21044, USA

⁴ Warwick Medical School—Health Sciences, University of Warwick, Coventry CV5 6EG, UK

⁵ Home Style Green, Auckland 1072, New Zealand

Int. J. Environ. Res. Public Health 2017, 14(11), 1352; https://doi.org/10.3390/ijerph14111352 - 7 Nov 2017

Cited by 22 | Viewed by 7814

Abstract

In New Zealand, as in many other countries, housing in the private-rental sector is in worse condition than in the owner-occupier housing sector. New Zealand residential buildings have no inspection regime after original construction signoff. Laws and regulations mandating standards for existing residential [...] Read more.

In New Zealand, as in many other countries, housing in the private-rental sector is in worse condition than in the owner-occupier housing sector. New Zealand residential buildings have no inspection regime after original construction signoff. Laws and regulations mandating standards for existing residential housing are outdated and spread over a range of instruments. Policies to improve standards in existing housing have been notoriously difficult to implement. In this methods paper, we describe the development and implementation of a rental Warrant of Fitness (WoF) intended to address these problems. Dwellings must pass each of 29 criteria for habitability, insulation, heating, ventilation, safety, amenities, and basic structural soundness to reach the WoF minimum standard. The WoF’s development was based on two decades of research on the impact of housing quality on health and wellbeing, and strongly influenced by the UK Housing Health and Safety Rating System and US federal government housing standards. Criteria were field-tested across a range of dwelling types and sizes, cities, and climate zones. The implementation stage of our WoF research consists of a non-random controlled quasi-experimental study in which we work with two city-level local government councils to implement the rental WoF, recruiting adjoining council areas as controls, and measuring changes in health, economic, and social outcomes. Full article

(This article belongs to the Special Issue Housing and Health)

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Open AccessArticle

BUS TRIPS—A Self-Management Program for People with Cognitive Impairments after Stroke

by Emma Carlstedt^1,*, Susanne Iwarsson¹, Agneta Ståhl², Hélène Pessah-Rasmussen^3,4 and Eva Månsson Lexell^1,3

¹ Department of Health Sciences, Lund University, P.O. Box 157, SE-22100 Lund, Sweden

² Department of Technology and Society, Lund University, P.O. Box 118, SE-22100 Lund, Sweden

³ Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, SE-22185 Lund-Malmö, Sweden

⁴ Department of Clinical Sciences, Lund University, P.O. Box 117, SE-22100 Lund, Sweden

Int. J. Environ. Res. Public Health 2017, 14(11), 1353; https://doi.org/10.3390/ijerph14111353 - 7 Nov 2017

Cited by 7 | Viewed by 4451

Abstract

Stroke is a major cause of disability worldwide and different types of impairments can affect the individual’s ability to manage everyday activities such as travel that is essential for participation in society. The purpose of this study was to investigate the feasibility of [...] Read more.

Stroke is a major cause of disability worldwide and different types of impairments can affect the individual’s ability to manage everyday activities such as travel that is essential for participation in society. The purpose of this study was to investigate the feasibility of a new self-management intervention (BUS TRIPS) focusing on travelling by bus, and potential contributions to an improved ability to travel by bus for people with cognitive impairments after stroke. This is a pilot study of five individuals, utilizing a multiple case study design with a mixed methods approach. Assessments (Stroke Impact Scale, General Self-Efficacy Scale and Life Satisfaction Scale-11, Item 1) were performed before, two weeks after, and three months after the program. The data collection also comprised reflection notes from the group leaders (an occupational therapist and a physiotherapist), a semi-structured group interview and an individual phone survey. The feasibility of the intervention was presented in four sub-categories: (1) appreciated group format despite too short sessions; (2) the importance of skilled leaders and motivated participants; (3) session material adequate but needs minor revision to fit the target group; and (4) homework is valuable but reflective group discussions must be supported. The narratives of each case showed that all participants made some progress related to travelling by bus, but the overall positive results could not be verified by all of the quantitative assessments. We conclude that the BUS TRIPS intervention is feasible and can potentially contribute to an improved ability to travel by bus for the target group. Future studies is called for, and should focus on recruitment challenges, to clarify assessments that would be suitable to use in larger scale clinical trials and during subsequent implementation in clinical practice. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessArticle

Pattern of Road Traffic Injuries in Rural Bangladesh: Burden Estimates and Risk Factors

by Md. Kamran Ul Baset¹, Aminur Rahman¹, Olakunle Alonge^2,*, Priyanka Agrawal²

, Shirin Wadhwaniya² and Fazlur Rahman¹

¹ Center for Injury Prevention and Research, Bangladesh, House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh

² Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1354; https://doi.org/10.3390/ijerph14111354 - 7 Nov 2017

Cited by 25 | Viewed by 6772

Abstract

Globally, road traffic injury (RTI) causes 1.3 million deaths annually. Almost 90% of all RTI deaths occur in low- and middle-income countries. RTI is one of the leading causes of death in Bangladesh; the World Health Organization estimated that it kills over 21,000 [...] Read more.

Globally, road traffic injury (RTI) causes 1.3 million deaths annually. Almost 90% of all RTI deaths occur in low- and middle-income countries. RTI is one of the leading causes of death in Bangladesh; the World Health Organization estimated that it kills over 21,000 people in the country annually. This study describes the current magnitude and risk factors of RTI for different age groups in rural Bangladesh. A household census was carried out in 51 unions of seven sub-districts situated in the north and central part of Bangladesh between June and November 2013, covering 1.2 million individuals. Trained data collectors collected information on fatal and nonfatal RTI events through face-to-face interviews using a set of structured pre-tested questionnaires. The recall periods for fatal and non-fatal RTI were one year and six months, respectively. The mortality and morbidity rates due to RTI were 6.8/100,000 population/year and 889/100,000 populations/six months, respectively. RTI mortality and morbidity rates were significantly higher among males compared to females. Deaths and morbidities due to RTI were highest among those in the 25–64 years age group. A higher proportion of morbidity occurred among vehicle passengers (34%) and pedestrians (18%), and more than one-third of the RTI mortality occurred among pedestrians. Twenty percent of all nonfatal RTIs were classified as severe injuries. RTI is a major public health issue in rural Bangladesh. Immediate attention is needed to reduce preventable deaths and morbidities in rural Bangladesh. Full article

(This article belongs to the Collection A Million Person Household Survey: Understanding the Burden of Injuries in Bangladesh)

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Open AccessArticle

Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions

by Rogério M. Pinto^1,*, Susan S. Witte², Prema L. Filippone²

, Karen L. Baird³ and Wendy R. Whitman²

¹ School of Social Work, University of Michigan—Ann Arbor, 1080 South University, Room 3792, Ann Arbor, MI 48109, USA

² School of Social Work, Columbia University, 1255 Amsterdam Avenue, 8th Floor, New York, NY 10027, USA

³ Department of Political Science, Purchase College, 735 Anderson Hill Road, Purchase, NY 10577, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1355; https://doi.org/10.3390/ijerph14111355 - 7 Nov 2017

Cited by 15 | Viewed by 4560

Abstract

Worldwide, the human immunodeficiency virus (HIV) continuum of care involves health promotion providers (e.g., social workers and health educators) linking patients to medical personnel who provide HIV testing, primary care, and antiretroviral treatments. Regrettably, these life-saving linkages are not always made consistently and [...] Read more.

Worldwide, the human immunodeficiency virus (HIV) continuum of care involves health promotion providers (e.g., social workers and health educators) linking patients to medical personnel who provide HIV testing, primary care, and antiretroviral treatments. Regrettably, these life-saving linkages are not always made consistently and many patients are not retained in care. To design, test and implement effective interventions, we need to first identify key factors that may improve linkage-making. To help close this gap, we used in-depth interviews with 20 providers selected from a sample of 250 participants in a mixed-method longitudinal study conducted in New York City (2012–2017) in order to examine the implementation of HIV services for at-risk populations. Following a sociomedical framework, we identified provider-, interpersonal- and environmental-level factors that influence how providers engage patients in the care continuum by linking them to HIV testing, HIV care, and other support services. These factors occurred in four domains of reference: Providers’ Professional Knowledge Base; Providers’ Interprofessional Collaboration; Providers’ Work-Related Changes; and Best Practices in a Competitive Environment. Of particular importance, our findings show that a competitive environment and a fear of losing patients to other agencies may inhibit providers from engaging in linkage-making. Our results suggest relationships between factors within and across all four domains; we recommend interventions to modify factors in all domains for maximum effect toward improving care continuum linkage-making. Our findings may be applicable in different areas of the globe with high HIV prevalence. Full article

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Open AccessFeature PaperArticle

Changes in Sports Participation across Transition to Retirement: Modification by Migration Background and Acculturation Status

by Johanna-Katharina Schönbach^1,2,*, Manuela Pfinder^3,4, Claudia Börnhorst¹, Hajo Zeeb^1,2 and Tilman Brand¹

¹ Leibniz Institute for Prevention Research and Epidemiology–BIPS, 28359 Bremen, Germany

² Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany

³ Department of General Practice and Health Services Research, Heidelberg University Hospital, 69120 Heidelberg, Germany

⁴ Department of Health Promotion/Occupational Health Management, AOK Baden-Württemberg, 70191 Stuttgart, Germany

Int. J. Environ. Res. Public Health 2017, 14(11), 1356; https://doi.org/10.3390/ijerph14111356 - 8 Nov 2017

Cited by 8 | Viewed by 5116

Abstract

While total physical activity decreases over the life course, sports and leisure-time physical activity (LTPA) have shown to increase after transition to retirement. This paper aimed to investigate whether this change in sports participation differs (1) between non-migrant persons (NMP) versus persons with [...] Read more.

While total physical activity decreases over the life course, sports and leisure-time physical activity (LTPA) have shown to increase after transition to retirement. This paper aimed to investigate whether this change in sports participation differs (1) between non-migrant persons (NMP) versus persons with a migrant background (PMB), and (2) by acculturation status. Data was drawn from 16 waves of the German Socio-Economic Panel Study (SOEP) including 2664 NMP and 569 PMB. PMB were grouped according to acculturation status (integrated, assimilated, marginalised, separated), assessed regarding three dimensions (language, social interaction and identification). We applied multilevel logistic regression models, adjusting for sex, retirement age, socioeconomic status, health status and body mass index. Our results show that (1) transition to retirement led to an increase in the sports participation of NMP during the first 5 years and the subsequent 5 years after retirement. Changes in sports participation were modified by migration status: In PMB sports participation increased to a lesser extent than in NMP. (2) While sports participation of integrated PMB was not significantly different from NMP in the preretirement phase, sports participation among integrated PMB increased less after retirement compared with NMP. Marginalized and assimilated PMB did not show consistent sports participation patterns before retirement, but seemingly increased their sports participation less than NMP over the retirement transition. Separated PMB had particularly low levels of sports participation. Considering that LTPA is a key factor for healthy ageing, the increasing gap in levels of sports participation after transition to retirement indicates the need for interventions targeting physical activity of the older migrant population. Full article

(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)

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Open AccessArticle

Coordinating Leader-Follower Supply Chain with Sustainable Green Technology Innovation on Their Fairness Concerns

by Bisheng Du^1,2,*

, Qing Liu¹ and Guiping Li^1,2,*

¹ School of Business, Ningbo University, Ningbo 315211, China

² Center for Collaborative Innovation on Port Trading Cooperation and Development (Collaborative Innovation Center of Port Economics), Ningbo University, Ningbo 315211, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1357; https://doi.org/10.3390/ijerph14111357 - 8 Nov 2017

Cited by 61 | Viewed by 5877

Abstract

Sustainable green technology innovation is essential in all the stages of the supply chain development. The members of the supply chain in each stage need to invest in sustainable green technology innovation research and development. However, whether the sustainable green technology innovation investments [...] Read more.

Sustainable green technology innovation is essential in all the stages of the supply chain development. The members of the supply chain in each stage need to invest in sustainable green technology innovation research and development. However, whether the sustainable green technology innovation investments and profits for all the members are fairness concerned is a critical factor to motivate the supply chain members. Motivated by a real business investigation, in this study, a supply chain model with one supplier and one manufacturer is analyzed. We consider fairness concerns for the supplier and the manufacturer with sustainable green technology innovation development. We derive the optimal results in both with and without fairness concern. The results indicate that fairness concerns can promote and coordinate the supply chain members without advantage inequity averseness, to invest more on their sustainable green technology innovation development. Full article

(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)

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Open AccessArticle

Hospital Smoke-Free Policy: Compliance, Enforcement, and Practices. A Staff Survey in Two Large Public Hospitals in Australia

by Sam McCrabb^1,*, Amanda L. Baker¹, John Attia^1,2,3

, Zsolt J. Balogh^1,4, Natalie Lott⁴, Kerrin Palazzi², Justine Naylor^5,6, Ian A. Harris^5,6, Christopher M. Doran⁷, Johnson George^8,9, Luke Wolfenden^1,9, Eliza Skelton¹ and Billie Bonevski¹

¹ School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308, Australia

² Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales 2305, Australia

³ Department of General Medicine, John Hunter Hospital, New Lambton Heights, New South Wales 2305, Australia

⁴ Department of Traumatology, John Hunter Hospital, New Lambton Heights, New South Wales 2305, Australia

⁵ Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, New South Wales 2170, Australia

⁶ South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, New South Wales 2170, Australia

⁷ School of Human, Health and Social Sciences, Central Queensland University, Brisbane, Queensland 4000, Australia

⁸ Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria 3052, Australia

⁹ Hunter New England Population Health, Wallsend, New South Wales 2287, Australia

Int. J. Environ. Res. Public Health 2017, 14(11), 1358; https://doi.org/10.3390/ijerph14111358 - 8 Nov 2017

Cited by 20 | Viewed by 6641

Abstract

Background: Smoke-free hospital policies are becoming increasingly common to promote good health and quit attempts among patients who smoke. This study aims to assess: staff perceived enforcement and compliance with smoke-free policy; the current provision of smoking cessation care; and the characteristics of [...] Read more.

Background: Smoke-free hospital policies are becoming increasingly common to promote good health and quit attempts among patients who smoke. This study aims to assess: staff perceived enforcement and compliance with smoke-free policy; the current provision of smoking cessation care; and the characteristics of staff most likely to report provision of care to patients. Methods: An online cross-sectional survey of medical, nursing, and allied staff from two Australian public hospitals was conducted. Staff report of: patient and staff compliance with smoke-free policy; perceived policy enforcement; the provision of the 5As for smoking cessation (Ask, Assess, Advise, Assist, and Arrange follow-up); and the provision of stop-smoking medication are described. Logistic regressions were used to determine respondent characteristics related to the provision of the 5As and stop-smoking medication use during hospital admission. Results: A total of 805 respondents participated. Self-reported enforcement of smoke-free policy was low (60.9%), together with compliance for both patients (12.9%) and staff (23.6%). The provision of smoking cessation care was variable, with the delivery of the 5As ranging from 74.7% (ask) to 18.1% (arrange follow-up). Medical staff (odds ratio (OR) = 2.09, CI = 1.13, 3.85, p = 0.018) and full time employees (OR = 2.03, CI = 1.06, 3.89, p = 0.033) were more likely to provide smoking cessation care always/most of the time. Stop-smoking medication provision decreased with increasing age of staff (OR = 0.98, CI = 0.96, 0.99, p = 0.008). Conclusions: Smoke-free policy enforcement and compliance and the provision of smoking cessation care remains low in hospitals. Efforts to improve smoking cessation delivery by clinical staff are warranted. Full article

(This article belongs to the Special Issue Reducing Exposure to Second-Hand Tobacco Smoke)

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Open AccessArticle

Burden of Mortality and Disease Attributable to Multiple Air Pollutants in Warsaw, Poland

by Piotr Holnicki^1,*

, Marko Tainio^1,2

, Andrzej Kałuszko¹ and Zbigniew Nahorski^1,3

¹ Systems Research Institute, Polish Academy of Sciences, 01-447 Warsaw, Poland

² UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 1TN, UK

³ Warsaw School of Information Technology (WIT), 01-447 Warsaw, Poland

Int. J. Environ. Res. Public Health 2017, 14(11), 1359; https://doi.org/10.3390/ijerph14111359 - 8 Nov 2017

Cited by 36 | Viewed by 5608

Abstract

Air pollution is a significant public health issue all over the world, especially in urban areas where a large number of inhabitants are affected. In this study, we quantify the health burden due to local air pollution for Warsaw, Poland. The health impact [...] Read more.

Air pollution is a significant public health issue all over the world, especially in urban areas where a large number of inhabitants are affected. In this study, we quantify the health burden due to local air pollution for Warsaw, Poland. The health impact of the main air pollutants, PM, NO_X, SO₂, CO, C₆H₆, BaP and heavy metals is considered. The annual mean concentrations are predicted with the CALPUFF air quality modeling system using the year 2012 emission and meteorological data. The emission field comprises point, mobile and area sources. The exposure to these pollutants was estimated using population data with a spatial resolution of 0.5 × 0.5 km². Changes in mortality and in disability-adjusted life-years (DALYs) were estimated with relative risk functions obtained from literature. It has been predicted that local emissions cause approximately 1600 attributable deaths and 29,000 DALYs per year. About 80% of the health burden was due to exposure to fine particulate matter (PM_2.5). Mobile and area sources contributed 46% and 52% of total DALYs, respectively. When the inflow from outside was included, the burden nearly doubled to 51,000 DALYs. These results indicate that local decisions can potentially reduce associated negative health effects, but a national-level policy is required for reducing the strong environmental impact of PM emissions. Full article

(This article belongs to the Section Environmental Science and Engineering)

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Open AccessArticle

Climatic Variables and Malaria Morbidity in Mutale Local Municipality, South Africa: A 19-Year Data Analysis

by Abiodun M. Adeola^1,*

, Joel O. Botai^1,2

, Hannes Rautenbach^1,3, Omolola M. Adisa²

, Katlego P. Ncongwane¹, Christina M. Botai¹ and Temitope C. Adebayo-Ojo³

¹ South African Weather Service, Private Bag X097, Pretoria 0001, South Africa

² Department of Geography, Geoinformatics & Meteorology, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa

³ School for Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1360; https://doi.org/10.3390/ijerph14111360 - 8 Nov 2017

Cited by 38 | Viewed by 6910

Abstract

The north-eastern parts of South Africa, comprising the Limpopo Province, have recorded a sudden rise in the rate of malaria morbidity and mortality in the 2017 malaria season. The epidemiological profiles of malaria, as well as other vector-borne diseases, are strongly associated with [...] Read more.

The north-eastern parts of South Africa, comprising the Limpopo Province, have recorded a sudden rise in the rate of malaria morbidity and mortality in the 2017 malaria season. The epidemiological profiles of malaria, as well as other vector-borne diseases, are strongly associated with climate and environmental conditions. A retrospective understanding of the relationship between climate and the occurrence of malaria may provide insight into the dynamics of the disease’s transmission and its persistence in the north-eastern region. In this paper, the association between climatic variables and the occurrence of malaria was studied in the Mutale local municipality in South Africa over a period of 19-year. Time series analysis was conducted on monthly climatic variables and monthly malaria cases in the Mutale municipality for the period of 1998–2017. Spearman correlation analysis was performed and the Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed. Microsoft Excel was used for data cleaning, and statistical software R was used to analyse the data and develop the model. Results show that both climatic variables’ and malaria cases’ time series exhibited seasonal patterns, showing a number of peaks and fluctuations. Spearman correlation analysis indicated that monthly total rainfall, mean minimum temperature, mean maximum temperature, mean average temperature, and mean relative humidity were significantly and positively correlated with monthly malaria cases in the study area. Regression analysis showed that monthly total rainfall and monthly mean minimum temperature (R² = 0.65), at a two-month lagged effect, are the most significant climatic predictors of malaria transmission in Mutale local municipality. A SARIMA (2,1,2) (1,1,1) model fitted with only malaria cases has a prediction performance of about 51%, and the SARIMAX (2,1,2) (1,1,1) model with climatic variables as exogenous factors has a prediction performance of about 72% in malaria cases. The model gives a close comparison between the predicted and observed number of malaria cases, hence indicating that the model provides an acceptable fit to predict the number of malaria cases in the municipality. To sum up, the association between the climatic variables and malaria cases provides clues to better understand the dynamics of malaria transmission. The lagged effect detected in this study can help in adequate planning for malaria intervention. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Development and Relative Validity of a Food Frequency Questionnaire to Assess Intakes of Total and Free Sugars in Australian Toddlers

by Gemma Devenish¹

, Aqif Mukhtar¹

, Andrea Begley¹

, Loc Do²

and Jane Scott^1,*

¹ School of Public Health, Curtin University, Perth 6102, Australia

² Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide 5000, Australia

Int. J. Environ. Res. Public Health 2017, 14(11), 1361; https://doi.org/10.3390/ijerph14111361 - 8 Nov 2017

Cited by 16 | Viewed by 4692

Abstract

Background: Dental research into early childhood caries is hindered by a lack of suitable dietary assessment tools that have been developed and validated for the population and outcomes of interest. The aim of this study was to develop and investigate the relative [...] Read more.

Background: Dental research into early childhood caries is hindered by a lack of suitable dietary assessment tools that have been developed and validated for the population and outcomes of interest. The aim of this study was to develop and investigate the relative validity and reproducibility of the Study of Mothers’ and Infants’ Life Events Food Frequency Questionnaire (SMILE-FFQ), to assess the total and free sugars intakes of Australian toddlers. Methods: The SMILE-FFQ was designed to capture the leading dietary contributors to dental caries risk in toddlers aged 18–30 months via a proxy report. Ninety-five parents of Australian toddlers completed the questionnaire online before and after providing three 24-h recalls (24HR), collected on non-consecutive days using the multipass method. Total and free sugars were compared between the two SMILE-FFQ administrations and between each SMILE-FFQ and the 24HR using multiple statistical tests and standardised validity criteria. Correlation (Pearson), mean difference (Wilcoxon rank test) and Bland Altman analyses were conducted to compare absolute values, with cross-classification (Chi-Square and Weighted Kappa) used to compare agreement across tertiles. Results: All reproducibility tests showed good agreement except weighted kappa, which showed acceptable agreement. Relative validity tests revealed a mix of good and acceptable agreement, with total sugars performing better at the individual level than free sugars. Compared to the 24HR, the SMILE-FFQ tended to underestimate absolute values at lower levels and overestimate them at higher levels. Conclusions: The combined findings of the various tests indicate that the SMILE-FFQ performs comparably to the 24HR for assessing both total and free sugars among individuals, is most effective for ranking participants rather than determining absolute intakes, and is therefore suitable for use in observational studies of Australian toddlers. Full article

(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)

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Open AccessArticle

Are PCI Service Volumes Associated with 30-Day Mortality? A Population-Based Study from Taiwan

by Tsung-Hsien Yu¹

, Ying-Yi Chou², Chung-Jen Wei³ and Yu-Chi Tung^2,*

¹ Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 108, Taiwan

² Institute of Health Policy and Management, National Taiwan University, Taipei 100, Taiwan

³ Department of Public Health, Fu-Jen Catholic University, Taipei 242, Taiwan

Int. J. Environ. Res. Public Health 2017, 14(11), 1362; https://doi.org/10.3390/ijerph14111362 - 9 Nov 2017

Cited by 2 | Viewed by 3009

Abstract

The volume-outcome relationship has been discussed for over 30 years; however, the findings are inconsistent. This might be due to the heterogeneity of service volume definitions and categorization methods. This study takes percutaneous coronary intervention (PCI) as an example to examine whether the [...] Read more.

The volume-outcome relationship has been discussed for over 30 years; however, the findings are inconsistent. This might be due to the heterogeneity of service volume definitions and categorization methods. This study takes percutaneous coronary intervention (PCI) as an example to examine whether the service volume was associated with PCI 30-day mortality, given different service volume definitions and categorization methods. A population-based, cross-sectional multilevel study was conducted. Two definitions of physician and hospital volume were used: (1) the cumulative PCI volume in a previous year before each PCI; (2) the cumulative PCI volume within the study period. The volume was further treated in three ways: (1) a categorical variable based on the American Heart Association’s recommendation; (2) a semi-data-driven categorical variable based on k-means clustering algorithm; and (3) a data-driven categorical variable based on the Generalized Additive Model. The results showed that, after adjusting the patient-, physician-, and hospital-level covariates, physician volume was associated inversely with PCI 30-day mortality, but hospital volume was not, no matter which definitions and categorization methods of service volume were applied. Physician volume is negatively associated with PCI 30-day mortality, but the results might vary because of definition and categorization method. Full article

(This article belongs to the Section Health Economics)

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Open AccessArticle

Variation in Point-of-Care Testing of HbA1c in Diabetes Care in General Practice

by Troels Kristensen^1,*

, Frans Boch Waldorff², Jørgen Nexøe², Christian Volmar Skovsgaard³

and Kim Rose Olsen¹

¹ COHERE, Department of Public Health & Research Unit of General Practice, University of Southern Denmark, 5000 Odense C, Denmark

² Research Unit of General Practice, University of Southern Denmark, 5000 Odense C, Denmark

³ COHERE, Department of Business and Economics, University of Southern Denmark, 5230 Odense M, Denmark

Int. J. Environ. Res. Public Health 2017, 14(11), 1363; https://doi.org/10.3390/ijerph14111363 - 9 Nov 2017

Cited by 8 | Viewed by 5811

Abstract

Background: Point-of-care testing (POCT) of HbA1c may result in improved diabetic control, better patient outcomes, and enhanced clinical efficiency with fewer patient visits and subsequent reductions in costs. In 2008, the Danish regulators created a framework agreement regarding a new fee-for-service fee for [...] Read more.

Background: Point-of-care testing (POCT) of HbA1c may result in improved diabetic control, better patient outcomes, and enhanced clinical efficiency with fewer patient visits and subsequent reductions in costs. In 2008, the Danish regulators created a framework agreement regarding a new fee-for-service fee for the remuneration of POCT of HbA1c in general practice. According to secondary research, only the Capital Region of Denmark has allowed GPs to use this new incentive for POCT. The aim of this study is to use patient data to characterize patients with diabetes who have received POCT of HbA1c and analyze the variation in the use of POCT of HbA1c among patients with diabetes in Danish general practice. Methods: We use register data from the Danish Drug Register, the Danish Health Service Register and the National Patient Register from the year 2011 to define a population of 44,981 patients with diabetes (type 1 and type 2 but not patients with gestational diabetes) from the Capital Region. The POCT fee is used to measure the amount of POCT of HbA1c among patients with diabetes. Next, we apply descriptive statistics and multilevel logistic regression to analyze variation in the prevalence of POCT at the patient and clinic level. We include patient characteristics such as gender, age, socioeconomic markers, health care utilization, case mix markers, and municipality classifications. Results: The proportion of patients who received POCT was 14.1% and the proportion of clinics which were “POCT clinics” was 26.9%. There were variations in the use of POCT across clinics and patients. A part of the described variation can be explained by patient characteristics. Male gender, age differences (older age), short education, and other ethnicity imply significantly higher odds for POCT. High patient costs in general practice and other parts of primary care also imply higher odds for POCT. In contrast, high patient costs for drugs and/or morbidity in terms of the Charlson Comorbidity index mean lower odds for POCT. The frequency of patients with diabetes per 1000 patients was larger in POCT clinics than Non-POCT clinics. A total of 22.5% of the unexplained variability was related to GP clinics. Conclusions: This study demonstrates variation in the use of POCT which can be explained by patient characteristics such as demographic, socioeconomic, and case mix markers. However, it appears relevant to reassess the system for POCT. Further studies are warranted in order to assess the impacts of POCT of HbA1c on health care outcomes. Full article

(This article belongs to the Special Issue Economic Causes and Impacts of Diabetes and Diabetes-Related Conditions)

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Open AccessArticle

Factors Associated with Activities of Daily Life Disability among Centenarians in Rural Chongqing, China: A Cross-Sectional Study

by Tingting Wu^1,2,3,†, Lu Lu^1,2,3,†, Li Luo^1,2,3, Yingqi Guo⁴, Liying Ying⁵, Qingliu Tao⁶, Huan Zeng^1,2,3, Lingli Han^1,2,3, Zumin Shi⁷

and Yong Zhao^1,2,3,*

¹ School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China

² Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China

³ Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China

⁴ Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China

⁵ School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310000, China

⁶ Chongqing Health Education Institute, Chongqing 404000, China

⁷ Adelaide Medical School, University of Adelaide, Adelaide 5000, Australia

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1364; https://doi.org/10.3390/ijerph14111364 - 9 Nov 2017

Cited by 17 | Viewed by 5214

Abstract

Objective: This study aims to ascertain the health and lifestyle factors associated with the activities of daily living (ADL) disability of centenarians in rural Chongqing, China. Method: 564 centenarians living in rural Chongqing were selected for this cross-sectional study. Demographic characteristics and self-reported [...] Read more.

Objective: This study aims to ascertain the health and lifestyle factors associated with the activities of daily living (ADL) disability of centenarians in rural Chongqing, China. Method: 564 centenarians living in rural Chongqing were selected for this cross-sectional study. Demographic characteristics and self-reported lifestyle factors were obtained from face-to-face interviews. ADL disability was measured using the Katz Activities of Daily Living Scale. Result: Among the respondents, 65.7% were considered ADL disability centenarians. Multivariable logistic regression analysis showed that preference for salt, drinking habits, social activities, physical activity, and failure to follow good diet habits were significantly associated with the ADL disability of centenarians. Conclusion: ADL disability of centenarians was associated with certain lifestyle habits. This outcome suggested that target intervention may help maintain ADL independence even among the oldest of the elderly population. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessFeature PaperArticle

Trait Rumination Predicts Elevated Evening Cortisol in Sexual and Gender Minority Young Adults

by Peggy M. Zoccola^1,*

, Andrew W. Manigault¹

, Wilson S. Figueroa¹, Cari Hollenbeck^1,2

, Anna Mendlein¹, Alex Woody^1,3, Katrina Hamilton^1,4, Matt Scanlin^1,2

and Ryan C. Johnson¹

¹ Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA

² Department of Social and Public Health, Ohio University, Grover Center W324, Athens, OH 45701, USA

³ Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH 43210, USA

⁴ Heritage College of Osteopathic Medicine, Ohio University, 35 W. Green Drive, Athens, OH 45701, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1365; https://doi.org/10.3390/ijerph14111365 - 9 Nov 2017

Cited by 11 | Viewed by 5323

Abstract

Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body’s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim [...] Read more.

Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body’s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol) in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults (M_age = 25.0, SD = 4.1) who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output). The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes. Full article

(This article belongs to the Special Issue Stress and Health)

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Open AccessArticle

Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States

by Kristen Cooksey-Stowers^1,*, Marlene B. Schwartz¹ and Kelly D. Brownell²

¹ Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT 06103, USA

² Sanford School of Public Policy, Duke University, Durham, NC 27708, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1366; https://doi.org/10.3390/ijerph14111366 - 14 Nov 2017

Cited by 376 | Viewed by 48648

Abstract

This paper investigates the effect of food environments, characterized as food swamps, on adult obesity rates. Food swamps have been described as areas with a high-density of establishments selling high-calorie fast food and junk food, relative to healthier food options. This study examines [...] Read more.

This paper investigates the effect of food environments, characterized as food swamps, on adult obesity rates. Food swamps have been described as areas with a high-density of establishments selling high-calorie fast food and junk food, relative to healthier food options. This study examines multiple ways of categorizing food environments as food swamps and food deserts, including alternate versions of the Retail Food Environment Index. We merged food outlet, sociodemographic and obesity data from the United States Department of Agriculture (USDA) Food Environment Atlas, the American Community Survey, and a commercial street reference dataset. We employed an instrumental variables (IV) strategy to correct for the endogeneity of food environments (i.e., that individuals self-select into neighborhoods and may consider food availability in their decision). Our results suggest that the presence of a food swamp is a stronger predictor of obesity rates than the absence of full-service grocery stores. We found, even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates. All three food swamp measures indicated the same positive association, but reflected different magnitudes of the food swamp effect on rates of adult obesity (p values ranged from 0.00 to 0.16). Our adjustment for reverse causality, using an IV approach, revealed a stronger effect of food swamps than would have been obtained by naïve ordinary least squares (OLS) estimates. The food swamp effect was stronger in counties with greater income inequality (p < 0.05) and where residents are less mobile (p < 0.01). Based on these findings, local government policies such as zoning laws simultaneously restricting access to unhealthy food outlets and incentivizing healthy food retailers to locate in underserved neighborhoods warrant consideration as strategies to increase health equity. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Estimation and Evaluation of Future Demand and Supply of Healthcare Services Based on a Patient Access Area Model

by Shunsuke Doi^1,2,*, Hiroo Ide², Koichi Takeuchi², Shinsuke Fujita² and Katsuhiko Takabayashi³

¹ Department of Healthcare and Information Management, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan

² Department of Welfare and Medical Intelligence, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan

³ Department of Internal Medicine, Sanwa Hospital, Medical Incorporated Association Kanae-kai, 7-379 Higurashi, Matsudo, Chiba 270-2253, Japan

Int. J. Environ. Res. Public Health 2017, 14(11), 1367; https://doi.org/10.3390/ijerph14111367 - 10 Nov 2017

Cited by 9 | Viewed by 5927

Abstract

Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the [...] Read more.

Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy. Full article

(This article belongs to the Special Issue The International Healthcare Industry Supply in a Changing Global Demand)

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Open AccessArticle

Associations of Fasting Blood Glucose with Influencing Factors in Northeast China: A Quantile Regression Analysis

by Xin Guo

, Li Shen, Jing Dou, Yaogai Lv, Anning Zhang, Fanchao Shi, Zhiqiang Xue, Yaqin Yu, Lina Jin^* and Yan Yao^*

Epidemiology and Statistics, School of Public Health, Jilin University, Changchun 130021, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1368; https://doi.org/10.3390/ijerph14111368 - 10 Nov 2017

Cited by 6 | Viewed by 4918

Abstract

Background: Diabetes mellitus (DM) has become a major public health problem in China. Although a number of researchers have investigated DM risk factors, little is known about the associations between values of fasting blood glucose (FBG) and influencing factors. This study aims [...] Read more.

Background: Diabetes mellitus (DM) has become a major public health problem in China. Although a number of researchers have investigated DM risk factors, little is known about the associations between values of fasting blood glucose (FBG) and influencing factors. This study aims to explore these associations by the quantile regression (QR) model. Methods: A cross-sectional survey based on a sample of 23,050 adults aged 18 to 79 years was conducted in Jilin in 2012, and some subjects were excluded due to missing values with respect to necessary variables or having glycemic control, in accordance with the purposes of this study. Finally, in total 14,698 people were included in this study. QR was performed to identify the factors influencing the level of FBG in different quantiles of FBG. Results: The distribution of FBG status was different between males and females (χ² = 175.30, p < 0.001). The QR model provided more detailed views on the associations of FBG with different factors and revealed apparent quantile-related patterns separately for different factors. Body mass index (BMI) was positively associated with the low and middle quantiles of FBG. Waist circumference (WC) had a positive association with the high quantiles of FBG. Conclusions: FBG had a positive association with BMI in normal FBG, and a positive association with WC in high FBG. Diet and alcohol intake were associated with FBG in normal FBG. FBG was more likely to be elevated in the elderly, female workers, and people with family history of DM. Full article

(This article belongs to the Special Issue Economic Causes and Impacts of Diabetes and Diabetes-Related Conditions)

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Open AccessArticle

Integration of GIS, Electromagnetic and Electrical Methods in the Delimitation of Groundwater Polluted by Effluent Discharge (Salamanca, Spain): A Case Study

by Rubén Vidal Montes¹, Antonio Miguel Martínez-Graña^1,*

, José Ramón Martínez Catalán¹

, Puy Ayarza Arribas¹

, Francisco Javier Sánchez San Román¹ and Caridad Zazo²

¹ Department of Geology, Faculty of Sciences, University of Salamanca, 37008 Salamanca, Spain

² CSIC-National Museum of Natural Sciences, Geology Section, 28006 Madrid, Spain

Int. J. Environ. Res. Public Health 2017, 14(11), 1369; https://doi.org/10.3390/ijerph14111369 - 10 Nov 2017

Cited by 10 | Viewed by 5017

Abstract

The present work envisages the possible geometry of a contaminated plume of groundwater near hospital facilities by combining GIS (Geographic Information System) and geophysical methods. The rock underlying the soil and thin sedimentary cover of the study area is moderately fractured quartzite, which [...] Read more.

The present work envisages the possible geometry of a contaminated plume of groundwater near hospital facilities by combining GIS (Geographic Information System) and geophysical methods. The rock underlying the soil and thin sedimentary cover of the study area is moderately fractured quartzite, which makes aquifers vulnerable to pollution. The GIS methodology is used to calculate the area that would be affected by the effluent source of residual water, based on algorithms that consider ground surface mapping (slopes, orientations, accumulated costs and cost per distance). Geophysical methods (electromagnetic induction and electric resistivity tomography) use changes in the electrical conductivity or resistivity of the subsurface to determine the geometry of the discharge and the degree of contamination. The model presented would allow a preliminary investigation regarding potential corrective measures. Full article

(This article belongs to the Special Issue Natural Hazards and Public Health: A Systems Approach)

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Open AccessArticle

Are Some of the Cigar Warnings Mandated in the U.S. More Believable Than Others?

by Kristen L. Jarman^1,*

, Sarah D. Kowitt², Jennifer Cornacchione Ross³ and Adam O. Goldstein^1,4

¹ Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, USA

² Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA

³ Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston Salem, NC 27157, USA

⁴ Department of Family Medicine, University of North Carolina, Chapel Hill, NC 27599, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1370; https://doi.org/10.3390/ijerph14111370 - 10 Nov 2017

Cited by 9 | Viewed by 3436

Abstract

Background: Text warnings are mandated on cigars sold in the United States (U.S.), however little published research has examined effectiveness of cigar warnings. This is the first study examining the believability of cigar warnings among adults in the U.S. Methods: Adults [...] Read more.

Background: Text warnings are mandated on cigars sold in the United States (U.S.), however little published research has examined effectiveness of cigar warnings. This is the first study examining the believability of cigar warnings among adults in the U.S. Methods: Adults in the U.S. (n = 5014) were randomized in a phone survey to receive one of three cigar-specific mandated warning messages (“Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”, “Cigar smoking can cause lung cancer and heart disease”, and “Cigars are not a safe alternative to cigarettes”) with one of four warning sources (no source, Surgeon General, CDC (Centers for Disease Control and Prevention), FDA (Food and Drug Administration)). Results: Most adults found the cigar warnings very believable (66.9%). Weighted logistic regression results indicate that the message “Cigar smoking can cause lung cancer and heart disease” was associated with higher odds of being very believable (AOR: 2.05, 95% CI: 1.55, 2.70) and the message “Cigars are not a safe alternative to cigarettes” was associated with lower odds of being very believable (AOR: 0.71, 95% CI: 0.55, 0.92) compared to the message “Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”. Warning source had no impact on believability. Conclusions: We tested three of the currently mandated cigar warnings in the U.S. and found significant differences in believability between them. Further research on cigar warnings may improve communication to the public on cigar health risks, ultimately preventing uptake of cigars and promoting cessation among cigar users. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessArticle

The Impact of a Multi-Level Multi-Component Childhood Obesity Prevention Intervention on Healthy Food Availability, Sales, and Purchasing in a Low-Income Urban Area

by Joel Gittelsohn^1,2,*, Angela C. Trude^1,2, Lisa Poirier^1,2, Alexandra Ross¹, Cara Ruggiero³, Teresa Schwendler¹ and Elizabeth Anderson Steeves⁴

¹ Global Obesity Prevention Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA

² Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA

³ Center for Childhood Obesity Research, Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA

⁴ Department of Nutrition, University of Tennessee, 1215 W. Cumberland Ave., Knoxville, TN 37996, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1371; https://doi.org/10.3390/ijerph14111371 - 10 Nov 2017

Cited by 33 | Viewed by 10137

Abstract

The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at [...] Read more.

The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community intervention. The B’more Healthy Communities for Kids (BHCK) intervention worked at the wholesaler (n = 3), corner store (n = 50), carryout (n = 30), recreation center (n = 28), household (n = 365) levels to improve availability, purchasing, and consumption of healthier foods and beverages (low-sugar, low-fat) in low-income food desert predominantly African American zones in the city of Baltimore (MD, USA), ultimately intending to lead to decreased weight gain in children (not reported in this manuscript). For this paper, we focus on more proximal impacts on the food environment, and measure change in stocking, sales and purchase of promoted foods at the different levels of the food system in 14 intervention neighborhoods, as compared to 14 comparison neighborhoods. Sales of promoted products increased in wholesalers. Stocking of these products improved in corner stores, but not in carryouts, and we did not find any change in total sales. Children more exposed to the intervention increased their frequency of purchase of promoted products, although improvement was not seen for adult caregivers. A multilevel food environment intervention in a low-income urban setting improved aspects of the food system, leading to increased healthy food purchasing behavior in children. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Open AccessArticle

Occurrences of Organochlorine Pesticides along the Course of the Buffalo River in the Eastern Cape of South Africa and Its Health Implications

by Abdulrazaq Yahaya^1,2,3,*

, Omobola O. Okoh^1,2, Anthony I. Okoh^1,3

and Abiodun O. Adeniji^1,2

¹ SAMRC Microbial Water Quality Monitoring Center, University of Fort Hare, Alice 5700, South Africa

² Department of Chemistry, University of Fort Hare, Alice 5700, South Africa

³ Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice 5700, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1372; https://doi.org/10.3390/ijerph14111372 - 10 Nov 2017

Cited by 47 | Viewed by 6705

Abstract

Most organochlorine pesticides (OCPs) which are increasingly used in agriculture and industry are not biodegradable and thereby persist in the environment for a very long period of time. They are capable of negatively impacting the health of humans and biota when present in [...] Read more.

Most organochlorine pesticides (OCPs) which are increasingly used in agriculture and industry are not biodegradable and thereby persist in the environment for a very long period of time. They are capable of negatively impacting the health of humans and biota when present in a higher concentration than recommended. This study evaluated the concentrations of 17 OCPs in surface water samples collected from six sampling sites along the course of the Buffalo River in Eastern Cape, South Africa, between December 2015 and May 2016. The samples were subjected to solvent extraction, followed by florisil clean up, and analyzed using gas chromatography coupled with an electron capture detector. The individual concentrations of OCPs detected ranged from <LOD to 4403 ng/L in summer and <LOD to 313 ng/L in autumn. The levels of OCPs in the study area were generally above the United State Environmental Protection Agency (USEPA) limit of 100 ng/L in all the sampling locations in the two seasons. The cancer risk assessment values were below the permissible limit of the 10⁻⁶ level, although the life average daily dose were slightly above the USEPA maximum limits of 10⁻⁴. Therefore, there is a need for the adequate regulation of agrochemical storage, use, and disposal in this province and other parts of South Africa. Full article

(This article belongs to the Special Issue Remediation and Analysis of Soil, Air, and Water Pollution)

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Open AccessFeature PaperReview

Work Stress and Altered Biomarkers: A Synthesis of Findings Based on the Effort–Reward Imbalance Model

by Johannes Siegrist^1,* and Jian Li²

¹ Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, 40225 Düsseldorf, Germany

² Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstrasse 1, 40225 Düsseldorf, Germany

Int. J. Environ. Res. Public Health 2017, 14(11), 1373; https://doi.org/10.3390/ijerph14111373 - 10 Nov 2017

Cited by 71 | Viewed by 8863

Abstract

While epidemiological studies provide statistical evidence on associations of exposures such as stressful work with elevated risks of stress-related disorders (e.g., coronary heart disease or depression), additional information on biological pathways and biomarkers underlying these associations is required. In this contribution, we summarize [...] Read more.

While epidemiological studies provide statistical evidence on associations of exposures such as stressful work with elevated risks of stress-related disorders (e.g., coronary heart disease or depression), additional information on biological pathways and biomarkers underlying these associations is required. In this contribution, we summarize the current state of the art on research findings linking stressful work, in terms of an established theoretical model—effort-reward imbalance—with a broad range of biomarkers. Based on structured electronic literature search and recent available systematic reviews, our synthesis of findings indicates that associations of work stress with heart rate variability, altered blood lipids, and risk of metabolic syndrome are rather consistent and robust. Significant relationships with blood pressure, heart rate, altered immune function and inflammation, cortisol release, and haemostatic biomarkers were also observed, but due to conflicting findings additional data will be needed to reach a firm conclusion. This narrative review of empirical evidence supports the argument that the biomarkers under study can act as mediators of epidemiologically established associations of work stress, as measured by effort–reward imbalance, with incident stress-related disorders. Full article

(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)

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Open AccessArticle

Modeling Skin Injury from Hot Spills on Clothing

by Torgrim Log

Department of Engineering, Western Norway University of Applied Sciences, Haugesund 5528, Norway

Int. J. Environ. Res. Public Health 2017, 14(11), 1374; https://doi.org/10.3390/ijerph14111374 - 11 Nov 2017

Cited by 11 | Viewed by 4198

Abstract

The present work analyzes scald burns from hot beverages, such as coffee and tea, spilled on the lap, i.e., an incident that may occur in daily life. The Pennes bioheat equation is solved numerically for small spills wetting the clothing, i.e., the fabric [...] Read more.

The present work analyzes scald burns from hot beverages, such as coffee and tea, spilled on the lap, i.e., an incident that may occur in daily life. The Pennes bioheat equation is solved numerically for small spills wetting the clothing, i.e., the fabric prevents the spilled liquid from draining away. Temperatures are analyzed in the wetted fabric and the skin layers and the resulting skin injury is calculated based on the basal layer temperature. Parameters influencing burn severity, such as clothing thickness, liquid temperature, removal of fabric and thermal effects of post scald water cooling are analyzed. The fabric cools the water some but represents a threat since the entrapped water results in a prolonged heat supply. The liquid temperature turned out to be the most important injury parameter, where liquid temperature of about 80–85 °C seems to be a limit for developing superficial partial-thickness burns in the present minimum case, i.e., where the liquid just wets the fabric. Spilling water in excess of just wetting the fabric, more severe burns will develop at lower liquid temperatures due to the prolonged heat supply. Higher liquid temperatures will nearly instantly develop more severe burns. It is demonstrated that removal of the clothing within the first seconds after the spill may significantly reduce the scalding severity. The general advice is therefore to avoid excessive heating of beverages and, if the beverage is spilled, to quickly remove the wetted clothing. Prolonged tempered water cooling is advised to improve the healing processes. Full article

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Open AccessArticle

Physical Activity of German Children and Adolescents 2003–2012: The MoMo-Study

by Steffen C. E. Schmidt^*

, Annette Henn, Claudia Albrecht and Alexander Woll

Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany

Int. J. Environ. Res. Public Health 2017, 14(11), 1375; https://doi.org/10.3390/ijerph14111375 - 11 Nov 2017

Cited by 36 | Viewed by 6529

Abstract

Organized and unorganized physical activity (PA) hold an important role in the daily life of children and adolescents. Regular representative tracking of PA in different settings is important to evaluate social trends and implemented interventions. In this paper, representative PA data of German [...] Read more.

Organized and unorganized physical activity (PA) hold an important role in the daily life of children and adolescents. Regular representative tracking of PA in different settings is important to evaluate social trends and implemented interventions. In this paper, representative PA data of German children and adolescents from the MoMo Baseline-Study (2004, n = 4528) are compared to those of Wave 1 (2010, n = 3994). Participants aged 4–17 were drawn out of 167 sample points in Germany and the data was weighted to ensure representativeness. PA was measured via questionnaire and was differentiated between organized (sports clubs and schools) and unorganized (unorganized sports and playing outside). Organized PA in extracurricular activities and sports clubs increased by eight percent, while unorganized PA decreased by seven percent. In addition to sports clubs, schools became a more prevalent setting for participation in physical activity in Germany. Full article

(This article belongs to the Special Issue Paediatric Exercise Science and Health)

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Open AccessArticle

Body Burden of Dichlorodiphenyl Dichloroethene (DDE) and Childhood Pulmonary Function

by Pallavi P. Balte¹, Joachim Kühr², Herrman Kruse³ and Wilfried J. J. Karmaus^4,*

¹ Division of General Medicine, Columbia University Medical Center, New York, NY 10032, USA

² Clinic for Pediatric and Adolescent Medicine Klinikum Karlsruhe, Karlsruhe 76133, Germany

³ Institute for Toxicology und Pharmacology, University Schleswig-Holstein, Kiel 24105, Germany

⁴ School of Public Health, Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN 38152, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1376; https://doi.org/10.3390/ijerph14111376 - 14 Nov 2017

Cited by 12 | Viewed by 3927

Abstract

Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE) can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was [...] Read more.

Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE) can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was to understand the relationships between DDE exposure and pulmonary function in children, and, particularly, whether associations are mediated by the height of the children. We used data from an environmental epidemiologic study conducted in central Germany in children aged 8-10 years. The pulmonary function (forced vital capacity, FVC, and forced expiratory volume in one second, FEV1) were measured in three consecutive years. Blood DDE levels were measured at 8 and 10 years. We used linear mixed models for repeated measurements and path analyses to assess the association between blood levels of DDE and pulmonary function measurements. All models were adjusted for confounders. Linear mixed approaches and modelling concurrent effects showed no significant associations. The path analytical models demonstrated that DDE measured at eight years had significant, inverse, indirect, and total effects on FVC at ten years (n = 328; −0.18 L per μg/L of DDE) and FEV1 (n = 328; −0.17 L per μg/L of DDE), mediated through effects of DDE on height and weight. The DDE burden reduces pulmonary function through its diminishing effects on height and weight in children. Further studies are required to test these associations in other samples, preferably from a region with ongoing, high DDT application. Full article

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Open AccessReview

Association between Small Fetuses and Puberty Timing: A Systematic Review and Meta-Analysis

by Xu Deng, Wenyan Li, Yan Luo, Shudan Liu, Yi Wen and Qin Liu^*

School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1377; https://doi.org/10.3390/ijerph14111377 - 13 Nov 2017

Cited by 77 | Viewed by 4470

Abstract

Background: Epidemiological studies reporting the effect of small fetuses (SF) on puberty development have shown inconsistent results. Objective: To examine current study evidence and determine the strength and direction of the association between SF and puberty timing. Methods: PubMed, OVID, [...] Read more.

Background: Epidemiological studies reporting the effect of small fetuses (SF) on puberty development have shown inconsistent results. Objective: To examine current study evidence and determine the strength and direction of the association between SF and puberty timing. Methods: PubMed, OVID, Web of Science, EBSCO, and four Chinese databases were searched from their date of inception to February 2016. All cohort studies that examined the association between SF and puberty timing in children were identified. Two reviewers independently screened the studies, assessed the quality of included studies, and extracted the data. The quality of the included cohort studies was assessed by the Newcastle–Ottawa Scale. Risk ratio (RR), Weighted Mean Difference (WMD), and 95% confidence intervals (CIs) were calculated and pooled by RevMan5.3 (Cochrane Collaboration, London, UK). Results: A total of 10 cohort studies involving 2366 subjects was included in the final analysis. The pooled estimates showed that SF did not significantly increase the number of pubertal children in boys (RR: 0.97; 95% CI: 0.82 to 1.15), or in girls (RR: 0.91; 95% CI: 0.79 to 1.04). Compared with the control group, the SF group had an earlier onset of puberty in girls (WMD: −0.64; 95% CI: −1.21 to −0.06), and in precocious pubarche (PP) girls (WMD: −0.10; 95% CI: −0.13 to −0.07). There was no difference in the onset of puberty in boys (WMD: −0.48; 95% CI: −1.45 to 0.50) between SF and control groups. The pooled result indicated an earlier age at menarche in girls born small for gestational age (WMD: −0.30; 95% CI: −0.58 to −0.03), but no difference in the age at menarche in the SF group of PP girls. Conclusions: SF may be associated with an earlier age of onset of puberty, especially among girls, as well as earlier age at menarche for girls. Well-designed studies with larger sample sizes and long-term follow-up among different countries and ethnicities are needed. Full article

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Open AccessArticle

Effect of Age on Glasgow Coma Scale in Patients with Moderate and Severe Traumatic Brain Injury: An Approach with Propensity Score-Matched Population

by Cheng-Shyuan Rau^1,†, Shao-Chun Wu^2,†

, Yi-Chun Chen³, Peng-Chen Chien³, Hsiao-Yun Hsieh³, Pao-Jen Kuo³ and Ching-Hua Hsieh^3,*

¹ Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan

² Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan

³ Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan

^† These authors contribute equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1378; https://doi.org/10.3390/ijerph14111378 - 13 Nov 2017

Cited by 24 | Viewed by 7231

Abstract

Background: The most widely used methods of describing traumatic brain injury (TBI) are the Glasgow Coma Scale (GCS) and the Abbreviated Injury Scale (AIS). Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an [...] Read more.

Background: The most widely used methods of describing traumatic brain injury (TBI) are the Glasgow Coma Scale (GCS) and the Abbreviated Injury Scale (AIS). Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an equivalent anatomical severity of TBI. This study aimed to assess these observations with a propensity-score matching approach using the data from Trauma Registry System in a Level I trauma center. Methods: We included all adult patients (aged ≥20 years old) with moderate to severe TBI from 1 January 2009 to 31 December 2016. Patients were categorized into elderly (aged ≥65 years) and young adults (aged 20–64 years). The severity of TBI was defined by an AIS score in the head (AIS 3‒4 and 5 indicate moderate and severe TBI, respectively). We examined the differences in the GCS scores by age at each head AIS score. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using either the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to the propensity scores calculated using NCSS software with the following covariates: sex, pre-existing chronic obstructive pulmonary disease, systolic blood pressure, hemoglobin, sodium, glucose, and alcohol level. Logistic regression was used to evaluate the effects of age on the GCS score in each head AIS stratum. Results: The study population included 2081 adult patients with moderate to severe TBI. These patients were categorized into elderly (n = 847) and young adults (n = 1234): each was exclusively further divided into three groups of patients with head AIS of 3, 4, or 5. In the 162 well-balanced pairs of TBI patients with head AIS of 3, the elderly demonstrated a significantly higher GCS score than the young adults (14.1 ± 2.2 vs. 13.1 ± 3.3, respectively; p = 0.002). In the 362 well-balanced pairs of TBI patients with head AIS of 4, the elderly showed a significantly higher GCS score than the young adults (13.1 ± 3.3 vs. 12.2 ± 3.8, respectively; p = 0.002). In the 89 well-balance pairs of TBI patients with head AIS of 5, no significant differences were observed for the GCS scores. Conclusions: This study demonstrated that elderly patients with moderate TBI present higher GCS score than younger patients. This study underscores the importance of determining of TBI severity in this group of elderly patients based on the GCS score alone. A lower threshold of GCS cutoff should be adopted in the management of the elderly patients with TBI. Full article

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Open AccessFeature PaperArticle

Asbestos Ban in Italy: A Major Milestone, Not the Final Cut

by Daniela Marsili^1,*, Alessia Angelini²

, Caterina Bruno¹, Marisa Corfiati³

, Alessandro Marinaccio³

, Stefano Silvestri²

, Amerigo Zona¹

and Pietro Comba¹

¹ Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy

² Institute for Study and Prevention of Cancer, 50139 Florence, Italy

³ Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers Compensation Authority (INAIL), 00143 Rome, Italy

Int. J. Environ. Res. Public Health 2017, 14(11), 1379; https://doi.org/10.3390/ijerph14111379 - 13 Nov 2017

Cited by 30 | Viewed by 6446

Abstract

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing [...] Read more.

Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use. Full article

(This article belongs to the Special Issue Global Panorama of National Experiences in Public Health Actions to Ban Asbestos)

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Open AccessArticle

Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score

by Cheng-Shyuan Rau^1,†, Shao-Chun Wu^2,†

, Pao-Jen Kuo³, Yi-Chun Chen³, Peng-Chen Chien³, Hsiao-Yun Hsieh³ and Ching-Hua Hsieh^3,*

¹ Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan

² Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan

³ Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan

^† These authors contribute equally to this paper.

Int. J. Environ. Res. Public Health 2017, 14(11), 1380; https://doi.org/10.3390/ijerph14111380 - 13 Nov 2017

Cited by 7 | Viewed by 4483

Abstract

Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female [...] Read more.

Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < −4, n = 1585), medium-risk (−1 ≥ OSTA ≥ −4, n = 1985), and low-risk (OSTA > −1, n = 3137) patients. Two-sided Pearson’s, chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann–Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed with injury mechanisms as adjusted variables to evaluate the effects of OSTA-related grouping on the fracture patterns. Results: High- and medium-risk patients were significantly older, had higher incidences of comorbidity, and were more frequently injured from a fall and bicycle accident than low-risk patients did. Compared to low-risk patients, high- and medium-risk patients had a higher injury severity and mortality. In the propensity-score matched population, the incidence of fractures was only different in the extremity regions between high- and low-risk patients as well as between medium- and low-risk patients. The incidences of femoral fractures were significantly higher in high-risk (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.73–4.24; p < 0.001) and medium-risk patients (OR, 1.4; 95% CI, 1.24–1.54; p < 0.001) than in low-risk patients. In addition, high-risk patients had significantly lower odds of humeral, radial, patellar, and tibial fractures; however, such lower odds were not found in medium- risk than low-risk patients. Conclusions: The fracture patterns of female trauma patients with high- and medium-risk osteoporosis were different from that of low-risk patients exclusively in the extremity region. Full article

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Open AccessArticle

The Interaction between Ambient PM₁₀ and NO₂ on Mortality in Guangzhou, China

by Yuzhou Gu¹

, Hualiang Lin², Tao Liu²

, Jianpeng Xiao², Weilin Zeng², Zhihao Li², Xiaojuan Lv² and Wenjun Ma^2,*

¹ Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China

² Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1381; https://doi.org/10.3390/ijerph14111381 - 13 Nov 2017

Cited by 22 | Viewed by 4487

Abstract

Air pollution is now a significant environmental issue in China. To better understand the health impacts of ambient air pollution, this study investigated the potential interaction between PM₁₀ and NO₂ on mortality in Guangzhou, China. Time series data of daily non-accidental [...] Read more.

Air pollution is now a significant environmental issue in China. To better understand the health impacts of ambient air pollution, this study investigated the potential interaction between PM₁₀ and NO₂ on mortality in Guangzhou, China. Time series data of daily non-accidental mortality and concentrations of PM₁₀ and NO₂ from 2006 to 2010 were collected. Based on generalized additive model, we developed two models (bivariate model and stratified model) to explore the interaction both qualitatively and quantitatively. At lag of 0–2 days, greater interactive effects between PM₁₀ and NO₂ were presented in the graphs. Positive modified effects were also found between the two pollutants on total non-accidental death and cardiovascular death. When the NO₂ concentration was at a high level (>76.14 μg/m³), PM₁₀ showed the greatest excess relative risk percentage (ERR%) for total non-accidental mortality (0.46, 95% CI: 0.13–0.79) and cardiovascular disease mortality (0.61, 95% CI: 0.06–1.16) for each 10 μg/m³ increase. During the period of high PM₁₀ concentration (>89.82 μg/m³), NO₂ demonstrated its strongest effect for total non-accidental mortality (ERR%: 0.92, 95% CI: 0.42–1.42) and cardiovascular disease mortality (ERR%: 1.20, 95% CI: 0.38–2.03). Our results suggest a positive interaction between PM₁₀ and NO₂ on non-accidental mortality in Guangzhou. Full article

(This article belongs to the Section Environmental Health)

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Open AccessReview

Establishing Smoke-Free Homes in the Indigenous Populations of Australia, New Zealand, Canada and the United States: A Systematic Literature Review

by Leah Stevenson^1,2,*, Sandy Campbell¹, India Bohanna¹, Gillian S. Gould³, Jan Robertson^1,2 and Alan R. Clough^1,2

¹ College of Public Health, Medicine and Veterinary Science, James Cook University, Cairns 4870, Australia

² Australian Institute of Tropical Health and Medicine, James Cook University, Cairns 4870, Australia

³ School of Medicine and Public Health, The University of Newcastle, Newcastle 2300, Australia

Int. J. Environ. Res. Public Health 2017, 14(11), 1382; https://doi.org/10.3390/ijerph14111382 - 14 Nov 2017

Cited by 20 | Viewed by 7619

Abstract

A smoke-free home can have multiple benefits by reducing exposure to secondhand smoke (SHS), supporting quit attempts among active smokers, and discouraging adolescents from taking up smoking. The aim of this review was to summarize the literature on the establishment of smoke-free homes [...] Read more.

A smoke-free home can have multiple benefits by reducing exposure to secondhand smoke (SHS), supporting quit attempts among active smokers, and discouraging adolescents from taking up smoking. The aim of this review was to summarize the literature on the establishment of smoke-free homes in Indigenous populations and identify the supporting influences and barriers, using the Social Cognitive Theory lens. A search of the Medline, CINAHL, Cochrane Collaboration and PyscINFO databases and manual searches of relevant peer-reviewed literature was completed, focusing on Indigenous populations in developed economies of North America and Oceania. Of 2567 articles identified, 15 studies were included. Ten studies included Indigenous participants only, and of these just three focused entirely on SHS in the home. Knowledge of the harms associated with SHS was the most common theme represented in all the studies. This knowledge fueled parents’ motivation to protect their children from SHS by establishing smoke-free homes. Individuals who approached implementation with confidence, coupled with clear communication about smoke-free home rules were more successful. Barriers included challenges for families with multiple smokers living in the same dwelling. There is limited research regarding managing smoking behaviors in the home among Indigenous populations, even though this approach is a successful catalyst for smoking prevention and cessation. Research to understand the influences that support the establishment of smoke-free homes is required for better-informed intervention studies. Full article

(This article belongs to the Special Issue Development and Evaluation of New Tobacco Control Interventions)

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Open AccessArticle

Humidity May Modify the Relationship between Temperature and Cardiovascular Mortality in Zhejiang Province, China

by Jie Zeng^1,†, Xuehai Zhang^2,†, Jun Yang³, Junzhe Bao¹, Hao Xiang⁴

, Keith Dear⁵, Qiyong Liu⁶, Shao Lin⁷, Wayne R. Lawrence⁷

, Aihua Lin^1,* and Cunrui Huang^1,*

¹ School of Public Health, Sun Yat-sen University, Guangzhou 510080, China

² Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China

³ Institute for Environmental and Climate Research, Jinan University, Guangzhou 510632, China

⁴ Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430072, China

⁵ School of Public Health, University of Adelaide, Adelaide 5005, Australia

⁶ National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China

⁷ School of Public Health, University at Albany, State University of New York, Albany, NY 12222, USA

^† Co-first authors.

Int. J. Environ. Res. Public Health 2017, 14(11), 1383; https://doi.org/10.3390/ijerph14111383 - 14 Nov 2017

Cited by 61 | Viewed by 8199

Abstract

Background: The evidence of increased mortality attributable to extreme temperatures is widely characterized in climate-health studies. However, few of these studies have examined the role of humidity on temperature-mortality association. We investigated the joint effect between temperature and humidity on cardiovascular disease [...] Read more.

Background: The evidence of increased mortality attributable to extreme temperatures is widely characterized in climate-health studies. However, few of these studies have examined the role of humidity on temperature-mortality association. We investigated the joint effect between temperature and humidity on cardiovascular disease (CVD) mortality in Zhejiang Province, China. Methods: We collected data on daily meteorological and CVD mortality from 11 cities in Zhejiang Province during 2010–2013. We first applied time-series Poisson regression analysis within the framework of distributed lag non-linear models to estimate the city-specific effect of temperature and humidity on CVD mortality, after controlling for temporal trends and potential confounding variables. We then applied a multivariate meta-analytical model to pool the effect estimates in the 11 cities to generate an overall provincial estimate. The joint effects between them were calculated by the attributable fraction (AF). The analyses were further stratified by gender, age group, education level, and location of cities. Results: In total, 120,544 CVD deaths were recorded in this study. The mean values of temperature and humidity were 17.6 °C and 72.3%. The joint effect between low temperature and high humidity had the greatest impact on the CVD death burden over a lag of 0–21 days with a significant AF of 31.36% (95% eCI: 14.79–38.41%), while in a condition of low temperature and low humidity with a significant AF of 16.74% (95% eCI: 0.89, 24.44). The AFs were higher at low temperature and high humidity in different subgroups. When considering the levels of humidity, the AFs were significant at low temperature and high humidity for males, youth, those with a low level of education, and coastal area people. Conclusions: The combination of low temperature and high humidity had the greatest impact on the CVD death burden in Zhejiang Province. This evidence has important implications for developing CVD interventions. Full article

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Open AccessArticle

Comparison of Ground-Based and Satellite-Derived Solar UV Index Levels at Six South African Sites

by Jean-Maurice Cadet^1,*, Hassan Bencherif^1,2

, Thierry Portafaix¹

, Kévin Lamy¹, Katlego Ncongwane³, Gerrie J. R. Coetzee³ and Caradee Y. Wright^4,5

¹ LACy, Laboratoire de l’Atmosphère et des Cyclones (UMR 8105 CNRS, Université de La Réunion, Météo-France), Saint-Denis de La Réunion 97744, France

² School of Chemistry and Physics, University of KwaZulu-Natal, Durban 4041, South Africa

³ South African Weather Service, Private Bag X097, Pretoria 0001, South Africa

⁴ Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa

⁵ Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1384; https://doi.org/10.3390/ijerph14111384 - 14 Nov 2017

Cited by 21 | Viewed by 4785

Abstract

South Africa has been measuring the ground-based solar UV index for more than two decades at six sites to raise awareness about the impacts of the solar UV index on human health. This paper is an exploratory study based on comparison with satellite [...] Read more.

South Africa has been measuring the ground-based solar UV index for more than two decades at six sites to raise awareness about the impacts of the solar UV index on human health. This paper is an exploratory study based on comparison with satellite UV index measurements from the OMI/AURA experiment. Relative UV index differences between ground-based and satellite-derived data ranged from 0 to 45% depending on the site and year. Most of time, these differences appear in winter. Some ground-based stations’ data had closer agreement with satellite-derived data. While the ground-based instruments are not intended for long-term trend analysis, they provide UV index information for public awareness instead, with some weak signs suggesting such long-term trends may exist in the ground-based data. The annual cycle, altitude, and latitude effects clearly appear in the UV index data measured in South Africa. This variability must be taken into account for the development of an excess solar UV exposure prevention strategy. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Prevalence of Mental Health Problems and Associated Risk Factors among Rural-to-Urban Migrant Children in Guangzhou, China

by Jun Wang

, Ke Liu, Jing Zheng, Jiali Liu and Liming You^*

School of Nursing, Sun Yat-Sen University, 74, Zhongshan 2nd Rd, Guangzhou 510080, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1385; https://doi.org/10.3390/ijerph14111385 - 14 Nov 2017

Cited by 27 | Viewed by 5978

Abstract

Rural-to-urban migration, which has achieved a huge scale during China’s economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen’s behavioral [...] Read more.

Rural-to-urban migration, which has achieved a huge scale during China’s economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen’s behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical. Full article

(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)

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Open AccessArticle

Forecasting the Water Demand in Chongqing, China Using a Grey Prediction Model and Recommendations for the Sustainable Development of Urban Water Consumption

by Hua’an Wu¹, Bo Zeng^1,*

and Meng Zhou²

¹ College of Rongzhi, Chongqing Technology and Business University, Chongqing 401320, China

² Chongqing Key Laboratory of Electronic Commerce & Supply Chain System, Chongqing Technology and Business University, Chongqing 400067, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1386; https://doi.org/10.3390/ijerph14111386 - 15 Nov 2017

Cited by 30 | Viewed by 4470

Abstract

High accuracy in water demand predictions is an important basis for the rational allocation of city water resources and forms the basis for sustainable urban development. The shortage of water resources in Chongqing, the youngest central municipality in Southwest China, has significantly increased [...] Read more.

High accuracy in water demand predictions is an important basis for the rational allocation of city water resources and forms the basis for sustainable urban development. The shortage of water resources in Chongqing, the youngest central municipality in Southwest China, has significantly increased with the population growth and rapid economic development. In this paper, a new grey water-forecasting model (GWFM) was built based on the data characteristics of water consumption. The parameter estimation and error checking methods of the GWFM model were investigated. Then, the GWFM model was employed to simulate the water demands of Chongqing from 2009 to 2015 and forecast it in 2016. The simulation and prediction errors of the GWFM model was checked, and the results show the GWFM model exhibits better simulation and prediction precisions than those of the classical Grey Model with one variable and single order equation GM(1,1) for short and the frequently-used Discrete Grey Model with one variable and single order equation, DGM(1,1) for short. Finally, the water demand in Chongqing from 2017 to 2022 was forecasted, and some corresponding control measures and recommendations were provided based on the prediction results to ensure a viable water supply and promote the sustainable development of the Chongqing economy. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Open AccessFeature PaperArticle

Cross-Cultural Adaptation of the Social Vulnerability Index for Use in the Dutch Context

by Steven Bunt^1,*

, Nardi Steverink^2,3

, Melissa K. Andrew⁴, Cees P. van der Schans^1,3,5 and Hans Hobbelen^1,6

¹ Research Group in Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, 9714 CA Groningen, The Netherlands

² Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, 9712 TG Groningen, The Netherlands

³ Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands

⁴ Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS B3H 2E1, Canada

⁵ Department of Rehabilitation, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands

⁶ Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9700 AD Groningen, The Netherlands

Int. J. Environ. Res. Public Health 2017, 14(11), 1387; https://doi.org/10.3390/ijerph14111387 - 14 Nov 2017

Cited by 13 | Viewed by 4901

Abstract

Being able to identify socially frail older adults is essential for designing interventions and policy and for the prediction of health outcomes, both on the level of individual older adults and of the population. The aim of the present study was to adapt [...] Read more.

Being able to identify socially frail older adults is essential for designing interventions and policy and for the prediction of health outcomes, both on the level of individual older adults and of the population. The aim of the present study was to adapt the Social Vulnerability Index (SVI) to the Dutch language and culture for those purposes. A systematic cross-cultural adaptation of the initial Social Vulnerability Index was performed following five steps: initial translation, synthesis of translations, back translation, a Delphi procedure, and a test for face validity and feasibility. The main result of this study is a face-valid 32 item Dutch version of the Social Vulnerability Index (SVI-D) that is feasible in health care and social care settings. The SVI-D is a useful index to measure social frailty in Dutch-language countries and offers a broad, holistic quantification of older people’s social circumstances related to the risk of adverse health outcomes. Full article

(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)

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Open AccessArticle

Comprehensive Survey on Improved Focality and Penetration Depth of Transcranial Magnetic Stimulation Employing Multi-Coil Arrays

by Xile Wei¹, Yao Li¹, Meili Lu², Jiang Wang¹ and Guosheng Yi^1,*

¹ Tianjin Key Laboratory of Process Measurement and Control, School of Electrical and Information Engineering, Tianjin University, Tianjin 300072, China

² School of Information Technology Engineering, Tianjin University of Technology and Education, Tianjin 300222, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1388; https://doi.org/10.3390/ijerph14111388 - 14 Nov 2017

Cited by 13 | Viewed by 5477

Abstract

Multi-coil arrays applied in transcranial magnetic stimulation (TMS) are proposed to accurately stimulate brain tissues and modulate neural activities by an induced electric field (EF). Composed of numerous independently driven coils, a multi-coil array has alternative energizing strategies to evoke EFs targeting at [...] Read more.

Multi-coil arrays applied in transcranial magnetic stimulation (TMS) are proposed to accurately stimulate brain tissues and modulate neural activities by an induced electric field (EF). Composed of numerous independently driven coils, a multi-coil array has alternative energizing strategies to evoke EFs targeting at different cerebral regions. To improve the locating resolution and the stimulating focality, we need to fully understand the variation properties of induced EFs and the quantitative control method of the spatial arrangement of activating coils, both of which unfortunately are still unclear. In this paper, a comprehensive analysis of EF properties was performed based on multi-coil arrays. Four types of planar multi-coil arrays were used to study the relationship between the spatial distribution of EFs and the structure of stimuli coils. By changing coil-driven strategies in a basic 16-coil array, we find that an EF induced by compactly distributed coils decays faster than that induced by dispersedly distributed coils, but the former has an advantage over the latter in terms of the activated brain volume. Simulation results also indicate that the attenuation rate of an EF induced by the 36-coil dense array is 3 times and 1.5 times greater than those induced by the 9-coil array and the 16-coil array, respectively. The EF evoked by the 36-coil dispense array has the slowest decay rate. This result demonstrates that larger multi-coil arrays, compared to smaller ones, activate deeper brain tissues at the expense of decreased focality. A further study on activating a specific field of a prescribed shape and size was conducted based on EF variation. Accurate target location was achieved with a 64-coil array 18 mm in diameter. A comparison between the figure-8 coil, the planar array, and the cap-formed array was made and demonstrates an improvement of multi-coil configurations in the penetration depth and the focality. These findings suggest that there is a tradeoff between attenuation rate and focality in the application of multi-coil arrays. Coil-energizing strategies and array dimensions should be based on an adequate evaluation of these two important demands and the topological structure of target tissues. Full article

(This article belongs to the Special Issue Electromagnetic Fields and Health—Effects on the Nervous System)

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Open AccessEditorial

What If Healthy Aging Is the ‘New Normal’?

by Marcia G. Ory^1,* and Matthew Lee Smith^1,2

¹ Center for Population Health and Aging, Texas A&M Health Science Center, College Station, TX 77843, USA

² College of Public Health, The University of Georgia, Athens, GA 30602, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1389; https://doi.org/10.3390/ijerph14111389 - 15 Nov 2017

Cited by 8 | Viewed by 4167

Abstract

We dedicate this special issue to our colleague, Dr. Lucinda Bryant (1941–2016).[...] Full article

(This article belongs to the Special Issue Aging and Health Promotion)

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Open AccessArticle

Do Effort and Reward at Work Predict Changes in Cognitive Function? First Longitudinal Results from the Representative German Socio-Economic Panel

by Natalie Riedel^1,2,*

, Johannes Siegrist³, Natalia Wege^1,4, Adrian Loerbroks¹, Peter Angerer¹

and Jian Li^1,*

¹ Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, 40225 Düsseldorf, Germany

² Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany

³ Senior Professorship on Work Stress Research, Life Science Center, Faculty of Medicine, University of Düsseldorf, 40225 Düsseldorf, Germany

⁴ Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Düsseldorf, 40225 Düsseldorf, Germany

Int. J. Environ. Res. Public Health 2017, 14(11), 1390; https://doi.org/10.3390/ijerph14111390 - 15 Nov 2017

Cited by 6 | Viewed by 4435

Abstract

It has been suggested that work characteristics, such as mental demands, job control, and occupational complexity, are prospectively related to cognitive function. However, current evidence on links between psychosocial working conditions and cognitive change over time is inconsistent. In this study, we applied [...] Read more.

It has been suggested that work characteristics, such as mental demands, job control, and occupational complexity, are prospectively related to cognitive function. However, current evidence on links between psychosocial working conditions and cognitive change over time is inconsistent. In this study, we applied the effort–reward imbalance model that allows to build on previous research on mental demands and to introduce reward-based learning as a principle with beneficial effect on cognitive function. We aimed to investigate whether high effort, high reward, and low over-commitment in 2006 were associated with positive changes in cognitive function in terms of perceptual speed and word fluency (2006–2012), and whether the co-manifestation of high effort and high reward would yield the strongest association. To this end, we used data on 1031 employees who participated in a large and representative study. Multivariate linear regression analyses supported our main hypotheses (separate and combined effects of effort and reward), particularly on changes in perceptual speed, whereas the effects of over-commitment did not reach the level of statistical significance. Our findings extend available knowledge by examining the course of cognitive function over time. If corroborated by further evidence, organization-based measures in the workplace can enrich efforts towards preventing cognitive decline in ageing workforces. Full article

(This article belongs to the Section Occupational Safety and Health)

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Open AccessArticle

The Trends in Cardiovascular Diseases and Respiratory Diseases Mortality in Urban and Rural China, 1990–2015

by Weiwei Sun^1,2

, Yun Zhou^1,2, Zhuang Zhang^1,2, Limin Cao^1,2 and Weihong Chen^1,2,*

¹ Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

² Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1391; https://doi.org/10.3390/ijerph14111391 - 15 Nov 2017

Cited by 17 | Viewed by 5008

Abstract

With the rapid development of the economy over the past 20 years, the mortality rates from cardiovascular diseases (CVDs) and respiratory diseases (RDs) have changed in China. This study aimed to analyze the trends of mortality rates and years of life lost (YLLs) [...] Read more.

With the rapid development of the economy over the past 20 years, the mortality rates from cardiovascular diseases (CVDs) and respiratory diseases (RDs) have changed in China. This study aimed to analyze the trends of mortality rates and years of life lost (YLLs) from CVDs and RDs in the rural and urban population from 1990 to 2015. Using data from Chinese yearbooks, joinpoint regression analysis was employed to estimate the annual percent change (APC) of mortality rates from CVDs and RDs. YLLs due to CVDs and RDs were calculated by a standard method, adopting recommended standard life expectancy at birth values of 80 years for men and 82.5 years for women. Age-standardized mortality rates and YLL rates were calculated by using the direct method based on the Chinese population from the sixth population census of 2010. Age-standardized mortality rates from CVDs for urban residents and from RDs for both urban and rural residents showed decreasing trends in China from 1990 to 2015. Age-standardized mortality rates from CVDs among rural residents remained constant during above period and outstripped those among urban residents gradually. The age-standardized YLL rates of CVDs for urban and rural residents decreased 35.2% and 8.3% respectively. Additionally, the age-standardized YLL rates of RDs for urban and rural residents decreased 64.2% and 79.0% respectively. The age-standardized mortality and YLL rates from CVDs and RDs gradually decreased in China from 1990 to 2015. We observed more substantial declines of the mortality rates from CVDs in urban areas and from RDs in rural areas. Full article

(This article belongs to the Section Global Health)

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Open AccessArticle

Air Pollution and Dispensed Medications for Asthma, and Possible Effect Modifiers Related to Mental Health and Socio-Economy: A Longitudinal Cohort Study of Swedish Children and Adolescents

by Anna Oudin^*, Lennart Bråbäck, Daniel Oudin Åström and Bertil Forsberg

Occupational and Environmental Medicine, Umeå University, 90187 Umeå, Sweden

Int. J. Environ. Res. Public Health 2017, 14(11), 1392; https://doi.org/10.3390/ijerph14111392 - 16 Nov 2017

Cited by 9 | Viewed by 6088

Abstract

It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health [...] Read more.

It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health and by socio-economic status (as markers of a stressful environment). All individuals under 18 years of age in four Swedish counties during 2007 to 2010 (1.2 million people) were included. The outcome was defined as dispensing at least two asthma medications during follow up. We linked data on NO₂ from an empirical land use regression to data from national registers on outcome and potential confounders. Data was analyzed with logistic regression. There was an odds ratio (OR) of 1.02 (95% Confidence Interval (CI: 1.01–1.03) for asthma associated with a 10 µg·m⁻³ increase in NO₂. The association only seemed to be present in areas where NO₂ was higher than 15 µg·m⁻³ with an OR of 1.09 (95% CI: 1.07–1.12), and the association seemed stronger in children with parents with a high education, OR = 1.05 (95% CI: 1.02–1.09) and OR = 1.04 (95% CI: 1.01–1.07) in children to mothers and father with a high education, respectively. The association did not seem to depend on medication history of psychiatric disorders. There was weak evidence for the association between air pollution and asthma to be stronger in neighborhoods with higher education levels. In conclusion, air pollution was associated with dispensed asthma medications, especially in areas with comparatively higher levels of air pollution, and in children to parents with high education. We did not observe support for our hypothesis that stressors linked to socio-economy or mental health problems would increase susceptibility to the effects of air pollution on the development of asthma. Full article

(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)

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Open AccessComment

Comment on Zheng et al. Association between Promoter Methylation of Gene ERCC3 and Benzene Hematotoxicity. Int. J. Environ. Res. Public Health 2017, 14, 921

by Hanns Moshammer^*

and Michael Poteser

Department of Environmental Health, Medical University of Vienna, ZPH, Kinderspitalgasse 15, 1090 Vienna, Austria

Int. J. Environ. Res. Public Health 2017, 14(11), 1393; https://doi.org/10.3390/ijerph14111393 - 16 Nov 2017

Cited by 1 | Viewed by 2930

Abstract

Benzene is an established carcinogenic substance [1,2].[...] Full article

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Open AccessArticle

Neighborhood Prices of Healthier and Unhealthier Foods and Associations with Diet Quality: Evidence from the Multi-Ethnic Study of Atherosclerosis

by David M. Kern¹, Amy H. Auchincloss^1,*, Mark F. Stehr², Ana V. Diez Roux³, Latetia V. Moore⁴, Genevieve P. Kanter⁵ and Lucy F. Robinson¹

¹ Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19140, USA

² School of Economics, LeBow College of Business, Drexel University, Philadelphia, PA 19104, USA

³ Dean’s Office, Epidemiology and Biostatistics, Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA

⁴ Division of Nutrition, Physical Activity & Obesity Prevention & Control, National Center for Chronic Disease Prevention & Health Promotion, Centers for Disease Control & Prevention, Atlanta, GA 30329, USA

⁵ Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Nesbitt Hall, 3215 Market St. Philadelphia, PA 19104, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1394; https://doi.org/10.3390/ijerph14111394 - 16 Nov 2017

Cited by 38 | Viewed by 17587

Abstract

It is known that the price of food influences the purchasing and consumption decisions of individuals; however, little work has examined if the price of healthier food relative to unhealthier food in an individual’s neighborhood is associated with overall dietary quality while using [...] Read more.

It is known that the price of food influences the purchasing and consumption decisions of individuals; however, little work has examined if the price of healthier food relative to unhealthier food in an individual’s neighborhood is associated with overall dietary quality while using data from multiple regions in the United States. Cross-sectional person-level data came from The Multi-Ethnic Study of Atherosclerosis (exam 5, 2010–2012, n = 2765); a food frequency questionnaire assessed diet. Supermarket food/beverage prices came from Information Resources Inc. (n = 794 supermarkets). For each individual, the average price of select indicators of healthier foods (vegetables, fruits, dairy) and unhealthier foods (soda, sweets, salty snacks), as well as their ratio, was computed for supermarkets within three miles of the person’s residential address. Logistic regression estimated odds ratios of a high-quality diet (top quintile of Healthy Eating Index 2010) associated with healthy-to-unhealthy price ratio, adjusted for individual and neighborhood characteristics. Sensitivity analyses used an instrumental variable (IV) approach. Healthier foods cost nearly twice as much as unhealthier foods per serving on average (mean healthy-to-unhealthy ratio = 1.97 [SD 0.14]). A larger healthy-to-unhealthy price ratio was associated with lower odds of a high-quality diet (OR = 0.76 per SD increase in the ratio, 95% CI = [0.64–0.9]). IV analyses largely confirmed these findings although—as expected with IV adjustment—confidence intervals were wide (OR = 0.82 [0.57–1.19]). Policies to address the large price differences between healthier and unhealthy foods may help improve diet quality in the United States. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Open AccessArticle

The Association between Environmental Lead Exposure and High School Educational Outcomes in Four Communities in New South Wales, Australia

by Jennifer McCrindle^1,*, Donna Green²

and Marianne Sullivan³

¹ Climate Change Research Centre, University of New South Wales, Kensington, Sydney 2052, Australia

² Climate Change Research Centre and the ARC Centre of Excellence for Climate Systems Science, University of New South Wales, Kensington, Sydney 2052, Australia

³ Department of Public Health, William Paterson University, Wayne, NJ 07470, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1395; https://doi.org/10.3390/ijerph14111395 - 16 Nov 2017

Cited by 1 | Viewed by 4231

Abstract

The associations between environmental lead exposure and high school educational outcomes in four communities located in New South Wales, Australia, were examined in this ecological study. A mixed model analysis was performed to account for each school’s results being more similar than results [...] Read more.

The associations between environmental lead exposure and high school educational outcomes in four communities located in New South Wales, Australia, were examined in this ecological study. A mixed model analysis was performed to account for each school’s results being more similar than results for other schools. The effect of environmental lead exposure on mean results for five educational outcomes was examined. ‘Leaded’ schools with more than five per cent of students living in the highest lead risk areas were tested against non-leaded ‘comparison’ schools that were matched by a pre-defined socio-educational advantage rating. A small disadvantage was found for leaded schools for four out of five outcomes, which was statistically significant for three outcomes: Higher School Certificate English (p < 0.01), School Certificate Mathematics (p < 0.05), and Australian Tertiary Admissions Rank eligibility rate (p < 0.01). This study adds to the large body of evidence in Australia and elsewhere supporting the importance of primary prevention to protect health at multiple stages of development. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Environmental Risks Associated with Symptoms of Acute Respiratory Infection among Preschool Children in North-Western and South-Southern Nigeria Communities

by Oluwafunmilade A. Adesanya¹ and Chi Chiao^2,*

¹ Ogun State Government and UPLIFT Development Foundation, Abeokuta 110001, Nigeria

² Institute of Health and Welfare Policy, College of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., Taipei 112, Taiwan

Int. J. Environ. Res. Public Health 2017, 14(11), 1396; https://doi.org/10.3390/ijerph14111396 - 16 Nov 2017

Cited by 22 | Viewed by 4569

Abstract

The exposure-disease-stress model places young children in their physical and social contexts and considers the extent and intensity of associational links to symptoms of acute respiratory infection (ARI), taking in to account a range of biological, social, and environment components. This study uses [...] Read more.

The exposure-disease-stress model places young children in their physical and social contexts and considers the extent and intensity of associational links to symptoms of acute respiratory infection (ARI), taking in to account a range of biological, social, and environment components. This study uses the 2013 Nigeria Demographic and Health Survey to assess the individual and environmental risks present in the North-Western and South-Southern Nigerian communities and examines their associations with ARI symptoms. The descriptive findings show that the prevalence of ARI symptoms is significantly higher among preschool children in the North-Western province (5.7%) than in the South-Southern province (1.4%) (p < 0.001). In addition to regional differences, multilevel logistic models further indicate that the increased likelihood of a child suffering from ARI symptoms is significantly associated with the dry season (aOR 1.42; 95% CI: 1.02–1.97) and household poverty (aOR 1.42; 95% CI: 1.01–1.99), even after adjusting for the cooking fuel used and various other characteristics of the children, households, and communities. These findings underscore the importance of taking into account environmental risks when addressing specific regional variations in ARI symptoms, because these determinants differ between communities in Nigeria. As it is imperative to achieve minimum levels of child health, in order to improve economic development across regions, future health policies aiming to promote child health will benefit from taking a region-specific perspective into consideration. Full article

(This article belongs to the Special Issue Global Children’s Environmental Health)

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Open AccessFeature PaperArticle

Climate Change and Schools: Environmental Hazards and Resiliency

by Perry E. Sheffield^1,*, Simone A. M. Uijttewaal^1,2, James Stewart¹ and Maida P. Galvez¹

¹ Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA

² Health & Society, Wageningen University, 6708 PB Wageningen, The Netherlands

Int. J. Environ. Res. Public Health 2017, 14(11), 1397; https://doi.org/10.3390/ijerph14111397 - 16 Nov 2017

Cited by 23 | Viewed by 16584

Abstract

The changing climate is creating additional challenges in maintaining a healthy school environment in the United States (U.S.) where over 50 million people, mostly children, spend approximately a third of their waking hours. Chronic low prioritization of funds and resources to support environmental [...] Read more.

The changing climate is creating additional challenges in maintaining a healthy school environment in the United States (U.S.) where over 50 million people, mostly children, spend approximately a third of their waking hours. Chronic low prioritization of funds and resources to support environmental health in schools and lack of clear regulatory oversight in the U.S. undergird the new risks from climate change. We illustrate the extent of risk and the variation in vulnerability by geographic region, in the context of sparse systematically collected and comparable data particularly about school infrastructure. Additionally, we frame different resilience building initiatives, focusing on interventions that target root causes, or social determinants of health. Disaster response and recovery are also framed as resilience building efforts. Examples from U.S. Federal Region 2 (New Jersey, New York, Puerto Rico, and the U.S. Virgin Islands) and nationally are used to illustrate these concepts. We conclude that better surveillance, more research, and increased federal and state oversight of environmental factors in schools (specific to climate risks) is necessary, as exposures result in short- and long term negative health effects and climate change risks will increase over time. Full article

(This article belongs to the Special Issue Global Children’s Environmental Health)

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Open AccessArticle

The Influence of Family Dog Ownership and Parental Perceived Built Environment Measures on Children’s Physical Activity within the Washington, DC Area

by Jennifer D. Roberts^1,*

, Lindsey Rodkey¹, Cortney Grisham² and Rashawn Ray³

¹ Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD 20742, USA

² College of Science and Mathematics, Austin Peay State University, Clarksville, TN 37044, USA

³ Department of Sociology, University of Maryland, College Park, MD 20742, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1398; https://doi.org/10.3390/ijerph14111398 - 16 Nov 2017

Cited by 5 | Viewed by 4426

Abstract

Sedentary behavior and physical inactivity are significant contributors to youth obesity in the United States. Neighborhood dog walking is an outlet for physical activity (PA). Therefore, understanding the relationship between built environment, dog ownership, and youth PA is essential. This study examined the [...] Read more.

Sedentary behavior and physical inactivity are significant contributors to youth obesity in the United States. Neighborhood dog walking is an outlet for physical activity (PA). Therefore, understanding the relationship between built environment, dog ownership, and youth PA is essential. This study examined the influence of dog ownership and parental built environment perceptions on children’s PA in the Washington, D.C. area. In 2014, questionnaires were mailed to 2000 parents to assess family dog ownership; children’s outdoor dog walking or playing; and parental perceived built environment measures. Chi-square analyses examined differences in parental perceived built environment measures between children with and without family dogs. The sample included 144 children (50% female; average-age 9.7 years; 56.3% White; 23.7% African-American; 10.4% Asian-American; 29.9% owned dog). Only 13% and 5.6% of the children walked or played outdoors with the dog daily, respectively. A significantly greater proportion (p-value < 0.05) of parents who owned dogs recognized and observed some home built environment measures (e.g., traffic speed on most streets is 30 mph or less) that were PA -promoting for their children. Findings suggest that dog ownership may provide more positive parental perceptions of the neighborhood built environment, which supports children’s outdoor PA through dog walking and playing. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

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Open AccessArticle

Bioabsorption and Bioaccumulation of Cadmium in the Straw and Grain of Maize (Zea mays L.) in Growing Soils Contaminated with Cadmium in Different Environment

by Jorge Retamal-Salgado^1,2

, Juan Hirzel^3,*, Ingrid Walter⁴ and Iván Matus³

¹ Faculty of Agronomy, Universidad de Concepción, Vicente Méndez 595, Casilla 537, Chillán 3812120, Chile

² Faculty of Engineering and Business, Universidad Adventista de Chile, km 12 Camino a Tanilvoro, Chillán 3780000, Chile

³ Instituto de Investigaciones Agropecuarias INIA, Avenida Vicente Méndez 515, Chillán 3800062, Chile

⁴ Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Apdo. Correos 8111, Madrid 28080, Spain

Int. J. Environ. Res. Public Health 2017, 14(11), 1399; https://doi.org/10.3390/ijerph14111399 - 16 Nov 2017

Cited by 47 | Viewed by 5309

Abstract

There is a worldwide increase of heavy metal or potentially toxic element (PTE), contamination in agricultural soils caused mainly by human and industrial action, which leads to food contamination in crops such as in maize. Cadmium (Cd) is a PTE often found in [...] Read more.

There is a worldwide increase of heavy metal or potentially toxic element (PTE), contamination in agricultural soils caused mainly by human and industrial action, which leads to food contamination in crops such as in maize. Cadmium (Cd) is a PTE often found in soils and it is ingested through food. It is necessary to determine the bioabsorption, distribution, and accumulation levels in maize to reduce or prevent food chain contamination. Cadmium absorption and accumulation in three maize cultivars were evaluated in three agricultural environments in Chile by increasing CdCl₂ rates (0, 1, and 2 mg·kg⁻¹). Evaluation included Cd accumulation and distribution in different plant tissues, bioaccumulation factor (BAF), bioconcentration factor (BCF), translocation factor (TF), and tolerance index (TI). Cadmium whole-plant uptake was only affected by the CdCl₂ rate; the highest uptake was obtained with 2 mg·kg⁻¹ CdCl₂ (34.4 g·ha⁻¹) (p < 0.05). Cadmium distribution in the maize plant usually exhibited the highest accumulation in the straw (p < 0.05), independently of the environment, Cd rate, and evaluated cultivar. Given the results for TF (TF > 2) and BAF (BAF > 1), the Los Tilos and Chillán environments were classified as having a high capacity to contaminate the food chain for all evaluated cultivars. Full article

(This article belongs to the Special Issue Soil Pollution and Remediation)

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Open AccessArticle

Antibiotic Susceptibility, Genetic Diversity, and the Presence of Toxin Producing Genes in Campylobacter Isolates from Poultry

by Jeeyeon Lee^1,2, Jiyeon Jeong¹, Heeyoung Lee², Jimyeong Ha^1,2, Sejeong Kim^1,2, Yukyung Choi^1,2, Hyemin Oh^1,2, Kunho Seo³, Yohan Yoon^1,2,* and Soomin Lee^2,*

¹ Department of Food and Nutrition, Sookmyung Women’s University, Seoul 04310, Korea

² Risk Analysis Research Center, Sookmyung Women’s University, Seoul 04310, Korea

³ Department of Veterinary Medicine, Konkuk University, Seoul 05029, Korea

Int. J. Environ. Res. Public Health 2017, 14(11), 1400; https://doi.org/10.3390/ijerph14111400 - 17 Nov 2017

Cited by 15 | Viewed by 4515

Abstract

This study examined antibiotic susceptibility, genetic diversity, and characteristics of virulence genes in Campylobacter isolates from poultry. Chicken (n = 152) and duck (n = 154) samples were collected from 18 wet markets in Korea. Campylobacter spp. isolated from the carcasses [...] Read more.

This study examined antibiotic susceptibility, genetic diversity, and characteristics of virulence genes in Campylobacter isolates from poultry. Chicken (n = 152) and duck (n = 154) samples were collected from 18 wet markets in Korea. Campylobacter spp. isolated from the carcasses were identified by PCR. The isolated colonies were analyzed for antibiotic susceptibility to chloramphenicol, amikacin, erythromycin, tetracycline, ciprofloxacin, nalidixic acid, and enrofloxacin. The isolates were also used to analyze genetic diversity using the DiversiLab^TM system and were tested for the presence of cytolethal distending toxin (cdt) genes. Campylobacter spp. were isolated from 45 poultry samples out of 306 poultry samples (14.7%) and the average levels of Campylobacter contamination were 22.0 CFU/g and 366.1 CFU/g in chicken and duck samples, respectively. Moreover, more than 90% of the isolates showed resistance to nalidixic acid and ciprofloxacin. Genetic correlation analysis showed greater than 95% similarity between 84.4% of the isolates, and three cdt genes (cdtA, cdtB, and cdtC) were present in 71.1% of Campylobacter isolates. These results indicate that Campylobacter contamination should be decreased to prevent and treat Campylobacter foodborne illness. Full article

(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)

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Open AccessArticle

Fatty Acid Composition of Dried Fruits of Sclerocarya birrea, Diospyros blancoi and Landolphia kirkii

by Athanasia O. Matemu^1,2, Durotoye Adeyemi¹, Hlengilizwe Nyoni¹, Ladislaus Mdee³, Papiso Tshabalala⁴, Bhekie Mamba¹ and Titus A. M. Msagati^1,*

¹ Nanotechnology and Water Sustainability, College of Science Engineering and Technology, University of South Africa, Johannesburg 1710, South Africa

² Department of Food and Nutritional Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institute of Science and Technology, P.O. Box 447 Arusha, Tanzania

³ School of Medicine, University of Limpopo C/O R71 Tzaneen Road and University Street Mankweng Township, Polokwane University of Limpopo Old Admin Block, Ground Floor Sovenga, Limpopo 0727, South Africa

⁴ Consumer Goods Council of South Africa, Johannesburg 1710, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1401; https://doi.org/10.3390/ijerph14111401 - 17 Nov 2017

Cited by 8 | Viewed by 4318

Abstract

Wild fruits are commonly consumed in the rural communities of South Africa. The information on their nutritionally important fatty acids is, however, limited. Three wild fruit species, Diospyros blancoi, Landolphia kirkii and Sclerocarya birrea from Limpopo Province were selected for evaluation of [...] Read more.

Wild fruits are commonly consumed in the rural communities of South Africa. The information on their nutritionally important fatty acids is, however, limited. Three wild fruit species, Diospyros blancoi, Landolphia kirkii and Sclerocarya birrea from Limpopo Province were selected for evaluation of fatty acid content. Fatty acids composition of dried fruits of Diospyros blancoi (Db), Landolphia kirkii (Lk) and ripe and/or overripe Sclerocarya birrea (Sb) were evaluated by a gas chromatography-time of flight-mass spectrometer (GC-TOF-MS). Hexadecanoic acid (C16:0) was found in highest abundance in L. kirkii (57.73–73.55%), followed by S. birrea (55.92–71.31%) and D. blancoi (46.31–62.05%), respectively. Octadecanoic acid (C18:0) was of second highest abundance, with 24.71–100% in D. blancoi, L. kirkii (31.03–41.60%) and S. birrea (9.11–17.0%). The 9-octadecenoic acid (C18:1n-9) was the major unsaturated fatty acid in both S. birrea (5.33–18.82%), D. blancoi (8.22–8.92%), and L. kirkii (3.84–8.63%). The 9,-12-octadecadienoic acid (C18:2n-6) was the major unsaturated fatty acid in D. blancoi (22.34%). The 9,-12,-15-octadecatrienoic acid (C18:3n-3) was found in L. kirkii (3.51%) and S. birrea (2.79%). From the results, saturated fatty acids were the most dominant, whereas mono- and poly-unsaturated fatty acids were the minor constituents. Therefore, presence of nutritionally important essential fatty acids from S. birrea, D. blancoi and L. kirkii has been shown. Full article

(This article belongs to the Special Issue Nutrition and Public Health)

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Open AccessArticle

Incidence and Consequences of Near-Drowning–Related Pneumonia—A Descriptive Series from Martinique, French West Indies

by Laura Cerland¹, Bruno Mégarbane², Hatem Kallel³, Yanick Brouste¹, Hossein Mehdaoui⁴

and Dabor Resiere^4,*

¹ Department of Emergency Medicine, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France

² Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris-Diderot University, INSERM UMR-S 1144, 75013 Paris, France

³ Intensive Care Unit, Hospital Centre of the French Guiana, 97306 Cayenne, France

⁴ Intensive Care Unit, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France

Int. J. Environ. Res. Public Health 2017, 14(11), 1402; https://doi.org/10.3390/ijerph14111402 - 17 Nov 2017

Cited by 14 | Viewed by 4648

Abstract

Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. One hundred and forty-four near-drowning patients [...] Read more.

Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. One hundred and forty-four near-drowning patients (33 children and 111 adults) admitted during four years to the University Hospital of Martinique, French Indies, were included. Patients presented pre-hospital cardiac arrest (41%) and exhibited acute respiratory failure (54%), cardiovascular failure (27%), and lactic acidosis (75%) on admission. Empirical antibiotics, as decided by the physicians in charge, were administered in 85 patients (59%). Post-drowning early onset bacterial pneumonia was diagnosed as “possible” in 13 patients (9%) and “confirmed” in 22 patients (15%). Tracheal aspiration revealed the presence of polymorphous pharyngeal flora (59%) or one predominant bacteria species (41%) including Enterobacter aerogenes, Enterobacter cloacae, Staphylococcus aureus, Pseudomonas aeruginosa, Aeromonas hydrophilia, and Morganella morgani. Despite adequate supportive care, drowning resulted in 45 fatalities (31%). Early onset bacterial aspiration pneumonia (either possible or confirmed) did not significantly influence the risk of death. In conclusion, near-drowning–related bacterial aspiration pneumonia seems rare and does not influence the mortality rate. There is still a need for practice standardization to improve diagnosis of post-drowning pneumonia and near-drowning patient management. Full article

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Open AccessArticle

Quit Methods Used by American Smokers, 2013–2014

by Brad Rodu^1,2,* and Nantaporn Plurphanswat¹

¹ James Graham Brown Cancer Center, University of Louisville, 505 South Hancock Street, Louisville, KY 40202, USA

² Department of Medicine, School of Medicine, University of Louisville, Louisville, KY 40202, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1403; https://doi.org/10.3390/ijerph14111403 - 17 Nov 2017

Cited by 9 | Viewed by 13942

Abstract

This report describes the quit methods used in the past 12 months by current and former smokers in the baseline Population Assessment of Tobacco and Health (PATH) Study during 2013–2014. Descriptive statistics were used to report the use of single and two or [...] Read more.

This report describes the quit methods used in the past 12 months by current and former smokers in the baseline Population Assessment of Tobacco and Health (PATH) Study during 2013–2014. Descriptive statistics were used to report the use of single and two or more quit methods; survey weights were used to compute population estimates. Logistic regression was used to estimate the association between past year former smokers and single quit method, including individual characteristics. Results: Of 11,402 current smokers and 4919 former smokers, 4541 had tried and 839 had quit in the past 12 months. Unaided quit attempts were the most common; the number was almost as high as all single methods combined (n = 1797 and n = 1831 respectively). The most frequently used single method was help from friends and family (n = 676) followed by e-cigarettes (n = 587). Use of e-cigarettes was the only method with higher odds of users being a former smoker than unaided attempts (OR = 1.42, 95% CI 1.12–1.81). Current use of e-cigarettes among current (34%) and former (54%) smokers was significantly higher than current use of nicotine replacement therapy (NRT). Conclusions: In 2013–2014 e-cigarettes were used by American adult smokers as quit-smoking aids more frequently than NRT products or prescription drugs. Full article

(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)

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Using Gamma and Quantile Regressions to Explore the Association between Job Strain and Adiposity in the ELSA-Brasil Study: Does Gender Matter?

by Maria De Jesus Mendes da Fonseca^1,*, Leidjaira Lopes Juvanhol², Lúcia Rotenberg³, Aline Araújo Nobre⁴, Rosane Härter Griep³, Márcia Guimarães de Mello Alves⁵, Letícia De Oliveira Cardoso¹

, Luana Giatti⁶, Maria Angélica Nunes⁷, Estela M. L. Aquino⁸ and Dóra Chor¹

¹ Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro 21041-210, Brazil

² Department of Nutrition and Health, Federal University of Viçosa, Viçosa 36.570-000, Brazil

³ Laboratory of Health and Environment Education, Oswaldo Cruz Fundation, Rio de Janeiro 21040-900, Brazil

⁴ Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil

⁵ Institute of Collective Health, Fluminense Federal University, Niterói 24033-900, Brazil

⁶ Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte 30310-100, Brazil

⁷ Pos graduate program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil

⁸ Institute of Collective Health, Federal University of Bahia, Salvador 40110-040, Brazil

Int. J. Environ. Res. Public Health 2017, 14(11), 1404; https://doi.org/10.3390/ijerph14111404 - 17 Nov 2017

Cited by 3 | Viewed by 3578

Abstract

This paper explores the association between job strain and adiposity, using two statistical analysis approaches and considering the role of gender. The research evaluated 11,960 active baseline participants (2008–2010) in the ELSA-Brasil study. Job strain was evaluated through a demand–control questionnaire, while body [...] Read more.

This paper explores the association between job strain and adiposity, using two statistical analysis approaches and considering the role of gender. The research evaluated 11,960 active baseline participants (2008–2010) in the ELSA-Brasil study. Job strain was evaluated through a demand–control questionnaire, while body mass index (BMI) and waist circumference (WC) were evaluated in continuous form. The associations were estimated using gamma regression models with an identity link function. Quantile regression models were also estimated from the final set of co-variables established by gamma regression. The relationship that was found varied by analytical approach and gender. Among the women, no association was observed between job strain and adiposity in the fitted gamma models. In the quantile models, a pattern of increasing effects of high strain was observed at higher BMI and WC distribution quantiles. Among the men, high strain was associated with adiposity in the gamma regression models. However, when quantile regression was used, that association was found not to be homogeneous across outcome distributions. In addition, in the quantile models an association was observed between active jobs and BMI. Our results point to an association between job strain and adiposity, which follows a heterogeneous pattern. Modelling strategies can produce different results and should, accordingly, be used to complement one another. Full article

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Open AccessArticle

Placement Stability, Cumulative Time in Care, and Permanency: Using Administrative Data from CPS to Track Placement Trajectories

by Sonia Hélie^1,*, Marie-Andrée Poirier², Tonino Esposito³ and Daniel Turcotte⁴

¹ Research Institute for Youth in Difficulty, University Health and Social Services Center-South Central Montreal, 1001, boulevard de Maisonneuve Est, Montreal, QC H2L 4R5, Canada

² School of Social Work, University of Montreal, 3150, Jean-Brillant, Montreal, QC H3C 3J7, Canada

³ Canada Research Chair in Social Services for Vulnerable Children, School of Social Work, University of Montreal, 3150, Jean-Brillant, Montreal, QC H3C 3J7, Canada

⁴ School of Social Work, Laval University, 1030, avenue des Sciences Humaines, Quebec, QC G1V 0A6, Canada

Int. J. Environ. Res. Public Health 2017, 14(11), 1405; https://doi.org/10.3390/ijerph14111405 - 17 Nov 2017

Cited by 14 | Viewed by 4402

Abstract

Objectives: The Quebec Youth Protection Act was amended in 2007. The main goal of this reform was to improve placement stability for children who are removed from their home for their protection. Among several legal provisions introduced was the establishment of maximum [...] Read more.

Objectives: The Quebec Youth Protection Act was amended in 2007. The main goal of this reform was to improve placement stability for children who are removed from their home for their protection. Among several legal provisions introduced was the establishment of maximum age-specific durations of out-of-home care, after which a plan must be established to provide stability for children placed in substitute care by finding permanent homes for them. The purpose of this study is (1) to examine trends in placement use and placement stability since the reform and (2) to document the current frequency of each type of placement setting, the cumulative time in care before the exit to permanency, and the sustainability of the permanency outcome. Methods: The study relies on 3 entry cohorts of all children investigated who received protection measures in the province of Quebec during 3 specific time frames before and after the reform (n = 9620, 8676, 8425). Cohorts were observed for a period varying from 3 to 4 years. Administrative data from all 16 child protection agencies were used to track placement trajectory indicators and to compare cohorts. Results: There has been a decrease in the proportion of children receiving protection measures who were placed in care since the reform, and placement in kinship care has become more frequent among children placed. Placement stability improved slightly after the reform. Overall, for infants, the most frequent type of permanency attained is adoption, while reunification is the option most often indicated for older children. Some children are at a greater risk of experiencing unstable placement trajectories: young children have a high rate of reunification breakdown, some wait a long time to be adopted, and adolescents are frequently removed from the substitute care setting where they were supposed to stay until the age of 18. Conclusions: The results suggest interesting avenues for policy makers and service providers to improve the stability of placement trajectories. Advantages and disadvantages of administrative data are discussed. Full article

(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)

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Social Environment and Hospitalisation after Release from Prison: A Prospective Cohort Study

by Alexander D. Love^1,*

, Stuart A. Kinner^1,2,3,4,5

and Jesse T. Young^1,6,7

¹ Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne 3010, Australia

² Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne 3052, Australia

³ Mater Research Institute-UQ, University of Queensland, Brisbane 4072, Australia

⁴ Griffith Criminology Institute, Griffith University, Brisbane 4222, Australia

⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia

⁶ Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth 6009, Australia

⁷ National Drug Research Institute, Curtin University, Perth 6008, Australia

Int. J. Environ. Res. Public Health 2017, 14(11), 1406; https://doi.org/10.3390/ijerph14111406 - 17 Nov 2017

Cited by 2 | Viewed by 5403

Abstract

This study examined the association between remoteness and area disadvantage, and the rate of subsequent hospitalisation, in a cohort of adults released from prisons in Queensland. A baseline survey of 1267 adult prisoners within 6 weeks of expected release was prospectively linked with [...] Read more.

This study examined the association between remoteness and area disadvantage, and the rate of subsequent hospitalisation, in a cohort of adults released from prisons in Queensland. A baseline survey of 1267 adult prisoners within 6 weeks of expected release was prospectively linked with hospital, mortality and reincarceration records. Postcodes were used to assign remoteness and area disadvantage categories. Multivariate Andersen–Gill regression models were fitted to test for associations between remoteness, area disadvantage and hospitalisation after release from prison. Over a total of 3090.9 person-years of follow-up, the highest crude incidence rates were observed in areas characterised by remoteness and area disadvantage (crude incidence rate (IR) = 649; 95%CI: 526–791), followed by remoteness only (IR = 420; 95%CI: 349–501), severe area disadvantage only (IR = 403; 95%CI: 351–461), and neither of these factors (IR = 361; 95%CI: 336–388). Unadjusted analyses indicated that remoteness (hazard ratio (HR) = 1.32; 95%CI: 1.04–1.69; p = 0.024) was associated with increased risk of hospitalisation; however, this attenuated to the null after adjustment for covariate factors. The incidence of hospitalisation for those who live in remote or socio-economically disadvantaged areas is increased compared to their counterparts in more urban and less socio-economically disadvantaged areas. Experiencing both these factors together may compound the hospitalisation in the community. Full article

(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)

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Open AccessFeature PaperArticle

Who Participates in the Great ShakeOut? Why Audience Segmentation Is the Future of Disaster Preparedness Campaigns

by Rachel M. Adams¹, Beth Karlin², David P. Eisenman^1,3, Johanna Blakley² and Deborah Glik^1,*

¹ Center for Public Health and Disasters, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA 90095, USA

² The Norman Lear Center, Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA 90089, USA

³ Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1407; https://doi.org/10.3390/ijerph14111407 - 17 Nov 2017

Cited by 34 | Viewed by 6539

Abstract

Background: In 2008, the Southern California Earthquake Center in collaboration with the U.S. Geological Survey Earthquake Hazards Program launched the first annual Great ShakeOut, the largest earthquake preparedness drill in the history of the United States. Materials and Methods: We collected [...] Read more.

Background: In 2008, the Southern California Earthquake Center in collaboration with the U.S. Geological Survey Earthquake Hazards Program launched the first annual Great ShakeOut, the largest earthquake preparedness drill in the history of the United States. Materials and Methods: We collected online survey data from 2052 campaign registrants to assess how people participated, whether audience segments shared behavioral patterns, and whether these segments were associated with five social cognitive factors targeted by the ShakeOut campaign. Results: Participants clustered into four behavioral patterns. The Minimal cluster had low participation in all activities (range: 0–39% participation). The Basic Drill cluster only participated in the drop, cover and hold drill (100% participation). The Community-Oriented cluster, involved in the drill (100%) and other interpersonal activities including attending disaster planning meetings (74%), was positively associated with interpersonal communication (β = 0.169), self-efficacy (β = 0.118), outcome efficacy (β = 0.110), and knowledge about disaster preparedness (β = 0.151). The Interactive and Games cluster, which participated in the drill (79%) and two online earthquake preparedness games (53% and 75%), was positively associated with all five social cognitive factors studied. Conclusions: Our results support audience segmentation approaches to engaging the public, which address the strengths and weaknesses of different segments. Offering games may help “gamers” gain competencies required to prepare for disasters. Targeting the highly active Community-Oriented cluster for leadership roles could help build community resilience by encouraging others to become more involved in disaster planning. We propose that the days of single, national education campaigns without local variation should end. Full article

(This article belongs to the Special Issue Public Health and Disasters)

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Comfort, Energy Efficiency and Adoption of Personal Cooling Systems in Warm Environments: A Field Experimental Study

by Yingdong He^1,2,*, Nianping Li^1,2,*, Xiang Wang^1,2, Meiling He^1,2 and De He^1,2

¹ College of Civil Engineering, Hunan University, Changsha 410082, China

² Key Laboratory of Building Safety and Energy Efficiency, Hunan University, Ministry of Education, Changsha 410082, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1408; https://doi.org/10.3390/ijerph14111408 - 17 Nov 2017

Cited by 35 | Viewed by 5644

Abstract

It is well known that personal cooling improves thermal comfort and save energy. This study aims to: (1) compare different personal cooling systems and (2) understand what influences users’ willingness to adopt them. A series of experiments on several types of personal cooling [...] Read more.

It is well known that personal cooling improves thermal comfort and save energy. This study aims to: (1) compare different personal cooling systems and (2) understand what influences users’ willingness to adopt them. A series of experiments on several types of personal cooling systems, which included physical measurements, questionnaires and feedback, was conducted in a real office environment. The obtained results showed that personal cooling improved comfort of participants in warm environments. Then an improved index was proposed and used to compare different types of personal cooling systems in terms of comfort and energy efficiency simultaneously. According to the improved index, desk fans were highly energy-efficient, while the hybrid personal cooling (the combination of radiant cooling desk and desk fan) consumed more energy but showed advantages of extending the comfortable temperature range. Moreover, if personal cooling was free, most participants were willing to adopt it and the effectiveness was the main factor influencing their willingness, whereas if participants had to pay, they probably refused to adopt it due to the cost and the availability of conventional air conditioners. Thus, providing effective and free personal cooling systems should be regarded as a better way for its wider application. Full article

(This article belongs to the Special Issue Indoor Environmental Quality)

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Open AccessArticle

Sleep and Dietary Patterns in Pregnancy: Findings from the GUSTO Cohort

by Linde Van Lee¹

, Ai-Ru Chia²

, See Ling Loy^3,4, Marjorelee Colega¹, Elaine K. H. Tham¹, Shirong Cai², Fabian Yap^3,4,5,6, Keith M. Godfrey^7,8

, Oon Hoe Teoh⁵, Daniel Goh⁹, Kok Hian Tan⁴, Yap-Seng Chong^1,2, Birit F. P. Broekman^1,10 and Mary F.F. Chong^1,11,12,*

¹ Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117549, Singapore

² Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore 119074, Singapore

³ Duke-NUS Medical School, Singapore 169857, Singapore

⁴ Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore

⁵ Department of Pediatrics, KK Women’s and Children’s Hospital, Singapore 229899, Singapore

⁶ Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore

⁷ MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK

⁸ NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK

⁹ Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore

¹⁰ Department of Psychiatry, VU Medical Centre, 1081 HV Amsterdam, The Netherlands

¹¹ Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #09-01Q, Singapore 117549, Singapore

¹² Clinical Nutrition Research Center, Agency for Science, Technology and Research, Singapore 117609, Singapore

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Int. J. Environ. Res. Public Health 2017, 14(11), 1409; https://doi.org/10.3390/ijerph14111409 - 17 Nov 2017

Cited by 32 | Viewed by 6772

Abstract

Evidence on the association between sleep, diet, and eating behaviors in pregnant women is lacking. We examine this in a cohort of apparently healthy pregnant women. At 26–28 weeks gestation, 497 participants completed the Pittsburgh Sleep Quality Index to assess sleep and a [...] Read more.

Evidence on the association between sleep, diet, and eating behaviors in pregnant women is lacking. We examine this in a cohort of apparently healthy pregnant women. At 26–28 weeks gestation, 497 participants completed the Pittsburgh Sleep Quality Index to assess sleep and a 24-h recall to assess dietary intake. Diet quality was assessed by the Healthy Eating Index for pregnant women in Singapore (HEI-SGP) score and previously derived dietary patterns (vegetables-fruit-rice, seafood-noodles, and pasta-cheese-meat pattern). Eating behaviors studied included the longest night-time fasting interval, frequency of consumption occasions, energy from discretionary foods, and nighttime eating. Adjusted means were estimated between poor/good quality and short/normal sleepers using linear regressions, including covariates. Good sleep quality versus poor sleep quality, was associated with better diet quality (mean HEI-SGP 54.6 vs. 52.0; p = 0.032), greater adherence to the vegetables-fruit-rice pattern (mean 0.03 vs. −0.15; p = 0.039), lesser adherence to the seafood-noodle pattern (mean −0.14 vs. 0.03; p = 0.024), and a trending lower calories from discretionary foods (mean 330.5 vs. 382.6 kcal; p = 0.073), after adjusting for covariates. After additional adjustment for anxiety, only sleep quality and the seafood-noodle pattern remained significantly associated (p = 0.018). Short sleep was not associated with any diet or eating behavior. In conclusion, good sleep quality is associated with a better diet quality and a greater adherence to the vegetable-fruit-rice pattern, but with lesser adherence to the seafood-noodle diets in pregnant women. Full article

(This article belongs to the Special Issue Maternal and Child Health 2018)

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Open AccessArticle

Indoor Temperatures in Low Cost Housing in Johannesburg, South Africa

by Nisha Naicker^1,2,3,4,*, June Teare^1,4

, Yusentha Balakrishna⁵

, Caradee Yael Wright^1,6

and Angela Mathee^1,2,7

¹ Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2028, South Africa

² Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa

³ The Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Services, Braamfontein 2001, South Africa

⁴ Department of Environmental Health, School of Behavioural Sciences, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth 6019, South Africa

⁵ Biostatistics Unit, South African Medical Research Council, Durban 4091, South Africa

⁶ Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0028, South Africa

⁷ Wits School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg 2193, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1410; https://doi.org/10.3390/ijerph14111410 - 18 Nov 2017

Cited by 44 | Viewed by 7793

Abstract

Ambient and indoor temperature affects thermal comfort and human health. In a changing climate with a predicted change in temperature extremes, understanding indoor temperatures, both hot and cold, of different housing types is important. This study aimed to assess the hourly, daily and [...] Read more.

Ambient and indoor temperature affects thermal comfort and human health. In a changing climate with a predicted change in temperature extremes, understanding indoor temperatures, both hot and cold, of different housing types is important. This study aimed to assess the hourly, daily and monthly variation in indoor temperatures in different housing types, namely formal houses, informal houses, flats, government-built low-cost houses and old, apartheid era low-cost housing, in five impoverished urban communities in Johannesburg, South Africa. During the cross-sectional survey of the Health, Environment and Development study data loggers were installed in 100 homes (20 per suburb) from February to May 2014. Indoor temperature and relative humidity were recorded on an hourly basis. Ambient outdoor temperatures were obtained from the nearest weather station. Indoor and outdoor temperature and relative humidity levels were compared; and an inter-comparison between the different housing types were also made. Apparent temperature was calculated to assess indoor thermal comfort. Data from 59 retrieved loggers showed a significant difference in monthly mean indoor temperature between the five different housing types (p < 0.0001). Low cost government-built houses and informal settlement houses had the greatest variation in temperature and experienced temperatures between 4 and 5 °C warmer than outdoor temperatures. Housing types occupied by poor communities experienced indoor temperature fluctuations often greater than that observed for ambient temperatures. Families living in government-built low-cost and informally-constructed homes are the most at risk for indoor temperature extremes. These types of housing should be prioritised for interventions aimed at assisting families to cope with extreme temperatures, gaining optimal thermal comfort and preventing temperature-related health effects. Full article

(This article belongs to the Special Issue Climate Change and Human Health)

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Open AccessArticle

Is All Urban Green Space the Same? A Comparison of the Health Benefits of Trees and Grass in New York City

by Colleen E. Reid^1,*

, Jane E. Clougherty^2,3, Jessie L.C. Shmool³ and Laura D. Kubzansky⁴

¹ Department of Geography, University of Colorado Boulder, Boulder, CO 80309, USA

² Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA

³ Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA

⁴ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1411; https://doi.org/10.3390/ijerph14111411 - 18 Nov 2017

Cited by 114 | Viewed by 14366

Abstract

Living near vegetation, often called “green space” or “greenness”, has been associated with numerous health benefits. We hypothesized that the two key components of urban vegetation, trees and grass, may differentially affect health. We estimated the association between near-residence trees, grass, and total [...] Read more.

Living near vegetation, often called “green space” or “greenness”, has been associated with numerous health benefits. We hypothesized that the two key components of urban vegetation, trees and grass, may differentially affect health. We estimated the association between near-residence trees, grass, and total vegetation (from the 2010 High Resolution Land Cover dataset for New York City (NYC)) with self-reported health from a survey of NYC adults (n = 1281). We found higher reporting of “very good” or “excellent” health for respondents with the highest, compared to the lowest, quartiles of tree (RR = 1.23, 95% CI = 1.06–1.44) but not grass density (relative risk (RR) = 1.00, 95% CI = 0.86–1.17) within 1000 m buffers, adjusting for pertinent confounders. Significant positive associations between trees and self-reported health remained after adjustment for grass, whereas associations with grass remained non-significant. Adjustment for air pollutants increased beneficial associations between trees and self-reported health; adjustment for parks only partially attenuated these effects. Results were null or negative using a 300 m buffer. Findings imply that higher exposure to vegetation, particularly trees outside of parks, may be associated with better health. If replicated, this may suggest that urban street tree planting may improve population health. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Patient–Provider Communication and Counseling about Gestational Weight Gain and Physical Activity: A Qualitative Study of the Perceptions and Experiences of Latinas Pregnant with their First Child

by Ana Cristina Lindsay^1,2,*, Sherrie F. Wallington³

, Mary L. Greaney⁴, Marcia M. Tavares Machado⁵ and Gabriela P. De Andrade¹

¹ Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, MA 02125, USA

² Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA

³ Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA

⁴ Health Studies and Department of Kinesiology, University of Rhode Island, Kingston, RI 02881, USA

⁵ Department of Community Health, Federal University of Ceará, Fortaleza, Ceará, 62010-560, Brazil

Int. J. Environ. Res. Public Health 2017, 14(11), 1412; https://doi.org/10.3390/ijerph14111412 - 18 Nov 2017

Cited by 23 | Viewed by 5793

Abstract

Latina women in the United States (U.S.) are disproportionately affected by obesity and are more likely to begin pregnancy overweight and gain excessive weight during pregnancy. The prenatal care period represents a window of opportunity for women to access the healthcare system and [...] Read more.

Latina women in the United States (U.S.) are disproportionately affected by obesity and are more likely to begin pregnancy overweight and gain excessive weight during pregnancy. The prenatal care period represents a window of opportunity for women to access the healthcare system and receive preventive services, education, nutritional support, and other social services to improve pregnancy outcomes. Excessive gestational weight gain (GWG) has numerous negative short- and long-term consequences for both the mother and newborn. We explored nulliparous Latina women’s perceptions about their experiences communicating with their primary healthcare provider about GWG and physical activity (PA) to identify possible intervention targets using in-depth, semi-structured interviews. Bilingual, trained research staff conducted 23 interviews with first-time pregnant Latinas between 22 and 36 weeks of gestation. Interviews were transcribed verbatim and analyzed using content analysis. Salient text passages were extracted, shortened, coded, and grouped into categories. Women, including those who self-identified as being overweight or obese prior to pregnancy, reported receiving limited or no advice from their healthcare providers about GWG or PA. Additionally, analysis revealed that although participants value information received from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program counselors, they would like to receive more information from their primary healthcare providers about adequate GWG. Furthermore, study findings indicate that some participants received conflicting information regarding PA during pregnancy. Study findings suggest the need for increased integration of communication and counseling about GWG and PA into prenatal care services to promote healthy weight gain and PA among low-income Latina women. Full article

(This article belongs to the Special Issue Maternal and Child Health 2018)

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Knowledge and Practices of Toxoplasmosis among Clinical Laboratory Professionals: A Cross-Sectional Study in Durango, Mexico

by Cosme Alvarado-Esquivel^1,*

, Luis Francisco Sánchez-Anguiano², Luis Omar Berumen-Segovia¹, Jesús Hernández-Tinoco², Yazmin Del Rosario Rico-Almochantaf¹, Alfredo Cisneros-Camacho¹ and Jorge Arturo Cisneros-Martínez¹

¹ Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico

² Institute for Scientific Research “Dr. Roberto Rivera Damm”, Juárez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico

Int. J. Environ. Res. Public Health 2017, 14(11), 1413; https://doi.org/10.3390/ijerph14111413 - 18 Nov 2017

Cited by 6 | Viewed by 3793

Abstract

Background: The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods: 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii; [...] Read more.

Background: The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods: 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii; (2) clinical manifestations, diagnosis, treatment, and epidemiology of toxoplasmosis; and (3) their practices with respect to toxoplasmosis. Results: The range of animals infected by T. gondii was known by 44.8% of participants. Clinical aspects of toxoplasmosis were known by up to 44.3% of subjects. Correct answers about the interpretation of serological markers of T. gondii infection were provided by up to 32.8% of participants. A minority (32.2%) of participants knew about a high number of false positive results of anti-T. gondii IgM antibody tests. Most participants (90.1%) did not know what the anti-T. gondii IgG avidity test was. Up to 55.7% of participants provided incorrect answers about the interpretation of serology tests for the treatment of pregnant women. Common routes of T. gondii infection were known by <15% of participants. Most (84.4%) participants had not performed tests for detection T. gondii infection. Conclusions: Results indicate incomplete knowledge of T. gondii infection and toxoplasmosis and a limited practice of laboratory tests among the professionals surveyed. Full article

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Acute Toxicity and Ecological Risk Assessment of Benzophenone-3 (BP-3) and Benzophenone-4 (BP-4) in Ultraviolet (UV)-Filters

by Yang Du^1,2, Wen-Qian Wang^1,2, Zhou-Tao Pei^1,2, Fahmi Ahmad^1,2, Rou-Rou Xu^1,2, Yi-Min Zhang^3,* and Li-Wei Sun^1,2,*

¹ School of Energy & Environment, Southeast University, Nanjing 210042, China

² Taihu Lake Water Environment Engineering Research Center (Wuxi), Southeast University, Wuxi 210042, China

³ Research Center of Watershed Ecological Conservation and Water Pollution Control, Nanjing Institute of Environmental Sciences, Ministry of Environmental Protection of the People’s Republic of China, Nanjing 210042, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1414; https://doi.org/10.3390/ijerph14111414 - 19 Nov 2017

Cited by 77 | Viewed by 7993

Abstract

Ultraviolet (UV)-absorbing chemicals (UV filters) are used in personal care products for the protection of human skin and hair from damage by UV radiation. Although these substances are released into the environment in the production and consumption processes, little is known about their [...] Read more.

Ultraviolet (UV)-absorbing chemicals (UV filters) are used in personal care products for the protection of human skin and hair from damage by UV radiation. Although these substances are released into the environment in the production and consumption processes, little is known about their ecotoxicology effects. The acute toxicity and potential ecological risk of UV filters benzophenone-3 (BP-3) and benzophenone-4 (BP-4) on Chlorella vulgaris, Daphnia magna, and Brachydanio rerio were analyzed in the present study. The EC₅₀ values (96 h) of BP-3 and BP-4 on C. vulgaris were 2.98 and 201.00 mg/L, respectively. The 48 h-LC₅₀ of BP-3 and BP-4 on D. magna were 1.09 and 47.47 mg/L, respectively. The 96 h-LC₅₀ of BP-3 and BP-4 on B. rerio were 3.89 and 633.00 mg/L, respectively. The toxicity of a mixture of BP-3 and BP-4 on C. vulgaris, D. magna, and B. rerio all showed antagonistic effects. The induced predicted no-effect concentrations of BP-3 and BP-4 by the assessment factor method were 1.80 × 10⁻³ and 0.47 mg/L, respectively, by assessment factor (AF) method, which were both lower than the concentrations detected in the environment at present, verifying that BP-3 and BP-4 remain low-risk chemicals to the aquatic ecosystem. Full article

(This article belongs to the Special Issue Emerging Contaminants VS. Legacy Pollutants: Their Impacts on the Environmental Integrity and Public Health)

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OMI and Ground-Based In-Situ Tropospheric Nitrogen Dioxide Observations over Several Important European Cities during 2005–2014

by Spiru Paraschiv¹

, Daniel-Eduard Constantin^2,*

, Simona-Lizica Paraschiv¹

and Mirela Voiculescu¹

¹ Department of Thermal Systems and Environmental Engineering, Faculty of Engineering, “Dunarea de Jos”, University of Galati, Str. Domneasca, Nr.111, 800008 Galati, Romania

² European Center of Excellence for the Environment, Faculty of Sciences and Environment, “Dunarea de Jos”, University of Galati, Str. Domneasca, Nr.111, 800008 Galati, Romania

Int. J. Environ. Res. Public Health 2017, 14(11), 1415; https://doi.org/10.3390/ijerph14111415 - 20 Nov 2017

Cited by 23 | Viewed by 5024

Abstract

In this work we present the evolution of tropospheric nitrogen dioxide (NO₂) content over several important European cities during 2005–2014 using space observations and ground-based in-situ measurements. The NO₂ content was derived using the daily observations provided by the Ozone [...] Read more.

In this work we present the evolution of tropospheric nitrogen dioxide (NO₂) content over several important European cities during 2005–2014 using space observations and ground-based in-situ measurements. The NO₂ content was derived using the daily observations provided by the Ozone Monitoring Instrument (OMI), while the NO₂ volume mixing ratio measurements were obtained from the European Environment Agency (EEA) air quality monitoring stations database. The European cities selected are: Athens (37.98° N, 23.72° E), Berlin (52.51° N, 13.41° E), Bucharest (44.43° N, 26.10° E), Madrid (40.38° N, 3.71° W), Lisbon (38.71° N, 9.13° W), Paris (48.85° N, 2.35° E), Rome (41.9° N, 12.50° E), and Rotterdam (51.91° N, 4.46° E). We show that OMI NO₂ tropospheric column data can be used to assess the evolution of NO₂ over important European cities. According to the statistical analysis, using the seasonal variation, we found good correlations (R > 0.50) between OMI and ground-based in-situ observations for all of the cities presented in this work. Highest correlation coefficients (R > 0.80) between ground-based monitoring stations and OMI observations were calculated for the cities of Berlin, Madrid, and Rome. Both types of observations, in-situ and remote sensing, show an NO₂ negative trend for all of locations presented in this study. Full article

(This article belongs to the Special Issue Remediation and Analysis of Soil, Air, and Water Pollution)

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Dual Competing Photovoltaic Supply Chains: A Social Welfare Maximization Perspective

by Zhisong Chen^1,*

and Shong-Iee Ivan Su²

¹ Business School, Nanjing Normal University, Qixia District, Nanjing 210023, China

² Supply Chain and Logistics Management Research Lab, Department of Business Administration, School of Business, Soochow University, Taipei 11102, Taiwan

Int. J. Environ. Res. Public Health 2017, 14(11), 1416; https://doi.org/10.3390/ijerph14111416 - 20 Nov 2017

Cited by 27 | Viewed by 4478

Abstract

In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV) industry in many nations. There is a clear shortage in the PV industry literature regarding [...] Read more.

In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV) industry in many nations. There is a clear shortage in the PV industry literature regarding how dual supply chains compete and the key decision issues regarding the competition between dual PV supply chains. It is critical to develop effective subsidy policies for the competing PV supply chains to achieve social welfare maximization. This study has explored the dual PV supply chain competition under the Bertrand competition assumption by three game-theoretical modeling scenarios (or supply chain strategies) considering either the public subsidy or no subsidy from a social welfare maximization perspective. A numerical analysis complemented by two sensitivity analyses provides a better understanding of the pricing and quantity decision dynamics in the dual supply chains under three different supply chain strategies and the corresponding outcomes regarding the total supply chain profits, the social welfare and the required total subsidies. The key findings disclose that if there are public subsidies, the dual PV supply chains have the strongest intention to pursue the decentralized strategy to achieve their maximal returns rather than the centralized strategy that would achieve the maximal social welfare; however, the government would need to pay for the maximal subsidy budget. Thus, the best option for the government would be to encourage the dual PV supply chains to adopt a centralized strategy since this will not only maximize the social welfare but also, at the same time, minimize the public subsidy. With a smart subsidy policy, the PV industry can make the best use of the subsidy budget and grow in a sustainable way to support the highly demanded solar power generation in many countries trying very hard to increase the proportion of their clean energy to combat the global warming effect. Several subsidy policies such as shared solar energy arrangements and performance-based incentive (PBI) are proposed to integrate the market users and the PV supply chains. This study serves as a pioneering study into the dual PV supply chain research which is very limited in the PV management and policy study literature. The findings and several untended issues provide a foundation for the future PV supply chain studies. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Is School Type Associated with Objectively Measured Physical Activity in 15-Year-Olds?

by Lovro Štefan^*

, Maroje Sorić

, Antonela Devrnja, Hrvoje Podnar

and Marjeta Mišigoj-Duraković

Faculty of Kinesiology, University of Zagreb, 10 000 Zagreb, Croatia

Int. J. Environ. Res. Public Health 2017, 14(11), 1417; https://doi.org/10.3390/ijerph14111417 - 20 Nov 2017

Cited by 11 | Viewed by 3903

Abstract

The main aims of this study were: (1) to determine the objectively assessed physical activity (PA) patterns in urban 15-year-old male and female adolescents according to school type and (2) to assess the differences in PA between school days and weekend days. In [...] Read more.

The main aims of this study were: (1) to determine the objectively assessed physical activity (PA) patterns in urban 15-year-old male and female adolescents according to school type and (2) to assess the differences in PA between school days and weekend days. In this cross-sectional study, participants were 187 secondary-school male and female adolescents (61.4% females) attending grammar and vocational schools. Patterns of PA were objectively evaluated using a multi-sensor body monitor for 5 consecutive days. Confounders assessed included biological age, socio-economic status, sum of 4 skinfolds, maximal temperature and the amount of rainfall. Males and females from grammar schools achieved higher total daily energy expenditure (TEE) and active energy expenditure (AEE) compared to their peers from vocational schools (TEE: 50 ± 12 kcal/kg/day vs. 47 ± 12 kcal/kg/day, p = 0.02; AEE: 23 ± 5 kcal/kg/day vs. vocational = 21 ± 6 kcal/kg/day, p = 0.04). No differences in time spent in light (LPA), moderate (MPA) or vigorous (VPA) physical activity were noted between the two groups (p = 0.16–0.43). Next, a significant decline in TEE and MPA between school days and weekends was observed (p< 0.001 and p = 0.02, respectively), while VPA remained the same throughout the week (p = 0.76). Weekly patterns of PA did not show differences by school type or gender (p for interactions = 0.21–0.50). In addition, significantly lower amount of MPA was accumulated during weekends compared to school days, resulting in lower TEE, regardless of school type or gender. Policies and strategies on PA in adolescents should focus vocational schools and weekend days. Full article

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Clinical Beneficial Effects of Using Crystalloid only in Recipients of Living Donor Liver Transplantation

by Chia-Jung Huang¹, Kwok-Wai Cheng¹, Chao-Long Chen², Shao-Chun Wu¹

, Tsung-Hsiao Shih¹, Sheng-Chun Yang¹, Sin-Ei Juang¹, Ying-En Lee¹, Chiu-En Huang¹, Bruno Jawan¹ and Chih-Hsien Wang^1,*

¹ Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan

² Department of Surgery and Liver Transplant Program, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan

Int. J. Environ. Res. Public Health 2017, 14(11), 1418; https://doi.org/10.3390/ijerph14111418 - 20 Nov 2017

Cited by 6 | Viewed by 3255

Abstract

Objective: Liver transplantation (LT) is a major surgery associated with intraoperative massive fluid shift, which is usually replaced by crystalloid, 5% albumin (colloid) and blood products. We studied 15 patients from 477 consecutive recipients of adult living donor liver transplantation. Each patient [...] Read more.

Objective: Liver transplantation (LT) is a major surgery associated with intraoperative massive fluid shift, which is usually replaced by crystalloid, 5% albumin (colloid) and blood products. We studied 15 patients from 477 consecutive recipients of adult living donor liver transplantation. Each patient received crystalloid only during LT. Whether LT provides any clinical benefit is not clear and must be determined. Methods and Patients: The anesthesia records of 477 adult LDLT were reviewed retrospectively. The patients were divided into three groups according to the fluids received. Group I (GI) had received blood products, 5% albumin and crystalloid, group II (GII) received 5% albumin and crystalloid, and group III (GIII) received crystalloid only. The characteristic intraoperative variable and postoperative acute rejection and survival rate were compared amongst groups by using One Way ANOVA post hoc with Bonferroni and by Ficher’s Exact test and Chi-square χ² test. Results and Conclusions: GIII had less intraoperative ascites and blood loss; they also had more stable hemodynamics. Furthermore, they could be extubated significantly earlier than GI, and the one- and three-year survival rates were excellent, with 100% in GIII, while that of GI and GII were 94.1%, 90.5% and 98.6%, 94.5%, respectively. Full article

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The Short-Term Effects of Visibility and Haze on Mortality in a Coastal City of China: A Time-Series Study

by Shaohua Gu^1,†, Jun Yang^2,†, Alistair Woodward³, Mengmeng Li⁴, Tianfeng He¹, Aihong Wang¹, Beibei Lu¹, Xiaobo Liu⁵, Guozhang Xu^1,* and Qiyong Liu^5,*

¹ Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China

² Institute for Environmental and Climate Research, Jinan University, Guangzhou 510000, China

³ School of Population Health, University of Auckland, Auckland 92019, New Zealand

⁴ Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China

⁵ State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1419; https://doi.org/10.3390/ijerph14111419 - 20 Nov 2017

Cited by 21 | Viewed by 4469

Abstract

Few studies have been conducted to investigate the acute health effects of visibility and haze, which may be regarded as proxy indicators of ambient air pollution. We used a distributed lag non-linear model (DLNM) combined with quasi-Poisson regression to estimate the relationship between [...] Read more.

Few studies have been conducted to investigate the acute health effects of visibility and haze, which may be regarded as proxy indicators of ambient air pollution. We used a distributed lag non-linear model (DLNM) combined with quasi-Poisson regression to estimate the relationship between visibility, haze and mortality in Ningbo, a coastal city of China. We found that the mortality risk of visibility was statistically significant only on the current day, while the risk of haze and PM₁₀ peaked on the second day and could last for three days. When the visibility was less than 10 km, each 1 km decrease of visibility at lag 0 day was associated with a 0.78% (95% CI: 0.22–1.36%) increase in total mortality and a 1.61% (95% CI: 0.39–2.85%) increase in respiratory mortality. The excess risk of haze at lag 0–2 days on total mortality, cardiovascular and respiratory mortality was 7.76% (95% CI: 3.29–12.42%), 7.73% (95% CI: 0.12–15.92%) and 17.77% (95% CI: 7.64–28.86%), respectively. Greater effects of air pollution were observed during the cold season than in the warm season, and the elderly were at higher risk compared to youths. The effects of visibility and haze were attenuated by single pollutants. These findings suggest that visibility and haze could be used as surrogates of air quality where pollutant data are scarce, and strengthen the evidence to develop policy to control air pollution and protect vulnerable populations. Full article

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Prediction of Mortality in Patients with Isolated Traumatic Subarachnoid Hemorrhage Using a Decision Tree Classifier: A Retrospective Analysis Based on a Trauma Registry System

by Cheng-Shyuan Rau^1,†, Shao-Chun Wu^2,†

, Peng-Chen Chien³, Pao-Jen Kuo³, Yi-Chun Chen³, Hsiao-Yun Hsieh³ and Ching-Hua Hsieh^3,*

¹ Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan

² Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan

³ Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan

^† These authors contribute equally to this paper.

Int. J. Environ. Res. Public Health 2017, 14(11), 1420; https://doi.org/10.3390/ijerph14111420 - 22 Nov 2017

Cited by 29 | Viewed by 5658

Abstract

Background: In contrast to patients with traumatic subarachnoid hemorrhage (tSAH) in the presence of other types of intracranial hemorrhage, the prognosis of patients with isolated tSAH is good. The incidence of mortality in these patients ranges from 0–2.5%. However, few data or predictive [...] Read more.

Background: In contrast to patients with traumatic subarachnoid hemorrhage (tSAH) in the presence of other types of intracranial hemorrhage, the prognosis of patients with isolated tSAH is good. The incidence of mortality in these patients ranges from 0–2.5%. However, few data or predictive models are available for the identification of patients with a high mortality risk. In this study, we aimed to construct a model for mortality prediction using a decision tree (DT) algorithm, along with data obtained from a population-based trauma registry, in a Level 1 trauma center. Methods: Five hundred and forty-five patients with isolated tSAH, including 533 patients who survived and 12 who died, between January 2009 and December 2016, were allocated to training (n = 377) or test (n = 168) sets. Using the data on demographics and injury characteristics, as well as laboratory data of the patients, classification and regression tree (CART) analysis was performed based on the Gini impurity index, using the rpart function in the rpart package in R. Results: In this established DT model, three nodes (head Abbreviated Injury Scale (AIS) score ≤4, creatinine (Cr) <1.4 mg/dL, and age <76 years) were identified as important determinative variables in the prediction of mortality. Of the patients with isolated tSAH, 60% of those with a head AIS >4 died, as did the 57% of those with an AIS score ≤4, but Cr ≥1.4 and age ≥76 years. All patients who did not meet the above-mentioned criteria survived. With all the variables in the model, the DT achieved an accuracy of 97.9% (sensitivity of 90.9% and specificity of 98.1%) and 97.7% (sensitivity of 100% and specificity of 97.7%), for the training set and test set, respectively. Conclusions: The study established a DT model with three nodes (head AIS score ≤4, Cr <1.4, and age <76 years) to predict fatal outcomes in patients with isolated tSAH. The proposed decision-making algorithm may help identify patients with a high risk of mortality. Full article

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Cross-Sectional Serological Survey for Leptospira spp. in Beef and Dairy Cattle in Two Districts in Uganda

by Anou Dreyfus^1,*, Terence Odoch²

, Lordrick Alinaitwe², Sabrina Rodriguez-Campos³

, Amanuel Tsegay²

, Valentine Jaquier³ and Clovice Kankya²

¹ Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8006 Zürich, Switzerland

² College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O. Box 7062 Kampala, Uganda

³ Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland

Int. J. Environ. Res. Public Health 2017, 14(11), 1421; https://doi.org/10.3390/ijerph14111421 - 21 Nov 2017

Cited by 6 | Viewed by 4548

Abstract

Seroprevalence of Leptospira spp. in cattle is unknown in Uganda. The aim of this study was to estimate the seroprevalence of L. interrogans Icterohaemorrhagiae, Pomona, L. kirschneri Butembo, Grippotyphosa, L. borgpetersenii Nigeria, Hardjo, Wolfii, and Kenya and an overall seroprevalence in cattle from [...] Read more.

Seroprevalence of Leptospira spp. in cattle is unknown in Uganda. The aim of this study was to estimate the seroprevalence of L. interrogans Icterohaemorrhagiae, Pomona, L. kirschneri Butembo, Grippotyphosa, L. borgpetersenii Nigeria, Hardjo, Wolfii, and Kenya and an overall seroprevalence in cattle from Kole and Mbale districts. Two hundred-seventy five bovine sera from 130 small holder farms from Kole (n = 159) and Mbale (n = 116), collected between January and July 2015, were tested for antibodies against eight Leptospira strains by Microscopic Agglutination Test. A titer of ≥100 was considered seropositive, indicating past exposure. Overall, the seroprevalence was 19.27% (95% CI 14.9–24.5%). Pomona seroprevalence was highest with 9.45% (6.4–13.7%), followed by Kenya 5.09% (2.9–8.6%), Nigeria 4.00% (2.1–7.2%), Wolfii 3.27% (1.6–6.3%), Butembo 1.86% (0.7–4.4%), Hardjo 1.45% (0.5–3.9%), and Icterohaemorragiae and Grippotyphosa with less than 1% positive. Seroprevalence did not differ between districts and gender (p ≥ 0.05). Seven animals had titers ≥400. Cross-reactions or exposure to ≥1 serovar was measured in 43% of serum samples. Seroprevalence of 19% implies exposure of cattle to leptospires. Full article

(This article belongs to the Special Issue Emerging Infectious Disease (EID) Research, Management and Response)

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The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research

by Joniqua Ceasar¹, Marlene H. Peters-Lawrence², Valerie Mitchell¹ and Tiffany M. Powell-Wiley^1,*

¹ Cardiovascular Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA

² Blood Epidemiology and Clinical Therapeutics Branch, Division of Blood Diseases and Resources, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1422; https://doi.org/10.3390/ijerph14111422 - 21 Nov 2017

Cited by 34 | Viewed by 8165

Abstract

Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment [...] Read more.

Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB), which influenced the study’s design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities. Full article

(This article belongs to the Collection Health Behavior and Public Health)

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Open AccessArticle

Towards More Nuanced Classification of NGOs and Their Services to Improve Integrated Planning across Disaster Phases

by Vivian L. Towe^*, Joie D. Acosta and Anita Chandra

RAND Corporation, 1200 S. Hayes Street, Arlington, VA 22202, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1423; https://doi.org/10.3390/ijerph14111423 - 21 Nov 2017

Cited by 10 | Viewed by 4605

Abstract

Nongovernmental organizations (NGOs) are being integrated into U.S. strategies to expand the services that are available during health security threats like disasters. Identifying better ways to classify NGOs and their services could optimize disaster planning. We surveyed NGOs about the types of services [...] Read more.

Nongovernmental organizations (NGOs) are being integrated into U.S. strategies to expand the services that are available during health security threats like disasters. Identifying better ways to classify NGOs and their services could optimize disaster planning. We surveyed NGOs about the types of services they provided during different disaster phases. Survey responses were used to categorize NGO services as core—critical to fulfilling their organizational mission—or adaptive—services implemented during a disaster based on community need. We also classified NGOs as being core or adaptive types of organizations by calculating the percentage of each NGO’s services classified as core. Service types classified as core were mainly social services, while adaptive service types were those typically relied upon during disasters (e.g., warehousing, food services, etc.). In total, 120 NGOs were classified as core organizations, meaning they mainly provided the same services across disaster phases, while 100 NGOs were adaptive organizations, meaning their services changed. Adaptive NGOs were eight times more likely to report routinely participating in disaster planning as compared to core NGOs. One reason for this association may be that adaptive NGOs are more aware of the changing needs in their communities across disaster phases because of their involvement in disaster planning. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Open AccessArticle

Using Twitter to Explore (un)Healthy Housing: Learning from the #Characterbuildings Campaign in New Zealand

by Elinor Chisholm

and Kimberley O’Sullivan^*

He Kainga Oranga/Housing and Health Research Programme, Department of Public Health, University of Otago, Wellington, P.O. Box 7343, Wellington 6242, New Zealand

Int. J. Environ. Res. Public Health 2017, 14(11), 1424; https://doi.org/10.3390/ijerph14111424 - 21 Nov 2017

Cited by 15 | Viewed by 5376

Abstract

While increasingly used for research, Twitter remains largely untapped as a source of data about housing. We explore the growth of social media and use of Twitter in health and social research, and question why housing researchers have avoided using Twitter to explore [...] Read more.

While increasingly used for research, Twitter remains largely untapped as a source of data about housing. We explore the growth of social media and use of Twitter in health and social research, and question why housing researchers have avoided using Twitter to explore housing issues to date. We use the #characterbuildings campaign, initiated by an online media platform in New Zealand in 2014 to illustrate that Twitter can provide insights into housing as a public health and social problem. We find that Twitter users share details of problems with past and present homes on this public platform, and that this readily available data can contribute to the case for improving building quality as a means of promoting public health. Moreover, the way people responded to the request to share details about their housing experiences provides insight into how New Zealanders conceive of housing problems. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Environmental Exposure to Dioxins, Dibenzofurans, Bisphenol A, and Phthalates in Children with and without Autism Spectrum Disorder Living near the Gulf of Mexico

by Mohammad H. Rahbar^1,2,3,*, Hanes M. Swingle⁴, MacKinsey A. Christian³, Manouchehr Hessabi³

, MinJae Lee^2,3, Meagan R. Pitcher⁵, Sean Campbell⁶, Amy Mitchell⁴, Ryan Krone⁴, Katherine A. Loveland⁷ and Donald G. Patterson Jr.⁶

¹ Department of Epidemiology, Human Genetics and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, Houston, TX 77030, USA

² Division of Clinical and Translational Sciences, Department of Internal Medicine, University of Texas McGovern Medical School at Houston, Houston, TX 77030, USA

³ Biostatistics/Epidemiology/Research Design (BERD) Component, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, Houston, TX 77030, USA

⁴ Division of Developmental-Behavioral Pediatrics, University of South Alabama, Mobile, AL 36604, USA

⁵ Baylor Licensing Group, Baylor College of Medicine, Houston, TX 77030, USA

⁶ AXYS Analytical Services Ltd., Sidney, BC V8L5X2, Canada

⁷ Department of Psychiatry and Behavioral Sciences, University of Texas McGovern Medical School at Houston, Houston, TX 77054, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1425; https://doi.org/10.3390/ijerph14111425 - 21 Nov 2017

Cited by 29 | Viewed by 5637

Abstract

Environmental exposure to organic endocrine disrupting chemicals, including dioxins, dibenzofurans, bisphenol A (BPA), and phthalates has been associated with neurodevelopmental disorders, including autism spectrum disorder (ASD). We conducted a pilot monitoring study of 30 ASD cases and 10 typically developing (TD) controls ages [...] Read more.

Environmental exposure to organic endocrine disrupting chemicals, including dioxins, dibenzofurans, bisphenol A (BPA), and phthalates has been associated with neurodevelopmental disorders, including autism spectrum disorder (ASD). We conducted a pilot monitoring study of 30 ASD cases and 10 typically developing (TD) controls ages 2–8 years from communities along the Gulf of Mexico near Alabama, which houses 14 Superfund sites, to assess the concentrations of dioxins and dibenzofurans in serum, and BPA and phthalate ester metabolites in urine. Based on General Linear Models, the lipid- or creatinine-adjusted geometric mean concentrations of the aforementioned chemicals did not differ between the ASD case and TD control groups (all p ≥ 0.27). We compared our findings to the adjusted means as reported by the National Health and Nutrition Examination Survey, survey years 2011–2012, and found that TD controls in our study had lower BPA (59%) and MEHHP (26%) concentrations, higher MBP (50%) concentration, and comparable (<20% difference) MEP, MBZP, MEOHP, and MCPP concentrations. We also conducted a preliminary investigation of dietary exposures and found that the consumption of certain types of fish may be associated with higher OCDD concentrations, and the consumption of soft drinks and juices may be associated with lower BPA and MEOHP concentrations, respectively. Full article

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Open AccessArticle

Relationships between Vacant Homes and Food Swamps: A Longitudinal Study of an Urban Food Environment

by Yeeli Mui^1,*, Jessica C. Jones-Smith², Rachel L. J. Thornton³, Keshia Pollack Porter⁴ and Joel Gittelsohn^1,5

¹ Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA

² Department of Health Services & Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA 98195, USA

³ Center for Child and Community Health Research, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA

⁴ Department of Health Policy and Management, Institute for Health and Social Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA

⁵ Global Obesity Prevention Center (GOPC) at Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1426; https://doi.org/10.3390/ijerph14111426 - 21 Nov 2017

Cited by 17 | Viewed by 6099

Abstract

Research indicates that living in neighborhoods with high concentrations of boarded-up vacant homes is associated with premature mortality due to cancer and diabetes, but the mechanism for this relationship is unclear. Boarded-up housing may indirectly impact residents’ health by affecting their food environment. [...] Read more.

Research indicates that living in neighborhoods with high concentrations of boarded-up vacant homes is associated with premature mortality due to cancer and diabetes, but the mechanism for this relationship is unclear. Boarded-up housing may indirectly impact residents’ health by affecting their food environment. We evaluated the association between changes in vacancy rates and changes in the density of unhealthy food outlets as a proportion of all food outlets, termed the food swamp index, in Baltimore, MD (USA) from 2001 to 2012, using neighborhood fixed-effects linear regression models. Over the study period, the average food swamp index increased from 93.5 to 95.3 percentage points across all neighborhoods. Among non-African American neighborhoods, increases in the vacancy rate were associated with statistically significant decreases in the food swamp index (b = −0.38; 90% CI, −0.64 to −0.12; p-value: 0.015), after accounting for changes in neighborhood SES, racial diversity, and population size. A positive association was found among low-SES neighborhoods (b = 0.15; 90% CI, 0.037 to 0.27; p-value: 0.031). Vacant homes may influence the composition of food outlets in urban neighborhoods. Future research should further elucidate the mechanisms by which more distal, contextual factors, such as boarded-up vacant homes, may affect food choices and diet-related health outcomes. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Open AccessArticle

Physical Fighting and Associated Factors among Adolescents Aged 13–15 Years in Six Western Pacific Countries

by Lili Yang¹

, Yuanyuan Zhang¹, Bo Xi^1,* and Pascal Bovet^2,*

¹ Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China

² Institute of Social and Preventive Medicine, University Hospital Center, 1010 Lausanne, Switzerland

Int. J. Environ. Res. Public Health 2017, 14(11), 1427; https://doi.org/10.3390/ijerph14111427 - 21 Nov 2017

Cited by 35 | Viewed by 5061

Abstract

Youth violence is an important public health challenge around the world, yet the literature on this problem in low- and middle-income countries (LMICs) has been limited. The present study aims to examine the prevalence of adolescent physical fighting (defined as having been involved [...] Read more.

Youth violence is an important public health challenge around the world, yet the literature on this problem in low- and middle-income countries (LMICs) has been limited. The present study aims to examine the prevalence of adolescent physical fighting (defined as having been involved in at least one physical fight during the past 12 months) in selected LMICs, and its relations with potential risk factors. We included 6377 school-going adolescents aged 13–15 years from six Western Pacific (WP) countries that had recently conducted a Global School-based Student Health Survey. Information was gathered through a self-administered anonymous closed-ended questionnaire. The prevalence of adolescent physical fighting varied across countries, ranging from 34.5% in Kiribati to 63.3% in Samoa. The prevalence was higher in boys than in girls, and lower at age 15 than 13–14 years. Physical fighting was significantly associated (pooled odds ratios (ORs), 95% confidence intervals (CIs)) with smoking (1.78, 1.53–2.06), drinking (1.57, 1.33–1.85), drug use (1.72, 1.33–2.23), and missing school (1.72, 1.51–1.95). The association with physical fighting increased with increasing number of joint adverse behaviors (increased from 1.99 (1.73–2.29) for one risk behavior to 4.95 (4.03–6.07) for at least 3 risk behaviors, versus having none of the 4 risk behaviors). The high prevalence of physical fighting and the associations with risk behaviors emphasize the need for comprehensive prevention programs to reduce youth violence and associated risk behaviors. Full article

(This article belongs to the Special Issue Youth Violence as a Public Health Issue)

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Open AccessArticle

Spatiotemporal Distribution of U5MR and Their Relationship with Geographic and Socioeconomic Factors in China

by Zeng Li^1,†, Jingying Fu^2,3,†, Dong Jiang^2,3,*

, Gang Lin^2,*

, Donglin Dong¹ and Xiaoxi Yan^2,3

¹ College of Geoscience and Surveying Engineering, China University of Mining & Technology (Beijing), Ding No.11 Xueyuan Road, Haidian District, Beijing 100083, China

² Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, 11A Datun Road, Chaoyang District, Beijing 100101, China

³ College of Resource and Environment, University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing 100049, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2017, 14(11), 1428; https://doi.org/10.3390/ijerph14111428 - 21 Nov 2017

Cited by 4 | Viewed by 4348

Abstract

Epidemiological studies conducted around the world have reported that the under-five mortality rate (U5MR) is closely associated with income and educational attainment. However, geographic elements should also remain a major concern in further improving child health issues, since they often play an important [...] Read more.

Epidemiological studies conducted around the world have reported that the under-five mortality rate (U5MR) is closely associated with income and educational attainment. However, geographic elements should also remain a major concern in further improving child health issues, since they often play an important role in the survival environment. This study was undertaken to investigate the relationship between the U5MR, geographic, and socioeconomic factors, and to explore the associated spatial variance of the relationship in China using the geographically weighted regression (GWR) model. The results indicate that the space pattern of a high U5MR had been narrowed notably during the period from 2001 to 2010. Nighttime lights (NL) and the digital elevation model (DEM) both have obvious influences on the U5MR, with the NL having a negative impact and DEM having a positive impact. Additionally, the relationship between the NL and DEM varied over space in China. Moreover, the relevance between U5MR and DEM was narrowed in 2010 compared to 2001, which indicates that the development of economic and medical standards can overcome geographical limits. Full article

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Open AccessArticle

Associations of Shift Work and Its Duration with Work-Related Injury among Electronics Factory Workers in South Korea

by Jia Ryu¹, Kyunghee Jung-Choi¹, Kyung-Hwa Choi²

, Ho-Jang Kwon³, Chungwon Kang⁴ and Hyunjoo Kim^4,*

¹ Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul 07985, Korea

² Taean Environmental Health Center, Taean 32148, Korea

³ Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea

⁴ Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea

Int. J. Environ. Res. Public Health 2017, 14(11), 1429; https://doi.org/10.3390/ijerph14111429 - 21 Nov 2017

Cited by 10 | Viewed by 5339

Abstract

This study aimed to explore the association between shift work and work-related injuries. We collected data on workers from an electronics factory. This cross-sectional study included 13,610 subjects, who were assessed based on a self-reported questionnaire about their shift work experiences, work-related injuries, [...] Read more.

This study aimed to explore the association between shift work and work-related injuries. We collected data on workers from an electronics factory. This cross-sectional study included 13,610 subjects, who were assessed based on a self-reported questionnaire about their shift work experiences, work-related injuries, and other covariates. Multiple logistic regression models were used to evaluate the associations between shift work and work-related injuries and were estimated using the odds ratio. We found that the current and past shift workers, compared to non-shift workers, were associated with a 2.7- and 1.7-fold higher risk of work-related injury. There was a dose-response relationship between shift work duration and work-related injury among current female shift workers. Shift work increased the risk of work-related injuries, and the impact could be different depending on gender. Full article

(This article belongs to the Section Occupational Safety and Health)

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Open AccessArticle

Effects of Sediment Chemical Properties on Phosphorus Release Rates in the Sediment-Water Interface of the Steppe Wetlands

by Jing He¹, Derong Su^1,*, Shihai Lv², Zhaoyan Diao², Jingjie Xie¹ and Yan Luo¹

¹ Grassland Resources and Ecology Research Center, Beijing Forestry University, Beijing 100083, China

² State Environmental Protection Key Laboratory of Regional Eco-Process and Function Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1430; https://doi.org/10.3390/ijerph14111430 - 22 Nov 2017

Cited by 10 | Viewed by 4339

Abstract

Rising temperature causes a process of phosphorus release, which can be characterized well using phosphorus release rates (V_P). The objective of the present study was to investigate the major factors affecting sediment phosphorus release rates through a wetland habitat simulation experiment. [...] Read more.

Rising temperature causes a process of phosphorus release, which can be characterized well using phosphorus release rates (V_P). The objective of the present study was to investigate the major factors affecting sediment phosphorus release rates through a wetland habitat simulation experiment. The results showed that the V_P of different wetland sediments were different and changed with the order of W–R (river wetland) > W–L (lake wetland) > W–M (grassy marsh wetland) > W–A (reservoir wetland). The main driving factors which influenced sediment phosphorus flux velocity in the sediment–water interface were sediment B-SO₄²⁻, B-MBN and A-MBP content. Path analysis and determination coefficient analysis indicated the standard multiple regression equation for sediment phosphorus release rates in the sediment–water interface, and each main factor was Y = −0.105 + 0.096X₁ + 0.275X₂ − 0.010X₃ (r = 0.416, p < 0.01, n = 144), where Y is sediment phosphorus release rates; X₁ is sediment B-SO₄²⁻ content; X₂ is sediment B-MBN; and X₃ is sediment A-MBP content. Sediment B-SO₄²⁻, B-MBN and A-MBP content and the interaction between them were the main factors affecting sediment phosphorus release rates in the sediment–water interface. Therefore, these results suggest that soil chemical properties and microbial activities likely play an important role in phosphorus release rates in the sediment–water interface. We hope to provide effective scientific management and control methods for relevant environmental protection departments. Full article

(This article belongs to the Section Environmental Science and Engineering)

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Open AccessArticle

The Economic Burden of Violence against Children in South Africa

by Xiangming Fang^1,2,*, Xiaodong Zheng¹, Deborah A. Fry³, Gary Ganz⁴, Tabitha Casey³, Celia Hsiao⁵ and Catherine L. Ward⁴

¹ College of Economics and Management, China Agricultural University, No. 17 Qinghuadong Road, Haidian District, Beijing 100083, China

² School of Public Health, Georgia State University, 140 Decatur Street, Atlanta, GA 30303, USA

³ Moray House School of Education, St John’s Land, 2.02, Holyrood Road, Edinburgh EH8 8AQ, Scotland

⁴ Department of Psychology and Safety and Violence Initiative, University of Cape Town, Rondebosch 7701, South Africa

⁵ Save the Children South Africa, 2nd Floor SAQA House, 1067 Arcadia Street, Hatfield 0028, South Africa

Int. J. Environ. Res. Public Health 2017, 14(11), 1431; https://doi.org/10.3390/ijerph14111431 - 22 Nov 2017

Cited by 34 | Viewed by 6521

Abstract

The purpose of this study was to estimate the economic burden of violence against children in South Africa. We assembled summative estimates of lifetime prevalence, calculated the magnitude of associations with negative outcomes, and thereby estimated the economic burden of violence against children. [...] Read more.

The purpose of this study was to estimate the economic burden of violence against children in South Africa. We assembled summative estimates of lifetime prevalence, calculated the magnitude of associations with negative outcomes, and thereby estimated the economic burden of violence against children. According to our calculations, 2.3 million and 84,287 disability-adjusted life-years (DALYs) lost in South Africa in 2015 were attributable to nonfatal and fatal violence against children, respectively. The estimated economic value of DALYs lost to violence against children (including both fatal and nonfatal) in South Africa in 2015 totalled ZAR173 billion (US $13.5 billion)—or 4.3% of South Africa’s gross domestic product (GDP) in 2015. In addition, the reduced earnings attributable to childhood physical violence and emotional violence in South Africa in 2015 were ZAR25.2 billion (US $2.0 billion) and ZAR9.6 billion (US $750 million), respectively. In addition, South Africa spent ZAR1.6 billion (US $124 million) on child care and protection in fiscal year 2015/2016, many of which costs are directly related to violence against children. This study confirms the importance of prioritising violence against children as a key social and economic concern for South Africa’s future. Full article

(This article belongs to the Section Health Economics)

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Open AccessCommentary

Urban Green Space and the Pursuit of Health Equity in Parts of the United States

by Viniece Jennings^1,*, April Karen Baptiste², Na’Taki Osborne Jelks³ and Renée Skeete⁴

¹ Southern Research Station, USDA Forest Service, 320 Green Street, Athens, GA 30602, USA

² Environmental Studies Program, Colgate University, 13 Oak Drive, Hamilton, NY 13346, USA

³ Department of Public Health, Agnes Scott College, 141 E. College Avenue, Decatur, GA 30030, USA

⁴ Department of Sociology, Georgia State University, 33 Gilmer Street SE, Atlanta, GA 30303, USA

Int. J. Environ. Res. Public Health 2017, 14(11), 1432; https://doi.org/10.3390/ijerph14111432 - 22 Nov 2017

Cited by 52 | Viewed by 15098

Abstract

Research has demonstrated that inequitable access to green space can relate to health disparities or inequalities. This commentary aims to shift the dialogue to initiatives that have integrated green spaces in projects that may promote health equity in the United States. Specifically, we [...] Read more.

Research has demonstrated that inequitable access to green space can relate to health disparities or inequalities. This commentary aims to shift the dialogue to initiatives that have integrated green spaces in projects that may promote health equity in the United States. Specifically, we connect this topic to factors such as community revitalization, affordable housing, neighborhood walkability, food security, job creation, and youth engagement. We provide a synopsis of locations and initiatives in different phases of development along with characteristics to support effectiveness and strategies to overcome challenges. The projects cover locations such as Atlanta (GA), Los Angeles (CA), the District of Columbia (Washington D.C.), South Bronx (NY), and Utica (NY). Such insight can develop our understanding of green space projects that support health equity and inform the dialogue on this topic in ways that advance research and advocacy. Full article

(This article belongs to the Special Issue Environmental Justice Research: Contemporary Issues and Emerging Topics)

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Open AccessArticle

The Tale of Asbestos in Sweden 1972–1986—The Pathway to a Near-Total Ban

by Peter Westerholm^1,*, Bertil Remaéus² and Magnus Svartengren¹

¹ Department of Medical Sciences—Occupational and Environmental Medicine, Uppsala University, 75185 Uppsala, Sweden

² Private Residence, Solängsvägen 28, 192 54 Sollentuna, Sweden

Int. J. Environ. Res. Public Health 2017, 14(11), 1433; https://doi.org/10.3390/ijerph14111433 - 22 Nov 2017

Cited by 8 | Viewed by 5319

Abstract

This paper provides a narrative of the national intervention strategy in Sweden aimed to restrict the industrial use of asbestos. For many years, asbestos was imported for widespread industrial use, resulting in large amounts throughout Swedish society. In 1972, the whistle was blown [...] Read more.

This paper provides a narrative of the national intervention strategy in Sweden aimed to restrict the industrial use of asbestos. For many years, asbestos was imported for widespread industrial use, resulting in large amounts throughout Swedish society. In 1972, the whistle was blown in a Communist Party parliamentary motion describing asbestos as a health hazard and requesting action to prohibit its use. Although the motion was rejected, it initiated the extensive charting of asbestos sources on a tripartite basis, involving government agencies, and employer and trade-union organizations. Restrictive asbestos management practices were enforced from July 1982. The year 1985 saw the Government Asbestos Commission review, covering use-determining factors, international regulations, and assessments of cancer risks. The relative risks of chrysotile and amphibole were considered internationally (by the IARC), since chrysotile (a Canadian export) was regarded as unharmful in Canada at that time. Prohibiting asbestos use resulted in its virtual disappearance as an import to Sweden from the early 1980s. However, asbestos has undergone a transition from an occupational to a public-health hazard (although some work-related hazards, such as handling and disposal, remain). The transition reflects the public’s exposure to existing stocks, in homes, workplaces, etc. Mesothelioma incidence has come to be regarded as an indicator of prevention effectiveness. Full article

(This article belongs to the Special Issue Global Panorama of National Experiences in Public Health Actions to Ban Asbestos)

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Open AccessArticle

The Associations among Psychological Distress, Coping Style, and Health Habits in Japanese Nursing Students: A Cross-Sectional Study

by Akio Tada

Department Faculty of Health Science, Hyogo University, 2301 Shinzaike Hiraoka-cho, Kakogawa, Hyogo 675-0195, Japan

Int. J. Environ. Res. Public Health 2017, 14(11), 1434; https://doi.org/10.3390/ijerph14111434 - 22 Nov 2017

Cited by 28 | Viewed by 5663

Abstract

Background: Nursing students in many countries have been reported to experience high levels of stress and psychological distress. Health habits could potentially mediate the association between coping styles and psychological status. The purpose of this study was to evaluate the mediation effect of [...] Read more.

Background: Nursing students in many countries have been reported to experience high levels of stress and psychological distress. Health habits could potentially mediate the association between coping styles and psychological status. The purpose of this study was to evaluate the mediation effect of health habits in the relationship between stress coping styles and psychological distress in Japanese nursing students. Methods: A total of 181 nursing students completed anonymous self-reported questionnaires comprised of the General Health Questionnaire-12 (GHQ-12), the Brief Coping Orientation questionnaire, and an additional questionnaire on health behavior. A mediation analysis using path analysis with bootstrapping was used for data analysis. Results: Multivariate linear regression analysis showed that psychological distress was significantly and positively associated with “Avoidance coping” (β = 0.39, p < 0.001), and was negatively associated with “Active coping” (β = −0.30, p < 0.001), “exercise habit” (β = −0.25, p = 0.001), and “sleeping” (β = −0.24, p = 0.002). In the path model, “Active coping” and “Avoidance coping” had significant or marginally significant associations with “exercise habits” (active: β = 0.19, p = 0.008, avoidance: β = −0.12, p = 0.088), and psychological distress (active: β = −0.25, p < 0.001, avoidance: β = 0.363, p < 0.001). However, these coping style variables did not have a significant association with “sleep”. In general, the size of the correlations was below 0.4. Conclusions: Exercise habits mediated the relationship between coping styles and psychological distress to a greater extent than sleep. The present study suggests the possibility that complex interactions between health habits and coping styles may influence the psychological status of nursing students. Full article

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Open AccessArticle

Integrated Evaluation of Coupling Coordination for Land Use Change and Ecological Security: A Case Study in Wuhan City of Hubei Province, China

by Ji Chai

, Zhanqi Wang^* and Hongwei Zhang

Department of Land Resource Management, School of Public Administration, China University of Geosciences (Wuhan), 388 Lumo Road, Hongshan District, Wuhan 430074, China

Int. J. Environ. Res. Public Health 2017, 14(11), 1435; https://doi.org/10.3390/ijerph14111435 - 22 Nov 2017

Cited by 40 | Viewed by 5020

Abstract

As land resources and ecosystems provide necessary materials and conditions for human development, land use change and ecological security play increasingly important roles in sustainable development. This study aims to reveal the mutual-influence and interaction between land use change and ecological security in [...] Read more.

As land resources and ecosystems provide necessary materials and conditions for human development, land use change and ecological security play increasingly important roles in sustainable development. This study aims to reveal the mutual-influence and interaction between land use change and ecological security in Wuhan, based on the coupling coordination degree model. As such, it provides strategies for the achievement of the synchronous and coordinated development of urbanization and ecological security. The results showed that, during the period from 2006 to 2012, the size of built-up area in Wuhan increased to 26.16%, and that all the other types of land use reduced due to the urbanization process, which appeared to be the main driving force of land use change. The ecological security in Wuhan has been improving as a whole although it was somewhat held back from 2006 to 2008 due to the rapid growth of built-up area. The coupling coordination analysis revealed that the relationship between built-up area and ecological security was more coordinated after 2008. The results can provide feasible recommendations for land use management and environmental protection from the viewpoint of coordinated development. To achieve sustainable development from economic and ecological perspective, policy makers should control the rate of urban expansion and exert more effort on intensive land use, clean energy development and emission reduction. Full article

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