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Int. J. Environ. Res. Public Health, Volume 15, Issue 12 (December 2018)

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Cover Story (view full-size image) The new WHO Recommendations for limiting adverse health impact of noise raise questions on how to [...] Read more.
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Open AccessArticle Hepatitis B Vaccination among 1999–2017 Birth Cohorts in Zhejiang Province: The Determinants Associated with Infant Coverage
Int. J. Environ. Res. Public Health 2018, 15(12), 2915; https://doi.org/10.3390/ijerph15122915
Received: 13 November 2018 / Revised: 16 December 2018 / Accepted: 17 December 2018 / Published: 19 December 2018
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Abstract
This study aimed to investigate the coverage of hepatitis B vaccine (Hep B) and its completeness and timeliness for birth cohorts from 1999 to 2017 in Zhejiang province, East China. Demographic characteristics and vaccination records of Hep B of children born from 1 [...] Read more.
This study aimed to investigate the coverage of hepatitis B vaccine (Hep B) and its completeness and timeliness for birth cohorts from 1999 to 2017 in Zhejiang province, East China. Demographic characteristics and vaccination records of Hep B of children born from 1 January 1999 to 31 June 2017 were extracted from the Zhejiang provincial immunization information system. The timeliness of the first dose of Hep B (Hep B1) was defined as the proportion of children who received the Hep B1 within 24 h after birth among the target population. The completeness of Hep B was defined as the proportion of children who completed the three-dose series of Hep B before 7 years of age. The demographic characteristics of the target population were described. The coverage of each dose of Hep B, the timeliness of Hep B1, and the completeness of Hep B for each birth cohort were described. A logistic regression model was applied to detect the determinants of the timeliness of Hep B1 and the completeness of Hep B vaccination. The coverage of Hep B1 increased from 90.3% to 98.3%, the coverage of Hep B2 increased from 88.8% to 96.1%, and the coverage of Hep B3 increased from 86.4% to 94.2%. The timeliness of Hep B1 increased from 80.3% to 91.3%. The completeness of Hep B increased from 81.3% to 91.5%. The determinants of timeliness of Hep B1 included children’s delivery place, immigration status, maternal education level, and economic development level of resident area. The determinants of completeness of Hep B included children’s delivery place, immigration status, maternal education level, economic development level of resident area, maternal occupation, and frequency of vaccination service. Zhejiang province had achieved significant improvements in the timely administration of Hep B1 and the completeness of Hep B. To accelerate progress toward additional reductions in the transmission of hepatitis B virus, further efforts need to be focused on improving the timeliness of Hep B1 vaccination and reducing the drop-outs among disadvantaged children with the risk factors identified in this study. Full article
Open AccessArticle Patient Satisfaction with Community Pharmacies Services: A Cross-Sectional Survey from Punjab; Pakistan
Int. J. Environ. Res. Public Health 2018, 15(12), 2914; https://doi.org/10.3390/ijerph15122914
Received: 2 October 2018 / Revised: 2 December 2018 / Accepted: 3 December 2018 / Published: 19 December 2018
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Abstract
Purpose: Patient satisfaction can identify specific areas of improvement in community pharmacy services. Currently in Pakistan, no evidence exists in this regard. This study was conducted to determine the needs of patients and the current standards of pharmacies. Methods: A cross-sectional [...] Read more.
Purpose: Patient satisfaction can identify specific areas of improvement in community pharmacy services. Currently in Pakistan, no evidence exists in this regard. This study was conducted to determine the needs of patients and the current standards of pharmacies. Methods: A cross-sectional study was conducted between October 2016 and June 2017. A pilot tested questionnaire was used to collected the data from 1088 patients of 544 community pharmacies. Likert scale and one way ANOVA was used to analyze the data. Results: The response rate of community pharmacies was 80% and that of purchasers was 68.1%. The mean age of participants was 35.2 years. The mean overall satisfaction score of participants was 2.78/5.00. Many patients were dissatisfied (1.65/5.00) with parking facilities provided by pharmacies. Pharmacy service time fulfilled the requirements of most patients (4.16/5.00). The counseling person’s good attitude (3.99/5.00) was credited by purchasers. Level of patient satisfaction with the availability of medicines (3.19/5.00), safe storage of medicines in pharmacy stores (3.66/5.00), and quality of medicines (3.41/5.00) were almost moderate. Many patients were very satisfied (4.35/5.00) with readable instructions for their medications. Approximately half of the patients were dissatisfied with the waiting time. Many patients were also dissatisfied (2.28/5.00) with the knowledge of the counseling person. Patients perceived that staff interest in patient recovery (2.24/5.00) was low. No significant difference in level of satisfaction with regard to participant’s characteristics was found. Conclusions: The current study demonstrated a low level of patient satisfaction with regard to community pharmacy services in Pakistan. These services need improvement. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessFeature PaperArticle Generalised Versus Specific Internet Use-Related Addiction Problems: A Mixed Methods Study on Internet, Gaming, and Social Networking Behaviours
Int. J. Environ. Res. Public Health 2018, 15(12), 2913; https://doi.org/10.3390/ijerph15122913
Received: 23 June 2018 / Revised: 23 November 2018 / Accepted: 24 November 2018 / Published: 19 December 2018
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Abstract
The field of technological behavioural addictions is moving towards specific problems (i.e., gaming disorder). However, more evidence of generalised versus specific Internet use-related addiction problems (generalised pathological Internet use (GPIU) vs. specific pathological Internet use (SPIU)) is still needed. This mixed methods study [...] Read more.
The field of technological behavioural addictions is moving towards specific problems (i.e., gaming disorder). However, more evidence of generalised versus specific Internet use-related addiction problems (generalised pathological Internet use (GPIU) vs. specific pathological Internet use (SPIU)) is still needed. This mixed methods study aimed to disentangle GPIU from SPIU. A partially mixed sequential equal status study design (QUAN→QUAL) was undertaken. First, through an online survey, which adapted the compulsive Internet use scale (CIUS) for three types of problems (i.e., generalised Internet use, and specific online gaming and social networking). Second, potential problem users’ perceptions of the evolution of these problems (aetiology, development, consequences, and factors) were ascertained, through semi-structured interviews, together with their opinion on present Internet gaming disorder (IGD) criteria adapted to each problem studied. Findings showed the CIUS remains valid and reliable for GPIU and SPIUs examined; a prevalence between 10.8% and 37.4% was estimated for potential at-risk problem gamers and Internet users, respectively, who reported their preference for maintaining their virtual lives. Half of the sample had a risk of a unique or mixed profile of these problems. Moreover, device patterns, gender, and age issues emerged, such as problem gamers being proportionally equal male and female young or middle-aged adults. GPIU was highly associated with problem social networking use, and weakly with problematic gaming, but both SPIUs were independent. Concerning addictive symptoms, salience, deception, and tolerance required redefinition, especially for SPIUs, while better-valued IGD criteria applied to GPIU and SPIUs were: Risk relationships or opportunities, give up other activities, withdrawal, and continue despite problems. Thus, although problems studied are present as risk behaviours, SPIUs seem to cover the addictive symptomatology in those categorised as potential problem users, online gaming being the most severe behavioural addiction problem. Full article
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Open AccessArticle Testing the Price of Healthy and Current Diets in Remote Aboriginal Communities to Improve Food Security: Development of the Aboriginal and Torres Strait Islander Healthy Diets ASAP (Australian Standardised Affordability and Pricing) Methods
Int. J. Environ. Res. Public Health 2018, 15(12), 2912; https://doi.org/10.3390/ijerph15122912
Received: 8 November 2018 / Revised: 6 December 2018 / Accepted: 18 December 2018 / Published: 19 December 2018
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Abstract
Aboriginal and Torres Strait Islander peoples suffer higher rates of food insecurity and diet-related disease than other Australians. However, assessment of food insecurity in specific population groups is sub-optimal, as in many developed countries. This study tailors the Healthy Diets ASAP (Australian Standardised [...] Read more.
Aboriginal and Torres Strait Islander peoples suffer higher rates of food insecurity and diet-related disease than other Australians. However, assessment of food insecurity in specific population groups is sub-optimal, as in many developed countries. This study tailors the Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol to be more relevant to Indigenous groups in assessing one important component of food security. The resultant Aboriginal and Torres Strait Islander Healthy Diets ASAP methods were used to assess the price, price differential, and affordability of healthy (recommended) and current (unhealthy) diets in five remote Aboriginal communities. The results show that the tailored approach is more sensitive than the original protocol in revealing the high degree of food insecurity in these communities, where the current diet costs nearly 50% of disposable household income compared to the international benchmark of 30%. Sixty-two percent of the current food budget appears to be spent on discretionary foods and drinks. Aided by community store pricing policies, healthy (recommended) diets are around 20% more affordable than current diets in these communities, but at 38.7% of disposable household income still unaffordable for most households. Further studies in urban communities, and on other socioeconomic, political and commercial determinants of food security in Aboriginal and Torres Strait Islander communities appear warranted. The development of the tailored method provides an example of how national tools can be adapted to better inform policy actions to improve food security and help reduce rates of diet-related chronic disease more equitably in developed countries. Full article
(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)
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Open AccessArticle Challenging Cognitive Demands at Work, Related Working Conditions, and Employee Well-Being
Int. J. Environ. Res. Public Health 2018, 15(12), 2911; https://doi.org/10.3390/ijerph15122911
Received: 8 October 2018 / Revised: 9 December 2018 / Accepted: 11 December 2018 / Published: 19 December 2018
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Abstract
In times of digitalized workplaces the extent of challenging cognitive demands at work is rising and employees increasingly have to manage new and unlearned tasks. Yet, these work characteristics have received little attention on how they relate to the worker’s well-being. Thus, we [...] Read more.
In times of digitalized workplaces the extent of challenging cognitive demands at work is rising and employees increasingly have to manage new and unlearned tasks. Yet, these work characteristics have received little attention on how they relate to the worker’s well-being. Thus, we analyze associations between cognitive work demands—also in interaction with other job characteristics—and indicators of employee well-being. The analyses are based on the BIBB/BAuA Employment Survey 2018, a cross-section that is representative for the German working population and covers approximately 20,000 employed individuals. Ordinary least squares (OLS) regressions suggest that cognitive demands are associated with a higher probability of feeling fatigued. In contrast, the results with respect to the employees’ self-rated health status and job satisfaction are ambiguous, depending on which cognitive demand is considered. Overall, the findings indicate that cognitive demands might be related to both resource and demand, depending on the individual resources of employees. Full article
(This article belongs to the Special Issue Using Total Worker Health to Advance Worker Health and Safety)
Open AccessArticle Spatiotemporal Characteristics of Ecological Conditions and Its Response to Natural Conditions and Human Activities during 1990–2010 in the Yangtze River Delta, China
Int. J. Environ. Res. Public Health 2018, 15(12), 2910; https://doi.org/10.3390/ijerph15122910
Received: 25 September 2018 / Revised: 11 November 2018 / Accepted: 14 December 2018 / Published: 19 December 2018
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Abstract
The Yangtze River Delta (YRD) region, including Shanghai City and the Jiangsu and Zhejiang Provinces, is the largest metropolitan region in China. In the past three decades, the region has experienced an unprecedented process of rapid and massive urbanization, which has dramatically altered [...] Read more.
The Yangtze River Delta (YRD) region, including Shanghai City and the Jiangsu and Zhejiang Provinces, is the largest metropolitan region in China. In the past three decades, the region has experienced an unprecedented process of rapid and massive urbanization, which has dramatically altered the landscape and detrimentally affected the ecological environments in the region. In this paper, we analyzed the spatiotemporal variations of ecological conditions (Eco_C) via a synthetic index with analytic hierarchy processes in the YRD during 1990–2010. The relative contributions of influencing factors, including two natural conditions (i.e., elevation (Elev) and land-sea gradient (Dis_coa)), three indicators of human activities (i.e., urbanization rate (Urb_rate), per capita GDP (Per_gdp), the percentage of secondary and tertiary industry employment (Per_ind)), to the total variance of regional Eco_C were also investigated. The results showed that: (1) The Eco_C over YRD region was “Moderately High”, which was better than the national average and demonstrated obvious spatial variations between south and north. There existed fluctuations and an overall increasing trend for Eco_C during the study period, with 20% of the area being deteriorated and 40% being improved. (2) The areas with elevation below 10 m was relatively poor in Eco_C, while the regions above 1000 m showed the best Eco_C and had the most obvious changes (9.33%) during the study period. (3) The selected five influencing factors could explain 91.0–94.4% of the Eco_C spatial variability. Elevation was the dominant factor for about 42.4–52.9%, while urbanization rate and per capita GDP were about 32.5% and 9.3%. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Healthy Nutrition and Physical Activity in Childcare: Views from Childcare Managers, Childcare Workers and Parents on Influential Factors
Int. J. Environ. Res. Public Health 2018, 15(12), 2909; https://doi.org/10.3390/ijerph15122909
Received: 20 November 2018 / Revised: 14 December 2018 / Accepted: 17 December 2018 / Published: 19 December 2018
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Abstract
Childhood obesity is an important public health issue influenced by both personal and environmental factors. The childcare setting plays an important role in children’s energy balance-related behaviours (EBRB), such as physical activity, sedentary behaviour and healthy nutrition. This study aimed to explore facilitators [...] Read more.
Childhood obesity is an important public health issue influenced by both personal and environmental factors. The childcare setting plays an important role in children’s energy balance-related behaviours (EBRB), such as physical activity, sedentary behaviour and healthy nutrition. This study aimed to explore facilitators and barriers of healthy EBRB in childcare in a comprehensive way, from the perspective of three crucial stakeholders: childcare managers, childcare workers and parents. A qualitative study was performed using semi-structured interviews. Content analysis was performed using the ‘Environmental Research framework for weight Gain prevention’ (EnRG framework) to guide the analysis. Forty-eight interviews were held with a total of 65 participants (9 childcare managers, 23 childcare workers and 33 parents). Influential factors in all types of environment (physical, sociocultural, economic and political) were mentioned. Although a need for change was not always expressed, the interviews revealed opportunities for improvement of healthy EBRB in childcare. These opportunities were related to the sociocultural, physical and political environment. Childcare workers and managers expressed an influence of the home setting on the childcare setting, resulting in a need for more congruence between these settings. There are opportunities for improvement in the childcare setting to promote healthy EBRB in young children in the Netherlands. It appears important to align intervention components between the childcare and home setting. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Health-Promoting Food Pricing Policies and Decision-Making in Very Remote Aboriginal and Torres Strait Islander Community Stores in Australia
Int. J. Environ. Res. Public Health 2018, 15(12), 2908; https://doi.org/10.3390/ijerph15122908
Received: 8 November 2018 / Revised: 10 December 2018 / Accepted: 14 December 2018 / Published: 19 December 2018
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Abstract
Aboriginal and Torres Strait Islander people living in remote communities in Australia experience a disproportionate burden of diet-related chronic disease. This occurs in an environment where the cost of store-purchased food is high and cash incomes are low, factors that affect both food [...] Read more.
Aboriginal and Torres Strait Islander people living in remote communities in Australia experience a disproportionate burden of diet-related chronic disease. This occurs in an environment where the cost of store-purchased food is high and cash incomes are low, factors that affect both food insecurity and health outcomes. Aboriginal and Torres Strait Islander storeowners and the retailers who work with them implement local policies with the aim of improving food affordability and health outcomes. This paper describes health-promoting food pricing policies, their alignment with evidence, and the decision-making processes entailed in their development in community stores across very remote Australia. Semi-structured interviews were conducted with a purposive sample of retailers and health professionals identified through the snowball method, September 2015 to October 2016. Data were complemented through review of documents describing food pricing policies. A content analysis of the types and design of policies was undertaken, while the decision-making process was considered through a deductive, thematic analysis. Fifteen retailers and 32 health professionals providing services to stores participated. Subsidies and subsidy/price increase combinations dominated. Magnitude of price changes ranged from 5% to 25% on fruit, vegetables, bottled water, artificially sweetened and sugar sweetened carbonated beverages, and broadly used ‘healthy/essential’ and ‘unhealthy’ food classifications. Feasibility and sustainability were considered during policy development. Greater consideration of acceptability, importance, effectiveness and unintended consequences of policies guided by evidence were deemed important, as were increased involvement of Aboriginal and Torres Strait Islander storeowners and nutritionists in policy development. A range of locally developed health-promoting food pricing policies exist and partially align with research-evidence. The decision-making processes identified offer an opportunity to incorporate evidence, based on consideration of the local context. Full article
(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)
Open AccessArticle Correlation Analysis to Identify the Effective Data in Machine Learning: Prediction of Depressive Disorder and Emotion States
Int. J. Environ. Res. Public Health 2018, 15(12), 2907; https://doi.org/10.3390/ijerph15122907
Received: 31 October 2018 / Revised: 6 December 2018 / Accepted: 14 December 2018 / Published: 19 December 2018
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Abstract
Correlation analysis is an extensively used technique that identifies interesting relationships in data. These relationships help us realize the relevance of attributes with respect to the target class to be predicted. This study has exploited correlation analysis and machine learning-based approaches to identify [...] Read more.
Correlation analysis is an extensively used technique that identifies interesting relationships in data. These relationships help us realize the relevance of attributes with respect to the target class to be predicted. This study has exploited correlation analysis and machine learning-based approaches to identify relevant attributes in the dataset which have a significant impact on classifying a patient’s mental health status. For mental health situations, correlation analysis has been performed in Weka, which involves a dataset of depressive disorder symptoms and situations based on weather conditions, as well as emotion classification based on physiological sensor readings. Pearson’s product moment correlation and other different classification algorithms have been utilized for this analysis. The results show interesting correlations in weather attributes for bipolar patients, as well as in features extracted from physiological data for emotional states. Full article
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Open AccessCommentary Analyzing Policies Through a DOHaD Lens: What Can We Learn?
Int. J. Environ. Res. Public Health 2018, 15(12), 2906; https://doi.org/10.3390/ijerph15122906
Received: 16 November 2018 / Revised: 14 December 2018 / Accepted: 17 December 2018 / Published: 19 December 2018
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Abstract
Social, health, and environmental policies are critical tools for providing the conditions needed for healthy populations. However, current policy analyses fall short of capturing their full potential impacts across the life course and from generation to generation. We argue that the field of [...] Read more.
Social, health, and environmental policies are critical tools for providing the conditions needed for healthy populations. However, current policy analyses fall short of capturing their full potential impacts across the life course and from generation to generation. We argue that the field of Developmental Origins of Health and Disease (DOHaD), a conceptual and research framework positing that early life experiences significantly affect health trajectories across the lifespan and into future generations, provides an important lens through which to analyze social policies. To illustrate this point, we synthesized evidence related to policies from three domains—family leave, nutrition, and housing—to examine the health implications for multiple generations. We selected these policy domains because they represent increasing distance from a reproductive health focus, each with a growing evidence base to support a potential impact on pregnant women and their offspring. Each of these examples represents an opportunity to extend our understanding of policy impact using a DOHaD lens, taking into account the potential life course and intergenerational effects that have previously been overlooked. Full article
(This article belongs to the Special Issue Developmental Origins of Health and Disease)
Open AccessArticle Changes in Smoking Behaviors following Exposure to Health Shocks in China
Int. J. Environ. Res. Public Health 2018, 15(12), 2905; https://doi.org/10.3390/ijerph15122905
Received: 9 November 2018 / Revised: 12 December 2018 / Accepted: 14 December 2018 / Published: 19 December 2018
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Abstract
Background: Evidence suggests that following major individual health shocks, smokers change their smoking behaviors. However, little is known about the association between spousal health shocks and smoking. This study examined the contemporaneous and long-term effects of individual and spousal health shocks on [...] Read more.
Background: Evidence suggests that following major individual health shocks, smokers change their smoking behaviors. However, little is known about the association between spousal health shocks and smoking. This study examined the contemporaneous and long-term effects of individual and spousal health shocks on males’ smoking behaviors in China. Methods: This study employed a nation-wide data base from the 1991–2011 China Health and Nutrition Study. Random effects models were estimated to ascertain the impacts of health shocks on males’ smoking behavior. Smoking behaviors were measured by smoking status, smoking consumption and smoking cessation. Results: In the short term, respondents who incurred health shocks decreased their likelihood of smoking by 10%. In addition, health shocks decreased the likelihood of heavy smoking versus the combined moderate and light categories by 41.6%, and increased their likelihood of quitting by 85.3% for ever smokers. Spousal health shocks had no significant effects on individual smoking behaviors. The long-term effects were similar to the short term impacts. Conclusions: People changed their smoking behaviors in response to their own health experiences but not those of their spouses. Antismoking messages about the health effects on others are unlikely to influence individual smoking behaviors, unless individuals believed that they are personally vulnerable to smoking-related diseases. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Social, Environmental and Behavioral Determinants of Asthma Symptoms in Brazilian Middle School Students—A National School Health Survey (Pense 2012)
Int. J. Environ. Res. Public Health 2018, 15(12), 2904; https://doi.org/10.3390/ijerph15122904
Received: 8 October 2018 / Revised: 30 November 2018 / Accepted: 3 December 2018 / Published: 19 December 2018
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Abstract
Biological and psychosocial factors are recognized contributors to the worldwide burden of asthma. However, the relationship between psychosocial factors and asthma symptoms among students in low- and middle-income countries remains underexplored. We aimed to identify socioeconomic, environmental, psychosocial, family-related and lifestyle factors associated [...] Read more.
Biological and psychosocial factors are recognized contributors to the worldwide burden of asthma. However, the relationship between psychosocial factors and asthma symptoms among students in low- and middle-income countries remains underexplored. We aimed to identify socioeconomic, environmental, psychosocial, family-related and lifestyle factors associated with the self-reporting of asthma symptoms in Brazilian adolescents. This is a cross-sectional study using data from the 2012 PeNSE survey (n = 109,104). We analyzed the following variables: socioeconomic conditions, demographic characteristics, lifestyle, family context and dynamics, psychosocial indicators, smoking, and exposure to violence. Our outcome variable was the self-report of asthma symptoms in the past 12 months. The prevalence of wheezing was 22.7% (21.5–23.9). After adjusting for sex, age and the variables from higher hierarchical levels, exposure to violence (feeling unsafe at school, being frequently bullied, being exposed to fights with firearms) and physical aggression by an adult in the family were the environmental factors that showed the strongest associations with self-reporting of asthma symptoms. For psychosocial indicators of mental health and social integration, feelings of loneliness and sleeping problems were the strongest factors, and among individual behavioral factors, the largest associations were found for tobacco consumption. Our findings were consistent with previous studies, showing an association between self-reported asthma symptoms and socio-economic status, family context and dynamics, psychosocial indicators of mental health, exposure to violence and social integration, as well as a sedentary lifestyle and tobacco use. Full article
(This article belongs to the Special Issue Asthma Risk and Prevention)
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Open AccessArticle The Mediating Roles of Happiness and Cohesion in the Relationship between Employee Volunteerism and Job Performance
Int. J. Environ. Res. Public Health 2018, 15(12), 2903; https://doi.org/10.3390/ijerph15122903
Received: 15 November 2018 / Revised: 8 December 2018 / Accepted: 10 December 2018 / Published: 18 December 2018
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Abstract
This study investigated the mediating effects of happiness and cohesion in the relationship between employee volunteerism, in-role behavior, and helping behavior. The study surveyed 312 full-time employees in South Korea, and regression analyses and the bootstrapping method were used to test the hypotheses. [...] Read more.
This study investigated the mediating effects of happiness and cohesion in the relationship between employee volunteerism, in-role behavior, and helping behavior. The study surveyed 312 full-time employees in South Korea, and regression analyses and the bootstrapping method were used to test the hypotheses. The study found happiness and cohesion to mediate the relationships between employee volunteerism and in-role and helping behavior. The findings suggest that employee volunteerism can promote a healthy working environment through increased feelings of happiness and cohesion as well as by improving performance behaviors. Full article
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Open AccessArticle IQOSTM vs. e-Cigarette vs. Tobacco Cigarette: A Direct Comparison of Short-Term Effects after Overnight-Abstinence
Int. J. Environ. Res. Public Health 2018, 15(12), 2902; https://doi.org/10.3390/ijerph15122902
Received: 13 November 2018 / Revised: 14 December 2018 / Accepted: 14 December 2018 / Published: 18 December 2018
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Abstract
Introduction: Research from Philip Morris International’s science division on its Heat-not-Burn product IQOSTM focused on its chemical, toxicological, clinical, and behavioral aspects. Independent research on the experiences and behavioral aspects of using IQOSTM, and how it compares to e-cigarettes, [...] Read more.
Introduction: Research from Philip Morris International’s science division on its Heat-not-Burn product IQOSTM focused on its chemical, toxicological, clinical, and behavioral aspects. Independent research on the experiences and behavioral aspects of using IQOSTM, and how it compares to e-cigarettes, is largely lacking. The current randomized, cross-over behavioral trial tried to bridge the latter gaps. Methods: Participants (n = 30) came to the lab on three consecutive days after being overnight smoking abstinent. During each session, participants used one of three products (cigarette, e-cigarette, or IQOSTM) for five minutes. Exhaled CO (eCO) measurements and questionnaires were repeatedly administered throughout the session. Results: Smoking a cigarette for five minutes resulted in a significant increase of eCO, whereas using an IQOSTM resulted in a small but reliable increase (0.3 ppm). Vaping did not affect eCO. Cigarette craving reduced significantly after product use, with the decline being stronger for smoking than for e-cigarettes or IQOSTM. Withdrawal symptoms declined immediately after smoking or using IQOSTM, and with some delay after vaping. IQOSTM scored higher in terms of subjective reward/satisfaction and was slightly preferred to the e-cigarette. Discussion: Short-term use of IQOSTM has a minimal impact on eCO, is equally effective in reducing cigarette craving and withdrawal symptoms as an e-cigarette, and is slightly preferred. Full article
(This article belongs to the Special Issue Smoking Cessation)
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Open AccessArticle Unmet Needs and Use of Assistive Products in Two Districts of Bangladesh: Findings from a Household Survey
Int. J. Environ. Res. Public Health 2018, 15(12), 2901; https://doi.org/10.3390/ijerph15122901
Received: 21 September 2018 / Revised: 13 December 2018 / Accepted: 14 December 2018 / Published: 18 December 2018
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Abstract
Access to assistive products (AP) is an under-researched public health issue. Using an adaptation of a draft World Health Organization tool—the ‘Assistive Technology Assessment—Needs (ATA-N)’ for measuring unmet needs and use of AP, we aimed to understand characteristics of AP users, self-reported needs [...] Read more.
Access to assistive products (AP) is an under-researched public health issue. Using an adaptation of a draft World Health Organization tool—the ‘Assistive Technology Assessment—Needs (ATA-N)’ for measuring unmet needs and use of AP, we aimed to understand characteristics of AP users, self-reported needs and unmet needs for AP, and current access patterns in Bangladesh. The ATA-N was incorporated in a Rapid Assessment of Disability (RAD), a population-based survey to estimate prevalence and correlates of disability. In each of two unions of Kurigram and Narsingdi districts, 60 clusters of 50 people each aged two years and older were selected using a two-staged cluster random sampling process, of whom, 4250 (59% Female; 41% Male) were adults, including 333 using AP. We estimate 7.1% of the studied population used any AP. AP use is positively associated with age and self-reported functional difficulty. The proportion of people using AP is higher for mobility than for sensory and cognitive difficulties. Of all people with any functional difficulty, 71% self-reported an unmet need for AP. Most products were home or self-made, at low cost, but provided benefits. Needs and unmet needs for AP are high, especially for people with greater functional difficulties. Assessing unmet needs for AP revealed important barriers to scale that can inform policy and practice. Full article
(This article belongs to the Special Issue Disability and Global Health)
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Open AccessArticle Aging in Flood-Prone Coastal Areas: Discerning the Health and Well-Being Risk for Older Residents
Int. J. Environ. Res. Public Health 2018, 15(12), 2900; https://doi.org/10.3390/ijerph15122900
Received: 2 November 2018 / Revised: 6 December 2018 / Accepted: 10 December 2018 / Published: 18 December 2018
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Abstract
Coastal communities are increasingly exposed to more intense and frequent hurricanes, accelerated sea-level rise, and prolonged tidal inundation, yet they are often a preferred retirement destination for older adults vulnerable to flooding and extreme weather events. The unique physical and psychosocial challenges of [...] Read more.
Coastal communities are increasingly exposed to more intense and frequent hurricanes, accelerated sea-level rise, and prolonged tidal inundation, yet they are often a preferred retirement destination for older adults vulnerable to flooding and extreme weather events. The unique physical and psychosocial challenges of older population age 65 and over may affect their level of preparedness, capacity to cope with, and ability to respond and recover from a hazard event. Despite the clear vulnerabilities of older residents living in high-risk areas when compared to younger coastal populations, there is a lack of empirical research on the integrated flood risks to this population group in the coastal context. This paper provides a holistic assessment of this emerging problem along the U.S. East Coast by measuring the exposure of older population to sea level rise and storm surge in coastal counties. It further evaluates how age-related vulnerabilities differ between rural and urban settings using the case study approach and geospatial and statistical analysis the paper also conducts a review of scientific literature to identify gaps in the current understanding of health and well-being risks to aging populations in coastal communities. The results show that older populations are unevenly distributed along the U.S. East Coast with some states and counties having significantly higher percent of residents age 65 and older living along the shoreline. Many places with larger older populations have other attributes that further shape the vulnerability of this age group such as older housing stock, disabilities, and lower income and that often differ between rural and urban settings. Lastly, our study found that vast majority of research on aging in high-risk coastal locations has been conducted in relation to major disasters and almost none on the recurrent nuisance flooding that is already affecting many coastal communities. Full article
(This article belongs to the Special Issue Extreme Weather Events and Health)
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Open AccessArticle Sistas Taking a Stand for Breast Cancer Research (STAR) Study: A Community-Based Participatory Genetic Research Study to Enhance Participation and Breast Cancer Equity among African American Women in Memphis, TN
Int. J. Environ. Res. Public Health 2018, 15(12), 2899; https://doi.org/10.3390/ijerph15122899
Received: 22 November 2018 / Revised: 11 December 2018 / Accepted: 14 December 2018 / Published: 18 December 2018
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Abstract
African American women are substantially underrepresented in breast cancer genetic research studies and clinical trials, yet they are more likely to die from breast cancer. Lack of trust in the medical community is a major barrier preventing the successful recruitment of African Americans [...] Read more.
African American women are substantially underrepresented in breast cancer genetic research studies and clinical trials, yet they are more likely to die from breast cancer. Lack of trust in the medical community is a major barrier preventing the successful recruitment of African Americans into research studies. When considering the city of Memphis, TN, where the percentage of African Americans is significantly higher than the national average and it has a high rate of breast cancer mortality inequities among African American women, we evaluated the feasibility of utilizing a community-based participatory (CBPR) approach for recruiting African American women into a breast cancer genetic study, called the Sistas Taking A Stand for Breast Cancer Research (STAR) study. From June 2016 and December 2017, African American women age 18 and above were recruited to provide a 2 mL saliva specimen and complete a health questionnaire. A total of 364 African American women provided a saliva sample and completed the health questionnaire. Greater than 85% agreed to be contacted for future studies. Educational workshops on the importance of participating in cancer genetic research studies, followed by question and answer sessions, were most successful in recruitment. Overall, the participants expressed a strong interest and a willingness to participate in the STAR study. Our findings highlight the importance of implementing a CBPR approach that provides an educational component detailing the importance of participating in cancer genetic research studies and that includes prominent community advocates to build trust within the community. Full article
(This article belongs to the Special Issue Health Care Equity)
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Open AccessArticle Analysis of Anxiety, Depression and Aggression in Patients Attending Pain Clinics
Int. J. Environ. Res. Public Health 2018, 15(12), 2898; https://doi.org/10.3390/ijerph15122898
Received: 25 November 2018 / Revised: 15 December 2018 / Accepted: 16 December 2018 / Published: 18 December 2018
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Abstract
The aim of the study was to measure the frequency of such emotional disturbances as anxiety, depression and aggression among patients treated in a pain clinic, as well as assess the factors contributing to such disorders. Research was conducted from January 2014 to [...] Read more.
The aim of the study was to measure the frequency of such emotional disturbances as anxiety, depression and aggression among patients treated in a pain clinic, as well as assess the factors contributing to such disorders. Research was conducted from January 2014 to April 2018 and involved patients treated in two pain clinics in the city of Warsaw, Poland. The study used the Hospital Anxiety and Depression Scale—Modified Version (HADS-M) and the Numerical Rating Scale (NSR). 1025 patients were recruited. The main reasons for their attending the pain clinic were osteoarticular pain (43.61%) and neuropathic pain (41.56%). Emotional disturbances in the form of anxiety were diagnosed in 32.39% of all the patients, depression in 17.85%, and aggression in 46.15%. The factors determining the level of anxiety in the study group were: sex, age, pain intensity and the lack of pharmacological treatment. Depression was determined by sex, pain intensity and the time of treatment in the clinic, while aggression by age and pain intensity. Full article
Open AccessEditorial Emerging Issues in Occupational Safety and Health
Int. J. Environ. Res. Public Health 2018, 15(12), 2897; https://doi.org/10.3390/ijerph15122897
Received: 12 December 2018 / Accepted: 14 December 2018 / Published: 18 December 2018
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Abstract
Working environments have various risks, which result in accidents and casualties. [...] Full article
(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)
Open AccessArticle Undeserving, Disadvantaged, Disregarded: Three Viewpoints of Charity Food Aid Recipients in Finland
Int. J. Environ. Res. Public Health 2018, 15(12), 2896; https://doi.org/10.3390/ijerph15122896
Received: 30 October 2018 / Revised: 3 December 2018 / Accepted: 13 December 2018 / Published: 17 December 2018
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Abstract
Since the economic recession of the 1990s, Finland has experienced the proliferation of charity food aid as a means of helping people who are afflicted by poverty. However, so far little research has been conducted regarding the food aid recipients. This article gives [...] Read more.
Since the economic recession of the 1990s, Finland has experienced the proliferation of charity food aid as a means of helping people who are afflicted by poverty. However, so far little research has been conducted regarding the food aid recipients. This article gives discursive, demographic, and experiential insights into charity food provision and reception in Finland. Drawing on quantitative survey data, online discussion data related to news published on Finnish newspapers’ web pages, and observation and interviews with food aid recipients, this article sheds new light on Finnish food aid recipients from three perspectives. First, public perceptions about food aid often portray food recipients as dishonourable and responsible for their own poverty. Secondly, the survey data shows that the main reason for people resorting to charity food aid is deep economic disadvantage, and further, that there is an unequal accumulation of disadvantage among the food aid recipients, illustrating internal diversity. Third, observational and interview data show that from the food recipients’ perspective, the food aid system has only a limited ability to answer even their immediate food needs, and for the recipients, food aid venues can become not only socially significant, but also socially demanding and emotionally burdening places. Full article
(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)
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Open AccessArticle The Public Health Responsibility Deal: Using a Systems-Level Analysis to Understand the Lack of Impact on Alcohol, Food, Physical Activity, and Workplace Health Sub-Systems
Int. J. Environ. Res. Public Health 2018, 15(12), 2895; https://doi.org/10.3390/ijerph15122895
Received: 11 October 2018 / Revised: 3 December 2018 / Accepted: 5 December 2018 / Published: 17 December 2018
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Abstract
The extent to which government should partner with business interests such as the alcohol, food, and other industries in order to improve public health is a subject of ongoing debate. A common approach involves developing voluntary agreements with industry or allowing them to [...] Read more.
The extent to which government should partner with business interests such as the alcohol, food, and other industries in order to improve public health is a subject of ongoing debate. A common approach involves developing voluntary agreements with industry or allowing them to self-regulate. In England, the most recent example of this was the Public Health Responsibility Deal (RD), a public–private partnership launched in 2011 under the then Conservative-led coalition government. The RD was organised around a series of voluntary agreements that aim to bring together government, academic experts, and commercial, public sector and voluntary organisations to commit to pledges to undertake actions of public health benefit. This paper brings together the main findings and implications of the evaluation of the RD using a systems approach. We analysed the functioning of the RD exploring the causal pathways involved and how they helped or hindered the RD; the structures and processes; feedback loops and how they might have constrained or potentiated the effects of the RD; and how resilient the wider systems were to change (i.e., the alcohol, food, and other systems interacted with). Both the production and uptake of pledges by RD partners were largely driven by the interests of partners themselves, enabling these wider systems to resist change. This analysis demonstrates how and why the RD did not meet its objectives. The findings have lessons for the development of effective alcohol, food and other policies, for defining the role of unhealthy commodity industries, and for understanding the limits of industry self-regulation as a public health measure. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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Open AccessArticle The Role of Job Demands–Resources (JDR) between Service Workers’ Emotional Labor and Burnout: New Directions for Labor Policy at Local Government
Int. J. Environ. Res. Public Health 2018, 15(12), 2894; https://doi.org/10.3390/ijerph15122894
Received: 12 October 2018 / Revised: 1 December 2018 / Accepted: 12 December 2018 / Published: 17 December 2018
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Abstract
Recently, research on service workers’ emotional labor has received considerable attention, both in theory and practice. Emotional labor has been reported to cause both stress and burnout in service workers, eventually leading to a decrease in organizational productivity. In this context, there is [...] Read more.
Recently, research on service workers’ emotional labor has received considerable attention, both in theory and practice. Emotional labor has been reported to cause both stress and burnout in service workers, eventually leading to a decrease in organizational productivity. In this context, there is also a growing interest in identifying ways to reduce such burnout. This study aimed to examine the influence of emotional labor and job demands–resources (JD–R) on service workers’ burnout. Specifically, we analyzed the direct, indirect, and moderating effects of JD–R on burnout. Data were collected from service workers (N = 1517) in public sectors. Results revealed that three dimensions—emotional labor, intensity/variety, and surface acting—increase burnout, whereas deep acting decreases it. Additionally, job demands were found to increase burnout, while job resources decreased it. Among the job demands, customer contact had the greatest positive impact on burnout, followed by role ambiguity and workload, respectively. Among the job resources, self-efficacy and social support had the greatest negative impact on burnout. Finally, customer contact, role ambiguity, job autonomy, and social support were identified as moderators that worsened or buffered the impact of emotional labor on burnout. Full article
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Open AccessArticle Comorbidity of Symptoms of Alcohol and Cannabis Use Disorders among a Population-Based Sample of Simultaneous Users. Insight from a Network Perspective
Int. J. Environ. Res. Public Health 2018, 15(12), 2893; https://doi.org/10.3390/ijerph15122893
Received: 2 October 2018 / Revised: 11 December 2018 / Accepted: 12 December 2018 / Published: 17 December 2018
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Abstract
Research into comorbidity of alcohol and cannabis use disorders has resulted in inconsistent findings, especially among simultaneous users, who used alcohol and cannabis together on a single occasion. This study investigated the association of alcohol and cannabis use disorders among simultaneous users using [...] Read more.
Research into comorbidity of alcohol and cannabis use disorders has resulted in inconsistent findings, especially among simultaneous users, who used alcohol and cannabis together on a single occasion. This study investigated the association of alcohol and cannabis use disorders among simultaneous users using a network perspective, which considers direct relationships between symptoms. We used a subset of simultaneous alcohol and cannabis users driven from the representative population-based sample of young Swiss men cohort study on substance use risk factors (C-SURF) (n = 1559 at baseline and n = 991 at follow-up). Self-reported symptoms of alcohol and cannabis use disorders were collected. Network analyses included network estimation, visualization, and community detection tests. Alcohol and cannabis use symptoms were separated in two distinct clusters, with few paths between them (eleven positive edges at baseline, three at follow-up). Withdrawal symptoms were likely to connect the two disorders at baseline, but not at follow-up. Alcohol and cannabis use disorders appeared as separate disorders among simultaneous users. Our findings mitigated previous findings on the detrimental association between alcohol and cannabis use. Future studies should incorporate network analyses as a means to study comorbidity in other community and clinical samples to confirm our preliminary findings. Full article
(This article belongs to the Special Issue Dual Disorder Patients: Clinical and Therapeutical Aspects)
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Open AccessArticle Relationship between Ventilator-Associated Events and Timing of Rehabilitation in Subjects with Emergency Tracheal Intubation at Early Mobilization Facility
Int. J. Environ. Res. Public Health 2018, 15(12), 2892; https://doi.org/10.3390/ijerph15122892
Received: 7 November 2018 / Revised: 12 December 2018 / Accepted: 14 December 2018 / Published: 17 December 2018
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Abstract
The present study aimed to investigate the relationship between the occurrence of ventilator-associated events (VAE) in the intensive care unit and the timing of rehabilitation intervention. We included subjects who underwent emergency tracheal intubation and received rehabilitation. We performed rehabilitation according to our [...] Read more.
The present study aimed to investigate the relationship between the occurrence of ventilator-associated events (VAE) in the intensive care unit and the timing of rehabilitation intervention. We included subjects who underwent emergency tracheal intubation and received rehabilitation. We performed rehabilitation according to our hospital’s protocol. We assessed the mechanical ventilation parameters of inspired oxygen fraction and positive-end expiratory pressure, and a VAE was identified if these parameters stabilized or decreased for ≥2 days and then had to be increased for ≥2 days. We defined time in hours from tracheal intubation to the first rehabilitation intervention as Timing 1 and that to first sitting on the edge of the bed as Timing 2. Data were analyzed by the t-test and χ2 tests. We finally analyzed 294 subjects. VAE occurred in 9.9% and high mortality at 48.3%. Median values of Timing 1 and Timing 2 in the non-VAE and VAE groups were 30.3 ± 24.0 and 30.0 ± 20.7 h, and 125.7 ± 136.6 and 127.9 ± 111.4 h, respectively, and the differences were not significant (p = 0.95 and p = 0.93, respectively). We found no significant relationship between the occurrence of VAE leading to high mortality and timing of rehabilitation intervention. Full article
(This article belongs to the Special Issue Advances in Big Data Analytics and Intelligence)
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Open AccessArticle Household Air Pollution, Levels of Micronutrients and Heavy Metals in Cord and Maternal Blood, and Pregnancy Outcomes
Int. J. Environ. Res. Public Health 2018, 15(12), 2891; https://doi.org/10.3390/ijerph15122891
Received: 27 October 2018 / Revised: 3 December 2018 / Accepted: 4 December 2018 / Published: 17 December 2018
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Abstract
Cooking with kerosene emits toxic pollutants that may impact pregnancy outcomes. Sixty-eight women in their first trimester of pregnancy, kerosene users (n = 42) and liquefied natural gas (LNG) users (n = 26), were followed until birth. Maternal and cord blood [...] Read more.
Cooking with kerosene emits toxic pollutants that may impact pregnancy outcomes. Sixty-eight women in their first trimester of pregnancy, kerosene users (n = 42) and liquefied natural gas (LNG) users (n = 26), were followed until birth. Maternal and cord blood were collected immediately after birth. Levels of micronutrients and heavy metals were quantified. Pregnancy outcomes (gestation age (GA), birth weight (BW), and chest and head circumference) were also measured. Mean (± standard deviation (SD)) age of mothers in kerosene and LNG groups were similar (p = 0.734). Mean (±SD) BW of newborns of LNG users was significantly higher compared to newborns of kerosene users (3.43 ± 0.32 vs. 3.02 ± 0.43, p < 0.001). Mean GA (in weeks) was similar between the two groups (p = 0.532). Women in the kerosene group had significantly higher cord blood levels of zinc, lead, mercury, iodine and vitamin B6 and lower levels of folic acid compared to LNG users (p < 0.05). Newborns of kerosene users had reduced levels of zinc, lead, mercury, iodine, vitamins B6 and B12, folic acid, and homocysteine compared with LNG users (p < 0.05). Also, cooking with kerosene was significantly associated with reduced birth weight after adjusting for potential confounders (β ± standard error (SE) = −0.326 ± 0.155; p = 0.040). Smoke from kerosene stove was associated with reduced birth weight and micronutrients imbalance in mothers and newborns. Full article
(This article belongs to the Section Children Health)
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Open AccessArticle Trends in Life Expectancy and Its Association with Economic Factors in the Belt and Road Countries—Evidence from 2000–2014
Int. J. Environ. Res. Public Health 2018, 15(12), 2890; https://doi.org/10.3390/ijerph15122890
Received: 13 September 2018 / Revised: 11 December 2018 / Accepted: 12 December 2018 / Published: 17 December 2018
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Abstract
In 2013, China launched the Belt and Road (B&R) Initiative in an effort to promote trade and economic collaboration. This study examined the change in life expectancy (LE) among countries along B&R and studied the impact of economic development on LE. Data from [...] Read more.
In 2013, China launched the Belt and Road (B&R) Initiative in an effort to promote trade and economic collaboration. This study examined the change in life expectancy (LE) among countries along B&R and studied the impact of economic development on LE. Data from 65 B&R countries from 2000 to 2014 were compiled and analyzed. Trend of LE was examined by sex and country. Linear quantile mixed model was used to study the associations between LE and economic factors. In 2014, the average LE in all B&R countries was 69.7 years for men and 73.7 years for women. Across countries in 2014, LE for men ranged from 58.6 years in Afghanistan to 80.2 years in Israel. LE for women ranged from 61.3 years in Afghanistan to 85.9 in Singapore. GDP per capita was positively associated with longevity across B&R countries. The unemployment rate was positively associated with LE only for countries in the top LE quantiles. GDP growth rate and Inflation were negatively associated with LE for the countries in the bottom LE quantiles for men, not for women. LE increased substantially among B&R countries during 2000–2014. The influence of macroeconomic factors on LE was related to the distribution of LE. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Unfavorable Mortality-To-Incidence Ratio of Lung Cancer Is Associated with Health Care Disparity
Int. J. Environ. Res. Public Health 2018, 15(12), 2889; https://doi.org/10.3390/ijerph15122889
Received: 20 November 2018 / Revised: 13 December 2018 / Accepted: 14 December 2018 / Published: 17 December 2018
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Abstract
The mortality-to-incidence ratio (MIR) is associated with the clinical outcome of cancer treatment. For several cancers, countries with relatively good health care systems have favorable MIRs. However, the association between lung cancer MIR and health care expenditures or rankings has not been evaluated. [...] Read more.
The mortality-to-incidence ratio (MIR) is associated with the clinical outcome of cancer treatment. For several cancers, countries with relatively good health care systems have favorable MIRs. However, the association between lung cancer MIR and health care expenditures or rankings has not been evaluated. We used linear regression to analyze the correlation between lung cancer MIRs and the total expenditures on health/gross domestic product (e/GDP) and the World Health Organization (WHO) rankings. We included 57 countries, for which data of adequate quality were available, and we found high rates of incidence and mortality but low MIRs in more developed regions. Among the continents, North America had the highest rates of incidence and mortality, whereas the highest MIRs were in Africa, Asia, Latin America, and the Caribbean. Globally, favorable MIRs correlated with high e/GDP and good WHO ranking (regression coefficient, −0.014 and 0.001; p = 0.004, and p = 0.014, respectively). In conclusion, the MIR for lung cancer in different countries varies with the expenditure on health care and health system rankings. Full article
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Open AccessArticle Depression and Quality of Life among Patients Living with HIV/AIDS in the Era of Universal Treatment Access in Vietnam
Int. J. Environ. Res. Public Health 2018, 15(12), 2888; https://doi.org/10.3390/ijerph15122888
Received: 10 October 2018 / Revised: 23 November 2018 / Accepted: 10 December 2018 / Published: 17 December 2018
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Abstract
Although antiretroviral treatment (ART) access has been universal in recent years, few studies have examined if this policy contributes to the mental health of the patients. This study assessed depression and its relations with health-related quality of life (HRQOL), which is defined as [...] Read more.
Although antiretroviral treatment (ART) access has been universal in recent years, few studies have examined if this policy contributes to the mental health of the patients. This study assessed depression and its relations with health-related quality of life (HRQOL), which is defined as the status of general well-being, physical, emotional, and psychological, among HIV patients. A cross-sectional study was conducted in 482 patients at five outpatient clinics. Patient Health Questionnaire-9 (PHQ-9) and EuroQol-5 dimensions-5 levels (EQ-5D-5L) were used to assess the severity of depression and HRQOL. About one-fifth of patients reported symptoms of depression. According to the result of a multivariate logistic regression model, patients who had a lower number of CD4 cells at the start of ART, who received ART in the clinic without HIV counseling and testing (HCT) services, who had a physical health problem, and who experienced discrimination were more likely to have depression. Depression was associated with significantly decreased HRQOL. Depression is prevalent and significantly negatively associated with HRQOL of HIV/AIDS patients. We recommend screening for depression and intervening in the lives of depressed individuals with respect to those who start ART late, and we also recommend community-based behavioral change campaigns to reduce HIV discrimination. Full article
(This article belongs to the Special Issue Adult Psychiatry)
Open AccessArticle Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology
Int. J. Environ. Res. Public Health 2018, 15(12), 2887; https://doi.org/10.3390/ijerph15122887
Received: 6 November 2018 / Revised: 13 December 2018 / Accepted: 15 December 2018 / Published: 17 December 2018
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Abstract
Case-control studies on malignant sinonasal tumors and occupational risk factors are generally weakened by non-occupational confounders and the selection of suitable controls. This study aimed to confirm the association between sinonasal malignant tumors and patients’ occupations with consideration for sinonasal inverted papillomas (SNIPs) [...] Read more.
Case-control studies on malignant sinonasal tumors and occupational risk factors are generally weakened by non-occupational confounders and the selection of suitable controls. This study aimed to confirm the association between sinonasal malignant tumors and patients’ occupations with consideration for sinonasal inverted papillomas (SNIPs) as a control group. Thirty-two patients affected by adenocarcinoma (ADC) and 21 non-adenocarcinoma epithelial tumors (NAETs) were compared to 65 patients diagnosed with SNIPs. All patients were recruited in the same clinical setting between 2004 and 2016. A questionnaire was used to collect information on non-occupational factors (age, sex, smoking, allergies, and chronic sinusitis) and occupations (wood- and leather-related occupations, textile industry, metal working). Odds ratios (OR) with 95% confidence intervals (CI) associated with selected occupations were obtained by a multinomial and exact logistic regression. Between the three groups of patients, SNIP patients were significantly younger than ADC patients (p = 0.026). The risk of NAET increased in woodworkers (OR = 9.42; CI = 1.94–45.6) and metal workers (OR = 5.65; CI = 1.12–28.6). The risk of ADC increased in wood (OR = 86.3; CI = 15.2–488) and leather workers (OR = 119.4; CI = 11.3–1258). On the exact logistic regression, the OR associated to the textile industry was 9.32 (95%CI = 1.10–Inf) for ADC, and 7.21 (95%CI = 0.55–Inf) for NAET. Comparing sinonasal malignant tumors with controls recruited from the same clinical setting allowed demonstrating an increased risk associated with multiple occupations. Well-matched samples of cases and controls reduced the confounding bias and increased the strength of the association. Full article
(This article belongs to the Section Occupational Safety and Health)
Open AccessReview Particulate Matter Exposure of Passengers at Bus Stations: A Review
Int. J. Environ. Res. Public Health 2018, 15(12), 2886; https://doi.org/10.3390/ijerph15122886
Received: 3 November 2018 / Revised: 3 December 2018 / Accepted: 14 December 2018 / Published: 17 December 2018
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Abstract
This review clarifies particulate matter (PM) pollution, including its levels, the factors affecting its distribution, and its health effects on passengers waiting at bus stations. The usual factors affecting the characteristics and composition of PM include industrial emissions and meteorological factors (temperature, humidity, [...] Read more.
This review clarifies particulate matter (PM) pollution, including its levels, the factors affecting its distribution, and its health effects on passengers waiting at bus stations. The usual factors affecting the characteristics and composition of PM include industrial emissions and meteorological factors (temperature, humidity, wind speed, rain volume) as well as bus-station-related factors such as fuel combustion in vehicles, wear of vehicle components, cigarette smoking, and vehicle flow. Several studies have proven that bus stops can accumulate high PM levels, thereby elevating passengers’ exposure to PM while waiting at bus stations, and leading to dire health outcomes such as cardiovascular disease (CVD), respiratory effects, and diabetes. In order to accurately predict PM pollution, an artificial neural network (ANN) and adaptive neuro-fuzzy inference systems (ANFIS) have been developed. ANN is a data modeling method of proven effectiveness in solving complex problems in the fields of alignment, prediction, and classification, while the ANFIS model has several advantages including non-requirement of a mathematical model, simulation of human thinking, and simple interpretation of results compared with other predictive methods. Full article
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