International Journal of Environmental Research and Public Health

Editorial

Jump to: Research, Review, Other

2 pages, 252 KiB

Open AccessEditorial

Health and Health Care for Homeless People in Various Contexts

by Stéphanie Vandentorren and Pierre Chauvin

Int. J. Environ. Res. Public Health 2018, 15(5), 948; https://doi.org/10.3390/ijerph15050948 - 10 May 2018

Cited by 1 | Viewed by 3642

Abstract

Although there is some uncertainty about the exact number of homeless people at any given time in different countries, it is undeniable that this number has steadily and dramatically grown in the recent years [...] Full article

(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)

Research

Jump to: Editorial, Review, Other

13 pages, 320 KiB

Open AccessArticle

Evaluating the Implementation of a Twitter-Based Foodborne Illness Reporting Tool in the City of St. Louis Department of Health

by Jenine K. Harris, Leslie Hinyard, Kate Beatty, Jared B. Hawkins, Elaine O. Nsoesie, Raed Mansour and John S. Brownstein

Int. J. Environ. Res. Public Health 2018, 15(5), 833; https://doi.org/10.3390/ijerph15050833 - 24 Apr 2018

Cited by 20 | Viewed by 5626

Abstract

Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City [...] Read more.

Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City of St. Louis Department of Health adopted the HealthMap Foodborne Dashboard (Dashboard), a tool that monitors Twitter for tweets about food poisoning in a geographic area and allows the health department to respond. We evaluated the implementation by interviewing employees of the City of St. Louis Department of Health involved in food safety. We interviewed epidemiologists, environmental health specialists, health services specialists, food inspectors, and public information officers. Participants viewed engaging innovation participants and executing the innovation as challenges while they felt the Dashboard had relative advantage over existing reporting methods and was not complex once in place. This study is the first to examine practitioner perceptions of the implementation of a new technology in a local health department. Similar implementation projects should focus more on process by developing clear and comprehensive plans to educate and involve stakeholders prior to implementation. Full article

(This article belongs to the Section Health Economics)

► Show Figures

Figure 1

17 pages, 1647 KiB

Open AccessArticle

Effects of Environmental Air Pollution on Pulmonary Function Level of Residents in Korean Industrial Complexes

by Eunju Hong, Seokwon Lee, Geun-Bae Kim, Tae-Jong Kim, Hyoung-Wook Kim, Kyoungho Lee and Bu-Soon Son

Int. J. Environ. Res. Public Health 2018, 15(5), 834; https://doi.org/10.3390/ijerph15050834 - 24 Apr 2018

Cited by 22 | Viewed by 6046

Abstract

This study aims to identify environmental air pollution adversely affecting pulmonary function among a community-based general population living in Korean industrial complexes. A total of 1963 residents participated in a pulmonary function test (PFT). The sample population consisted of an exposed group ( [...] Read more.

This study aims to identify environmental air pollution adversely affecting pulmonary function among a community-based general population living in Korean industrial complexes. A total of 1963 residents participated in a pulmonary function test (PFT). The sample population consisted of an exposed group (n = 1487) living within a radius of 5 km of industrial complexes and a control group (n = 476) living over a radius of 10 km from the industrial complexes in Gwangyang and Yeosu cities. PFT results were calculated for each resident of the study population. On-site questionnaire surveys with face-to-face interviews were also conducted to collect more detailed information on personal lifestyles, medical history, exposure to air pollution, and respiratory disease and related symptoms. A total of 486 measured samples were collected by eight automated air-monitoring stations installed in four counties of Gwangyang and four counties of Yeosu in South Korea from January 2006 to February 2007. Mean levels of SO₂ (0.012 ppm), CO (0.648 ppm), NO₂ (0.02 ppm), O₃ (0.034 ppm), and PM₁₀ (43.07 μg/m³), collected within a radius of 5 km, were significantly higher than those collected over a radius of 10 km from Gwangyang and Yeosu industrial complexes. Prevalence odds ratio (OR) of abnormal pulmonary function in the exposed group of residents (<5 km) was elevated at 1.24 (95% CI 0.71–1.96), but not statistically significant (p > 0.05). In multiple linear regression analysis, forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) levels significantly declined as SO₂, CO, and O₃ levels increased when adjusting for age, sex, body mass index (BMI), alcohol, smoking, secondhand smoke, and respiratory disease and related symptoms (n = 1963) (p < 0.05). These results suggest that exposure to air pollution affects pulmonary function levels of residents living in Korean industrial complexes. Full article

(This article belongs to the Special Issue Lung Diseases Associated with Environmental Pollutants)

► Show Figures

Figure 1

15 pages, 394 KiB

Open AccessArticle

Mobile Exergaming in Adolescents’ Everyday Life—Contextual Design of Where, When, with Whom, and How: The SmartLife Case

by Ayla Schwarz, Ann DeSmet, Greet Cardon, Sebastien Chastin, Ruben Costa, António Grilo, Josue Ferri, Jorge Domenech and Jeroen Stragier

Int. J. Environ. Res. Public Health 2018, 15(5), 835; https://doi.org/10.3390/ijerph15050835 - 24 Apr 2018

Cited by 12 | Viewed by 6472

Abstract

Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential [...] Read more.

Exergames, more specifically console-based exergames, are generally enjoyed by adolescents and known to increase physical activity. Nevertheless, they have a reduced usage over time and demonstrate little effectiveness over the long term. In order to increase playing time, mobile exergames may increase potential playing time, but need to be engaging and integrated in everyday life. The goal of the present study was to examine the context of gameplay for mobile exergaming in adolescents’ everyday life to inform game design and the integration of gameplay into everyday life. Eight focus groups were conducted with 49 Flemish adolescents (11 to 17 years of age). The focus groups were audiotaped, transcribed, and analyzed by means of thematic analysis via Nvivo 11 software (QSR International Pty Ltd., Victoria, Australia). The adolescents indicated leisure time and travel time to and from school as suitable timeframes for playing a mobile exergame. Outdoor gameplay should be restricted to the personal living environment of adolescents. Besides outdoor locations, the game should also be adaptable to at-home activities. Activities could vary from running outside to fitness exercises inside. Furthermore, the social context of the game was important, e.g., playing in teams or meeting at (virtual) meeting points. Physical activity tracking via smart clothing was identified as a motivator for gameplay. By means of this study, game developers may be better equipped to develop mobile exergames that embed gameplay in adolescents’ everyday life. Full article

(This article belongs to the Special Issue Advances in Technology Enabled Health and Care)

20 pages, 2081 KiB

Open AccessArticle

The Relationship between Urbanization, the Built Environment, and Physical Activity among Older Adults in Taiwan

by Nuan-Ching Huang, Shiann-Far Kung and Susan C. Hu

Int. J. Environ. Res. Public Health 2018, 15(5), 836; https://doi.org/10.3390/ijerph15050836 - 24 Apr 2018

Cited by 46 | Viewed by 7473

Abstract

Urbanization and ageing are global phenomena and offer unique challenges in different countries. A supportive environment plays a critical role in addressing the issue of behavioral change and health promotion among older adults. Many studies in the U.S., EU, and Australia have considered [...] Read more.

Urbanization and ageing are global phenomena and offer unique challenges in different countries. A supportive environment plays a critical role in addressing the issue of behavioral change and health promotion among older adults. Many studies in the U.S., EU, and Australia have considered promoting physical activity in the community based on ecological models, whereas very few Asian studies have examined the relationships among urbanization, the built environment and physical activity in elderly at the ecological level, especially from a multi-level perspective. Due to the prevalence of post-war baby boomers and a very low birth-rate, the older population (aged 65 years old and older) in Taiwan has increased rapidly since 2011 and has exceeded the younger generation (0–14 years old) in 2017. Hence, the purpose of this study was first to examine the degree of urbanization in townships and the status of related built environments in Taiwan and then to investigate whether the built environment is associated with recommended amounts of physical activity among older adults. Three national datasets and a multi-level design were used in this research. Data at the individual level was obtained from the 2009 National Health Interview Survey (NHIS) which was taken from June 2009 to February 2010. Ecological data was obtained from the 2006 National Land Use Investigation of the National Geographic Information System and the 2010 Population and Housing Census. The analyses included a descriptive analysis, a bivariate analysis, a multiple logistic regression, and a multi-level analysis, utilizing a mostly hierarchical linear model (HLM). The results showed a significant relationship between factors at the environmental levels and physical activity in older adults. Urbanization, the built environment, and the median income of townships were positively correlated to the physical activity of the older adults. After controlling for individual-level factors, urbanization still exhibited this correlation. Parks and green spaces were associated with achieving the recommended amount of physical activity. However, there was no relationship after controlling for factors at the individual level. Detailed discussions were provided. Full article

► Show Figures

Figure 1

17 pages, 1839 KiB

Open AccessArticle

Social Network Analysis Applied to a Historical Ethnographic Study Surrounding Home Birth

by Elena Andina-Diaz, Mª Antonia Ovalle-Perandones, Ignacio Ramos-Vidal, Francisca Camacho-Morell, Jose Siles-Gonzalez and Pilar Marques-Sanchez

Int. J. Environ. Res. Public Health 2018, 15(5), 837; https://doi.org/10.3390/ijerph15050837 - 24 Apr 2018

Cited by 3 | Viewed by 5547

Abstract

Safety during birth has improved since hospital delivery became standard practice, but the process has also become increasingly medicalised. Hence, recent years have witnessed a growing interest in home births due to the advantages it offers to mothers and their newborn infants. The [...] Read more.

Safety during birth has improved since hospital delivery became standard practice, but the process has also become increasingly medicalised. Hence, recent years have witnessed a growing interest in home births due to the advantages it offers to mothers and their newborn infants. The aims of the present study were to confirm the transition from a home birth model of care to a scenario in which deliveries began to occur almost exclusively in a hospital setting; to define the social networks surrounding home births; and to determine whether geography exerted any influence on the social networks surrounding home births. Adopting a qualitative approach, we recruited 19 women who had given birth at home in the mid 20th century in a rural area in Spain. We employed a social network analysis method. Our results revealed three essential aspects that remain relevant today: the importance of health professionals in home delivery care, the importance of the mother’s primary network, and the influence of the geographical location of the actors involved in childbirth. All of these factors must be taken into consideration when developing strategies for maternal health. Full article

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

► Show Figures

Figure 1

14 pages, 1499 KiB

Open AccessArticle

Effect of Drought on Agronomic Traits of Rice and Wheat: A Meta-Analysis

by Jinmeng Zhang, Shiqiao Zhang, Min Cheng, Hong Jiang, Xiuying Zhang, Changhui Peng, Xuehe Lu, Minxia Zhang and Jiaxin Jin

Int. J. Environ. Res. Public Health 2018, 15(5), 839; https://doi.org/10.3390/ijerph15050839 - 24 Apr 2018

Cited by 300 | Viewed by 13885

Abstract

Drought has been one of the most important limiting factors for crop production, which deleteriously affects food security worldwide. The main objective of the present study was to quantitatively assess the effect of drought on the agronomic traits (e.g., plant height, biomass, yield, [...] Read more.

Drought has been one of the most important limiting factors for crop production, which deleteriously affects food security worldwide. The main objective of the present study was to quantitatively assess the effect of drought on the agronomic traits (e.g., plant height, biomass, yield, and yield components) of rice and wheat in combination with several moderators (e.g., drought stress intensity, rooting environment, and growth stage) using a meta-analysis study. The database was created from 55 published studies on rice and 60 published studies on wheat. The results demonstrated that drought decreased the agronomic traits differently between rice and wheat among varying growth stages. Wheat and rice yields decreased by 27.5% and 25.4%, respectively. Wheat grown in pots showed greater decreases in agronomic traits than those grown in the field. Rice showed opposite growing patterns when compared to wheat in rooting environments. The effect of drought on rice increased with plant growth and drought had larger detrimental influences during the reproductive phase (e.g., blooming stage, filling stage, and maturity). However, an exception was found in wheat, which had similar decreased performance during the complete growth cycle. Based on these results, future droughts could produce lower yields of rice and wheat when compared to the current drought. Full article

(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)

► Show Figures

Figure 1

14 pages, 664 KiB

Open AccessArticle

Do Low Income Youth of Color See “The Bigger Picture” When Discussing Type 2 Diabetes: A Qualitative Evaluation of a Public Health Literacy Campaign

by Dean Schillinger, Jessica Tran and Sarah Fine

Int. J. Environ. Res. Public Health 2018, 15(5), 840; https://doi.org/10.3390/ijerph15050840 - 24 Apr 2018

Cited by 19 | Viewed by 6498

Abstract

As Type 2 diabetes spikes among minority and low-income youth, there is an urgent need to tackle the drivers of this preventable disease. The Bigger Picture (TBP) is a counter-marketing campaign using youth-created, spoken-word public service announcements (PSAs) to reframe the epidemic as [...] Read more.

As Type 2 diabetes spikes among minority and low-income youth, there is an urgent need to tackle the drivers of this preventable disease. The Bigger Picture (TBP) is a counter-marketing campaign using youth-created, spoken-word public service announcements (PSAs) to reframe the epidemic as a socio-environmental phenomenon requiring communal action, civic engagement and norm change. Methods: We examined whether and how TBP PSAs advance health literacy among low-income, minority youth. We showed nine PSAs, asking individuals open-ended questions via questionnaire, then facilitating a focus group to reflect upon the PSAs. Results: Questionnaire responses revealed a balance between individual vs. public health literacy. Some focused on individual responsibility and behaviors, while others described socio-environmental forces underlying risk. The focus group generated a preponderance of public health literacy responses, emphasizing future action. Striking sociopolitical themes emerged, reflecting tensions minority and low-income youth experience, such as entrapment vs. liberation. Conclusion: Our findings speak to the structural barriers and complexities underlying diabetes risk, and the ability of spoken word medium to make these challenges visible and motivate action. Practice Implications: Delivering TBP content to promote interactive reflection has potential to change behavioral norms and build capacity to confront the social, economic and structural factors that influence behaviors. Full article

(This article belongs to the Special Issue Health Literacy in Context—Settings, Media, and Populations)

► Show Figures

Figure 1

10 pages, 323 KiB

Open AccessArticle

Seasonal Influenza Vaccination in Health Care Workers. A Pre-Post Intervention Study in an Italian Paediatric Hospital

by Francesco Gilardi, Guido Castelli Gattinara, Maria Rosaria Vinci, Marta Ciofi Degli Atti, Veronica Santilli, Rita Brugaletta, Annapaola Santoro, Rosina Montanaro, Luisa Lavorato, Massimiliano Raponi and Salvatore Zaffina

Int. J. Environ. Res. Public Health 2018, 15(5), 841; https://doi.org/10.3390/ijerph15050841 - 24 Apr 2018

Cited by 38 | Viewed by 5649

Abstract

Despite relevant recommendations and evidences on the efficacy of influenza vaccination in health care workers (HCWs), vaccination coverage rates in Europe and Italy currently do not exceed 25%. Aim of the study is to measure the variations in vaccination coverage rates in an [...] Read more.

Despite relevant recommendations and evidences on the efficacy of influenza vaccination in health care workers (HCWs), vaccination coverage rates in Europe and Italy currently do not exceed 25%. Aim of the study is to measure the variations in vaccination coverage rates in an Italian pediatric hospital after a promotion campaign performed in the period October–December 2017. The design is a pre-post intervention study. The intervention is based on a wide communication campaign and an expanded offer of easy vaccination on site. The study was carried out at Bambino Gesù Children’s hospital in Rome, Italy, on the whole population of HCWs. Univariate and multivariate statistical analyses were performed. Vaccination coverage rate increased in 2017/18 campaign compared with the 2016/17 one (+95 HCWs vaccinated; +4.4%). The highest increases were detected in males (+45.7%), youngest employees (+142.9%), mean age of employment (+175%), other HCWs (+209.1%), Emergency Area (+151.6%) and Imaging Diagnostic Department (+200.0%). At multivariate logistic regression, working in some departments and being nurses represents a higher risk of being unvaccinated. Although the vaccination coverage rate remained low, a continuous increase of the coverage rate and development of a different consciousness in HCWs was highlighted. The study significantly identified the target for future campaigns. Full article

(This article belongs to the Special Issue Workplace Health Promotion 2018)

10 pages, 321 KiB

Open AccessArticle

The Status of Musculoskeletal Disorders and Its Influence on the Working Ability of Oil Workers in Xinjiang, China

by Hua Ge, Xuemei Sun, Jiwen Liu and Chen Zhang

Int. J. Environ. Res. Public Health 2018, 15(5), 842; https://doi.org/10.3390/ijerph15050842 - 24 Apr 2018

Cited by 23 | Viewed by 5389

Abstract

The purpose of this study was to investigate the status of musculoskeletal disorders (MSDs) and its influence on the working ability of oil workers, and to provide a theoretical basis for helping lessen the burden of MSDs and improve the man-machine environment of [...] Read more.

The purpose of this study was to investigate the status of musculoskeletal disorders (MSDs) and its influence on the working ability of oil workers, and to provide a theoretical basis for helping lessen the burden of MSDs and improve the man-machine environment of oil workers. The cluster sampling method was used to study 2000 workers who had been employed for more than 1 year in this field. We investigated the prevalence rate and the work ability index (WAI). A total of 1935 valid questionnaires were collected, a response rate of 96.75%. There were 1639 people who had suffered from MSDs in the past year, a prevalence rate of 84.7%. The damage detection rate in female oil workers was higher than in males, and the damage detection rate in workers aged 30 to 45 years was higher than that in the other two age groups. The detection rate in less highly-educated oil workers was higher than that in more highly-educated workers. The detection rate in divorced workers was higher than that in other groups. The detection rate in workers between the number of working years of 18 to 25 years was higher than in the other two groups. The detection rate in workers with a high professional title was significantly higher than that in lower-titled workers (p < 0.05). The results showed that the WAI scores of the subjects with MSDs were significantly lower than for subjects without MSDs (p < 0.05). In a logistic regression analysis, sex, number of working years and WAI index all had an impact on MSDs. We concluded that due to the demands of their role, the oil workers had serious MSDs that influenced their working ability. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders)

21 pages, 3158 KiB

Open AccessArticle

General Practitioners’ Perceptions of Heat Health Impacts on the Elderly in the Face of Climate Change—A Qualitative Study in Baden-Württemberg, Germany

by Alina Herrmann and Rainer Sauerborn

Int. J. Environ. Res. Public Health 2018, 15(5), 843; https://doi.org/10.3390/ijerph15050843 - 24 Apr 2018

Cited by 31 | Viewed by 18428

Abstract

Heat health impacts (HHI) on the elderly are a growing concern in the face of climate change and aging populations. General practitioners (GPs) have an important role in health care for the elderly. To inform the development of effective prevention measures, it is [...] Read more.

Heat health impacts (HHI) on the elderly are a growing concern in the face of climate change and aging populations. General practitioners (GPs) have an important role in health care for the elderly. To inform the development of effective prevention measures, it is important to investigate GPs’ perceptions of HHI. Twenty four qualitative expert interviews were conducted with GPs and analyzed using the framework approach. GPs were generally aware of heat health impacts, focusing on cardiovascular morbidity and volume imbalances. Perceptions of mortality and for instance impacts on respiratory diseases or potentially risky drugs in heat waves partly diverged from findings in literature. GPs judged the current relevance of HHI differently depending on their attitudes towards: (i) sensitivity of the elderly, (ii) status of nursing care and (iii) heat exposure in Baden-Württemberg. Future relevance of HHI was perceived to be increasing by most GPs. The main cause identified for this was population aging, while impacts of climate change were judged as uncertain by many. GPs’ perceptions, partly diverging from literature, show that GPs’ knowledge and awareness on HHI and climate change needs to be strengthened. However, they also emphasize the need for more research on HHI in the ambulant health care setting. Furthermore, GPs perceptions suggest that strong nursing care and social networks for elderly are major elements of a climate resilient health system. Full article

(This article belongs to the Section Climate Change)

► Show Figures

Figure 1

12 pages, 3371 KiB

Open AccessArticle

Integration of a Copper-Containing Biohybrid (CuHARS) with Cellulose for Subsequent Degradation and Biomedical Control

by Anik Karan, Margarita Darder, Urna Kansakar, Zach Norcross and Mark A. DeCoster

Int. J. Environ. Res. Public Health 2018, 15(5), 844; https://doi.org/10.3390/ijerph15050844 - 25 Apr 2018

Cited by 7 | Viewed by 8162

Abstract

We previously described the novel synthesis of a copper high-aspect ratio structure (CuHARS) biohybrid material using cystine. While extremely stable in water, CuHARS is completely (but slowly) degradable in cellular media. Here, integration of the CuHARS into cellulose matrices was carried out to [...] Read more.

We previously described the novel synthesis of a copper high-aspect ratio structure (CuHARS) biohybrid material using cystine. While extremely stable in water, CuHARS is completely (but slowly) degradable in cellular media. Here, integration of the CuHARS into cellulose matrices was carried out to provide added control for CuHARS degradation. Synthesized CuHARS was concentrated by centrifugation and then dried. The weighed mass was re-suspended in water. CuHARS was stable in water for months without degradation. In contrast, 25 μg/mL of the CuHARS in complete cell culture media was completely degraded (slowly) in 18 days under physiological conditions. Stable integration of CuHARS into cellulose matrices was achieved through assembly by mixing cellulose micro- and nano-fibers and CuHARS in an aqueous (pulp mixture) phase, followed by drying. Additional materials were integrated to make the hybrids magnetically susceptible. The cellulose-CuHARS composite films could be transferred, weighed, and cut into usable pieces; they maintained their form after rehydration in water for at least 7 days and were compatible with cell culture studies using brain tumor (glioma) cells. These studies demonstrate utility of a CuHARS-cellulose biohybrid for applied applications including: (1) a platform for biomedical tracking and (2) integration into a 2D/3D matrix using natural products (cellulose). Full article

(This article belongs to the Special Issue Selected Paper from the 14th International Symposium on Recent Advances in Environmental Health Research)

► Show Figures

Figure 1

10 pages, 713 KiB

Open AccessArticle

Influence of Latitude on the Prevalence of Kawasaki Disease: A Retrospective Cohort Study from the Taiwan National Health Insurance Database and Review of the Literature

by Chaw-Liang Chang, Chih-Shung Wong, Yi-Chen Yang and Nan-Chang Chiu

Int. J. Environ. Res. Public Health 2018, 15(5), 845; https://doi.org/10.3390/ijerph15050845 - 25 Apr 2018

Cited by 6 | Viewed by 4869

Abstract

Background: Countries at higher latitudes have higher incidence rates of Kawasaki disease (KD) than do countries at lower latitudes in the Asian and West Pacific area. However, the precise influence of latitude on KD incidence rates requires further clarification. Methods: We searched the [...] Read more.

Background: Countries at higher latitudes have higher incidence rates of Kawasaki disease (KD) than do countries at lower latitudes in the Asian and West Pacific area. However, the precise influence of latitude on KD incidence rates requires further clarification. Methods: We searched the Longitudinal Health Insurance Database 2005 to retrieve patients’ medical records from 1996 to 2009. The patients with KD were categorized as living in northern, middle, and southern Taiwan; the period prevalence of KD for each area was determined. Climate variables, including temperature, sunshine duration, precipitation, and relative humidity, were collected from the Taiwan Central Weather Bureau. The effect of latitude on the period KD prevalence and the correlation between climate variables and KD prevalence were calculated. Results: After patients without complete data excluded, a total of 61,830 children up to 10 years old were retrieved, from which 404 patients with KD were recognized. The period prevalence of KD increased significantly with latitude (p = 0.0004). Climate variables associated with high temperature demonstrated a connection with KD prevalence; however, this correlation was not statistically significant. Conclusions: Our study demonstrated that higher latitude is associated with a higher KD prevalence in Taiwan. Full article

► Show Figures

Figure 1

11 pages, 360 KiB

Open AccessArticle

Suicidal Ideation and Healthy Immigrant Effect in the Canadian Population: A Cross-Sectional Population Based Study

by Rasha Elamoshy and Cindy Feng

Int. J. Environ. Res. Public Health 2018, 15(5), 848; https://doi.org/10.3390/ijerph15050848 - 25 Apr 2018

Cited by 11 | Viewed by 4545

Abstract

Understanding suicidal ideation is crucial for preventing suicide. Although “healthy immigrant effect” is a phenomenon that has been well documented across a multitude of epidemiological and social studies—where immigrants are, on average, healthier than the native-born, little research has examined the presence of [...] Read more.

Understanding suicidal ideation is crucial for preventing suicide. Although “healthy immigrant effect” is a phenomenon that has been well documented across a multitude of epidemiological and social studies—where immigrants are, on average, healthier than the native-born, little research has examined the presence of such effect on suicidal ideation. The objective of this study is to investigate if there is a differential effect of immigration identity on suicidal ideation and how the effect varies by socio-demographic characteristics in the Canadian population. Data from the Canadian Community Health Survey in year 2014 were used. Multivariate logistic regression was employed. Our findings indicated that recent immigrants (lived in Canada for 9 or less years) were significantly less likely to report suicidal ideation compared with non-immigrants. However, for established immigrants (10 years and above of living in Canada), the risk of suicidal ideation converged to Canadian-born population. Moreover, male immigrants were at significantly lower risk of having suicidal ideation than Canadian-born counterparts; whereas, female immigrants did not benefit from the “healthy immigrant effect”. Our findings suggest the need for targeted intervention strategies on suicidal ideation among established immigrants and female immigrants. Full article

(This article belongs to the Special Issue Advances in Suicide Research)

► Show Figures

Figure 1

11 pages, 1052 KiB

Open AccessArticle

Measurement of Pesticide Residues from Chemical Control of the Invasive Spodoptera frugiperda (Lepidoptera: Noctuidae) in a Maize Experimental Field in Mokwa, Nigeria

by Abou Togola, Silvestro Meseka, Abebe Menkir, Baffour Badu-Apraku, Ousmane Boukar, Manuele Tamò and Rousseau Djouaka

Int. J. Environ. Res. Public Health 2018, 15(5), 849; https://doi.org/10.3390/ijerph15050849 - 25 Apr 2018

Cited by 64 | Viewed by 6905

Abstract

The management of the fall armyworm Spodoptera frugiperda in maize field necessitates the use a big quantities of insecticides and sometimes the use of multiple types and formulations of chemicals. The use of insecticides in crops is associated with environmental risks and health [...] Read more.

The management of the fall armyworm Spodoptera frugiperda in maize field necessitates the use a big quantities of insecticides and sometimes the use of multiple types and formulations of chemicals. The use of insecticides in crops is associated with environmental risks and health hazards to both producers and consumers. This study was designed to evaluate the residue of 11 insecticides that were used to control high population of the fall armyworm in maize field in Mokwa, Nigeria. Maize and soil samples were collected from an experimental field to investigate the residue level using high performance liquid chromatography (HPLC, Agilent Technologies, Santa Clara, CA, USA) analysis techniques. Results revealed the presence of five insecticide compounds (Cypermethrin, Deltamethrin, Lambda-Cyhalothrin, Permethrin, and Chorpyrifos) in soil samples with possible adverse effects on soil born organisms and other non-targeted species. In contrast, no residue was found in maize stems and seeds. From these results, we conclude that the treated maize remains safe for consumption and the producers may not get any serious risk of contamination from the chemical control of the fall armyworm. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

13 pages, 354 KiB

Open AccessArticle

University Students’ Willingness to Assist Fellow Students Who Experience Alcohol-Related Facial Flushing to Reduce Their Drinking

by Lanyan Ding, Lok-Wa Yuen, Ian M. Newman and Duane F. Shell

Int. J. Environ. Res. Public Health 2018, 15(5), 850; https://doi.org/10.3390/ijerph15050850 - 25 Apr 2018

Cited by 5 | Viewed by 4126

Abstract

This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive [...] Read more.

This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive cancers. Individuals who flush should reduce their alcohol exposure, but they may continue to drink if social pressures and rules of etiquette make not drinking socially risky. The analysis used data from 2912 undergraduate students from 13 universities in southwestern, central and northeastern China from a survey asking how they respond to someone’s flushing in various scenarios. Latent class analysis grouped students by similar responses to flushing. A multinomial logistic regression explored how class membership was associated with knowledge, drinking status, and reactions to one’s own flushing. Five classes were derived from the latent class analysis, ranging from always intervene to mostly hesitate to help; in between were classes of students who were willing to help in some scenarios and hesitant in other scenarios. Only 11.6% students knew the connection between facial flushing and impaired alcohol metabolism, and knowledgeable students were somewhat more likely to assist when they saw someone flushing. In the absence of knowledge, other factors—such as drinking status, the gender of the bystander, the gender of the person who flushed, and degree of friendship with the person who flushed—determined how willing a person was to help someone reduce or stop drinking. Class membership was predicted by knowledge, gender, drinking status, and reactions to one’s own flushing. Of these 4 factors, knowledge and reactions to one’s own flushing could be influenced through alcohol education programs. It will take some time for alcohol education to catch up to and change social and cultural patterns of drinking. Meanwhile, motivational strategies should be developed to increase the willingness of bystanders to assist friends and to create a social expectation that flushers should stop or reduce their drinking. Full article

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

15 pages, 716 KiB

Open AccessFeature PaperArticle

Impact of a Translated Disease Self-Management Program on Employee Health and Productivity: Six-Month Findings from a Randomized Controlled Trial

by Matthew Lee Smith, Mark G. Wilson, Melissa M. Robertson, Heather M. Padilla, Heather Zuercher, Robert Vandenberg, Phaedra Corso, Kate Lorig, Diana D. Laurent and David M. DeJoy

Int. J. Environ. Res. Public Health 2018, 15(5), 851; https://doi.org/10.3390/ijerph15050851 - 25 Apr 2018

Cited by 21 | Viewed by 8785

Abstract

Disease management is gaining importance in workplace health promotion given the aging workforce and rising chronic disease prevalence. The Chronic Disease Self-Management Program (CDSMP) is an effective intervention widely offered in diverse community settings; however, adoption remains low in workplace settings. As part [...] Read more.

Disease management is gaining importance in workplace health promotion given the aging workforce and rising chronic disease prevalence. The Chronic Disease Self-Management Program (CDSMP) is an effective intervention widely offered in diverse community settings; however, adoption remains low in workplace settings. As part of a larger NIH-funded randomized controlled trial, this study examines the effectiveness of a worksite-tailored version of CDSMP (wCDSMP [n = 72]) relative to CDSMP (‘Usual Care’ [n = 109]) to improve health and work performance among employees with one or more chronic conditions. Multiple-group latent-difference score models with sandwich estimators were fitted to identify changes from baseline to 6-month follow-up. Overall, participants were primarily female (87%), non-Hispanic white (62%), and obese (73%). On average, participants were age 48 (range: 23–72) and self-reported 3.25 chronic conditions (range: 1–16). The most commonly reported conditions were high cholesterol (45%), high blood pressure (45%), anxiety/emotional/mental health condition (26%), and diabetes (25%). Among wCDSMP participants, significant improvements were observed for physically unhealthy days (uΔ = −2.07, p = 0.018), fatigue (uΔ = −2.88, p = 0.002), sedentary behavior (uΔ = −4.49, p = 0.018), soda/sugar beverage consumption (uΔ = −0.78, p = 0.028), and fast food intake (uΔ = −0.76, p = 0.009) from baseline to follow-up. Significant improvements in patient–provider communication (uΔ = 0.46, p = 0.031) and mental work limitations (uΔ = −8.89, p = 0.010) were also observed from baseline to follow-up. Relative to Usual Care, wCDSMP participants reported significantly larger improvements in fatigue, physical activity, soda/sugar beverage consumption, and mental work limitations (p < 0.05). The translation of Usual Care (content and format) has potential to improve health among employees with chronic conditions and increase uptake in workplace settings. Full article

(This article belongs to the Collection Aging and Public Health)

► Show Figures

Figure 1

16 pages, 1735 KiB

Open AccessArticle

Gender and Body-Fat Status as Predictors of Parental Feeding Styles and Children’s Nutritional Knowledge, Eating Habits and Behaviours

by Małgorzata Lipowska, Mariusz Lipowski, Paweł Jurek, Anna M. Jankowska and Paulina Pawlicka

Int. J. Environ. Res. Public Health 2018, 15(5), 852; https://doi.org/10.3390/ijerph15050852 - 25 Apr 2018

Cited by 36 | Viewed by 8316

Abstract

The home food environment is critically important for the development of children’s health-related practices. By managing dietary restrictions, providing nutritional knowledge and demonstrating eating behaviours, parents contribute to children’s food preferences and eating patterns. The present study examined nutritional knowledge, eating habits and [...] Read more.

The home food environment is critically important for the development of children’s health-related practices. By managing dietary restrictions, providing nutritional knowledge and demonstrating eating behaviours, parents contribute to children’s food preferences and eating patterns. The present study examined nutritional knowledge, eating habits and appetite traits among 387 Polish five-year-old healthy and overfat boys and girls in the context of parental feeding styles and body-fat status. We observed that girls presented healthier eating habits than boys; however, overfat boys had better nutritional knowledge. Children’s body-fat percentage (%BF) was found to be linked with eating behaviours such as low satiety responsiveness and increased food responsiveness in girls as well as low emotional undereating and increased emotional overeating in boys. Our results revealed that overfat mothers, who were more prone to use the encouragement feeding style, rarely had daughters with increased %BF. Parents of overfat girls, however, were less likely to apply encouragement and instrumental feeding styles. Contrary to popular belief and previous studies, overfat women do not necessarily transmit unhealthy eating patterns to their children. Parents’ greater emphasis on managing the weight and eating habits of daughters (rather than sons) probably results from their awareness of standards of female physical attractiveness. Full article

(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)

► Show Figures

Figure 1

16 pages, 344 KiB

Open AccessArticle

Observance of Sterilization Protocol Guideline Procedures of Critical Instruments for Preventing Iatrogenic Transmission of Creutzfeldt-Jakob Disease in Dental Practice in France, 2017

by Denis Bourgeois, Claude Dussart, Ina Saliasi, Laurent Laforest, Paul Tramini and Florence Carrouel

Int. J. Environ. Res. Public Health 2018, 15(5), 853; https://doi.org/10.3390/ijerph15050853 - 25 Apr 2018

Cited by 9 | Viewed by 4466

Abstract

Effective sterilization of reusable instruments contaminated by Creutzfeldt–Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental [...] Read more.

Effective sterilization of reusable instruments contaminated by Creutzfeldt–Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33) were classified into 4 groups: (1) Pre-sterilization cleaning of reusable instruments; (2) Biological verification of sterilization cycles—Monitoring steam sterilization procedures; (3) Autoclave performance and practitioner knowledge of autoclave use; (4) Monitoring and documentation of sterilization procedures—Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed). Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%). Dental practices ≥ 3 dental units performed significantly better (>80%) procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively), while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their non-compliance are needed. Full article

(This article belongs to the Section Environmental Health)

12 pages, 337 KiB

Open AccessArticle

Association between Sleep Duration and Overweight/Obesity at Age 7–18 in Shenyang, China in 2010 and 2014

by Qi Sun, Yinglong Bai, Lingling Zhai, Wei Wei and Lihong Jia

Int. J. Environ. Res. Public Health 2018, 15(5), 854; https://doi.org/10.3390/ijerph15050854 - 25 Apr 2018

Cited by 7 | Viewed by 5092

Abstract

This study was designed to examine the association between sleep duration and being overweight/obese in primary, middle, and high school students. This was a multiple cross-sectional study using data from the 2010 and 2014 National Survey on Students’ Constitution and Health (CNSSCH). A [...] Read more.

This study was designed to examine the association between sleep duration and being overweight/obese in primary, middle, and high school students. This was a multiple cross-sectional study using data from the 2010 and 2014 National Survey on Students’ Constitution and Health (CNSSCH). A total of 23,602 students aged 7–18 years were enrolled in this study. The prevalence of being overweight and obese—stratified by age, gender, and sleep duration—in 2010 and 2014 were compared. Sleep duration was categorized as <7 h, ≥7 to 8 h, ≥8 to 9 h, and ≥9 h. Overweight and obesity were defined according to the cut-point criteria in China. Multivariable logistic regression results in 2010 and 2014 revealed that students sleeping <7 h and aged 7–12 years had an increased risk of becoming overweight/obese. In 2010, the adjusted prevalence ratios of overweight for 7–12-year-old students sleeping <9 h was 1.196 (95%CI: 1.004–1.424) and 13–15-year-old students sleeping <8 h was 1.265 (95%CI: 1.023–1.565). In 2014, the adjusted prevalence ratios of overweight and obesity for 7–12-year-old students sleeping <9 h were 1.295 (95%CI: 1.091–1.537) and 1.231 (95%CI: 1.045–1.449); 16–18-year-old students sleeping <7 h were 1.530 (95%CI: 1.239–1.888) and 1.585 (95%CI: 1.270–2.081). Our study revealed that different levels of sleep curtailment increased the risk of becoming overweight/obesity in different age groups of students. Full article

(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)

14 pages, 4905 KiB

Open AccessArticle

Ecological Vulnerability Assessment Based on Fuzzy Analytical Method and Analytic Hierarchy Process in Yellow River Delta

by Chunsheng Wu, Gaohuan Liu, Chong Huang, Qingsheng Liu and Xudong Guan

Int. J. Environ. Res. Public Health 2018, 15(5), 855; https://doi.org/10.3390/ijerph15050855 - 25 Apr 2018

Cited by 69 | Viewed by 6221

Abstract

The Yellow River Delta (YRD), located in Yellow River estuary, is characterized by rich ecological system types, and provides habitats or migration stations for wild birds, all of which makes the delta an ecological barrier or ecotone for inland areas. Nevertheless, the abundant [...] Read more.

The Yellow River Delta (YRD), located in Yellow River estuary, is characterized by rich ecological system types, and provides habitats or migration stations for wild birds, all of which makes the delta an ecological barrier or ecotone for inland areas. Nevertheless, the abundant natural resources of YRD have brought huge challenges to the area, and frequent human activities and natural disasters have damaged the ecological systems seriously, and certain ecological functions have been threatened. Therefore, it is necessary to determine the status of the ecological environment based on scientific methods, which can provide scientifically robust data for the managers or stakeholders to adopt timely ecological protection measures. The aim of this study was to obtain the spatial distribution of the ecological vulnerability (EV) in YRD based on 21 indicators selected from underwater status, soil condition, land use, landform, vegetation cover, meteorological conditions, ocean influence, and social economy. In addition, the fuzzy analytic hierarchy process (FAHP) method was used to obtain the weights of the selected indicators, and a fuzzy logic model was constructed to obtain the result. The result showed that the spatial distribution of the EV grades was regular, while the fuzzy membership of EV decreased gradually from the coastline to inland area, especially around the river crossing, where it had the lowest EV. Along the coastline, the dikes had an obviously protective effect for the inner area, while the EV was higher in the area where no dikes were built. This result also showed that the soil condition and groundwater status were highly related to the EV spatially, with the correlation coefficients −0.55 and −0.74 respectively, and human activities had exerted considerable pressure on the ecological environment. Full article

(This article belongs to the Collection Environmental Risk Assessment)

► Show Figures

Figure 1

11 pages, 624 KiB

Open AccessArticle

Impact of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany

by Kevin Claassen and Pia Jäger

Int. J. Environ. Res. Public Health 2018, 15(5), 856; https://doi.org/10.3390/ijerph15050856 - 25 Apr 2018

Cited by 20 | Viewed by 6033

Abstract

Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, [...] Read more.

Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence regarding its actual impact on the use of medical services. The aim of the study is to examine this impact on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). Study Design: For this purpose, a standardized survey was conducted with 260 asylum seekers in different municipalities, some of which have introduced the EHIC for asylum seekers, while others have not. Methods: The period prevalence was compared between the groups “with EHIC” and “without EHIC” using a two-sided t-test. Multivariate analysis was done using a linear OLS regression model. Results: Asylum seekers in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Conclusions: The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers. Full article

(This article belongs to the Special Issue Refugee, Migrant and Ethnic Minority Health)

► Show Figures

Figure 1

11 pages, 464 KiB

Open AccessArticle

The Preschool-Aged and School-Aged Children Present Different Odds of Mortality than Adults in Southern Taiwan: A Cross-Sectional Retrospective Analysis

by Shu-Hui Peng, Chun-Ying Huang, Shiun-Yuan Hsu, Li-Hui Yang and Ching-Hua Hsieh

Int. J. Environ. Res. Public Health 2018, 15(5), 858; https://doi.org/10.3390/ijerph15050858 - 25 Apr 2018

Cited by 3 | Viewed by 4016

Abstract

Background: This study aimed to profile the epidemiology of injury among preschool-aged and school-aged children in comparison to those in adults. Methods: According to the Trauma Registry System of a level I trauma center, the medical data were retrieved from 938 [...] Read more.

Background: This study aimed to profile the epidemiology of injury among preschool-aged and school-aged children in comparison to those in adults. Methods: According to the Trauma Registry System of a level I trauma center, the medical data were retrieved from 938 preschool-aged children (aged less than seven years), 670 school-aged children (aged 7–12 years), and 16,800 adults (aged 20–64 years) between 1 January 2009 and 31 December 2016. Two-sided Pearson’s, chi-squared, and Fisher’s exact tests were used to compare categorical data. A one-way analysis of variance (ANOVA) with the Games-Howell post-hoc test was used to assess the differences in continuous variables among different groups of patients. The mortality outcomes of different subgroups were assessed by a multivariable regression model under the adjustment of sex, injury mechanisms, and injury severity. Results: InFsupppjury mechanisms in preschool-aged and school-aged children were remarkably different from that in adults; in preschool-aged children, burns were the most common cause of injury requiring hospitalization (37.4%), followed by falls (35.1%) and being struck by/against objects (11.6%). In school-aged children, injuries were most commonly sustained from falls (47.8%), followed by bicycle accidents (14%) and being struck by/against objects (12.5%). Compared to adults, there was no significant difference of the adjusted mortality of the preschool-aged children (AOR = 0.9; 95% CI 0.38–2.12; p = 0.792) but there were lower adjusted odds of mortality of the school-aged children (AOR = 0.4; 95% CI 0.10–0.85; p = 0.039). The school-aged children had lower odds of mortality than adults (OR, 0.2; 95% CI, 0.06–0.74; p = 0.012), but such lower odds of risk of mortality were not found in preschool-aged children (OR, 0.7; 95% CI, 0.29–1.81; p = 0.646). Conclusions: This study suggests that specific types of injuries from different injury mechanisms are predominant among preschool-aged and school-aged children. The school-aged children had lower odds of mortality than adults; nonetheless there was no difference in mortality rates of preschool-aged children than adults, with or without controlling for sex, injury mechanisms and ISS. These results highlight the importance of injury prevention, particularly for preschool-aged children in Southern Taiwan. Full article

► Show Figures

Figure 1

10 pages, 352 KiB

Open AccessArticle

Effects of Internet and Smartphone Addictions on Depression and Anxiety Based on Propensity Score Matching Analysis

by Yeon-Jin Kim, Hye Min Jang, Youngjo Lee, Donghwan Lee and Dai-Jin Kim

Int. J. Environ. Res. Public Health 2018, 15(5), 859; https://doi.org/10.3390/ijerph15050859 - 25 Apr 2018

Cited by 96 | Viewed by 13848

Abstract

The associations of Internet addiction (IA) and smartphone addiction (SA) with mental health problems have been widely studied. We investigated the effects of IA and SA on depression and anxiety while adjusting for sociodemographic variables. In this study, 4854 participants completed a cross-sectional [...] Read more.

The associations of Internet addiction (IA) and smartphone addiction (SA) with mental health problems have been widely studied. We investigated the effects of IA and SA on depression and anxiety while adjusting for sociodemographic variables. In this study, 4854 participants completed a cross-sectional web-based survey including socio-demographic items, the Korean Scale for Internet Addiction, the Smartphone Addiction Proneness Scale, and the subscales of the Symptom Checklist 90 Items-Revised. The participants were classified into IA, SA, and normal use (NU) groups. To reduce sampling bias, we applied the propensity score matching method based on genetics matching. The IA group showed an increased risk of depression (relative risk 1.207; p < 0.001) and anxiety (relative risk 1.264; p < 0.001) compared to NUs. The SA group also showed an increased risk of depression (relative risk 1.337; p < 0.001) and anxiety (relative risk 1.402; p < 0.001) compared to NCs. These findings show that both, IA and SA, exerted significant effects on depression and anxiety. Moreover, our findings showed that SA has a stronger relationship with depression and anxiety, stronger than IA, and emphasized the need for prevention and management policy of the excessive smartphone use. Full article

(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)

11 pages, 796 KiB

Open AccessArticle

Associations between Urban Sprawl and Life Expectancy in the United States

by Shima Hamidi, Reid Ewing, Zaria Tatalovich, James B. Grace and David Berrigan

Int. J. Environ. Res. Public Health 2018, 15(5), 861; https://doi.org/10.3390/ijerph15050861 - 26 Apr 2018

Cited by 67 | Viewed by 15694

Abstract

In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study [...] Read more.

In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study investigated cross-sectional associations between sprawl and life expectancy for metropolitan counties in the United States in 2010. In this study, the measure of life expectancy in 2010 came from a recently released dataset of life expectancies by county. This study modeled average life expectancy with a structural equation model that included five mediators: annual vehicle miles traveled (VMT) per household, average body mass index, crime rate, and air quality index as mediators of sprawl, as well as percentage of smokers as a mediator of socioeconomic status. After controlling for sociodemographic characteristics, this study found that life expectancy was significantly higher in compact counties than in sprawling counties. Compactness affects mortality directly, but the causal mechanism is unclear. For example, it may be that sprawling areas have higher traffic speeds and longer emergency response times, lower quality and less accessible health care facilities, or less availability of healthy foods. Compactness affects mortality indirectly through vehicle miles traveled, which is a contributor to traffic fatalities, and through body mass index, which is a contributor to many chronic diseases. This study identified significant direct and indirect associations between urban sprawl and life expectancy. These findings support further research and practice aimed at identifying and implementing changes to urban planning designed to support health and healthy behaviors. Full article

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

► Show Figures

Figure 1

10 pages, 667 KiB

Open AccessArticle

The Comprehensive Snack Parenting Questionnaire (CSPQ): Development and Test-Retest Reliability

by Dorus W. M. Gevers, Stef P. J. Kremers, Nanne K. De Vries and Patricia Van Assema

Int. J. Environ. Res. Public Health 2018, 15(5), 862; https://doi.org/10.3390/ijerph15050862 - 26 Apr 2018

Cited by 17 | Viewed by 5683

Abstract

The narrow focus of existing food parenting instruments led us to develop a food parenting practices instrument measuring the full range of food practices constructs with a focus on snacking behavior. We present the development of the questionnaire and our research on the [...] Read more.

The narrow focus of existing food parenting instruments led us to develop a food parenting practices instrument measuring the full range of food practices constructs with a focus on snacking behavior. We present the development of the questionnaire and our research on the test-retest reliability. The developed Comprehensive Snack Parenting Questionnaire (CSPQ) covers 21 constructs. Test-retest reliability was assessed by calculating intra class correlation coefficients and percentage agreement after two administrations of the CSPQ among a sample of 66 Dutch parents. Test-retest reliability analysis revealed acceptable intra class correlation coefficients (≥0.41) or agreement scores (≥0.60) for all items. These results, together with earlier work, suggest sufficient psychometric characteristics. The comprehensive, but brief CSPQ opens up chances for highly essential but unstudied research questions to understand and predict children’s snack intake. Example applications include studying the interactional nature of food parenting practices or interactions of food parenting with general parenting or child characteristics. Full article

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

► Show Figures

Figure 1

10 pages, 354 KiB

Open AccessArticle

Disability-Adjusted Life Years for Cancer in 2010–2014: A Regional Approach in Mexico

by Efrén Murillo-Zamora, Oliver Mendoza-Cano, Mónica Ríos-Silva, Ramón Alberto Sánchez-Piña, Martha Alicia Higareda-Almaraz, Enrique Higareda-Almaraz and Agustin Lugo-Radillo

Int. J. Environ. Res. Public Health 2018, 15(5), 864; https://doi.org/10.3390/ijerph15050864 - 26 Apr 2018

Cited by 8 | Viewed by 4428

Abstract

The disability-adjusted life years (DALYs) were used to estimate the regional (state of Colima, Mexico) cancer burden in 2010–2014. The years of life lost (YLL) were estimated with mortality data and years lived with disability (YLD) using incidence data. The DALYs were calculated [...] Read more.

The disability-adjusted life years (DALYs) were used to estimate the regional (state of Colima, Mexico) cancer burden in 2010–2014. The years of life lost (YLL) were estimated with mortality data and years lived with disability (YLD) using incidence data. The DALYs were calculated as the arithmetic addition of YLL and YLD. Sex and cancer site-specific estimations were made and DALY rates were used to identify the leading causes of disease burden. Data from 2532 deaths were analyzed and, for all malignant tumors combined, 18,712.9 DALYs and 20,243.3 DALYs were estimated in males and females respectively. The overall contribution of YLL in DALY estimates was higher among females (93.7% vs. 87.4%). Age-standardized DALY rates (and 95% confidence intervals, CI) per 100,000 inhabitants were used to rank the leading causes of disease burden and, among males, malignant tumors from the prostate, lower respiratory tract, and colon and rectum accounted the highest rates (45.7, 95% CI 32.7–59.3; 37.6, 95% CI 25.7–49.9; and 25.9, 95% CI 16.0–36.1 DALYs). Breast, cervix uteri, and lower respiratory tract cancer showed the highest burden in females (66.0, 95% CI 50.3–82.4; 44.4, 95% CI 31.5–57.7; and 20.9, 95% CI 12.0–30.0 DALYs). The present study provides an indication of the burden of cancer at the regional level, underscoring the need to expand cancer prevention, screening, and awareness programs, as well as to improve early diagnosis and medical treatment. Full article

(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)

13 pages, 549 KiB

Open AccessArticle

Differentiating Medicated Patients Suffering from Major Depressive Disorder from Healthy Controls by Spot Urine Measurement of Monoamines and Steroid Hormones

by Chandra S. Wijaya, Jovia J. Z. Lee, Syeda F. Husain, Cyrus S. H. Ho, Roger S. McIntyre, Wilson W. Tam and Roger C. M. Ho

Int. J. Environ. Res. Public Health 2018, 15(5), 865; https://doi.org/10.3390/ijerph15050865 - 26 Apr 2018

Cited by 26 | Viewed by 5225

Abstract

Introduction: Major Depressive Disorder (MDD) is a common psychiatric disorder. Currently, there is no objective, cost-effective and non-invasive method to measure biological markers related to the pathogenesis of MDD. Previous studies primarily focused on urinary metabolite markers which are not proximal to [...] Read more.

Introduction: Major Depressive Disorder (MDD) is a common psychiatric disorder. Currently, there is no objective, cost-effective and non-invasive method to measure biological markers related to the pathogenesis of MDD. Previous studies primarily focused on urinary metabolite markers which are not proximal to the pathogenesis of MDD. Herein, we compare urinary monoamines, steroid hormones and the derived ratios amongst MDD when compared to healthy controls. Methods: Morning urine samples of medicated patients suffering from MDD (n = 47) and healthy controls (n = 41) were collected. Enzyme-linked immunosorbent assay (ELISA) was performed to measure five biomarkers: cortisol, dopamine, noradrenaline, serotonin and sulphate derivative of dehydroepiandrosterone (DHEAS). The mean urinary levels and derived ratios of monoamines and steroid hormones were compared between patients and controls to identify potential biomarkers. The receiver operative characteristic curve (ROC) analysis was conducted to evaluate the diagnostic performance of potential biomarkers. Results: Medicated patients with MDD showed significantly higher spot urine ratio of DHEAS/serotonin (1.56 vs. 1.19, p = 0.004) and lower ratio of serotonin/dopamine (599.71 vs. 888.60, p = 0.008) than healthy controls. A spot urine serotonin/dopamine ratio cut-off of >667.38 had a sensitivity of 73.2% and specificity of 51.1%. Conclusions: Our results suggest that spot urine serotonin/dopamine ratio can be used as an objective diagnostic method for adults with MDD. Full article

(This article belongs to the Special Issue Adult Psychiatry)

► Show Figures

Figure 1

15 pages, 4621 KiB

Open AccessArticle

Biomethanation of Harmful Macroalgal Biomass in Leach-Bed Reactor Coupled to Anaerobic Filter: Effect of Water Regime and Filter Media

by Heejung Jung, Jaai Kim and Changsoo Lee

Int. J. Environ. Res. Public Health 2018, 15(5), 866; https://doi.org/10.3390/ijerph15050866 - 26 Apr 2018

Cited by 9 | Viewed by 4696

Abstract

Ulva is a marine macroalgal genus which causes serious green tides in coastal areas worldwide. This study investigated anaerobic digestion as a way to manage Ulva waste in a leach-bed reactor coupled to an anaerobic filter (LBR-AF). Two LBR-AF systems with different filter [...] Read more.

Ulva is a marine macroalgal genus which causes serious green tides in coastal areas worldwide. This study investigated anaerobic digestion as a way to manage Ulva waste in a leach-bed reactor coupled to an anaerobic filter (LBR-AF). Two LBR-AF systems with different filter media, blast furnace slag grains for R1, and polyvinyl chloride rings for R2, were run at increasing water replacement rates (WRRs). Both achieved efficient volatile solids reduction (68.4–87.1%) and methane yield (148–309 mL/g VS fed) at all WRRs, with the optimal WRR for maximum methane production being 100 mL/d. R1 maintained more stable methanation performance than R2, possibly due to the different surface properties (i.e., biomass retention capacity) of the filter media. Such an effect was also noted in the different behaviors of the LBR and AF between R1 and R2. The molecular analysis results revealed that the development of the microbial community structure in the reactors was primarily determined by the fermentation type, i.e., dry (LBR) or wet (AF). Full article

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

► Show Figures

Figure 1

13 pages, 3381 KiB

Open AccessArticle

Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines

by Lu-jie Zhou, Qing-gui Cao, Kai Yu, Lin-lin Wang and Hai-bin Wang

Int. J. Environ. Res. Public Health 2018, 15(5), 868; https://doi.org/10.3390/ijerph15050868 - 26 Apr 2018

Cited by 54 | Viewed by 10570

Abstract

This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; [...] Read more.

This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines. Full article

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

► Show Figures

Graphical abstract

15 pages, 370 KiB

Open AccessArticle

Sufficient Social Support as a Possible Preventive Factor against Fighting and Bullying in School Children

by Kastytis Šmigelskas, Tomas Vaičiūnas, Justė Lukoševičiūtė, Marta Malinowska-Cieślik, Marina Melkumova, Eva Movsesyan and Apolinaras Zaborskis

Int. J. Environ. Res. Public Health 2018, 15(5), 870; https://doi.org/10.3390/ijerph15050870 - 26 Apr 2018

Cited by 28 | Viewed by 8196

Abstract

Background: This study aims to explore how sufficient social support can act as a possible preventive factor against fighting and bullying in school-aged children in 9 European countries. Methods: Data for this study were collected during the 2013/2014 Health Behaviour in School-aged [...] Read more.

Background: This study aims to explore how sufficient social support can act as a possible preventive factor against fighting and bullying in school-aged children in 9 European countries. Methods: Data for this study were collected during the 2013/2014 Health Behaviour in School-aged Children (HBSC) survey. The sample consisted of 9 European countries, involving 43,667 school children in total, aged 11, 13 and 15 years. The analysed data focus on social context (relations with family, peers, and school) as well as risk behaviours such as smoking, drunkenness, fighting and bullying in adolescents. The relationships between social support and violent behaviour variables were estimated using multiple regression models and multivariate analyses. Results: Bullying, across 9 countries, was more prevalent than fighting, except for Armenia, Israel, and Poland. The prevalence among countries differed considerably, with fighting being most expressed in Armenia and bullying—in Latvia and Lithuania. The strongest risk factors for bullying and fighting were male gender (less expressed for bullying), smoking and alcohol consumption. In addition, for bullying the social support was similarly strong factor like above-mentioned factors, while for fighting—less significant, but still independent. All forms of social support were significantly relate with lower violent behaviour of school children, and family support was associated most strongly. Regardless the socioeconomic, historical, and cultural differences among selected countries, the enhancement and reinforcement of the social support from possible many different resources should be taken into consideration in prevention programs against school violence behaviours. Full article

8 pages, 317 KiB

Open AccessArticle

Self-Reported Environmental Tobacco Smoke Exposure and Avoidance Compared with Cotinine Confirmed Tobacco Smoke Exposure among Pregnant Women and Their Infants

by Adam Gregory Gavarkovs, Patricia Markham Risica, Donna R. Parker, Ernestine Jennings, Jennifer Mello and Maureen Phipps

Int. J. Environ. Res. Public Health 2018, 15(5), 871; https://doi.org/10.3390/ijerph15050871 - 27 Apr 2018

Cited by 12 | Viewed by 4671

Abstract

Background: Exposure to environmental tobacco smoke (ETS) presents substantial health risks for pregnant women and newborn infants. Measurements of ETS include invasive and expensive biochemical tests, as well as less invasive and lower-cost, self-reported exposure and avoidance measures. Better understanding of self-report measures [...] Read more.

Background: Exposure to environmental tobacco smoke (ETS) presents substantial health risks for pregnant women and newborn infants. Measurements of ETS include invasive and expensive biochemical tests, as well as less invasive and lower-cost, self-reported exposure and avoidance measures. Better understanding of self-report measures will help to select ETS assessments for evaluation. Methods: This analysis was conducted within the context of a tailored video intervention to reduce tobacco smoking and ETS exposure during pregnancy and after delivery in the control group sample of 147 nonsmoking women. Measurements of salivary cotinine concentration, self-reported ETS exposure, and avoidance behaviors were captured at 32 weeks’ gestation and 6 months postpartum. Results: Salivary cotinine concentration was significantly related to ETS avoidance among pregnant nonsmokers at 32 weeks’ gestation, but not ETS exposure. At 6 months postpartum, both the reported ETS exposure of the infant and maternal avoidance behaviors to reduce her infant’s exposure were associated with the infant’s salivary cotinine concentration. At 32 weeks’ gestation and 6 months postpartum, avoidance behaviors decreased as exposure increased. Discussion: This study suggests that for nonsmoking women during pregnancy, reports of tobacco smoke avoidance are more valid than reports of exposure. After delivery, self-reported ETS exposure or avoidance are associated with each other and the biochemical measurement of salivary cotinine. These results provide researchers and clinicians with evidence to support the inclusion of avoidance behaviors in the selection of ETS measures. Full article

(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)

13 pages, 3072 KiB

Open AccessArticle

Dechlorination of Hexachlorobenzene in Contaminated Soils Using a Nanometallic Al/CaO Dispersion Mixture: Optimization through Response Surface Methodology

by Yuhui Jiang, Yixuan Shang, Shuyao Yu and Jianguo Liu

Int. J. Environ. Res. Public Health 2018, 15(5), 872; https://doi.org/10.3390/ijerph15050872 - 27 Apr 2018

Cited by 17 | Viewed by 5309

Abstract

Hexachlorobenzene (HCB) contamination of soils remains a significant environmental challenge all over the world. Reductive stabilization is a developing technology that can decompose the HCB with a dechlorination process. A nanometallic Al/CaO (n-Al/CaO) dispersion mixture was developed utilizing ball-milling technology in this study. [...] Read more.

Hexachlorobenzene (HCB) contamination of soils remains a significant environmental challenge all over the world. Reductive stabilization is a developing technology that can decompose the HCB with a dechlorination process. A nanometallic Al/CaO (n-Al/CaO) dispersion mixture was developed utilizing ball-milling technology in this study. The dechlorination efficiency of HCB in contaminated soils by the n-Al/CaO grinding treatment was evaluated. Response surface methodology (RSM) was employed to investigate the effects of three variables (soil moisture content, n-Al/CaO dosage and grinding time) and the interactions between these variables under the Box-Behnken Design (BBD). A high regression coefficient value (R² = 0.9807) and low p value (<0.0001) of the quadratic model indicated that the model was accurate in predicting the experimental results. The optimal soil moisture content, n-Al/CaO dosage, and grinding time were found to be 7% (m/m), 17.7% (m/m), and 24 h, respectively, in the experimental ranges and levels. Under optimal conditions, the dechlorination efficiency was 80%. The intermediate product analysis indicated that dechlorination was the process by stepwise loss of chloride atoms. The main pathway observed within 24 h was HCB → pentachlorobenzene (PeCB) → 1,2,3,4-tetrachlorobenzene (TeCB) and 1,2,4,5-TeCB. The results indicated that the moderate soil moisture content was crucial for the hydrodechlorination of HCB. A probable mechanism was proposed wherein water acted like a hydrogen donor and promoted the hydrodechlorination process. The potential application of n-Al/CaO is an environmentally-friendly and cost-effective option for decontamination of HCB-contaminated soils. Full article

(This article belongs to the Special Issue Soil Pollution and Remediation)

► Show Figures

Figure 1

12 pages, 303 KiB

Open AccessArticle

Health Risk Behavior Patterns in a National Adult Population Survey

by Ulrich John, Monika Hanke and Jennis Freyer-Adam

Int. J. Environ. Res. Public Health 2018, 15(5), 873; https://doi.org/10.3390/ijerph15050873 - 27 Apr 2018

Cited by 31 | Viewed by 4839

Abstract

Background: The aim of this paper is to analyze the co-occurrence of health risk behaviors (HRBs), namely, tobacco smoking, alcohol risk drinking, overeating, and physical inactivity, as well as their 16 combinations (patterns), which are stratified by age and gender. Methods: [...] Read more.

Background: The aim of this paper is to analyze the co-occurrence of health risk behaviors (HRBs), namely, tobacco smoking, alcohol risk drinking, overeating, and physical inactivity, as well as their 16 combinations (patterns), which are stratified by age and gender. Methods: The data of 19,294 study participants, from a telephone survey among the adult general population of Germany that was conducted in 2012, were analyzed. Results: In adults, two or more of the four HBRs were found among 51.5% of females and 61.9% of males. The single most prevalent HRB pattern among all of the female (20.7, 19.6–21.8%) and male participants (18.2, 17.1–19.3%) was being overweight combined with a lack of physical activity, and its prevalence increased by 4% with each year of life. A multinomial regression analysis revealed that education was inversely associated with 11 of the 15 HRB patterns. The risk of having four, compared to zero, HRBs was 3.3 (2.5–4.4) for males relative to females. Conclusion: Similar to the findings from other western countries, the majority of the participants in this adult national sample from Germany had two or more HRBs. The most common of all possible HRB patterns was overweight and inactivity. The data confirm inverse relations between education and most HRB patterns. Full article

(This article belongs to the Collection Health Behavior and Public Health)

12 pages, 974 KiB

Open AccessArticle

A Prospective Study on the Influence of Scholastic Factors on the Prevalence and Initiation of Illicit Drug Misuse in Adolescence

by Zoran Zubak, Natasa Zenic, Ljerka Ostojic, Ivana Zubak and Haris Pojskic

Int. J. Environ. Res. Public Health 2018, 15(5), 874; https://doi.org/10.3390/ijerph15050874 - 27 Apr 2018

Cited by 9 | Viewed by 4694

Abstract

Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia and Herzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of [...] Read more.

Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia and Herzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of 16 years old at the beginning of the study (baseline). The participants were tested at baseline and follow-up (20 months later). The predictors included variables of scholastic-achievement (grade point average, school absences, unexcused absences and behavioral grade). The criteria were: (i) IDM at baseline; (ii) IDM at follow-up; and (iii) initiation of IDM over the study course. Results: Logistic regression indicated increased odds of IDM in adolescents who were more frequent absent from school (baseline: Odds Ratio (OR): 3.73, 95% Confidence Interval (CI): 2.12–6.57; follow-up: OR: 2.91, 95% CI: 1.90–4.65). The lower grade point average and more unexcused absences were evidenced for adolescents who consumed drugs on follow-up (OR: 1.67, 95% CI: 1.11–2.51; OR: 1.74, 95% CI: 1.30–2.32 for grade point average and unexcused absences, respectively). Initiation of IDM was predicted by frequent absences from school (OR: 2.2, 95% CI: 1.3–3.8), and lower behavioral grades (OR: 1.9, 95% CI: 1.2–3.3). Conclusions: The findings confirmed strong correlations between scholastic failure and IDM. Absences from school and lower behavioral grades at baseline were predictive of the initiation of IDM in older adolescents. Full article

(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)

► Show Figures

Figure 1

11 pages, 2038 KiB

Open AccessArticle

How Well Do COP22 Attendees Understand Graphs on Climate Change Health Impacts from the Fifth IPCC Assessment Report?

by Helen Fischer, Stefanie Schütte, Anneliese Depoux, Dorothee Amelung and Rainer Sauerborn

Int. J. Environ. Res. Public Health 2018, 15(5), 875; https://doi.org/10.3390/ijerph15050875 - 27 Apr 2018

Cited by 10 | Viewed by 5258

Abstract

Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put [...] Read more.

Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put the understandability of three graphs taken from the Health chapter of the Fifth Assessment Report to an empirical test. We present a pilot study where we evaluate objective understanding (mean accuracy in multiple-choice questions) and subjective understanding (self-assessed confidence in accuracy) in a sample of attendees of the United Nations Climate Change Conference in Marrakesh, 2016 (COP22), and a student sample. Results show a mean objective understanding of M = 0.33 for the COP sample, and M = 0.38 for the student sample. Subjective and objective understanding were unrelated for the COP22 sample, but associated for the student sample. These results suggest that (i) understandability of the IPCC health chapter graphs is insufficient, and that (ii) particularly COP22 attendees lacked insight into which graphs they did, and which they did not understand. Implications for the construction of graphs to communicate health impacts of climate change to decision-makers are discussed. Full article

(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)

► Show Figures

Figure 1

9 pages, 992 KiB

Open AccessCommunication

Glucose Gel as a Potential Alternative Treatment to Infant Formula for Neonatal Hypoglycaemia in Australia

by Raenee L. Barber, Amy E. Ekin, Pushparani Sivakumar, Kay Howard and Therese A. O’Sullivan

Int. J. Environ. Res. Public Health 2018, 15(5), 876; https://doi.org/10.3390/ijerph15050876 - 27 Apr 2018

Cited by 4 | Viewed by 7283

Abstract

Infant formula is often used as a treatment for neonatal hypoglycaemia in Australia; however, there are concerns that this may jeopardise mother-baby bonding and breastfeeding. Successful use of glucose gel as an alternative treatment for hypoglycaemia has been reported. We wanted to investigate [...] Read more.

Infant formula is often used as a treatment for neonatal hypoglycaemia in Australia; however, there are concerns that this may jeopardise mother-baby bonding and breastfeeding. Successful use of glucose gel as an alternative treatment for hypoglycaemia has been reported. We wanted to investigate in a pilot study whether the use of glucose gel has the potential to quickly and safely restore normoglycaemia in the infants of diabetic mothers in an Australian setting. Infants with asymptomatic hypoglycaemia were treated with glucose gel (n = 36) and compared to a historical group of infants which had been treated with infant formula (n = 24). Within 15 min of the first treatment, the gel group had a mean blood glucose level (BGL) of 2.6 mmol/L, and 2.7 mmol/L 30 min after the second treatment. This was lower than the BGL after the first treatment for the formula group, which rose to a mean of 2.8 then to 3.2 mmol/L after the second treatment (p = 0.003). In successfully treated infants, administration of the gel resulted in normoglycaemia within 30 min. The likelihood of special care nursery admission was not significantly different between the groups, although we had a small sample size, and our findings should be interpreted with caution. These pilot results provide support for further investigations into the use of glucose gel as an alternative treatment to infant formula. Full article

(This article belongs to the Special Issue Nutrition in the First 1000 Days)

► Show Figures

Figure 1

19 pages, 901 KiB

Open AccessArticle

Dust at Various Workplaces—Microbiological and Toxicological Threats

by Beata Gutarowska, Justyna Szulc, Adriana Nowak, Anna Otlewska, Małgorzata Okrasa, Anita Jachowicz and Katarzyna Majchrzycka

Int. J. Environ. Res. Public Health 2018, 15(5), 877; https://doi.org/10.3390/ijerph15050877 - 27 Apr 2018

Cited by 24 | Viewed by 6030

Abstract

The aim of the present study was to evaluate the relation between the chemical (analysis of elements and pH) and microbiological composition (culture and metagenomics analysis) of the dust at various workplaces (cement plant, composting plant, poultry farm, and cultivated area) and the [...] Read more.

The aim of the present study was to evaluate the relation between the chemical (analysis of elements and pH) and microbiological composition (culture and metagenomics analysis) of the dust at various workplaces (cement plant, composting plant, poultry farm, and cultivated area) and the cytotoxicity effect on the human adenocarcinoma lung epithelial adherent cell line A-549 (MTT assay test). Analysis of the Particulate Matter (PM) fraction showed that the dust concentration in cultivated areas exceeded the OELs. For the remaining workplaces examined, the dust concentration was lower than OELs limits. The number of microorganisms in the dust samples was 3.8 × 10²–1.6 × 10⁸ CFU/g bacteria and 1.5 × 10²–6.5 × 10⁶ CFU/g fungi. The highest number of microorganisms was noted for dust from cultivated areas (total number of bacteria, actinomycetes, P. fluorescens) and composting plants (xerophilic fungi and staphylococci), while the least number of microorganisms was observed for dust from cement plants. Many types of potentially pathogenic microorganisms have been identified, including bacteria, such as Bacillus, Actinomyces, Corynebacterium, Prevotella, Clostridium, and Rickettsia, and fungi, such as Alternaria, Cladosporium, Penicillium, and Aspergillus. The most cytotoxic to the human lung cell line A-549 was dust from cultivated areas (IC₅₀ = 3.8 mg/mL after 72 h). The cytotoxicity of the tested dust samples depends on the PM concentration, the number of microorganisms, including potentially pathogenic genera, and the exposure time. Full article

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

► Show Figures

Figure 1

8 pages, 629 KiB

Open AccessArticle

Occurrence of Aflatoxin M1 in Raw Milk from Manufacturers of Infant Milk Powder in China

by Songli Li, Li Min, Gang Wang, Dagang Li, Nan Zheng and Jiaqi Wang

Int. J. Environ. Res. Public Health 2018, 15(5), 879; https://doi.org/10.3390/ijerph15050879 - 28 Apr 2018

Cited by 23 | Viewed by 5449

Abstract

This survey was performed to investigate the occurrence of aflatoxin M1 (AFM1) contamination of raw milk from manufacturers of infant milk powder in China. A total of 1207 raw milk samples were collected overall from four seasons of 2016 in Northeast China, Northwest [...] Read more.

This survey was performed to investigate the occurrence of aflatoxin M1 (AFM1) contamination of raw milk from manufacturers of infant milk powder in China. A total of 1207 raw milk samples were collected overall from four seasons of 2016 in Northeast China, Northwest China, Northern China, and Central China (11 provinces and one municipality). Results showed that 56 of the 1207 raw milk samples (4.64%) were positive for AFM1, which were obtained from Heilongjiang (two samples), Gansu (one sample), Shaanxi (46 samples), Beijing (one sample), and Hunan (six samples) provinces. None of the raw milk samples from manufacturers of infant milk powder exceeded the Chinese limit (62.5 ng/L) in 2016. Only a few raw milk samples were not suitable for use in infant milk according to EU (European Union) or U.S. infant milk limits. Furthermore, based on this survey and previous studies, it is particularly important to avoid AFM1 contamination in raw milk during the winter. Full article

(This article belongs to the Section Global Health)

► Show Figures

Figure 1

27 pages, 11281 KiB

Open AccessArticle

Evaluating Health Co-Benefits of Climate Change Mitigation in Urban Mobility

by Brigitte Wolkinger, Willi Haas, Gabriel Bachner, Ulli Weisz, Karl W. Steininger, Hans-Peter Hutter, Jennifer Delcour, Robert Griebler, Bernhard Mittelbach, Philipp Maier and Raphael Reifeltshammer

Int. J. Environ. Res. Public Health 2018, 15(5), 880; https://doi.org/10.3390/ijerph15050880 - 28 Apr 2018

Cited by 34 | Viewed by 9460

Abstract

There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they [...] Read more.

There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they are not easy to capture. In an interdisciplinary multi-model approach we address this gap, investigating the co-benefits resulting from increased physical activity and improved air quality due to climate mitigation policies for three urban areas. Additionally we take a (macro-)economic perspective, since that is the ultimate interest of policy-makers. Methodologically, we link a transport modelling tool, a transport emission model, an emission dispersion model, a health model and a macroeconomic Computable General Equilibrium (CGE) model to analyze three climate change mitigation scenarios. We show that higher levels of physical exercise and reduced exposure to pollutants due to mitigation measures substantially decrease morbidity and mortality. Expenditures are mainly born by the public sector but are mostly offset by the emerging co-benefits. Our macroeconomic results indicate a strong positive welfare effect, yet with slightly negative GDP and employment effects. We conclude that considering economic co-benefits of climate change mitigation policies in urban mobility can be put forward as a forceful argument for policy makers to take action. Full article

(This article belongs to the Special Issue Climate Change and Health: An Interdisciplinary Perspective)

► Show Figures

Figure 1

17 pages, 1160 KiB

Open AccessArticle

Employee Perceptions of Workplace Health Promotion Programs: Comparison of a Tailored, Semi-Tailored, and Standardized Approach

by Tamara D. Street and Sarah J. Lacey

Int. J. Environ. Res. Public Health 2018, 15(5), 881; https://doi.org/10.3390/ijerph15050881 - 28 Apr 2018

Cited by 17 | Viewed by 5894

Abstract

In the design of workplace health promotion programs (WHPPs), employee perceptions represent an integral variable which is predicted to translate into rate of user engagement (i.e., participation) and program loyalty. This study evaluated employee perceptions of three workplace health programs promoting nutritional consumption [...] Read more.

In the design of workplace health promotion programs (WHPPs), employee perceptions represent an integral variable which is predicted to translate into rate of user engagement (i.e., participation) and program loyalty. This study evaluated employee perceptions of three workplace health programs promoting nutritional consumption and physical activity. Programs included: (1) an individually tailored consultation with an exercise physiologist and dietitian; (2) a semi-tailored 12-week SMS health message program; and (3) a standardized group workshop delivered by an expert. Participating employees from a transport company completed program evaluation surveys rating the overall program, affect, and utility of: consultations (n = 19); SMS program (n = 234); and workshops (n = 86). Overall, participants’ affect and utility evaluations were positive for all programs, with the greatest satisfaction being reported in the tailored individual consultation and standardized group workshop conditions. Furthermore, mode of delivery and the physical presence of an expert health practitioner was more influential than the degree to which the information was tailored to the individual. Thus, the synergy in ratings between individually tailored consultations and standardized group workshops indicates that low-cost delivery health programs may be as appealing to employees as tailored, and comparatively high-cost, program options. Full article

(This article belongs to the Special Issue Workplace Health Promotion 2018)

► Show Figures

Figure 1

19 pages, 1711 KiB

Open AccessArticle

Health Seeking Behavior among Rural Left-Behind Children: Evidence from Shaanxi and Gansu Provinces in China

by Hongyu Guan, Huan Wang, Juerong Huang, Kang Du, Jin Zhao, Matthew Boswell, Yaojiang Shi, Mony Iyer and Scott Rozelle

Int. J. Environ. Res. Public Health 2018, 15(5), 883; https://doi.org/10.3390/ijerph15050883 - 28 Apr 2018

Cited by 16 | Viewed by 5813

Abstract

More than 60 million children in rural China are “left-behind”—both parents live and work far from their rural homes and leave their children behind. This paper explores differences in how left-behind and non-left-behind children seek health remediation in China’s vast but understudied rural [...] Read more.

More than 60 million children in rural China are “left-behind”—both parents live and work far from their rural homes and leave their children behind. This paper explores differences in how left-behind and non-left-behind children seek health remediation in China’s vast but understudied rural areas. This study examines this question in the context of a program to provide vision health care to myopic rural students. The data come from a randomized controlled trial of 13,100 students in Gansu and Shaanxi provinces in China. The results show that without a subsidy, uptake of health care services is low, even if individuals are provided with evidence of a potential problem (an eyeglasses prescription). Uptake rises two to three times when this information is paired with a subsidy voucher redeemable for a free pair of prescription eyeglasses. In fact, left-behind children who receive an eyeglasses voucher are not only more likely to redeem it, but also more likely to use the eyeglasses both in the short term and long term. In other words, in terms of uptake of care and compliance with treatment, the voucher program benefitted left-behind students more than non-left-behind students. The results provide a scientific understanding of differential impacts for guiding effective implementation of health policy to all groups in need in developing countries. Full article

(This article belongs to the Section Health Economics)

► Show Figures

Figure 1

15 pages, 752 KiB

Open AccessArticle

Electrocardiographic and Electrooculographic Responses to External Emotions and Their Transitions in Bipolar I and II Disorders

by Guorong Ma, Chu Wang, Yanli Jia, Jiawei Wang, Bingren Zhang, Chanchan Shen, Hongying Fan, Bing Pan and Wei Wang

Int. J. Environ. Res. Public Health 2018, 15(5), 884; https://doi.org/10.3390/ijerph15050884 - 28 Apr 2018

Cited by 10 | Viewed by 4416

Abstract

Bipolar disorder has two main types, bipolar I (BD I) and II (BD II), which present different affective states and personality characteristics, they might present different modes of emotional regulation. We hypothesized that the electrocardiogram and electrooculogram to external emotions are different in [...] Read more.

Bipolar disorder has two main types, bipolar I (BD I) and II (BD II), which present different affective states and personality characteristics, they might present different modes of emotional regulation. We hypothesized that the electrocardiogram and electrooculogram to external emotions are different in BD I and BD II. We asked 69 BD I and 54 BD II patients, and 139 healthy volunteers to undergo these tests in response to disgust, erotica, fear, happiness, neutral, and sadness, and their transitions. Their affective states were also measured. The heart rate in BD I was significantly higher under background fear after target neutral. The eyeball movement was quicker in BD I under target happiness after background disgust; in BD I under target sadness after background disgust; and in BD I under background disgust after target neutral. Some electrocardiographic and electrooculographic changes were correlated with affective states in patients. BD I and BD II had different physiological responses to external emotions and their transitions, indicating different pathophysiologies and suggesting different emotional-therapies for BD I and BD II. Full article

(This article belongs to the Special Issue Adult Psychiatry)

► Show Figures

Figure 1

13 pages, 1699 KiB

Open AccessArticle

Frequency Analysis of Failure Scenarios from Shale Gas Development

by Noura Abualfaraj, Patrick L. Gurian and Mira S. Olson

Int. J. Environ. Res. Public Health 2018, 15(5), 885; https://doi.org/10.3390/ijerph15050885 - 29 Apr 2018

Cited by 5 | Viewed by 4013

Abstract

This study identified and prioritized potential failure scenarios for natural gas drilling operations through an elicitation of people who work in the industry. A list of twelve failure scenarios of concern was developed focusing on specific events that may occur during the shale [...] Read more.

This study identified and prioritized potential failure scenarios for natural gas drilling operations through an elicitation of people who work in the industry. A list of twelve failure scenarios of concern was developed focusing on specific events that may occur during the shale gas extraction process involving an operational failure or a violation of regulations. Participants prioritized the twelve scenarios based on their potential impact on the health and welfare of the general public, potential impact on worker safety, how well safety guidelines protect against their occurrence, and how frequently they occur. Illegal dumping of flowback water, while rated as the least frequently occurring scenario, was considered the scenario least protected by safety controls and the one of most concern to the general public. In terms of worker safety, the highest concern came from improper or inadequate use of personal protective equipment (PPE). While safety guidelines appear to be highly protective regarding PPE usage, inadequate PPE is the most directly witnessed failure scenario. Spills of flowback water due to equipment failure are of concern both with regards to the welfare of the general public and worker safety as they occur more frequently than any other scenario examined in this study. Full article

(This article belongs to the Special Issue Environmental Health Impacts of Hydraulic Fracturing)

► Show Figures

Graphical abstract

22 pages, 5832 KiB

Open AccessArticle

Risk Analysis of Earth-Rock Dam Failures Based on Fuzzy Event Tree Method

by Xiao Fu, Chong-Shi Gu, Huai-Zhi Su and Xiang-Nan Qin

Int. J. Environ. Res. Public Health 2018, 15(5), 886; https://doi.org/10.3390/ijerph15050886 - 29 Apr 2018

Cited by 34 | Viewed by 9350

Abstract

Earth-rock dams make up a large proportion of the dams in China, and their failures can induce great risks. In this paper, the risks associated with earth-rock dam failure are analyzed from two aspects: the probability of a dam failure and the resulting [...] Read more.

Earth-rock dams make up a large proportion of the dams in China, and their failures can induce great risks. In this paper, the risks associated with earth-rock dam failure are analyzed from two aspects: the probability of a dam failure and the resulting life loss. An event tree analysis method based on fuzzy set theory is proposed to calculate the dam failure probability. The life loss associated with dam failure is summarized and refined to be suitable for Chinese dams from previous studies. The proposed method and model are applied to one reservoir dam in Jiangxi province. Both engineering and non-engineering measures are proposed to reduce the risk. The risk analysis of the dam failure has essential significance for reducing dam failure probability and improving dam risk management level. Full article

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

► Show Figures

Figure 1

20 pages, 4605 KiB

Open AccessArticle

Groundwater Flow Processes and Human Impact along the Arid US-Mexican Border, Evidenced by Environmental Tracers: The Case of Tecate, Baja California

by Jürgen Mahlknecht, Luis Walter Daessle, Maria Vicenta Esteller, Juan Antonio Torres-Martinez and Abrahan Mora

Int. J. Environ. Res. Public Health 2018, 15(5), 887; https://doi.org/10.3390/ijerph15050887 - 30 Apr 2018

Cited by 17 | Viewed by 5405

Abstract

With the increasing population, urbanization and industry in the arid area of Tecate, there is a concomitant increase in contaminants being introduced into the Tecate River and its aquifer. This contamination is damaging the usable groundwater supply and making local residents and commercial [...] Read more.

With the increasing population, urbanization and industry in the arid area of Tecate, there is a concomitant increase in contaminants being introduced into the Tecate River and its aquifer. This contamination is damaging the usable groundwater supply and making local residents and commercial enterprises increasingly dependent on imported water from the Colorado River basin. In this study we apply a suite of chemical and isotopic tracers in order to evaluate groundwater flow and assess contamination trends. Groundwater recharge occurs through mountain-block and mountain-front recharge at higher elevations of the ranges. Groundwater from the unconfined, alluvial aquifer indicates recent recharge and little evolution. The increase in salinity along the flow path is due to interaction with weathering rock-forming silicate minerals and anthropogenic sources such as urban wastewater, residual solids and agricultural runoff from fertilizers, livestock manure and/or septic tanks and latrines. A spatial analysis shows local differences and the impact of the infiltration of imported waters from the Colorado River basin. The general trend of impaired water quality has scarcely been documented in the last decades, but it is expected to continue. Since the groundwater system is highly vulnerable, it is necessary to protect groundwater sources. Full article

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

► Show Figures

Figure 1

10 pages, 1511 KiB

Open AccessArticle

A Pooled Data Analysis to Determine the Relationship between Selected Metals and Arsenic Bioavailability in Soil

by Kaihong Yan, Ravi Naidu, Yanju Liu, Ayanka Wijayawardena, Luchun Duan and Zhaomin Dong

Int. J. Environ. Res. Public Health 2018, 15(5), 888; https://doi.org/10.3390/ijerph15050888 - 30 Apr 2018

Cited by 9 | Viewed by 4629

Abstract

Chronic exposure to arsenic (As) is a global concern due to worldwide exposure and adverse effects, and the importance of incorporating bioavailability in the exposure assessment and risk assessment of As is increasing acknowledged. The bioavailability of As is impacted by a number [...] Read more.

Chronic exposure to arsenic (As) is a global concern due to worldwide exposure and adverse effects, and the importance of incorporating bioavailability in the exposure assessment and risk assessment of As is increasing acknowledged. The bioavailability of As is impacted by a number of soil properties, such as pH, clay and metal concentrations. By retrieving 485 data from 32 publications, the aim of this study was to determine the relationship between selected metals (Fe and Al) and As bioavailability. In present study, the bioaccessibility (BAC) data measured by in vitro approaches were converted into bioavailability data based on the previously determined relationship between BAC and bioavailability. The As relative bioavailability (RBA) was summarized to be 24.36 ± 18.49%, which is in the range previously reported. A significant association between Fe concentration and the bioavailability of As was observed while this association varied for different types of RBA data. This disparity may suggest a non-reliable association between Fe and As bioavailability. The correlations between logarithmically transformed total content of Fe + Al and As bioavailability is then outlined: RBA = (−8.40 ± 1.02) × Ln(Fe + Al) + (58.25 ± 4.09), R² = 0.25, p < 0.001, n = 212. Jackknife resampling was also applied to validate the relation between total content of (Fe + Al) and As bioavailability, which suggested that the relation is robust. This is the first pooled study to address the relations between selected metal concentrations and As bioavailability, which may provide some implications to establish soil properties-based RBA prediction for As. Full article

(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)

► Show Figures

Figure 1

11 pages, 348 KiB

Open AccessArticle

Association of Insulin Resistance with Bone Strength and Bone Turnover in Menopausal Chinese-Singaporean Women without Diabetes

by Maria Kalimeri, Francesca Leek, Nan Xin Wang, Huann Rong Koh, Nicole C. Roy, David Cameron-Smith, Marlena C. Kruger, Christiani Jeyakumar Henry and John J. Totman

Int. J. Environ. Res. Public Health 2018, 15(5), 889; https://doi.org/10.3390/ijerph15050889 - 30 Apr 2018

Cited by 18 | Viewed by 4758

Abstract

Insulin resistance (IR) is accompanied by increased areal or volumetric bone mineral density (aBMD or vBMD), but also higher fracture risk. Meanwhile, imbalances in bone health biomarkers affect insulin production. This study investigates the effect of IR on proximal femur and lumbar spine [...] Read more.

Insulin resistance (IR) is accompanied by increased areal or volumetric bone mineral density (aBMD or vBMD), but also higher fracture risk. Meanwhile, imbalances in bone health biomarkers affect insulin production. This study investigates the effect of IR on proximal femur and lumbar spine BMD, femoral neck bending, compressive and impact strength indices (Composite Strength Indices) and circulating levels of parathyroid hormone (PTH), C-telopeptide of Type I collagen (CTx-1) and 25(OH) Vitamin D₃, in a cohort of 97 healthy, non-obese, menopausal Chinese-Singaporean women. Lumbar spine aBMD was inversely associated with IR and dependent on lean body mass (LBM) and age. No such associations were found for vBMD of the third lumbar vertebra, aBMD and vBMD of the proximal femur, or circulating levels of PTH, CTx-1 and 25(OH) Vitamin D₃. Composite Strength Indices were inversely associated with IR and independent of LBM, but after adjusting for fat mass and age, this association remained valid only for the impact strength index. Composite Strength Indices were significantly lower in participants with a high degree of IR. Our findings on IR and Composite Strength Indices relationships were in agreement with previous studies on different cohorts, but those on IR and BMD associations were not. Full article

(This article belongs to the Special Issue New Concepts in Women’s Bone Health)

18 pages, 372 KiB

Open AccessArticle

Expressed Emotion, Shame, and Non-Suicidal Self-Injury

by Jessica Hack and Graham Martin

Int. J. Environ. Res. Public Health 2018, 15(5), 890; https://doi.org/10.3390/ijerph15050890 - 30 Apr 2018

Cited by 31 | Viewed by 6802

Abstract

A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed [...] Read more.

A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed Emotion (EE) than non-injurers (t(254) = −3.24, p = 0.001), linear contrasts explaining 6% of between-groups variability (F(2, 254) = 7.36, p = 0.001, η² = 0.06). Differences in EE between current and past self-injurers were not significant. Overall shame accounted for 33% of between-groups variance (F(2, 252) = 61.99, p < 0.001, η² = 0.33), with linear contrasts indicating self-injurers experienced higher levels compared to non-injurers (t(252) = −8.23, p < 0.001). Current self-injurers reported higher overall shame than past self-injurers (t(252) = 6.78, p < 0.001). In further logistic regression, emotional involvement and overall shame were the only significant predictors of self-injury status. With every one-unit increase in emotional involvement, odds of currently engaging in self-injury decreased by a factor of 0.860. Conversely, a one-unit increase in overall shame was associated with an increase in the odds of being a current self-injurer by a factor of 1.05. The findings have important treatment implications for engaging key family members in intervention and prevention efforts. Full article

(This article belongs to the Special Issue Advances in Suicide Research)

12 pages, 482 KiB

Open AccessArticle

Weight Shame, Social Connection, and Depressive Symptoms in Late Adolescence

by Alexandra A. Brewis and Meg Bruening

Int. J. Environ. Res. Public Health 2018, 15(5), 891; https://doi.org/10.3390/ijerph15050891 - 1 May 2018

Cited by 24 | Viewed by 12776

Abstract

Child and adolescent obesity is increasingly the focus of interventions, because it predicts serious disease morbidity later in life. However, social environments that permit weight-related stigma and body shame may make weight control and loss more difficult. Rarely do youth obesity interventions address [...] Read more.

Child and adolescent obesity is increasingly the focus of interventions, because it predicts serious disease morbidity later in life. However, social environments that permit weight-related stigma and body shame may make weight control and loss more difficult. Rarely do youth obesity interventions address these complexities. Drawing on repeated measures in a large sample (N = 1443) of first-year (freshman), campus-resident university students across a nine-month period, we model how weight-related shame predicts depressive symptom levels, how being overweight (assessed by anthropometric measures) shapes that risk, and how social connection (openness to friendship) might mediate/moderate. Body shame directly, clearly, and repeatedly predicts depression symptom levels across the whole school year for all students, but overweight youth have significantly elevated risk. Social connections mediate earlier in the school year, and in all phases moderate, body shame effects on depression. Youth obesity interventions would be well-served recognizing and incorporating the influential roles of social-environmental factors like weight stigma and friendship in program design. Full article

(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)

► Show Figures

Figure 1

14 pages, 738 KiB

Open AccessArticle

Antibiotic-Resistant Pathogenic Escherichia Coli Isolated from Rooftop Rainwater-Harvesting Tanks in the Eastern Cape, South Africa

by Mokaba Shirley Malema, Akebe Luther King Abia, Roman Tandlich, Bonga Zuma, Jean-Marc Mwenge Kahinda and Eunice Ubomba-Jaswa

Int. J. Environ. Res. Public Health 2018, 15(5), 892; https://doi.org/10.3390/ijerph15050892 - 1 May 2018

Cited by 23 | Viewed by 6635

Abstract

Although many developing countries use harvested rainwater (HRW) for drinking and other household purposes, its quality is seldom monitored. Continuous assessment of the microbial quality of HRW would ensure the safety of users of such water. The current study investigated the prevalence of [...] Read more.

Although many developing countries use harvested rainwater (HRW) for drinking and other household purposes, its quality is seldom monitored. Continuous assessment of the microbial quality of HRW would ensure the safety of users of such water. The current study investigated the prevalence of pathogenic Escherichia coli strains and their antimicrobial resistance patterns in HRW tanks in the Eastern Cape, South Africa. Rainwater samples were collected weekly between June and September 2016 from 11 tanks in various areas of the province. Enumeration of E. coli was performed using the Colilert^®18/Quanti-Tray^® 2000 method. E. coli isolates were obtained and screened for their virulence potentials using polymerase chain reaction (PCR), and subsequently tested for antibiotic resistance using the disc-diffusion method against 11 antibiotics. The pathotype most detected was the neonatal meningitis E. coli (NMEC) (ibeA 28%) while pathotype enteroaggregative E. coli (EAEC) was not detected. The highest resistance of the E. coli isolates was observed against Cephalothin (76%). All tested pathotypes were susceptible to Gentamicin, and 52% demonstrated multiple-antibiotic resistance (MAR). The results of the current study are of public health concern since the use of untreated harvested rainwater for potable purposes may pose a risk of transmission of pathogenic and antimicrobial-resistant E. coli. Full article

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

► Show Figures

Figure 1

8 pages, 714 KiB

Open AccessArticle

Comparing the Effects of Different Body Armor Systems on the Occupational Performance of Police Officers

by Ben Schram, Robin Orr, Rodney Pope, Ben Hinton and Geoff Norris

Int. J. Environ. Res. Public Health 2018, 15(5), 893; https://doi.org/10.3390/ijerph15050893 - 1 May 2018

Cited by 20 | Viewed by 5455

Abstract

Policing duties may inherently be dangerous due to stab, blunt trauma and ballistic threats. The addition of individual light armor vests (ILAVs) has been suggested as a means to protect officers. However, the addition of the extra load of the ILAV may affect [...] Read more.

Policing duties may inherently be dangerous due to stab, blunt trauma and ballistic threats. The addition of individual light armor vests (ILAVs) has been suggested as a means to protect officers. However, the addition of the extra load of the ILAV may affect officer ability to conduct occupational tasks. The purpose of this study was to determine if wearing any of three different ILAVs made by different companies with their preferred materials and designs (ILAV A, 4.68 percent body weight, ILAV B, 4.05 percent body weight, & ILAV C, 3.71 percent body weight) affected occupational task performance when compared to that in normal station wear. A prospective, within-subjects repeated measures design was employed, using a counterbalanced randomization in which each ILAV was worn for an entire day while officers completed a variety of occupationally relevant tasks. These tasks included a victim drag, car exit and 5-meter sprint, step down and marksmanship task. To compare the effects of the ILAVs on these tasks, a multivariate repeated measures analysis of variance (ANOVA) was conducted, with post hoc pairwise comparisons using a Bonferroni adjustment. Results showed that performance in each task did not vary between any of the ILAV or normal station wear conditions. There was less variability in the marksmanship task with ILAV B, however. The results suggest that none of the ILAVs used in this study were heavy enough to significantly affect task performance in the assessed tasks when compared to wearing normal station wear. Full article

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

► Show Figures

Figure 1

14 pages, 1079 KiB

Open AccessArticle

Emotional Intelligence, Motivational Climate and Levels of Anxiety in Athletes from Different Categories of Sports: Analysis through Structural Equations

by Manuel Castro-Sánchez, Félix Zurita-Ortega, Ramón Chacón-Cuberos, Carlos Javier López-Gutiérrez and Edson Zafra-Santos

Int. J. Environ. Res. Public Health 2018, 15(5), 894; https://doi.org/10.3390/ijerph15050894 - 1 May 2018

Cited by 67 | Viewed by 12697

Abstract

(1) Background: Psychological factors can strongly affect the athletes’ performance. Therefore, currently the role of the sports psychologist is particularly relevant, being in charge of training the athlete’s psychological factors. This study aims at analysing the connections between motivational climate in sport, anxiety [...] Read more.

(1) Background: Psychological factors can strongly affect the athletes’ performance. Therefore, currently the role of the sports psychologist is particularly relevant, being in charge of training the athlete’s psychological factors. This study aims at analysing the connections between motivational climate in sport, anxiety and emotional intelligence depending on the type of sport practised (individual/team) by means of a multigroup structural equations analysis. (2) 372 semi-professional Spanish athletes took part in this investigation, analysing motivational climate (PMCSQ-2), emotional intelligence (SSRI) and levels of anxiety (STAI). A model of multigroup structural equations was carried out which fitted accordingly (χ² = 586.77; df = 6.37; p < 0.001; Comparative Fit Index (CFI) = 0.951; Normed Fit Index (NFI) = 0.938; Incremental Fit Index (IFI) = 0.947; Root Mean Square Error of Approximation (RMSEA) = 0.069). (3) Results: A negative and direct connection has been found between ego oriented climate and task oriented climate, which is stronger and more differentiated in team sports. The most influential indicator in ego oriented climate is intra-group rivalry, exerting greater influence in individual sports. For task-oriented climate the strongest indicator is having an important role in individual sports, while in team sports it is cooperative learning. Emotional intelligence dimensions correlate more strongly in team sports than in individual sports. In addition, there was a negative and indirect relation between task oriented climate and trait-anxiety in both categories of sports. (4) Conclusions: This study shows how the task-oriented motivational climate or certain levels of emotional intelligence can act preventively in the face of anxiety states in athletes. Therefore, the development of these psychological factors could prevent anxiety states and improve performance in athletes. Full article

(This article belongs to the Special Issue Effect of Sport Activity on Health Promotion)

► Show Figures

Figure 1

23 pages, 2667 KiB

Open AccessArticle

Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study

by Julie Cowie, Eileen Calveley, Gillian Bowers and John Bowers

Int. J. Environ. Res. Public Health 2018, 15(5), 896; https://doi.org/10.3390/ijerph15050896 - 2 May 2018

Cited by 63 | Viewed by 9598

Abstract

Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate [...] Read more.

Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s) within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success. Full article

(This article belongs to the Special Issue Advances in Technology Enabled Health and Care)

► Show Figures

Figure 1

13 pages, 307 KiB

Open AccessArticle

Water-Based Automobile Paints Potentially Reduce the Exposure of Refinish Painters to Toxic Metals

by Der-Jen Hsu, Shun-Hui Chung, Jie-Feng Dong, Hui-Chung Shih, Hong-Bin Chang and Yeh-Chung Chien

Int. J. Environ. Res. Public Health 2018, 15(5), 899; https://doi.org/10.3390/ijerph15050899 - 3 May 2018

Cited by 11 | Viewed by 4668

Abstract

Exposure to lead-containing dusts is a global public health concern. This work addresses an important issue of whether eco-friendly water-based paints reduce the exposure potential of auto-repainting workers to metals. With this aim, metal levels in automobile paints and worker metal exposure were [...] Read more.

Exposure to lead-containing dusts is a global public health concern. This work addresses an important issue of whether eco-friendly water-based paints reduce the exposure potential of auto-repainting workers to metals. With this aim, metal levels in automobile paints and worker metal exposure were measured using both solvent- and water-based paints. The levels of metals, and particularly Pb, Cr (total), Fe, and Cu, in solvent-based paints varied greatly among colors and brands. Lead concentrations ranged from below the detection limit (~0.25 μg/g) to 107,928 μg/g (dry film) across all samples. In water-based paints, the concentrations of Pb and Cr (total) were generally two to three orders of magnitude lower, but the concentrations of Al and Cu exceeded those in some solvent-based paints. The personal short-term exposure of workers who applied water-based paints of popular colors, such as black and white, were generally low, with Pb levels of less than <4 µg/m³ and Cr (total) levels of less than 1 µg/m³. Conversely, mean short-term exposure to Pb during the painting of a yellow cab using solvent-based paints were 2028 µg/m³, which was ~14 times the Taiwan short-term permissible exposure limit, while the mean level of exposure to Cr (total) was 290 µg/m³, which was well below the exposure limit. This study demonstrates that water-based paints reduce the exposure potential to lead, and highlights the importance of source control in limiting the toxic metals in paints. Full article

22 pages, 1316 KiB

Open AccessArticle

Will Happiness Improve the Psychological Integration of Migrant Workers?

by Tian-Cheng Li, Chien-Chi Chu, Fan-Cun Meng, Qin Li, Di Mo, Bin Li and Sang-Bing Tsai

Int. J. Environ. Res. Public Health 2018, 15(5), 900; https://doi.org/10.3390/ijerph15050900 - 3 May 2018

Cited by 16 | Viewed by 5310

Abstract

Happiness is a major factor that influences people’s perceptions and behavior. Two-stage least squares regression was applied to investigate the effect of happiness on the psychological integration of migrant workers in China. The data for a total of 1625 individuals were obtained from [...] Read more.

Happiness is a major factor that influences people’s perceptions and behavior. Two-stage least squares regression was applied to investigate the effect of happiness on the psychological integration of migrant workers in China. The data for a total of 1625 individuals were obtained from the 2014 China Labor-force Dynamics Survey (CLDS). This study describes happiness from three main aspects: happiness, life satisfaction, and economic satisfaction. The psychological integration includes two dimensions of settlement willingness, and trust level; these have gone through dimension-reduced processing by using the weighted average method. The empirical evidence shows, first, that happiness has a significantly positive effect on the psychological integration of migrant workers and second, that the sense of life satisfaction in particular plays a more significant role. The acceleration of the social and political integration in migrant workers will enhance their psychological integration. Additionally, social, cultural and economic integration is found to influence migrant workers’ psychological integration by promoting happiness. Happiness between different generations of migrant workers was found to have a noticeably positive impact on their psychological integration; however, the happiness of the younger migrant workers was more perceivable than that of the other generations. Preferential policies should therefore be provided to improve the happiness of migrant workers. Full article

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

► Show Figures

Figure 1

12 pages, 619 KiB

Open AccessArticle

Evidence for an Association between Macular Degeneration and Thyroid Cancer in the Aged Population

by Shih-Yi Lin, Wu-Huei Hsu, Cheng-Li Lin, Cheng-Chieh Lin, Jane-Ming Lin, Yun-Lun Chang, Chung-Y. Hsu and Chia-Hung Kao

Int. J. Environ. Res. Public Health 2018, 15(5), 902; https://doi.org/10.3390/ijerph15050902 - 3 May 2018

Cited by 16 | Viewed by 3932

Abstract

Direct evidence of whether thyroid cancer patients have a higher risk of age-related macular degeneration (AMD) has yet to be investigated. Patients older than 50 years-old and newly diagnosed with thyroid cancer between 2000 and 2008 were identified from the national health insurance [...] Read more.

Direct evidence of whether thyroid cancer patients have a higher risk of age-related macular degeneration (AMD) has yet to be investigated. Patients older than 50 years-old and newly diagnosed with thyroid cancer between 2000 and 2008 were identified from the national health insurance research database (NHIRD). We applied time-varying Cox proportional hazard models to assess the association between thyroid cancer and AMD. The multivariable models included conventional cardiovascular risk factors, myopia, vitreous floaters, hypothyroidism, hyperthyroidism, and treatment modality of thyroid cancer. The analysis process was stratified by age, gender, and comorbidity. In this study, 5253 patients were included in a thyroid cancer cohort (men 24.5%; median age 59.1 years (53.7–67.4 years), and 21,012 matched controls were included in a non-thyroid cancer cohort. The AMD incidence was 40.7 per 10,000 person/year in the thyroid cancer cohort. The thyroid cancer cohort had a higher risk (adjusted hazard ratio (aHR) = 1.38, 95% confidence interval, CI = 1.09–1.75) of AMD than the non-thyroid cohort. Thyroid cancer patients had a higher risk of AMD, especially the male patients (aHR = 1.92, 95% CI = 1.38–3.14) and the patients with comorbidities (aHR = 1.38, 95% CI = 1.09–1.74). In conclusion, thyroid cancer patients older than 50 years-old have increased risk of AMD. Full article

► Show Figures

Figure 1

12 pages, 1379 KiB

Open AccessArticle

Young-Adult Polycystic Kidney Disease is Associated with Major Cardiovascular Complications

by Ya-Wen Chuang, Tung-Min Yu, Shih-Ting Huang, Kuo-Ting Sun, Ying-Chih Lo, Pin-Kuei Fu, Bor-Jen Lee, Cheng-Hsu Chen, Cheng-Li Lin and Chia-Hung Kao

Int. J. Environ. Res. Public Health 2018, 15(5), 903; https://doi.org/10.3390/ijerph15050903 - 3 May 2018

Cited by 7 | Viewed by 4086

Abstract

Background: Patients with polycystic kidney disease (PKD) might have a risk of cardiovascular diseases because several cardiovascular risk factors are occasionally associated with PKD patients. Data on the association between PKD and the risk of cardiovascular events, including acute coronary syndrome (ACS), stroke, [...] Read more.

Background: Patients with polycystic kidney disease (PKD) might have a risk of cardiovascular diseases because several cardiovascular risk factors are occasionally associated with PKD patients. Data on the association between PKD and the risk of cardiovascular events, including acute coronary syndrome (ACS), stroke, and congestive heart failure (CHF), are scant. Methods: Patients aged ≥20 years who were newly diagnosed with PKD (International Classification of Diseases, Ninth Revision, Clinical Modification codes 753.12 and 753.13) between 2000 and 2011 were selected as a PKD cohort (N = 5157). The association between PKD and cardiovascular events was analyzed. Results: We randomly selected a comparison cohort of people without PKD, who were frequency-matched by sex, age, and index date of diagnosis. At the end of 2011, the PKD cohort had a 1.40-fold greater incidence of ACS compared with the comparison cohort (8.59 vs. 6.17 per 1000 person-years), in addition to a 1.40-fold greater incidence of stroke, a 1.49-fold greater incidence of CHF, and a 1.64-fold greater incidence of mortality. Conclusions: This retrospective cohort study shows that patients with PKD have an increased risk of cardiovascular events including ACS, stroke, and CHF as well as mortality, particularly in younger patients. Early identification is necessary to attenuate the risk of cardiovascular complications in patients with PKD. Full article

► Show Figures

Figure 1

8 pages, 331 KiB

Open AccessArticle

Seroprevalence of Hepatitis E Virus in Roma Settlements: A Comparison with the General Population in Slovakia

by Monika Halánová, Eduard Veseliny, Zuzana Kalinová, Peter Jarčuška, Martin Janičko, Ingrid Urbančíková, Daniel Pella, Sylvia Dražilová, Ingrid Babinská and HepaMeta Team

Int. J. Environ. Res. Public Health 2018, 15(5), 904; https://doi.org/10.3390/ijerph15050904 - 3 May 2018

Cited by 9 | Viewed by 4339

Abstract

Hepatitis E infection is one of the most frequent causes of acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in past [...] Read more.

Hepatitis E infection is one of the most frequent causes of acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in past years. Because the most important risk factors associated with HEV infection include consumption of contaminated pork meat and poor hygienic standards, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the population living in separated and segregated Roma settlements (n = 195), which represent places with increased risk of infection in Slovakia and to compare it with the prevalence in the general population (n = 69). Of 264 respondents included in the study, 47 (17.8%) showed positivity for anti-HEV antibodies, 42 of whom were Roma (21.5%, n = 195) and 5 (7.2%, n = 69) non-Roma. The population living in Roma settlements lives in poorer conditions and are at higher risk of HEV in comparison to the general population. However, differences in living conditions within the settlements do not contributed to lower risk of HEV antibody prevalence between Roma living in settlements. Full article

(This article belongs to the Special Issue Roma Health)

19 pages, 693 KiB

Open AccessArticle

The Relationship between Household Sanitation and Women’s Experience of Menstrual Hygiene: Findings from a Cross-Sectional Survey in Kaduna State, Nigeria

by Julie Hennegan, Linnea Zimmerman, Alexandra K. Shannon, Natalie G. Exum, Funmilola OlaOlorun, Elizabeth Omoluabi and Kellogg J. Schwab

Int. J. Environ. Res. Public Health 2018, 15(5), 905; https://doi.org/10.3390/ijerph15050905 - 3 May 2018

Cited by 26 | Viewed by 6630

Abstract

Global efforts to improve sanitation have emphasized the needs of women and girls. Managing menstruation is one such need, yet there is scarce research capturing current practices. This study investigated the relationships between household sanitation and women’s experience of menstrual management. Secondary analyses [...] Read more.

Global efforts to improve sanitation have emphasized the needs of women and girls. Managing menstruation is one such need, yet there is scarce research capturing current practices. This study investigated the relationships between household sanitation and women’s experience of menstrual management. Secondary analyses were undertaken on data from 1994 women and girls collected through the Performance Monitoring and Accountability 2020 survey in Kaduna, Nigeria. In multivariable models, women had higher odds of using the main household sanitation facility for menstrual management when they had access to a basic (OR = 1.76 95%CI 1.26–2.46) or limited (OR = 1.63 95%CI 1.08–2.48) sanitation facility, compared to an unimproved facility. Women with no household sanitation facility had higher odds of using their sleeping area (OR = 3.56 95%CI 2.50–5.06) or having no facility for menstrual management (OR = 9.86 95%CI 5.76–16.87) than women with an unimproved sanitation facility. Menstrual management locations were associated with ratings of their characteristics. Safely managed or basic sanitation facilities were not rated more favorably than unimproved facilities in privacy (OR = 1.02 95%CI 0.70–1.48), safety (OR = 1.45 95%CI 0.98–2.15), access to a lock (OR = 0.93 95%CI 0.62–1.37), or soap and water (OR = 1.04 95%CI 0.70–1.56). Women using their sleeping area had more favorable perceptions of their environment. Findings suggest household sanitation influences women’s choices for menstrual management, but that existing indicators for improvement are not sensitive to menstrual needs. Full article

(This article belongs to the Section Global Health)

► Show Figures

Figure 1

12 pages, 1303 KiB

Open AccessArticle

Exposure to Quartz in Finnish Workplaces Declined during the First Six Years after the Signing of the NEPSI Agreement, but Evened out between 2013 and 2017

by Tapani Tuomi, Markku Linnainmaa and Sirpa Pennanen

Int. J. Environ. Res. Public Health 2018, 15(5), 906; https://doi.org/10.3390/ijerph15050906 - 3 May 2018

Cited by 9 | Viewed by 3426

Abstract

To reduce the incidence of occupational diseases related to exposure to respirable silica at work, the main industries in the EU associated with respirable silica agreed on measures to improve working conditions through the application of good practices. These practices were included in [...] Read more.

To reduce the incidence of occupational diseases related to exposure to respirable silica at work, the main industries in the EU associated with respirable silica agreed on measures to improve working conditions through the application of good practices. These practices were included in “The Agreement on Workers Health Protection through the Good Handling and Use of Crystalline Silica and Products Containing it” (NEPSI agreement), signed in April 2006. In Finland, we have previously seen a decline in exposure to respirable quartz in relevant industries upon the treaty coming into effect, during the years 2006–2013. The present paper examines trends in exposure to respirable crystalline silica in Finland from 2006 to the end of 2017. In addition, we looked at changes in the number of exposed workers and the prevalence of silicosis and lung cancer associated with the exposure during the same period. The aim was to find out whether the decline in exposure previously recorded had continued, and whether this, in addition to the previously reported descent in exposure, was reflected in the amount and prevalence of occupational diseases associated with inhaling respirable quartz. In the present study, during the period 2013 to 2017 no further improvements were observed. The exposure remained at an average level of 20–50% of the current OEL_8h. This is not necessarily sufficient to eliminate silicosis, lung cancer or other health effects associated with exposure to respirable silica in affected workplaces. To bring about further improvements in exposure, we suggest the present OEL_8h in Finland (0.05 mg/m³) and particularly in the many EU countries with an OEL_8h of 0.1 mg/m³ be lowered to 0.020–0.025 mg/m³. Secondly, branches outside of the NEPSI treaty where the number of exposed workers is increasing in Finland and possibly in some other EU countries as well, namely building and refinery industries, would be advised to sign the treaty. In addition, as a result of signing, good practices should be developed for work tasks where exposure to respirable silica is of concern in these industries. Full article

(This article belongs to the Special Issue Lung Diseases Associated with Environmental Pollutants)

► Show Figures

Figure 1

7 pages, 919 KiB

Open AccessArticle

The Relationship between Diabetes Mellitus and Respiratory Function in Patients Eligible for Coronary Artery Bypass Grafting

by Aleksandra Szylińska, Mariusz Listewnik, Żaneta Ciosek, Magdalena Ptak, Anna Mikołajczyk, Wioletta Pawlukowska and Iwona Rotter

Int. J. Environ. Res. Public Health 2018, 15(5), 907; https://doi.org/10.3390/ijerph15050907 - 3 May 2018

Cited by 3 | Viewed by 4173

Abstract

Introduction: Spirometry performed prior to surgery provides information on the types of lung disorders in patients. The purpose of this study was to look for a relationship between the prevalence of diabetes and spirometry parameters. Material and Methods: The study was conducted in [...] Read more.

Introduction: Spirometry performed prior to surgery provides information on the types of lung disorders in patients. The purpose of this study was to look for a relationship between the prevalence of diabetes and spirometry parameters. Material and Methods: The study was conducted in patients with coronary artery disease who were eligible for an isolated coronary artery bypass graft in 2013. The study group included 367 patients (287 men and 80 women) aged 68.7 ± 8.4 years. They were divided into those with diagnosed diabetes (group I, n = 138, 37.6%) and without diabetes (group II, n = 229, 62.4%). Spirometry tests were performed on the day of admission to the hospital. Results: Patients with diabetes (group I) had a significantly higher body mass index than those without diabetes (group II). Spirometry tests also showed that patients with diabetes had statistically significantly lower forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1.0). Both FVC and FEV1.0 were also statistically significantly lower for overweight and obese individuals in group I than those in group II. Conclusion: Patients with diabetes eligible for coronary artery bypass grafting with concurrent overweight or obesity are more likely to have lower spirometry parameters than those without diabetes. Full article

(This article belongs to the Collection Aging and Public Health)

► Show Figures

Figure 1

24 pages, 380 KiB

Open AccessArticle

Factors Associated with Physical Activity and Sedentary Behavior in Older Adults from Six Low- and Middle-Income Countries

by Cadeyrn J. Gaskin and Liliana Orellana

Int. J. Environ. Res. Public Health 2018, 15(5), 908; https://doi.org/10.3390/ijerph15050908 - 3 May 2018

Cited by 43 | Viewed by 4756

Abstract

Rising life expectancy in low- and middle-income countries (LMIC), coupled with the increasing burden of non-communicable diseases, accentuates the importance of generating information to support public health strategies. With this aim in mind, the purpose of this study was to identify correlates of [...] Read more.

Rising life expectancy in low- and middle-income countries (LMIC), coupled with the increasing burden of non-communicable diseases, accentuates the importance of generating information to support public health strategies. With this aim in mind, the purpose of this study was to identify correlates of physical activity and sedentary behavior in LMIC. We analyzed Wave 1 data (collected 2007–2010) from the World Health Organization’s longitudinal Study on global AGEing and adult health (SAGE), which focuses on nationally representative samples of adults aged 50 years and older from six countries (China, n = 13,157; India, n = 6560; Mexico, n = 2301; Russian Federation, n = 3763; South Africa, n = 3836; and Ghana, n = 4305). Associations of physical activity (operationalized as meeting physical activity guidelines of ≥150 min/week of moderate-to-vigorous physical activity or not) and sedentary behavior (≥4 h/day versus <4 h/day) with demographic, health and health risk, functional, interpersonal, and environmental factors were assessed using multivariate logistic models. Across the six countries, we found fairly consistent and reasonably strong associations between both physical activity and sedentary behavior and several demographic factors (age and employment, in particular), self-reported health, instrumental activities of daily living, factors relating to socializing, and household location. Correlates of physical activity and sedentary behavior in LMIC appear to be similar to those found in high-income countries. Full article

11 pages, 456 KiB

Open AccessArticle

Identification of Depression and Screening for Work Disabilities among Long-Term Unemployed People

by Kirsti Nurmela, Aino Mattila, Virpi Heikkinen, Jukka Uitti, Aarne Ylinen and Pekka Virtanen

Int. J. Environ. Res. Public Health 2018, 15(5), 909; https://doi.org/10.3390/ijerph15050909 - 3 May 2018

Cited by 15 | Viewed by 5107

Abstract

The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as [...] Read more.

The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as eligible to apply for disability pension. Among them, 188 were diagnosed as clinically depressed. They were classified into those with earlier depression diagnosis (n = 85), those whose depression had not been diagnosed earlier (n = 103), and those without diagnosed depression (n = 176). The association of this ‘Depression identification pattern’ with being granted a disability pension was explored by logistic regression analyses. Compared to those with earlier diagnosis, those whose depression had not been diagnosed earlier were granted disability pension more commonly (72% vs. 54% OR 2.2, p = 0.012). Corresponding figures of the undepressed were 73%, OR 2.3, p = 0.002. The adjustments did not affect the results. Clinical examination of the long-term unemployed people in terms of work disability seems to be worthwhile. In particular, the examination reveals new depression diagnoses, which contribute more to the award of disability pension than depression diagnosed earlier by regular health care. Novel ways to detect depression among the unemployed should be implemented in the health and employment services. Full article

(This article belongs to the Special Issue Mental Health and its Social and Cultural Implications)

► Show Figures

Figure 1

12 pages, 581 KiB

Open AccessArticle

Suicide Prevention Guideline Implementation in Specialist Mental Healthcare Institutions in The Netherlands

by Jan Mokkenstorm, Gerdien Franx, Renske Gilissen, Ad Kerkhof and Johannes Hendrikus Smit

Int. J. Environ. Res. Public Health 2018, 15(5), 910; https://doi.org/10.3390/ijerph15050910 - 3 May 2018

Cited by 24 | Viewed by 5590

Abstract

In The Netherlands, on average 40% of all suicides concern patients treated by mental healthcare institutions (MHIs). Recent evidence indicates that implemented guideline recommendations significantly reduce the odds for patients to die by suicide. Implementation of the multidisciplinary guideline for diagnosis and treatment [...] Read more.

In The Netherlands, on average 40% of all suicides concern patients treated by mental healthcare institutions (MHIs). Recent evidence indicates that implemented guideline recommendations significantly reduce the odds for patients to die by suicide. Implementation of the multidisciplinary guideline for diagnosis and treatment of suicidal behaviors is a main objective of the Dutch National Suicide Prevention Strategy. To this end, 24 MHIs that collectively reported 73% of patient suicides in 2015 received an educational outreach intervention offered by the national center of expertise. Aim: To investigate changes in levels of implementation of guideline recommendations; and to assess the degree of variation on suicide prevention policies and practices between MHIs. Methods: Implementation study with a prospective cohort design studying change over time on all domains of a Suicide Prevention Monitor, a guideline-based instrument assessing suicide prevention policies and practices within MHIs. Data were collected in six-month intervals between 2015 and 2017. Results: MHIs improved significantly on four out of ten domains: the development of an organizational suicide prevention policy; monitoring and trend-analysis of suicides numbers; evaluations after suicide; and clinician training. No improvement was measured on the domains pertaining to multi-annual training policies; collaborative care with external partners; recording and evaluation of suicide attempts; routine assessment of suicidality in all patients; safety planning and involving next of kin and carers. Furthermore, marked practice variation between MHIs was found which did not decrease over time. Conclusion: This study shows significant improvement in the implementation of four out of ten guideline-based suicide prevention policies in 24 specialist mental healthcare institutions in The Netherlands. The implementation level of suicide prevention policies and practices still appears to vary significantly between MHIs in The Netherlands. Full article

(This article belongs to the Special Issue Suicide Risk and Mental Disorders)

► Show Figures

Figure 1

13 pages, 671 KiB

Open AccessArticle

PCBs and PCDD/Fs in Bluefin Tuna: Occurrence and Dietary Intake

by Grazia Barone, Arianna Storelli, Rita Garofalo, Rosanna Mallamaci, Nicoletta C. Quaglia and Maria Maddalena Storelli

Int. J. Environ. Res. Public Health 2018, 15(5), 911; https://doi.org/10.3390/ijerph15050911 - 3 May 2018

Cited by 15 | Viewed by 4609

Abstract

Polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-furans (PCDD/Fs) were measured in Mediterranean bluefin tuna (Thunnus thynnus) to verify the compliance with the EU regulations for food commercialization. The estimated intakes were also evaluated. The analyses were performed by gas chromatography-ion trap tandem [...] Read more.

Polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-furans (PCDD/Fs) were measured in Mediterranean bluefin tuna (Thunnus thynnus) to verify the compliance with the EU regulations for food commercialization. The estimated intakes were also evaluated. The analyses were performed by gas chromatography-ion trap tandem mass spectrometry (GC-MS-MS). The PCBs were dominant (1132.0 ng g⁻¹ l.w.), followed by PCDFs (23.2 pg g⁻¹ l.w.) and PCDDs (8.5 pg g⁻¹ l.w.). The pollutant levels (dl-PCBs: 0.7 pg TEQ/g w.w.; PCDD/Fs: 1.9 pg TEQ/g w.w.) and their sum expressed as TEQ values (2.6 pg TEQ/g w.w.) remained below the limits for human consumption proposed by the European Union. On the contrary, the sum of the six indicator non-dioxin-like PCBs (84.2 ng g⁻¹ w.w.) was slightly above the maximum level fixed by the in-force legislation. The estimated dietary intakes for PCDD/Fs plus dl-PCBs were below the toxicological reference values (TRVs) set by various international bodies, while non-cancer and cancer risk assessment revealed a safety concern. Additionally, the estimated intake of ndl-PCBs exceeded the maximum levels set by different European countries. These findings suggest caution in tuna consumption together with an active and frequent surveillance of the chemical quality of its flesh. Full article

(This article belongs to the Special Issue Dietary Exposures)

► Show Figures

Figure 1

8 pages, 675 KiB

Open AccessArticle

Association between Peptic Ulcer Disease and Periodontitis: A Nationwide Population-Based Case-Control Study in Taiwan

by Hui-Chieh Yu, Tsung-Po Chen, Chia-Yi Wei and Yu-Chao Chang

Int. J. Environ. Res. Public Health 2018, 15(5), 912; https://doi.org/10.3390/ijerph15050912 - 4 May 2018

Cited by 23 | Viewed by 7330

Abstract

Previous studies have suggested that peptic ulcer disease (PUD) including stomach and duodenal ulcers might be associated with periodontitis (PD); however, no clear conclusions have been reached thus far. In this retrospective case-control study, we aimed to investigate the association between PUD and [...] Read more.

Previous studies have suggested that peptic ulcer disease (PUD) including stomach and duodenal ulcers might be associated with periodontitis (PD); however, no clear conclusions have been reached thus far. In this retrospective case-control study, we aimed to investigate the association between PUD and PD by using a large population-based dataset in Taiwan. A population-based retrospective case control study was conducted using the Longitudinal Health Insurance Database 2010 (LHID2010) derived from the National Health Insurance Research database (NHIRD) in Taiwan from 2000 to 2013. The case and control group were matched with gender, age, urbanization level, socioeconomic status, and Charlson comorbidity index (CCI) by using the propensity score method at a 1:1 ratio. A total of 177,240 cases and 177,240 control patients were included in this study, with an average age of 46.96

\pm

11.76 years. The risk of PUD for patients diagnosed with PD was 1.15-fold when compared with those without PD (OR, 1.15; 95% CI, 1.12–1.18). This population-based case control study demonstrated a significantly positive association between PUD and PD in Taiwan. Full article

► Show Figures

Figure 1

19 pages, 577 KiB

Open AccessArticle

A Cross-Disciplinary Successful Aging Intervention and Evaluation: Comparison of Person-to-Person and Digital-Assisted Approaches

by Hui-Chuan Hsu, Tsuann Kuo, Ju-Ping Lin, Wei-Chung Hsu, Chia-Wen Yu, Yen-Cheng Chen, Wan-Zhen Xie, Wei-Chiang Hsu, Ya-Lan Hsu and Mu-Ting Yu

Int. J. Environ. Res. Public Health 2018, 15(5), 913; https://doi.org/10.3390/ijerph15050913 - 4 May 2018

Cited by 23 | Viewed by 7060

Abstract

Background: Successful aging has been the paradigm of old-age life. The purpose of this study was to implement and evaluate a cross-disciplinary intervention program using two approaches for community-based older adults in Taichung, Taiwan. Methods: The content of the intervention included [...] Read more.

Background: Successful aging has been the paradigm of old-age life. The purpose of this study was to implement and evaluate a cross-disciplinary intervention program using two approaches for community-based older adults in Taichung, Taiwan. Methods: The content of the intervention included successful aging concepts and preparation, physical activity, chronic disease and health management, dietary and nutrition information, cognitive training, emotional awareness and coping skills, family relationship and resilience, legal concepts regarding financial protection, and Internet use. The traditional person-to-person (P2P) intervention approach was implemented among participants at urban centers, and the personal-and-digital (P&D) intervention approach was implemented among participants at rural centers; before the P&D group received the intervention, participants were assessed as the control group for comparison. Results: Healthy behavior and nutrition improved for the P2P group, although not significantly. Strategies for adapting to old age and reducing ineffective coping were significantly improved in the P2P group. The ability to search for health information improved in the P&D group, and knowledge of finance-related law increased in the P2P group. Conclusion: A continuous, well-designed and evidence-based intervention program is beneficial for improving the health of older adults, or at least delaying its decline. Full article

(This article belongs to the Collection Aging and Public Health)

► Show Figures

Figure 1

19 pages, 463 KiB

Open AccessArticle

Changes in Weight, Sedentary Behaviour and Physical Activity during the School Year and Summer Vacation

by Chiaki Tanaka, John J. Reilly, Maki Tanaka and Shigeho Tanaka

Int. J. Environ. Res. Public Health 2018, 15(5), 915; https://doi.org/10.3390/ijerph15050915 - 4 May 2018

Cited by 17 | Viewed by 5106

Abstract

Background: To examine bidirectional associations between body weight and objectively assessed sedentary behaviour (SB) and physical activity (PA) during the school year and summer vacation. Methods: Participants were 209 Japanese boys and girls (9.0 ± 1.8 years at baseline). SB and [...] Read more.

Background: To examine bidirectional associations between body weight and objectively assessed sedentary behaviour (SB) and physical activity (PA) during the school year and summer vacation. Methods: Participants were 209 Japanese boys and girls (9.0 ± 1.8 years at baseline). SB and PA were measured using triaxial accelerometry that discriminated between ambulatory and non-ambulatory PA, screen time measured by questionnaire during the school-term was evaluated in May and the summer vacation, and relative body weight measured in May and just after the end of summer vacation. Results: There were no significant relationships between changes in SB or PA and changes in body weight. However, higher relative body weight at baseline was associated with decreased non-ambulatory moderate PA (p = 0.049), but this association was slightly diminished after adjusting for change in SB (p = 0.056). Longer screen time at baseline was also associated with increased relative body weight (p = 0.033). Conclusions: The present study revealed that body weight might be particularly influential on non-ambulatory moderate PA while SB, PA or changes in these variables did not predict changes in body weight. Moreover, screen time during the school year is a predictor of change in relative body weight during the subsequent summer vacation. Full article

(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)

19 pages, 1202 KiB

Open AccessArticle

Active Ottumwa: Adapting Evidence-Based Recommendations to Promote Physical Activity in a Micropolitan New Destination Community

by Barbara Baquero, Christine M. Kava, Sato Ashida, Jason Daniel-Ulloa, Helena H. Laroche, Heidi Haines, Rebecca Bucklin, Adriana Maldonado, Mayra Coronado Garcia, Sandy Berto, Dan Sewell, Nicole Novak, Kathleen Janz, Claudia Gates and Edith A. Parker

Int. J. Environ. Res. Public Health 2018, 15(5), 917; https://doi.org/10.3390/ijerph15050917 - 4 May 2018

Cited by 6 | Viewed by 7298

Abstract

Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a [...] Read more.

Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

► Show Figures

Figure 1

16 pages, 1348 KiB

Open AccessArticle

Sedentary Behaviour in Swiss Children and Adolescents: Disentangling Associations with the Perceived and Objectively Measured Environment

by Bettina Bringolf-Isler, Kees De Hoogh, Christian Schindler, Bengt Kayser, L. Suzanne Suggs, Alain Dössegger, Nicole Probst-Hensch and The SOPHYA Study Group

Int. J. Environ. Res. Public Health 2018, 15(5), 918; https://doi.org/10.3390/ijerph15050918 - 4 May 2018

Cited by 14 | Viewed by 6476

Abstract

Identifying correlates of sedentary behaviour across all levels of the ecological model and understanding their interrelations is a promising method to plan effective interventions. The present study examined whether the objectively assessed and the perceived neighbourhood are associated with children’s sedentary behaviour time [...] Read more.

Identifying correlates of sedentary behaviour across all levels of the ecological model and understanding their interrelations is a promising method to plan effective interventions. The present study examined whether the objectively assessed and the perceived neighbourhood are associated with children’s sedentary behaviour time (SBT). A comprehensive set of factors at different levels of influence across the ecological model were taken into account and analysed for mediating and modifying effects. Analyses were based on 1306 children and adolescents (6–16 years) participating in the population-based SOPHYA-study. Accelerometers were used to assess SBT, the perceived environment was examined by a validated parental questionnaire, and objective environmental data were allocated using GIS (ArcMap 10.2, Esri, Redlands, CA, USA) for each family’s residential address. A high perceived safety was associated with less SBT. Boys, those whose residential neighbourhood was characterized by dead ends in urban areas, a low main street density in the neighbourhood of children and greenness were less likely to exhibit SBT. The association of the objective environment with the respective parental perceptions was low and no significant mediating effect was found for the perceived environment. We conclude for land-use planning to reduce sedentary behaviour objective environments should be complemented with efforts to increase parental sense of security. Full article

(This article belongs to the Special Issue Sedentary Behaviour and Health)

► Show Figures

Figure 1

18 pages, 737 KiB

Open AccessArticle

Arsenic and Other Elemental Concentrations in Mushrooms from Bangladesh: Health Risks

by Md Harunur Rashid, Mohammad Mahmudur Rahman, Ray Correll and Ravi Naidu

Int. J. Environ. Res. Public Health 2018, 15(5), 919; https://doi.org/10.3390/ijerph15050919 - 4 May 2018

Cited by 31 | Viewed by 5574

Abstract

Mushroom cultivation has been increasing rapidly in Bangladesh. Arsenic (As) toxicity is widespread in the world and Bangladesh faces the greatest havoc due to this calamity. Rice is the staple food in Bangladesh and among all the crops grown, it is considered to [...] Read more.

Mushroom cultivation has been increasing rapidly in Bangladesh. Arsenic (As) toxicity is widespread in the world and Bangladesh faces the greatest havoc due to this calamity. Rice is the staple food in Bangladesh and among all the crops grown, it is considered to be the main cause of As poisoning to its population after drinking water. Consequently, rice straw, an important growing medium of mushrooms in Bangladesh, is known to have high As content. The objective of this study was, therefore, to determine the concentrations of As in mushrooms cultivated in Bangladesh and to assess the health risk as well. It also considered other elements, including Cd, Cr, Co, Cu, Pb, Mn, Hg, Ni, and Zn concentrations in mushrooms from Bangladesh. The mean concentrations (mg/kg) of As, Cd, Cr, Co, Cu, Pb, Mn, Hg, Ni, and Zn in mushrooms were 0.51, 0.38, 0.28, 0.01, 13.7, 0.31, 11.7, 0.12, 0.28, and 53.5, respectively. Based on the dietary intake of mushrooms, the weekly intakes of As, Cd, Cr, Co, Cu, Pb, Mn, Hg, Ni, and Zn from mushrooms for adults were 0.0042, 0.0030, 0.0024, 0.0001, 0.1125, 0.0019, 0.1116, 0.0011, 0.0023, and 0.4734 mg, respectively. Due to the low concentrations of As and other trace elements observed in mushrooms from Bangladesh, as well as relatively lower consumption of this food in people’s diet, it can be inferred that consumption of the species of mushrooms analysed will cause no toxicological risk. Full article

(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)

► Show Figures

Figure 1

13 pages, 3581 KiB

Open AccessArticle

Commuting Mode Choice in a High-Density City: Do Land-Use Density and Diversity Matter in Hong Kong?

by Yi Lu, Guibo Sun, Chinmoy Sarkar, Zhonghua Gou and Yang Xiao

Int. J. Environ. Res. Public Health 2018, 15(5), 920; https://doi.org/10.3390/ijerph15050920 - 4 May 2018

Cited by 44 | Viewed by 9487

Abstract

Hong Kong is a densely populated and transit-oriented Chinese city, which provides an ideal urban environment with which to study the various successful facets of land use policy as a model for potential replication to curb increasing car use in other Chinese cities. [...] Read more.

Hong Kong is a densely populated and transit-oriented Chinese city, which provides an ideal urban environment with which to study the various successful facets of land use policy as a model for potential replication to curb increasing car use in other Chinese cities. We examine the commuting mode choice of 203,900 households living in 4768 street blocks in Hong Kong from 2011 census. A street block is the smallest planning unit, made up of one or more housing estates with a homogenous built environment and socioeconomic status. The built environment is measured using the five Ds framework, an international dimensioning framework for classifying and measuring attributes of the built environment for physical activity and travel behaviors. Generalized, multi-level mixed models were applied to detect the associations between travel choice and built environment characteristics, while adjusting for socioeconomic status. Design and destination accessibility had greater effects on the choices to walk and take public transport than on the choice to drive. Density and diversity had only marginal effects on mode choice. Unexpectedly, distance to the urban center had the opposite effect on automobile use to that found in Western studies. Hong Kong residents living close to the urban center were more likely to drive for commuting trips. The contrasting findings between our study and Western studies suggest that the associations between a high-density built environment and travel choice vary with urban context. Full article

► Show Figures

Figure 1

10 pages, 634 KiB

Open AccessArticle

Mood Regulation Focused CBT Based on Memory Reconsolidation, Reduced Suicidal Ideation and Depression in Youth in a Randomised Controlled Study

by Göran Högberg and Tore Hällström

Int. J. Environ. Res. Public Health 2018, 15(5), 921; https://doi.org/10.3390/ijerph15050921 - 5 May 2018

Cited by 17 | Viewed by 8605

Abstract

Suicide attempts and suicidal ideation in adolescence are considered to be related to suicide and psychiatric adversity later in life. Secondary prevention by improving the treatment of suicidal youth is a distinct possibility. In this study, treatment with a systematised mood-regulation focused cognitive [...] Read more.

Suicide attempts and suicidal ideation in adolescence are considered to be related to suicide and psychiatric adversity later in life. Secondary prevention by improving the treatment of suicidal youth is a distinct possibility. In this study, treatment with a systematised mood-regulation focused cognitive behavioural therapy (MR-CBT) (n = 15) was compared with treatment as usual (TAU) (n = 12) in a group of depressed adolescents in a clinical setting. MR-CBT focuses on mood regulation by means of counter conditioning with memory reconsolidation being the proposed mechanism of change. Subjects practice keeping emotionally positive memories to diminish the emotional impact of negative memories. Symptoms of depression were tested with a short version of the Mood and Feelings Questionnaire (SMFQ), and wellbeing with the World Health Organization 5 Wellbeing Index (WHO-5). Suicidal events were rated according to the clinical interview Columbia Suicide Severity Rating Scale (C-SSRS). Suicidal events at the end of treatment were significantly reduced in the MR-CBT group, but not in the TAU group. Depression and wellbeing improved significantly in both treatment groups. While far from conclusive, the results are encouraging enough to suggest that further studies should be undertaken to examine whether psychotherapy focusing on mood regulation for young individuals at risk might enhance secondary prevention of suicide. Full article

(This article belongs to the Special Issue Advances in Suicide Research)

► Show Figures

Figure 1

13 pages, 1191 KiB

Open AccessArticle

Trends in the Prevalences of Selected Birth Defects in Korea (2008–2014)

by Jung-Keun Ko, Dirga Kumar Lamichhane, Hwan-Cheol Kim and Jong-Han Leem

Int. J. Environ. Res. Public Health 2018, 15(5), 923; https://doi.org/10.3390/ijerph15050923 - 5 May 2018

Cited by 31 | Viewed by 4829

Abstract

Little information is available on the prevalences of birth defects in Korea. The aims of this study were to estimate recent prevalences of selected birth defects and to analyze the prevalence trends of these defects during the period from 2008 to 2014. Prevalences [...] Read more.

Little information is available on the prevalences of birth defects in Korea. The aims of this study were to estimate recent prevalences of selected birth defects and to analyze the prevalence trends of these defects during the period from 2008 to 2014. Prevalences were calculated for 69 major birth defects using health insurance claim data obtained from the Korea National Health Insurance Service (NHIS). Prevalence rate ratios were calculated using Poisson regression to analyze trends over the 7-year study period. The overall prevalence of a major birth defect was 446.3 per 10,000 births (95% CI: 444.0–448.6); 470.9 per 10,000 births (95% CI: 467.6–474.2) for males and 420.2 per 10,000 births (95% CI: 417–423.4) for females. The prevalence rates of the most common birth defects over the study period were; septal defect (138.2 per 10,000; 95% CI: 136.9–139.5), congenital hip dislocation (652 per 10,000; 95% CI: 64.1–65.9), and ventricular septal defect (62.62 per 10,000; 95% CI: 61.7–63.5). During the study period, a significant increase in the prevalence of a major birth defect was observed with a prevalence rate ratio (PRR) of 1.091. The strongest trend was observed for renal dysplasia, which had a PRR of 1.275 (95% CI: 1.211–1.343), and upward trends were observed for urogenital anomalies, such as, renal agenesis (PRR 1.102, 95% CI: 1.067–1.138), undescended testis (PRR 1.082, 95% CI: 1.072–1.093) and hypospadias (PRR 1.067, 95% CI: 1.044–1.090). This study shows an overall increase in the prevalences of birth defects, including hypospadias and undescended testis, which are known to be associated with endocrine factors. In the future, standardized birth defect registries should be established to enable these trends to be monitored. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

12 pages, 1426 KiB

Open AccessArticle

Risk Factors and Spatial Clusters of Cryptosporidium Infection among School-Age Children in a Rural Region of Eastern China

by Hao Zheng, Jianfeng He, Li Wang, Rong Zhang, Zhen Ding and Wenbiao Hu

Int. J. Environ. Res. Public Health 2018, 15(5), 924; https://doi.org/10.3390/ijerph15050924 - 6 May 2018

Cited by 8 | Viewed by 4104

Abstract

The epidemiological features of Cryptosporidium infection among school-age children in China still remain unclear. Hereby, a cross-sectional study of 1637 children aged 3–9 years was designed to investigate the risk factors and spatial clusters of Cryptosporidium infection in a rural region of Eastern [...] Read more.

The epidemiological features of Cryptosporidium infection among school-age children in China still remain unclear. Hereby, a cross-sectional study of 1637 children aged 3–9 years was designed to investigate the risk factors and spatial clusters of Cryptosporidium infection in a rural region of Eastern China. Stool specimens collected from participants were examined using the auramine-phenol and modified acid-fast staining. Univariable and multivariable analyses were performed to identify the risk factors of Cryptospordium infection. The spatial clusters were analyzed by a discrete Poisson model using SaTScan software. Our results showed that the overall prevalence of Cryptosporidium infection was 11‰ in the research region. At the age of 3–6 years (odds ratios (OR) = 3.072, 95% confidence intervals (CI): 1.001–9.427), not washing hands before eating and after defecation (OR = 3.003, 95% CI: 1.060–8.511) were recognized as risk factors. Furthermore, a high-risk spatial cluster (relative risk = 4.220, p = 0.025) was identified. These findings call for effective sustainable interventions including family and school-based hygienic education to reduce the prevalence of Cryptosporidium infection. Therefore, an early warning system based spatiotemporal models with risk factors is required to further improve the effectiveness and efficiency of cryptosporidiosis control in the future. Full article

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

► Show Figures

Figure 1

15 pages, 4158 KiB

Open AccessArticle

Antibiotic Sensitivity Profiling and Virulence Potential of Campylobacter jejuni Isolates from Estuarine Water in the Eastern Cape Province, South Africa

by Anthony C. Otigbu, Anna M. Clarke, Justine Fri, Emmanuel O. Akanbi and Henry A. Njom

Int. J. Environ. Res. Public Health 2018, 15(5), 925; https://doi.org/10.3390/ijerph15050925 - 6 May 2018

Cited by 22 | Viewed by 6020

Abstract

Campylobacter jejuni (CJ) is a zoonotic microbe and a major causative organism of diarrheal infection in humans that often has its functional characteristics inactivated in stressed conditions. The current study assessed the correlation between recovered CJ and water quality parameters and the drug [...] Read more.

Campylobacter jejuni (CJ) is a zoonotic microbe and a major causative organism of diarrheal infection in humans that often has its functional characteristics inactivated in stressed conditions. The current study assessed the correlation between recovered CJ and water quality parameters and the drug sensitivity patterns of the pathogen to frontline antibiotics in human and veterinary medicine. Water samples (n = 244) from rivers/estuarines were collected from April–September 2016, and physicochemical conditions were recorded on-site. CJ was isolated from the samples using standard microbiological methods and subjected to sensitivity testing to 10 antibiotics. Mean CJ counts were between 1 and 5 logs (CFU/mL). Ninety-five isolates confirmed as CJ by PCR showed varying rates of resistance. Sensitivity testing showed resistance to tetracycline (100%), azithromycin (92%), clindamycin (84.2%), clarithromycin and doxycycline (80%), ciprofloxacin (77.8%), vancomycin (70.5%), erythromycin (70%), metronidazole (36.8%) and nalidixic acid (30.5%). Virulence encoding genes were detected in the majority 80/95, 84.2%) of the confirmed isolates from cdtB; 60/95 (63.2%) from cstII; 49/95 (51.6%) from cadF; 45/95 (47.4%) from clpP; 30/95 (31.6%) from htrB, and 0/95 (0%) from csrA. A multiple resistance cmeABC active efflux pump system was present in 69/95 (72.6) isolates. The presence of CJ was positively correlated with temperature (r = 0.17), pH (r = 0.02), dissolved oxygen (r = 0.31), and turbidity (r = 0.23) but negatively correlated with salinity (r = −0.39) and conductivity (r = −0.28). The detection of multidrug resistant CJ strains from estuarine water and the differential gene expressions they possess indicates a potential hazard to humans. Moreover, the negative correlation between the presence of the pathogen and physicochemical parameters such as salinity indicates possible complementary expression of stress tolerance response mechanisms by wild-type CJ strains. Full article

(This article belongs to the Special Issue Recreational Water Illnesses)

► Show Figures

Figure 1

10 pages, 302 KiB

Open AccessArticle

The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36–59 Months in Honduras

by Helga Bjørnøy Urke, Mariela Contreras and Dennis Juma Matanda

Int. J. Environ. Res. Public Health 2018, 15(5), 926; https://doi.org/10.3390/ijerph15050926 - 7 May 2018

Cited by 27 | Viewed by 6349

Abstract

Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to [...] Read more.

Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36–59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011–2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD. Full article

(This article belongs to the Special Issue The Health Needs of Vulnerable Children: Challenges and Solutions)

10 pages, 676 KiB

Open AccessArticle

In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia

by Adel A. Alhazzani, Ahmed A. Mahfouz, Ahmed Y. Abolyazid, Nabil J. Awadalla, Khaled Katramiz, Aesha Faraheen, Shamsun Nahar Khalil and Razia Aftab

Int. J. Environ. Res. Public Health 2018, 15(5), 927; https://doi.org/10.3390/ijerph15050927 - 7 May 2018

Cited by 29 | Viewed by 5908

Abstract

Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time [...] Read more.

Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over one-year period (January through December 2016) were included in the study. Data about personal characteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital complications and survival status were collected. The last reported Aseer region population was used to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios (HR) and concomitant 95% confidence intervals (95% CI) were computed using multivariate Cox regression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted. Results: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall case fatality rate (CFR) of 9.7%. Non-significant difference with gender and age were observed in CFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed a significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke smoking (HR = 2.36), pre-stroke hypertension (HR = 1.77), post-stroke disturbed consciousness (HR = 6.86), poor mobility (HR = 2.60) and developing pulmonary embolism (HR = 2.63) as significant predictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital stroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could be improved by smoking cessation, better control of hypertension and prevention of in hospital complication particularly pulmonary embolism. Full article

(This article belongs to the Section Global Health)

► Show Figures

Figure 1

9 pages, 861 KiB

Open AccessArticle

The Challenges of Predicting Suicidal Thoughts and Behaviours in a Sample of Rural Australians with Depression

by Tonelle Handley, Jane Rich, Kate Davies, Terry Lewin and Brian Kelly

Int. J. Environ. Res. Public Health 2018, 15(5), 928; https://doi.org/10.3390/ijerph15050928 - 7 May 2018

Cited by 60 | Viewed by 9665

Abstract

Suicide is a leading cause of death, particularly in rural and remote areas. Although depression is strongly related to both suicidal ideation and attempt, it lacks specificity as a predictor, and little is known about characteristics that increase suicide risk among people with [...] Read more.

Suicide is a leading cause of death, particularly in rural and remote areas. Although depression is strongly related to both suicidal ideation and attempt, it lacks specificity as a predictor, and little is known about characteristics that increase suicide risk among people with depression. A telephone version of the World Mental Health Composite International Diagnostic Interview explored lifetime depression, suicidal ideation, suicide attempt, and related factors among a community-dwelling sample of rural and remote Australians, selected for an interview based on a screener for psychological distress (100% of those with high distress, 75% of those with moderate distress, and 16% of those with low distress). Of 1051 participants interviewed, 364 reported lifetime symptoms of depression; of these, 48% reported lifetime suicidal ideation and 16% reported a lifetime suicide attempt. While depression severity was a significant correlate of suicidality for both males and females, suicide attempt was significantly more common among females with a younger age of depression onset, and a higher number of psychiatric comorbidities. No additional factors were significant for males. Among rural and remote residents with lifetime symptoms of depression, the identification of suicide risk may be enhanced by considering individual and contextual factors beyond depression severity. Further research focusing on risk factors for males would be beneficial. Full article

(This article belongs to the Special Issue Suicide Risk and Mental Disorders)

► Show Figures

Figure 1

12 pages, 507 KiB

Open AccessArticle

Influence of Gender on Associations of Obstructive Sleep Apnea Symptoms with Chronic Conditions and Quality of Life

by Sarah Appleton, Tiffany Gill, Anne Taylor, Douglas McEvoy, Zumin Shi, Catherine Hill, Amy Reynolds and Robert Adams

Int. J. Environ. Res. Public Health 2018, 15(5), 930; https://doi.org/10.3390/ijerph15050930 - 7 May 2018

Cited by 39 | Viewed by 6473

Abstract

Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA). We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of [...] Read more.

Women are less likely than men to be diagnosed with obstructive sleep apnea (OSA). We examined contemporary gender differences in symptoms, health status, and quality of life associated with diagnosed OSA and OSA symptoms in a population-based sample. A 2015 postal/on-line questionnaire of 2889 active participants of The North West Adelaide Health Study (response rate = 54%, male n = 704; female n = 856; age 30–100 years) assessed previously diagnosed OSA, OSA symptoms, insomnia, doctor-diagnosed medical conditions, and the SF-36. In weighted analyses, self-reported diagnosed OSA (men: 12.6%, n = 95; women: 3.3%, n = 27) and OSA symptoms (men: 17.1%; women: 9.7%) were more common in men. Diagnosed OSA showed stronger adjusted associations with typical OSA features in women, including obesity (women-odds ratio (OR), 95% CI: 5.7, 1.9–17.1, men: 2.2, 1.2–4.0), daytime sleepiness (women: 6.4, 2.7–15.6, men: 3.3, 2.1–5.4), and loud snoring (women: 25.4, 9.4–69.1, men: 8.7, 5.2–14.4). Diagnosed OSA was independently associated with cardiovascular disease (CVD) in men, and in women with high cholesterol, respiratory disease, insomnia, and reduced SF-36 Physical Component Summary score. In both sexes, OSA symptoms were significantly associated with depression, insomnia, and moderate to severe impairments in SF-36 physical and mental component summary scores. Diagnosed women showed clinical characteristics overtly related to OSA. A higher index of clinical suspicion of OSA may be required in women for a condition regarded as male-predominant to increase equity in health outcomes. Full article

(This article belongs to the Collection Health Behavior and Public Health)

► Show Figures

Figure 1

22 pages, 830 KiB

Open AccessArticle

Association between Organochlorine Pesticide Levels in Breast Milk and Their Effects on Female Reproduction in a Taiwanese Population

by Men-Wen Chen, Harvey M. Santos, Danielle E. Que, Yan-You Gou, Lemmuel L. Tayo, Yi-Chyun Hsu, Young-Bin Chen, Fu-An Chen, How-Ran Chao and Kuo-Lin Huang

Int. J. Environ. Res. Public Health 2018, 15(5), 931; https://doi.org/10.3390/ijerph15050931 - 7 May 2018

Cited by 44 | Viewed by 7111

Abstract

Only few studies have focused on organochlorine pesticides (OCPs) in breast milk and the related health risks for women in Taiwan. Our goal is to examine breast milk OCPs and their associations with female reproductive function (infertility, gynecological diseases, and menstruation characteristics) as [...] Read more.

Only few studies have focused on organochlorine pesticides (OCPs) in breast milk and the related health risks for women in Taiwan. Our goal is to examine breast milk OCPs and their associations with female reproductive function (infertility, gynecological diseases, and menstruation characteristics) as well as their correlation with sociodemographic parameters (age, pre-pregnant body mass index (BMI), annual incomes, population, birth year, and parity) and dietary habit. The breast milk samples were collected in southern Taiwan (n = 68) from 2013 to 2016 and the OCP residues were analyzed using high resolution gas chromatography with low resolution mass spectrometry (HRGC/LRMS). The results show that the most abundant OCP residues in the breast milk was ΣDDT with the geometric mean ± standard deviation of 9.81 ± 7.52 ng⁻¹ lipid⁻¹ followed by ΣHCH (0.539 ± 0.557 ng⁻¹·lipid⁻¹). In the principal component analysis, cis-chlordane (cis-CHL) and γ-HCH were found to be related to participants who received medical treatment for infertility, and 4,4′-DDT was associated with those who received gynecological surgery. The logistic regression showed that the odds ratio (OR) of log γ-hexachlorocyclohexane (γ-HCH) was higher for mothers who had received medical treatment for infertility than for the normal group (OR = 25.6, p = 0.035) after adjustments for age, pre-pregnant BMI, annual income, population (i.e., native-born Taiwanese), birth year, and parity. Cow milk and beef consumption as well as menstruation characteristics such as average menstrual period (>5 days), shortest menstrual period (<3 days), and women who had taken hormonal drugs were significantly associated to several OCP residues in the breast milk. In addition, ΣHCH including β-HCH and γ-HCH was correlated with annual family income and gravidity as well as cow milk and beef consumptions. Overall, γ-HCH exhibited a probable association with the infertility diseases of Taiwanese women, and dietary habit might play an important role in the female Taiwanese exposure to OCPs. Full article

(This article belongs to the Special Issue Exposure to Endocrine Disruptors in Pregnancy and Early Childhood)

► Show Figures

Figure 1

15 pages, 1090 KiB

Open AccessArticle

Smelting Remains a Public Health Risk Nearly a Century Later: A Case Study in Pueblo, Colorado, USA

by Moussa M. Diawara, Sofy Shrestha, Jim Carsella and Shanna Farmer

Int. J. Environ. Res. Public Health 2018, 15(5), 932; https://doi.org/10.3390/ijerph15050932 - 7 May 2018

Cited by 7 | Viewed by 6122

Abstract

Pueblo, Colorado has a long history of smelting activities, and recent studies raised concerns about lead exposure. This study tested 240 children in Pueblo for blood lead levels (BLLs) and found a significant association between distance from old smelters and children BLLs. Around [...] Read more.

Pueblo, Colorado has a long history of smelting activities, and recent studies raised concerns about lead exposure. This study tested 240 children in Pueblo for blood lead levels (BLLs) and found a significant association between distance from old smelters and children BLLs. Around 7.5% of Pueblo children had BLLs above the Centers for Disease Control and Prevention reference level of 5 µg/dL for elevated BLL, and 18.3% had BLLs between 3.3–4.9 µg/dL. Out of the 36 children who lived near former smelters, 13.9% had BLLs above 5 µg/dL vs. 6.37% for children living away from old smelters. The proportion of Pueblo children with elevated BLL was nearly three times the 2007–2010 United States national average (7.5% vs. 2.6%), and this was higher in the immediate vicinity of old smelters (13.9% vs. 2.6%). Genetic polymorphisms for ALAD-1 or ALAD-2 alleles, which play a role in susceptibility to lead toxicity, were not associated with children BBLs. Around 38.5% of houses sampled near the smelters had topsoil lead levels higher than the Environmental Protection Agency’s benchmark of 400 mg/kg. Our study resulted in the addition of areas of Pueblo to the EPA Superfund National Priorities List in December 2014, and cleanup is currently underway to minimize the public health risks. Full article

(This article belongs to the Special Issue Urban Geochemistry and Human Health)

► Show Figures

Figure 1

13 pages, 347 KiB

Open AccessArticle

Metabolic Syndrome in First Episode Schizophrenia, Based on the National Mental Health Registry of Schizophrenia (NMHR) in a General Hospital in Malaysia: A 10-Year Retrospective Cohort Study

by Albert Muh Haur Lee, Chong Guan Ng, Ong Hui Koh, Jesjeet Singh Gill and Salina Abdul Aziz

Int. J. Environ. Res. Public Health 2018, 15(5), 933; https://doi.org/10.3390/ijerph15050933 - 7 May 2018

Cited by 14 | Viewed by 5370

Abstract

Schizophrenia has been linked with various medical comorbidities, particularly metabolic syndrome. The number of studies on this aspect is lacking in Malaysia. (1) Objective: To investigate metabolic syndrome rates and its associated factors. (2) Method: This is the first 10-year retrospective-outcome study of [...] Read more.

Schizophrenia has been linked with various medical comorbidities, particularly metabolic syndrome. The number of studies on this aspect is lacking in Malaysia. (1) Objective: To investigate metabolic syndrome rates and its associated factors. (2) Method: This is the first 10-year retrospective-outcome study of patients with first episode schizophrenia in Malaysia. Out of 394 patients diagnosed with first episode schizophrenia and registered with the National Mental Health Registry of Schizophrenia (NMHR) in the General Hospital Kuala Lumpur (GHKL) in 2004–2005, 174 patients consented to participate in the study. They were interviewed using a Schizophrenia outcome questionnaire and the International Physical Activity Questionnaire (IPAQ). The diagnosis of metabolic syndrome was made using the National Cholesterol Education Program—Third Adult Treatment Panel (NCEP ATP III). (3) Results: All patients’ weight, body mass index, fasting blood sugar, and blood pressure are significantly increased. Sixty-three subjects (36.2%) developed metabolic syndrome while 36 (23.2%) were hypertensive, and 41 (28.1%) were diabetic. Use of fluphenthixol depot (CI = 1.05–5.09, OR: 0.84, p = 0.039), reduced physical activity (CI = 0.13–1.00, OR: −1.04, p = 0.049), and substance use disorder (CI = 1.40, 13.89, OR: 1.48, p = 0.012) were significantly associated with metabolic syndrome based on univariate analysis. In further multivariate analysis, comorbid substance abuse was the only significant factor associated with metabolic syndrome after adjusting for physical activity and intramuscular depot. (4) Conclusion: Patients with schizophrenia are at high risk of metabolic syndrome. It is important to address substance use problems as an important risk factor of this comorbidity. Full article

(This article belongs to the Special Issue Adult Psychiatry)

12 pages, 874 KiB

Open AccessArticle

Teens Implementing a Childhood Obesity Prevention Program in the Community: Feasibility and Perceptions of a Partnership with HSTA and iCook 4-H

by Rebecca L. Hagedorn, Jade A. White, Lisa Franzen-Castle, Sarah E. Colby, Kendra K. Kattelmann, Adrienne A. White and Melissa D. Olfert

Int. J. Environ. Res. Public Health 2018, 15(5), 934; https://doi.org/10.3390/ijerph15050934 - 7 May 2018

Cited by 10 | Viewed by 6806

Abstract

High school student researchers and teen leaders from the Health Science Technology Academy (HSTA), under the supervision of HSTA teachers, led a childhood obesity prevention (COP) program (iCook 4-H). The objective was to evaluate the feasibility and perceptions of having teen leaders implement [...] Read more.

High school student researchers and teen leaders from the Health Science Technology Academy (HSTA), under the supervision of HSTA teachers, led a childhood obesity prevention (COP) program (iCook 4-H). The objective was to evaluate the feasibility and perceptions of having teen leaders implement a COP program for dyads of youth (9–10 years old) and their primary adult food preparer. Behavior change and perceptions were assessed through surveys and open-ended interviews. Across eight HSTA organizations, 43 teen leaders participated in teaching the iCook 4-H program to 24 dyads. Increased frequency of culinary skills, physical activity and mealtime behavior were reported by youth. Almost all adults (93%) reported that their youth had learned kitchen skills and that the program provided youth-adult quality time and developed culinary skills. Youth echoed adult perceptions with additional themes of food safety and physical activity. HSTA teen leaders perceived the program to be successful and reported the training they received to implement the program was adequate 98% of the time. HSTA teachers found the program to be beneficial for HSTA students in improving leadership, confidence and responsibility. iCook 4-H was feasible to be disseminated through teen leaders in the HSTA program. This teen-led approach could serve as a model for youth health-related programming. Full article

(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)

► Show Figures

Figure 1

18 pages, 1779 KiB

Open AccessArticle

Removal of Emerging Contaminants and Estrogenic Activity from Wastewater Treatment Plant Effluent with UV/Chlorine and UV/H₂O₂ Advanced Oxidation Treatment at Pilot Scale

by Eduard Rott, Bertram Kuch, Claudia Lange, Philipp Richter, Amélie Kugele and Ralf Minke

Int. J. Environ. Res. Public Health 2018, 15(5), 935; https://doi.org/10.3390/ijerph15050935 - 7 May 2018

Cited by 29 | Viewed by 7399

Abstract

Effluent of a municipal wastewater treatment plant (WWTP) was treated on-site with the UV/chlorine (UV/HOCl) advanced oxidation process (AOP) using a pilot plant equipped with a medium pressure UV lamp with an adjustable performance of up to 1 kW. Results obtained from parallel [...] Read more.

Effluent of a municipal wastewater treatment plant (WWTP) was treated on-site with the UV/chlorine (UV/HOCl) advanced oxidation process (AOP) using a pilot plant equipped with a medium pressure UV lamp with an adjustable performance of up to 1 kW. Results obtained from parallel experiments with the same pilot plant, where the state of the art UV/H₂O₂ AOP was applied, were compared regarding the removal of emerging contaminants (EC) and the formation of adsorbable organohalogens (AOX). Furthermore, the total estrogenic activity was measured in samples treated with the UV/chlorine AOP. At an energy consumption of 0.4 kWh/m³ (0.4 kW, 1 m³/h) and in a range of oxidant concentrations from 1 to 6 mg/L, the UV/chlorine AOP had a significantly higher EC removal yield than the UV/H₂O₂ AOP. With free available chlorine concentrations (FAC) in the UV chamber influent of at least 5 mg/L (11 mg/L of dosed Cl₂), the total estrogenic activity could be reduced by at least 97%. To achieve a certain concentration of FAC in the UV chamber influent, double to triple the amount of dosed Cl₂ was needed, resulting in AOX concentrations of up to 520 µg/L. Full article

(This article belongs to the Special Issue Municipal Wastewater Treatment)

► Show Figures

Graphical abstract

11 pages, 318 KiB

Open AccessArticle

Body Weight Misperception and Its Association with Unhealthy Eating Behaviors among Adolescents in China

by Hanyi Yan, Yingru Wu, Theresa Oniffrey, Jason Brinkley, Rui Zhang, Xinge Zhang, Yueqiao Wang, Guoxun Chen, Rui Li and Justin B. Moore

Int. J. Environ. Res. Public Health 2018, 15(5), 936; https://doi.org/10.3390/ijerph15050936 - 8 May 2018

Cited by 31 | Viewed by 6912

Abstract

This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students (N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based [...] Read more.

This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students (N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based on the World Health Organization’s Global School-Based Student Health Survey was employed to assess responses. Self-reported data, including weight, height, body weight perception, and eating habits, were collected. Body Mass Index (BMI) for age z-score was calculated from self-reported height and weight using WHO AnthroPlus. We used descriptive, logistic regression analysis and a Kappa test to analyze the data using SPSS. Overall, 56.6% of participants did not correctly categorize their weight status; these were much more likely to be girls. Compared with the correctly-perceived group, those who underestimated their weight tended to report eating late at night, having dinners with family, and checking nutrition labels. In contrast, weight overestimating students were less likely to report eating late at night, having breakfasts with family, having dinners with family, and discussing nutrition topics over meals. Body weight misperception was associated with unhealthy eating behaviors among Chinese adolescents. Full article

(This article belongs to the Collection Health Behavior and Public Health)

16 pages, 28736 KiB

Open AccessArticle

Understanding the Natural and Socioeconomic Factors behind Regional Longevity in Guangxi, China: Is the Centenarian Ratio a Good Enough Indicator for Assessing the Longevity Phenomenon?

by Qucheng Deng, Yongping Wei, Yan Zhao, Xuerong Han and Juan Yin

Int. J. Environ. Res. Public Health 2018, 15(5), 938; https://doi.org/10.3390/ijerph15050938 - 8 May 2018

Cited by 19 | Viewed by 5067

Abstract

Despite a number of longevity indicators having been used in previous longevity studies, few studies have critically evaluated whether these indicators are suitable to assess the regional longevity level. In addition, an increasing number of studies have attempted to determine the influence of [...] Read more.

Despite a number of longevity indicators having been used in previous longevity studies, few studies have critically evaluated whether these indicators are suitable to assess the regional longevity level. In addition, an increasing number of studies have attempted to determine the influence of socioeconomic and natural factors on regional longevity, but only certain factors were considered. This study aims to bridge this gap by determining the relationship between the 7 longevity indicators and selecting 24 natural and socioeconomic indicators in 109 selected counties and urban districts in Guangxi, China. This study has applied spatial analysis and geographically weighted regression as the main research methods. The seven longevity indicators here refer to centenarian ratio, longevity index, longevity level, aging tendency, 80⁺ ratio, 90⁺ ratio, and 95⁺ ratio. Natural indicators in this study mainly refer to atmospheric pressure, temperature, difference in temperature, humidity, rainfall, radiation, water vapor, and altitude. Socioeconomic indicators can be categorized into those related to economic status, education, local infrastructure, and health care facilities. The results show that natural factors such as the difference in temperature and altitude, along with socioeconomic factors such as GDP, might be the most significant contributors to the longevity of people aged 60–90 years in Guangxi. The longevity index and longevity level are useful supplementary indexes to the centenarian ratio for assessing the regional longevity. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

12 pages, 312 KiB

Open AccessArticle

Factors Associated with Immunization Opinion Leadership among Men Who Have Sex with Men in Los Angeles, California

by Ian W. Holloway, Robert Bednarczyk, Vincent L. Fenimore, Cameron Goldbeck, Elizabeth Wu, Rebecca Himmelstein, Diane Tan, Laura Randall, Chelsea S. Lutz and Paula M. Frew

Int. J. Environ. Res. Public Health 2018, 15(5), 939; https://doi.org/10.3390/ijerph15050939 - 8 May 2018

Cited by 5 | Viewed by 4965

Abstract

We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled [...] Read more.

We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled MSM living in Los Angeles (N = 520) from December 2016 to February 2017 and evaluated characteristic differences in sociodemographic characteristics, health behaviors, and technology use among those classified as opinion leaders versus those who were not. We also asked respondents about their past receipt of meningococcal serogroups A, C, W, and Y (MenACWY) and meningococcal B (MenB) vaccines, as well as their opinions on the importance of 13 additional vaccines. Multivariable results revealed that non-Hispanic black (aOR = 2.64; 95% CI: 1.17–5.95) and other race/ethnicity (aOR = 2.98; 95% CI: 1.41–6.29) respondents, as well as those with a history of an STI other than HIV (aOR = 1.95; 95% CI: 1.10–3.48), were more likely to be opinion leaders. MenACWY (aOR = 1.92; 95% CI: 1.13–3.25) and MenB (aOR = 3.09; 95% CI: 1.77–5.41) vaccine uptake, and perceived importance for these and seven additional vaccines, were also associated with being an opinion leader. The results suggest that the co-promotion of vaccination and other health promotion initiatives via opinion leaders could be a useful strategy for increasing vaccination among MSM. Full article

(This article belongs to the Special Issue Interventions and Approaches to Optimize Immunization Coverage Across the Lifespan)

13 pages, 2293 KiB

Open AccessArticle

Temporal Variation and Ecological Risk Assessment of Metals in Soil Nearby a Pb–Zn Mine in Southern China

by Congcong Cao, Li Wang, Hairong Li, Binggan Wei and Linsheng Yang

Int. J. Environ. Res. Public Health 2018, 15(5), 940; https://doi.org/10.3390/ijerph15050940 - 9 May 2018

Cited by 14 | Viewed by 4839

Abstract

Metal contamination in soil from tailings induces risks for the ecosystem and for humans. In this study, the concentrations and ecological risks of Cd, Cu, Pb, and Zn in soil contaminated by a tailing from Yangshuo (YS) lead and zinc (Pb–Zn) mine, which [...] Read more.

Metal contamination in soil from tailings induces risks for the ecosystem and for humans. In this study, the concentrations and ecological risks of Cd, Cu, Pb, and Zn in soil contaminated by a tailing from Yangshuo (YS) lead and zinc (Pb–Zn) mine, which collapsed for more than 40 years, were determined in 2015. The mean concentrations of Zn, Pb, Cu, and Cd were 1301.79, 768.41, 82.60, and 4.82 mg/kg, respectively, which, with years of remediation activities, decreased by 66.9%, 61.7%, 65.4%, and 65.3% since 1986, but still exceed the national standards. From 1986 to 2015, soil pH increased significantly, with available concentrations of Zn, Pb, Cu and Cd decreasing by 13%, 81%, 77%, and 67%, respectively, and potential ecological risk indexes (E_r) of the determined metals decreasing by more than 60%. Horizontally, total contents and percentages of available concentrations of Zn, Pb, Cu, and Cd decreased with the distance from the tailing heap in SD village, while pH values showed the reverse pattern. Vertically, Zn and Cd, Pb, and Cu showed similar vertical distribution patterns in the soil profiles. There was a slight downward migration for the determined metals in soil of M and H area and the mobility was in the order of Cd > Zn > Pb > Cu. It can be concluded that although concentrations and ecological risks of Cd, Cu, Pb, and Zn in soil decreased significantly, SD village is still a high risk area, and the priority pollutant is Cd. Full article

(This article belongs to the Collection Environmental Risk Assessment)

► Show Figures

Figure 1

13 pages, 308 KiB

Open AccessArticle

The Physical Activity Patterns among Rural Chinese Adults: Data from China National Nutrition and Health Survey in 2010–2012

by Caicui Ding, Chao Song, Fan Yuan, Yan Zhang, Ganyu Feng, Zheng Chen and Ailing Liu

Int. J. Environ. Res. Public Health 2018, 15(5), 941; https://doi.org/10.3390/ijerph15050941 - 9 May 2018

Cited by 26 | Viewed by 4608

Abstract

China has experienced a rapid increase in non-communicable diseases (NCDs), especially in rural China. In addition to a dramatic increase in energy intake, the decrease in physical activity (PA) may be a reason. The study described the patterns and factors of physical activity [...] Read more.

China has experienced a rapid increase in non-communicable diseases (NCDs), especially in rural China. In addition to a dramatic increase in energy intake, the decrease in physical activity (PA) may be a reason. The study described the patterns and factors of physical activity and sedentary behaviors of 70,038 adults in rural China, based on data from the Chinese Nutrition and Health Survey (CNNHS) in 2010–2012. The mean working time of the employed subjects was 6.04 ± 1.3 day/week, 8.38 ± 2.2 h/day, of which 3.37 ± 2.8 h was sitting time. The occupational PA intensity was significantly relevant with occupation. The average transportation time of the rural Chinese adults was 57.9 ± 45.4 min, and 60.0% took the active transportation mode. The leisure-time PA (LTPA) participation rate was 3.8%, the LTPA time of those who had LTPA was 234.9 ± 231.3 min/week, lower participation was found in farmers and those in younger age groups, and those with lower educational and economic levels. The average domestic PA time, sedentary leisure-time, and sleeping time was 93.0 ± 72.7 min, 2.5 ± 1.4 h, and 7.9 ± 1.1 h, respectively. PA programs should be implemented in rural China, and the PA guidelines for farmers should be developed separately for the farming and non-farming seasons. Full article

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

16 pages, 516 KiB

Open AccessArticle

Development of a National Aboriginal and Torres Strait Islander Cancer Framework: A Shared Process to Guide Effective Policy and Practice

by Jenny Brands, Gail Garvey, Kate Anderson, Joan Cunningham, Jennifer Chynoweth, Isabella Wallington, Bronwyn Morris, Vikki Knott, Samantha Webster, Lauren Kinsella, John Condon and Helen Zorbas

Int. J. Environ. Res. Public Health 2018, 15(5), 942; https://doi.org/10.3390/ijerph15050942 - 9 May 2018

Cited by 9 | Viewed by 6066

Abstract

Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an [...] Read more.

Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an initiative by Cancer Australia and Menzies School of Health Research (Menzies) to develop Australia’s first National Aboriginal and Torres Strait Islander Cancer Framework using a process of co-design with relevant stakeholders. The initiative was guided by three core principles: achieving policy-relevant evidence-based outcomes; engaging and maintaining trust with Indigenous Australians at every phase; and employing best-practice and appropriate research methods. Four components of research comprised the Framework development: evidence review; multifaceted stakeholder consultation and input; triangulation of findings; and direct stakeholder input in drafting and refining the Framework. The evidence review confirmed the increasing burden of cancer on Indigenous Australians, while stakeholder consultations facilitated comprehensive input from those with lived experience. The consultations revealed issues not identified in existing literature, and gave different emphases of priority, thus reinforcing the value of including stakeholder perspectives. This paper focuses primarily on documenting the methods used; findings are presented only in order to illustrate the results of the process. The published Framework is available at www.canceraustralia.gov.au; further description and analyses of findings from the consultations will be published elsewhere. The logistics inherent in large-scale consultation are considerable. However, the quality of data and the foundation for sustained partnership with stakeholders and knowledge translation vastly outweighed the challenges. The process of wide-ranging stakeholder consultation described in this paper offers a model for other areas of national and international Indigenous priority setting and policy and practice development that meets the needs of those most affected. The Framework, through the establishment of an agreed, shared and evidence-based agenda, provides guidance for jurisdictional cancer plans, optimal care pathways, and program and service planning for the multiple players across all levels of the health system. Full article

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

► Show Figures

Figure 1

12 pages, 361 KiB

Open AccessArticle

Characteristics Associated with Non-Disclosure of Suicidal Ideation in Adults

by Saskia Mérelle, Elise Foppen, Renske Gilissen, Jan Mokkenstorm, Resi Cluitmans and Wouter Van Ballegooijen

Int. J. Environ. Res. Public Health 2018, 15(5), 943; https://doi.org/10.3390/ijerph15050943 - 9 May 2018

Cited by 33 | Viewed by 5682

Abstract

Suicide prevention efforts often depend on the willingness or ability of people to disclose current suicidal behavior. The aim of this study is to identify characteristics that are associated with non-disclosure of suicidal ideation. Data from the Dutch cross-sectional survey Health Monitor 2016 [...] Read more.

Suicide prevention efforts often depend on the willingness or ability of people to disclose current suicidal behavior. The aim of this study is to identify characteristics that are associated with non-disclosure of suicidal ideation. Data from the Dutch cross-sectional survey Health Monitor 2016 were used, resulting in 14,322 respondents (age 19+). Multiple logistic regression analyses were conducted to assess the strength of the associations between demographics and health-related characteristics as independent variables, and non-disclosure of suicidal ideation as the dependent variable. The mean age of the respondents was 60 years (SD 16.7) and 45% were male. Of these adults, 5% (n = 719) reported suicidal ideation in the past year, nearly half of which (48%) did not disclose suicidal ideation. Non-disclosure was significantly associated with social loneliness (OR = 1.29). Inverse significant associations were found for age (35–49 years, OR = 0.53), poor health status (OR = 0.63), frequent suicidal ideation (OR = 0.48), and severe psychological distress (OR = 0.63). The accuracy of this model was fair (AUC = 0.73). To conclude, non-disclosure is a substantial problem in adults experiencing suicidal ideation. Adults who do not disclose suicidal ideation are more likely to have few social contacts, while they are less likely to experience poor (mental) health and frequent suicidal thoughts. Full article

(This article belongs to the Special Issue Suicide Risk and Mental Disorders)

12 pages, 371 KiB

Open AccessFeature PaperArticle

by Mireille Luc, Hélène Corriveau, Gilles Boire, Johanne Filiatrault, Marie-Claude Beaulieu and Isabelle Gaboury

Int. J. Environ. Res. Public Health 2018, 15(5), 944; https://doi.org/10.3390/ijerph15050944 - 9 May 2018

Cited by 21 | Viewed by 4110

Abstract

A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care for patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone health recommendations from FLS staff is high. This prospective study combined participants’ telephone longitudinal [...] Read more.

A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care for patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone health recommendations from FLS staff is high. This prospective study combined participants’ telephone longitudinal survey data (intervention group, n = 354) and interviews with 16 individuals from FLS in three health regions of the province of Quebec (Canada). Participants were recruited between January 2013 and April 2015. Regression models were fit to examine the relationship between participant-related factors and adherence at 12 months to osteoporosis medication, vitamin D supplementation, and participation in physical activity. Participants acknowledging FF as a consequence of osteoporosis were more likely to adhere to medication (odds ratio (OR) 2.5; p = 0.001) and vitamin D supplementation (OR 2.3; p = 0.01). Paradoxically, the same participants were less prone to engage in physical activity (OR 0.5, p = 0.01). Qualitative interviews suggested that feedback from FLS coordinators helped participants understand the underlying cause of their FF. This study highlighted the key roles of FLS staff in helping patients to recognize FF as a sign of underlying bone disease and encouraging adherence to care recommendations. Full article

(This article belongs to the Special Issue New Concepts in Women’s Bone Health)

16 pages, 1473 KiB

Open AccessArticle

Lifestyle Health Behaviors of Nurses and Midwives: The ‘Fit for the Future’ Study

by Lin Perry, Xiaoyue Xu, Robyn Gallagher, Rachel Nicholls, David Sibbritt and Christine Duffield

Int. J. Environ. Res. Public Health 2018, 15(5), 945; https://doi.org/10.3390/ijerph15050945 - 9 May 2018

Cited by 55 | Viewed by 9079

Abstract

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to [...] Read more.

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014–2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25–34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required. Full article

(This article belongs to the Special Issue Workplace Health Promotion 2018)

► Show Figures

Figure 1

18 pages, 6743 KiB

Open AccessArticle

Spatial Pattern and Population Structure of Artemisia ordosica Shrub in a Desert Grassland under Enclosure, Northwest China

by Jiankang Liu and Kebin Zhang

Int. J. Environ. Res. Public Health 2018, 15(5), 946; https://doi.org/10.3390/ijerph15050946 - 9 May 2018

Cited by 16 | Viewed by 4624

Abstract

Enclosure is an effective practice for restoring and rehabilitating the degraded grassland ecosystem caused by overgrazing. Shrub species, which are dominant in most desert grasslands in arid and semiarid regions, have some beneficial ecological functions for grassland restoration. However, how the population structure [...] Read more.

Enclosure is an effective practice for restoring and rehabilitating the degraded grassland ecosystem caused by overgrazing. Shrub species, which are dominant in most desert grasslands in arid and semiarid regions, have some beneficial ecological functions for grassland restoration. However, how the population structure and spatial pattern of the Artemisia ordosica shrub changes in a grassland ecosystem under enclosed practice is not well understood. This study, conducted in the Mu Us desert in northwest China, was designed to measure the A. ordosica population according to the chronosequence of enclosure (enclosure periods ranged from 5 years, 10 years, 15 years, and 25 years), contrasting this with an adjacent continuously grazed grassland. The results showed that the enclosed grasslands had a higher number of individuals of different age classes (seedling, adult, aging, and dead group) and greater population coverage, but shrubs had significant lower (p < 0.05) crown diameter and height in comparison with those in continuously grazed grassland. Further, enclosed grasslands had a significantly higher (p < 0.05) Shannon-Wiener index (H) and Evenness index (E), but a significantly lower (p < 0.05) Richness index (R) than continuously grazed grassland. The crown of A. ordosica showed a significant linear positive correlation with height in all plots across succession, indicating that it was feasible to analyze the age structure by crown. The crown-class distribution structure of the A. ordosica population approximated a Gaussian distribution model in all survey plots. Within the population, seedling and adult groups exhibited aggregated spatial distribution at small scales, while aging and dead A. ordosica groups showed random distribution at almost all scales in different plots. The seedling A. ordosica group showed a positive correlation with adults at small scales in all plots except in 10 years of enclosure. However, it showed independent correlation with aging and dead groups at almost all scales. In long-term enclosed plots, the mortality rate of the A. ordosica population increased, therefore assistance management practices, such as fertilization, mowing, interval grazing, and seasonal grazing, must be employed to maintain population stability after long-term enclosure. This study can improve understanding and clarify the effects of enclosures in the desert grasslands of northwest China. Full article

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

► Show Figures

Figure 1

12 pages, 339 KiB

Open AccessArticle

A New TS Algorithm for Solving Low-Carbon Logistics Vehicle Routing Problem with Split Deliveries by Backpack—From a Green Operation Perspective

by Yangkun Xia, Zhuo Fu, Sang-Bing Tsai and Jiangtao Wang

Int. J. Environ. Res. Public Health 2018, 15(5), 949; https://doi.org/10.3390/ijerph15050949 - 10 May 2018

Cited by 30 | Viewed by 4524

Abstract

In order to promote the development of low-carbon logistics and economize logistics distribution costs, the vehicle routing problem with split deliveries by backpack is studied. With the help of the model of classical capacitated vehicle routing problem, in this study, a form of [...] Read more.

In order to promote the development of low-carbon logistics and economize logistics distribution costs, the vehicle routing problem with split deliveries by backpack is studied. With the help of the model of classical capacitated vehicle routing problem, in this study, a form of discrete split deliveries was designed in which the customer demand can be split only by backpack. A double-objective mathematical model and the corresponding adaptive tabu search (TS) algorithm were constructed for solving this problem. By embedding the adaptive penalty mechanism, and adopting the random neighborhood selection strategy and reinitialization principle, the global optimization ability of the new algorithm was enhanced. Comparisons with the results in the literature show the effectiveness of the proposed algorithm. The proposed method can save the costs of low-carbon logistics and reduce carbon emissions, which is conducive to the sustainable development of low-carbon logistics. Full article

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

19 pages, 7155 KiB

Open AccessArticle

SIMPL: A Simplified Model-Based Program for the Analysis and Visualization of Groundwater Rebound in Abandoned Mines to Prevent Contamination of Water and Soils by Acid Mine Drainage

by Sung-Min Kim and Yosoon Choi

Int. J. Environ. Res. Public Health 2018, 15(5), 951; https://doi.org/10.3390/ijerph15050951 - 10 May 2018

Cited by 9 | Viewed by 4447

Abstract

Cessation of dewatering following underground mine closure typically results in groundwater rebound, because mine voids and surrounding strata undergo flooding up to the levels of the decant points, such as shafts and drifts. SIMPL (Simplified groundwater program In Mine workings using the Pipe [...] Read more.

Cessation of dewatering following underground mine closure typically results in groundwater rebound, because mine voids and surrounding strata undergo flooding up to the levels of the decant points, such as shafts and drifts. SIMPL (Simplified groundwater program In Mine workings using the Pipe equation and Lumped parameter model), a simplified lumped parameter model-based program for predicting groundwater levels in abandoned mines, is presented herein. The program comprises a simulation engine module, 3D visualization module, and graphical user interface, which aids data processing, analysis, and visualization of results. The 3D viewer facilitates effective visualization of the predicted groundwater level rebound phenomenon together with a topographic map, mine drift, goaf, and geological properties from borehole data. SIMPL is applied to data from the Dongwon coal mine and Dalsung copper mine in Korea, with strong similarities in simulated and observed results. By considering mine workings and interpond connections, SIMPL can thus be used to effectively analyze and visualize groundwater rebound. In addition, the predictions by SIMPL can be utilized to prevent the surrounding environment (water and soil) from being polluted by acid mine drainage. Full article

► Show Figures

Figure 1

16 pages, 4042 KiB

Open AccessArticle

Current and Potential Future Seasonal Trends of Indoor Dwelling Temperature and Likely Health Risks in Rural Southern Africa

by Thandi Kapwata, Michael T. Gebreslasie, Angela Mathee and Caradee Yael Wright

Int. J. Environ. Res. Public Health 2018, 15(5), 952; https://doi.org/10.3390/ijerph15050952 - 10 May 2018

Cited by 28 | Viewed by 5366

Abstract

Climate change has resulted in rising temperature trends which have been associated with changes in temperature extremes globally. Attendees of Conference of the Parties (COP) 21 agreed to strive to limit the rise in global average temperatures to below 2 °C compared to [...] Read more.

Climate change has resulted in rising temperature trends which have been associated with changes in temperature extremes globally. Attendees of Conference of the Parties (COP) 21 agreed to strive to limit the rise in global average temperatures to below 2 °C compared to industrial conditions, the target being 1.5 °C. However, current research suggests that the African region will be subjected to more intense heat extremes over a shorter time period, with projections predicting increases of 4–6 °C for the period 2071–2100, in annual average maximum temperatures for southern Africa. Increased temperatures may exacerbate existing chronic ill health conditions such as cardiovascular disease, respiratory disease, cerebrovascular disease, and diabetes-related conditions. Exposure to extreme temperatures has also been associated with mortality. This study aimed to consider the relationship between temperatures in indoor and outdoor environments in a rural residential setting in a current climate and warmer predicted future climate. Temperature and humidity measurements were collected hourly in 406 homes in summer and spring and at two-hour intervals in 98 homes in winter. Ambient temperature, humidity and windspeed were obtained from the nearest weather station. Regression models were used to identify predictors of indoor apparent temperature (AT) and to estimate future indoor AT using projected ambient temperatures. Ambient temperatures will increase by a mean of 4.6 °C for the period 2088–2099. Warming in winter was projected to be greater than warming in summer and spring. The number of days during which indoor AT will be categorized as potentially harmful will increase in the future. Understanding current and future heat-related health effects is key in developing an effective surveillance system. The observations of this study can be used to inform the development and implementation of policies and practices around heat and health especially in rural areas of South Africa. Full article

(This article belongs to the Special Issue Health Impacts of Warming of 1.5 °C and 2 °C)

► Show Figures

Figure 1

16 pages, 497 KiB

Open AccessArticle

Sport Activity for Health!! The Effects of Karate Participants’ Involvement, Perceived Value, and Leisure Benefits on Recommendation Intention

by Ying-Chih Chang, Tsu-Ming Yeh, Fan-Yun Pai and Tai-Peng Huang

Int. J. Environ. Res. Public Health 2018, 15(5), 953; https://doi.org/10.3390/ijerph15050953 - 10 May 2018

Cited by 32 | Viewed by 7708

Abstract

This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that [...] Read more.

This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that karate participants from different places of residence do not display significant differences in involvement, perceived value, leisure benefits, and recommendation intention. Furthermore, “attraction” in the involvement category reveals the highest mean, “paid spirit and energy being worthy” in perceived value appears as the highest mean, and “physiological benefits” in leisure benefits shows the highest mean. The Pearson correlation analysis result presents significant strong positive correlations between involvement, perceived value, leisure benefits, and recommendation intention. Finally, multiple regression analysis reveals that leisure benefits, except “physiological benefits”, show notably positive effects on recommendation intention. According to the research results, suggestions are proposed for the reference of karate teaching business managers, participants, and future research. Full article

(This article belongs to the Special Issue Effect of Sport Activity on Health Promotion)

► Show Figures

Figure 1

11 pages, 2986 KiB

Open AccessFeature PaperArticle

Experiences and Opinions of Adults with Type 2 Diabetes Regarding a Self-Regulation-Based eHealth Intervention Targeting Physical Activity and Sedentary Behaviour

by Louise Poppe, Geert Crombez, Ilse De Bourdeaudhuij, Celien Van der Mispel, Samyah Shadid and Maïté Verloigne

Int. J. Environ. Res. Public Health 2018, 15(5), 954; https://doi.org/10.3390/ijerph15050954 - 10 May 2018

Cited by 14 | Viewed by 6134

Abstract

Background: Online interventions targeting a healthy lifestyle in adults with type 2 diabetes are more effective when informed by behaviour change theories. Although these theories provide guidance in developing the content of an intervention, information regarding how to present this content in an [...] Read more.

Background: Online interventions targeting a healthy lifestyle in adults with type 2 diabetes are more effective when informed by behaviour change theories. Although these theories provide guidance in developing the content of an intervention, information regarding how to present this content in an engaging way is often lacking. Consequently, incorporating users’ views in the creation of eHealth interventions has become an important target. Methods: Via a qualitative interview study with 21 adults with type 2 diabetes who had completed an online self-regulation-based intervention (‘MyPlan 2.0’), we assessed participants’ opinions regarding the usefulness of the implemented self-regulation techniques, the design of the programme as well as their knowledge regarding physical activity and sedentary behaviour. A directed content analysis was performed to synthesize the interview data. Results: Participants experienced difficulties completing the coping planning component. The simple design of the website was considered helpful, and most participants were aware of the beneficial effects of an active lifestyle. Conclusions: ‘MyPlan 2.0’ was well-accepted by the majority of participants. However, the coping planning component will need to be adapted. Based on these findings, recommendations on how to tailor eHealth interventions to the population of adults with type 2 diabetes have been formulated. Full article

(This article belongs to the Special Issue Sedentary Behaviour and Health)

► Show Figures

Figure 1

12 pages, 838 KiB

Open AccessArticle

Single Mothers’ Experiences with Pregnancy and Child Rearing in Korea: Discrepancy between Social Services/Policies and Single Mothers’ Needs

by Jung-Eun Kim, Jin Yong Lee and Sang Hyung Lee

Int. J. Environ. Res. Public Health 2018, 15(5), 955; https://doi.org/10.3390/ijerph15050955 - 10 May 2018

Cited by 12 | Viewed by 8215

Abstract

This study aims to explore single mothers’ experiences with social services/policies for their independent living and to identify gaps between these experiences and the needs of single mothers. A focus group discussion was performed to collect data. Seven single mothers discussed their experiences [...] Read more.

This study aims to explore single mothers’ experiences with social services/policies for their independent living and to identify gaps between these experiences and the needs of single mothers. A focus group discussion was performed to collect data. Seven single mothers discussed their experiences in significant periods of their lives: pregnancy, childbirth, and parenting. Findings from the qualitative thematic analysis show discrepancies between the direction of social services/policies and single mothers’ needs, in terms of difficulties in healthcare, childcare, housing, employment, and income security. To the single mothers in this study, the social safety net is not inclusive, compared to that which is available to two-parent families or adoptive families. It is necessary to intervene in current blind spots of services/policies for single mothers, and to provide a social safety net to strengthen single mothers’ self-reliance and their children’s social security in the long term. Full article

(This article belongs to the Section Health Economics)

► Show Figures

Figure 1

22 pages, 557 KiB

Open AccessArticle

A Case–Control Study of Socio-Economic and Nutritional Characteristics as Determinants of Dental Caries in Different Age Groups, Considered as Public Health Problem: Data from NHANES 2013–2014

by Laura A. Zanella-Calzada, Carlos E. Galván-Tejada, Nubia M. Chávez-Lamas, Ma. Del Carmen Gracia-Cortés, Arturo Moreno-Báez, Jose G. Arceo-Olague, Jose M. Celaya-Padilla, Jorge I. Galván-Tejada and Hamurabi Gamboa-Rosales

Int. J. Environ. Res. Public Health 2018, 15(5), 957; https://doi.org/10.3390/ijerph15050957 - 10 May 2018

Cited by 3 | Viewed by 5912

Abstract

One of the principal conditions that affects oral health worldwide is dental caries, occurring in about 90% of the global population. This pathology has been considered a challenge because of its high prevalence, besides being a chronic but preventable disease which can be [...] Read more.

One of the principal conditions that affects oral health worldwide is dental caries, occurring in about 90% of the global population. This pathology has been considered a challenge because of its high prevalence, besides being a chronic but preventable disease which can be caused by a series of different demographic, dietary, among others. Based on this problem, in this research a demographic and dietary features analysis is performed for the classification of subjects according to their oral health status based on caries, according to the age group where the population belongs, using as feature selector a technique based on fast backward selection (FBS) approach for the development of three predictive models, one for each age range (group 1: 10–19; group 2: 20–59; group 3: 60 or more years old). As validation, a net reclassification improvement (NRI), AUC, ROC, and OR values are used to evaluate their classification accuracy. We analyzed 189 demographic and dietary features from National Health and Nutrition Examination Survey (NHANES) 2013–2014. Each model obtained statistically significant results for most features and narrow OR confidence intervals. Age group 2 obtained a mean NRI = −0.080 and AUC = 0.933; age group 3 obtained a mean NRI = −0.024 and AUC = 0.787; and age group 4 obtained a mean NRI = −0.129 and AUC = 0.735. Based on these results, it is concluded that these specific demographic and dietary features are significant determinants for estimating the oral health status in patients based on their likelihood of developing caries, and the age group could imply different risk factors for subjects. Full article

► Show Figures

Figure 1

14 pages, 498 KiB

Open AccessArticle

Does Type 1 Diabetes Modify Sexuality and Mood of Women and Men?

by Ewelina Bak, Czeslaw Marcisz, Sylwia Krzeminska, Dorota Dobrzyn-Matusiak, Agnieszka Foltyn and Agnieszka Drosdzol-Cop

Int. J. Environ. Res. Public Health 2018, 15(5), 958; https://doi.org/10.3390/ijerph15050958 - 11 May 2018

Cited by 24 | Viewed by 5160

Abstract

Background: Sexual disorders occurring in women and men with type 1 diabetes have not been sufficiently investigated and described until now. This study attempts to evaluate sexuality in women and men. Methods: Altogether, the study comprised 115 patients with type 1 diabetes and [...] Read more.

Background: Sexual disorders occurring in women and men with type 1 diabetes have not been sufficiently investigated and described until now. This study attempts to evaluate sexuality in women and men. Methods: Altogether, the study comprised 115 patients with type 1 diabetes and 105 healthy people constituting the control group. All the studied persons underwent survey studies determining sexuality using the Female Sexual Function Index (FSFI-19) in women and the International Index of Erectile Function (IIEF-15) in men, and the occurrence of depression using the Beck Depression Inventory. The acceptance of illness among patients with diabetes was examined using the Acceptance of Illness Scale questionnaire. Results: In 35% of the examined women with diabetes, the study demonstrated sexual dysfunction as determined by total FSFI. The point values of all the investigated FSFI domains were significantly lower in women with diabetes than in healthy ones (p < 0.001). Erectile dysfunction occurred in 50% of the studied men with diabetes and in 23% of the control group of men (p = 0.0017). Conclusions: Type 1 diabetes leads to sexual disorders which occur in 1/3 of women and in 1/2 of men. Sexual disorders in patients with diabetes more frequently occur in men, persons with coexisting complications of diabetes, and in those with a concentration of glycated hemoglobin higher than 6.5%. Full article

(This article belongs to the Collection Health Care and Diabetes)

► Show Figures

Figure 1

20 pages, 1520 KiB

Open AccessArticle

Advice and Frequently Asked Questions (FAQs) for Citizen-Science Environmental Health Assessments

by Timothy M. Barzyk, Hongtai Huang, Ronald Williams, Amanda Kaufman and Jonathan Essoka

Int. J. Environ. Res. Public Health 2018, 15(5), 960; https://doi.org/10.3390/ijerph15050960 - 11 May 2018

Cited by 17 | Viewed by 6521

Abstract

Citizen science provides quantitative results to support environmental health assessments (EHAs), but standardized approaches do not currently exist to translate findings into actionable solutions. The emergence of low-cost portable sensor technologies and proliferation of publicly available datasets provides unparalleled access to supporting evidence; [...] Read more.

Citizen science provides quantitative results to support environmental health assessments (EHAs), but standardized approaches do not currently exist to translate findings into actionable solutions. The emergence of low-cost portable sensor technologies and proliferation of publicly available datasets provides unparalleled access to supporting evidence; yet data collection, analysis, interpretation, visualization, and communication are subjective approaches that must be tailored to a decision-making audience capable of improving environmental health. A decade of collaborative efforts and two citizen science projects contributed to three lessons learned and a set of frequently asked questions (FAQs) that address the complexities of environmental health and interpersonal relations often encountered in citizen science EHAs. Each project followed a structured step-by-step process in order to compare and contrast methods and approaches. These lessons and FAQs provide advice to translate citizen science research into actionable solutions in the context of a diverse range of environmental health issues and local stakeholders. Full article

(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)

► Show Figures

Figure 1

20 pages, 3682 KiB

Open AccessArticle

Dietary Differences in Male Workers among Smaller Occupational Groups within Large Occupational Categories: Findings from the Japan Environment and Children’s Study (JECS)

by Rie Tanaka, Mayumi Tsuji, Ayako Senju, Koichi Kusuhara, Toshihiro Kawamoto and Japan Environment and Children’s Study Group

Int. J. Environ. Res. Public Health 2018, 15(5), 961; https://doi.org/10.3390/ijerph15050961 - 11 May 2018

Cited by 7 | Viewed by 4007

Abstract

Studies examining workers’ diet according to smaller occupational groups within “large occupational categories” are sparse. The aim of this study was to examine the potential differences in workers’ diets based on the classification of workers into smaller occupational groups that comprise “large occupational [...] Read more.

Studies examining workers’ diet according to smaller occupational groups within “large occupational categories” are sparse. The aim of this study was to examine the potential differences in workers’ diets based on the classification of workers into smaller occupational groups that comprise “large occupational categories”. The subjects of this study were working fathers who had participated in the Japan Environment and Children’s Study (N = 38,656). Energy and nutrient intake were calculated based on data collected from the Food Frequency Questionnaire. Occupations were classified according to the Japanese Standard Occupational Classification. Logistic regression analyses were performed to examine the adherence to current dietary recommendations within smaller occupational groups. In particular, significant differences were observed among the categorical groups of “professional and engineering workers”, “service workers”, and “agricultural, forestry, and fishery workers”. In “professional and engineering workers”, teachers showed higher odds of adherence to calcium intake recommendations compared with nurses (OR, 2.54; 95% CI, 2.02–3.14; p < 0.001). In “agricultural, forestry, and fishery workers”, agriculture workers showed higher odds of adherence to calcium (OR, 2.15; 95% CI, 1.46–3.15; p < 0.001) and vitamin C (OR 1.90, 95% CI 1.31–2.74, p = 0.001) intake recommendations compared with forestry and fishery workers. These findings may be beneficial from a research perspective as well as in the development of more effective techniques to improve workers’ diet and health. Full article

(This article belongs to the Special Issue Occupational Epidemiology)

► Show Figures

Figure 1

10 pages, 286 KiB

Open AccessArticle

A Cost Benefit Analysis of an Active Travel Intervention with Health and Carbon Emission Reduction Benefits

by Ralph Chapman, Michael Keall, Philippa Howden-Chapman, Mark Grams, Karen Witten, Edward Randal and Alistair Woodward

Int. J. Environ. Res. Public Health 2018, 15(5), 962; https://doi.org/10.3390/ijerph15050962 - 11 May 2018

Cited by 79 | Viewed by 16904

Abstract

Active travel (walking and cycling) is beneficial for people’s health and has many co-benefits, such as reducing motor vehicle congestion and pollution in urban areas. There have been few robust evaluations of active travel, and very few studies have valued health and emissions [...] Read more.

Active travel (walking and cycling) is beneficial for people’s health and has many co-benefits, such as reducing motor vehicle congestion and pollution in urban areas. There have been few robust evaluations of active travel, and very few studies have valued health and emissions outcomes. The ACTIVE before-and-after quasi-experimental study estimated the net benefits of health and other outcomes from New Zealand’s Model Communities Programme using an empirical analysis comparing two intervention cities with two control cities. The Programme funded investment in cycle paths, other walking and cycling facilities, cycle parking, ‘shared spaces’, media campaigns and events, such as ‘Share the Road’, and cycle-skills training. Using the modified Integrated Transport and Health Impacts Model, the Programme’s net economic benefits were estimated from the changes in use of active travel modes. Annual benefits for health in the intervention cities were estimated at 34.4 disability-adjusted life years (DALYs) and two lives saved due to reductions in cardiac disease, diabetes, cancer, and respiratory disease. Reductions in transport-related carbon emissions were also estimated and valued. Using a discount rate of 3.5%, the estimated benefit/cost ratio was 11:1 and was robust to sensitivity testing. It is concluded that when concerted investment is made in active travel in a city, there is likely to be a measurable, positive return on investment. Full article

(This article belongs to the Section Environmental Health)

20 pages, 13129 KiB

Open AccessArticle

Biodegradation of Di-(2-ethylhexyl) Phthalate by Rhodococcus ruber YC-YT1 in Contaminated Water and Soil

by Ting Yang, Lei Ren, Yang Jia, Shuanghu Fan, Junhuan Wang, Jiayi Wang, Ruth Nahurira, Haisheng Wang and Yanchun Yan

Int. J. Environ. Res. Public Health 2018, 15(5), 964; https://doi.org/10.3390/ijerph15050964 - 11 May 2018

Cited by 91 | Viewed by 7944

Abstract

Di-(2-ethylehxyl) phthalate (DEHP) is one of the most broadly representative phthalic acid esters (PAEs) used as a plasticizer in polyvinyl chloride (PVC) production, and is considered to be an endocrine-disrupting chemical. DEHP and its monoester metabolites are responsible for adverse effects on human [...] Read more.

Di-(2-ethylehxyl) phthalate (DEHP) is one of the most broadly representative phthalic acid esters (PAEs) used as a plasticizer in polyvinyl chloride (PVC) production, and is considered to be an endocrine-disrupting chemical. DEHP and its monoester metabolites are responsible for adverse effects on human health. An efficient DEHP-degrading bacterial strain Rhodococcus ruber YC-YT1, with super salt tolerance (0–12% NaCl), is the first DEHP-degrader isolated from marine plastic debris found in coastal saline seawater. Strain YC-YT1 completely degraded 100 mg/L DEHP within three days (pH 7.0, 30 °C). According to high-performance liquid chromatography–mass spectrometry (HPLC-MS) analysis, DEHP was transformed by strain YC-YT1 into phthalate (PA) via mono (2-ethylehxyl) phthalate (MEHP), then PA was used for cell growth. Furthermore, YC-YT1 metabolized initial concentrations of DEHP ranging from 0.5 to 1000 mg/L. Especially, YC-YT1 degraded up to 60% of the 0.5 mg/L initial DEHP concentration. Moreover, compared with previous reports, strain YC-YT1 had the largest substrate spectrum, degrading up to 13 kinds of PAEs as well as diphenyl, p-nitrophenol, PA, benzoic acid, phenol, protocatechuic acid, salicylic acid, catechol, and 1,2,3,3-tetrachlorobenzene. The excellent environmental adaptability of strain YC-YT1 contributed to its ability to adjust its cell surface hydrophobicity (CSH) so that 79.7–95.9% of DEHP-contaminated agricultural soil, river water, coastal sediment, and coastal seawater were remedied. These results demonstrate that R. ruber YC-YT1 has vast potential to bioremediate various DEHP-contaminated environments, especially in saline environments. Full article

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

► Show Figures

Figure 1

22 pages, 4099 KiB

Open AccessArticle

Sludge Biochar Amendment and Alfalfa Revegetation Improve Soil Physicochemical Properties and Increase Diversity of Soil Microbes in Soils from a Rare Earth Element Mining Wasteland

by Caigui Luo, Yangwu Deng, Kazuyuki Inubushi, Jian Liang, Sipin Zhu, Zhenya Wei, Xiaobin Guo and Xianping Luo

Int. J. Environ. Res. Public Health 2018, 15(5), 965; https://doi.org/10.3390/ijerph15050965 - 11 May 2018

Cited by 30 | Viewed by 7033

Abstract

Long-term unregulated mining of ion-adsorption clays (IAC) in China has resulted in severe ecological destruction and created large areas of wasteland in dire need of rehabilitation. Soil amendment and revegetation are two important means of rehabilitation of IAC mining wasteland. In this study, [...] Read more.

Long-term unregulated mining of ion-adsorption clays (IAC) in China has resulted in severe ecological destruction and created large areas of wasteland in dire need of rehabilitation. Soil amendment and revegetation are two important means of rehabilitation of IAC mining wasteland. In this study, we used sludge biochar prepared by pyrolysis of municipal sewage sludge as a soil ameliorant, selected alfalfa as a revegetation plant, and conducted pot trials in a climate-controlled chamber. We investigated the effects of alfalfa revegetation, sludge biochar amendment, and their combined amendment on soil physicochemical properties in soil from an IAC mining wasteland as well as the impact of sludge biochar on plant growth. At the same time, we also assessed the impacts of these amendments on the soil microbial community by means of the Illumina Miseq sequences method. Results showed that alfalfa revegetation and sludge biochar both improved soil physicochemical properties and microbial community structure. When alfalfa revegetation and sludge biochar amendment were combined, we detected additive effects on the improvement of soil physicochemical properties as well as increases in the richness and diversity of bacterial and fungal communities. Redundancy analyses suggested that alfalfa revegetation and sludge biochar amendment significantly affected soil microbial community structure. Critical environmental factors consisted of soil available K, pH, organic matter, carbon–nitrogen ratio, bulk density, and total porosity. Sludge biochar amendment significantly promoted the growth of alfalfa and changed its root morphology. Combining alfalfa the revegetation with sludge biochar amendment may serve to not only achieve the revegetation of IAC mining wasteland, but also address the challenge of municipal sludge disposal by making the waste profitable. Full article

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

► Show Figures

Figure 1

18 pages, 34260 KiB

Open AccessArticle

A Simulation-Based Study on the Comparison of Statistical and Time Series Forecasting Methods for Early Detection of Infectious Disease Outbreaks

by Eunjoo Yang, Hyun Woo Park, Yeon Hwa Choi, Jusim Kim, Lkhagvadorj Munkhdalai, Ibrahim Musa and Keun Ho Ryu

Int. J. Environ. Res. Public Health 2018, 15(5), 966; https://doi.org/10.3390/ijerph15050966 - 11 May 2018

Cited by 31 | Viewed by 9102

Abstract

Early detection of infectious disease outbreaks is one of the important and significant issues in syndromic surveillance systems. It helps to provide a rapid epidemiological response and reduce morbidity and mortality. In order to upgrade the current system at the Korea Centers for [...] Read more.

Early detection of infectious disease outbreaks is one of the important and significant issues in syndromic surveillance systems. It helps to provide a rapid epidemiological response and reduce morbidity and mortality. In order to upgrade the current system at the Korea Centers for Disease Control and Prevention (KCDC), a comparative study of state-of-the-art techniques is required. We compared four different temporal outbreak detection algorithms: the CUmulative SUM (CUSUM), the Early Aberration Reporting System (EARS), the autoregressive integrated moving average (ARIMA), and the Holt-Winters algorithm. The comparison was performed based on not only 42 different time series generated taking into account trends, seasonality, and randomly occurring outbreaks, but also real-world daily and weekly data related to diarrhea infection. The algorithms were evaluated using different metrics. These were namely, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, symmetric mean absolute percent error (sMAPE), root-mean-square error (RMSE), and mean absolute deviation (MAD). Although the comparison results showed better performance for the EARS C3 method with respect to the other algorithms, despite the characteristics of the underlying time series data, Holt–Winters showed better performance when the baseline frequency and the dispersion parameter values were both less than 1.5 and 2, respectively. Full article

(This article belongs to the Special Issue Emerging Infectious Disease (EID) Research, Management and Response)

► Show Figures

Figure 1

8 pages, 625 KiB

Open AccessArticle

The Relative Contribution of Dietary Habits, Leisure-Time Exercise, Exercise Attitude, and Body Mass Index to Self-Rated Health among College Students in Taiwan

by Huey-Hong Hsieh, Chia-Ming Chang, Li-Wei Liu and Hsiu-Chin Huang

Int. J. Environ. Res. Public Health 2018, 15(5), 967; https://doi.org/10.3390/ijerph15050967 - 11 May 2018

Cited by 11 | Viewed by 6274

Abstract

Background: Self-rated health (SRH) is consistent with objective health status and can serve as a global measure of health status in the general population. The purpose of this study is to find the connections of dietary habits, leisure-time exercise, exercise attitude, and [...] Read more.

Background: Self-rated health (SRH) is consistent with objective health status and can serve as a global measure of health status in the general population. The purpose of this study is to find the connections of dietary habits, leisure-time exercise, exercise attitude, and body mass index (BMI) to SRH among college students. Methods: The “dietary–exercise attitude and SRH” questionnaire was developed to investigate college students in Taiwan through the Internet. Partial least squares structural equation modeling (PLS-SEM) was used to test the relationship among them. Results: The reliability and validity were confirmed using PLS-SEM. The results found exercise habits, dietary habits, and BMI explained 26.5% of SRH. Poor dietary habits and being overweight led to bad health status (negative path coefficients to SRH). Additionally, the study found that positive exercise attitude had a positive relationship with exercise habits. Conclusions: Based on the results, college students should be well-informed of the potential threat of poor dietary habits and being overweight to health and should improve their attitude with respect to exercise so as to prevent overweight-related diseases. Full article

(This article belongs to the Special Issue Selected Paper from the 14th International Symposium on Recent Advances in Environmental Health Research)

► Show Figures

Figure 1

14 pages, 672 KiB

Open AccessArticle

Immunization Offer Targeting Migrants: Policies and Practices in Italy

by Teresa Dalla Zuanna, Martina Del Manso, Cristina Giambi, Flavia Riccardo, Antonino Bella, Maria Grazia Caporali, Maria Grazia Dente, Silvia Declich and The Italian Survey CARE Working Group

Int. J. Environ. Res. Public Health 2018, 15(5), 968; https://doi.org/10.3390/ijerph15050968 - 12 May 2018

Cited by 12 | Viewed by 4796

Abstract

The unprecedented flow of migrants over the last three years places Italy in front of new issues regarding medical care from the rescue phase up to the integration into the national health services, including preventive actions. We used online questionnaires to investigate the [...] Read more.

The unprecedented flow of migrants over the last three years places Italy in front of new issues regarding medical care from the rescue phase up to the integration into the national health services, including preventive actions. We used online questionnaires to investigate the Italian national and regional policies for immunization offer targeting asylum seekers, refugees, irregular migrants and unaccompanied minors. Another questionnaire was used to assess how these policies are translated into practice in migrant reception centres and community health services. Questionnaires were filled out at the national level, in 14 out of 21 Regions/Autonomous Provinces, and in 36 community health services and 28 migrant reception centres. Almost all responders stated that all vaccinations included in the National Immunization Plan are offered to migrant children and adolescents. The situation concerning adults is fragmented, with most of the Regions and local centres offering more vaccines than the national offer—which include polio, tetanus and measles–mumps-rubella. Data on immunized immigrants is archived at the regional/local level with different methods and not available at the national level. Further efforts to ensure consistency in vaccine provision and adequate mechanisms of exchanging data are needed to guarantee a complete vaccination offer and avoid unnecessary health actions, including unnecessary re-vaccination. Full article

(This article belongs to the Special Issue Refugee, Migrant and Ethnic Minority Health)

► Show Figures

Figure 1

14 pages, 3988 KiB

Open AccessArticle

Study of the Kinetics and Equilibrium of the Adsorption of Oils onto Hydrophobic Jute Fiber Modified via the Sol-Gel Method

by Na Lv, Xiaoli Wang, Shitao Peng, Huaqin Zhang and Lei Luo

Int. J. Environ. Res. Public Health 2018, 15(5), 969; https://doi.org/10.3390/ijerph15050969 - 12 May 2018

Cited by 77 | Viewed by 6492

Abstract

A new kind of hydrophobic and oil sorbent based on jute fiber was successfully prepared by the integration of silica onto a fiber surface via the sol-gel method and subsequent hydrophobic modification with octadecyltrichlorosilane (OTS). Compared with the hydrophilic raw fiber, the modified [...] Read more.

A new kind of hydrophobic and oil sorbent based on jute fiber was successfully prepared by the integration of silica onto a fiber surface via the sol-gel method and subsequent hydrophobic modification with octadecyltrichlorosilane (OTS). Compared with the hydrophilic raw fiber, the modified fiber had a water contact angle (CA) of 136.2°, suggesting that the material has good hydrophobicity. Furthermore, the ability of oil in the oil/water system (taking diesel for example) to absorb was revealed by the kinetics, the isotherm equation, and the thermodynamic parameters. Adsorption behavior was kinetically investigated using pseudo first-order and pseudo second-order models. The data mostly correlated with the pseudo first-order model. The equilibrium adsorption at 298 K was assessed by using the Langmuir and Freundlich isotherm models. The Freundlich model had greater consistency with the experimental data. The obtained thermodynamic parameters demonstrate that the adsorption of diesel is spontaneous, favorable, and exothermic. Full article

(This article belongs to the Special Issue Nanomaterials for Environmental Remediation)

► Show Figures

Figure 1

18 pages, 1477 KiB

Open AccessArticle

Children’s Imaginaries of Human-Robot Interaction in Healthcare

by Núria Vallès-Peris, Cecilio Angulo and Miquel Domènech

Int. J. Environ. Res. Public Health 2018, 15(5), 970; https://doi.org/10.3390/ijerph15050970 - 12 May 2018

Cited by 26 | Viewed by 6067

Abstract

This paper analyzes children’s imaginaries of Human-Robots Interaction (HRI) in the context of social robots in healthcare, and it explores ethical and social issues when designing a social robot for a children’s hospital. Based on approaches that emphasize the reciprocal relationship between society [...] Read more.

This paper analyzes children’s imaginaries of Human-Robots Interaction (HRI) in the context of social robots in healthcare, and it explores ethical and social issues when designing a social robot for a children’s hospital. Based on approaches that emphasize the reciprocal relationship between society and technology, the analytical force of imaginaries lies in their capacity to be embedded in practices and interactions as well as to affect the construction and applications of surrounding technologies. The study is based on a participatory process carried out with six-year-old children for the design of a robot. Imaginaries of HRI are analyzed from a care-centered approach focusing on children’s values and practices as related to their representation of care. The conceptualization of HRI as an assemblage of interactions, the prospective bidirectional care relationships with robots, and the engagement with the robot as an entity of multiple potential robots are the major findings of this study. The study shows the potential of studying imaginaries of HRI, and it concludes that their integration in the final design of robots is a way of including ethical values in it. Full article

(This article belongs to the Special Issue Advances in Technology Enabled Health and Care)

► Show Figures

Figure 1

23 pages, 1139 KiB

Open AccessArticle

The Development of a Multiple-Item Annoyance Scale (MIAS) for Transportation Noise Annoyance

by Dirk Schreckenberg, Christin Belke and Jan Spilski

Int. J. Environ. Res. Public Health 2018, 15(5), 971; https://doi.org/10.3390/ijerph15050971 - 12 May 2018

Cited by 22 | Viewed by 5788

Abstract

In 2001, Team#6 of the International Commission on Biological Effects of Noise (ICBEN) recommended the use of two single international standardised questions and response scales. This recommendation has been widely accepted in the scientific community. Nevertheless, annoyance can be regarded as a multidimensional [...] Read more.

In 2001, Team#6 of the International Commission on Biological Effects of Noise (ICBEN) recommended the use of two single international standardised questions and response scales. This recommendation has been widely accepted in the scientific community. Nevertheless, annoyance can be regarded as a multidimensional construct comprising the three elements: (1) experience of an often repeated noise-related disturbance and the behavioural response to cope with it, (2) an emotional/attitudinal response to the sound and its disturbing impact, and (3) the perceived control or coping capacity with regard to the noise situation. The psychometric properties of items reflecting these three elements have been explored for aircraft noise annoyance. Analyses were conducted using data of the NORAH-Study (Noise-Related Annoyance, Cognition, and Health), and a multi-item noise annoyance scale (MIAS) has been developed and tested post hoc by using a stepwise process (exploratory and confirmatory factor analyses). Preliminary results were presented to the 12th ICBEN Congress in 2017. In this study, the validation of MIAS is done for aircraft noise and extended to railway and road traffic noise. The results largely confirm the concept of MIAS as a second-order construct of annoyance for all of the investigated transportation noise sources; however, improvements can be made, in particular with regard to items addressing the perceived coping capacity. Full article

(This article belongs to the Special Issue Noise-Related Annoyance)

► Show Figures

Figure 1

9 pages, 1151 KiB

Open AccessArticle

The Importance of Nidotherapy and Environmental Change in the Management of People with Complex Mental Disorders

by Peter Tyrer

Int. J. Environ. Res. Public Health 2018, 15(5), 972; https://doi.org/10.3390/ijerph15050972 - 13 May 2018

Cited by 6 | Viewed by 4849

Abstract

Much has been done in the last 50 years to achieve a better understanding of the psychosocial causes and other factors influencing the manifestation of mental illness, but there has been a conspicuous omission. Although gross environmental deficiencies were exposed in old mental [...] Read more.

Much has been done in the last 50 years to achieve a better understanding of the psychosocial causes and other factors influencing the manifestation of mental illness, but there has been a conspicuous omission. Although gross environmental deficiencies were exposed in old mental institutions, 70 years ago the more subtle maladaptive settings that reinforce chronicity in mental illness have often been forgotten. In this review, the potential of systematic environmental manipulation as a treatment (nidotherapy) and other similar forms of management, used many times in the past but now mainly in forensic settings, is examined. There is now accumulating evidence, reinforced by controlled trials, that planned environmental change, preferably carried out with the full cooperation of the patient, can be a major contributor to therapeutic benefit. It is also very cost-effective. All forms of the environment, physical, social and personal, can be addressed in making assessments, and once a planned way forward has been chosen, progress can be monitored by personnel with limited mental health experience. These interventions have applications in general mental health and occupational health services and deserve much wider use. Full article

(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)

► Show Figures

Figure 1

15 pages, 1278 KiB

Open AccessArticle

Social Networks and Health: Understanding the Nuances of Healthcare Access between Urban and Rural Populations

by Padmore Adusei Amoah, Joseph Edusei and David Amuzu

Int. J. Environ. Res. Public Health 2018, 15(5), 973; https://doi.org/10.3390/ijerph15050973 - 13 May 2018

Cited by 33 | Viewed by 8114

Abstract

Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population [...] Read more.

Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare. Full article

(This article belongs to the Special Issue Social Networks and Health)

► Show Figures

Figure 1

9 pages, 543 KiB

Open AccessCommunication

Preliminary Assessment of Hurricane Harvey Exposures and Mental Health Impact

by Rebecca M. Schwartz, Stephanie Tuminello, Samantha M. Kerath, Janelle Rios, Wil Lieberman-Cribbin and Emanuela Taioli

Int. J. Environ. Res. Public Health 2018, 15(5), 974; https://doi.org/10.3390/ijerph15050974 - 13 May 2018

Cited by 57 | Viewed by 7807

Abstract

Hurricane Harvey made landfall in Houston, Texas on 25 August 2017, the psychological and physical effects of which are still unknown. We assessed hurricane exposure and the immediate mental health needs of the population to define public health priorities for a larger epidemiological [...] Read more.

Hurricane Harvey made landfall in Houston, Texas on 25 August 2017, the psychological and physical effects of which are still unknown. We assessed hurricane exposure and the immediate mental health needs of the population to define public health priorities for a larger epidemiological study. Convenience sampling was used to recruit participants (n = 41) from the greater Houston area aged ≥18 years. Participants completed a questionnaire about demographics, hurricane exposures, and physical/mental health. Post-Traumatic Stress Disorder (PTSD) was measured with the Post-Traumatic Stress Disorder Checklist-S (PCL-S; a score ≥30 indicated probable PTSD symptoms). The Patient Health Questionnaire-4 (PHQ-4) was used to assess symptoms of depression and generalized anxiety disorder. The average PTSD score was 32.9 (SD = 17.1); a total of 46% of participants met the threshold for probable PTSD. Increased overall hurricane exposure (adjusted odds ratio (OR_adj) 1.42; 95% confidence interval (CI): 1.06–2.05) and property-related exposure (OR_adj 1.53; 95% CI: 1.07–2.18) were both statistically significantly associated with increased odds of probable PTSD symptoms. A perception of chemical/toxin exposure due to Hurricane Harvey was reported by 44% of participants. A higher number of personal or property exposures were associated with greater mental health symptoms three weeks post-hurricane. This work has implications for the ongoing response to Hurricane Harvey and for assessing the immediate needs of the population. Full article

(This article belongs to the Special Issue Frontiers in Mental Health and the Environment)

► Show Figures

Figure 1

14 pages, 1988 KiB

Open AccessArticle

Characterization of a Microbial Consortium for the Bioremoval of Polycyclic Aromatic Hydrocarbons (PAHs) in Water

by Esmeralda G. Blanco-Enríquez, Francisco Javier Zavala-Díaz de la Serna, María Del Rosario Peralta-Pérez, Lourdes Ballinas-Casarrubias, Iván Salmerón, Héctor Rubio-Arias and Beatriz A. Rocha-Gutiérrez

Int. J. Environ. Res. Public Health 2018, 15(5), 975; https://doi.org/10.3390/ijerph15050975 - 13 May 2018

Cited by 22 | Viewed by 4637

Abstract

Pollution of freshwater ecosystems from polycyclic aromatic hydrocarbons (PAHs) is a global concern. The US Environmental Protection Agency (EPA) has included the PAHs pyrene, phenanthrene, and naphthalene among the 16 priority compounds of special concern for their toxicological effects. The aim of this [...] Read more.

Pollution of freshwater ecosystems from polycyclic aromatic hydrocarbons (PAHs) is a global concern. The US Environmental Protection Agency (EPA) has included the PAHs pyrene, phenanthrene, and naphthalene among the 16 priority compounds of special concern for their toxicological effects. The aim of this study was to adapt and characterize a microbial consortium from ore waste with the potential to remove these three PAHs from water. This microbial consortium was exposed to the target PAHs at levels of 5, 10, 20, 50, and 100 mg L⁻¹ for 14 days. PAH bioremoval was measured using the analytical technique of solid phase microextraction, followed by gas chromatography mass spectrometry (SPME-GC/MS). The results revealed that up to 90% of the target PAHs can be removed from water after 14 days at a concentration level of 100 mg L⁻¹. The predominant group of microorganisms identified at the phylum taxonomic level were the Proteobacteria, while the Actinobacteria were the predominant subgroup. The removal of phenanthrene, naphthalene, and pyrene predominantly occurred in specimens of genera Stenotrophomonas, Williamsia, and Chitinophagaceae, respectively. This study demonstrates that the use of specific microorganisms is an alternative method of reducing PAH levels in water. Full article

(This article belongs to the Special Issue Selected Paper from the 14th International Symposium on Recent Advances in Environmental Health Research)

► Show Figures

Figure 1

15 pages, 376 KiB

Open AccessArticle

Improving Physical Fitness and Cognitive Functions in Middle School Students: Study Protocol for the Chinese Childhood Health, Activity and Motor Performance Study (Chinese CHAMPS)

by Zhixiong Zhou, Shanshan Dong, Jun Yin, Quan Fu, Hong Ren and Zenong Yin

Int. J. Environ. Res. Public Health 2018, 15(5), 976; https://doi.org/10.3390/ijerph15050976 - 14 May 2018

Cited by 11 | Viewed by 6018

Abstract

Background: Sedentary lifestyles and their associated harmful consequences are public health concerns that impact more than half of the world’s youth population in both developed and developing countries. Methods: The Chinese Childhood Health; Activity and Motor Performance Study (Chinese CHAMPS) was [...] Read more.

Background: Sedentary lifestyles and their associated harmful consequences are public health concerns that impact more than half of the world’s youth population in both developed and developing countries. Methods: The Chinese Childhood Health; Activity and Motor Performance Study (Chinese CHAMPS) was a cluster randomized controlled trial to modify school physical activity policies and the physical education (PE) curriculum; using teacher training and parent engagement to increase opportunities and support students’ physical activity and healthy eating. Using a 2 × 2 factorial design, the study tested the incremental effects of increasing the amount and intensity of physical activity, alongside adding support for healthy eating, on health-related and cognitive function outcomes in Chinese middle school students. Results: The intervention was implemented by PE teachers in 12 middle schools in three Chinese cities, with a targeted enrollment of 650 students from August 2015–June 2016. The assessment of the outcomes involved a test battery of physical fitness and cognitive functioning at both baseline and at the end of the intervention. Process information on implementation was also collected. Discussion: The Chinese CHAMPS is a multi-level intervention that is designed to test the influences of policy and environmental modifications on the physical activity and eating behaviors of middle school students. It also addresses some key weaknesses in school-based physical activity interventions. Full article

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

13 pages, 342 KiB

Open AccessArticle

Understanding of Information about Medicines Use among Parents of Pre-School Children in Serbia: Parental Pharmacotherapy Literacy Questionnaire (PTHL-SR)

by Stana Ubavić, Nataša Bogavac-Stanojević, Aleksandra Jović-Vraneš and Dušanka Krajnović

Int. J. Environ. Res. Public Health 2018, 15(5), 977; https://doi.org/10.3390/ijerph15050977 - 14 May 2018

Cited by 14 | Viewed by 4390

Abstract

Parental health literacy plays an important role in children’s health. Experiences from pharmacy practice show that is necessary to check if parents understand instructions about use of medicines for children. This study aimed to assess pharmacotherapy literacy of parents of pre-school children and [...] Read more.

Parental health literacy plays an important role in children’s health. Experiences from pharmacy practice show that is necessary to check if parents understand instructions about use of medicines for children. This study aimed to assess pharmacotherapy literacy of parents of pre-school children and to examine association of parental pharmacotherapy literacy level with parent’s socio-demographic characteristics. The study was cross-sectional, conducted among parents of pre-school children (1–7 years of age), in kindergartens in several municipalities of Belgrade, Serbia, during regular parents meetings, from May to October 2016. Functional health literacy was measured by the Serbian version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Parental pharmacotherapy literacy was assessed with newly constructed PTHL-SR questionnaire with good psychometric characteristics (Parental pharmacotherapy literacy questionnaire—Serbian). Overall, 813 parents participated in the study, mostly females (81.30%), between 30 to 40 years of age (70.85%) with two children (56.70%). Almost all of our study participants (99%) had adequate health literacy as assessed by S-TOFHLA. Mean score on PTHL-SR was 72.83% (standard deviation was 13.37), with better results among females than males (72% of women were in the group of highest PTHL-SR results). Our study showed that many parents (76.5%) knew the appropriate usage of non-prescription medicine for children, 57.2% parents were able to correctly calculate the dose of oral syrup for a child, and only 43.3% were able to interpret non-prescription dosage information written on the package. The majority of parents (61.3%) would make a dosage to child based on age and not on their weight. Every fifth parent with adequate functional health literacy measured by S-TOFHLA test, achieved the lowest results measured by PTHL-SR. Higher performance of the PTHL-SR was significantly correlated with education (p < 0.001), female sex (p < 0.001), married parents and those living in common-law (p < 0.001), older parents (p < 0.05) and parents who have more children (p < 0.05), and are non-smokers (p < 0.05). These results provide evidence that limitations in understanding common information about use of medicines are widespread among parents of pre-school children and encourage efforts for further investigation. PTHL-SR questionnaire may be a useful tool for identification of parents who need more instructions and assistance from healthcare providers, above all in providing better communication, written or spoken at community pharmacy settings. Full article

(This article belongs to the Special Issue Health Literacy in Context—Settings, Media, and Populations)

13 pages, 338 KiB

Open AccessArticle

Exploring How the Home Environment Influences Eating and Physical Activity Habits of Low-Income, Latino Children of Predominantly Immigrant Families: A Qualitative Study

by Ana Cristina Lindsay, Sherrie F. Wallington, Faith D. Lees and Mary L. Greaney

Int. J. Environ. Res. Public Health 2018, 15(5), 978; https://doi.org/10.3390/ijerph15050978 - 14 May 2018

Cited by 66 | Viewed by 12430

Abstract

Latinos are the largest and fastest growing minority population group in the United States, and children in low-income Latino families are at elevated risk of becoming overweight or having obesity. A child’s home is an important social environment in which he/she develops and [...] Read more.

Latinos are the largest and fastest growing minority population group in the United States, and children in low-income Latino families are at elevated risk of becoming overweight or having obesity. A child’s home is an important social environment in which he/she develops and maintains dietary and physical activity (PA) habits that ultimately impact weight status. Previous research suggests the parents are central to creating a home environment that facilitates or hinders the development of children’s early healthy eating and PA habits. Therefore, the purpose of this study was to explore low-income Latino parents’ beliefs, parenting styles, and parenting practices related to their children’s eating and PA behaviors while at home. Methods: Qualitative study using focus group discussions (FGDs) with 33 low-income Latino parents of preschool children 2 to 5 years of age. FGDs were transcribed verbatim and analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and PA for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment may influence low-income Latino preschool children’s eating and PA habits, which may be useful for health promotion and disease prevention efforts targeting low-income Latino families with young children, and for developing home-based and parenting interventions to prevent and control childhood obesity among this population group. Pediatric healthcare providers can play an important role in facilitating communication, providing education, and offering guidance to low-income Latino parents that support their children’s development of early healthy eating and PA habits, while taking into account daily life barriers faced by families. Moreover, pediatric healthcare providers also can play an important role in the integration and coordination of home-visitations to complement office-based visits and provide a continuum of care to low-income Latino families. Full article

(This article belongs to the Special Issue Obesity Prevention in Children and Adolescents)

13 pages, 599 KiB

Open AccessArticle

Heterogeneity in the Relationship between Disinfection By-Products in Drinking Water and Cancer: A Systematic Review

by Tarik Benmarhnia, Ianis Delpla, Lara Schwarz, Manuel J. Rodriguez and Patrick Levallois

Int. J. Environ. Res. Public Health 2018, 15(5), 979; https://doi.org/10.3390/ijerph15050979 - 14 May 2018

Cited by 21 | Viewed by 5822

Abstract

The epidemiological evidence demonstrating the effect of disinfection by-products (DBPs) from drinking water on colon and rectal cancers is well documented. However, no systematic assessment has been conducted to assess the potential effect measure modification (EMM) in the relationship between DBPs and cancer. [...] Read more.

The epidemiological evidence demonstrating the effect of disinfection by-products (DBPs) from drinking water on colon and rectal cancers is well documented. However, no systematic assessment has been conducted to assess the potential effect measure modification (EMM) in the relationship between DBPs and cancer. The objective of this paper is to conduct a systematic literature review to determine the extent to which EMM has been assessed in the relationship between DBPs in drinking water in past epidemiological studies. Selected articles (n = 19) were reviewed, and effect estimates and covariates that could have been used in an EMM assessment were gathered. Approximately half of the studies assess EMM (n = 10), but the majority of studies only estimate it relative to sex subgroups (n = 6 for bladder cancer and n = 2 both for rectal and colon cancers). Although EMM is rarely assessed, several variables that could have a potential modification effect are routinely collected in these studies, such as socioeconomic status or age. The role of environmental exposures through drinking water can play an important role and contribute to cancer disparities. We encourage a systematic use of subgroup analysis to understand which populations or territories are more vulnerable to the health impacts of DBPs. Full article

(This article belongs to the Special Issue Drinking Water Quality and Human Health)

► Show Figures

Figure 1

18 pages, 1437 KiB

Open AccessArticle

Adsorption Performance Analysis of Alternative Reactive Media for Remediation of Aquifers Affected by Heavy Metal Contamination

by Antonio Molinari, Celia Margarita Mayacela Rojas, Amerigo Beneduci, Adalgisa Tavolaro, Maria Fernanda Rivera Velasquez and Carmine Fallico

Int. J. Environ. Res. Public Health 2018, 15(5), 980; https://doi.org/10.3390/ijerph15050980 - 14 May 2018

Cited by 8 | Viewed by 4215

Abstract

A series of experimental batch tests has been carried out with the aim of improving the knowledge of fundamental processes related to the fate and behavior of heavy metals that can be of environmental concern in groundwater. The analysis of contaminants (i.e., Cu, [...] Read more.

A series of experimental batch tests has been carried out with the aim of improving the knowledge of fundamental processes related to the fate and behavior of heavy metals that can be of environmental concern in groundwater. The analysis of contaminants (i.e., Cu, Zn, Cd and Pb) dynamics in different environmental compartments is specifically addressed by comparing the removal efficiencies of different types of reactive materials, three natural (i.e., vegetal fibers, natural limestone and natural zeolite) and one synthetic (i.e., synthetic zeolite). Results stemming from these reactive media has been compared with the outcomes related to the same test performed using zero valent iron which is the reactant usually employed for heavy metals remediation. All tested reactants exhibited important removal percentages, even larger than 90% in most cases, achieved in a contact time ranging between about 12 h and slightly longer than a day (i.e., 30 h). Maximum adsorption percentages are observed for pH ranging between 4 and 8 for all tested materials and contaminants. Our findings provided relevant evidence, to both researchers and technicians, on the competitiveness of the explored alternative mediums with respect to the classical reactants usually employed for heavy metals remediation. Full article

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

► Show Figures

Graphical abstract

12 pages, 357 KiB

Open AccessArticle

Consumer Preference and Attitude Regarding Online Food Products in Hanoi, Vietnam

by Anh Kim Dang, Bach Xuan Tran, Cuong Tat Nguyen, Huong Thi Le, Hoa Thi Do, Hinh Duc Nguyen, Long Hoang Nguyen, Tu Huu Nguyen, Hue Thi Mai, Tho Dinh Tran, Chau Ngo, Thuc Thi Minh Vu, Carl A. Latkin, Melvyn W.B. Zhang and Roger C.M. Ho

Int. J. Environ. Res. Public Health 2018, 15(5), 981; https://doi.org/10.3390/ijerph15050981 - 14 May 2018

Cited by 52 | Viewed by 14358

Abstract

This study aimed to examine: (1) how the Internet has changed consumers food-buying behavior and identify its associated factors; (2) consumers’ concern about food safety information of online food products. A cross-sectional study was performed from October to December 2015 in Hanoi—a Vietnamese [...] Read more.

This study aimed to examine: (1) how the Internet has changed consumers food-buying behavior and identify its associated factors; (2) consumers’ concern about food safety information of online food products. A cross-sectional study was performed from October to December 2015 in Hanoi—a Vietnamese epicenter of food service. One thousand seven hundred and thirty six (1736) customers were randomly chosen from food establishments of 176 communes. Data were collected through face-to-face interviews using structured questionnaires. The majority of participants reported using the Internet to search for food products (81.3%). The most crucial factors influencing food purchases through the Internet were convenience (69.1%) and price (59.3%). Only one-third of participants selected products based on accurate evidence about food safety certification or food origin. The majority of participants were concerned about the expiration date (51.6%), while brand (9.8%) and food licensing information (11.3%) were often neglected. People who were:(1) female, (2) highly influenced by online relationships, and (3) having difficulty in doing usual activities were more likely to look for online food products. These findings produce practical advice to consumers when purchasing their desired food products on the Internet, to online food retailers and to the Government of Vietnam to implement appropriate legislation regarding trading online food products. Full article

12 pages, 536 KiB

Open AccessArticle

Comparison of Factors Associated with Fear of Falling between Older Adults with and without a Fall History

by Seonhye Lee, Eunmi Oh and Gwi-Ryung Son Hong

Int. J. Environ. Res. Public Health 2018, 15(5), 982; https://doi.org/10.3390/ijerph15050982 - 14 May 2018

Cited by 62 | Viewed by 6313

Abstract

Background: Although fear of falling (FOF) has been studied since FOF has negative consequences for the elderly, there is limited information about the risk factors of FOF, including the environment. The purpose of this study was to describe individual and environmental factors [...] Read more.

Background: Although fear of falling (FOF) has been studied since FOF has negative consequences for the elderly, there is limited information about the risk factors of FOF, including the environment. The purpose of this study was to describe individual and environmental factors of FOF between those with and without a fall history from an ecological aspect and to examine whether individual and environmental factors differently affect the FOF according to the state of fall history in community-dwelling older adults in Korea. Methods: Data from the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Adults were used. Participants were 7730 older adults. Hierarchical logistic regression analysis was conducted to examine the predictors of FOF. Results: According to the ecological model, female and discomfort with the neighborhood environment were significantly associated with greater odds of reporting FOF in both older adults with fall history and those without. A significant interaction was not observed between any variable of FOF in participants with and without a fall history. Conclusions: An ecological model including individual and environmental factors should be considered when conducting research and designing programs and decision policies related to FOF for older adults with and without a history of falling. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

9 pages, 354 KiB

Open AccessArticle

The Relationship between Shoe Fitting and Foot Health of Persons with Down Syndrome: A Case Control Study

by César Calvo-Lobo, Ana Ramos García, Marta Elena Losa Iglesias, Daniel López-López, David Rodríguez-Sanz, Carlos Romero-Morales and Ricardo Becerro-de-Bengoa-Vallejo

Int. J. Environ. Res. Public Health 2018, 15(5), 983; https://doi.org/10.3390/ijerph15050983 - 14 May 2018

Cited by 11 | Viewed by 4825

Abstract

Background: Down syndrome is the most common chromosomal abnormality and a cause of intellectual disability. It is also associated with orthopaedic and musculoskeletal problems of the locomotive apparatus, especially of the feet. These problems are believed to have a harmful effect on [...] Read more.

Background: Down syndrome is the most common chromosomal abnormality and a cause of intellectual disability. It is also associated with orthopaedic and musculoskeletal problems of the locomotive apparatus, especially of the feet. These problems are believed to have a harmful effect on health, social functioning, and mobility. In addition, these persons generally don’t have access to podiatric health services, even when their foot problems are well known, because of limited access to healthcare facilities. The goal of our research was to evaluate and compare the foot health status of study participants with and without Down syndrome and to determine whether inadequate footwear is being used with normalized reference values. Methods: A total of 105 participants with and without Down syndrome, with a mean age of 35.71 (SD = 12.93) years, were enrolled in the study. They self-reported demographic data and their clinical characteristic data were recorded. Measurements of their foot and shoe fitting were taken at all stages of the research process. Ninety-two percent of the participants with Down syndrome had foot problems. Results: Only 12 (24%) participants with Down syndrome used bilateral shoes that met the requirements of their feet compared to their controls (50 participants, 90.9% for the right foot; 46 participants, 83.6% for the left foot). Participants with Down syndrome presented statistically significant differences with respect to controls and wore incorrectly sized shoe. Conclusions: Evaluation of foot length and width may prevent development of foot deformities, as well as to improve general health. Full article

13 pages, 4346 KiB

Open AccessArticle

Acute Toxicity of an Emerging Insecticide Pymetrozine to Procambarus clarkii Associated with Rice-Crayfish Culture (RCIS)

by Jixin Yu, Elvis Genbo Xu, Wei Li, Shiyu Jin, Ting Yuan, Jiashou Liu, Zhongjie Li and Tanglin Zhang

Int. J. Environ. Res. Public Health 2018, 15(5), 984; https://doi.org/10.3390/ijerph15050984 - 14 May 2018

Cited by 28 | Viewed by 5529

Abstract

This study aims to evaluate the acute toxicity of pymetrozine to juvenile Procambarus clarkii. Two 96-h toxicity tests were conducted to assess the lethal concentration 50 (LC₅₀) values, behaviors, and histopathology (at 50% of the 96 h LC₅₀) [...] Read more.

This study aims to evaluate the acute toxicity of pymetrozine to juvenile Procambarus clarkii. Two 96-h toxicity tests were conducted to assess the lethal concentration 50 (LC₅₀) values, behaviors, and histopathology (at 50% of the 96 h LC₅₀) after pymetrozine exposure. The results showed high toxicity of pymetrozine to juvenile P. clarkii in a dose and time dependent manner, with a decreasing LC₅₀ from 1.034 mg/L at 24 h to 0.479 mg/L at 96 h. The maximum allowable concentration (MAC) of pymetrozine for P. clarkii was 0.106 mg/L. Behavioral abnormalities were observed in pymetrozine-treated crayfish, such as incunabular hyperexcitability, subsequent disequilibrium, lethargy, and increased defecation. Significant lesions were observed in all pymetrozine-treated tissues, including: (1) in gill, hemocytic infiltration and 33.27% of epithelial cells lesions; (2) in perigastric organs, 64.37%, 29.06%, and 13.99% of tubules with lumen atrophy, vacuolation, and cell lysis, respectively; (3) in heart, 2.5%, 8.55% and 7.74% of hemocytic infiltration, vacuolization, and hyperplasia, respectively; (4) in stomach, 80.82%, 17.77%, 6.98%, 5.24% of cuticula swelling, vacuolization, muscle fragmentation, hemocytic infiltration, respectively; (5) in midgut, 7.45%, 10.98%, 6.74%, and 13.6% of hyperplasia, tissue lysis and vacuolation, hemocytic infiltration, muscle fracture; and (6) in abdominal muscle, 14.09% of myofiber fracture and lysis. This research demonstrates that pymetrozine is highly toxic to juvenile P. clarkii, with significant effects on mortality, behavior and histopathology at concentrations of ≤1.1 mg/L, while the estimated practical concentration of pymetrozine in rice-crayfish culture water was around 20 times lower than the calculated MAC. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

13 pages, 339 KiB

Open AccessArticle

Dose–Response Relationships between Second-Hand Smoke Exposure and Depressive Symptoms among Adolescents in Guangzhou, China

by Jingya Huang, Bin Xu, Dan Guo, Ting Jiang, Wei Huang, Guocong Liu and Xiaohua Ye

Int. J. Environ. Res. Public Health 2018, 15(5), 985; https://doi.org/10.3390/ijerph15050985 - 14 May 2018

Cited by 18 | Viewed by 3759

Abstract

There has been little focus on the possible association between second-hand smoke (SHS) exposure and depressive symptoms among adolescents. Thus, this study aimed to explore the dose–response relationships between SHS exposure and depressive symptoms among adolescents and differentiate these associations in setting-specific exposure [...] Read more.

There has been little focus on the possible association between second-hand smoke (SHS) exposure and depressive symptoms among adolescents. Thus, this study aimed to explore the dose–response relationships between SHS exposure and depressive symptoms among adolescents and differentiate these associations in setting-specific exposure and severity-specific outcomes. A cross-sectional study was conducted using a stratified cluster sampling method to obtain a representative sample of high school students in Guangzhou, China. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Univariable and multivariable logistic regression models were used to explore the potential associations between SHS exposure and depressive symptoms. Among 3575 nonsmoking students, 29.6% were classified as having probable depressive symptoms and 9.6% had severe depressive symptoms. There were monotonically increasing dose–response relationships between setting-specific (public places, homes, or indoor/outdoor campuses) SHS exposure and severity-specific (probable or severe) depressive symptoms. When examining these relations by source of exposure, we also observed similar dose–response relationships for SHS exposure in campuses from smoking teachers and from smoking classmates. Our findings suggest that regular SHS exposure is associated with a significant, dose-dependent increase in risk of depressive symptoms among adolescents, and highlight the need for smoke-free environments to protect the health of adolescents. Full article

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

14 pages, 785 KiB

Open AccessArticle

Evidencing Protective and Risk Factors for Harmful Alcohol Drinking in Adolescence: A Prospective Analysis of Sport-Participation and Scholastic-Achievement in Older Adolescents from Croatia

by Sime Devcic, Damir Sekulic, Divo Ban, Zvonimir Kutlesa, Jelena Rodek and Dorica Sajber

Int. J. Environ. Res. Public Health 2018, 15(5), 986; https://doi.org/10.3390/ijerph15050986 - 14 May 2018

Cited by 14 | Viewed by 3815

Abstract

Background: The prevalence of alcohol drinking (AD) in Croatian adolescents is alarming, but there is an evident lack of prospective analyses of the protective/risk factors of AD. This study aimed to prospectively investigate the relationships between scholastic and sport factors and harmful [...] Read more.

Background: The prevalence of alcohol drinking (AD) in Croatian adolescents is alarming, but there is an evident lack of prospective analyses of the protective/risk factors of AD. This study aimed to prospectively investigate the relationships between scholastic and sport factors and harmful alcohol drinking (HD) in older adolescents. Methods: The participants (n = 644, 53.7% females) were 16 years of age at study baseline and were tested at baseline and again 20 months later (follow-up). The predictors included four variables of scholastic achievement and four factors evidencing involvement in sport. Criterion was AD observed on the Alcohol Use Disorders Identification Test (AUDIT), and results were later categorized into harmful drinking (HD) and non-harmful drinking (NHD). The HD at baseline, HD at follow-up and HD initiation during the study course were observed as criteria in logistic regression analyses, which were additionally controlled for confounders (age, gender, socioeconomic status, and conflict with parents). Results: With 22% and 29% adolescents who reported HD at baseline and follow-up, respectively, the prevalence of HD remains among the highest in Europe. Scholastic failure was systematically related to HD at baseline and follow-up, but scholastic variables did not predict HD initiation during the course of the study. The higher odds for HD at baseline were evidenced for current and former team sport athletes. Those who quit individual sport were more likely to engage in HD at follow-up. Longer involvement in sport (OR: 2.10, 95% CI: 1.18–3.72), higher sport result (OR: 3.15, 95% CI: 1.19–8.34), and quitting individual sport (OR: 13.13, 95% CI: 2.67–64.62) were predictive of HD initiation. Conclusions: The results indicated specific associations between sport factors with HD initiation, which is understandable knowing the high stress placed on young athletes in this period of life, mainly because of the forthcoming selection between junior (amateur) and senior (professional) level. The results did not allow interpretation of the cause-effect relationship between scholastic failure and HD in the studied period. Full article

► Show Figures

Figure 1

11 pages, 3837 KiB

Open AccessArticle

Personality Traits, Strategies for Coping with Stress and the Level of Internet Addiction—A Study of Polish Secondary-School Students

by Joanna Chwaszcz, Bernadeta Lelonek-Kuleta, Michał Wiechetek, Iwona Niewiadomska and Agnieszka Palacz-Chrisidis

Int. J. Environ. Res. Public Health 2018, 15(5), 987; https://doi.org/10.3390/ijerph15050987 - 14 May 2018

Cited by 38 | Viewed by 7984

Abstract

Among the many contributing factors in addictions there are also those describing the individual characteristics and ways of dealing with various life challenges. Despite numerous studies in this area, there is still no unambiguous data on the nature and specificity of this relationship [...] Read more.

Among the many contributing factors in addictions there are also those describing the individual characteristics and ways of dealing with various life challenges. Despite numerous studies in this area, there is still no unambiguous data on the nature and specificity of this relationship in different age groups. The aim of the study was to assess the relationship between personality dimensions and strategies of coping with stress and the level of Internet addiction. The study was funded by the Ministry of Health under grant no. 93/HM/2015. The study was carried out in a group of 383 persons aged 15 to 19 (M = 16.6, SD = 0.77) attending secondary schools. The following research tools were used: Ten Item Personality Measure, Brief Cope and Internet Addiction Test. Both specific personality traits and styles of coping with stress are related to the addiction to the analysed medium. The personality traits most strongly associated with the risky Internet use were conscientiousness and emotional stability. An association was demonstrated between Internet addiction and the use of coping strategies, such as disengagement, substance use and self-blame. The results obtained demonstrate a major role of personality-related factors in the development of Internet addiction. The attitude to difficulties seems to be the key issue. The findings presented also make it possible to delineate the areas for improvement (e.g., through psychoeducational interventions) to protect young people from the risk of developing the addiction. Full article

(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)

► Show Figures

Figure 1

13 pages, 745 KiB

Open AccessArticle

The Influence of Professional Identity, Job Satisfaction, and Work Engagement on Turnover Intention among Township Health Inspectors in China

by Wenjie Zhang, Hongdao Meng, Shujuan Yang and Danping Liu

Int. J. Environ. Res. Public Health 2018, 15(5), 988; https://doi.org/10.3390/ijerph15050988 - 14 May 2018

Cited by 103 | Viewed by 12298

Abstract

Health inspectors are part of the public health workforce in China, and its shortage has been identified as an urgent priority that should be addressed. Turnover is one of the main contributors to the shortage problem. This research assessed the influence of professional [...] Read more.

Health inspectors are part of the public health workforce in China, and its shortage has been identified as an urgent priority that should be addressed. Turnover is one of the main contributors to the shortage problem. This research assessed the influence of professional identity, job satisfaction and work engagement on turnover intention of township health inspectors and explored the intermediary effect of job satisfaction and work engagement between professional identity and turnover intention among township health inspectors in China. Data were collected from 2426 township health inspectors in Sichuan Province, China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. Results showed that a total of 11.3% of participants had a high turnover intention and 34.0% of participants had a medium turnover intention. Job satisfaction had a direct negative effect on turnover intention (β = −0.38, p < 0.001), work engagement had a direct negative effect on turnover intention (β = −0.13, p < 0.001), and professional identity had an indirect negative effect on turnover intention through the mediating effect of job satisfaction and work engagement. Our results strongly confirmed that professional identity, job satisfaction and work engagement were strong predicators of turnover intention. According to the results, desirable work environment, quality facilities, fair compensation and adequate advancement opportunities should be emphasized to improve job satisfaction. The turnover intention of health inspectors could be reduced through improving professional identity, enhancing job satisfaction and work engagement. Full article

(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)

► Show Figures

Figure 1

14 pages, 701 KiB

Open AccessArticle

Determinants and Temporal Trends of Perfluoroalkyl Substances in Pregnant Women: The Hokkaido Study on Environment and Children’s Health

by Meng-Shan Tsai, Chihiro Miyashita, Atsuko Araki, Sachiko Itoh, Yu Ait Bamai, Houman Goudarzi, Emiko Okada, Ikuko Kashino, Hideyuki Matsuura and Reiko Kishi

Int. J. Environ. Res. Public Health 2018, 15(5), 989; https://doi.org/10.3390/ijerph15050989 - 14 May 2018

Cited by 65 | Viewed by 6016

Abstract

Perfluoroalkyl substances (PFAS) are persistent bio-accumulative chemicals that impact the health of pregnant women and their children. PFAS derive from environmental and consumer products, which depend on human lifestyle, socioeconomic characteristics, and time variation. Here, we aimed to explore the temporal trends of [...] Read more.

Perfluoroalkyl substances (PFAS) are persistent bio-accumulative chemicals that impact the health of pregnant women and their children. PFAS derive from environmental and consumer products, which depend on human lifestyle, socioeconomic characteristics, and time variation. Here, we aimed to explore the temporal trends of PFAS in pregnant women and the characteristics related to maternal PFAS concentration. Our study is part of the Hokkaido Study on Environment and Children’s Health, the Hokkaido large-scale cohort that recruited pregnant women between 2003 and 2011. Blood samples were acquired from pregnant women during the third trimester to measure PFAS and cotinine concentrations. Maternal basic information was collected with a baseline structured questionnaire. Eleven PFAS were measured from 2123 samples with ultra-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry. Eight PFAS were above 80% detection rate and were included in the final analysis. We used multivariable linear regression to analyze the association of pregnant women characteristics with the levels of eight PFAS. The temporal trend of PFAS was observed in two periods (August 2003 to January 2006 and February 2006 to July 2012). The concentration of perfluorooctane sulfonate (PFOS) significantly decreased from August 2003 to January 2006 and from February 2006 to July 2012. The concentrations of perfluorododecanoic acid (PFDoDA), perfluoroundecanoic acid (PFUnDA), and perfluorotridecanoic acid (PFTrDA) increased significantly between August 2003 and January 2006, whereas they decreased significantly between February 2006 and July 2012. Women with pre-pregnancy body mass index (BMI) >25 kg/m² had lower PFUnDA, PFDoDA, and PFTrDA levels than did those with normal BMI (18.5–24.9 kg/m²). Pregnant women, who were active smokers (cotinine > 11.49 ng/mL), had higher PFOS than the non-smokers (cotinine < 0.22 ng/mL). Lower levels of PFHxS, PFOS, PFOA, PFNA, and PFDA were observed in women, who had given birth to more than one child. There were also significant positive associations between PFAS levels and annual income or maternal education. PFAS levels varied in women with higher pre-pregnancy BMI, active smoking status, higher education level and annual income. The causes of the individual PFAS differences should be explored in an independent study. Full article

(This article belongs to the Special Issue Maternal and Child Health 2018)

► Show Figures

Figure 1

24 pages, 732 KiB

Open AccessArticle

The Work Ability of Hong Kong Construction Workers in Relation to Individual and Work-Related Factors

by Jacky Y. K. Ng and Alan H. S. Chan

Int. J. Environ. Res. Public Health 2018, 15(5), 990; https://doi.org/10.3390/ijerph15050990 - 14 May 2018

Cited by 26 | Viewed by 5724

Abstract

The shortage in Hong Kong of construction workers is expected to worsen in future due to the aging population and increasing construction activity. Construction work is dangerous and to help reduce the premature loss of construction workers due to work-related disabilities, this study [...] Read more.

The shortage in Hong Kong of construction workers is expected to worsen in future due to the aging population and increasing construction activity. Construction work is dangerous and to help reduce the premature loss of construction workers due to work-related disabilities, this study measured the work ability of 420 Hong Kong construction workers with a Work Ability Index (WAI) which can be used to predict present and future work performance. Given the importance of WAI, in this study the effects of individual and work-related factors on WAI were examined to develop and validate a WAI model to predict how individual and work-related factors affect work ability. The findings will be useful for formulating a pragmatic intervention program to improve the work ability of construction workers and keep them in the work force. Full article

(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)

► Show Figures

Figure 1

9 pages, 610 KiB

Open AccessArticle

The Mediating Effect of Regulatory Emotional Self-Efficacy on the Association between Self-Esteem and School Bullying in Middle School Students: A Cross-Sectional Study

by Xiaoqin Wang, Yue Zhang, Zhaozhao Hui, Wanyue Bai, Paul D. Terry, Mei Ma, Yang Li, Li Cheng, Wei Gu and Mingxu Wang

Int. J. Environ. Res. Public Health 2018, 15(5), 991; https://doi.org/10.3390/ijerph15050991 - 15 May 2018

Cited by 37 | Viewed by 11657

Abstract

School bullying is negatively associated with self-esteem, but psychological mediators of bullying have yet to be clarified. We examined regulatory emotional self-efficacy (RESE) as a possible mediator in the association between self-esteem and school bullying. A cross-sectional study of 995 adolescents was conducted [...] Read more.

School bullying is negatively associated with self-esteem, but psychological mediators of bullying have yet to be clarified. We examined regulatory emotional self-efficacy (RESE) as a possible mediator in the association between self-esteem and school bullying. A cross-sectional study of 995 adolescents was conducted in two middle schools of Xi’an. All of the participants completed the Chinese version of the School Bullying Experience Questionnaire (C-SBEQ), Self-Esteem Scale (SES), and Regulatory Emotional Self-Efficacy Scale (RESE). Descriptive statistics analysis, the bias corrected percentile Bootstrap CI method, and structural equation modelling were used to analyze the data. The results showed that 418 students (42.0%) reported that they were involved in school bullying in the past year. Self-esteem was negatively associated with school bullying (total effect: β = −0.275, 95% CI = −0.381–−0.034), and RESE mediated the association between self-esteem and school bullying (indirect effect: β = −0.136, 95% CI = −0.245–−0.037). Furthermore, self-esteem had an indirect effect through perceived self-efficacy in managing negative affect, while self-esteem had no indirect effect through self-efficacy in the expression of positive affect. The present study suggests that school authorities and the related education departments should not only focus on improving students’ self-esteem, but should also pay more attention to students’ RESE, in order to mitigate, and potentially reduce, the occurrence of bullying. Full article

► Show Figures

Figure 1

10 pages, 695 KiB

Open AccessArticle

Stress-Induced and Diabetic Hyperglycemia Associated with Higher Mortality among Intensive Care Unit Trauma Patients: Cross-Sectional Analysis of the Propensity Score-Matched Population

by Meng-Wei Chang, Chun-Ying Huang, Hang-Tsung Liu, Yi-Chun Chen and Ching-Hua Hsieh

Int. J. Environ. Res. Public Health 2018, 15(5), 992; https://doi.org/10.3390/ijerph15050992 - 15 May 2018

Cited by 37 | Viewed by 4355

Abstract

Background: This study was designed to measure the effect of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) versus non-diabetic normoglycemia (NDN) on the outcomes of trauma patients in the intensive care unit (ICU). Methods: Diabetes mellitus (DM) was determined based on patient history [...] Read more.

Background: This study was designed to measure the effect of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) versus non-diabetic normoglycemia (NDN) on the outcomes of trauma patients in the intensive care unit (ICU). Methods: Diabetes mellitus (DM) was determined based on patient history and/or a hemoglobin A1c (HbA1c) level of ≥6.5% at admission. The patients who had serum glucose levels of ≥200 mg/dL in the absence or presence of DM were assigned into the groups SIH and DH, respectively. Diabetic normoglycemia (DN) and NDN were determined based on serum glucose levels of <200 mg/dL in patients with and without DM, respectively. Patients with burn injury or incomplete data were excluded. Detailed data of trauma patients in the ICU of a Level-I trauma center from 1 January 2009 to 31 December 2016 were retrieved from the database of the Trauma Registry System. These patients were classified into four exclusive groups, including NDN (n = 1745), DN (n = 306), SIH (n = 225) and DH (n = 206). The Pearson chi-square test was used to compare categorical data between groups. Continuous variables were compared using one-way analysis of variance along with the Games–Howell post hoc test. To decrease the confounding effect of the differences in sex and age, preexisting comorbidities and injury severity score (ISS) among different groups of patients, 1:1 ratio propensity score-matched cohorts were assigned using the NCSS software. The effect of hyperglycemia on the outcomes of patients with and without DM was assessed with a logistic regression analysis. Results: Among those selected propensity score-matched patient cohorts, the patients with SIH and DH had a 3.88-fold (95% CI, 2.13–7.06; p < 0.001) and 1.83-fold (95% CI, 1.00–3.34; p = 0.048) higher mortality, respectively, than those with NDN. Moreover, the patients in the SIH group (10.0 vs. 7.4 days; p = 0.005) and those in the DH group (10.1 vs. 7.4 days; p = 0.006) who were admitted to the ICU had a significantly longer length of stay than those in the NDN group. In addition, the SIH group had a 2.13-fold (95% CI, 1.04–4.36; p = 0.038) higher adjusted odds ratio for mortality than the DH group. Conclusions: This study revealed significantly worse outcomes in terms of mortality among patients with SIH and DH who were admitted to the ICU after controlling for sex and age, preexisting comorbidities and ISS. In addition, patients who had SIH presented significantly higher adjusted odds for mortality than those DH patients. These results suggest that hyperglycemia is detrimental in patients with or without DM who were admitted to the ICU, and there is a different pathophysiological mechanisms behind the SIH and DH. Full article

► Show Figures

Figure 1

10 pages, 894 KiB

Open AccessArticle

Study of Factors Influencing the Bioaccessibility of Triazolone in Cherry Tomatoes Using a Static SHIME Model

by Yu-Ying Liu, Jin-Jing Xiao, Yun-Yao Fu, Min Liao, Hai-Qun Cao and Yan-Hong Shi

Int. J. Environ. Res. Public Health 2018, 15(5), 993; https://doi.org/10.3390/ijerph15050993 - 15 May 2018

Cited by 12 | Viewed by 4005

Abstract

Estimating the influence of bioaccessibility of pesticide residues in fruits and vegetables on dietary exposure is a challenge for human health risk assessment. This study investigated the bioaccessibility of pesticide residues in cherry tomatoes and contributing factors (digestion time, pH, solid/liquid ratio, and [...] Read more.

Estimating the influence of bioaccessibility of pesticide residues in fruits and vegetables on dietary exposure is a challenge for human health risk assessment. This study investigated the bioaccessibility of pesticide residues in cherry tomatoes and contributing factors (digestion time, pH, solid/liquid ratio, and dietary nutrition) using an in vitro test simulating the human gastrointestinal tract. pH had the largest effect on triazolone precipitation in the simulated gastric intestinal juice, which had a significant impact on the bioaccessibility. The bioaccessibility of triazolone in the intestinal stage was slightly higher than that in the stomach stage, owing to bile salts and pancreatic enzymes present in the intestinal juice. The bioaccessibility of triazolone did not change significantly with digestion time. In the gastric stage, there was a logarithmic relationship between the bioaccessibility and solid/liquid ratio (R² = 0.9941). The addition of oil significantly changed the bioaccessibility in the gastrointestinal stage. Protein and dietary fiber only affected bioaccessibility in the stomach stage. Dietary nutrition can reduce the release of pesticides from fruits and vegetables into the stomach, sharply reducing the bioaccessibility, and the dietary exposure of pesticide residues in fruits and vegetables can be properly evaluated. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Graphical abstract

19 pages, 1633 KiB

Open AccessArticle

Seasonal Patterns in the Prevalence and Diversity of Tick-Borne Borrelia burgdorferi Sensu Lato, Anaplasma phagocytophilum and Rickettsia spp. in an Urban Temperate Forest in South Western Slovakia

by Michal Chvostáč, Eva Špitalská, Radovan Václav, Tatiana Vaculová, Lenka Minichová and Markéta Derdáková

Int. J. Environ. Res. Public Health 2018, 15(5), 994; https://doi.org/10.3390/ijerph15050994 - 15 May 2018

Cited by 42 | Viewed by 5402

Abstract

In Europe, Ixodes ricinus is the most important vector of tick-borne zoonotic bacteria. It transmits spirochaetes from the Borrelia burgdorferi sensu lato complex, Anaplasma phagocytophilum and Rickettsia spp. Although spatial differences in the prevalence of tick-borne pathogens have been intensively studied, seasonal (within-year) [...] Read more.

In Europe, Ixodes ricinus is the most important vector of tick-borne zoonotic bacteria. It transmits spirochaetes from the Borrelia burgdorferi sensu lato complex, Anaplasma phagocytophilum and Rickettsia spp. Although spatial differences in the prevalence of tick-borne pathogens have been intensively studied, seasonal (within-year) fluctuations in the prevalence of these pathogens within sites are often overlooked. We analyzed the occurrence and seasonal dynamics of Ixodes ricinus in an urban forest in Bratislava, Slovakia. Furthemore, we examined temporal trends in the community structure of B. burgdorferi s.l., A. phagocytophilum and Rickettsia spp. in questing and bird-feeding ticks. The total prevalence for B. burgdorferi s.l. in questing I. ricinus was 6.8%, involving six genospecies with the dominance of bird-associated B. garinii and B. valaisiana. A. phagocytophilum, R. helvetica and R. monacensis occurred in 5.9%, 5.0% and 0.2% of questing ticks, respectively. In total, 12.5% and 4.4% of bird-feeding I. ricinus ticks carried B. burgdorferi s.l. and R. helvetica. The total prevalence of B. burgdorferi s.l. in our study site was two times lower than the mean prevalence for Europe. In contrast, A. phagocytophilum prevalence was significantly higher compared to those in other habitats of Slovakia. Our results imply that tick propagation and the transmission, suppression and seasonal dynamics of tick-borne pathogens at the study site were primarily shaped by abundance and temporal population fluctuations in ruminant and bird hosts. Full article

(This article belongs to the Special Issue Emergence of Tick-Borne Diseases Resulting from Human Landscape Change)

► Show Figures

Figure 1

10 pages, 496 KiB

Open AccessArticle

Condom and Substance Use at Last Sex: Differences between MSMO and MSWO High School Youth

by Gregory Phillips, Mariah M. Kalmin, Blair Turner, Dylan Felt, Rachel Marro, Paul Salamanca and Lauren B. Beach

Int. J. Environ. Res. Public Health 2018, 15(5), 995; https://doi.org/10.3390/ijerph15050995 - 15 May 2018

Cited by 8 | Viewed by 4923

Abstract

HIV disproportionately impacts youth, particularly young men who have sex with men (YMSM), a population that includes subgroups of young men who have sex with men only (YMSMO) and young men who have sex with men and women (YMSMW). In 2015, among male [...] Read more.

HIV disproportionately impacts youth, particularly young men who have sex with men (YMSM), a population that includes subgroups of young men who have sex with men only (YMSMO) and young men who have sex with men and women (YMSMW). In 2015, among male youth, 92% of new HIV diagnoses were among YMSM. The reasons why YMSM are disproportionately at risk for HIV acquisition, however, remain incompletely explored. We performed event-level analyses to compare how the frequency of condom use, drug and/or alcohol use at last sex differed among YMSMO and YMSWO (young men who have sex with women only) over a ten-year period from 2005–2015 within the Youth Risk Behavior Survey (YRBS). YMSMO were less likely to use condoms at last sex compared to YMSWO. However, no substance use differences at last sexual encounter were detected. From 2005–2015, reported condom use at last sex significantly declined for both YMSMO and YMSWO, though the decline for YMSMO was more notable. While there were no significant differences in alcohol and substance use at last sex over the same ten-year period for YMSMO, YMSWO experienced a slight but significant decrease in reported alcohol and substance use. These event-level analyses provide evidence that YMSMO, similar to adult MSMO, may engage in riskier sexual behaviors compared to YMSWO, findings which may partially explain the increased burden of HIV in this population. Future work should investigate how different patterns of event-level HIV risk behaviors vary over time among YMSMO, YMSWO, and YMSMW, and are tied to HIV incidence among these groups. Full article

(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)

► Show Figures

Figure 1

14 pages, 365 KiB

Open AccessFeature PaperArticle

Pregnancy Trimester-Specific Exposure to Ambient Air Pollution and Child Respiratory Health Outcomes in the First 2 Years of Life: Effect Modification by Maternal Pre-Pregnancy BMI

by Shu-E Soh, Anne Goh, Oon Hoe Teoh, Keith M. Godfrey, Peter D. Gluckman, Lynette Pei-Chi Shek and Yap-Seng Chong

Int. J. Environ. Res. Public Health 2018, 15(5), 996; https://doi.org/10.3390/ijerph15050996 - 15 May 2018

Cited by 29 | Viewed by 5060

Abstract

Prenatal exposure to air pollution is associated with childhood respiratory health; however, no previous studies have examined maternal pre-pregnancy body mass index (BMI) as a potential effect modifier. We investigated whether maternal pre-pregnancy BMI modified the association of trimester-specific air pollution divided into [...] Read more.

Prenatal exposure to air pollution is associated with childhood respiratory health; however, no previous studies have examined maternal pre-pregnancy body mass index (BMI) as a potential effect modifier. We investigated whether maternal pre-pregnancy BMI modified the association of trimester-specific air pollution divided into quartiles of exposure (Q1–4) on respiratory health in the Growing Up in Singapore towards healthy Outcomes (GUSTO) study (n = 953) in 2-year-old children. For episodes of wheezing, children of overweight/obese mothers and who were exposed to particulate matter less than 2.5 μm (PM_2.5) in the first trimester had an adjusted incidence rate ratio (IRR) (95% confidence interval (CI)) of 1.85 (1.23–2.78), 1.76 (1.08–2.85) and 1.90 (1.10–3.27) in quartile (Q) 2–4, with reference to Q1. This association is seen in the second trimester for bronchiolitis/bronchitis. The risk of ear infection in the first year of life was associated with exposure to PM_2.5in the first trimester with adjusted Odds Ratio (adjOR) (95% CI) = 7.64 (1.18–49.37), 11.37 (1.47–87.97) and 8.26 (1.13–60.29) for Q2–4, and similarly in the second year with adjOR (95% CI) = 3.28 (1.00–10.73) and 4.15 (1.05–16.36) for Q2–3. Prenatal exposure to air pollution has an enhanced impact on childhood respiratory health, and differs according to maternal pre-pregnancy BMI. Full article

(This article belongs to the Special Issue Maternal and Child Health 2018)

9 pages, 342 KiB

Open AccessArticle

Insufficient Sleep Duration and Overweight/Obesity among Adolescents in a Chinese Population

by Qing-Hai Gong, Si-Xuan Li, Hui Li, Jun Cui and Guo-Zhang Xu

Int. J. Environ. Res. Public Health 2018, 15(5), 997; https://doi.org/10.3390/ijerph15050997 - 15 May 2018

Cited by 24 | Viewed by 4550

Abstract

Objectives: The objective of this study was to investigate the relationship between sleep duration and overweight/obesity among Chinese adolescents. Methods: A school-based cross-sectional study was conducted among Chinese adolescents in 2016. In total, 2795 school-aged Chinese children aged 12 to 13 years participated [...] Read more.

Objectives: The objective of this study was to investigate the relationship between sleep duration and overweight/obesity among Chinese adolescents. Methods: A school-based cross-sectional study was conducted among Chinese adolescents in 2016. In total, 2795 school-aged Chinese children aged 12 to 13 years participated in this study. Participants were asked to complete self-administered surveys during a 45-min class period in their classroom. Details of the questionnaire about health-related behaviors included sleep habits, physical activity, screen time, cigarette use, and alcohol use. Height, weight, waist circumference and hip circumference were directly measured. Results: The mean sleep duration was 8.7 h/day. In total, 43.0% of the participants had a sleep duration of less than 9 h/day. Sleep duration was significantly inversely related to BMI, waist circumference, hip circumference and WHtR in multiple linear regression analyses in both genders. Logistic regression models showed that insufficient sleep (<9 h/day) was associated with high odds of overweight/obesity among both young boys and girls. Conclusions: Insufficient sleep duration was associated with overweight/obesity in Chinese adolescents, and short sleep duration was probably associated with central adiposity, especially among boys. Full article

16 pages, 2625 KiB

Open AccessArticle

Investigating the Role of Gold Nanoparticle Shape and Size in Their Toxicities to Fungi

by Kangze Liu, Zhonglei He, Hugh J. Byrne, James F. Curtin and Furong Tian

Int. J. Environ. Res. Public Health 2018, 15(5), 998; https://doi.org/10.3390/ijerph15050998 - 16 May 2018

Cited by 21 | Viewed by 5320

Abstract

Gold nanoparticles (GNPs) are increasingly being used in a wide range of applications, and such they are being released in greater quantities into the environment. Consequently, the environmental effects of GNPs, especially toxicities to living organisms, have drawn great attention. However, their toxicological [...] Read more.

Gold nanoparticles (GNPs) are increasingly being used in a wide range of applications, and such they are being released in greater quantities into the environment. Consequently, the environmental effects of GNPs, especially toxicities to living organisms, have drawn great attention. However, their toxicological characteristics still remain unclear. Fungi, as the decomposers of the ecosystem, interact directly with the environment and critically control the overall health of the biosphere. Thus, their sensitivity to GNP toxicity is particularly important. The aim of this study was to evaluate the role of GNP shape and size in their toxicities to fungi, which could help reveal the ecotoxicity of GNPs. Aspergillus niger, Mucor hiemalis, and Penicillium chrysogenum were chosen for toxicity assessment, and spherical and star/flower-shaped GNPs ranging in size from 0.7 nm to large aggregates of 400 nm were synthesised. After exposure to GNPs and their corresponding reaction agents and incubation for 48 h, the survival rates of each kind of fungus were calculated and compared. The results indicated that fungal species was the major determinant of the variation of survival rates, whereby A. niger was the most sensitive and M. himalis was the least sensitive to GNP exposure. Additionally, larger and non-spherical GNPs had relatively stronger toxicities. Full article

(This article belongs to the Special Issue Nano-Bio Interactions: Nanomedicine and Nanotoxicology)

► Show Figures

Figure 1

11 pages, 1445 KiB

Open AccessArticle

Reducing Amputations in People with Diabetes (RAPID): Evaluation of a New Care Pathway

by Sandra MacRury, Kate Stephen, Fiona Main, Jane Gorman, Sandra Jones and David Macfarlane

Int. J. Environ. Res. Public Health 2018, 15(5), 999; https://doi.org/10.3390/ijerph15050999 - 16 May 2018

Cited by 12 | Viewed by 5769

Abstract

People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly [...] Read more.

People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study. Omni-Hub^TM enabled a face-to-face consultation by the community podiatrist to be enhanced by virtual consultation with members of the multidisciplinary foot team, including specialist diabetes podiatrists and a diabetes consultant. The technical feasibility study provided recommended changes focused around adaptations to the equipment used and the best means to gain successful connectivity. The process enhancement study demonstrated positive outcomes in the process with positive effects both in the service received by patients and experiences of healthcare professionals involved. The RAPID project provides evidence and justification for a larger-scale empirical study to test an embedded pathway and technology solution, which will inform policy change and a paradigm shift in the management of foot ulceration in the community. Full article

(This article belongs to the Special Issue Advances in Technology Enabled Health and Care)

► Show Figures

Figure 1

11 pages, 2271 KiB

Open AccessArticle

Global Asbestos Disaster

by Sugio Furuya, Odgerel Chimed-Ochir, Ken Takahashi, Annette David and Jukka Takala

Int. J. Environ. Res. Public Health 2018, 15(5), 1000; https://doi.org/10.3390/ijerph15051000 - 16 May 2018

Cited by 175 | Viewed by 43083

Abstract

Introduction: Asbestos has been used for thousands of years but only at a large industrial scale for about 100–150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global [...] Read more.

Introduction: Asbestos has been used for thousands of years but only at a large industrial scale for about 100–150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global number of asbestosis deaths from the Global Burden of Disease estimate 2016 is 3495. Asbestos-caused cancer was identified in the late 1930’s but despite today’s overwhelming evidence of the strong carcinogenicity of all asbestos types, including chrysotile, it is still widely used globally. Various estimates have been made over time including those of World Health Organization and International Labour Organization: 107,000–112,000 deaths. Present estimates are much higher. Objective: This article summarizes the special edition of this Journal related to asbestos and key aspects of the past and present of the asbestos problem globally. The objective is to collect and provide the latest evidence of the magnitude of asbestos-related diseases and to provide the present best data for revitalizing the International Labor Organization/World Health Organization Joint Program on Asbestos-related Diseases. Methods: Documentation on asbestos-related diseases, their recognition, reporting, compensation and prevention efforts were examined, in particular from the regulatory and prevention point of view. Estimated global numbers of incidence and mortality of asbestos-related diseases were examined. Results: Asbestos causes an estimated 255,000 deaths (243,223–260,029) annually according to latest knowledge, of which work-related exposures are responsible for 233,000 deaths (222,322–242,802). In the European Union, United States of America and in other high income economies (World Health Organization regional classification) the direct costs for sickness, early retirement and death, including production losses, have been estimated to be very high; in the Western European countries and European Union, and equivalent of 0.70% of the Gross Domestic Product or 114 × 10⁹ United States Dollars. Intangible costs could be much higher. When applying the Value of Statistical Life of 4 million EUR per cancer death used by the European Commission, we arrived at 410 × 10⁹ United States Dollars loss related to occupational cancer and 340 × 10⁹ related to asbestos exposure at work, while the human suffering and loss of life is impossible to quantify. The numbers and costs are increasing practically in every country and region in the world. Asbestos has been banned in 55 countries but is used widely today; some 2,030,000 tons consumed annually according to the latest available consumption data. Every 20 tons of asbestos produced and consumed kills a person somewhere in the world. Buying 1 kg of asbestos powder, e.g., in Asia, costs 0.38 United States Dollars, and 20 tons would cost in such retail market 7600 United States Dollars. Conclusions: Present efforts to eliminate this man-made problem, in fact an epidemiological disaster, and preventing exposures leading to it are insufficient in most countries in the world. Applying programs and policies, such as those for the elimination of all kind of asbestos use—that is banning of new asbestos use and tight control and management of existing structures containing asbestos—need revision and resources. The International Labor Organization/World Health Organization Joint Program for the Elimination of Asbestos-Related Diseases needs to be revitalized. Exposure limits do not protect properly against cancer but for asbestos removal and equivalent exposure elimination work, we propose a limit value of 1000 fibres/m³. Full article

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

► Show Figures

Figure 1

16 pages, 2243 KiB

Open AccessArticle

Changes in Lumbopelvic Movement and Muscle Recruitment Associated with Prolonged Deep Squatting: A Pilot Study

by Tim K. S. Lui, Sharon M. H. Tsang and Anthony W. L. Kwok

Int. J. Environ. Res. Public Health 2018, 15(5), 1001; https://doi.org/10.3390/ijerph15051001 - 16 May 2018

Cited by 7 | Viewed by 4630

Abstract

This study examined the changes in spinal kinematics and muscle recruitment of the lumbopelvic region associated with prolonged squatting. Eight subjects with chronic nonspecific low back pain (LBP) and eight asymptomatic subjects (AS) performed squat-to-stand and reverse movements, before and immediately after 15 [...] Read more.

This study examined the changes in spinal kinematics and muscle recruitment of the lumbopelvic region associated with prolonged squatting. Eight subjects with chronic nonspecific low back pain (LBP) and eight asymptomatic subjects (AS) performed squat-to-stand and reverse movements, before and immediately after 15 min deep-squatting. Within-group and between-group differences in lumbopelvic kinematics and electromyographic activity acquired in lumbar erector spinae (ES), gluteus maximus (GM), and vastus lateralis (VL) were analyzed. During squat-to-stand after squatting, the LBP group showed slower then faster lumbar movement in the second and third quartiles, respectively. In the second quartile, the AS group moved with a significantly greater lumbar angle. However, significantly greater bilateral GM activity (+4–4.5%) was found in the LBP group only. A more profound decrease in bilateral ES activity (−10%) was also shown in the LBP group, yet this was nonsignificant compared to the AS group (−4%). In the third quartile, only the LBP group moved with a significantly greater lumbar angle, together with a significant increase in bilateral ES (+6–8%) and GM muscle (+2–3%) activity. The findings of the altered pattern of joint kinematics and recruitment of the key lumbopelvic muscles displayed in the LBP group inform on the possible mechanisms that may contribute to the increased risk of developing lumbar dysfunctions for people who work in prolonged squatting postures. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders)

► Show Figures

Figure 1

21 pages, 1718 KiB

Open AccessArticle

Activities of Daily Living and Determinant Factors among Older Adult Subjects with Lower Body Fracture after Discharge from Hospital: A Prospective Study

by Nurul Izzah Ibrahim, Mohd Sharkawi Ahmad, Mohamed S Zulfarina, Sharifah Nurul Aqilah Sayed Mohd Zaris, Isa Naina Mohamed, Norazlina Mohamed, Sabarul Afian Mokhtar and Ahmad Nazrun Shuid

Int. J. Environ. Res. Public Health 2018, 15(5), 1002; https://doi.org/10.3390/ijerph15051002 - 16 May 2018

Cited by 13 | Viewed by 5954

Abstract

Fracture is a type of musculoskeletal injury that contributes to an inability to perform daily activities. The objective of this study was to evaluate activities of daily living (ADL) of older adult patients with lower body fracture and to determine factors influencing ADL. [...] Read more.

Fracture is a type of musculoskeletal injury that contributes to an inability to perform daily activities. The objective of this study was to evaluate activities of daily living (ADL) of older adult patients with lower body fracture and to determine factors influencing ADL. Patient’s ADL was assessed at pre-fracture, ward admission and post-discharge phases using the Katz ADL questionnaire. There were 129 subjects at pre-fracture and ward phases and 89 subjects at discharge phase. There were four independent variables; age, gender, type of fracture and ability to walk before fracture. Logistic regression models showed that ‘age’ and ‘ability to walk before fracture’ were the determinant factors of dependent for ‘bathing’, ‘dressing’ and ‘toileting’. The ‘ability to walk before fracture’ was the determinant factor of dependent for ‘transferring’. ‘Age’ and ‘gender’ were the determinant factors of dependent for ‘continence’, while ‘age’ was the determinant factor of dependent for ‘feeding’. The ADL score changes were significant across the phases with a reduction in ADL score in the ward admission phase and partial increment during the post-discharge phase. There were improvements in the health outcomes of subjects aged more than 50 years old after 3 months of being discharged from the hospital. In conclusion, age, being female, having a hip fracture and using a walking aid before fracture were the determinants identified in this study. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders)

► Show Figures

Figure 1

9 pages, 314 KiB

Open AccessArticle

Within and between Individual Variability of Exposure to Work-Related Musculoskeletal Disorder Risk Factors

by Mohsen Zare, Jean-Claude Sagot and Yves Roquelaure

Int. J. Environ. Res. Public Health 2018, 15(5), 1003; https://doi.org/10.3390/ijerph15051003 - 17 May 2018

Cited by 23 | Viewed by 4460

Abstract

Industrial companies indicate a tendency to eliminate variations in operator strategies, particularly following implementation of the lean principle. Companies believe when the operators perform the same prescribed tasks, they have to execute them in the same manner (completing the same gestures and being [...] Read more.

Industrial companies indicate a tendency to eliminate variations in operator strategies, particularly following implementation of the lean principle. Companies believe when the operators perform the same prescribed tasks, they have to execute them in the same manner (completing the same gestures and being exposed to the same risk factors). They attempt to achieve better product quality by standardizing and reducing operational leeway. However, operators adjust and modify ways of performing tasks to balance between their abilities and the requirements of the job. This study aims to investigate the variability of exposure to physical risk factors within and between operators when executing the same prescribed tasks. The Ergonomic Standard method was used to evaluate two workstations. Seven operators were observed thirty times between repeated cycle times at those workstations. The results revealed the variability of exposure to risk factors between and within operators in the repeated execution of the same tasks. Individual characteristics and operators’ strategies might generate the variability of exposure to risk factors that may be an opportunity to reduce the risks of work-related musculoskeletal disorders (WR-MSDs). However, sometimes operators’ strategies may cause overexposure to risk factors; operators most often adopt such strategies to undertake their tasks while reducing the workload. Full article

(This article belongs to the Special Issue Musculoskeletal Disorders)

14 pages, 4341 KiB

Open AccessArticle

The Radon Gas in Underground Buildings in Clay Soils. The Plaza Balmis Shelter as a Paradigm

by Carlos Rizo Maestre and Víctor Echarri Iribarren

Int. J. Environ. Res. Public Health 2018, 15(5), 1004; https://doi.org/10.3390/ijerph15051004 - 17 May 2018

Cited by 16 | Viewed by 4409

Abstract

In healthy buildings, it is considered essential to quantify air quality. One of the most fashionable indicators is radon gas. To determine the presence of this element, which is harmful to health, in the environment, the composition of the soil is studied. The [...] Read more.

In healthy buildings, it is considered essential to quantify air quality. One of the most fashionable indicators is radon gas. To determine the presence of this element, which is harmful to health, in the environment, the composition of the soil is studied. The presence of radon gas within a building depends both on the terrain in which it is located and on the composition of the materials of which it is composed, and not as was previously believed, only by the composition of the soil (whether granitic or not). Many countries are currently studying this phenomenon, including Spain where the building regulations regarding the accumulation of radon gas, do not list in their technical codes, the maximum dose that can a building can hold so that it is not harmful to people and the measures to correct excessive accumulation. Therefore, once the possible existence of radon in any underground building has been verified, regardless of the characteristics of the soil, the importance of defining and unifying the regulations on different levels of radon in all architectural constructions is evident. Medical and health science agencies, including the World Health Organization, consider that radon gas is a very harmful element for people. This element, in its gaseous state, is radioactive and it is present in almost soils in which buildings are implanted. Granitic type soils present higher levels of radon gas. Non-granitic soils have traditionally been considered to have very low radon levels. However, this paper demonstrates the relevant presence of radon in non-granitic soils, specifically in clayey soils, by providing the results of research carried out in the underground air raid shelter at Balmis Square in Alicante (Spain). The results of the measurements of radon accumulation in the Plaza Balmis shelter are five times higher than those obtained in a similar ungrounded building. This research addresses the constructive typology of an under-ground building and the radon presence in its interior obtained using rigorous measurement techniques. Full article

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

► Show Figures

Figure 1

16 pages, 603 KiB

Open AccessArticle

The Impact of Activity Based Working (ABW) on Workplace Activity, Eating Behaviours, Productivity, and Satisfaction

by Lauren Arundell, Bronwyn Sudholz, Megan Teychenne, Jo Salmon, Brooke Hayward, Genevieve N. Healy and Anna Timperio

Int. J. Environ. Res. Public Health 2018, 15(5), 1005; https://doi.org/10.3390/ijerph15051005 - 17 May 2018

Cited by 60 | Viewed by 15208

Abstract

The redesign of the physical workplace according to activity-based working (ABW) principles has potential to influence employee health and workplace outcomes. This natural experiment examined changes in accelerometer-derived workplace activity, self-reported eating behaviours, productivity, workplace satisfaction before (March to November 2014) and six [...] Read more.

The redesign of the physical workplace according to activity-based working (ABW) principles has potential to influence employee health and workplace outcomes. This natural experiment examined changes in accelerometer-derived workplace activity, self-reported eating behaviours, productivity, workplace satisfaction before (March to November 2014) and six to nine months after moving to an ABW workplace compared to a comparison workplace (n = 146 at baseline (56% ABW, aged 40.1 ± 8.5 years, 72% female). Interviews were also conducted with 21 ABW participants. Between- and within-group differences were examined and mixed model analysis examined intervention effects over time. Effect sizes were calculated on change scores (Cohen’s d). Although not statistically significant, ABW participants had meaningful improvements in workday sedentary time, light-, and moderate-to-vigorous intensity physical activity, job satisfaction and relationship with co-workers (d = 0.379–0.577), and small declines in productivity (d = 0.278). There were significant, meaningful, and beneficial intervention effects on perceived organisational support for being active in the workplace, frequency of eating lunch with colleagues, and satisfaction with the physical environment in ABW compared to comparison participants (d = 0.501–0.839). Qualitative data suggested that ABW employees associated ABW with greater opportunities for movement and collaboration, but had mixed views on the impact on productivity. Future research with larger samples and over longer follow-up periods is warranted. Full article

(This article belongs to the Special Issue Sedentary Behaviour and Health)

► Show Figures

Figure 1

13 pages, 1681 KiB

Open AccessArticle

Cancer Incidence Trend in the Hebei Spirit Oil Spill Area, from 1999 to 2014: An Ecological Study

by Kyung-Hwa Choi, Myung-Sook Park, Mina Ha, Jong-Il Hur and Hae-Kwan Cheong

Int. J. Environ. Res. Public Health 2018, 15(5), 1006; https://doi.org/10.3390/ijerph15051006 - 17 May 2018

Cited by 16 | Viewed by 4090

Abstract

The Hebei Spirit oil spill (HSOS) occurred in the Republic of Korea on 7 December 2007. We aimed to describe the cancer incidence trend in Taean County before and after the oil spill. Five major cancers and leukemia were analyzed. Cancer incidence data [...] Read more.

The Hebei Spirit oil spill (HSOS) occurred in the Republic of Korea on 7 December 2007. We aimed to describe the cancer incidence trend in Taean County before and after the oil spill. Five major cancers and leukemia were analyzed. Cancer incidence data were obtained from the Korean National Cancer Center. We compared the standardized incidence rates in Taean with those observed nationwide and selected three coastal areas. Joinpoint regression analysis was used to examine the trends in the average annual percent change and perform comparisons. The incidence rate of prostate cancer increased from 2007 to 2009 at an annual average of 39.3% (95% confidence interval (CI): −25.9, 161.8), 13.5% (95% CI: 11.7, 15.4), and 15.6% (95% CI: 11.9, 19.5), respectively, in Taean, nationwide, and in the coastal areas. The incidence of leukemia among women increased at an annual average of 9.5% (95% CI: −26.6, 63.4) in Taean and 0.6% (95% CI: 0.2, 0.9) nationwide; the rate decreased by 1.9% (95% CI: −12.8, 10.4) in the coastal areas. The trends between Taean County and the coastal areas differed only for prostate cancer (p = 0.0004). The incidence of prostate cancer among Taean County residents has increased since the HSOS. Full article

► Show Figures

Figure 1

13 pages, 1760 KiB

Open AccessArticle

Mercury Levels in Women and Children from Interior Villages in Suriname, South America

by Paul E. Ouboter, Gwendolyn Landburg, Gaitrie U. Satnarain, Sheryl Y. Starke, Indra Nanden, Bridget Simon-Friedt, William B. Hawkins, Robert Taylor, Maureen Y. Lichtveld, Emily Harville and Jeffrey K. Wickliffe

Int. J. Environ. Res. Public Health 2018, 15(5), 1007; https://doi.org/10.3390/ijerph15051007 - 17 May 2018

Cited by 22 | Viewed by 6542

Abstract

Natural sources of mercury, historical gold mining, and contemporary artisanal and small-scale gold mining (ASGM) activities have led to mercury contamination in Suriname. Our primary objective was to evaluate mercury levels in hair of women and children from interior villages in Suriname where [...] Read more.

Natural sources of mercury, historical gold mining, and contemporary artisanal and small-scale gold mining (ASGM) activities have led to mercury contamination in Suriname. Our primary objective was to evaluate mercury levels in hair of women and children from interior villages in Suriname where mercury levels in fish are elevated. We also estimated blood levels of mercury using an established mathematical conversion to facilitate comparison with other biomonitoring programs in the United States. Estimated levels of mercury in the blood of participants from Suriname were significantly higher than those in women from a heavy marine fish-consuming population in southeast Louisiana and estimates of the US national average. This includes women from Surinamese villages well upstream of ASGM activities. Since residents in these areas rely heavily on local fish, this is likely the source of their exposure to mercury. The levels in hair are similar to those seen in women from longitudinal studies finding neurological impairments in children exposed pre- and postnatally. Additional biomonitoring and neurodevelopmental assessments are warranted in these areas, as well as other areas of the Suriname. Mercury levels in hair (Suriname) and blood (southeast LA USA) were determined using cold vapor atomic absorption spectroscopy (CVAAS). Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

10 pages, 277 KiB

Open AccessArticle

Change and Continuity in Vaping and Smoking by Young People: A Qualitative Case Study of A Friendship Group

by Neil McKeganey and Marina Barnard

Int. J. Environ. Res. Public Health 2018, 15(5), 1008; https://doi.org/10.3390/ijerph15051008 - 17 May 2018

Cited by 15 | Viewed by 10208

Abstract

This paper reports a qualitative case study of a small friendship group (n = 8) in Glasgow, Scotland. Interviewed twice at six months apart, these 16 to 17 year olds reported a substantial change in their use of and attitudes towards e-cigarettes [...] Read more.

This paper reports a qualitative case study of a small friendship group (n = 8) in Glasgow, Scotland. Interviewed twice at six months apart, these 16 to 17 year olds reported a substantial change in their use of and attitudes towards e-cigarettes and tobacco. At time 1, vaping generated much excitement and interest, with six out of eight individuals having their own vape device. At time 2, only two young people still vaped, with the others no longer professing any interest in continued vaping. The two regular smokers, who had been smoking before they first vaped, now only vaped privately and to reduce their tobacco intake. This small case study illustrates plasticity in the use of these devices; just as young people can move into their use, so too can they move away from them. This small study underscores the importance of differentiating between long-term, frequent, consistent use and more episodic, experimental and infrequent use by young people and for undertaking a measurement of actual e-cigarette use at multiple time points in both quantitative and qualitative studies. In addition, the case study illustrates the powerful impact which peers can have on teenagers use of e-cigarettes. Full article

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

22 pages, 350 KiB

Open AccessArticle

Do Young People Ever Sit Still? Variations in Accelerometer Counts, Muscle Activity and Heart Rate across Various Sedentary Activities in Youth

by Evi Van Ekris, Mai J. M. Chinapaw, Joost Rotteveel and Teatske M. Altenburg

Int. J. Environ. Res. Public Health 2018, 15(5), 1009; https://doi.org/10.3390/ijerph15051009 - 17 May 2018

Cited by 3 | Viewed by 4398

Abstract

Evidence of adverse health effects of TV viewing is stronger than for overall sedentary behaviour in youth. One explanation may be that TV viewing involves less body movement than other sedentary activities. Variations in body movement across sedentary activities are currently unknown, as [...] Read more.

Evidence of adverse health effects of TV viewing is stronger than for overall sedentary behaviour in youth. One explanation may be that TV viewing involves less body movement than other sedentary activities. Variations in body movement across sedentary activities are currently unknown, as are age differences in such variations. This study examined body movement differences across various sedentary activities in children and adolescents, assessed by hip-, thigh- and wrist-worn accelerometers, muscle activity and heart rate. Body movement differences between sedentary activities and standing were also examined. Fifty-three children (aged 10–12 years) and 37 adolescents (aged 16–18 years) performed seven different sedentary activities, a standing activity, and a dancing activity (as a control activity) in a controlled setting. Each activity lasted 10 minutes. Participants wore an Actigraph on their hip and both wrists, an activPAL on their thigh and a heart rate monitor. The muscle activity of weight-bearing leg muscles was measured in a subgroup (n = 38) by surface electromyography. Variations in body movement across activities were examined using general estimation equations analysis. Children showed significantly more body movement during sedentary activities and standing than adolescents. In both age groups, screen-based sedentary activities involved less body movement than non-screen-based sedentary activities. This may explain the stronger evidence for detrimental health effects of TV viewing while evidence for child sedentary behaviour in general is inconsistent. Differences in body movement during standing and sedentary activities were relatively small. Future research should examine the potential health effects of differences in body movement between screen-based versus non-screen based and standing versus sedentary activities. Full article

(This article belongs to the Special Issue Sedentary Behaviour and Health)

15 pages, 6758 KiB

Open AccessArticle

Statistical Analysis of Bathing Water Quality in Puglia Region (Italy)

by Daniela Malcangio, Claudio Donvito and Nicola Ungaro

Int. J. Environ. Res. Public Health 2018, 15(5), 1010; https://doi.org/10.3390/ijerph15051010 - 17 May 2018

Cited by 12 | Viewed by 4700

Abstract

Geostatistic analysis was applied to the dataset from multi-year monitoring, in the Apulian marine-coastal zone (Mediterranean Sea, Italy), on the presence and abundance of intestinal Enterococci and Escherichia coli, microbiological indicators of faecal contamination at the sea. The same faecal contamination can [...] Read more.

Geostatistic analysis was applied to the dataset from multi-year monitoring, in the Apulian marine-coastal zone (Mediterranean Sea, Italy), on the presence and abundance of intestinal Enterococci and Escherichia coli, microbiological indicators of faecal contamination at the sea. The same faecal contamination can be considered as the main cause of pollution phenomenon under current Italian and European regulations for the bathing waters (Italian Government Decree 116/2008, European Directive 2006/7/CE). The main objective of the study is to verify, taking into the account the anthropic pressures acting on the coastal zone, the efficiency of the Apulian regional monitoring plan currently in force for the assessment of bathing waters quality, with a view to a hypothetical reduction of sample collection points. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

18 pages, 1166 KiB

Open AccessFeature PaperArticle

Evaluation of a Pilot School-Based Physical Activity Clustered Randomised Controlled Trial—Active Schools: Skelmersdale

by Sarah L. Taylor, Robert J. Noonan, Zoe R. Knowles, Michael B. Owen, Bronagh McGrane, Whitney B. Curry and Stuart J. Fairclough

Int. J. Environ. Res. Public Health 2018, 15(5), 1011; https://doi.org/10.3390/ijerph15051011 - 17 May 2018

Cited by 30 | Viewed by 6675

Abstract

Schools are key environments in which physical activity (PA) can be promoted. Various strategies and opportunities should be used to engage children in PA within schools. The aim of this study was to evaluate the effectiveness of the multi-component Active Schools: Skelmersdale (AS:Sk) [...] Read more.

Schools are key environments in which physical activity (PA) can be promoted. Various strategies and opportunities should be used to engage children in PA within schools. The aim of this study was to evaluate the effectiveness of the multi-component Active Schools: Skelmersdale (AS:Sk) pilot intervention on children’s PA and sedentary time (ST). The AS:Sk intervention was implemented for eight weeks in four schools with three control schools continuing normal practice. It consisted of eight components: active breaks, bounce at the bell, ‘Born To Move’ videos, Daily Mile or 100 Mile Club, playground activity challenge cards, physical education teacher training, newsletters, and activity homework. Child-level measures were collected at baseline and follow-up, including objectively measured PA. After accounting for confounding variables, the intervention had a significant effect on school day ST which was significantly less for the intervention children by 9 min per day compared to the control group. The AS:Sk pilot intervention was effective in reducing school day ST but significant changes in PA were negligible. To increase the efficacy of the current and future school-based interventions, authors should focus on implementation and process evaluations to better understand how schools are implementing intervention components. Full article

► Show Figures

Figure 1

17 pages, 380 KiB

Open AccessArticle

Relationship Between Orthodontic Treatment Need and Oral Health-Related Quality of Life among 11–18-Year-Old Adolescents in Lithuania

by Aistė Kavaliauskienė, Antanas Šidlauskas and Apolinaras Zaborskis

Int. J. Environ. Res. Public Health 2018, 15(5), 1012; https://doi.org/10.3390/ijerph15051012 - 17 May 2018

Cited by 15 | Viewed by 4190

Abstract

The aim was to examine the relationship between orthodontic treatment need and Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 across gender and age groups. A representative cross-sectional study of 911 adolescents aged 11–18 (mean (M) = 15.53; Standard Deviation [...] Read more.

The aim was to examine the relationship between orthodontic treatment need and Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 across gender and age groups. A representative cross-sectional study of 911 adolescents aged 11–18 (mean (M) = 15.53; Standard Deviation (SD) = 1.52) was conducted in 26 public schools. The schoolchildren completed the Child Perceptions Questionnaire to evaluate their OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to evaluate the severity of malocclusion. The strength of association between variables was evaluated via negative binomial regression estimating the ratio of sum score means (RSSM). A worse OHRQoL score was associated with a higher grade of IOTN; however, only the Emotional and Social wellbeing domains were significantly affected by malocclusion (RSSM = 1.158; 95% Confidence Interval (CI): 1.083–1.237 and RSSM = 1.205; 95% CI: 1.114–1.304, respectively). The significant association was identified only among females (RSSM = 1.264; 95% CI: 1.176–1.359). A significant association was observed in all age groups for Emotional and Social well-being domains but only in the oldest age group for Oral Symptoms and Functional Limitations domains. Conclusions: Malocclusion has a negative impact on the OHRQoL of young people with emotional and social aspects being the most affected. Girls and older adolescents suffered from malocclusion more than boys and their younger counterparts. Full article

7 pages, 599 KiB

Open AccessArticle

Analysis of the Content of Chromium in Certain Parts of the Human Knee Joint

by Wojciech Roczniak, Barbara Brodziak-Dopierała, Elżbieta Cipora, Agata Jakóbik-Kolon, Magdalena Konieczny and Magdalena Babuśka-Roczniak

Int. J. Environ. Res. Public Health 2018, 15(5), 1013; https://doi.org/10.3390/ijerph15051013 - 17 May 2018

Cited by 8 | Viewed by 3606

Abstract

Chromium is an essential microelement in the human body. It exerts an effect on bones by modulating their biochemical parameters: alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP). With considerable accumulation of chromium in the skeleton, the activity of alkaline phosphatase was found [...] Read more.

Chromium is an essential microelement in the human body. It exerts an effect on bones by modulating their biochemical parameters: alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP). With considerable accumulation of chromium in the skeleton, the activity of alkaline phosphatase was found to decrease, which affected bone formation rate. The study objective was to analyze chromium content in the knee tissues. Tissues for analysis were obtained during endoprosthesoplasty of the knee joint and included tibia, femur, and meniscus tissues. Samples were collected from 50 patients, including 36 women and 14 men. The analysis was performed using the inductively coupled plasma atomic emission spectroscopy (ICP-AES) method, by means of a Varian 710-ES apparatus. The results revealed no significant differences in the content of chromium in the knee joint tissues between women and men. The highest level of chromium was found in the femoral bone of the knee joint, then in the meniscus, and was lowest in the tibia, although the differences were statistically insignificant. Chromium content increased with age. Full article

► Show Figures

Figure 1

8 pages, 537 KiB

Open AccessArticle

Increased Vaccination Coverage among Adolescents and Young Adults in the District of Palermo as a Result of a Public Health Strategy to Counteract an ‘Epidemic Panic’

by Claudio Costantino, Vincenzo Restivo, Gianmarco Ventura, Claudio D’Angelo, Maria Angela Randazzo, Nicolò Casuccio, Mario Palermo, Alessandra Casuccio and Francesco Vitale

Int. J. Environ. Res. Public Health 2018, 15(5), 1014; https://doi.org/10.3390/ijerph15051014 - 17 May 2018

Cited by 15 | Viewed by 3598

Abstract

During the summer of 2016 four cases of invasive meningococcal disease in rapid succession among young adults in the district of Palermo, Italy, resulting in one death, were widely reported by local and national mass media. The resultant ‘epidemic panic’ among the general [...] Read more.

During the summer of 2016 four cases of invasive meningococcal disease in rapid succession among young adults in the district of Palermo, Italy, resulting in one death, were widely reported by local and national mass media. The resultant ‘epidemic panic’ among the general population overloaded the vaccination units of the Palermo district over the following months. Strategies implemented by the Sicilian and local public health authorities to counteract ‘meningitis fear’ included the following: (a) extension of active and free-of-charge anti-meningococcal tetravalent vaccination from age class 12–18 to 12–30 years old; (b) implementation of vaccination units during normal clinic hours in rooms tailored for vaccine administration; (c) development of informative institutional tools and timely communication throughout local mass media to reassure the general population. In 2016, an increase in the anti-meningococcal coverage was observed in the Palermo district (+18% for 16-year-olds and +14% for 18-year-olds) and at the regional level (+11.2% and +13.5%, respectively). Concurrent catch-up of other recommended vaccinations for age (diphtheria-tetanus-pertussis-poliomyelitis and papillomavirus) resulted in a further increase of administered doses. The fear of meningitis, managed by the Sicilian public health authorities, had positive impacts in terms of prevention. In particular, the communication strategies that were adopted contributed to educating Sicilian young adults about vaccination issues. Full article

(This article belongs to the Special Issue Interventions and Approaches to Optimize Immunization Coverage Across the Lifespan)

► Show Figures

Figure 1

12 pages, 1910 KiB

Open AccessArticle

A Simple Alternative Method for Preservation of 2-Methylisoborneol in Water Samples

by Chun-Cheng Fan, Yi-Ting Chiu and Tsair-Fuh Lin

Int. J. Environ. Res. Public Health 2018, 15(5), 1015; https://doi.org/10.3390/ijerph15051015 - 18 May 2018

Cited by 3 | Viewed by 3175

Abstract

2-Methylisoborneol (2-MIB) is one of the most commonly observed taste and odor (T&O) compounds present in drinking water sources. As it is biodegradable, a preservation agent, typically mercury chloride, is needed if the water is not analyzed right after sampling. Since mercury is [...] Read more.

2-Methylisoborneol (2-MIB) is one of the most commonly observed taste and odor (T&O) compounds present in drinking water sources. As it is biodegradable, a preservation agent, typically mercury chloride, is needed if the water is not analyzed right after sampling. Since mercury is a toxic metal, an alternative chemical that is cheaper and less toxic is desirable. In this study, two chemicals commonly used in water treatment processes, chlorine (as sodium hypochlorite) and KMnO₄ (potassium permanganate), are studied to determine their feasibility as preservation agents for 2-MIB in water. Preservation experiments were first conducted in deionized water spiked with 2-MIB and with chlorine or permanganate at 4 and 25 °C. The results indicate that 2-MIB concentrations in the water samples spiked with both chemicals remained almost constant within 14 days for all the tested conditions, suggesting that oxidation and volatilization did not cause the loss of 2-MIB in the system. The experiments were further conducted for three different reservoir water samples with 30–60 ng/L of indulgent 2-MIB. The experimental results demonstrated that preservation with permanganate may have underestimated the 2-MIB concentration in the samples as a result of the formation of manganese dioxide particles in natural water and adsorption of 2-MIB onto the particles. Chlorine was demonstrated to be a good preservation agent for all three tested natural waters since oxidation of 2-MIB was negligible and biodegradation was inhibited. When the residual chlorine concentrations were controlled to be higher than 0.5 mg/L on the final day (day 14) of the experiments, the concentration reduction of 2-MIB became lower than 13% at both of the tested temperatures. The results demonstrated that sodium hypochlorite can be used as an alternative preservation agent for 2-MIB in water before analysis. Full article

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

► Show Figures

Figure 1

10 pages, 738 KiB

Open AccessArticle

Does Molimina Indicate Ovulation? Prospective Data in a Hormonally Documented Single-Cycle in Spontaneously Menstruating Women

by Jerilynn C. Prior, Chiaki Konishi, Christine L. Hitchcock, Elaine Kingwell, Patti Janssen, Anthony P. Cheung, Nichole Fairbrother and Azita Goshtasebi

Int. J. Environ. Res. Public Health 2018, 15(5), 1016; https://doi.org/10.3390/ijerph15051016 - 18 May 2018

Cited by 10 | Viewed by 5972

Abstract

Approximately 33% of normal-length (21–35 days) cycles have subclinical ovulatory disturbances and lack sufficient progesterone, although their normal length ensures enough estrogen. Subclinical ovulatory disturbances are related to significant premenopausal spine bone loss (−0.86%/year). Molimina, non-distressing premenstrual experiences, may detect ovulation within normal-length [...] Read more.

Approximately 33% of normal-length (21–35 days) cycles have subclinical ovulatory disturbances and lack sufficient progesterone, although their normal length ensures enough estrogen. Subclinical ovulatory disturbances are related to significant premenopausal spine bone loss (−0.86%/year). Molimina, non-distressing premenstrual experiences, may detect ovulation within normal-length cycles. This prospective study assessed the relationship between molimina and ovulation. After 1-cycle of daily diary and first morning urine collections, women answered the Molimina Question (MQ): “Can you tell by the way you feel that your period is coming?” and were invited to share (a) predictive premenstrual experience(s). A 3-fold increase in follicular-luteal pregnanediol levels confirmed ovulation. In 610 spontaneously menstruating women (not on hormonal contraception, mean age 31.5 ± 5.3, menarche age 12.7 ± 1.5, cycle length [CL] 29 days, MQ positive in 89%), reported premenstrual experiences which included negative moods (62%), cramps (48%), bloating (39%), and front (26%) or axillary (25%) breast tenderness. Of 432 women with pregnanediol-documented cycles, 398 (92%) were ovulatory (CL: 29 ± 5) and 34 (8%) had ovulatory disturbances (CL: 32 ± 14). Women with/without ovulatory cycles were similar in parity, body mass index, smoking, dietary restraint and the MQ; ovulatory-disturbed cycles were longer. Molimina did not confirm ovulation. A non-invasive, inexpensive ovulation indicator is needed to prevent osteoporosis. Full article

(This article belongs to the Special Issue New Concepts in Women’s Bone Health)

► Show Figures

Figure 1

14 pages, 385 KiB

Open AccessArticle

The Stability and Continuity of Maternally Reported and Observed Child Eating Behaviours and Feeding Practices across Early Childhood

by Faye Powell, Claire Farrow, Caroline Meyer and Emma Haycraft

Int. J. Environ. Res. Public Health 2018, 15(5), 1017; https://doi.org/10.3390/ijerph15051017 - 18 May 2018

Cited by 25 | Viewed by 5182

Abstract

Given that many eating behaviours and food preferences develop early in childhood and track across childhood, adolescence and into adulthood, interest has grown in the developmental trajectory of these behaviours. The aims of this study were twofold. First, to explore whether maternal reports [...] Read more.

Given that many eating behaviours and food preferences develop early in childhood and track across childhood, adolescence and into adulthood, interest has grown in the developmental trajectory of these behaviours. The aims of this study were twofold. First, to explore whether maternal reports of child eating behaviour and feeding practices are validated by independent observations of these constructs. Second, to explore the continuity and stability of both maternally reported and independently observed child eating behaviours and maternal feeding practices during early childhood. Sixty-five mothers completed measures of their child’s eating behaviour and their own feeding practices and mother–child dyads were observed during a family mealtime at approximately 3 and 4 years of age. Maternal reports of their child’s eating behaviours were validated by independent observations, however maternally reported feeding practices were not validated by observations of these behaviours. Maternally reported and independently observed child eating behaviours and parental feeding practices remained stable and showed continuity between 3 and 4 years of age, with the exception of child difficulty to feed and maternal pressure to eat which both significantly decreased over time. Findings provide an insight into the validity of maternal reports of fussy eating behaviour and parental feeding practices and the developmental trajectory of these behaviours across early childhood. Full article

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

12 pages, 806 KiB

Open AccessArticle

Premature Spinal Bone Loss in Women Living with HIV is Associated with Shorter Leukocyte Telomere Length

by Shirin Kalyan, Neora Pick, Alice Mai, Melanie C. M. Murray, Kristen Kidson, Jackson Chu, Arianne Y. K. Albert, Hélène C. F. Côté, Evelyn J. Maan, Azita Goshtasebi, Deborah M. Money and Jerilynn C. Prior

Int. J. Environ. Res. Public Health 2018, 15(5), 1018; https://doi.org/10.3390/ijerph15051018 - 18 May 2018

Cited by 9 | Viewed by 4203

Abstract

With advances in combination antiretroviral therapy (cART), people living with HIV are now surviving to experience aging. Evidence suggests that individuals living with HIV are at greater risk for low bone mineral density (BMD), osteoporosis, and fractures. Better understanding of the pathophysiology of [...] Read more.

With advances in combination antiretroviral therapy (cART), people living with HIV are now surviving to experience aging. Evidence suggests that individuals living with HIV are at greater risk for low bone mineral density (BMD), osteoporosis, and fractures. Better understanding of the pathophysiology of bone health in women living with HIV (WLWH) is important for treatment strategies. The goal of this study was to explore new biological factors linked to low BMD in WLWH. Standardized BMD measures of WLWH were compared to reference values from an unselected population of women from the same geographical region of the same age range. Linear regression analysis was used to assess relationships among health-related characteristics, cellular aging (measured by leukocyte telomere length; LTL), cART, and BMD of WLWH. WLWH (n = 73; mean age 43 ± 9 years) had lower BMD Z-scores at the lumbar spine (LS) (mean difference = −0.39, p < 0.001) and total hip (TH) (−0.29, p = 0.012) relative to controls (n = 290). WLWH between 50 and 60 years (n = 17) had lower Z-scores at the LS (p = 0.008) and TH (p = 0.027) compared to controls (n = 167). Among WLWH, LS BMD was significantly associated with LTL (R² = 0.09, p = 0.009) and BMI (R² = 0.06, p = 0.042). Spinal BMD was adversely affected in WLWH. Reduction of LTL was strongly associated with lower BMD and may relate to its pathophysiology and premature aging in WLWH. Full article

(This article belongs to the Special Issue New Concepts in Women’s Bone Health)

► Show Figures

Figure 1

16 pages, 1094 KiB

Open AccessArticle

Quorum Sensing versus Quenching Bacterial Isolates Obtained from MBR Plants Treating Leachates from Municipal Solid Waste

by Albert Soler, Lucía Arregui, Miguel Arroyo, José Antonio Mendoza, Andrea Muras, Cristina Álvarez, Cristina García-Vera, Domingo Marquina, Antonio Santos and Susana Serrano

Int. J. Environ. Res. Public Health 2018, 15(5), 1019; https://doi.org/10.3390/ijerph15051019 - 18 May 2018

Cited by 17 | Viewed by 5055

Abstract

Quorum sensing (QS) is a mechanism dependent on bacterial density. This coordinated process is mediated by the synthesis and the secretion of signal molecules, called autoinducers (AIs). N-acyl-homoserine lactones (AHLs) are the most common AIs that are used by Gram-negative bacteria and [...] Read more.

Quorum sensing (QS) is a mechanism dependent on bacterial density. This coordinated process is mediated by the synthesis and the secretion of signal molecules, called autoinducers (AIs). N-acyl-homoserine lactones (AHLs) are the most common AIs that are used by Gram-negative bacteria and are involved in biofilm formation. Quorum Quenching (QQ) is the interference of QS by producing hydrolyzing enzymes, among other strategies. The main objective of the present study was to identify QS and QQ strains from MBR wastewater treatment plants. A total of 99 strains were isolated from two Spanish plants that were intended to treat leachate from municipal solid waste. Five AHL producers were detected using AHL biosensor strains (Chromobacterium violaceum CV026 and Agrobacterium tumefaciens NT1). Fifteen strains of seventy-one Gram-positive were capable of eliminating or reducing at least one AHL activity. The analysis of 16S rRNA gene sequence showed the importance of the Pseudomonas genus in the production of biofilms and the relevance of the genus Bacillus in the disruption of the QS mechanism, in which the potential activity of lactonase or acylase enzymes was investigated with the aim to contribute to solve biofouling problems and to increase the useful lifespan of membranes. Full article

(This article belongs to the Special Issue Membrane Technologies for Water and Wastewater Treatment)

► Show Figures

Figure 1

14 pages, 1198 KiB

Open AccessArticle

Eating Alone is Differentially Associated with the Risk of Metabolic Syndrome in Korean Men and Women

by Chul-Kyoo Kim, Hyun-jin Kim, Hae-Kyung Chung and Dayeon Shin

Int. J. Environ. Res. Public Health 2018, 15(5), 1020; https://doi.org/10.3390/ijerph15051020 - 18 May 2018

Cited by 10 | Viewed by 5808

Abstract

Few studies have examined overall patterns of eating alone in relation to the risk of metabolic syndrome (MetS) in Korean populations. The present study aimed to examine the relationship between patterns of eating alone and the risk of MetS in Korean adults. Data [...] Read more.

Few studies have examined overall patterns of eating alone in relation to the risk of metabolic syndrome (MetS) in Korean populations. The present study aimed to examine the relationship between patterns of eating alone and the risk of MetS in Korean adults. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) for 2013–2015 were used, with 8988 Korean adult participants, including 3624 men and 5364 women, aged 18 to 64 years. Patterns of eating alone were categorized into eight groups based on the total frequency of eating alone on a daily basis in the past one year: (1) three times for breakfast, lunch, and dinner; (2) twice for breakfast and dinner; (3) twice for lunch and dinner; (4) twice for breakfast and lunch; (5) once for breakfast only; (6) once for lunch only; (7) once for dinner only; and (8) never eating alone. The presence of MetS has been defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF). Multivariable logistic regression analyses were performed to assess the association between patterns of eating alone versus the risk of MetS after controlling for age, income, occupation, number of family members, generation types, marital status, smoking status, and physical activity. The prevalence of MetS was the highest in men and women aged 40–64 who had breakfast, lunch, and dinner alone (50.1% and 36.8%, respectively). Men who had dinner alone or lunch and dinner alone compared with those who eat with others had a significantly higher risk of MetS, with adjusted odds ratios (AOR) of 1.51, and a 95% confidence interval (CI) of 1.06–2.16; and an AOR of 1.54, with a 95% CI of 1.05–2.25, respectively. Women who had breakfast alone compared with those who ate with others had a significantly lower risk of MetS (AOR 0.70, 95% CI 0.53–0.94). In conclusion, patterns of eating alone are differentially associated with the risk of MetS in a representative sample of Korean adults. Future studies are warranted to identify dietary patterns across the different eating alone patterns in relation to various health outcomes in Korean adult populations. Full article

► Show Figures

Figure 1

15 pages, 2273 KiB

Open AccessArticle

Analysis of Short-Term Smoking Effects in PBMC of Healthy Subjects—Preliminary Study

by Joanna Wieczfinska, Tomasz Kowalczyk, Przemyslaw Sitarek, Ewa Skała and Rafal Pawliczak

Int. J. Environ. Res. Public Health 2018, 15(5), 1021; https://doi.org/10.3390/ijerph15051021 - 18 May 2018

Cited by 6 | Viewed by 4871

Abstract

Early structural changes exist in the small airways before the establishment of Chronic Obstructive Pulmonary Disease (COPD). These changes are believed to be induced by oxidation. The aim of this study was to analyze the influence of short-term smoking on the expression of [...] Read more.

Early structural changes exist in the small airways before the establishment of Chronic Obstructive Pulmonary Disease (COPD). These changes are believed to be induced by oxidation. The aim of this study was to analyze the influence of short-term smoking on the expression of the genes contributing to airway remodeling and their relationship with the oxidative status of human blood cells. Blood mononuclear cells were isolated from 16 healthy volunteers and treated with cigarette smoke ingredients (CSI): nicotine, 1-Nitrosodimethylamine, N-Nitrosopyrrolidyne, vinyl chloride, acetone, and acrolein. The expression of TGF-β1, TIMP-1, SOD1, and arginase I was determined by qPCR. Additionally, thiol groups and TBARs were assessed. CSI induced TGF and TIMP-1 expression in peripheral blood mononuclear cells (PBMC), and apocynin alleviated this effect. The changes were more noticeable in the smoking group (p < 0.05). TBARs concentrations were higher in smokers, and in this group, apocynin acted more effectively. SOD1 correlated with arginase expression in smokers (p < 0.05). MMP-9 showed a significant correlation with SOD1 in both groups, but only on the protein level. Blood cells appear to mirror the general changes caused by cigarette smoke ingredients, which seem to be connected with the oxidative status of the cell. Our findings indicate that a short period of smoking influences the gene expression and oxidative balance of blood cells, which might result in the development of serious disorders such as COPD. Full article

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

► Show Figures

Figure 1

28 pages, 736 KiB

Open AccessArticle

Views and Experiences of Persons with Chronic Diseases about Strategies that Aim to Integrate and Re-Integrate Them into Work: A Systematic Review of Qualitative Studies

by Eva Esteban, Michaela Coenen, Elizabeth Ito, Sonja Gruber, Chiara Scaratti, Matilde Leonardi, Olga Roka, Evdokia Vasilou, Amalia Muñoz-Murillo, Carolina C. Ávila, Dare S. Kovačič, Ivana Ivandic and Carla Sabariego

Int. J. Environ. Res. Public Health 2018, 15(5), 1022; https://doi.org/10.3390/ijerph15051022 - 18 May 2018

Cited by 22 | Viewed by 6061

Abstract

The effectiveness of strategies targeting professional integration and reintegration strongly depends on the experiences of participants. The aim of this systematic literature review is to synthesize European qualitative studies exploring views and experiences of persons with chronic conditions regarding strategies for integration and [...] Read more.

The effectiveness of strategies targeting professional integration and reintegration strongly depends on the experiences of participants. The aim of this systematic literature review is to synthesize European qualitative studies exploring views and experiences of persons with chronic conditions regarding strategies for integration and reintegration into work. The systematic search was conducted in Medline, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 24 studies published in English between January 2011 and April 2016 were included. Most studies were carried out in Nordic countries or in the UK, and most participants were persons with either mental or musculoskeletal disorders. Ten themes emerged: individual and holistic approach, clarity of strategy and processes, timing of rehabilitation processes, experience with professionals, at the workplace and with peer groups, changes in the understanding of health and work, active involvement in the process, competencies development and motivating aspects of work. Findings highlight, among others, the need to actively involve participants in the return to work process and to provide timely and clearly structured processes and interventions. This review provides stakeholders key information to develop, plan, implement and evaluate interventions to integrate and re-integrate persons with chronic conditions into work in Europe. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

► Show Figures

Figure 1

14 pages, 874 KiB

Open AccessArticle

Adult Premenopausal Bone Health Related to Reproductive Characteristics—Population-Based Data from the Canadian Multicentre Osteoporosis Study (CaMos)

by Azita Goshtasebi, Claudie Berger, Susan I. Barr, Christopher S. Kovacs, Tanveer Towheed, K. Shawn Davison and Jerilynn C. Prior

Int. J. Environ. Res. Public Health 2018, 15(5), 1023; https://doi.org/10.3390/ijerph15051023 - 18 May 2018

Cited by 17 | Viewed by 4845

Abstract

Amenorrhea is important for women’s bone health. However, few have reported reproductive, anthropometric (body mass index [BMI], height) and bone health (areal bone mineral density [BMD], prevalent fractures) in a population-based study. The purposes of this cross-sectional study of women in the randomly-selected [...] Read more.

Amenorrhea is important for women’s bone health. However, few have reported reproductive, anthropometric (body mass index [BMI], height) and bone health (areal bone mineral density [BMD], prevalent fractures) in a population-based study. The purposes of this cross-sectional study of women in the randomly-selected Canadian Multicentre Osteoporosis Study (CaMos) population were: (1) to describe reproductive, demographic, anthropometric and lifestyle variables; and (2) in menstruating women, to relate reproductive and other variables to BMD at the lumbar spine (L1-4, LS), femoral neck (FN) and total hip (TH) sites and to prevalent fragility fractures. This study describes the reproductive characteristics of 1532 women aged 30–60 years. BMD relationships with reproductive and other variables were described in the 499 menstruating women. Mean menarche age was 12.8 years, 96% of women were parous and 95% had used combined hormonal contraceptives (CHC). Infertility was reported by 9%, androgen excess by 13%, amenorrhea by 8% and nulliparity by 4%. LS BMD was negatively associated with amenorrhea and androgen excess and positively related to current BMI and height. A later age at menarche negatively related to FN BMD. BMI and height were strongly related to BMD at all sites. Prevalent fragility fractures were significantly associated with quartiles of both LS and TH BMD. Full article

(This article belongs to the Special Issue New Concepts in Women’s Bone Health)

► Show Figures

Figure 1

10 pages, 746 KiB

Open AccessArticle

Smoking Topography among Korean Smokers: Intensive Smoking Behavior with Larger Puff Volume and Shorter Interpuff Interval

by Sungroul Kim and Sol Yu

Int. J. Environ. Res. Public Health 2018, 15(5), 1024; https://doi.org/10.3390/ijerph15051024 - 18 May 2018

Cited by 8 | Viewed by 4172

Abstract

The difference of smoker’s topography has been found to be a function many factors, including sex, personality, nicotine yield, cigarette type (i.e., flavored versus non-flavored) and ethnicity. We evaluated the puffing behaviors of Korean smokers and its association with smoking-related biomarker levels. A [...] Read more.

The difference of smoker’s topography has been found to be a function many factors, including sex, personality, nicotine yield, cigarette type (i.e., flavored versus non-flavored) and ethnicity. We evaluated the puffing behaviors of Korean smokers and its association with smoking-related biomarker levels. A sample of 300 participants was randomly recruited from metropolitan areas in South Korea. Topography measures during a 24-hour period were obtained using a CReSS pocket device. Korean male smokers smoked two puffs less per cigarette compared to female smokers (15.0 (13.0–19.0) vs. 17.5 (15.0–21.0) as the median (Interquartile range)), but had a significantly larger puff volume (62.7 (52.7–75.5) mL vs. 53.5 (42.0–64.2) mL); p = 0.012). The interpuff interval was similar between men and women (8.9 (6.5–11.2) s vs. 8.3 (6.2–11.0) s; p = 0.122) but much shorter than other study results. A dose-response association (p = 0.0011) was observed between daily total puff volumes and urinary cotinine concentrations, after controlling for sex, age, household income level and nicotine addiction level. An understanding of the difference of topography measures, particularly the larger puff volume and shorter interpuff interval of Korean smokers, may help to overcome a potential underestimation of internal doses of hazardous byproducts of smoking. Full article

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

► Show Figures

Figure 1

9 pages, 1469 KiB

Open AccessArticle

Smoking, Blood Pressure, and Cardiovascular Disease Mortality in a Large Cohort of Chinese Men with 15 Years Follow-up

by Jibin Tan, Xiumin Zhang, Weihua Wang, Peng Yin, Xiaomin Guo and Maigeng Zhou

Int. J. Environ. Res. Public Health 2018, 15(5), 1026; https://doi.org/10.3390/ijerph15051026 - 18 May 2018

Cited by 23 | Viewed by 5122

Abstract

Background: To examine the joint effects of smoking and blood pressure on the risk of mortality from cardiovascular disease (CVD) in a cohort of Chinese men. Methods: This study followed a cohort of 213,221 men over 40 years of age who were recruited [...] Read more.

Background: To examine the joint effects of smoking and blood pressure on the risk of mortality from cardiovascular disease (CVD) in a cohort of Chinese men. Methods: This study followed a cohort of 213,221 men over 40 years of age who were recruited from 45 district/counties across China between 1990–1991, and whose cause-specific mortality was examined for 15 years, up to 31 December 2005. We calculated hazard ratios for all-cause mortality and CVD, ischemic heart disease (IHD), and stroke mortality for the combined sets of smoking status and blood pressure levels using the Cox proportional hazard model, adjusting for potential individual-level and contextual-level risk factors. Results: During the 15 years of follow-up, 52,795 deaths occurred, including 18,833 deaths from CVD, 3744 deaths from IHD, and 11,288 deaths from stroke. The risk of mortality from CVD, IHD, and stroke increased significantly, with increased systolic blood pressure (SBP), diastolic blood pressure (DBP), and with more pack years of smoking. Compared with never-smokers with normal blood pressure, the hazard ratios and 95% CI of CVD, IHD, and stroke mortality for those who smoked over 20 pack years with hypertension were remarkably increased to 2.30 (95% CI: 2.12–2.50), 1.78 (95% CI: 1.48–2.14), and 2.74 (95% CI: 2.45–3.07), respectively. Conclusion: There was a combined effect on the risk of CVD, IHD, and stroke mortality between smoking and hypertension. The joint efforts on smoking cessation and lowered blood pressure should be made to prevent cardiovascular disease mortality in Chinese men. Full article

► Show Figures

Figure 1

13 pages, 972 KiB

Open AccessArticle

Sensitivity Analysis of Weather Variables on Offsite Consequence Analysis Tools in South Korea and the United States

by Min-Uk Kim, Kyong Whan Moon, Jong-Ryeul Sohn and Sang-Hoon Byeon

Int. J. Environ. Res. Public Health 2018, 15(5), 1027; https://doi.org/10.3390/ijerph15051027 - 18 May 2018

Viewed by 4130

Abstract

We studied sensitive weather variables for consequence analysis, in the case of chemical leaks on the user side of offsite consequence analysis (OCA) tools. We used OCA tools Korea Offsite Risk Assessment (KORA) and Areal Location of Hazardous Atmospheres (ALOHA) in South Korea [...] Read more.

We studied sensitive weather variables for consequence analysis, in the case of chemical leaks on the user side of offsite consequence analysis (OCA) tools. We used OCA tools Korea Offsite Risk Assessment (KORA) and Areal Location of Hazardous Atmospheres (ALOHA) in South Korea and the United States, respectively. The chemicals used for this analysis were 28% ammonia (NH₃), 35% hydrogen chloride (HCl), 50% hydrofluoric acid (HF), and 69% nitric acid (HNO₃). The accident scenarios were based on leakage accidents in storage tanks. The weather variables were air temperature, wind speed, humidity, and atmospheric stability. Sensitivity analysis was performed using the Statistical Package for the Social Sciences (SPSS) program for dummy regression analysis. Sensitivity analysis showed that impact distance was not sensitive to humidity. Impact distance was most sensitive to atmospheric stability, and was also more sensitive to air temperature than wind speed, according to both the KORA and ALOHA tools. Moreover, the weather variables were more sensitive in rural conditions than in urban conditions, with the ALOHA tool being more influenced by weather variables than the KORA tool. Therefore, if using the ALOHA tool instead of the KORA tool in rural conditions, users should be careful not to cause any differences in impact distance due to input errors of weather variables, with the most sensitive one being atmospheric stability. Full article

► Show Figures

Figure 1

15 pages, 3383 KiB

Open AccessArticle

An Effectiveness Assessment of China’s WEEE Treatment Fund

by Wenyan Zhao and Jianxin Yang

Int. J. Environ. Res. Public Health 2018, 15(5), 1028; https://doi.org/10.3390/ijerph15051028 - 19 May 2018

Cited by 7 | Viewed by 3847

Abstract

Policy is essential to the management of waste electrical and electronic equipment (WEEE). In order to present valuable findings for policy improvement, we performed a quantitative effectiveness assessment of China’s WEEE treatment fund from 2012 to 2015. The achievement of the general goal [...] Read more.

Policy is essential to the management of waste electrical and electronic equipment (WEEE). In order to present valuable findings for policy improvement, we performed a quantitative effectiveness assessment of China’s WEEE treatment fund from 2012 to 2015. The achievement of the general goal of the WEEE treatment fund was evaluated with various indicators. We calculated the values of all indicators and analyzed the changes in them. The results show that the WEEE treatment fund was important in promoting WEEE collection and recycling activities and has provided great benefits in the form of resources and the environment. Moreover, the authorized enterprises also experienced progress in their development. In a word, the WEEE treatment fund was effective to some extent. However, because of the limited subsidies and other factors, the WEEE treatment fund had different effects on five categories of WEEE. We found that its approach worked best for the TV set. Although the promotional effects on the other four categories of WEEE have been increasingly significant since 2014, there is room for improvement. Fortunately, the subsidy rates have been adjusted by administrations and new subsidies were provided in 2016. As it is crucial for the effectiveness of the WEEE treatment fund, new subsidy rates should be evaluated regularly. Full article

► Show Figures

Figure 1

17 pages, 3308 KiB

Open AccessArticle

Effects of Different Spectral Shapes and Amplitude Modulation of Broadband Noise on Annoyance Reactions in a Controlled Listening Experiment

by Beat Schäffer, Reto Pieren, Sabine J. Schlittmeier and Mark Brink

Int. J. Environ. Res. Public Health 2018, 15(5), 1029; https://doi.org/10.3390/ijerph15051029 - 19 May 2018

Cited by 32 | Viewed by 5291

Abstract

Environmental noise from transportation or industrial infrastructure typically has a broad frequency range. Different sources may have disparate acoustical characteristics, which may in turn affect noise annoyance. However, knowledge of the relative contribution of the different acoustical characteristics of broadband noise to annoyance [...] Read more.

Environmental noise from transportation or industrial infrastructure typically has a broad frequency range. Different sources may have disparate acoustical characteristics, which may in turn affect noise annoyance. However, knowledge of the relative contribution of the different acoustical characteristics of broadband noise to annoyance is still scarce. In this study, the subjectively perceived short-term (acute) annoyance reactions to different broadband sounds (namely, realistic outdoor wind turbine and artificial, generic sounds) at 40 dBA were investigated in a controlled laboratory listening experiment. Combined with the factorial design of the experiment, the sounds allowed for separation of the effects of three acoustical characteristics on annoyance, namely, spectral shape, depth of periodic amplitude modulation (AM), and occurrence (or absence) of random AM. Fifty-two participants rated their annoyance with the sounds. Annoyance increased with increasing energy content in the low-frequency range as well as with depth of periodic AM, and was higher in situations with random AM than without. Similar annoyance changes would be evoked by sound pressure level changes of up to 8 dB. The results suggest that besides standard sound pressure level metrics, other acoustical characteristics of (broadband) noise should also be considered in environmental impact assessments, e.g., in the context of wind turbine installations. Full article

(This article belongs to the Special Issue Noise-Related Annoyance)

► Show Figures

Figure 1

16 pages, 8263 KiB

Open AccessArticle

Effects of Pb Smelting on the Soil Bacterial Community near a Secondary Lead Plant

by Zhanbin Luo, Jing Ma, Fu Chen, Xiaoxiao Li and Shaoliang Zhang

Int. J. Environ. Res. Public Health 2018, 15(5), 1030; https://doi.org/10.3390/ijerph15051030 - 20 May 2018

Cited by 38 | Viewed by 5056

Abstract

Secondary lead smelting is a widespread industrial activity which has exacerbated Pb or Cd contamination of soil and water across the world. Soil physicochemical properties, soil enzyme activities, heavy metal concentrations, and bacterial diversity near a secondary lead plant in Xuzhou, China were [...] Read more.

Secondary lead smelting is a widespread industrial activity which has exacerbated Pb or Cd contamination of soil and water across the world. Soil physicochemical properties, soil enzyme activities, heavy metal concentrations, and bacterial diversity near a secondary lead plant in Xuzhou, China were examined in this study. The results showed that secondary lead smelting activities influenced nearby soils. Soil acidification decreased one order of magnitude, with a mean value of 7.3. Soil organic matter also showed a downward trend, while potassium and nitrogen appeared to accumulate. Soil urease and protease activity increased in samples with greater heavy metal pollution, but overall the soil microbial biodiversity decreased. Soil heavy metal concentration—especially Pb and Cd—greatly exceeded the concentrations of Chinese Environmental Quality Standard for Soils (GB 15618-1995). Some environmental factors—such as pH, organic matter, enzyme activity, and the concentration of heavy metals—significantly affected bacterial diversity: compared with the control site, the Chao1 estimator decreased about 50%, while the Shannon diversity index dropped approximately 20%. Moreover, some genera have significant relationships with heavy metal concentration—such as Ramlibacter with Zn and Steroidobacter with Cd—which might act as bio-indicators for soil remediation. These results will provide a new insight in the future for reclaiming soil contaminants caused by secondary lead smelting. Full article

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

► Show Figures

Figure 1

16 pages, 3367 KiB

Open AccessArticle

Removing Organic Matter and Nutrients from Pig Farm Wastewater with a Constructed Wetland System

by Celia De La Mora-Orozco, Irma Julieta González-Acuña, Ruben Alfonso Saucedo-Terán, Hugo Ernesto Flores-López, Hector Osbaldo Rubio-Arias and Jesús Manuel Ochoa-Rivero

Int. J. Environ. Res. Public Health 2018, 15(5), 1031; https://doi.org/10.3390/ijerph15051031 - 21 May 2018

Cited by 40 | Viewed by 7915

Abstract

Pollutants from pig farms in Mexico have caused problems in many surface water reservoirs. Growing concern has driven the search for low-cost wastewater treatment solutions. The objective of this research was to evaluate the potential of an in-series constructed wetland to remove nutrients [...] Read more.

Pollutants from pig farms in Mexico have caused problems in many surface water reservoirs. Growing concern has driven the search for low-cost wastewater treatment solutions. The objective of this research was to evaluate the potential of an in-series constructed wetland to remove nutrients from wastewater from a pig farm. The wetland system had a horizontal flow that consisted of three cells, the first a surface water wetland, the second a sedimentation cell, and the third a subsurface flow wetland. The vegetation used was Thypa sp. and Scirpus sp. A mix of soil with red volcanic rock (10–30 mm diameter) and yellow sand (2–8 mm diameter) was used as a substrate for the vegetation. The experiments were carried out in duplicate. Water samples were collected at the inflow and outflow of the cells. Two hydraulic retention times (HRT) (5 and 10 days) and three treatments were evaluated: 400, 800, and 1200 mg·L⁻¹ of chemical oxygen demand (COD) concentration. Data was collected in situ for temperature, pH, dissolved oxygen (DO), electrical conductivity (EC), and total dissolved solids (TDS). COD, total Kjeldahl nitrogen (TKN), ammonia nitrogen (NH₃–N), and total phosphorous (TP) were analyzed in the laboratory. The results showed that the in-series constructed wetland is a feasible system for nutrient pollutant removal, with COD removal efficiency of 76% and 80% mg·L⁻¹ for a 5- and 10-day HRT, respectively. The removal efficiency for TKN, NH₃–N, and TP reached about 70% with a 5-day HRT, while a removal of 85% was obtained with a 10-day HRT. The wetland reached the maximum removal efficiency with a 10-day HRT and an inflow load of 400 mg·L⁻¹ of organic matter. The results indicate that HRT positively affects removal efficiency of COD and TDS. On the other hand, the HRT was not the determining factor for TP removal. Treatment one, with an initial COD concentration of 400 mg·L⁻¹, had the highest removal of the assessed pollutants, allowing for the use of water for irrigation according to Mexican regulatory standards (NOM-001). The water quality resulting from treatments two and three (T2 = 800 mg·L⁻¹ of COD and T3 = 1200 mg·L⁻¹ of COD) did not comply with minimal requirements for irrigation water. Full article

(This article belongs to the Special Issue Selected Paper from the 14th International Symposium on Recent Advances in Environmental Health Research)

► Show Figures

Figure 1

23 pages, 8684 KiB

Open AccessArticle

A Novel Hybrid Data-Driven Model for Daily Land Surface Temperature Forecasting Using Long Short-Term Memory Neural Network Based on Ensemble Empirical Mode Decomposition

by Xike Zhang, Qiuwen Zhang, Gui Zhang, Zhiping Nie, Zifan Gui and Huafei Que

Int. J. Environ. Res. Public Health 2018, 15(5), 1032; https://doi.org/10.3390/ijerph15051032 - 21 May 2018

Cited by 93 | Viewed by 7619

Abstract

Daily land surface temperature (LST) forecasting is of great significance for application in climate-related, agricultural, eco-environmental, or industrial studies. Hybrid data-driven prediction models using Ensemble Empirical Mode Composition (EEMD) coupled with Machine Learning (ML) algorithms are useful for achieving these purposes because they [...] Read more.

Daily land surface temperature (LST) forecasting is of great significance for application in climate-related, agricultural, eco-environmental, or industrial studies. Hybrid data-driven prediction models using Ensemble Empirical Mode Composition (EEMD) coupled with Machine Learning (ML) algorithms are useful for achieving these purposes because they can reduce the difficulty of modeling, require less history data, are easy to develop, and are less complex than physical models. In this article, a computationally simple, less data-intensive, fast and efficient novel hybrid data-driven model called the EEMD Long Short-Term Memory (LSTM) neural network, namely EEMD-LSTM, is proposed to reduce the difficulty of modeling and to improve prediction accuracy. The daily LST data series from the Mapoling and Zhijaing stations in the Dongting Lake basin, central south China, from 1 January 2014 to 31 December 2016 is used as a case study. The EEMD is firstly employed to decompose the original daily LST data series into many Intrinsic Mode Functions (IMFs) and a single residue item. Then, the Partial Autocorrelation Function (PACF) is used to obtain the number of input data sample points for LSTM models. Next, the LSTM models are constructed to predict the decompositions. All the predicted results of the decompositions are aggregated as the final daily LST. Finally, the prediction performance of the hybrid EEMD-LSTM model is assessed in terms of the Mean Square Error (MSE), Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), Root Mean Square Error (RMSE), Pearson Correlation Coefficient (CC) and Nash-Sutcliffe Coefficient of Efficiency (NSCE). To validate the hybrid data-driven model, the hybrid EEMD-LSTM model is compared with the Recurrent Neural Network (RNN), LSTM and Empirical Mode Decomposition (EMD) coupled with RNN, EMD-LSTM and EEMD-RNN models, and their comparison results demonstrate that the hybrid EEMD-LSTM model performs better than the other five models. The scatterplots of the predicted results of the six models versus the original daily LST data series show that the hybrid EEMD-LSTM model is superior to the other five models. It is concluded that the proposed hybrid EEMD-LSTM model in this study is a suitable tool for temperature forecasting. Full article

(This article belongs to the Section Climate Change)

► Show Figures

Figure 1

15 pages, 3188 KiB

Open AccessArticle

Relationship between Job Stress and 5-HT2A Receptor Polymorphisms on Self-Reported Sleep Quality in Physicians in Urumqi (Xinjiang, China): A Cross-Sectional Study

by Xiaoyan Gao, Hua Ge, Yu Jiang, Yulong Lian, Chen Zhang and Jiwen Liu

Int. J. Environ. Res. Public Health 2018, 15(5), 1034; https://doi.org/10.3390/ijerph15051034 - 21 May 2018

Cited by 16 | Viewed by 5210

Abstract

The serotonin receptor (5-HTR) plays a key role in sleep quality regulation. Job-related stress is an important factor that influences sleep quality. However, few reports on the interaction between 5-HTR2A polymorphisms and job stress, and how they may impact upon sleep quality are [...] Read more.

The serotonin receptor (5-HTR) plays a key role in sleep quality regulation. Job-related stress is an important factor that influences sleep quality. However, few reports on the interaction between 5-HTR2A polymorphisms and job stress, and how they may impact upon sleep quality are available. Therefore this study investigated the effects of job stress, 5-HTR2A polymorphisms, and their interaction on sleep quality, in physicians. Using a two-stage stratified sampling method, 918 participants were initially invited to participate in the study. After screening for study inclusion and exclusion criteria, 504 subjects were eventually included in the study. Job stress and sleep quality were assessed using the Job Stress Survey (JSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. The 5-HTR2A receptor gene polymorphisms T102C and -1438G/A of were determined using polymerase chain reaction-restriction fragment length polymorphism. Job stress was significantly associated with sleep quality. High levels of job stress were linked to a higher risk of poor sleep quality compared to low or moderate levels [odds ratio (OR) = 2.909, 95% confidence interval (CI): 1.697–4.986]. High levels of stress may reduce subjects’ sleep quality, leading to an increase the likelihood of sleep disturbances and subsequent daytime dysfunction. The 5-HTR2A receptor gene polymorphism T102C was not significantly associated with sleep quality in this study, however, the -1438G/A polymorphism was significantly associated with sleep quality. The GG genotype of the -1438G/A polymorphism was linked to poorer sleep quality. When compared with subjects with low job-related stress levels×AG/AA genotype (OR = 2.106, 95% CI: 1.278–3.471), physicians with high job-related stress levels×GG genotype had a higher risk of experiencing poor sleep quality (OR = 13.400, 95% CI: 3.143–57.137). The findings of our study indicate that job stress and 5-HTR2A receptor gene polymorphisms are associated with sleep quality in physicians. Subjects with high job stress level or/and the -1438G/A GG genotype were more likely to report poor sleep quality, and furthermore, their combination effect on sleep quality was higher than their independent effects, so it may be suggested that job-related stress and genes have a cumulative effect on sleep quality; that is, stress can increase the risk of poor sleep quality, but this effect is worse in a group of people with specific gene polymorphisms. Full article

(This article belongs to the Special Issue Sleep Health)

► Show Figures

Figure 1

15 pages, 934 KiB

Open AccessArticle

An Empirical Study Analyzing Job Productivity in Toxic Workplace Environments

by Amna Anjum, Xu Ming, Ahmed Faisal Siddiqi and Samma Faiz Rasool

Int. J. Environ. Res. Public Health 2018, 15(5), 1035; https://doi.org/10.3390/ijerph15051035 - 21 May 2018

Cited by 89 | Viewed by 45716

Abstract

Purpose: This empirical study aims to determine the effects of a toxic workplace environment, which can negatively impact the job productivity of an employee. Methodology: Three hundred questionnaires were randomly distributed among the staff members of seven private universities in Pakistan with a [...] Read more.

Purpose: This empirical study aims to determine the effects of a toxic workplace environment, which can negatively impact the job productivity of an employee. Methodology: Three hundred questionnaires were randomly distributed among the staff members of seven private universities in Pakistan with a final response rate of 89%. For analysis purposes, AMOS 22 was used to study the direct and indirect effects of the toxic workplace environment on job productivity. Confirmatory Factor Analysis (CFA) was conducted to ensure the convergent and discriminant validity of the factors, while the Hayes mediation approach was used to verify the mediating role of job burnout between the four dimensions of toxic workplace environment and job productivity. A toxic workplace with multiple dimensions, such as workplace ostracism, workplace incivility, workplace harassment, and workplace bullying, was used in this study. Findings: By using the multiple statistical tools and techniques, it has been proven that ostracism, incivility, harassment, and bullying have direct negative significant effects on job productivity, while job burnout was shown to be a statistical significant mediator between the dimensions of a toxic workplace environment and job productivity. Finally, we concluded that organizations need to eradicate the factors of toxic workplace environments to ensure their prosperity and success. Practical Implications: This study encourages managers, leaders, and top management to adopt appropriate policies for enhancing employees’ productivity. Limitations: This study was conducted by using a cross-sectional research design. Future research aims to expand the study by using a longitudinal research design. Full article

(This article belongs to the Special Issue Workplace Health Promotion 2018)

► Show Figures

Figure 1

22 pages, 1024 KiB

Open AccessArticle

Home as a Place of Noise Control for the Elderly? A Cross-Sectional Study on Potential Mediating Effects and Associations between Road Traffic Noise Exposure, Access to a Quiet Side, Dwelling-Related Green and Noise Annoyance

by Natalie Riedel, Heike Köckler, Joachim Scheiner, Irene Van Kamp, Raimund Erbel, Adrian Loerbroks, Thomas Claßen and Gabriele Bolte

Int. J. Environ. Res. Public Health 2018, 15(5), 1036; https://doi.org/10.3390/ijerph15051036 - 21 May 2018

Cited by 23 | Viewed by 6338

Abstract

Urban residents’ need to be in control of their home environment can be constrained by perceived uncontrollability of exposure to road traffic noise. Noise annoyance may indicate a psychological stress reaction due to this uncontrollability perception, thereby undermining the restoration process. Environmental resources, [...] Read more.

Urban residents’ need to be in control of their home environment can be constrained by perceived uncontrollability of exposure to road traffic noise. Noise annoyance may indicate a psychological stress reaction due to this uncontrollability perception, thereby undermining the restoration process. Environmental resources, such as having access to a quiet side at home and dwelling-related green, may reduce noise annoyance both directly by shielding acoustically and indirectly by enhancing residents’ perceived noise control. We assessed the potential mediating role of perceived noise control in independent and joint associations of road traffic noise exposure (>65 dB L_den) and of an absent dwelling-related environmental resource (three indicators concerning quiet sides and one indicator concerning dwelling-related green) with noise annoyance. In our cross-sectional, questionnaire-based study on elderly urban citizens (N = 1812), we observed a statistically significant indirect effect of noise exposure on noise annoyance through perceived noise control (39%, 95%CI 26–55%). Statistical mediation between indicators of absent environmental resources and noise annoyance was weaker. The potential indirect effect was confirmed for combinations of noise exposure with each of the four indicators of an absent environmental resource. Our findings may call for mitigating noise levels while fostering quietness and green at residents’ homes. Full article

(This article belongs to the Special Issue Noise-Related Annoyance)

► Show Figures

Figure 1

14 pages, 6090 KiB

Open AccessArticle

Clinical Efficacy Associated with Enhanced Antioxidant Enzyme Activities of Silver Nanoparticles Biosynthesized Using Moringa oleifera Leaf Extract, Against Cutaneous Leishmaniasis in a Murine Model of Leishmania major

by Manal El-khadragy, Ebtesam M. Alolayan, Dina M. Metwally, Mohamed F. Serag El-Din, Sara S. Alobud, Nour I. Alsultan, Sarah S. Alsaif, Manal A. Awad and Ahmed E. Abdel Moneim

Int. J. Environ. Res. Public Health 2018, 15(5), 1037; https://doi.org/10.3390/ijerph15051037 - 22 May 2018

Cited by 70 | Viewed by 7116

Abstract

Leishmaniasis is one of the most significant vector-borne syndromes of individuals. This parasitic infection can be affected by many species of Leishmania, most of which are zoonotic. Natural products have made and are continuing to make important contributions to the search for new [...] Read more.

Leishmaniasis is one of the most significant vector-borne syndromes of individuals. This parasitic infection can be affected by many species of Leishmania, most of which are zoonotic. Natural products have made and are continuing to make important contributions to the search for new antileishmanial agents. The use of plants in the production assembly of silver nanoparticles has drawn attention because of its rapid, eco-friendly, non-pathogenic, economical protocol and provides a single step technique for the biosynthetic process. Hence, we aimed to biosynthesize silver nanoparticles (Ag-NPs) using Moringa oleifera leaf extract and investigated the antileishmanial activity of these nanoparticles in a murine model of Leishmania major infection. A total of 50 mice were used and divided into five groups—healthy control, infected, infected mice treated with pentostam, infected mice treated with Ag-NPs and infected mice pretreated with Ag-NPs. In the present study, the leaf extract of the plant species Moringa oleifera was found to be a good source for the synthesis of silver nanoparticles, their formation being confirmed by color change and stability in solution. In the present murine model of Leishmania major infection, we found that oral treatment with silver nanoparticles biosynthesized using Moringa oleifera extract resulted in a significant reduction in the average size of leishmaniasis cutaneous lesions compared with untreated mice. Furthermore, the clinical efficacy of Moringa oleifera extract was associated with enhanced antioxidant enzyme activities. In conclusion, treatment with silver nanoparticles biosynthesized using Moringa oleifera extract has higher and faster clinical efficacy than standard pentavalent antimonial treatment, probably by boosting the endogenous antioxidant activity. Full article

► Show Figures

Figure 1

14 pages, 1900 KiB

Open AccessArticle

The Impacts of Spatiotemporal Landscape Changes on Water Quality in Shenzhen, China

by Zhenhuan Liu and Haiyan Yang

Int. J. Environ. Res. Public Health 2018, 15(5), 1038; https://doi.org/10.3390/ijerph15051038 - 22 May 2018

Cited by 22 | Viewed by 4631

Abstract

The urban landscape in China has changed rapidly over the past four decades, which has led to various environmental consequences, such as water quality degradation at the regional scale. To improve water restoration strategies and policies, this study assessed the relationship between water [...] Read more.

The urban landscape in China has changed rapidly over the past four decades, which has led to various environmental consequences, such as water quality degradation at the regional scale. To improve water restoration strategies and policies, this study assessed the relationship between water quality and landscape change in Shenzhen, China, using panel regression analysis. The results show that decreases in natural and semi-natural landscape compositions have had significant negative effects on water quality. Landscape composition and configuration changes accounted for 39–58% of the variation in regional water quality degradation. Additionally, landscape fragmentation indices, such as patch density (PD) and the number of patches (NP), are important indicators of the drivers of water quality degradation. PD accounted for 2.03–5.44% of the variability in water quality, while NP accounted for −1.63% to −4.98% of the variability. These results indicate that reducing landscape fragmentation and enhancing natural landscape composition at the watershed scale are vital to improving regional water quality. The study findings suggest that urban landscape optimization is a promising strategy for mitigating urban water quality degradation, and the results can be used in policy making for the sustainable development of the hydrological environment in rapidly urbanizing areas. Full article

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

► Show Figures

Figure 1

15 pages, 1919 KiB

Open AccessArticle

Map Changes and Theme Evolution in Work Hours: A Co-Word Analysis

by Bei Liu, Hong Chen and Xinru Huang

Int. J. Environ. Res. Public Health 2018, 15(5), 1039; https://doi.org/10.3390/ijerph15051039 - 22 May 2018

Cited by 16 | Viewed by 4797

Abstract

(1) Background: Work hours are the basic carrier impacting employees’ work–life experience and organizational performance, and employees have greater anxiety in relation to work hours as new technology requires an increasingly faster work rhythm. However, scientific research on this topic lags far behind [...] Read more.

(1) Background: Work hours are the basic carrier impacting employees’ work–life experience and organizational performance, and employees have greater anxiety in relation to work hours as new technology requires an increasingly faster work rhythm. However, scientific research on this topic lags far behind the practice, calling to attention the need for research on work hours from the perspective of historical evolution; (2) Methods: The Bibliometric method is used to analyze the 6364 articles and their contained 77 high-frequency keywords related to work hours from the Web of Science published between 1901 and 2017. Additionally, an individual–organization–society integrative perspective was adopted to describe the map changes and theme evolution of work hours; (3) Results and conclusions: The hot spots of research at the organizational level changed significantly around 1990, with the theme of “long work hours” becoming the core issue in recent years. Studies on the individual level have gradually moved from physiological aspects to the issues of burnout and psychological distress. Research topics related to the social level are somewhat loose, and mainly focused on work–life conflict areas. In addition, the cluster analysis based on the high-frequency keywords classifies six research types according to their research themes. Based on these findings, future trends are proposed to provide theoretical and practical reference for future studies. Full article

(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)

► Show Figures

Figure 1

15 pages, 2021 KiB

Open AccessArticle

Human Health Risk Assessment of Toxic Elements in Farmland Topsoil with Source Identification in Jilin Province, China

by Fengxu Li, Jiquan Zhang, Tiehua Cao, Sijia Li, Yanan Chen, Xuanhe Liang, Xin Zhao and Junwei Chen

Int. J. Environ. Res. Public Health 2018, 15(5), 1040; https://doi.org/10.3390/ijerph15051040 - 22 May 2018

Cited by 22 | Viewed by 5455

Abstract

The presence of toxic elements in agricultural soils from anthropogenic activities is a potential threat to human health through the food chain. In this study, the concentration of toxic elements in 122 agricultural topsoil composite samples were determined in order to study the [...] Read more.

The presence of toxic elements in agricultural soils from anthropogenic activities is a potential threat to human health through the food chain. In this study, the concentration of toxic elements in 122 agricultural topsoil composite samples were determined in order to study the current status, identify their sources and assess the level of pollution and human health risk. The results showed that the mean concentrations of Zn, Cu, Pb, Cd, Hg and As in the farmland topsoil were 21.72, 15.09, 36.08, 0.2451, 0.0378 and 4.957 mg·kg⁻¹, respectively. The spatial distribution showed that the soils were mainly contaminated by Cd, Pb and Hg in midwest Jilin but by Cu and As in the east. According to the pollution index (Pi), Nemerow integrated pollution index (PN) and Geo-Accumulation Index (I_geo), Cd and Pb were the main pollutants in the soils. The occurrence of these elements was caused by anthropogenic activities and they were concentrated in the Songyuan-Changchun-Siping economic belt. There is limited non-carcinogenic and carcinogenic health risk to humans. Principal component analyses suggest the Pb, Cd and Hg soil contamination was mainly derived from anthropogenic activities in the Midwest, but all examined toxic elements in the east were mainly due to geogenic anomalies and came from atmospheric deposition. Full article

(This article belongs to the Collection Environmental Risk Assessment)

► Show Figures

Figure 1

16 pages, 6392 KiB

Open AccessArticle

Identifying the Driving Factors of Water Quality in a Sub-Watershed of the Republican River Basin, Kansas USA

by Morgen W. V. Burke, Mojtaba Shahabi, Yeqian Xu, Haochi Zheng, Xiaodong Zhang and Jeffrey VanLooy

Int. J. Environ. Res. Public Health 2018, 15(5), 1041; https://doi.org/10.3390/ijerph15051041 - 22 May 2018

Cited by 9 | Viewed by 4463

Abstract

Studies have shown that the agricultural expansion and land use changes in the Midwest of the U.S. are major drivers for increased nonpoint source pollution throughout the regional river systems. In this study, we empirically examined the relationship of planted area and production [...] Read more.

Studies have shown that the agricultural expansion and land use changes in the Midwest of the U.S. are major drivers for increased nonpoint source pollution throughout the regional river systems. In this study, we empirically examined the relationship of planted area and production of three dominant crops with nitrate flux in the Republican River, Kansas, a sub-watershed of Mississippi River Basin. Our results show that land use in the region could not explain the observed changes in nitrate flux in the river. Instead, after including explanatory variables such as precipitation, growing degree days, and well water irrigation in the regression model we found that irrigation and spring precipitation could explain >85% of the variability in nitrate flux from 2000 to 2014. This suggests that changes in crop acreage and production alone cannot explain variability in nitrate flux. Future agricultural policy for the region should focus on controlling both the timing and amount of fertilizer applied to the field to reduce the potential leaching of excess fertilizer through spring time runoff and/or over-irrigation into nearby river systems. Full article

(This article belongs to the Special Issue Non-Point Source Pollution and Environmental Assessment)

► Show Figures

Figure 1

14 pages, 1454 KiB

Open AccessArticle

Effect of Sewage Irrigation on the CT-Measured Soil Pore Characteristics of a Clay Farmland in Northern China

by Xiaoming Guo, Tongqian Zhao, Lin Liu, Chunyan Xiao and Yuxiao He

Int. J. Environ. Res. Public Health 2018, 15(5), 1043; https://doi.org/10.3390/ijerph15051043 - 22 May 2018

Cited by 20 | Viewed by 4525

Abstract

Sewage irrigation has a strong influence on the physical, chemical, and biological properties of soil. However, the effects of sewage irrigation on the pore characteristics of soil are not well understood. This study compares the effects of sewage irrigation and groundwater irrigation on [...] Read more.

Sewage irrigation has a strong influence on the physical, chemical, and biological properties of soil. However, the effects of sewage irrigation on the pore characteristics of soil are not well understood. This study compares the effects of sewage irrigation and groundwater irrigation on computed tomography (CT)-measured pore parameters and examines the relationships between CT-measured pore parameters and soil physicochemical and microbial properties. Intact soil cores were collected from S1 irrigated with sewage for 25 years, S2 irrigated with sewage for 52 years, and CK irrigated with groundwater. Various soil pore characteristics were determined, including the total pore number, macropore number (>1 mm diam.), coarse mesopore number (0.264–1 mm diam.), total porosity, macroporosity, coarse mesoporosity, and circularity. The results indicated that sewage irrigation significantly affected soil pore number and porosity. Compared with S1 and S2, CK exhibited a higher average total pore number (91), macropore number (40), coarse mesopore number (51), total porosity (2.08%), macroporosity (1.90%), and coarse mesoporosity (0.18%) throughout the 50–350 mm layer. At depths of 200–350 mm, S2 exhibited the lowest average total pore number (33), macropore number (13), coarse mesopore number (21), total porosity (0.42%), macroporosity (0.35%), and coarse mesoporosity (0.07%) among the three sites. In addition, the average pore numbers and porosity at depths of 200–350 mm decreased with increasing sewage irrigation time. There were significant positive correlations between pore features (including pore numbers and porosity) and soil properties (phosphorus content and fungi numbers). Our results suggest that decreased macropore numbers and macroporosity in the sewage-irrigated farmland may strongly intensify the accumulation of metals and nutrients in the upper layer. The findings of this study are useful for understanding the negative effects of sewage irrigation on soil pore structure and are critical for developing sustainable strategies in agriculture. Full article

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

► Show Figures

Figure 1

17 pages, 347 KiB

Open AccessArticle

The Social Basis of Vaccine Questioning and Refusal: A Qualitative Study Employing Bourdieu’s Concepts of ‘Capitals’ and ‘Habitus’

by Katie Attwell, Samantha B. Meyer and Paul R. Ward

Int. J. Environ. Res. Public Health 2018, 15(5), 1044; https://doi.org/10.3390/ijerph15051044 - 22 May 2018

Cited by 41 | Viewed by 9409

Abstract

This article is an in-depth analysis of the social nature of vaccine decision-making. It employs the sociological theory of Bourdieu and Ingram to consider how parents experience non-vaccination as a valued form of capital in specific communities, and how this can affect their [...] Read more.

This article is an in-depth analysis of the social nature of vaccine decision-making. It employs the sociological theory of Bourdieu and Ingram to consider how parents experience non-vaccination as a valued form of capital in specific communities, and how this can affect their decision-making. Drawing on research conducted in two Australian cities, our qualitative analysis of new interview data shows that parents experience disjuncture and tugs towards ‘appropriate’ forms of vaccination behavior in their social networks, as these link to broader behaviors around food, school choices and birth practices. We show how differences emerge between the two cities based on study designs, such that we are able to see some parents at the center of groups valorizing their decisions, whilst others feel marginalized within their communities for their decisions to vaccinate. We draw on the work of philosopher Mark Navin to consider how all parents join epistemic communities that reward compliance and conformity with the status quo and consider what this means for interventions that seek to influence the flow of pro-vaccine information through vaccine-critical social groups. Full article

(This article belongs to the Special Issue Interventions and Approaches to Optimize Immunization Coverage Across the Lifespan)

18 pages, 956 KiB

Open AccessArticle

Association of Plasma Lipids and Polar Metabolites with Low Bone Mineral Density in Singaporean-Chinese Menopausal Women: A Pilot Study

by Diana Cabrera, Marlena Kruger, Frances M. Wolber, Nicole C. Roy, John J. Totman, Christiani Jeyakumar Henry, David Cameron-Smith and Karl Fraser

Int. J. Environ. Res. Public Health 2018, 15(5), 1045; https://doi.org/10.3390/ijerph15051045 - 22 May 2018

Cited by 37 | Viewed by 5225

Abstract

The diagnosis of osteoporosis is mainly based on clinical examination and bone mineral density assessments. The present pilot study compares the plasma lipid and polar metabolite profiles in blood plasma of 95 Singaporean-Chinese (SC) menopausal women with normal and low bone mineral density [...] Read more.

The diagnosis of osteoporosis is mainly based on clinical examination and bone mineral density assessments. The present pilot study compares the plasma lipid and polar metabolite profiles in blood plasma of 95 Singaporean-Chinese (SC) menopausal women with normal and low bone mineral density (BMD) using an untargeted metabolomic approach. The primary finding of this study was the association between lipids and femoral neck BMD in SC menopausal women. Twelve lipids were identified to be associated with low BMD by the orthogonal partial least squares (OPLS) model. Plasma concentrations of eight glycerophospholipid, glycerolipid, and sphingolipid species were significantly lower in menopausal women with low BMD but higher in two glycerophospholipid species (phosphatidylinositol and phosphatidic acid). Further, this study found no significant differences in plasma amino acid metabolites. However, trends for lower 4-aminobutyric acid, turanose, proline, aminopropionitrile, threonine, and methionine were found in women with low BMD. This pilot study identified associations between lipid metabolism and femoral neck BMD in SC women. Further studies are required on larger populations for evaluating the bone health effect of these compounds and their usefulness as clinical biomarkers for osteoporosis prediction in women. Full article

(This article belongs to the Special Issue New Concepts in Women’s Bone Health)

► Show Figures

Figure 1

14 pages, 351 KiB

Open AccessArticle

Nursing Intervention Practices for Smoking Cessation: A Large Survey in Hong Kong

by Yim Wah Mak, Alice Yuen Loke and Frances K. Y. Wong

Int. J. Environ. Res. Public Health 2018, 15(5), 1046; https://doi.org/10.3390/ijerph15051046 - 22 May 2018

Cited by 26 | Viewed by 8935

Abstract

Previous studies have shown that nursing interventions are effective in helping people to stop smoking, but that the participation of nurses in tobacco control activities has been far from satisfactory. The primary objective of this study is to identify factors that encourage or [...] Read more.

Previous studies have shown that nursing interventions are effective in helping people to stop smoking, but that the participation of nurses in tobacco control activities has been far from satisfactory. The primary objective of this study is to identify factors that encourage or discourage nurses from participating in providing smoking-cessation interventions to their clients, based on the 5 A’s (ask, advise, assess, assist, arrange) framework. A cross-sectional survey was conducted among 4413 nurses in Hong Kong from different clinical specialties. A logistics regression analysis found that predictors for the practicing of all of the 5 A’s are nurses who want to receive training in smoking-cessation interventions, those who have received such training, and those who are primarily working in a medical unit or in ambulatory/outpatient settings. The regression model also showed that attitude towards smoking cessation was positively associated with all of the 5 A’s. The results indicate a need to encourage and provide nurses with opportunities to receive training on smoking-cessation interventions. Strategies to persuade nurses to provide smoking-cessation interventions are also important, since nurses are motivated to perform smoking-cessation interventions when they feel a stronger sense of mission to control tobacco use. Full article

11 pages, 346 KiB

Open AccessArticle

Prevalence and Risk Factors for Hepatitis B Virus Infection in Roma and Non-Roma People in Slovakia

by Sylvia Drazilova, Martin Janicko, Pavol Kristian, Ivan Schreter, Monika Halanova, Ingrid Urbancikova, Andrea Madarasova-Geckova, Maria Marekova, Daniel Pella, Peter Jarcuska and HepaMeta Team

Int. J. Environ. Res. Public Health 2018, 15(5), 1047; https://doi.org/10.3390/ijerph15051047 - 22 May 2018

Cited by 16 | Viewed by 5407

Abstract

Prevalence of Hepatitis B is relatively low in developed European countries. However specific subpopulations may exist within each country with markedly different Hepatitis B burden. Roma minority is very numerous in Slovakia and their lifestyle is completely different to non-Roma population. The aim [...] Read more.

Prevalence of Hepatitis B is relatively low in developed European countries. However specific subpopulations may exist within each country with markedly different Hepatitis B burden. Roma minority is very numerous in Slovakia and their lifestyle is completely different to non-Roma population. The aim of this study is to map Hepatitis B prevalence in Roma and compare it to non-Roma population and to explore potential socio-economic and health related risk factors. Cross-sectional epidemiology study was performed in Slovakia that included randomly sampled Roma population and geographically corresponding random sampled non-Roma population. Comprehensive questionnaire about risk factors was administered and blood samples were drawn for Hepatitis B serology and virology tests. Altogether 855 participants were included. Global Hepatitis B surface Antigen (HBsAg) positivity rate was 7.7% (i.e., active Hepatitis B) and anti Hepatitis B core IgG antibody (antiHBcIgG) positivity rate was 34.6%. Roma population had significantly higher prevalence of Hepatitis B, both active chronic infection (12.4%; 95% Confidence Interval (CI) 9.58%–15.97% versus 2.8%; 95% CI 1.56%–4.91%; p < 0.0001) and antiHBcIgG positivity (52.8%; 95% CI 48.17%–57.44% versus 25.9%; 95% CI 12.56%–20.02%; p < 0.0001) Main risk factors for HBsAg positivity were Roma ethnicity, male sex and tattoo. Conclusion: There is a very high prevalence of Hepatitis B in Roma communities in Slovakia, with potential for grave medical consequences. Full article

(This article belongs to the Special Issue Roma Health)

15 pages, 4342 KiB

Open AccessArticle

Reconciling the Entomological Hazard and Disease Risk in the Lyme Disease System

by Max McClure and Maria Diuk-Wasser

Int. J. Environ. Res. Public Health 2018, 15(5), 1048; https://doi.org/10.3390/ijerph15051048 - 22 May 2018

Cited by 26 | Viewed by 5933

Abstract

Lyme disease (LD) is a commonly cited model for the link between habitat loss and/or fragmentation and disease emergence, based in part on studies showing that forest patch size is negatively related to LD entomological risk. An equivalent relationship has not, however, been [...] Read more.

Lyme disease (LD) is a commonly cited model for the link between habitat loss and/or fragmentation and disease emergence, based in part on studies showing that forest patch size is negatively related to LD entomological risk. An equivalent relationship has not, however, been shown between patch size and LD incidence (LDI). Because entomological risk is measured at the patch scale, while LDI is generally assessed in relation to aggregate landscape statistics such as forest cover, we posit that the contribution of individual patches to human LD risk has not yet been directly evaluated. We design a model that directly links theoretical entomological risk at the patch scale to larger-scale epidemiological data. We evaluate its predictions for relative LD risk in artificial landscapes with varying composition and configuration, and test its ability to predict countywide LDI in a 12-county region of New York. On simulated landscapes, we find that the model predicts a unimodal relationship between LD incidence and forest cover, mean patch size, and mean minimum distance (a measure of isolation), and a protective effect for percolation probability (a measure of connectivity). In New York, risk indices generated by this model are significantly related to countywide LDI. The results suggest that the lack of concordance between entomological risk and LDI may be partially resolved by this style of model. Full article

(This article belongs to the Special Issue Emergence of Tick-Borne Diseases Resulting from Human Landscape Change)

► Show Figures

Figure 1

11 pages, 765 KiB

Open AccessCommunication

From Evidence-Based Research to Practice-Based Evidence: Disseminating a Web-Based Computer-Tailored Workplace Sitting Intervention through a Health Promotion Organisation

by Katrien De Cocker, Greet Cardon, Jason A. Bennie, Tracy Kolbe-Alexander, Femke De Meester and Corneel Vandelanotte

Int. J. Environ. Res. Public Health 2018, 15(5), 1049; https://doi.org/10.3390/ijerph15051049 - 22 May 2018

Cited by 6 | Viewed by 5598

Abstract

Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts [...] Read more.

Prolonged sitting has been linked to adverse health outcomes; therefore, we developed and examined a web-based, computer-tailored workplace sitting intervention. As we had previously shown good effectiveness, the next stage was to conduct a dissemination study. This study reports on the dissemination efforts of a health promotion organisation, associated costs, reach achieved, and attributes of the website users. The organisation systematically registered all the time and resources invested to promote the intervention. Website usage statistics (reach) and descriptive statistics (website users’ attributes) were also assessed. Online strategies (promotion on their homepage; sending e-mails, newsletters, Twitter, Facebook and LinkedIn posts to professional partners) were the main dissemination methods. The total time investment was 25.6 h, which cost approximately 845 EUR in salaries. After sixteen months, 1599 adults had visited the website and 1500 (93.8%) completed the survey to receive personalized sitting advice. This sample was 38.3 ± 11.0 years, mainly female (76.9%), college/university educated (89.0%), highly sedentary (88.5% sat >8 h/day) and intending to change (93.0%) their sitting. Given the small time and money investment, these outcomes are positive and indicate the potential for wide-scale dissemination. However, more efforts are needed to reach men, non-college/university educated employees, and those not intending behavioural change. Full article

(This article belongs to the Special Issue Sedentary Behaviour and Health)

► Show Figures

Figure 1

Review

Jump to: Editorial, Research, Other

19 pages, 817 KiB

Open AccessReview

Furthering the Evidence of the Effectiveness of Employment Strategies for People with Mental Disorders in Europe: A Systematic Review

by Amalia Muñoz-Murillo, Eva Esteban, Carolina C. Ávila, Klemens Fheodoroff, Josep Maria Haro, Matilde Leonardi and Beatriz Olaya

Int. J. Environ. Res. Public Health 2018, 15(5), 838; https://doi.org/10.3390/ijerph15050838 - 24 Apr 2018

Cited by 10 | Viewed by 5084

Abstract

(1) Purpose: This systematic review aims to assess the effectiveness of strategies used in the professional (re)integration of persons with mental disorders (MD) in European countries; (2) Methods: We conducted a search for scientific publications available in relevant electronic databases (Medline, PsycINFO, CDR-HTA, [...] Read more.

(1) Purpose: This systematic review aims to assess the effectiveness of strategies used in the professional (re)integration of persons with mental disorders (MD) in European countries; (2) Methods: We conducted a search for scientific publications available in relevant electronic databases (Medline, PsycINFO, CDR-HTA, CDR-DARE, and Cochrane Library). The present study collected evidence on the effectiveness, from 2011 to 2016, of employment strategies for persons with MDs; (3) Results: A total of 18 studies were included, representing 5216 participants (aged 18–65, mean age of 38.5 years old) from 7 countries. Job access programs demonstrated effectiveness in four out of six studies. Return to work (RTW) interventions showed significant positive results in two studies, while four studies did not refer to effectiveness. There were inconsistent results in another four studies; (4) Conclusions: Our findings highlight the complexities of the implementation of employment strategies (job access and return to work). Job access strategies seem to improve employment outcomes. The effectiveness of return to work strategies remains unclear. The involvement and commitment of physicians, employment specialists, and employers, and employees capacity for self-care seem decisive for employment re-integration success. Further analyses are needed to assess the cost-effectiveness of these interventions and corroborate our results, with longer follow-ups. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

► Show Figures

Figure 1

12 pages, 637 KiB

Open AccessReview

Maternal Vaccination as an Essential Component of Life-Course Immunization and Its Contribution to Preventive Neonatology

by Naomi Bergin, Janice Murtagh and Roy K. Philip

Int. J. Environ. Res. Public Health 2018, 15(5), 847; https://doi.org/10.3390/ijerph15050847 - 25 Apr 2018

Cited by 32 | Viewed by 7232

Abstract

Maternal immunisation schedules are increasingly coming under the spotlight as part of the development of lifetime immunisation programmes for the role that they play in improving maternal, foetal, and neonatal health. Maternally-acquired antibodies are critical in protecting infants during the first months of [...] Read more.

Maternal immunisation schedules are increasingly coming under the spotlight as part of the development of lifetime immunisation programmes for the role that they play in improving maternal, foetal, and neonatal health. Maternally-acquired antibodies are critical in protecting infants during the first months of their lives. Maternal immunisation was previously overlooked owing to concerns regarding vaccinations in this untested and high-risk population but is now acknowledged for its potential impact on the outcomes in many domains of foetal and neonatal health, aside from its maternal benefits. This article highlights the role that maternal immunisation may play in reducing infections in preterm and term infants. It explores the barriers to antenatal vaccinations and the optimisation of the immunisation uptake. This review also probes the part that maternal immunisation may hold in the reduction of perinatal antimicrobial resistance and the prevention of non-infectious diseases. Both healthcare providers and expectant mothers should continue to be educated on the importance and safety of the appropriate immunizations during pregnancy. Maternal vaccination merits its deserved priority in a life-course immunization approach and it is perhaps the only immunization whereby two generations benefit directly from a single input. We outline the current recommendations for antenatal vaccinations and highlight the potential advances in the field contributing to “preventive neonatology”. Full article

(This article belongs to the Special Issue Interventions and Approaches to Optimize Immunization Coverage Across the Lifespan)

► Show Figures

Figure 1

32 pages, 880 KiB

Open AccessReview

PALTEM: What Parameters Should Be Collected in Disaster Settings to Assess the Long-Term Outcomes of Famine?

by Alexandra Moraru, Maria Moitinho De Almeida and Jean-Marie Degryse

Int. J. Environ. Res. Public Health 2018, 15(5), 857; https://doi.org/10.3390/ijerph15050857 - 25 Apr 2018

Cited by 7 | Viewed by 5056

Abstract

Evidence suggests that nutritional status during fetal development and early life leaves an imprint on the genome, which leads to health outcomes not only on a person as an adult but also on his offspring. The purpose of this study is to bring [...] Read more.

Evidence suggests that nutritional status during fetal development and early life leaves an imprint on the genome, which leads to health outcomes not only on a person as an adult but also on his offspring. The purpose of this study is to bring forth an overview of the relevant parameters that need to be collected to assess the long-term and transgenerational health outcomes of famine. A literature search was conducted for the most pertinent articles on the epigenetic effects of famine. The results were compiled, synthesized and discussed with an expert in genetics for critical input and validation. Prenatal and early life exposure to famine was associated with metabolic, cardiovascular, respiratory, reproductive, neuropsychiatric and oncologic diseases. We propose a set of parameters to be collected in disaster settings to assess the long-term outcomes of famine: PALTEM (parameters to assess long-term effects of malnutrition). Full article

(This article belongs to the Special Issue Dietary Exposures)

► Show Figures

Figure 1

28 pages, 6233 KiB

Open AccessReview

Campylobacteriosis, Salmonellosis, Yersiniosis, and Listeriosis as Zoonotic Foodborne Diseases: A Review

by Agnieszka Chlebicz and Katarzyna Śliżewska

Int. J. Environ. Res. Public Health 2018, 15(5), 863; https://doi.org/10.3390/ijerph15050863 - 26 Apr 2018

Cited by 421 | Viewed by 27762

Abstract

Zoonoses are diseases transmitted from animals to humans, posing a great threat to the health and life of people all over the world. According to WHO estimations, 600 million cases of diseases caused by contaminated food were noted in 2010, including almost 350 [...] Read more.

Zoonoses are diseases transmitted from animals to humans, posing a great threat to the health and life of people all over the world. According to WHO estimations, 600 million cases of diseases caused by contaminated food were noted in 2010, including almost 350 million caused by pathogenic bacteria. Campylobacter, Salmonella, as well as Yersinia enterocolitica and Listeria monocytogenes may dwell in livestock (poultry, cattle, and swine) but are also found in wild animals, pets, fish, and rodents. Animals, often being asymptomatic carriers of pathogens, excrete them with faeces, thus delivering them to the environment. Therefore, pathogens may invade new individuals, as well as reside on vegetables and fruits. Pathogenic bacteria also penetrate food production areas and may remain there in the form of a biofilm covering the surfaces of machines and equipment. A common occurrence of microbes in food products, as well as their improper or careless processing, leads to common poisonings. Symptoms of foodborne infections may be mild, sometimes flu-like, but they also may be accompanied by severe complications, some even fatal. The aim of the paper is to summarize and provide information on campylobacteriosis, salmonellosis, yersiniosis, and listeriosis and the aetiological factors of those diseases, along with the general characteristics of pathogens, virulence factors, and reservoirs. Full article

► Show Figures

Figure 1

25 pages, 2606 KiB

Open AccessReview

A Systematic Review of the Time Series Studies Addressing the Endemic Risk of Acute Gastroenteritis According to Drinking Water Operation Conditions in Urban Areas of Developed Countries

by Pascal Beaudeau

Int. J. Environ. Res. Public Health 2018, 15(5), 867; https://doi.org/10.3390/ijerph15050867 - 26 Apr 2018

Cited by 13 | Viewed by 5783

Abstract

Time series studies (TSS) can be viewed as an inexpensive way to tackle the non-epidemic health risk from fecal pathogens in tap water in urban areas. Following the PRISMA recommendations, I reviewed TSS addressing the endemic risk of acute gastroenteritis risk according to [...] Read more.

Time series studies (TSS) can be viewed as an inexpensive way to tackle the non-epidemic health risk from fecal pathogens in tap water in urban areas. Following the PRISMA recommendations, I reviewed TSS addressing the endemic risk of acute gastroenteritis risk according to drinking water operation conditions in urban areas of developed countries. Eighteen studies were included, covering 17 urban sites (seven in North-America and 10 in Europe) with study populations ranging from 50,000 to 9 million people. Most studies used general practitioner consultations or visits to hospitals for acute gastroenteritis (AGE) as health outcomes. In 11 of the 17 sites, a significant and plausible association was found between turbidity (or particle count) in finished water and the AGE indicator. When provided and significant, the interquartile excess of relative risk estimates ranged from 3–13%. When examined, water temperature, river flow, and produced flow were strongly associated with the AGE indicator. The potential of TSS for the study of the health risk from fecal pathogens in tap water is limited by the lack of specificity of turbidity and its site-sensitive value as an exposure proxy. Nevertheless, at the DWS level, TSS could help water operators to identify operational conditions most at risk, almost if considering other water operation indicators, in addition to turbidity, as possible relevant proxies for exposure. Full article

(This article belongs to the Special Issue Drinking Water Quality and Human Health)

► Show Figures

Figure 1

17 pages, 2364 KiB

Open AccessReview

Exercise Early and Often: Effects of Physical Activity and Exercise on Women’s Bone Health

by Karen L. Troy, Megan E. Mancuso, Tiffiny A. Butler and Joshua E. Johnson

Int. J. Environ. Res. Public Health 2018, 15(5), 878; https://doi.org/10.3390/ijerph15050878 - 28 Apr 2018

Cited by 130 | Viewed by 29870

Abstract

In 2011 over 1.7 million people were hospitalized because of a fragility fracture, and direct costs associated with osteoporosis treatment exceeded 70 billion dollars in the United States. Failure to reach and maintain optimal peak bone mass during adulthood is a critical factor [...] Read more.

In 2011 over 1.7 million people were hospitalized because of a fragility fracture, and direct costs associated with osteoporosis treatment exceeded 70 billion dollars in the United States. Failure to reach and maintain optimal peak bone mass during adulthood is a critical factor in determining fragility fracture risk later in life. Physical activity is a widely accessible, low cost, and highly modifiable contributor to bone health. Exercise is especially effective during adolescence, a time period when nearly 50% of peak adult bone mass is gained. Here, we review the evidence linking exercise and physical activity to bone health in women. Bone structure and quality will be discussed, especially in the context of clinical diagnosis of osteoporosis. We review the mechanisms governing bone metabolism in the context of physical activity and exercise. Questions such as, when during life is exercise most effective, and what specific types of exercises improve bone health, are addressed. Finally, we discuss some emerging areas of research on this topic, and summarize areas of need and opportunity. Full article

(This article belongs to the Special Issue New Concepts in Women’s Bone Health)

► Show Figures

Figure 1

15 pages, 3471 KiB

Open AccessReview

Lifestyle Interventions for People with, and at Risk of Type 2 Diabetes in Polynesian Communities: A Systematic Review and Meta-Analysis

by Dorothy W. Ndwiga, Freya MacMillan, Kate A. McBride and David Simmons

Int. J. Environ. Res. Public Health 2018, 15(5), 882; https://doi.org/10.3390/ijerph15050882 - 28 Apr 2018

Cited by 12 | Viewed by 5926

Abstract

There is evidence that lifestyle intervention among Polynesian people can reduce diabetes incidence and complications, but this evidence has not been systematically reviewed. The aim of this study was to systematically review the efficacy of lifestyle interventions, targeting the prevention and management of [...] Read more.

There is evidence that lifestyle intervention among Polynesian people can reduce diabetes incidence and complications, but this evidence has not been systematically reviewed. The aim of this study was to systematically review the efficacy of lifestyle interventions, targeting the prevention and management of type 2 diabetes among Polynesian people. MEDLINE, Web of Science, Cochrane Library, and Embase were searched to find randomised controlled trials (RCTs) and pre-post studies. Eight studies (four RCTs and four pre-post studies) with 1590 participants met the inclusion criteria. The data on health outcomes that was reported in these studies included blood pressure, body mass index, waist circumference, weight, and glycated haemoglobin (HbA1c). The meta-analyses showed that the interventions had resulted in statistically significant reductions in systolic blood pressure (SBP) across four of the studies (WMD, −9.93 mmHg; 95% Cl, −10.77 to −9.09; and p < 0.00001). However, the effects on weight across five of the studies (WMD, −1.15 kg; 95% Cl, −2.80 to 0.51; p = 0.18) and the HbA1c levels across two of the studies (WMD, −0.38%; 95% Cl, −1.15 to 0.39; and p = 0.33) were not statistically significant. This review provides evidence that lifestyle interventions may be effective in achieving modest reductions in SBP in Polynesian people. Further research is needed to fully assess the effectiveness of these interventions in this population long-term. Full article

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

► Show Figures

Figure 1

36 pages, 2238 KiB

Open AccessReview

A Review of Environmental Contamination and Health Risk Assessment of Wastewater Use for Crop Irrigation with a Focus on Low and High-Income Countries

by Sana Khalid, Muhammad Shahid, Natasha, Irshad Bibi, Tania Sarwar, Ali Haidar Shah and Nabeel Khan Niazi

Int. J. Environ. Res. Public Health 2018, 15(5), 895; https://doi.org/10.3390/ijerph15050895 - 1 May 2018

Cited by 313 | Viewed by 18907

Abstract

Population densities and freshwater resources are not evenly distributed worldwide. This has forced farmers to use wastewater for the irrigation of food crops. This practice presents both positive and negative effects with respect to agricultural use, as well as in the context of [...] Read more.

Population densities and freshwater resources are not evenly distributed worldwide. This has forced farmers to use wastewater for the irrigation of food crops. This practice presents both positive and negative effects with respect to agricultural use, as well as in the context of environmental contamination and toxicology. Although wastewater is an important source of essential nutrients for plants, many environmental, sanitary, and health risks are also associated with the use of wastewater for crop irrigation due to the presence of toxic contaminants and microbes. This review highlights the harmful and beneficial impacts of wastewater irrigation on the physical, biological, and chemical properties of soil (pH, cations and anions, organic matter, microbial activity). We delineate the potentially toxic element (PTEs) build up in the soil and, as such, their transfer into plants and humans. The possible human health risks associated with the use of untreated wastewater for crop irrigation are also predicted and discussed. We compare the current condition of wastewater reuse in agriculture and the associated environmental and health issues between developing and developed countries. In addition, some integrated sustainable solutions and future perspectives are also proposed, keeping in view the regional and global context, as well as the grounded reality of wastewater use for crop production, sanitary and planning issues, remedial techniques, awareness among civil society, and the role of the government and the relevant stakeholders. Full article

(This article belongs to the Special Issue Studies on Heavy Metals and Health)

► Show Figures

Graphical abstract

21 pages, 527 KiB

Open AccessReview

Neighbourhood Built Environment Influences on Physical Activity among Adults: A Systematized Review of Qualitative Evidence

by Grazia Salvo, Bonnie M. Lashewicz, Patricia K. Doyle-Baker and Gavin R. McCormack

Int. J. Environ. Res. Public Health 2018, 15(5), 897; https://doi.org/10.3390/ijerph15050897 - 2 May 2018

Cited by 130 | Viewed by 12827

Abstract

Qualitative studies can provide important information about how and why the built environment impacts physical activity decision-making—information that is important for informing local urban policies. We undertook a systematized literature review to synthesize findings from qualitative studies exploring how the built environment influences [...] Read more.

Qualitative studies can provide important information about how and why the built environment impacts physical activity decision-making—information that is important for informing local urban policies. We undertook a systematized literature review to synthesize findings from qualitative studies exploring how the built environment influences physical activity in adults. Our review included 36 peer-reviewed qualitative studies published from 1998 onwards. Our findings complemented existing quantitative evidence and provided additional insight into how functional, aesthetic, destination, and safety built characteristics influence physical activity decision-making. Sociodemographic characteristics (age, sex, ethnicity, and socioeconomic status) also impacted the BE’s influence on physical activity. Our review findings reinforce the need for synergy between transportation planning, urban design, landscape architecture, road engineering, parks and recreation, bylaw enforcement, and public health to be involved in creating neighbourhood environments that support physical activity. Our findings support a need for local neighbourhood citizens and associations with representation from individuals and groups with different sociodemographic backgrounds to have input into neighbourhood environment planning process. Full article

► Show Figures

Figure 1

16 pages, 1415 KiB

Open AccessReview

Aluminum Adjuvant-Containing Vaccines in the Context of the Hygiene Hypothesis: A Risk Factor for Eosinophilia and Allergy in a Genetically Susceptible Subpopulation?

by Todd D. Terhune and Richard C. Deth

Int. J. Environ. Res. Public Health 2018, 15(5), 901; https://doi.org/10.3390/ijerph15050901 - 3 May 2018

Cited by 18 | Viewed by 8494

Abstract

There are similarities between the immune response following immunization with aluminum adjuvants and the immune response elicited by some helminthic parasites, including stimulation of immunoglobulin E (IgE) and eosinophilia. Immunization with aluminum adjuvants, as with helminth infection, induces a Th2 type cell mediated [...] Read more.

There are similarities between the immune response following immunization with aluminum adjuvants and the immune response elicited by some helminthic parasites, including stimulation of immunoglobulin E (IgE) and eosinophilia. Immunization with aluminum adjuvants, as with helminth infection, induces a Th2 type cell mediated immune response, including eosinophilia, but does not induce an environment conducive to the induction of regulatory mechanisms. Helminths play a role in what is known as the hygiene hypothesis, which proposes that decreased exposure to microbes during a critical time in early life has resulted in the increased prevalence and morbidity of asthma and atopic disorders over the past few decades, especially in Western countries. In addition, gut and lung microbiome composition and their interaction with the immune system plays an important role in a properly regulated immune system. Disturbances in microbiome composition are a risk factor for asthma and allergies. We propose that immunization with aluminum adjuvants in general is not favorable for induction of regulatory mechanisms and, in the context of the hygiene hypothesis and microbiome theory, can be viewed as an amplifying factor and significant contributing risk factor for allergic diseases, especially in a genetically susceptible subpopulation. Full article

(This article belongs to the Special Issue Vaccination and Health Outcomes)

► Show Figures

Figure 1

22 pages, 1124 KiB

Open AccessReview

Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review

by Genevieve C. Lai, Emma V. Taylor, Margaret M. Haigh and Sandra C. Thompson

Int. J. Environ. Res. Public Health 2018, 15(5), 914; https://doi.org/10.3390/ijerph15050914 - 4 May 2018

Cited by 58 | Viewed by 20782

Abstract

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of [...] Read more.

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change. Full article

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

► Show Figures

Figure 1

23 pages, 710 KiB

Open AccessReview

Are Differences in Physical Activity across Socioeconomic Groups Associated with Choice of Physical Activity Variables to Report?

by Ragna Stalsberg and Arve Vorland Pedersen

Int. J. Environ. Res. Public Health 2018, 15(5), 922; https://doi.org/10.3390/ijerph15050922 - 5 May 2018

Cited by 157 | Viewed by 12311

Abstract

Despite being challenged in recent years, the hypothesis that individuals of higher socioeconomic status (SES) are more physically active than their lower SES counterparts is generally considered a fact. Recent reviews, however, have suggested that differences across groups might be related to which [...] Read more.

Despite being challenged in recent years, the hypothesis that individuals of higher socioeconomic status (SES) are more physically active than their lower SES counterparts is generally considered a fact. Recent reviews, however, have suggested that differences across groups might be related to which physical activity (PA) domains have been investigated. In the present review, searches for relevant studies were performed in the MEDLINE, ISI Web of Knowledge and SPORTDiscus databases. Search terms included “socioeconomic”, “socio-economic”, “socio economic” and “social class” to meet all variations of the variable “socioeconomic status” in combination with the term “physical activity”. Studies were included when applying the dimensions of intensity, frequency, type/mode, and duration in measuring PA. Fifty-six studies were included and were subsequently split into four PA domains: transport PA (TPA), occupational PA (OPA), housing PA (HPA) and leisure time PA (LTPA). It turned out that the positive relationship held only for LTPA, whereas the relationship was non-existent or even opposite for all other domains. It is concluded that the assumed positive relationship between SES and PA is mainly a relationship between LTPA and SES. It is further suggested that the PA domain should always be considered when studying said relationships. Full article

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

► Show Figures

Figure 1

13 pages, 468 KiB

Open AccessReview

Systematic Literature Review of Attempted Suicide and Offspring

by Ingeborg Lunde, Marte Myhre Reigstad, Kristin Frisch Moe and Tine K. Grimholt

Int. J. Environ. Res. Public Health 2018, 15(5), 937; https://doi.org/10.3390/ijerph15050937 - 8 May 2018

Cited by 11 | Viewed by 9105

Abstract

Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient [...] Read more.

Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care. Full article

(This article belongs to the Special Issue Advances in Suicide Research)

► Show Figures

Figure 1

7 pages, 362 KiB

Open AccessReview

Use of Diabetes Treatment Satisfaction Questionnaire in Diabetes Care: Importance of Patient-Reported Outcomes

by Yoshifumi Saisho

Int. J. Environ. Res. Public Health 2018, 15(5), 947; https://doi.org/10.3390/ijerph15050947 - 9 May 2018

Cited by 101 | Viewed by 14245

Abstract

The efficacy of diabetes treatment should not be evaluated solely by HbA1c levels as they should also focus on patient-reported outcomes (PROs), such as patient satisfaction, wellbeing and quality of life. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) has been developed to assess patient [...] Read more.

The efficacy of diabetes treatment should not be evaluated solely by HbA1c levels as they should also focus on patient-reported outcomes (PROs), such as patient satisfaction, wellbeing and quality of life. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) has been developed to assess patient satisfaction with diabetes treatment. DTSQ has been translated into more than 100 languages and is widely used in many countries, since it is relatively easy to answer and is used for both patients with and without medical therapy. Novel therapeutic options, such as insulin analogs, incretin-based therapy and sodium-glucose cotransporter 2 (SGLT2) inhibitors, have been shown to improve patient satisfaction using DTSQ for assessments. DTSQ is not only used for comparisons between different medications or treatment strategies, but also can be used to assess the quality of diabetes care in clinical settings. This is important as an improvement in treatment satisfaction may enhance patients’ self-efficacy and adherence to therapy, leading to the achievement of long-term stable glycemic control and reduced risk of diabetic complications. In this review, we summarize the current topics in DTSQ, introducing our own experience, and discuss the role of PROs in diabetes treatment. Full article

(This article belongs to the Collection Health Care and Diabetes)

► Show Figures

Figure 1

14 pages, 651 KiB

Open AccessReview

Caring for Young People Who Self-Harm: A Review of Perspectives from Families and Young People

by Sophie Curtis, Pinar Thorn, Alison McRoberts, Sarah Hetrick, Simon Rice and Jo Robinson

Int. J. Environ. Res. Public Health 2018, 15(5), 950; https://doi.org/10.3390/ijerph15050950 - 10 May 2018

Cited by 42 | Viewed by 12924

Abstract

Self-harm among young people remains largely stigmatised and misunderstood. Parents have been identified as key facilitators in the help-seeking process, yet they typically report feeling ill-equipped to support the young person in their care. The aim of this review was to examine the [...] Read more.

Self-harm among young people remains largely stigmatised and misunderstood. Parents have been identified as key facilitators in the help-seeking process, yet they typically report feeling ill-equipped to support the young person in their care. The aim of this review was to examine the perspectives of both young people (aged 12–28) and parents and to develop the conceptual framework for a future qualitative study. A systematic search of MEDLINE and PsycINFO was performed to identify articles that focused on the experiences of family members and young people related to managing the discovery of self-harm. Fourteen articles were included for review. Four addressed the perspectives of young people and 10 reported on the impact of adolescent self-harm on parents. The impact of self-harm is substantial and there exists a discrepancy between the most common parental responses and the preferences of young people. In addition, parents are often reluctant to seek help for themselves due to feelings of shame and guilt. This highlights the need for accessible resources that seek to alleviate parents’ distress, influence the strategies implemented to manage the young person’s self-harm behaviour, reduce self-blame of family members, and increase the likelihood of parental help seeking. Full article

(This article belongs to the Special Issue Advances in Suicide Research)

► Show Figures

Figure 1

16 pages, 362 KiB

Open AccessReview

Biochar from Biosolids Pyrolysis: A Review

by Jorge Paz-Ferreiro, Aurora Nieto, Ana Méndez, Matthew Peter James Askeland and Gabriel Gascó

Int. J. Environ. Res. Public Health 2018, 15(5), 956; https://doi.org/10.3390/ijerph15050956 - 10 May 2018

Cited by 176 | Viewed by 11530

Abstract

Ever increasing volumes of biosolids (treated sewage sludge) are being produced by municipal wastewater facilities. This is a consequence of the continued expansion of urban areas, which in turn require the commissioning of new treatment plants or upgrades to existing facilities. Biosolids contain [...] Read more.

Ever increasing volumes of biosolids (treated sewage sludge) are being produced by municipal wastewater facilities. This is a consequence of the continued expansion of urban areas, which in turn require the commissioning of new treatment plants or upgrades to existing facilities. Biosolids contain nutrients and energy which can be used in agriculture or waste-to-energy processes. Biosolids have been disposed of in landfills, but there is an increasing pressure from regulators to phase out landfilling. This article performs a critical review on options for the management of biosolids with a focus on pyrolysis and the application of the solid fraction of pyrolysis (biochar) into soil. Full article

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

16 pages, 757 KiB

Open AccessReview

Protective Effects of Selected Botanical Agents on Bone

by James Jam Jolly, Kok-Yong Chin, Ekram Alias, Kien Hui Chua and Ima Nirwana Soelaiman

Int. J. Environ. Res. Public Health 2018, 15(5), 963; https://doi.org/10.3390/ijerph15050963 - 11 May 2018

Cited by 22 | Viewed by 4264

Abstract

Osteoporosis is a serious health problem affecting more than 200 million elderly people worldwide. The early symptoms of this disease are hardly detectable. It causes progressive bone loss, which ultimately renders the patients susceptible to fractures. Osteoporosis must be prevented because the associated [...] Read more.

Osteoporosis is a serious health problem affecting more than 200 million elderly people worldwide. The early symptoms of this disease are hardly detectable. It causes progressive bone loss, which ultimately renders the patients susceptible to fractures. Osteoporosis must be prevented because the associated fragility fractures result in high morbidity, mortality, and healthcare costs. Many plants used in herbal medicine contain bioactive compounds possessing skeletal protective effects. This paper explores the anti-osteoporotic properties of selected herbal plants, including their actions on osteoblasts (bone forming cells), osteoclasts (bone resorbing cells), and bone remodelling. Some of the herbal plant families included in this review are Berberidaceae, Fabaceae, Arecaceae, Labiatae, Simaroubaceaea, and Myrsinaceae. Their active constituents, mechanisms of action, and pharmaceutical applications were discussed. The literature shows that very few herbal plants have undergone human clinical trials to evaluate their pharmacological effects on bone to date. Therefore, more intensive research should be performed on these plants to validate their anti-osteoporotic properties so that they can complement the currently available conventional drugs in the battle against osteoporosis. Full article

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

► Show Figures

Figure 1

23 pages, 693 KiB

Open AccessReview

Measuring Cortisol in the Classroom with School-Aged Children—A Systematic Review and Recommendations

by Mirena Dimolareva, Nancy R. Gee, Karen Pfeffer, Laëtitia Maréchal, Kyla Pennington and Kerstin Meints

Int. J. Environ. Res. Public Health 2018, 15(5), 1025; https://doi.org/10.3390/ijerph15051025 - 18 May 2018

Cited by 15 | Viewed by 7474

Abstract

The collection of salivary cortisol has been chosen as one of the least intrusive, easiest to collect, analyze, and store methods of obtaining information on physiological changes. It is, however, not clear what the best practice is when collecting salivary cortisol from children [...] Read more.

The collection of salivary cortisol has been chosen as one of the least intrusive, easiest to collect, analyze, and store methods of obtaining information on physiological changes. It is, however, not clear what the best practice is when collecting salivary cortisol from children within the school setting. The aim of this systematic review is to evaluate the feasibility of cortisol collection in schools for future research and to make recommendations for best practice. The review included 25 peer-reviewed articles from seven databases. The hypotheses of the included studies vary, but they all use cortisol as a diurnal, baseline, or acute measure, or to measure the effect of an intervention. Two methods of salivary cortisol collection were preferred by most of the research, i.e., passive drool or cotton Salivettes. The review has concluded that cortisol is a physiological marker that can be successfully measured in school-based research. However, there are discrepancies across studies when evaluating the collection guidelines, protocols, and instructions to participants as well as transparency of the success rate of obtaining all samples. Recommendations are made for future research to address and avoid such discrepancies and improve cross-study comparisons by implementing standard protocol guidelines. Full article

► Show Figures

Figure 1

35 pages, 1583 KiB

Open AccessReview

Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review

by Agnieszka Strzelak, Aleksandra Ratajczak, Aleksander Adamiec and Wojciech Feleszko

Int. J. Environ. Res. Public Health 2018, 15(5), 1033; https://doi.org/10.3390/ijerph15051033 - 21 May 2018

Cited by 443 | Viewed by 29315

Abstract

Many studies have been undertaken to reveal how tobacco smoke skews immune responses contributing to the development of chronic obstructive pulmonary disease (COPD) and other lung diseases. Recently, environmental tobacco smoke (ETS) has been linked with asthma and allergic diseases in children. This [...] Read more.

Many studies have been undertaken to reveal how tobacco smoke skews immune responses contributing to the development of chronic obstructive pulmonary disease (COPD) and other lung diseases. Recently, environmental tobacco smoke (ETS) has been linked with asthma and allergic diseases in children. This review presents the most actual knowledge on exact molecular mechanisms responsible for the skewed inflammatory profile that aggravates inflammation, promotes infections, induces tissue damage, and may promote the development of allergy in individuals exposed to ETS. We demonstrate how the imbalance between oxidants and antioxidants resulting from exposure to tobacco smoke leads to oxidative stress, increased mucosal inflammation, and increased expression of inflammatory cytokines (such as interleukin (IL)-8, IL-6 and tumor necrosis factor α ([TNF]-α). Direct cellular effects of ETS on epithelial cells results in increased permeability, mucus overproduction, impaired mucociliary clearance, increased release of proinflammatory cytokines and chemokines, enhanced recruitment of macrophages and neutrophils and disturbed lymphocyte balance towards Th2. The plethora of presented phenomena fully justifies a restrictive policy aiming at limiting the domestic and public exposure to ETS. Full article

(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)

► Show Figures

Figure 1

10 pages, 312 KiB

Open AccessReview

Physical Activity Recommendations for Health and Beyond in Currently Inactive Populations

by Eszter Füzéki and Winfried Banzer

Int. J. Environ. Res. Public Health 2018, 15(5), 1042; https://doi.org/10.3390/ijerph15051042 - 22 May 2018

Cited by 55 | Viewed by 8206

Abstract

Widespread persistent inactivity makes continued efforts in physical activity promotion a persistent challenge. The precise content of physical activity recommendations is not broadly known, and there are concerns that the general messaging of the guidelines, including the recommendations to perform at least 150 [...] Read more.

Widespread persistent inactivity makes continued efforts in physical activity promotion a persistent challenge. The precise content of physical activity recommendations is not broadly known, and there are concerns that the general messaging of the guidelines, including the recommendations to perform at least 150 min of at least moderate intensity physical activity per week might seem unattainable for and even actually discourage currently inactive people. Here we show that there are a myriad of ways of being physically active, and provide (in part) out-of-the-box examples of evidence based, pragmatic, easily accessible physical activity regimes below 150 min and/or with lower than moderate intensity that yield meaningful health benefits for currently inactive people. Full article

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

Other

Jump to: Editorial, Research, Review

4 pages, 250 KiB

Open AccessCorrection

Correction: Lee, Y.-H., et al. Beverage Intake, Smoking Behavior, and Alcohol Consumption in Contemporary China—A Cross-Sectional Analysis from the 2011 China Health and Nutrition Survey. Int. J. Environ. Res. Public Health 2017, 14, 493

by Yen-Han Lee, Zhi Wang, Timothy C. Chiang and Ching-Ti Liu

Int. J. Environ. Res. Public Health 2018, 15(5), 846; https://doi.org/10.3390/ijerph15050846 - 25 Apr 2018

Cited by 5 | Viewed by 3482

Abstract

The authors wish to add the following amendments and corrections to their paper published in IJERPH [1]. [...] Full article

(This article belongs to the Collection Health Behavior and Public Health)

8 pages, 1932 KiB

Open AccessCommentary

Dynamic Geochemistry of Tetraethyl Lead Dust during the 20th Century: Getting the Lead In, Out, and Translational Beyond

by Howard W. Mielke

Int. J. Environ. Res. Public Health 2018, 15(5), 860; https://doi.org/10.3390/ijerph15050860 - 26 Apr 2018

Cited by 7 | Viewed by 5519

Abstract

This commentary provides a brief overview of policy decisions that permitted getting tetraethyl lead (TEL) into petrol; global geochemical lead-dust deposition evidence; 1975 catalytic converter requirements; concern about habitability of cities; a personal perspective on legacy lead research that accelerated getting TEL out [...] Read more.

This commentary provides a brief overview of policy decisions that permitted getting tetraethyl lead (TEL) into petrol; global geochemical lead-dust deposition evidence; 1975 catalytic converter requirements; concern about habitability of cities; a personal perspective on legacy lead research that accelerated getting TEL out of petrol; and translational beyond, including New Orleans pre- vs. post-Hurricane Katrina observations about legacy lead interventions that effectively improve urban children’s health outcomes. Full article

(This article belongs to the Special Issue Urban Geochemistry and Human Health)

► Show Figures

Figure 1

7 pages, 1467 KiB

Open AccessCorrection

Correction: Renzaho, A.M.N., et al. The Synergetic Effect of Targeted Resource Transfers for Families, Child Sensitive Social Protection Programs, and Capacity Building for Effective Social Protection on Children’s Nutritional Status in Nepal. Int. J. Environ. Res. Public Health 2017, 14, 1502

by Andre M. N. Renzaho, Stanley Chitekwe, Wen Chen, Sanjay Rijal, Thakur Dhakal and Pradiumna Dahal

Int. J. Environ. Res. Public Health 2018, 15(5), 869; https://doi.org/10.3390/ijerph15050869 - 26 Apr 2018

Viewed by 3225

Abstract

The authors wish to add the following corrections to their paper published in the International Journal of Environmental Research and Public Health [1]. [...] Full article

► Show Figures

Figure 1

17 pages, 904 KiB

Open AccessCase Report

Addressing the Mental Health Needs of Black American Youth and Families: A Case Study from the EMBRace Intervention

by Riana E. Anderson, Shawn C. T. Jones, Crystal C. Navarro, Monique C. McKenny, Tulsi J. Mehta and Howard C. Stevenson

Int. J. Environ. Res. Public Health 2018, 15(5), 898; https://doi.org/10.3390/ijerph15050898 - 2 May 2018

Cited by 29 | Viewed by 9830

Abstract

Black American youth are vulnerable to the consequences of repeated exposure to racial discrimination, particularly through hampered coping abilities and greater internalizing and externalizing problems. One way in which Black American parents have protected their children from these deleterious consequences is through racial [...] Read more.

Black American youth are vulnerable to the consequences of repeated exposure to racial discrimination, particularly through hampered coping abilities and greater internalizing and externalizing problems. One way in which Black American parents have protected their children from these deleterious consequences is through racial socialization, or communication regarding aspects of racialized experiences and contexts. Less is known, however, about the potential therapeutic benefits of racial socialization via clinical intervention. The five-week Engaging, Managing, and Bonding through Race (EMBRace) racial socialization intervention was developed to enhance coping strategies for parents and adolescents and reduce adolescent internalizing and externalizing problems. The purpose of this study is to describe a case study of one family through a mixed methods approach. Variables of interest included racial discrimination, racial socialization, coping, and psychological well-being. Quantitative and qualitative assessments were performed two weeks prior to and one week after the implementation of EMBRace, with qualitative data collected throughout the intervention. Results indicate a developing sense of coping for the adolescent and parent and reduced adolescent psychosocial problems despite increased racialized stress. Results will be used to further investigate the hypotheses proposed in the pilot with a powered sample, and future studies will explore how sociodemographic and biopsychosocial variables relate to policy recommendations, program implementation, and psychosocial outcomes. Full article

(This article belongs to the Special Issue The Health Needs of Vulnerable Children: Challenges and Solutions)

► Show Figures

Figure 1

25 pages, 404 KiB

Open AccessPerspective

The Inverse Response Law: Theory and Relevance to the Aftermath of Disasters

by Suzanne Phibbs, Christine Kenney, Graciela Rivera-Munoz, Thomas J. Huggins, Christina Severinsen and Bruce Curtis

Int. J. Environ. Res. Public Health 2018, 15(5), 916; https://doi.org/10.3390/ijerph15050916 - 4 May 2018

Cited by 25 | Viewed by 8397

Abstract

The Inverse Care Law is principally concerned with the effect of market forces on health care which create inequities in access to health services through privileging individuals who possess the forms of social capital that are valued within health care settings. The fields [...] Read more.

The Inverse Care Law is principally concerned with the effect of market forces on health care which create inequities in access to health services through privileging individuals who possess the forms of social capital that are valued within health care settings. The fields of disaster risk reduction need to consider the ways in which inequities, driven by economic and social policy as well as institutional decision-making, create vulnerabilities prior to a disaster, which are then magnified post disaster through entrenched structural differences in access to resources. Drawing on key principles within the Inverse Care Law, the Inverse Response Law refers to the idea that people in lower socio-economic groups are more likely to be impacted and to experience disparities in service provision during the disaster response and recovery phase. In a market model of recovery, vulnerable groups struggle to compete for necessary services creating inequities in adaptive capacity as well as in social and wellbeing outcomes over time. Both the Inverse Care Law and the Inverse Response Law focus on the structural organisation of services at a macro level. In this article, the Inverse Care Law is outlined, its application to medical treatment following disasters considered and an explanation of the Inverse Response Law provided. Case studies from recent disasters, in London, New Zealand, Puerto Rico and Mexico City are examined in order to illustrate themes at work relating to the Inverse Response Law. Full article

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

2 pages, 225 KiB

Open AccessCorrection

Correction: Chu et al. Inorganic Arsenic in Drinking Water and Bladder Cancer: A Meta-Analysis for Dose-Response Assessment. Int. J. Environ. Res. Public Health 2006, 3(4), 316–322

by Huei-An Chu and Douglas Crawford-Brown

Int. J. Environ. Res. Public Health 2018, 15(5), 929; https://doi.org/10.3390/ijerph15050929 - 7 May 2018

Cited by 4 | Viewed by 3180

Abstract

In our previous paper [1], we provided details of a meta-analysis of cancer risks associated with exposure to arsenic. [...] Full article

(This article belongs to the Section Environmental Health)

6 pages, 31753 KiB

Open AccessCase Report

Inflamed Phylloides Tumour in a Girl: A Challenging Diagnosis in Paediatric Breast Lesions

by Ilaria Testa, Cristina Salvatori, Marco Prestipino, Maria Elena Laurenti, Paolo Gerli, Giuseppe Di Cara, Nicola Principi, Susanna Esposito and Mirko Bertozzi

Int. J. Environ. Res. Public Health 2018, 15(5), 959; https://doi.org/10.3390/ijerph15050959 - 11 May 2018

Cited by 4 | Viewed by 3755

Abstract

Introduction: Phylloides tumours (PTs) are rare fibroepithelial neoplasms that account for 0.3–0.9% of all breast tumours. These tumours typically occur in women aged 30–70 years. The occurrence of these tumours in older children and adolescents poses particular diagnostic and therapeutic problems. However, [...] Read more.

Introduction: Phylloides tumours (PTs) are rare fibroepithelial neoplasms that account for 0.3–0.9% of all breast tumours. These tumours typically occur in women aged 30–70 years. The occurrence of these tumours in older children and adolescents poses particular diagnostic and therapeutic problems. However, early diagnosis is mandatory because although most of the cases of PTs in children are benign, the borderline and malignant cases with potential negative outcomes cannot be excluded. Case presentation: A 12-year-old girl presented at the Paediatric Emergency Department for hyperaemia and warmth of the left breast that occurred a few days prior without fever. The girl experienced menarche 8 months previously. She experienced no previous trauma and she had no family history of breast cancer. On physical examination, the left breast was painful, enlarged and tender. The overlying skin was erythematous and warm. A breast ultrasonography (US) revealed a large mass with features of an abscess, including a hyperechoic wall, scattered internal echoes and hypoechoic peripheral lacunae of apparent colliquative nature. After 4 days of unsuccessful antibiotic therapy, surgical drainage was performed due to the suspicion of a mammary abscess. At the surgical incision site, the lesion was not-well circumscribed and lacked a capsule. In addition, purulent material was not detected. Histological examination revealed that the tissue alterations were compatible with benign PT. With this diagnosis, the girl underwent definitive surgical removal of the lesion. The postoperative period passed without negative events. An US performed 6 months later revealed that no new mass was present at this time, suggesting no recurrence of the tumour. Conclusion: This case shows that in the presence of a clinical picture suggesting the inflammation of the breast in adolescent females, PT should be considered as a possible diagnosis and US-guided core biopsy should be considered to confirm this suspicion. Thereafter, when surgical excision is performed, particular attention must be paid to both the preservation of all the normal breast parenchyma and future aesthetic problems. Full article

► Show Figures

Figure 1

Journal Menu

Journal Browser

Int. J. Environ. Res. Public Health, Volume 15, Issue 5 (May 2018) – 217 articles

Editorial

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI