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Int. J. Environ. Res. Public Health, Volume 16, Issue 5 (March-1 2019)

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Cover Story (view full-size image) The mental health issues of elderly urban residents increase the social and economic costs to [...] Read more.
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Open AccessArticle Protective Behavioral Strategies and Alcohol Consumption: The Moderating Role of Drinking-Group Gender Composition
Int. J. Environ. Res. Public Health 2019, 16(5), 900; https://doi.org/10.3390/ijerph16050900
Received: 7 February 2019 / Revised: 7 March 2019 / Accepted: 8 March 2019 / Published: 12 March 2019
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Abstract
Background. There is international concern about the negative consequences for health related to young people’s alcohol consumption. Peer relationships can play a positive and protective role to cope with risky behaviors associated with alcohol consumption. Objective. This study investigated the influence [...] Read more.
Background. There is international concern about the negative consequences for health related to young people’s alcohol consumption. Peer relationships can play a positive and protective role to cope with risky behaviors associated with alcohol consumption. Objective. This study investigated the influence of protective behavioral strategies (PBS) on alcohol consumption and the moderating role of drinking-group gender composition and drinking-group size. Methods. The sample comprised 286 youths (mean age = 23.49; SD = 2.78; 67.5% female). Participants reported their protective behavioral strategies, their alcohol consumption and the size (overall mean = 7.44; SD = 3.83) and gender composition (62.58% mixed; 19.93% all-female; 9.8% all-male) of their social drinking groups. The mean sizes of mixed, all-female, and all-male groups were 8.27, 5.34, and 6.2, respectively. Results. Data showed that women consume less alcohol and use more protective strategies than men, particularly those strategies directed at avoiding negative consequences. Furthermore, the number of men in a group influences protective strategies and consumption, therefore drinking-group gender composition moderates the relationship between protective strategies and alcohol consumption. The more protective strategies that young adults use, the lower their alcohol consumption. This relationship is moderated by the size of the group. Conclusion. Strategies to prevent risky drinking behavior should focus on both PBS shared by drinking-group members and the training in individual PBS associated with drinking behavior. Finally, taking into account the relationship between drinking-group gender composition and protective behavioral strategies for alcohol consumption, a positive protector role for individual and group habits in relation to alcohol consumption is discussed. Full article
(This article belongs to the collection Health Behaviors, Risk Factors, NCDs and Health Promotion)
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Open AccessArticle Prescription Infant Formulas Are Contaminated with Aluminium
Int. J. Environ. Res. Public Health 2019, 16(5), 899; https://doi.org/10.3390/ijerph16050899
Received: 6 February 2019 / Revised: 7 March 2019 / Accepted: 10 March 2019 / Published: 12 March 2019
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Abstract
Historical and recent data demonstrate that off-the-shelf infant formulas are heavily contaminated with aluminium. The origin of this contamination remains to be elucidated though may be imported via ingredients, packaging and processing. Specialised infant formulas exist to address health issues, such as low [...] Read more.
Historical and recent data demonstrate that off-the-shelf infant formulas are heavily contaminated with aluminium. The origin of this contamination remains to be elucidated though may be imported via ingredients, packaging and processing. Specialised infant formulas exist to address health issues, such as low birth weight, allergy or intolerance and medical conditions, such as renal insufficiency. The aluminium content of these prescription infant formulas is measured here for the first time. We obtained 24 prescription infant formulas through a paediatric clinic and measured their total aluminium content by transversely heated graphite furnace atomic absorption spectrometry following microwave assisted acid/peroxide digestion. The aluminium content of ready-to-drink formulas ranged from 49.9 (33.7) to 1956.3 (111.0) μg/L. The most heavily contaminated products were those designed as nutritional supplements for infants struggling to gain weight. The aluminium content of powdered formulas ranged from 0.27 (0.04) to 3.27 (0.19) μg/g. The most heavily contaminated products tended to be those addressing allergies and intolerance. Prescription infant formulas are contaminated with aluminium. Ready-made formulas available as nutritional supplements to aid infant growth contained some of the highest concentrations of aluminium in infant formulas measured in our laboratory. However, a number of prescription infant formulas contained the lowest concentrations of aluminium yet measured in our laboratory. These higher cost specialist preparations demonstrate that the contamination of infant formulas by aluminium is not inevitable. They represent what is achievable should manufacturers wish to address the threat posed to health through infant exposure to aluminium. Full article
(This article belongs to the Special Issue Environmental Factors, Children’s Health and Safety)
Open AccessArticle Aquifer Sustainability and the Use of Desalinated Seawater for Greenhouse Irrigation in the Campo de Níjar, Southeast Spain
Int. J. Environ. Res. Public Health 2019, 16(5), 898; https://doi.org/10.3390/ijerph16050898
Received: 11 February 2019 / Revised: 7 March 2019 / Accepted: 8 March 2019 / Published: 12 March 2019
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Abstract
In the Campo de Níjar (southeast Spain), an intensive horticulture model under plastic has been developed based on the use of groundwater. For many years, aquifers have been overexploited, almost generating an environmental collapse. The construction of a desalination plant was planned to [...] Read more.
In the Campo de Níjar (southeast Spain), an intensive horticulture model under plastic has been developed based on the use of groundwater. For many years, aquifers have been overexploited, almost generating an environmental collapse. The construction of a desalination plant was planned to improve this situation and to achieve sustainable aquifer management. However, the aquifer is still being overexploited, since farmers scarcely use desalinated seawater for irrigation. In this paper, farmers irrigating with desalinated seawater are characterized, since they contribute to aquifer sustainability. The study aimed to identify the variables which condition the use of this water resource, as well as the kinds of incentives that encourage this option. For this purpose, a survey was undertaken within a sample of 110 farmers. A cluster analysis and a binary logistic regression were employed. The results from the cluster analysis allowed the characterization of farmers who use desalinated seawater for irrigation. Furthermore, the regression model showed the variables that determine a more intensive use of this irrigation source, such as crop diversification, availability of different water resources and the conductivity of aquifer water available for irrigation. The incentives promoting the use of desalinated seawater for irrigation that most encourage farmers are the implementation of tax relief, price reductions and the obligation to install rainwater collection systems. Full article
(This article belongs to the Special Issue Greenhouse and Horticulture)
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Open AccessArticle Visualising Combined Time Use Patterns of Children’s Activities and Their Association with Weight Status and Neighbourhood Context
Int. J. Environ. Res. Public Health 2019, 16(5), 897; https://doi.org/10.3390/ijerph16050897
Received: 21 January 2019 / Revised: 23 February 2019 / Accepted: 6 March 2019 / Published: 12 March 2019
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Abstract
Compositional data techniques are an emerging method in physical activity research. These techniques account for the complexities of, and interrelationships between, behaviours that occur throughout a day (e.g., physical activity, sitting, and sleep). The field of health geography research is also developing rapidly. [...] Read more.
Compositional data techniques are an emerging method in physical activity research. These techniques account for the complexities of, and interrelationships between, behaviours that occur throughout a day (e.g., physical activity, sitting, and sleep). The field of health geography research is also developing rapidly. Novel spatial techniques and data visualisation approaches are increasingly being recognised for their utility in understanding health from a socio-ecological perspective. Linking compositional data approaches with geospatial datasets can yield insights into the role of environments in promoting or hindering the health implications of the daily time-use composition of behaviours. The 7-day behaviour data used in this study were derived from accelerometer data for 882 Auckland school children and linked to weight status and neighbourhood deprivation. We developed novel geospatial visualisation techniques to explore activity composition over a day and generated new insights into links between environments and child health behaviours and outcomes. Visualisation strategies that integrate compositional activities, time of day, weight status, and neighbourhood deprivation information were devised. They include a ringmap overview, small-multiple ringmaps, and individual and aggregated time–activity diagrams. Simultaneous visualisation of geospatial and compositional behaviour data can be useful for triangulating data from diverse disciplines, making sense of complex issues, and for effective knowledge translation. Full article
(This article belongs to the Special Issue Health Inequalities in Children)
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Open AccessArticle Youth Perspectives of Healthcare in Central Mexico: An Application of Massey’s Critical Health Literacy Framework
Int. J. Environ. Res. Public Health 2019, 16(5), 896; https://doi.org/10.3390/ijerph16050896
Received: 28 December 2018 / Revised: 27 February 2019 / Accepted: 1 March 2019 / Published: 12 March 2019
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Abstract
Attention to health literacy is essential more now than ever given the recognition, attention, and resources being dedicated to addressing health disparities throughout the world. Unfortunately, health literacy research is scarce in many parts of the world, particularly among youth. Using focus group [...] Read more.
Attention to health literacy is essential more now than ever given the recognition, attention, and resources being dedicated to addressing health disparities throughout the world. Unfortunately, health literacy research is scarce in many parts of the world, particularly among youth. Using focus group discussions with junior high school students (N = 98) in a rural town of Central Mexico, we sought to learn about their experiences utilizing healthcare services at a local health clinic. The themes that naturally emerged from focus group discussions aligned with Massey’s framework on critical health literacy among US youth, and included problems navigating the health system, embarrassment speaking to doctors about sensitive issues, and minimal importance being placed on preventative care. This suggests that Massey’s framework may be appropriate to use when seeking to understand and promote health literacy among youth in Mexico. Furthermore, the challenges faced by adolescent participants in this study suggest that additional research is needed to assess how youth in other areas of Mexico are faring in efforts to understand and access their new and evolving universal healthcare system. Full article
(This article belongs to the Special Issue IJERPH: 15th Anniversary)
Open AccessArticle The Role of Women’s Autonomy and Experience of Intimate Partner Violence as a Predictor of Maternal Healthcare Service Utilization in Nepal
Int. J. Environ. Res. Public Health 2019, 16(5), 895; https://doi.org/10.3390/ijerph16050895
Received: 16 February 2019 / Revised: 6 March 2019 / Accepted: 6 March 2019 / Published: 12 March 2019
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Abstract
This study aims to identify the relationship of women’s autonomy and intimate partner violence (IPV) with maternal healthcare service utilization among married women of reproductive age in Nepal. This study used data from the 2016 Nepal Demographic and Health Survey (NDHS), which is [...] Read more.
This study aims to identify the relationship of women’s autonomy and intimate partner violence (IPV) with maternal healthcare service utilization among married women of reproductive age in Nepal. This study used data from the 2016 Nepal Demographic and Health Survey (NDHS), which is a nationally representative sample survey. The association between outcome variables with selected factors were examined by using the Chi-square test (χ2), followed by multiple logistic regression. The sample was adjusted for multi-stage sampling design, cluster weight, and sample weight. Of the total sample, 68.4% reported attending sufficient Antenatal care (ANC) visits throughout their pregnancy, while 59.9% reported having a health facility delivery. The factors associated with both, sufficient ANC visits and institutional delivery includes ethnicity, place of residence, household wealth status, and the number of living children. Women who have access to media, and who have intended pregnancy were more likely to have sufficient ANC visits. Exposure to some forms of violence was found to be the barrier for maternal health service utilization. Attending ANC visits enables mothers to make the decision regarding skilled attendance or health facility delivery. Preventing any forms of violence need to be considered as a vital element in interventions aimed at increasing maternal health service utilization. Full article
Open AccessArticle Evidence-based Birth Attendance in Spain: Private versus Public Centers
Int. J. Environ. Res. Public Health 2019, 16(5), 894; https://doi.org/10.3390/ijerph16050894
Received: 31 December 2018 / Revised: 7 March 2019 / Accepted: 9 March 2019 / Published: 12 March 2019
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Abstract
The type of hospital (public or private) has been associated with the type of clinical practice carried out. The purpose of this study was to determine the association between the type of hospital (public or private) and delivery attendance with practices based on [...] Read more.
The type of hospital (public or private) has been associated with the type of clinical practice carried out. The purpose of this study was to determine the association between the type of hospital (public or private) and delivery attendance with practices based on the recommendations by the World Health Organization (WHO). A cross-sectional study with puerperal women (n = 2906) was conducted in Spain during 2017. The crude Odds Ratios (OR), adjusted (aOR) and their 95% confidence intervals (CI) were calculated through binary logistic regression. For multiparous women in private centers, a higher rate of induced labor was observed (aOR: 1.49; 95% CI: 1.11–2.00), fewer natural methods were used to relieve pain (aOR: 0.51; 95% CI: 0.35–0.73), and increased odds of cesarean section (aOR: 2.50; 95% CI: 1.81–3.46) were found as compared to public hospitals. For primiparous women in private centers, a greater use of the epidural was observed (aOR: 1.57; 95% CI: 1.03–1.40), as well as an increased likelihood of instrumental birth (aOR: 1.53; 95% CI: 1.09–2.15) and of cesarean section (aOR: 1.77; 95% CI: 1.33–2.37) than in public hospitals. No differences were found in hospitalization times among women giving birth in public and private centers (p > 0.05). The World Health Organization birth attendance recommendations are more strictly followed in public hospitals than in private settings. Full article
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Open AccessCommunication Health Data Collection Before, During and After Emergencies and Disasters—The Result of the Kobe Expert Meeting
Int. J. Environ. Res. Public Health 2019, 16(5), 893; https://doi.org/10.3390/ijerph16050893
Received: 31 January 2019 / Revised: 3 March 2019 / Accepted: 4 March 2019 / Published: 12 March 2019
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Abstract
In October 2018, the World Health Organization (WHO) convened a meeting to identify key research needs, bringing together leading experts from WHO, WHO Thematic Platform for Health Emergency and Disaster Risk Management (Health-EDRM) Research Network (TPRN), World Association for Disaster and Emergency Medicine [...] Read more.
In October 2018, the World Health Organization (WHO) convened a meeting to identify key research needs, bringing together leading experts from WHO, WHO Thematic Platform for Health Emergency and Disaster Risk Management (Health-EDRM) Research Network (TPRN), World Association for Disaster and Emergency Medicine (WADEM), the Japan International Cooperation Agency (JICA), and delegates to the Asia Pacific Conference for Disaster Medicine (APCDM) 2018. The meeting identified key research needs in five major research areas for Health-EDRM. One of the five major research areas was “Health data collection during emergency and disaster”. Experts for this research area highlighted WHO Emergency Medical Team Minimum Data Set (EMT MDS), a standardized medical data collection method during and after disasters, as an example of substantial progress, with knowledge gaps and challenges in implementation in some regions and countries (i.e., information collection methodology in medical facilities of affected local areas, seamless and practical connection between acute phase data collection and post-acute phase local surveillance). The discussion on this research area also identified key research needs in standardization of broader health-related data to inform effective Health EDRM (i.e., community vulnerabilities, hospital functional status, infrastructure, lifelines and health workforce). Full article
(This article belongs to the Special Issue Health-Related Emergency Disaster Risk Management (Health-EDRM))
Open AccessFeature PaperArticle Alcohol Industry CSR Organisations: What Can Their Twitter Activity Tell Us about Their Independence and Their Priorities? A Comparative Analysis
Int. J. Environ. Res. Public Health 2019, 16(5), 892; https://doi.org/10.3390/ijerph16050892
Received: 14 November 2018 / Revised: 27 February 2019 / Accepted: 3 March 2019 / Published: 12 March 2019
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Abstract
There are concerns about the accuracy of the health information provided by alcohol industry (AI)-funded organisations and about their independence. We conducted a content analysis of the health information disseminated by AI-funded organisations through Twitter, compared with non-AI-funded charities, to assess whether their [...] Read more.
There are concerns about the accuracy of the health information provided by alcohol industry (AI)-funded organisations and about their independence. We conducted a content analysis of the health information disseminated by AI-funded organisations through Twitter, compared with non-AI-funded charities, to assess whether their messages align with industry and/or public health objectives. We compared all tweets from 2016 from Drinkaware (UK); Drinkaware.ie (Ireland); and DrinkWise (Australia), to non-AI-funded charities Alcohol Concern (UK), Alcohol Action Ireland, and FARE (Australia). Industry-funded bodies were significantly less likely to tweet about alcohol marketing, advertising and sponsorship; alcohol pricing; and physical health harms, including cancers, heart disease and pregnancy. They were significantly more likely to tweet about behavioural aspects of drinking and less likely to mention cancer risk; particularly breast cancer. These findings are consistent with previous evidence that the purpose of such bodies is the protection of the alcohol market, and of the alcohol industry’s reputation. Their messaging strongly aligns with AI corporate social responsibility goals. The focus away from health harms, particularly cancer, is also consistent with previous evidence. The evidence does not support claims by these alcohol-industry-funded bodies about their independence from industry. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
Open AccessArticle Behaviors and Attitudes of Polish Health Care Workers with Respect to the Hazards from Blood-Borne Pathogens: A Questionnaire-Based Study
Int. J. Environ. Res. Public Health 2019, 16(5), 891; https://doi.org/10.3390/ijerph16050891
Received: 30 January 2019 / Revised: 6 March 2019 / Accepted: 8 March 2019 / Published: 12 March 2019
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Abstract
Blood-borne infections represent an important occupational health issue in health care settings. The aim of this study was to analyze behaviors of health care workers (HCWs) in the field of needlestick injuries (NSIs) as well as to learn about their attitudes to patients [...] Read more.
Blood-borne infections represent an important occupational health issue in health care settings. The aim of this study was to analyze behaviors of health care workers (HCWs) in the field of needlestick injuries (NSIs) as well as to learn about their attitudes to patients infected with blood-borne viruses. A total of 487 HCWs based at 26 hospitals in Poland completed an anonymous self-administered questionnaire in the period of October–December 2015. Data was analyzed using descriptive statistics and multiple logistic regression. Of the HCWs, 44.8% suffered superficial wounds, and 17.9% HCWs were cut deeply at least once. The most frequent causes of injuries were: rush (31.4%), unpredictable patient behavior (29%), and lack of attention (27%). The rate of underreporting NSIs was 45.2%. Males showed more than three times higher chance of not reporting injuries (odds ratio (OR) 3.495, 95% Confidence Interval (CI): 1.65–7.49). The nurses more often took off their protective gloves to make the procedure easier (p = 0.036). Taking off protective clothes was positively associated with long work experience (OR 1.16, 95% CI: 0.995–1.36). Recapping concerned 15.5% of doctors, 8.2% of nurses, and 11.2% of paramedics. 25.9% HCWs feared infection in the workplace, and every tenth HCW refused to help the infected patient. The longer the work experience, the greater the concern about the possibility of infection (OR 1.33, 95% CI: 0.99–1.78). Most HCWs were more cautious when dealing with an infected patient and in their opinion infected patients should be required to inform HCWs of their serological status and such information should be compulsorily transferred between different health institutions. The emphasis in the training of HCWs in the future should be on classes perfecting practical skills like paying more attention to reporting NSIs, improving occupational behaviors like avoiding needle recapping, and on the development of appropriate attitudes towards patients infected with HIV, HBV, or HCV. Full article
(This article belongs to the Special Issue Worker and Public Health and Safety: Current Views)
Open AccessArticle Prevention of Cardiovascular Disease and Cancer Mortality by Achieving Healthy Dietary Goals for the Swedish Population: A Macro-Simulation Modelling Study
Int. J. Environ. Res. Public Health 2019, 16(5), 890; https://doi.org/10.3390/ijerph16050890
Received: 1 February 2019 / Revised: 5 March 2019 / Accepted: 7 March 2019 / Published: 12 March 2019
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Abstract
The objective is to estimate the number of deaths attributable to cardiovascular diseases and diet-related cancers that could be prevented or delayed in Sweden if adults adhere to the official dietary recommendations. We used an age-group and sex-specific epidemiological macro-simulation model to estimate [...] Read more.
The objective is to estimate the number of deaths attributable to cardiovascular diseases and diet-related cancers that could be prevented or delayed in Sweden if adults adhere to the official dietary recommendations. We used an age-group and sex-specific epidemiological macro-simulation model to estimate preventable deaths due to the discrepancies between actual intake and recommended intake of changes in food components. Data included in the model are a baseline scenario (actual dietary intake), a counterfactual scenario (recommended intake) and age- and sex-specific mortality for cardiovascular and diet-related cancer diseases together compared with the total population risk of a specific year. Monte Carlo analyses with 5000 iterations was performed to produce the 95% uncertainty intervals (UI). The model predicts that 6405 (95% UI: 5086–7086) deaths could be prevented or delayed if the Swedish population could adhere to official dietary recommendations in a year. More deaths would be saved for men than women. The recommendations for fruits and vegetables could have saved 47% of the deaths, followed by fiber intake (32%). For men, fruits and vegetables could have saved more compared to other dietary components, while for women dietary fiber was the prominent factor. Public health policies should consider ensuring healthy eating practices for the Swedish population. Full article
(This article belongs to the collection Health Behaviors, Risk Factors, NCDs and Health Promotion)
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Open AccessArticle The Role of Neuroticism in Predicting Psychological Harassment in Nursing: A Longitudinal Study
Int. J. Environ. Res. Public Health 2019, 16(5), 889; https://doi.org/10.3390/ijerph16050889
Received: 14 February 2019 / Revised: 8 March 2019 / Accepted: 9 March 2019 / Published: 11 March 2019
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Abstract
Psychological harassment is a serious occupational risk for nurses, but little is known about its related factors and possible predictors. The objective of the present study was to investigate whether nursing students’ neuroticism trait and coping styles can predict psychological harassment at work [...] Read more.
Psychological harassment is a serious occupational risk for nurses, but little is known about its related factors and possible predictors. The objective of the present study was to investigate whether nursing students’ neuroticism trait and coping styles can predict psychological harassment at work when they later become nurses. A non-experimental, longitudinal, three-wave prospective study with a time lag of 6 years was carried out, following nursing students from three Spanish universities until they joined the health labor market. The age range of the sample was 20–48 years, and the mean age was 26.99 ± 5.72; the majority of the sample were women (88.5%). Predictor variables were neuroticism and coping styles (emotional and behavioral coping). The criterion variable was psychological harassment. To examine the model fit between the predictor and criterion variables, we conducted structural equation modelling. Results confirmed a high correlation between neuroticism and psychological harassment. In addition, a direct effect of neuroticism on psychological harassment was found; however, emotional and behavioral coping styles did not show a good fit. Proactive interventions to improve emotional self-control are needed in order to prevent negative effects of psychological harassment at work on nurses. Full article
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Open AccessArticle Pregnant Women’s Intentions to Deliver at a Health Facility in the Pastoralist Communities of Afar, Ethiopia: An Application of the Health Belief Model
Int. J. Environ. Res. Public Health 2019, 16(5), 888; https://doi.org/10.3390/ijerph16050888
Received: 12 February 2019 / Revised: 27 February 2019 / Accepted: 1 March 2019 / Published: 11 March 2019
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Abstract
Despite the significant benefits of giving birth at a health facility to improve maternal and child health, the practice remains lower than expected in pastoralist communities of Ethiopia. Understanding the intentions of pregnant women to use health facilities for delivery predicts the adoption [...] Read more.
Despite the significant benefits of giving birth at a health facility to improve maternal and child health, the practice remains lower than expected in pastoralist communities of Ethiopia. Understanding the intentions of pregnant women to use health facilities for delivery predicts the adoption of the behavior, yet documented evidence of intention in the context of pastoralist populations remains scarce. The current study aimed to assess pregnant women’s intentions to use a health facility for delivery in the Afar region of Ethiopia using the framework of the health belief model (HBM). A community-based, cross sectional survey was conducted from April 1 to April 30 2016 among 357 randomly sampled pregnant women using an interviewer-administered, semi-structured questionnaire. Data were entered into EpiData and exported to SPSS version 20.0 for analysis. Principal component factor analysis was done to extract relevant constructs of the model, and the reliability of items in each construct was assessed for acceptability. Multivariate logistic regressions were applied to identify predictors of pregnant women’s intentions to give birth at a health facility. The odds ratio was reported, and statistical significance was declared at 95% CI and 0.05 p value. Three hundred fifty seven pregnant women participated in the study (104.6% response rate indicating above the minimum sample size required). Among the respondents, only 108 (30.3%) participants intended to use a health facility for the delivery for their current pregnancy. Higher household average monthly income [AOR = 1.23, 95% CI = (1.10 − 2.90), antenatal clinic (ANC) attendance for their current pregnancy [AOR = 1.41, 95% CI = (1.31 − 2.10), perceived susceptibility to delivery-related complications [AOR = 1.52, 95% CI = (1.30 − 2.70), and perceived severity of the delivery complications [AOR = 1.66, 95% CI = (1.12 − 2.31) were positively associated with pregnant women’s intentions to deliver at a health facility. Intention was negatively associated with participants’ perceived barriers to accessing a health facility [AOR = 0.62, 95% CI = (0.36 − 0.85). Conclusions: A low proportion of pregnant women in the sampled community intended to deliver at a health facility. Pastoralist communities may have special needs in this regard, with household income, antenatal care attendance, perceived risk of complications, and perceived barriers to accessing a health facility largely explaining the variance in intention. Community-based interventions providing counseling and messaging on danger signs in the perinatal period and emphasizing benefits of delivering at a facility are recommended, alongside improving access. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Determination of Metal Content of Waste Mobile Phones and Estimation of Their Recovery Potential in Turkey
Int. J. Environ. Res. Public Health 2019, 16(5), 887; https://doi.org/10.3390/ijerph16050887
Received: 22 January 2019 / Revised: 23 February 2019 / Accepted: 27 February 2019 / Published: 11 March 2019
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Abstract
Waste mobile phones constitute one of the fastest growing Waste Electrical and Electronic Equipment (WEEE) types all over the world due to technological innovations and shortening of their life span. They contain a complex mix of various materials, such as basic metals, precious [...] Read more.
Waste mobile phones constitute one of the fastest growing Waste Electrical and Electronic Equipment (WEEE) types all over the world due to technological innovations and shortening of their life span. They contain a complex mix of various materials, such as basic metals, precious metals and rare earth elements and represent an important secondary raw metal source. The main objectives of this study were to characterize the metal concentration of waste mobile phones by optimizing the inductively coupled plasma optical emission spectrometer (ICP-OES) operation parameters and estimate the metal recovery potential of waste mobile phones in Turkey. Therefore, selected mobile phone samples collected from a recycling center in Turkey were analyzed to determine their metal concentrations. Then, the theoretical recovery potentials of precious and rare earth metals from waste mobile phones were estimated for Turkey. The analytical methods optimized in this study can help further research activities to obtain comprehensive data for determination of the critical metals (precious metals and rare earth elements) in WEEE samples so that proper recycling and recovery strategies can be selected and implemented. Full article
(This article belongs to the Special Issue Hazardous Waste and Human Health)
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Open AccessArticle Hydrogeochemical Characterization and Suitability Assessment of Groundwater: A Case Study in Central Sindh, Pakistan
Int. J. Environ. Res. Public Health 2019, 16(5), 886; https://doi.org/10.3390/ijerph16050886
Received: 27 December 2018 / Revised: 1 March 2019 / Accepted: 5 March 2019 / Published: 11 March 2019
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Abstract
Groundwater is the most important water resource, on which depends human geo-economic development and survival. Recent environmental changes and anthropogenic activities render groundwater severely vulnerable. Groundwater in Central Sindh, Pakistan, is facing a similar situation. Hydrogeochemical characteristics of the groundwater in the said [...] Read more.
Groundwater is the most important water resource, on which depends human geo-economic development and survival. Recent environmental changes and anthropogenic activities render groundwater severely vulnerable. Groundwater in Central Sindh, Pakistan, is facing a similar situation. Hydrogeochemical characteristics of the groundwater in the said region were investigated by analyzing 59 groundwater samples via agricultural and drinking indices, using various statistical methods and graphical approaches to identify factors affecting groundwater. Major reactions occurring in the groundwater system were quantified by hydrogeochemical modeling. A statistical summary reveals the abundance of cations is Na+ > Ca2+ > Mg2+ > K+, while the abundance of anions is HCO3 > Cl > SO42. Groundwater chemistry is mainly of rock dominance. Correlation analysis and graphical relationships between ions reveal that ion exchange and rock weathering such as the dissolution of halite, albite, and dissolution of carbonate minerals are important rock–water interactions, governing the evolution of groundwater chemistry. Hydrochemical facies are predominantly of mixed CaMgCl and Na-Cl type, with few samples of Ca-HCO3 type, which constitutes fresh recharged water. Based on the Water Quality Index (WQI), 28.82% samples were found to be unsuitable for drinking. A United States Salinity Laboratory (USSL) diagram, Wilcox diagram, and other agricultural indices indicate that majority of the groundwater samples fall within the acceptable range for irrigation purposes. Full article
(This article belongs to the Special Issue Drinking Water and Health Risks)
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Open AccessReview Sleep Quality among Police Officers: Implications and Insights from a Systematic Review and Meta-Analysis of the Literature
Int. J. Environ. Res. Public Health 2019, 16(5), 885; https://doi.org/10.3390/ijerph16050885
Received: 16 January 2019 / Revised: 28 February 2019 / Accepted: 7 March 2019 / Published: 11 March 2019
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Abstract
Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, [...] Read more.
Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems. The aim of the present study was to analyze the sleep quality among police officers. A systematic literature search, in PubMed/MEDLINE, PsycINFO, Scopus, ISI/Web of Science (WoS) and the Cochrane Library was conducted. Original articles, published in English, French, Italian, Spanish and Portuguese, the primary objective of which was the evaluation of the quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) in Police Forces, were selected. From an initial sample of 1,149 studies, 13 articles were included in the meta-analysis (3,722 police officers). The pooled prevalence of bad sleep quality in police officers was 51% [95%CI 42–60%]. The pooled global score of the PSQI was 5.6 [95%CI 5.0–6.3], corresponding to a low average quality. At the meta-regressions, statistically significant associations could be found for work seniority (in terms of years of service) and being on shift. The poor quality of sleep in police officers could have negative consequences for workers’ health and for the safety of third parts. The implementation of health and sleep hygiene promotion programs in police forces is strongly recommended. Full article
(This article belongs to the Special Issue Sleep Disorders Across the Lifespan: A Different Perspective)
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Open AccessArticle Searching for the Role of the IFNγ rs2430561 Polymorphism in Inducible Inflammation: Contribution to Metabolic Syndrome in 45 to 60-Year-Old Women
Int. J. Environ. Res. Public Health 2019, 16(5), 884; https://doi.org/10.3390/ijerph16050884
Received: 10 January 2019 / Revised: 25 February 2019 / Accepted: 7 March 2019 / Published: 11 March 2019
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Abstract
Metabolic syndrome (MetS) is a cluster of conditions, increasing the risk of developing diseases that can lead to premature death. Interferon γ-inducible (the production of which is dependent on the IFNγ rs2430561 polymorphism) tryptophan-kynurenine inflammatory cascade helps to understand the increased association between [...] Read more.
Metabolic syndrome (MetS) is a cluster of conditions, increasing the risk of developing diseases that can lead to premature death. Interferon γ-inducible (the production of which is dependent on the IFNγ rs2430561 polymorphism) tryptophan-kynurenine inflammatory cascade helps to understand the increased association between inflammatory process and MetS, which is why we seek the relationship between the IFNγ gene polymorphisms and serum levels of markers of interferon-gamma (IFNγ)-inducible inflammatory cascade. The study sample consisted of 416 women, including 118 (28.4%) with MetS. The research procedure involved interview, anthropometric measurements, and blood collection. Kynurenine levels were significantly higher in the group of women with MetS. In the group with MetS, the A/T genotype of the IFNγ gene was accompanied by higher kynurenine levels. A direct relationship between the IFNγ gene polymorphisms and the rest of the markers of IFNγ-inducible inflammatory cascade was not confirmed with regard to MetS in 45 to 60-year-old women. A disparity in the kynurenine level, as well as the relationship between the presence of the A/T genotype of the IFNγ gene and a higher level of kynurenine in the group of women with MetS, may indicate an association between inflammation, metabolic disorders and tryptophan-kynurenine inflammatory cascade. Full article
(This article belongs to the Section Women's Health)
Open AccessArticle Combination of In Situ Feeding Rate Experiments and Chemical Body Burden Analysis to Assess the Influence of Micropollutants in Wastewater on Gammarus pulex
Int. J. Environ. Res. Public Health 2019, 16(5), 883; https://doi.org/10.3390/ijerph16050883
Received: 11 January 2019 / Revised: 27 February 2019 / Accepted: 6 March 2019 / Published: 11 March 2019
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Abstract
Wastewater discharge is one of the main sources of micropollutants within the aquatic environment. To reduce the risks for the aquatic environment, the reduction of the chemical load of wastewater treatment plant effluent is critical. Based on this need, additional treatment methods, such [...] Read more.
Wastewater discharge is one of the main sources of micropollutants within the aquatic environment. To reduce the risks for the aquatic environment, the reduction of the chemical load of wastewater treatment plant effluent is critical. Based on this need, additional treatment methods, such as ozonation, are currently being tested in several wastewater treatment plants (WWTPs). In the present study, effects were investigated using in situ feeding experiments with Gammarus pulex and body burden analyses of frequently detected micropollutants which used a Quick Easy Cheap Effective Rugged and Safe (QuEChERS) multi-residue method to quantify internal concentrations in collected gammarids. Information obtained from these experiments complemented data from the chemical analysis of water samples and bioassays, which predominantly cover hydrophilic substances. When comparing up- and downstream feeding rates of Gammarus pulex for seven days, relative to the WWTPs, no significant acute effects were detected, although a slight trend of increased feeding rate downstream of the WWTP Aachen-Soers was observed. The chemical load released by the WWTP or at other points, or by diffuse sources, might be too low to lead to clear acute effects on G. pulex. However, some compounds found in wastewater are able to alter the microbial community on its leaves, leading to an increase in the feeding rate of G. pulex. Chemical analysis of internal concentrations of pollutants in the tissues of collected gammarids suggests a potential risk for chronic effects with the chemicals imidacloprid, thiacloprid, carbendazim, and 1H-benzotriazole when exceeding the critical toxic unit value of −3. This study has demonstrated that a combination of acute testing and measurement of the internal concentration of micropollutants that might lead to chronic effects is an efficient tool for investigating river systems, assuming all relevant factors (e.g., species or season) are taken into account. Full article
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Open AccessArticle A Model for Promoting Occupational Safety and Health in Taiwan’s Hospitals: An Integrative Approach
Int. J. Environ. Res. Public Health 2019, 16(5), 882; https://doi.org/10.3390/ijerph16050882
Received: 11 February 2019 / Revised: 3 March 2019 / Accepted: 5 March 2019 / Published: 11 March 2019
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Abstract
Advocating for improving workplace safety and health has gained substantial support in recent years. The medical industry is a high-risk industry and receives considerable public attention. This study used an integrative approach as a starting point and combined the contextual factors of an [...] Read more.
Advocating for improving workplace safety and health has gained substantial support in recent years. The medical industry is a high-risk industry and receives considerable public attention. This study used an integrative approach as a starting point and combined the contextual factors of an organization: perceived organizational support, safety climate, social influence, and shared decision making. Subsequently, the effects of these factors on preventive action and safety satisfaction were investigated. This study surveyed employees of two hospitals, one in Northern Taiwan and one in Eastern Taiwan, collecting valid data from 468 respondents. Structural equation modeling (SEM) was used to verify our research framework. The finding indicates that (1) All hypotheses proposed in this study were supported. (2) The overall goodness of fit of the model was excellent, and the explained variance of the outcome variables was high. (3) Safety climate had the strongest total effects on preventive action and safety satisfaction simultaneously, whereas preventive action had the strongest direct effect on safety satisfaction. The objective of this study was to obtain empirical conclusions and make suggestions for academic theory and clinical practice. The findings may serve as a reference for future research and for scholars and practitioners, enabling the creation of healthy workplaces and, thus, a brighter future. Full article
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Open AccessArticle Development and Validation of an Environmental Health Literacy Assessment Screening Tool for Domestic Well Owners: The Water Environmental Literacy Level Scale (WELLS)
Int. J. Environ. Res. Public Health 2019, 16(5), 881; https://doi.org/10.3390/ijerph16050881
Received: 5 January 2019 / Revised: 25 February 2019 / Accepted: 26 February 2019 / Published: 11 March 2019
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Abstract
In the U.S., privately owned wells are not subject to any regulatory testing requirements. Well owners must have sufficient environmental health literacy (EHL) to understand and interpret information that contain complex terms and labels to manage their water quality. The objective of this [...] Read more.
In the U.S., privately owned wells are not subject to any regulatory testing requirements. Well owners must have sufficient environmental health literacy (EHL) to understand and interpret information that contain complex terms and labels to manage their water quality. The objective of this paper is to assess the performance and validity of a new EHL screening tool. The Water Environmental Literacy Level Scale (WELLS) is based on the Newest Vital Sign (NVS) and contains six questions on comprehension, calculations and application of information. Content validity was assessed from expert review. Criterion-related and construct validity were evaluated using an online, convenience sample of adults (n = 869). Percent of correct responses for items ranged from 53% to 96% for NVS and from 41% to 97% for WELLS. Completion time, mean scores, distributions, and internal consistency were equivalent between both scales. Higher scores suggest higher EHL. The scales were moderately correlated (ρ = 0.47, p < 0.001). Kappa agreement was 74%. Bland-Altman plots depicted little mean difference between the scales. Education and income level were positively associated with EHL. WELLS showed criterion-validity with NVS and construct validity with education and income. In practice or research, WELLS could quickly screen individuals for low EHL. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Eight Weeks of Aerobic Interval Training Improves Psychomotor Function in Patients with Parkinson’s Disease—Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2019, 16(5), 880; https://doi.org/10.3390/ijerph16050880
Received: 18 January 2019 / Revised: 5 March 2019 / Accepted: 7 March 2019 / Published: 11 March 2019
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Abstract
Background: This study examined the generalized effects of cycle ergometer aerobic interval training (AIT) on psychomotor behaviors in individuals with Parkinson’s disease (PD), including bimanual motor control, cognitive function, and neurological motor and non-motor parkinsonian signs. Methods: Twenty mild to moderate PD patients [...] Read more.
Background: This study examined the generalized effects of cycle ergometer aerobic interval training (AIT) on psychomotor behaviors in individuals with Parkinson’s disease (PD), including bimanual motor control, cognitive function, and neurological motor and non-motor parkinsonian signs. Methods: Twenty mild to moderate PD patients were randomly allocated to the following groups: (1) trained group (PD-TR, n = 10), which besides receiving usual care, underwent an 8-week moderate intensity AIT program; or (2) control group (PD-CO, n = 10) which received usual care, including participation in conventional physical therapy. Both groups were tested before and after the 8-week AIT program period with the following assessments: (1) laboratory analyses of bimanual motor control, (2) psychological evaluation of cognitive function, and (3) an evaluation of neurological parkinsonian signs. Results: The PD-TR group exhibited improved (1) bimanual motor control, reflected by a decreased time (p = 0.013) and increased rate of grip force development (p = 0.013) in the manipulating hand and a decreased time delay between grip force initiation in the manipulating and stabilizing hand (p = 0.020); (2) executive function, reflected by decreased performance time in part II of the Stroop Test (p = 0.007); and (3) neurological parkinsonian signs, reflected by an amelioration of upper-extremity bradykinesia (p = 0.015) and improvement in daily life manual functions (p = 0.004), mood, and intellectual function (p = 0.005). Conclusions: Following an 8-week moderate intensity AIT program, patients with PD exhibited improved psychomotor behaviors, reflected by bimanual motor control, executive function, and neurological parkinsonian signs. Full article
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Open AccessArticle Relative Risk Perceptions between Snus and Cigarettes in a Snus-Prevalent Society—An Observational Study over a 16 Year Period
Int. J. Environ. Res. Public Health 2019, 16(5), 879; https://doi.org/10.3390/ijerph16050879
Received: 30 January 2019 / Revised: 5 March 2019 / Accepted: 6 March 2019 / Published: 11 March 2019
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Abstract
Background: Most studies on perceived risks of smokeless tobacco products (SLT) have been conducted in the U.S., and the vast majority conclude that perceptions of the relative harmfulness of SLT versus cigarettes in the population are inconsistent with epidemiologically-based risk estimates, and typically [...] Read more.
Background: Most studies on perceived risks of smokeless tobacco products (SLT) have been conducted in the U.S., and the vast majority conclude that perceptions of the relative harmfulness of SLT versus cigarettes in the population are inconsistent with epidemiologically-based risk estimates, and typically conflated to that of cigarettes. We tested whether such inaccuracies also existed in Norway, where SLT-products are less toxic (Swedish snus) and SLT use is more prevalent than in the U.S. Methods: Over a 16 years period (2003–2018), 13,381 respondents (aged 16–79 years) answered questions about risk perceptions in Statistics Norway’s nationally representative survey of tobacco behavior. We applied an indirect measure of comparative harm where risk beliefs for eight nicotine products were assessed independently of other products and then compared the answers. The wording of the question was: “We will now mention a variety of nicotine products and ask you how harmful you think daily use of these are. Use a scale from 1 to 7, where 1 is slightly harmful and 7 is very harmful”. Mean scores with 95% confidence intervals were calculated. Results: The overall risk score for cigarettes was 6.48. The risk score for snus was 5.14–79.3% of the risk score of cigarettes. The relative risk scores for e-cigarettes (3.78) and NRT products (3.39) was 58.4% and 52.3% when compared to cigarettes. Perceptions of risk were stable over time. A strong association was observed between perceived risk of snus and having used snus in attempts to quit smoking. Conclusion: Perceptions of relative risk between snus and cigarettes is inconsistent with estimates from medical expert committees, which assess the overall health risk from use of Swedish snus to be minor when compared to the risk from smoking. Like the situation in the US, incorrect beliefs about SLT risks seem to be prevalent also in the snus-prevalent Norwegian setting. Accurate information on differential harms needs to be communicated. Future research should try to identify reasons why health authorities in the US and Scandinavia allow these well-documented misconceptions to persist. Full article
(This article belongs to the Special Issue Tobacco Harm Reduction)
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Open AccessArticle Do Sleep Disorders Positively Correlate with Dry Eye Syndrome? Results of National Claim Data
Int. J. Environ. Res. Public Health 2019, 16(5), 878; https://doi.org/10.3390/ijerph16050878
Received: 13 November 2018 / Revised: 6 March 2019 / Accepted: 7 March 2019 / Published: 11 March 2019
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Abstract
Purpose: Dry eye syndrome (DES) is a common disease with an increasing occurrence. Although DES symptoms are considered mild, it can reduce quality of life for individuals. Many studies on DES have been conducted, but these focused on the use of electronic [...] Read more.
Purpose: Dry eye syndrome (DES) is a common disease with an increasing occurrence. Although DES symptoms are considered mild, it can reduce quality of life for individuals. Many studies on DES have been conducted, but these focused on the use of electronic devices. Here, we investigate an association between DES and sleep disorders in the context of emerging health issues. Methods: Our data came from the National Health Insurance Service (NHIS) National Sample Cohort, which included 44,366 patients and was based on a 1:1 matching method (sleep disorder patients vs. patients without sleep disorders) during 2012–2015. Using survival analysis with a Cox proportional hazard model, we identified an association of sleep disorders with DES. Results: About 16.7% of all patients were diagnosed with DES, and prevalence was higher in patients with sleep disorders (sleep disorders: 19.82%, no sleep disorders: 13.67%). Survival analysis showed that sleep disorders positively correlated with DES diagnosis (Hazard Ratio (HR): 1.320, 95% Confidence Interval (CI): 1.261–1.382, p-value < 0.0001). Positive trends were enhanced in males, younger patients, lower economic levels, and with higher severity of comorbid. Conclusions: Our findings suggest that sleep disorder was positively associated with DES. This correlation can be helpful in effective management of both sleep disorders and DES in South Koreans. Full article
(This article belongs to the Special Issue Sleep Health)
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Open AccessArticle Farmers’ Rural-To-Urban Migration, Influencing Factors and Development Framework: A Case Study of Sihe Village of Gansu, China
Int. J. Environ. Res. Public Health 2019, 16(5), 877; https://doi.org/10.3390/ijerph16050877
Received: 24 January 2019 / Revised: 5 March 2019 / Accepted: 6 March 2019 / Published: 10 March 2019
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Abstract
Farmers are the major participants in rural development process and their willingness to settle in urban areas directly affects the implementation of rural revitalization strategy. Based on Ostrom’s institutional analysis and development (IAD) framework, we analyzed farmers’ willingness to settle in urban areas [...] Read more.
Farmers are the major participants in rural development process and their willingness to settle in urban areas directly affects the implementation of rural revitalization strategy. Based on Ostrom’s institutional analysis and development (IAD) framework, we analyzed farmers’ willingness to settle in urban areas and its influencing factors by binary Logistic regression and cluster analysis of survey data of 190 rural households in Sihe village of Gansu Province of China. The results show that: (1) In Sihe village, farmers’ willingness to settle in urban areas was low in general and influenced by their neighbors’ decisions or behaviors. Households willing and unwilling to migrate to urban areas both presented significant spatial agglomeration. (2) The factors influencing farmers’ willingness to settle in urban areas were analyzed from six aspects: individual characteristics, family characteristics, residence characteristics, cognitive characteristics, institutions, and constraints. The main influencing factors were found to be age, occupation, number of non-agricultural workers in the family, household cultivated land area, annual household income, house building materials, degree of satisfaction with social pension, homestead and contracted land subsidies, income constraints, and other constraints. (3) Individual heterogeneity and difference in economic basis determined the difference in farmers’ willingness to settle in urban areas. Institutions and constraints played different roles in the migration willingness of different groups of farmers (Note: More details on the sample as well as further interpretation and discussion of the surveys are available in the associated research article (“Village-Scale Livelihood Change and the Response of Rural Settlement Land Use: Sihe Village of Tongwei County in Mid-Gansu Loess Hilly Region as an Example” (Ma, L.B.; Liu, S.C.; Niu, Y.W.; Chen, M.M., 2018)). Full article
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Open AccessArticle Objectively-Measured Neighbourhood Attributes as Correlates and Moderators of Quality of Life in Older Adults with Different Living Arrangements: The ALECS Cross-Sectional Study
Int. J. Environ. Res. Public Health 2019, 16(5), 876; https://doi.org/10.3390/ijerph16050876
Received: 7 February 2019 / Revised: 1 March 2019 / Accepted: 7 March 2019 / Published: 10 March 2019
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Abstract
With an ageing world population, preservation of older adults’ health and quality of life (QoL) is paramount. Due to lower levels of physical functionality, older adults are particularly susceptible to local environment influences, especially those living alone and lacking family support. Using generalised [...] Read more.
With an ageing world population, preservation of older adults’ health and quality of life (QoL) is paramount. Due to lower levels of physical functionality, older adults are particularly susceptible to local environment influences, especially those living alone and lacking family support. Using generalised additive mixed models, we examined associations and confounder-adjusted associations between objectively-measured neighbourhood attributes and QoL domains in 909 Hong Kong Chinese elderly community dwellers. Most examined neighbourhood attributes were not associated with QoL in the whole sample. Neighbourhood residential and entertainment density was curvilinearly and/or linearly related to specific QoL domains. Number of parks was negatively associated with social QoL and having well-treed parks with higher levels of social QoL. Older adults living alone in neighbourhoods with poor access to destinations and few activities in parks showed lower environmental and/or social QoL than their counterparts. Neighbourhood built environment characteristics do not seem to impact Hong Kong older adults’ physical and psychological QoL. Medium-to-high density, well-ordered neighbourhoods with optimal mixes of well-treed public open spaces and services meeting their daily needs may significantly contribute to social and environmental QoL in this population and appear particularly important to those living alone. Full article
(This article belongs to the Special Issue Neighborhood Environmental Influences on Health and Well-Being)
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Open AccessArticle Selected Healthy Behaviors and Quality of Life in People Who Practice Combat Sports and Martial Arts
Int. J. Environ. Res. Public Health 2019, 16(5), 875; https://doi.org/10.3390/ijerph16050875
Received: 20 January 2019 / Revised: 4 March 2019 / Accepted: 7 March 2019 / Published: 10 March 2019
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Abstract
Background: The quality of life of a society is conditioned by many factors, and depends, among other things, on preferred behavior patterns. Combat sports (CS) and martial arts (MA) have a special educational potential in the area of shaping positive behavior patterns [...] Read more.
Background: The quality of life of a society is conditioned by many factors, and depends, among other things, on preferred behavior patterns. Combat sports (CS) and martial arts (MA) have a special educational potential in the area of shaping positive behavior patterns and transmitting moral values which could help reduce aggression in society. The aim of the work was to determine the relationship between health behaviors and the quality of life of people who practice combat sports and martial arts (CS and MA) recreationally, in addition to practicing other sports, and as competitors at the master level. Methods: The research embraced 543 people who practice combat sports and martial arts. Three groups were selected: recreational (n = 362), people who reconciled practicing various sports (n = 115), and competitors who practiced combat sports or martial arts at the master level (n = 66). The average age of the respondents was 24.49 ± 7.82. The standardized WHOQOL-BREF questionnaire and another questionnaire for a lifestyle survey were applied. The Kruskal-Wallis test was used to compare several independent samples. In the case of determining statistical significance of differences the Mann-Whitney test was employed, and for the qualitative data analyses the trait frequency and the independence chi-square test were used. The effect size was calculated for each test ( E R 2 , rg, Cramér’s V). The value of p ≤ 0.05 was assumed to be statistically significant. Results: The highest quality of life (in the physical, psychological and environmental domains) was characteristic of the competitors, who practiced only combat sports and martial arts. They also displayed the most health-oriented behaviors. The surprising results were: lower quality of life in the assessment of nondrinkers and nonsmokers, and higher among people who were overweight. Conclusions: We have found positive correlations between practicing CS and MA, health behaviours and higher scores in quality of life self-evaluation, particularly where practitioners are exclusively focused on CS and MA and practice these at a competitive level. Our findings thus support the growing evidence that competitive level CS and MA are an effective means of improving people’s quality of life. Future research needs to clarify whether CS and MA can also be recommended to recreational and non-competitive practitioners as a means to improve their subjective quality of life. Full article
(This article belongs to the Special Issue Health, Exercise and Sports Performance)
Open AccessArticle Contextual Association between Political Regime and Adolescent Suicide Risk in Korea: A 12-year Repeated Cross-Sectional Study from Korea
Int. J. Environ. Res. Public Health 2019, 16(5), 874; https://doi.org/10.3390/ijerph16050874
Received: 7 February 2019 / Revised: 5 March 2019 / Accepted: 6 March 2019 / Published: 10 March 2019
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Abstract
This study evaluated associations between contextual political determinants and individual adolescent suicide risk (SR). Using repeated cross-sectional individual-level data of 829,861 students in the Korea Youth Risk Behavior Web-based Survey and national contextual-level data during 2005–2016, cross-classified random effects models were conducted to [...] Read more.
This study evaluated associations between contextual political determinants and individual adolescent suicide risk (SR). Using repeated cross-sectional individual-level data of 829,861 students in the Korea Youth Risk Behavior Web-based Survey and national contextual-level data during 2005–2016, cross-classified random effects models were conducted to estimate fixed period and cohort effects of political determinants on SR. Adolescent SR was reduced during conservative presidential regimes. Contrary to presidencies’ period effects, conservative regimes had negative cohort effects on adolescent SR. The odds of suicide attempt and depression increased in the grade cohorts affected by college entrance examination policies of conservative regimes. Politics has significantly impacted adolescent SR despite differences in period and cohort effects of politics. These findings imply the need to encourage adolescents’ political participation in choosing political forces with policies favorable to their own mental health. Full article
(This article belongs to the Section Mental Health)
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Open AccessArticle Handgrip Strength is Associated with Psychological Functioning, Mood and Sleep in Women over 65 Years
Int. J. Environ. Res. Public Health 2019, 16(5), 873; https://doi.org/10.3390/ijerph16050873
Received: 16 February 2019 / Revised: 1 March 2019 / Accepted: 7 March 2019 / Published: 10 March 2019
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Abstract
Background: The predictive nature of handgrip strength (HGS) was analyzed, showing a direct association with the functional domains of health, cognitive and social levels, and some inverse association with depressive values. Aim: To analyze the relationship between HGS and the psychological functioning of [...] Read more.
Background: The predictive nature of handgrip strength (HGS) was analyzed, showing a direct association with the functional domains of health, cognitive and social levels, and some inverse association with depressive values. Aim: To analyze the relationship between HGS and the psychological functioning of older people, such as depression, mood and sleep. Method: A total of 38 women, participated in this study (age = 72.29 ± 5.21 year). As measurement instruments a hand dynamometer was used for HGS, Profile of Mood Status (POMS) 29 was used for mood, the geriatric depression scale was used for depression, and the Oviedo questionnaire was used for sleep. A cluster analysis was performed taking into account the performance in the HGS. Results: The group that obtained a high HGS result showed a better total score for vigor, depression, insomnia and sleep. Pearson correlation analysis showed significant correlations between HGS and vigor, depression, insomnia and sleep total score. Conclusion: HGS in women over 65 years was associated with psychological functioning and sleep quality. Full article
(This article belongs to the Special Issue Physical Activity and Mental Health)
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Open AccessConcept Paper A Multisensory Multilevel Health Education Model for Diverse Communities
Int. J. Environ. Res. Public Health 2019, 16(5), 872; https://doi.org/10.3390/ijerph16050872
Received: 10 January 2019 / Revised: 18 February 2019 / Accepted: 5 March 2019 / Published: 10 March 2019
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Abstract
Owing to their enormous capacity to improve health and save lives, public health researchers and practitioners have worked on developing effective frameworks for the optimization of health promotion strategies. A multilevel focus, as exemplified by the Socio-Ecological Model (SEM), is one common denominator [...] Read more.
Owing to their enormous capacity to improve health and save lives, public health researchers and practitioners have worked on developing effective frameworks for the optimization of health promotion strategies. A multilevel focus, as exemplified by the Socio-Ecological Model (SEM), is one common denominator among these frameworks. The SEM highlights important social and ecological influences on health behavior by delineating the different levels of influence. These include public policy, organizational, community, interpersonal, and intrapersonal levels, which, when considered during the development of health promotion campaigns—especially those that focus on health education—strengthen the influence of that campaign on targeted behaviors. However, the SEM lacks a complimenting framework for understanding the role of conventional and unconventional approaches to health education; that is, how to design a health education intervention that considers both the context, such as the social and ecological levels of influence, and the best approaches for developing and delivering the health education in a manner that optimizes its effectiveness in today’s modern and increasingly diverse world. Addressing this gap, the current article presents an integrative Multisensory Multilevel Health Education Model (MMHEM), which incorporates three key domains—(1) Art (innovativeness/creativity), (2) Culture (cultural tailoring), and (3) Science (evidence-based), while promoting the importance of considering the socio-ecological levels of influence on targeted behaviors. Using a successful health education intervention, called the Hip Hop Stroke, we deconstruct the Multisensory Multilevel Health Education Model and discuss its potential role as a guide for developing public health education interventions. Full article
(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)
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Open AccessArticle In Vitro and In Vivo Testing to Determine Cd Bioaccessibility and Bioavailability in Contaminated Rice in Relation to Mouse Chow
Int. J. Environ. Res. Public Health 2019, 16(5), 871; https://doi.org/10.3390/ijerph16050871
Received: 17 February 2019 / Revised: 4 March 2019 / Accepted: 6 March 2019 / Published: 10 March 2019
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Abstract
A combination of an in vitro physiologically based extraction test (PBET) and an in vivo mouse model was used to determine Cd oral bioaccessibility and estimate bioavailability in Cd-contaminated rice. The PBET found lower Cd bioaccessibility in the intestinal stage (40–50%) than in [...] Read more.
A combination of an in vitro physiologically based extraction test (PBET) and an in vivo mouse model was used to determine Cd oral bioaccessibility and estimate bioavailability in Cd-contaminated rice. The PBET found lower Cd bioaccessibility in the intestinal stage (40–50%) than in the gastric stage (93–98%) for both rice and mouse chow. No significant difference was found in Cd bioaccessibility between contaminated rice and Cd-amended mouse chow in the gastric or gastrointestinal phase (except for rice 1). The result of the in vivo bioassay revealed that Cd absorption in the kidney or liver of mice fed with contaminated rice were significantly higher than in the mouse chow group containing an equal Cd concentration. Correlation analysis between concentrations of different elements in mouse chow or rice and Cd concentrations in mice kidney or liver showed that Fe, Ca, Cu, and Zn had significant negative correlation (r2 > 0.7, p < 0.01). These results suggest that nutritional elements in the diet could affect Cd absorption and distribution in organs and that different food matrices may result in unequal Cd health risks at an equal Cd concentration due to the specific mineral content of food. Full article
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