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Int. J. Environ. Res. Public Health, Volume 16, Issue 7 (April-1 2019)

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Cover Story (view full-size image) Coccidioidomycosis (CM) is a fungal infection endemic in the southwestern United States (U.S.). In [...] Read more.
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Open AccessArticle Quantity–Quality Trade-Off and Early Childhood Development in Rural Family: Evidence from China’s Guizhou Province
Int. J. Environ. Res. Public Health 2019, 16(7), 1307; https://doi.org/10.3390/ijerph16071307
Received: 4 March 2019 / Revised: 4 April 2019 / Accepted: 9 April 2019 / Published: 11 April 2019
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Abstract
This paper empirically investigates the causal effect of having siblings on the cognitive, language, motor, and social-emotional skills of infants under the age of 2 in rural families in Guizhou Province in China. The results are based on data from a survey conducted [...] Read more.
This paper empirically investigates the causal effect of having siblings on the cognitive, language, motor, and social-emotional skills of infants under the age of 2 in rural families in Guizhou Province in China. The results are based on data from a survey conducted in 2017. To effectively relieve the endogeneity induced by selection bias, we applied the matching-smoothing (MS) method to evaluate the effects of having siblings. The results show that, first, having siblings produces significant negative impacts on an infant’s cognitive, language, and social-emotional skills; second, intrahousehold resource allocation is the mechanism behind the Quantity–Quality (Q–Q) trade-off, and it exerts its effects through two key identified channels—the home environment and parental warmth. By spreading the parents’ investment among siblings in terms of both the home environment and parental warmth, having siblings hinders infants’ early development. Our findings provide new evidence for the relation between the Q–Q trade-off and early childhood development in rural families in western China. Full article
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Open AccessArticle Reduction of Dental Caries Among Children and Adolescents From a 15-Year Community Water Fluoridation Program in a Township Area, Korea
Int. J. Environ. Res. Public Health 2019, 16(7), 1306; https://doi.org/10.3390/ijerph16071306
Received: 26 March 2019 / Revised: 8 April 2019 / Accepted: 10 April 2019 / Published: 11 April 2019
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Abstract
Since 2000, a community water fluoridation program (CWFP) has been implemented in Hapcheon for over 15 years. We aimed to evaluate the caries-reducing effect on permanent teeth after this implementation. In 2015, evaluation surveys were conducted by our study group, 498 subjects aged [...] Read more.
Since 2000, a community water fluoridation program (CWFP) has been implemented in Hapcheon for over 15 years. We aimed to evaluate the caries-reducing effect on permanent teeth after this implementation. In 2015, evaluation surveys were conducted by our study group, 498 subjects aged 8, 10, 12, and 15 years. As the control, 952 similarly aged subjects were selected from the Sixth Korean National Health and Nutrition Examination Survey (2013-2015 KNHANES). Data of a prospective cohort of 671 8-,10- and 12-year-olds, collected when CWFP started, were used for the evaluation. Caries-reducing effects were estimated by decayed, missing and filled teeth (DMFT) scores between CWFP and control groups, pre- and post-program. Confounders including the mean number of sealant teeth and gender were adjusted for. The mean adjusted DMFT scores of 10-, 12- and 15-year-olds in Hapcheon were significantly lower compared to KNHANES DMFT scores; in addition, those of 8-, 10- and 12-year-olds after the 15-year CWFP were significantly lower than in 2000. The caries-reducing effect among 12-year-olds was 37.6% compared to those recorded in KNHANES, and 67.4% compared to those in 2000. In conclusion, the caries-reducing effect was so high that health policy makers should consider CWFP as a priority policy for caries-reducing in Korean children and adolescents. Full article
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Open AccessArticle An Evaluation of a Low-Intensity Cognitive Behavioral Therapy mHealth-Supported Intervention to Reduce Loneliness in Older People
Int. J. Environ. Res. Public Health 2019, 16(7), 1305; https://doi.org/10.3390/ijerph16071305
Received: 5 March 2019 / Revised: 2 April 2019 / Accepted: 3 April 2019 / Published: 11 April 2019
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There is a high prevalence of loneliness among older people, especially in residential care settings. Loneliness is often accompanied by maladaptive cognitions which can affect the maintenance and establishment of meaningful social connections. This study implemented and evaluated a low-intensity Cognitive Behavior Therapy [...] Read more.
There is a high prevalence of loneliness among older people, especially in residential care settings. Loneliness is often accompanied by maladaptive cognitions which can affect the maintenance and establishment of meaningful social connections. This study implemented and evaluated a low-intensity Cognitive Behavior Therapy (LI-CBT) mHealth-supported intervention which targeted maladaptive cognitions in older people (≥60 years) experiencing loneliness. The three-month intervention using WhatsApp was implemented with older people in four inner-city residential care facilities. The intervention included three components: technology acceptance, psycho-education, and individualized positively worded messages addressing maladaptive cognitions. The intervention was evaluated using a randomized control design. Key outcomes were measured pre-, post-, and one month after the intervention. There were significant changes in social cognition (YSQ-SF T0–T1–T2, X2 = 9.69, p = 0.008) and loneliness levels (total loneliness T0–T1–T2, X2 = 14.62, p = 0.001), and an increase in WhatsApp usage (T0 = 26% vs. T1 = 60%, X2=15.22, p = 0.019). At 1-month follow-up, even with a significant reduction in WhatsApp usage, a significant reduction in loneliness was maintained. LI-CBT delivered via instant messaging may be effective in reducing loneliness experienced by older people. Full article
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Open AccessArticle Theory Content, Question-Behavior Effects, or Form of Delivery Effects for Intention to Become an Organ Donor? Two Randomized Trials
Int. J. Environ. Res. Public Health 2019, 16(7), 1304; https://doi.org/10.3390/ijerph16071304
Received: 11 March 2019 / Revised: 8 April 2019 / Accepted: 9 April 2019 / Published: 11 April 2019
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Abstract
Eliciting different attitudes with survey questionnaires may impact on intention to donate organs. Previous research used varying numbers of questionnaire items, or different modes of intervention delivery, when comparing groups. We aimed to determine whether intention to donate organs differed among groups exposed [...] Read more.
Eliciting different attitudes with survey questionnaires may impact on intention to donate organs. Previous research used varying numbers of questionnaire items, or different modes of intervention delivery, when comparing groups. We aimed to determine whether intention to donate organs differed among groups exposed to different theoretical content, but similar questionnaire length, in different countries. We tested the effect of excluding affective attitudinal items on intention to donate, using constant item numbers in two modes of intervention delivery. Study 1: A multi-country, interviewer-led, cross-sectional randomized trial recruited 1007 participants, who completed questionnaires as per group assignment: including all affective attitude items, affective attitude items replaced, negatively-worded affective attitude items replaced. Study 2 recruited a UK-representative, cross-sectional sample of 616 participants using an online methodology, randomly assigned to the same conditions. Multilevel models assessed effects of group membership on outcomes: intention to donate (primary), taking a donor card, following a web-link (secondary). In study 1, intention to donate did not differ among groups. Study 2 found a small, significantly higher intention to donate in the negatively-worded affective attitudes replaced group. Combining data yielded no group differences. No differences were seen for secondary outcomes. Ancillary analyses suggest significant interviewer effects. Contrary to previous research, theoretical content may be less relevant than number or valence of questionnaire items, or form of intervention delivery, for increasing intention to donate organs. Full article
(This article belongs to the Special Issue Chronic Kidney Disease)
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Open AccessArticle Application of Artificial Neural Networks to Identify Alzheimer’s Disease Using Cerebral Perfusion SPECT Data
Int. J. Environ. Res. Public Health 2019, 16(7), 1303; https://doi.org/10.3390/ijerph16071303
Received: 18 March 2019 / Revised: 9 April 2019 / Accepted: 10 April 2019 / Published: 11 April 2019
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The aim of this study was to demonstrate the usefulness of artificial neural networks in Alzheimer disease diagnosis (AD) using data of brain single photon emission computed tomography (SPECT). The results were compared with discriminant analysis. The study population consisted of 132 clinically [...] Read more.
The aim of this study was to demonstrate the usefulness of artificial neural networks in Alzheimer disease diagnosis (AD) using data of brain single photon emission computed tomography (SPECT). The results were compared with discriminant analysis. The study population consisted of 132 clinically diagnosed patients. There were 72 subjects with AD and 60 belonging to the normal control group. The artificial neural network used 36 numerical values being the count numbers obtained for each area of brain SPECT. These numbers determined the set of input data for the artificial neural network. The sensitivity of Alzheimer disease diagnosis detection by artificial neural network and discriminant analysis were 93.8% and 86.1%, respectively, and the corresponding specificity was 100% and 95%. We also used receiver operating characteristic curve (ROC) analysis and areas under receiver operating characteristics curves were correspondingly 0.97 (p < 0.0001) for the artificial neural networks (ANN) and 0.96 (p < 0.0001) for discriminant analysis. In conclusion, artificial neural networks and conventional statistics methods (discriminant analysis) are a useful tool in Alzheimer disease diagnosis. Full article
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Open AccessArticle Unmet Mental Health Care Needs among Asian Americans 10–11 Years After Exposure to the World Trade Center Attack
Int. J. Environ. Res. Public Health 2019, 16(7), 1302; https://doi.org/10.3390/ijerph16071302
Received: 28 February 2019 / Revised: 2 April 2019 / Accepted: 5 April 2019 / Published: 11 April 2019
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This study investigated the prevalence of unmet mental health care needs (UMHCN) and their associated factors among 2344 Asian Americans directly exposed to the World Trade Center (WTC) attack 10–11 years afterwards. Given the pervasive underutilization of mental health services among Asians, their [...] Read more.
This study investigated the prevalence of unmet mental health care needs (UMHCN) and their associated factors among 2344 Asian Americans directly exposed to the World Trade Center (WTC) attack 10–11 years afterwards. Given the pervasive underutilization of mental health services among Asians, their subjective evaluation of unmet needs could provide more nuanced information on disparities of service. We used the WTC Health Registry data and found that 12% of Asian Americans indicated UMHCN: 69% attributing it to attitudinal barriers, 36% to cost barriers, and 29% to access barriers. Among all the factors significantly related to UMHCN in the logistic model, disruption of health insurance in the past year had the largest odds ratio (OR = 2.37, 95% confidence interval: 1.61–3.48), though similar to functional impairment due to mental disorders. Post-9/11 mental health diagnosis, probable mental disorder and ≥14 poor mental health days in the past month were also associated with greater odds of UMHCN, while greater social support was associated with lower odds. Results suggest that continued outreach efforts to provide mental health education to Asian communities to increase knowledge about mental illness and treatment options, reduce stigmatization of mental illness, and offer free mental health services are crucial to address UMHCN. Full article
(This article belongs to the Special Issue Long-Term Health Effects of the 9/11 Disaster)
Open AccessArticle Hygiene During Childbirth: An Observational Study to Understand Infection Risk in Healthcare Facilities in Kogi and Ebonyi States, Nigeria
Int. J. Environ. Res. Public Health 2019, 16(7), 1301; https://doi.org/10.3390/ijerph16071301
Received: 8 March 2019 / Revised: 5 April 2019 / Accepted: 7 April 2019 / Published: 11 April 2019
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Background: Infections acquired during labour and delivery are a significant cause of maternal and child morbidity and mortality. Adherence to hand hygiene protocols is a critical component of infection prevention strategies, but few studies have closely examined the hand hygiene of health [...] Read more.
Background: Infections acquired during labour and delivery are a significant cause of maternal and child morbidity and mortality. Adherence to hand hygiene protocols is a critical component of infection prevention strategies, but few studies have closely examined the hand hygiene of health care providers with sufficient detail to understand infection risks and prioritize prevention strategies. Methods: This observational study was conducted in six healthcare facilities in Nigeria. In each, five women were observed from the onset of labour through to delivery of the placenta. Hand hygiene infection risk was estimated for all procedures requiring aseptic technique compared against adherence to proper hand hygiene protocol and potential recontamination events. Results: Hands were washed with soap and sterile gloves applied with no observed recontamination before only 3% of all observed procedures requiring aseptic technique. There was no significant difference in hygiene compliance between midwives and doctors nor facilities or states. Adherence to proper hygiene protocol was observed more in morning compared to afternoon and night shifts. Conclusions: This study highlights that hand hygiene remains a barrier to delivering high-quality and safe care in health facilities. Improving hygiene practices during labour and delivery will require strategies that extend beyond infrastructure provision. Full article
(This article belongs to the Section Health Care Sciences & Services)
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Open AccessArticle Asian Culturally Specific Predictors in a Large-Scale Land Use Regression Model to Predict Spatial-Temporal Variability of Ozone Concentration
Int. J. Environ. Res. Public Health 2019, 16(7), 1300; https://doi.org/10.3390/ijerph16071300
Received: 27 February 2019 / Revised: 25 March 2019 / Accepted: 4 April 2019 / Published: 11 April 2019
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This paper developed a land use regression (LUR) model to study the spatial-temporal variability of O3 concentrations in Taiwan, which has typical Asian cultural characteristics with diverse local emission sources. The Environmental Protection Agency’s (EPA) data of O3 concentrations from 2000 [...] Read more.
This paper developed a land use regression (LUR) model to study the spatial-temporal variability of O3 concentrations in Taiwan, which has typical Asian cultural characteristics with diverse local emission sources. The Environmental Protection Agency’s (EPA) data of O3 concentrations from 2000 and 2013 were used to develop this model, while observations from 2014 were used as the external data verification to assess model reliability. The distribution of temples, cemeteries, and crematoriums was included for a potential predictor as an Asian culturally specific source for incense and joss money burning. We used stepwise regression for the LUR model development, and applied 10-fold cross-validation and external data for the verification of model reliability. With the overall model R2 of 0.74 and a 10-fold cross-validated R2 of 0.70, this model presented a mid-high prediction performance level. Moreover, during the stepwise selection procedures, the number of temples, cemeteries, and crematoriums was selected as an important predictor. By using the long-term monitoring data to establish an LUR model with culture specific predictors, this model can better depict O3 concentration variation in Asian areas. Full article
(This article belongs to the Special Issue Spatio-Temporal Environmental Monitoring and Social Sensing)
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Open AccessArticle Negative Impacts of Self-Stigma on the Quality of Life of Patients in Methadone Maintenance Treatment: The Mediated Roles of Psychological Distress and Social Functioning
Int. J. Environ. Res. Public Health 2019, 16(7), 1299; https://doi.org/10.3390/ijerph16071299
Received: 12 March 2019 / Revised: 1 April 2019 / Accepted: 6 April 2019 / Published: 11 April 2019
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A sample of heroin users (n = 250) in methadone maintenance treatment (MMT) was used in this cross-sectional study to clarify the mechanisms of the effects of stigma on quality of life (QoL) through psychological distress and social functioning. All the participants [...] Read more.
A sample of heroin users (n = 250) in methadone maintenance treatment (MMT) was used in this cross-sectional study to clarify the mechanisms of the effects of stigma on quality of life (QoL) through psychological distress and social functioning. All the participants had their self-stigma, psychological distress, social functioning, and QoL measured. Psychological distress and social functioning were proposed to be mediators between self-stigma and QoL. Several linear models using structural equation modeling were conducted to examine the mediated effects. The negative effects of self-stigma on QoL were significantly mediated by psychological distress, as self-stigma directly and significantly influenced psychological distress, but not social functioning. This study demonstrated a linear model describing the effects of self-stigma on QoL for opioid-dependent individuals; psychological distress was also an important mediator between self-stigma and their QoL. Clinicians were able to notice the importance of reducing self-stigma for opioid-dependent individuals according to the following results: higher levels of self-stigma were associated with high psychological distress, decreased social functioning, and impaired QoL. Our mediation findings suggest that treating psychological distress is better than treating social functioning if we want to eliminate the effects of self-stigma on QoL for heroin users. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle When Do Service Employees Suffer More from Job Insecurity? The Moderating Role of Coworker and Customer Incivility
Int. J. Environ. Res. Public Health 2019, 16(7), 1298; https://doi.org/10.3390/ijerph16071298
Received: 11 March 2019 / Revised: 2 April 2019 / Accepted: 5 April 2019 / Published: 11 April 2019
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The present study examines the effect of service employees’ job insecurity on job performance through emotional exhaustion. We identified workplace incivility (i.e., coworker and customer incivility) as a boundary condition that strengthens the positive relationship between job insecurity and emotional exhaustion. To test [...] Read more.
The present study examines the effect of service employees’ job insecurity on job performance through emotional exhaustion. We identified workplace incivility (i.e., coworker and customer incivility) as a boundary condition that strengthens the positive relationship between job insecurity and emotional exhaustion. To test this moderating effect, we collected online panel surveys from 264 Korean service employees at two time points three months apart. As predicted, the positive relationship between job insecurity and job performance was partially mediated by emotional exhaustion. Of the two forms of workplace incivility, only coworker incivility exerted a significant moderating effect on the job insecurity–emotional exhaustion relationship, such that this relationship was more pronounced when service employees experienced a high level of coworker incivility than when coworker incivility was low. Coworker incivility further moderated the indirect effect of job insecurity on job performance through emotional exhaustion. These findings have theoretical implications for job insecurity research and managerial implications for practitioners. Full article
(This article belongs to the Special Issue The Impact of Job Insecurity on Non-Traditional Outcomes)
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Open AccessArticle Geochemical Characteristics and Toxic Elements in Alumina Refining Wastes and Leachates from Management Facilities
Int. J. Environ. Res. Public Health 2019, 16(7), 1297; https://doi.org/10.3390/ijerph16071297
Received: 27 February 2019 / Revised: 1 April 2019 / Accepted: 4 April 2019 / Published: 11 April 2019
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A nationwide investigation was carried out to evaluate the geochemical characteristics and environmental impacts of red mud and leachates from the major alumina plants in China. The chemical and mineralogical compositions of red mud were investigated, and major, minor, and trace elements in [...] Read more.
A nationwide investigation was carried out to evaluate the geochemical characteristics and environmental impacts of red mud and leachates from the major alumina plants in China. The chemical and mineralogical compositions of red mud were investigated, and major, minor, and trace elements in the leachates were analyzed. The mineral and chemical compositions of red mud vary over refining processes (i.e., Bayer, sintering, and combined methods) and parental bauxites. The main minerals in the red mud are quartz, calcite, dolomite, hematite, hibschite, sodalite, anhydrite, cancrinite, and gibbsite. The major chemical compositions of red mud are Al, Fe, Si, Ca, Ti, and hydroxides. The associated red mud leachate is hyperalkaline (pH > 12), which can be toxic to aquatic life. The concentrations of Al, Cl, F, Na, NO32−, and SO42− in the leachate exceed the recommended groundwater quality standard of China by up to 6637 times. These ions are likely to increase the salinization of the soil and groundwater. The minor elements in red mud leachate include As, B, Ba, Cr, Cu, Fe, Ni, Mn, Mo, Ti, V, and Zn, and the trace elements in red mud leachate include Ag, Be, Cd, Co, Hg, Li, Pb, Sb, Se, Sr, and Tl. Some of these elements have the concentration up to 272 times higher than those of the groundwater quality standard and are toxic to the environment and human health. Therefore, scientific guidance is needed for red mud management, especially for the design of the containment system of the facilities. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Strength Decrease, Perceived Physical Exertion and Endurance Time for Backpacking Tasks
Int. J. Environ. Res. Public Health 2019, 16(7), 1296; https://doi.org/10.3390/ijerph16071296
Received: 1 March 2019 / Revised: 9 April 2019 / Accepted: 9 April 2019 / Published: 11 April 2019
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Manual material handling (MMH) tasks create a burden for workers which could result in musculoskeletal injuries. Assessments of the decrease of muscular strength and the maximum endurance time (MET) for MMH tasks are essential in studying the ergonomic risk of MMH tasks. A [...] Read more.
Manual material handling (MMH) tasks create a burden for workers which could result in musculoskeletal injuries. Assessments of the decrease of muscular strength and the maximum endurance time (MET) for MMH tasks are essential in studying the ergonomic risk of MMH tasks. A backpacking experiment was conducted for measuring the MET for MMH tasks. Human participants carried a load on their back and walked on a treadmill under various load, walking speed, and ramp angle conditions until they coud no longer do so. It was found that the participants were able to walk for approximately 15 min to two hours before they needed to have a pause. Their back and leg strengths declined moderately due to performing the tasks. These tasks resulted in an increase in heart rate and elevated perceived physical exertion. The rating of perceived exertion (RPE)/heart rate ratio in our backpacking tasks was 31% higher than that in the literature, implying the calibration of the RPE may be required for such tasks. A MET model incorporating the fMVC_back, body weight, walking speed, and ramp angle was established. This model may be used to determine the work/rest allowance for backpacking tasks under conditions similar to this study. Full article
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Open AccessArticle Identification of Key Success Factors for Private Science Parks Established from Brownfield Regeneration: A Case Study from China
Int. J. Environ. Res. Public Health 2019, 16(7), 1295; https://doi.org/10.3390/ijerph16071295
Received: 14 March 2019 / Revised: 7 April 2019 / Accepted: 9 April 2019 / Published: 11 April 2019
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Private science parks (PSPs) are infrastructure elements of national high technology industrial development zones. Increasing private capital is being invested in this field to transform abandoned factories into science parks through brownfield regeneration, which not only effectively utilizes urban space, but also greatly [...] Read more.
Private science parks (PSPs) are infrastructure elements of national high technology industrial development zones. Increasing private capital is being invested in this field to transform abandoned factories into science parks through brownfield regeneration, which not only effectively utilizes urban space, but also greatly strengthens the power of scientific and technological innovation. The evolution of these PSPs, however, is not satisfactory, and some operation and innovation-related problems often lead to their failures. Therefore, identifying key success factors is crucial for the sustainable growth of PSPs. This study employs Fuzzy Analytic hierarchy process (FAHP) and Fuzzy-DEMATEL (Decision Making Trial and Evaluation Laboratory) methods to construct an identification model for key success factors of PSPs established from brownfield regeneration. Associated influencing factors were collected through literature analysis, on-site interviews, and questionnaire, based on which key success factors were identified. The results of the study showed that five factors—resources sharing capacity of the park, park scale, financing and financial services, legal policy services and administrative capability, and construction level of facilities in the park—are the key success factors for such PSPs. The results also provide a theoretical basis for the development of PSPs established from brownfield regeneration, and support the formulation of PSP-related policies. Full article
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Open AccessArticle Association between Diabetes and Cognitive Function among People over 45 Years Old in China: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2019, 16(7), 1294; https://doi.org/10.3390/ijerph16071294
Received: 18 February 2019 / Revised: 3 April 2019 / Accepted: 9 April 2019 / Published: 11 April 2019
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Objectives: The aim of this study is to identify the relationship between diabetes status including characteristics of diabetes and cognition among the middle-aged and elderly population (≥45 years) in China. Methods: A sample of 8535 people who participated in the China [...] Read more.
Objectives: The aim of this study is to identify the relationship between diabetes status including characteristics of diabetes and cognition among the middle-aged and elderly population (≥45 years) in China. Methods: A sample of 8535 people who participated in the China Health and Retirement Longitudinal Study (CHARLS) from June 2011 to March 2012 was analyzed. Two cognitive domains including episodic memory and executive function were measured through questionnaires. People were classified into four groups: no diabetes, controlled diabetes, untreated diabetes, treated but uncontrolled diabetes. Weighted multiple regression model was conducted to explore the association between diabetes and cognition in full sample as well as three different age groups (45–59, 60–74, ≥75). Adjustments were made for demographics and cardiovascular risk factors. Results: After adjusting several covariates, untreated diabetes (β = −0.192, p < 0.05) was significantly associated with episodic memory. In the age group of 45–69 years, untreated diabetes (β = −0.471, p < 0.05) and HbA1c level (β = −0.074, p < 0.05) were significantly associated with episodic memory. When adjusting for cardiovascular risk factors, all correlations were non-significant. Conclusion: The cross-sectional study suggests that untreated diabetes and HbA1c are the potential risk factor for cognitive impairment, and these associations are more significant in the age group of 45–59 years old. Cardiovascular factors are important mediating factors in the pathway between diabetes and cognitive impairment. More longitudinal studies are needed to confirm these associations. Full article
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Open AccessArticle Refugee Status as a Possible Risk Factor for Childhood Enuresis
Int. J. Environ. Res. Public Health 2019, 16(7), 1293; https://doi.org/10.3390/ijerph16071293
Received: 9 March 2019 / Revised: 8 April 2019 / Accepted: 10 April 2019 / Published: 11 April 2019
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This study investigated the influence of refugee status on the occurrence of enuresis. It was performed among school children aged 6 to 11 years and their parents in the Vukovarsko-srijemska County (eastern Croatia), which had many displaced persons and refugees (mostly women and [...] Read more.
This study investigated the influence of refugee status on the occurrence of enuresis. It was performed among school children aged 6 to 11 years and their parents in the Vukovarsko-srijemska County (eastern Croatia), which had many displaced persons and refugees (mostly women and children) in the 1990s due to the wars in Croatia and Bosnia and Herzegovina. A specially designed questionnaire (about the child’s age and gender, the child’s enuresis history and that of the parents, and data on parental refugee status in childhood) was completed by one of the parents. Adequate data were collected for 3046 children. The prevalence of enuresis among the studied children was quite low (2.3%) but the prevalence distribution according to gender, the decline by age, and the higher odds ratio for paternal enuresis were in line with the results of other studies. The prevalence of parental enuresis in childhood was higher than their children’s enuresis (mothers: 5.8%, fathers: 3.6%, p < 0.001), and significantly higher among parents who had been refugees (mothers: p = 0.001, fathers: p = 0.04). Parental refugee status had no influence on the children’s enuresis. The results suggest that refugee status is a risk factor for the occurrence of enuresis in childhood. Full article
(This article belongs to the Section Children Health)
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Open AccessArticle Impact of Outpatient Rehabilitation Service in Preventing the Deterioration of the Care-Needs Level Among Japanese Older Adults Availing Long-Term Care Insurance: A Propensity Score Matched Retrospective Study
Int. J. Environ. Res. Public Health 2019, 16(7), 1292; https://doi.org/10.3390/ijerph16071292
Received: 25 February 2019 / Revised: 4 April 2019 / Accepted: 6 April 2019 / Published: 10 April 2019
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Abstract
Outpatient rehabilitation (OR) and outpatient day long-term care (ODLC) services are frequently used by older adult patients in Japan. However, there is a need to clarify that OR service, which has more rehabilitation professionals than ODLC, has the role of providing rehabilitation. This [...] Read more.
Outpatient rehabilitation (OR) and outpatient day long-term care (ODLC) services are frequently used by older adult patients in Japan. However, there is a need to clarify that OR service, which has more rehabilitation professionals than ODLC, has the role of providing rehabilitation. This retrospective study examined the impact of OR services by comparing the two services based on City A data from the care-needs certification survey conducted between 2015 to 2017. We performed a propensity score matched analysis to compare the changes in the care level and function of OR and ODLC users after two years. The results showed that OR users showed a lower deterioration in care levels and less decline in the activities of daily living (ADL) in dementia and adaptation to social life. In the analysis of older adults requiring support, OR users had a lower deterioration in care levels and less decline in the ADL in dementia and behavioral and psychological symptoms than ODLC users did. There was no difference between the two services with respect to older adults requiring long-term care. The OR service has had an increasingly preventive effect on the deterioration of care levels compared to the ODLC service, which was particularly evident in older adults requiring support. Full article
(This article belongs to the Special Issue Geriatrics Syndromes Prevention)
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Open AccessArticle Clinical Evaluation of Sarcoidosis in Community Members with World Trade Center Dust Exposure
Int. J. Environ. Res. Public Health 2019, 16(7), 1291; https://doi.org/10.3390/ijerph16071291
Received: 28 February 2019 / Revised: 2 April 2019 / Accepted: 4 April 2019 / Published: 10 April 2019
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Abstract
Background: Sarcoidosis is a granulomatous disease involving intrathoracic and extrathoracic organs. Genetic and environmental factors, such as exposure to World-Trade Center (WTC) dust after 9/11, may play a role in clinical presentation. Characterization of sarcoidosis in community members with exposure to the [...] Read more.
Background: Sarcoidosis is a granulomatous disease involving intrathoracic and extrathoracic organs. Genetic and environmental factors, such as exposure to World-Trade Center (WTC) dust after 9/11, may play a role in clinical presentation. Characterization of sarcoidosis in community members with exposure to the WTC dust can provide further insight into the relationship between environmental exposure and sarcoidosis. Methods: Patients with documented sarcoidosis were identified in the WTC Environmental Health Center (EHC), a treatment program for community members. Demographic and clinical data were collected from standardized questionnaires and chart review. Organ involvement was assessed with a standard instrument. Results: Among patients in the WTC EHC, 87 were identified with sarcoidosis after 9/11. Sarcoidosis cases were more likely African-American, local workers, and had more respiratory symptoms, compared with non-sarcoidosis WTC EHC patients. Many (46%) had ≥ Scadding stage 3 on chest imaging, and had reduced lung function measures. Extrathoracic involvement was identified in 33/87 (38%) with a diversity of organs involved. Conclusions: WTC-exposed sarcoidosis in community members is often characterized by severe pulmonary disease and a high rate of diverse extrathoracic involvement. Further analysis is required to characterize the course of disease progression or resolution. Full article
(This article belongs to the Special Issue Long-Term Health Effects of the 9/11 Disaster)
Open AccessArticle Prevalence and Risk Factors for Anemia in Non-pregnant Childbearing Women from the Chinese Fifth National Health and Nutrition Survey
Int. J. Environ. Res. Public Health 2019, 16(7), 1290; https://doi.org/10.3390/ijerph16071290
Received: 20 February 2019 / Revised: 4 April 2019 / Accepted: 6 April 2019 / Published: 10 April 2019
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Abstract
Anemia is a public health issue for developing countries, especially for women of childbearing age. The aim of this study was to assess the anemia status and analyze the risk factors for anemia in Chinese childbearing women aged 18–49 years. Hemoglobin concentration was [...] Read more.
Anemia is a public health issue for developing countries, especially for women of childbearing age. The aim of this study was to assess the anemia status and analyze the risk factors for anemia in Chinese childbearing women aged 18–49 years. Hemoglobin concentration was measured by the HiCN method in the Fifth Chinese National Nutrition and Health Survey (CNNHS) in 2010–2012. Age, region type, ethnicity, bodyweight, height, education, season and smoke habit were recorded in unified questionnaires. Latitude was divided by China’s Qinling Mountains and Huaihe River. Childbearing women (28,289) from the CNNHS 2010–2012 were included in this study. The median hemoglobin concentration was 136.2(126.6–145.0) g/L, and it was significantly higher than in CNNHS 2002 (132.5 (122.3–141.6) g/L). The prevalence of anemia was 15.0%, and it was significantly lower than 10 years ago. The logistic regression analysis showed anemia in Chinese childbearing women was specifically related to 30–39 age group (P = 0.004), in spring (P < 0.0001) or in winter (P = 0.006), small and medium-sized cities (P = 0.044) and middle school education level (P = 0.027). The results showed that anemia status among childbearing women was greatly improved over 10 years since 2002, but it was still more severe than the rest of the populations. The nutrition propaganda and education is recommended for childbearing women to help them to improve the nutritional status on their own. Full article
(This article belongs to the Section Women's Health)
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Open AccessCase Report Melkersson–Rosenthal Syndrome in Childhood: Report of Three Paediatric Cases and a Review of the Literature
Int. J. Environ. Res. Public Health 2019, 16(7), 1289; https://doi.org/10.3390/ijerph16071289
Received: 25 February 2019 / Revised: 2 April 2019 / Accepted: 9 April 2019 / Published: 10 April 2019
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Abstract
Melkersson–Rosenthal syndrome (MRS) in children is a rare condition, clinically characterised by a triad of synchronous or metachronous symptoms: recurrent peripheral facial palsy, relapsing orofacial oedema, and a fissured tongue; the most recent review published on the topic has reported 30 published patients. [...] Read more.
Melkersson–Rosenthal syndrome (MRS) in children is a rare condition, clinically characterised by a triad of synchronous or metachronous symptoms: recurrent peripheral facial palsy, relapsing orofacial oedema, and a fissured tongue; the most recent review published on the topic has reported 30 published patients. The aetiology of this disease is still unclear. However, genetic factors, as well as alterations in immune functions, infections, and allergic reactions have been postulated. We report three children suffering from MRS and perform a literature review of paediatric cases. Taking into account that clinical and laboratoristical criteria for the diagnosis of MRS are lacking, this syndrome is probably underestimated, and we suggest increasing awareness of such a rare syndrome. Close multidisciplinary follow-up of these children with a team composed by paediatricians, neurologists, neuro-ophthalmologists, dermatologists, and otolaryngologists is crucial to guarantee exhaustive management and treatment success, while minimising relapses. Full article
(This article belongs to the Section Children Health)
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Open AccessArticle Differences in Eye Health, Access to Eye Care Specialists and Use of Lenses among Immigrant and Native-Born Workers in Spain
Int. J. Environ. Res. Public Health 2019, 16(7), 1288; https://doi.org/10.3390/ijerph16071288
Received: 14 March 2019 / Revised: 4 April 2019 / Accepted: 6 April 2019 / Published: 10 April 2019
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Abstract
Latin American immigrants make up 49% of the total immigrant population in Spain, yet little is known about their eye health. The aim of this study is to determine if there are differences in self-perceived eye health, access to eye care specialists, and [...] Read more.
Latin American immigrants make up 49% of the total immigrant population in Spain, yet little is known about their eye health. The aim of this study is to determine if there are differences in self-perceived eye health, access to eye care specialists, and use of lenses between a sample of Latin American immigrant workers from Colombia and Ecuador, and native-born workers in Spain. We used data from the PELFI cohort (Project for Longitudinal Studies of Immigrant Families). The sample consisted of 179 immigrant workers born in Colombia or Ecuador, and 83 Spanish-born workers. The outcome variables were self-perceived eye health, access to eye specialists, and use of lenses. A descriptive analysis of the sample was carried out, and the prevalence of the three outcome variables in immigrants and natives was calculated and adjusted for explanatory variables. Random effects logistic regression models examined eye health outcomes by workers’ country of birth. Immigrants are less likely to report poor self-perceived eye health than native-born (ORc 0.46; CI 95%, 0.22–0.96). Furthermore, they have less access to specialists (ORc 2.61; CI 95%, 1.32–5.15) and a higher probability of needing lenses but not having them (ORc 14.14; CI 95%, 1.77–112.69). This latter variable remained statistically significant after adjusting for covariates (ORa 34.05; CI 95%, 1.59–729.04). Latin American immigrants may not value the use of lenses, despite eye care specialists indicating that they need them. Eye health education is required to recognize the importance of using lenses according to their visual needs. Full article
(This article belongs to the Special Issue Migration, Work and Health)
Open AccessReview What Works? Prevention and Control of Sexually Transmitted Infections and Blood-Borne Viruses in Migrants from Sub-Saharan Africa, Northeast Asia and Southeast Asia Living in High-Income Countries: A Systematic Review
Int. J. Environ. Res. Public Health 2019, 16(7), 1287; https://doi.org/10.3390/ijerph16071287
Received: 12 March 2019 / Revised: 3 April 2019 / Accepted: 5 April 2019 / Published: 10 April 2019
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Abstract
Migration is a significant risk factor for the acquisition of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other sexually transmitted infections (STIs). An increasing proportion of these infections in high-income countries, such as Australia, are among migrants moving from low and [...] Read more.
Migration is a significant risk factor for the acquisition of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other sexually transmitted infections (STIs). An increasing proportion of these infections in high-income countries, such as Australia, are among migrants moving from low and middle-income countries with a high prevalence of HIV, HBV and other STIs. This systematic review explored the prevention and control of HIV, HBV and other STIs in migrants (>18 years) from Southeast Asia, Northeast Asia and sub-Saharan Africa living in high-income countries with universal health care. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Six academic databases were searched for articles published between 2002 and 2018. Sixteen peer-reviewed articles met the inclusion criteria, consisting of fourteen quantitative and two qualitative studies conducted in Australia, the Netherlands, Canada, Spain, Italy, and Germany. Three levels of interventions were identified: individual, community and structural interventions. Most studies addressed factors at an individual level; interventions were most commonly outreach testing for HIV, HBV and other STIs. Few studies addressed structural factors or demonstrated comprehensive evaluation of interventions. Limited population-specific findings could be determined. To prevent further transmission of HIV, HBV and other STIs, comprehensive public health approaches must consider the complex interactions between migration, health care system determinants, and broader socioeconomic and sociocultural factors. Full article
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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Open AccessArticle Effects of 220 MHz Pulsed Modulated Radiofrequency Field on the Sperm Quality in Rats
Int. J. Environ. Res. Public Health 2019, 16(7), 1286; https://doi.org/10.3390/ijerph16071286
Received: 19 March 2019 / Revised: 1 April 2019 / Accepted: 4 April 2019 / Published: 10 April 2019
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Abstract
Under some occupational conditions, workers are inevitably exposed to high-intensity radiofrequency (RF) fields. In this study, we investigated the effects of one-month exposure to a 220 MHz pulsed modulated RF field at the power density of 50 W/m2 on the sperm quality [...] Read more.
Under some occupational conditions, workers are inevitably exposed to high-intensity radiofrequency (RF) fields. In this study, we investigated the effects of one-month exposure to a 220 MHz pulsed modulated RF field at the power density of 50 W/m2 on the sperm quality in male adult rats. The sperm quality was evaluated by measuring the number, abnormality and survival rate of sperm cells. The morphology of testis was examined by hematoxylin–eosin (HE) staining. The levels of secreting factors by Sertoli cells (SCs) and Leydig cells (LCs) were determined by enzyme linked immunosorbent assay (ELISA). The level of cleaved caspase 3 in the testis was detected by immunofluorescence staining. Finally, the expression levels of the apoptosis-related protein (caspase 3, BAX and BCL2) in the testis were assessed by Western blotting. Compared with the sham group, the sperm quality in the RF group decreased significantly. The levels of secreting factors of SCs and the morphology of the testis showed an obvious change after RF exposure. The level of the secreting factor of LCs decreased significantly after RF exposure. The levels of cleaved caspase 3, caspase 3, and the BAX/BCL2 ratio in the testis increased markedly after RF exposure. These data collectively suggested that under the present experimental conditions, 220 MHz pulsed modulated RF exposure could impair sperm quality in rats, and the disruption of the secreting function of LCs and increased apoptosis of testis cells induced by the RF field might be accounted for by this damaging effect. Full article
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Open AccessArticle Can Gossip Buffer the Effect of Job Insecurity on Workplace Friendships?
Int. J. Environ. Res. Public Health 2019, 16(7), 1285; https://doi.org/10.3390/ijerph16071285
Received: 14 March 2019 / Revised: 30 March 2019 / Accepted: 6 April 2019 / Published: 10 April 2019
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Abstract
Although previous research has documented a host of negative consequences of job insecurity, workplace interpersonal relationships have rarely been considered. This omission might be caused by the application of broad stress theories to the job insecurity literature without taking a nuanced perspective to [...] Read more.
Although previous research has documented a host of negative consequences of job insecurity, workplace interpersonal relationships have rarely been considered. This omission might be caused by the application of broad stress theories to the job insecurity literature without taking a nuanced perspective to understand the nature of job insecurity. To address this issue, we conceptualized job insecurity as a threat to employee social acceptance by their employer. This conceptualization, therefore, allows us to apply the multimotive model of social rejection to investigate a previously-overlooked outcome of job insecurity—workplace friendships. Specifically, we investigated the relationship between both job feature insecurity and job loss insecurity with workplace friendships. Based on stress coping theory and the fundamental differences between job feature insecurity and job loss insecurity, we further proposed that employees’ tendency to engage in positive gossip buffers the negative impact of job feature insecurity on workplace friendships, whereas employees’ tendency to engage in negative gossip buffers the negative impact of job loss insecurity on workplace friendships. Data collected from 286 working adults from Mturk supported our hypotheses. Our study opens the door for future research to take a more nuanced approach when examining nontraditional consequences of job insecurity. Full article
(This article belongs to the Special Issue The Impact of Job Insecurity on Non-Traditional Outcomes)
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Open AccessArticle Going beyond Quietness: Determining the Emotionally Restorative Effect of Acoustic Environments in Urban Open Public Spaces
Int. J. Environ. Res. Public Health 2019, 16(7), 1284; https://doi.org/10.3390/ijerph16071284
Received: 15 February 2019 / Revised: 5 April 2019 / Accepted: 7 April 2019 / Published: 10 April 2019
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Abstract
The capacity of natural settings to promote psychological restoration has attracted increasing research attention, especially with regards to the visual dimension. However, there is a need to extend these studies to urban settings, such as squares, parks or gardens, due to the global [...] Read more.
The capacity of natural settings to promote psychological restoration has attracted increasing research attention, especially with regards to the visual dimension. However, there is a need to extend these studies to urban settings, such as squares, parks or gardens, due to the global trend towards urbanisation, and to integrate the dimension of sound into landscape. Such was the main aim of this study, in which 53 participants assessed four public spaces in Vitoria-Gasteiz (Spain) as part of the CITI-SENSE Project (137 observations were used for analysis). A smartphone application was used to simultaneously collect objective and subjective data. The results show that at the end of the urban environmental experience, there was a statistically significant reduction in negative emotions and perceived stress, and a slight increase in positive emotions. Emotional restoration was mainly associated with prior emotional states, but also with global environmental comfort and acoustic comfort. The soundscape characteristics that contributed to greater emotional restoration and a reduction in perceived stress were pleasantness, calm, fun and naturalness. Therefore, in agreement with previous research, the findings of the present study indicate that besides contributing to the quietness of the urban environment, the urban soundscape can promote psychological restoration in users of these spaces. Full article
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Open AccessArticle Risks of Ear Complaints of Passengers and Drivers While Trains Are Passing Through Tunnels at High Speed: A Numerical Simulation and Experimental Study
Int. J. Environ. Res. Public Health 2019, 16(7), 1283; https://doi.org/10.3390/ijerph16071283
Received: 12 March 2019 / Revised: 5 April 2019 / Accepted: 6 April 2019 / Published: 10 April 2019
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Abstract
Ear complaints induced by interior pressure transients are common experiences for passengers and crew members when high-speed trains are passing through tunnels. However, approaches to assessing the risks of the pressure-related aural discomfort have not been reported until recently. The objective of this [...] Read more.
Ear complaints induced by interior pressure transients are common experiences for passengers and crew members when high-speed trains are passing through tunnels. However, approaches to assessing the risks of the pressure-related aural discomfort have not been reported until recently. The objective of this study was to evaluate the hazards of interior pressure transients of high-speed train on human ears combining the effects of operation speed and seal index. Moving model tests were conducted to obtain the pressure transients when the model train runs in the tunnel. The recorded data were transformed into the interior pressures by empirical formula. Furthermore, the aural sensations were divided into four levels hierarchically and the range for each level was derived by logistic regression analysis method and represented by three biomechanical metrics. Furthermore, a human middle ear finite element (FE) model was used to simulate its dynamics under the interior pressures. The results indicate that lifting operation speed from 250 km/h to 350 km/h in tunnel will prolong the duration of ear complaints by more than two times whereas improving the seal index from 4 s to 12 s will reduce the incidences of the onset of tinnitus and hearing loss by more than ten times. In addition, the duration of aural comfort shortens from the head car to the tail car against the running direction. It is desirable that enhancing the seal index improve the aural sensations of the passengers and crew members considering the lifting operation speed of high-speed train. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessReview Integration of Green Energy and Advanced Energy-Efficient Technologies for Municipal Wastewater Treatment Plants
Int. J. Environ. Res. Public Health 2019, 16(7), 1282; https://doi.org/10.3390/ijerph16071282
Received: 1 March 2019 / Revised: 28 March 2019 / Accepted: 4 April 2019 / Published: 10 April 2019
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Abstract
Wastewater treatment can consume a large amount of energy to meet discharge standards. However, wastewater also contains resources which could be recovered for secondary uses under proper treatment. Hence, the goal of this paper is to review the available green energy and biomass [...] Read more.
Wastewater treatment can consume a large amount of energy to meet discharge standards. However, wastewater also contains resources which could be recovered for secondary uses under proper treatment. Hence, the goal of this paper is to review the available green energy and biomass energy that can be utilized in wastewater treatment plants. Comprehensive elucidation of energy-efficient technologies for wastewater treatment plants are revealed. For these energy-efficient technologies, this review provides an introduction and current application status of these technologies as well as key performance indicators for the integration of green energy and energy-efficient technologies. There are several assessment perspectives summarized in the evaluation of the integration of green energy and energy-efficient technologies in wastewater treatment plants. To overcome the challenges in wastewater treatment plants, the Internet of Things (IoT) and green chemistry technologies for the water and energy nexus are proposed. The findings of this review are highly beneficial for the development of green energy and energy-efficient wastewater treatment plants. Future research should investigate the integration of green infrastructure and ecologically advanced treatment technologies to explore the potential benefits and advantages. Full article
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Open AccessArticle A Deep Neural Network-Based Method for Early Detection of Osteoarthritis Using Statistical Data
Int. J. Environ. Res. Public Health 2019, 16(7), 1281; https://doi.org/10.3390/ijerph16071281
Received: 4 March 2019 / Revised: 29 March 2019 / Accepted: 7 April 2019 / Published: 10 April 2019
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Abstract
A large number of people suffer from certain types of osteoarthritis, such as knee, hip, and spine osteoarthritis. A correct prediction of osteoarthritis is an essential step to effectively diagnose and prevent severe osteoarthritis. Osteoarthritis is commonly diagnosed by experts through manual inspection [...] Read more.
A large number of people suffer from certain types of osteoarthritis, such as knee, hip, and spine osteoarthritis. A correct prediction of osteoarthritis is an essential step to effectively diagnose and prevent severe osteoarthritis. Osteoarthritis is commonly diagnosed by experts through manual inspection of patients’ medical images, which are usually collected in hospitals. Checking the occurrence of osteoarthritis is somewhat time-consuming for patients. In addition, the current studies are focused on automatically detecting osteoarthritis through image-based deep learning algorithms. This needs patients’ medical images, which requires patients to visit the hospital. However, medical utilization and health behavior information as statistical data are easier to collect and access than medical images. Using indirect statistical data without any medical images to predict the occurrence of diverse forms of OA can have significant impacts on pro-active and preventive medical care. In this study, we used a deep neural network for detecting the occurrence of osteoarthritis using patient’s statistical data of medical utilization and health behavior information. The study was based on 5749 subjects. Principal component analysis with quantile transformer scaling was employed to generate features from the patients’ simple background medical records and identify the occurrence of osteoarthritis. Our experiments showed that the proposed method using deep neural network with scaled PCA resulted in 76.8% of area under the curve (AUC) and minimized the effort to generate features. Hence, this methos can be a promising tool for patients and doctors to prescreen for possible osteoarthritis to reduce health costs and patients’ time in hospitals. Full article
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Open AccessReview The Thermal Effects of Water Immersion on Health Outcomes: An Integrative Review
Int. J. Environ. Res. Public Health 2019, 16(7), 1280; https://doi.org/10.3390/ijerph16071280
Received: 13 February 2019 / Revised: 8 April 2019 / Accepted: 9 April 2019 / Published: 10 April 2019
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Abstract
Hydrotherapy is widely used for the treatment and rehabilitation of patients, but it can also be applied to prevent diseases in healthy people. This review investigates the health effects of water immersion, a form of hydrotherapy, and the mechanisms by which the properties [...] Read more.
Hydrotherapy is widely used for the treatment and rehabilitation of patients, but it can also be applied to prevent diseases in healthy people. This review investigates the health effects of water immersion, a form of hydrotherapy, and the mechanisms by which the properties of water elicit such an effect. We searched PubMed, EMBASE, Cochrane Library, and CINAHL to identify relevant articles, of which 13 met the inclusion criteria. Various factors of water immersion were investigated in the 13 selected articles, including water temperature, immersion height, and application area. With respect to health effects, warm and cold water immersion affects the cardiovascular and neuromuscular systems, respectively. Nine articles focused on the effects of warm water immersion, explaining its thermal effect in relation to changes in disease-related serum substance levels and hemodynamic changes. While the sample population in most studies comprised young adults, two articles applied partial water immersion to the legs of elderly subjects to assess its effect on sleep. Because the water immersion protocols applied in the 13 articles were inconsistent, the health benefits could not be clearly explained. However, we expect the present findings to be beneficial for providing research guidelines for studies on the application of water immersion. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Hand Hygiene Practices Among Adults with Diabetes Living in Communities: The 2015 Korea Community Health Survey
Int. J. Environ. Res. Public Health 2019, 16(7), 1279; https://doi.org/10.3390/ijerph16071279
Received: 16 March 2019 / Revised: 4 April 2019 / Accepted: 6 April 2019 / Published: 10 April 2019
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Abstract
Hand hygiene is the most effective strategy to prevent infectious diseases. This study investigated and compared the hand hygiene practices of adults with diabetes and an age- and gender-matched comparison group. Adults with diabetes (n = 22,920) who participated in the 2015 [...] Read more.
Hand hygiene is the most effective strategy to prevent infectious diseases. This study investigated and compared the hand hygiene practices of adults with diabetes and an age- and gender-matched comparison group. Adults with diabetes (n = 22,920) who participated in the 2015 Korea Community Health Survey and an appropriate comparison group (n = 22,920) were selected. Descriptive analyses, chi-square tests, and multiple logistic regression analyses were used. Greater than 98% of participants with diabetes recognized that hand hygiene helps prevent infectious diseases. Among participants with diabetes, 84.3%, 82.4%, 72.5%, and 64.1% washed their hands frequently before eating, after using the restroom, after returning from the outdoors, and with soap or hand sanitizer, respectively, but these values were significantly lower than those of the comparison group. After performing multiple regression analyses, treatments for diabetes, being educated about diabetes management and handwashing, and awareness of hemoglobin A1c levels were significantly associated with hand hygiene practices in participants with diabetes. Almost all people with diabetes were aware of the efficacy of hand hygiene, but handwashing rates were significantly lower in people with diabetes than in the comparison group. Considering treatments for diabetes, educational campaigns regarding handwashing, and increasing awareness of handwashing efficacy will help improve hand hygiene in people with diabetes. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Family Functioning and Psychological Health of Children with Mentally Ill Parents
Int. J. Environ. Res. Public Health 2019, 16(7), 1278; https://doi.org/10.3390/ijerph16071278
Received: 6 March 2019 / Revised: 8 April 2019 / Accepted: 8 April 2019 / Published: 10 April 2019
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Abstract
Parental mental illness can be linked to reduced family functioning, which is associated with more conflicts, less adaptability and cohesion as well as a disorganized pattern of everyday planning. Concurrently, family functioning is an important moderator for the influence of parental mental disorders [...] Read more.
Parental mental illness can be linked to reduced family functioning, which is associated with more conflicts, less adaptability and cohesion as well as a disorganized pattern of everyday planning. Concurrently, family functioning is an important moderator for the influence of parental mental disorders on the development of the children. Consequently, the current study addresses the correlation of family functioning in families with mentally ill parents and the psychological health of the children. The sample consists of 67 mentally ill parents. Both parents and therapists completed questionnaires related to family functioning and the psychological health of the children. Family functioning was rated as dysfunctional in 38% of the families. The psychological health of the children was classified as clinical or subclinical in 43% of the cases. 52% of the children were rated to have no psychological problems. In families with good family functioning, children were assessed to have less psychological problems than in families with poor functioning. Children outside the clinical range lived in families with good family functioning and vice versa. Significant positive correlations were found between the FB-A scales, the CBCL/4-18 syndrome scales and the CBCL/4–18 total score. Results indicate that family functioning and psychological health of children in families with mentally ill parents correlate closely and represent potential targets for future family interventions. Full article
(This article belongs to the Special Issue Parenting and Offspring Health and Well-Being)
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