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Int. J. Environ. Res. Public Health, Volume 16, Issue 9 (May-1 2019)

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Cover Story (view full-size image) In this study, we explored what workers think about when they are asked to indicate the degree to [...] Read more.
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Open AccessArticle
Use of Planning Training Courses and Activities to Enhance the Understanding of Eco-Community Planning Concepts in Participatory Planning Workshop Participants: A Case Study in Taiwan
Int. J. Environ. Res. Public Health 2019, 16(9), 1666; https://doi.org/10.3390/ijerph16091666
Received: 14 March 2019 / Revised: 4 May 2019 / Accepted: 10 May 2019 / Published: 13 May 2019
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Abstract
In recent years, in order to make community planning content closer to people’s life needs and psychological expectations, and to obtain the support of the people, “citizen participatory planning” and “community-engagement” have become two important strategies of the community planning process. In this [...] Read more.
In recent years, in order to make community planning content closer to people’s life needs and psychological expectations, and to obtain the support of the people, “citizen participatory planning” and “community-engagement” have become two important strategies of the community planning process. In this study, an indigenous people participatory planning workshop was conducted with the support of government funds, and pre-training and post-training questionnaires were completed by the participants of the planning training of the citizen participation planning. Through questionnaire analysis, this study obtained data of the participants’ cognitive status related to community planning and analyzed the basic background of the participants in order to determine the effectiveness of the planning training. According to the results of this study, most of the participating citizens had a basic understanding of the “community environment”, “the relationship between ecological knowledge and community planning”, and “community identity” before the training. Moreover, the research results also confirm that planning training can effectively enhance participants’ understanding of community planning, spatial planning, planning tools, planning laws, and the environment of the community. Additionally, planning training also contributes to the implementation of participatory decision-making and the promotion of public support for planning content. However, it is necessary to obtain a more comprehensive understanding of the needs of participants, and to make appropriate adjustments to the planning training courses and activities in order to obtain stable training effectiveness and build the basic ability of citizens with respect to participatory planning. Full article
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Open AccessArticle
Is the Whole More Than the Sum of Its Parts? Health Effects of Different Types of Traffic Noise Combined
Int. J. Environ. Res. Public Health 2019, 16(9), 1665; https://doi.org/10.3390/ijerph16091665
Received: 4 April 2019 / Revised: 6 May 2019 / Accepted: 12 May 2019 / Published: 13 May 2019
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Abstract
Many epidemiological studies find that people exposed to aircraft, road or railway traffic noise are at increased risk of illness, including cardiovascular disease (CVD) and depression. It is unclear how the combined exposure to these different types of traffic noise affects disease risks. [...] Read more.
Many epidemiological studies find that people exposed to aircraft, road or railway traffic noise are at increased risk of illness, including cardiovascular disease (CVD) and depression. It is unclear how the combined exposure to these different types of traffic noise affects disease risks. This study addresses this question with a large secondary data-based case-control study (“NORAH disease risk study”). The Akaike information criterion (AIC) is used to compare two different models estimating the disease risks of combined traffic noise. In comparison with the conventional energetic addition of noise levels, the multiplication of CVD risks as well as depression risks reveals a considerably better model fit as expressed by much lower AIC values. This is also the case when risk differences between different types of traffic noise are taken into account by applying supplements or reductions to the single traffic noise pressure levels in order to identify the best fitting energetic addition model. As a consequence, the conventionally performed energetic addition of noise levels might considerably underestimate the health risks of combined traffic noise. Based on the NORAH disease risk study, “epidemiological risk multiplication” seems to provide a better estimate of the health risks of combined traffic noise exposures compared to energetic addition. If confirmed in further studies, these results should imply consequences for noise protection measures as well as for traffic planning. Full article
(This article belongs to the Special Issue Health Effects of Future Traffic Noise)
Open AccessArticle
Analysis of Genetic Characterization and Clonality of Legionella pneumophila Isolated from Cooling Towers in Japan
Int. J. Environ. Res. Public Health 2019, 16(9), 1664; https://doi.org/10.3390/ijerph16091664
Received: 25 April 2019 / Revised: 9 May 2019 / Accepted: 10 May 2019 / Published: 13 May 2019
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Abstract
We investigated the genetic characteristics of 161 Legionella pneumophila strains isolated over a period of 10 years from cooling towers in Japan. Minimum spanning tree analysis based on the sequence-based typing (SBT) of them identified three clonal complexes (CCs); CC1 (105/161, 65.2%), CC2 [...] Read more.
We investigated the genetic characteristics of 161 Legionella pneumophila strains isolated over a period of 10 years from cooling towers in Japan. Minimum spanning tree analysis based on the sequence-based typing (SBT) of them identified three clonal complexes (CCs); CC1 (105/161, 65.2%), CC2 (22 /161, 13.7%), and CC3 (20/161, 12.4%). CC1 was formed by serogroup (SG) 1 and SG7, whereas CC2 was mainly formed by SG1. All of the CC3 isolates except two strains were SG13. The major sequence types (STs) in CC1 and CC2 were ST1 (88/105, 83.8%) and ST154 (15/22, 68.2%), respectively. These STs are known as typical types of L. pneumophila SG1 in Japanese cooling tower. Additionally, we identified 15 strains of ST2603 as the major type in CC3. This ST has not been reported in Japanese cooling tower. Whole genome sequencing (WGS) analysis of the representative strains in the three CCs, which were isolated from various cooling towers over the 10 years, elucidated high clonal population of L. pneumophila in Japanese cooling tower. Moreover, it revealed that the strains of CC2 are phylogenetically distant compared to those of CC1 and CC3, and belonged to L. pneumophila subsp. fraseri. Full article
(This article belongs to the Special Issue Environmental Microbiology and Urban Health)
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Open AccessArticle
Effects of Simulated Herbivory on the Vegetative Reproduction and Compensatory Growth of Hordeum brevisubulatum at Different Ontogenic Stages
Int. J. Environ. Res. Public Health 2019, 16(9), 1663; https://doi.org/10.3390/ijerph16091663
Received: 10 April 2019 / Revised: 7 May 2019 / Accepted: 12 May 2019 / Published: 13 May 2019
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Abstract
The response of plant vegetative reproduction and compensatory growth to herbivory has been widely discussed in biological and ecological research. Most previous research has supported the idea that both vegetative reproduction and compensatory growth are affected by their ontogenic stage. However, in many [...] Read more.
The response of plant vegetative reproduction and compensatory growth to herbivory has been widely discussed in biological and ecological research. Most previous research has supported the idea that both vegetative reproduction and compensatory growth are affected by their ontogenic stage. However, in many studies, the effects of foraging at different ontogenic stages was often confounded with the effects of foraging at different phenological periods for perennials. Our experiment was conducted in a natural meadow with a perennial grass, Hordeum brevisubulatum, and four ontogenic stages were chosen as our experimental objects. Three different clipping intensities during three phenological periods were implemented to explore the effects of simulating animal foraging on vegetative reproduction and compensatory plant growth. The results indicated that there were significant effects of ontogenic stage, phenological period, and clipping intensity on vegetative reproduction and compensatory growth. Moderate clipping intensities significantly increased the number of vegetative tillers, the total number of juvenile tillers and buds, and the aboveground biomass at early phenological periods for individuals at early ontogenic stages. Our results suggested that moderate clipping intensities could induce only an over-compensation response in perennial grasses at both the early ontogenic stage and phenological period, and the ability of compensatory growth gradually decreased with the progression of the ontogenic stage. This is of great significance to the primary production of grasslands subjected to herbivory. Full article
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Open AccessArticle
Oxidative Stress Effects of Soluble Sulfide on Human Hepatocyte Cell Line LO2
Int. J. Environ. Res. Public Health 2019, 16(9), 1662; https://doi.org/10.3390/ijerph16091662
Received: 1 April 2019 / Revised: 8 May 2019 / Accepted: 10 May 2019 / Published: 13 May 2019
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Abstract
Soluble sulfide is well known for its toxicity and corrosion for hundreds of years. However, recent studies have demonstrated that hydrogen sulfide (H2S)—a novel gasotransmitter—supports a critical role during neuromodulation, cell proliferation, and cardioprotection for organisms. In particular, soluble sulfide plays [...] Read more.
Soluble sulfide is well known for its toxicity and corrosion for hundreds of years. However, recent studies have demonstrated that hydrogen sulfide (H2S)—a novel gasotransmitter—supports a critical role during neuromodulation, cell proliferation, and cardioprotection for organisms. In particular, soluble sulfide plays multifaceted signaling functions in mammals during oxidative stress processes. However, the specific molecular regulation of soluble sulfide during oxidative stress remains unclear. In this study, Na2S was implemented as a soluble sulfide donor to expose LO2 cells. The 3-(4,5-dimethylthiazolyl-2),-2,5-diphenyltetrazolium bromide (MTT) assay, hydroxyl radical assay, superoxide dismutase (SOD) assay, and glutathione peroxidase (GSH-PX) assay were applied to analyze cytotoxicity, hydroxyl radical levels, SOD and GSH-Px activities, respectively. Soluble sulfide at a concentration 0.01–1.0 mM/L resulted in a marked and concentration-dependent reduction of LO2 cell viability. At low concentrations, sulfide solutions increased SOD activity and GSH-Px activity of LO2 after 24 h exposure, exhibiting a clear hormesis-effect and indicating the protective ability of soluble sulfide against oxidative stress. The decline in SOD and GSH-Px and the increase in hydroxyl radical (0.08–1.0 mM/L) suggested that oxidative damage could be a possible mechanism for sulfide-induced cytotoxicity. Full article
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Open AccessArticle
Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths
Int. J. Environ. Res. Public Health 2019, 16(9), 1661; https://doi.org/10.3390/ijerph16091661
Received: 23 April 2019 / Revised: 8 May 2019 / Accepted: 9 May 2019 / Published: 13 May 2019
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Abstract
Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. [...] Read more.
Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees’ motivation for ACW, which is the first step towards behavior change. Full article
(This article belongs to the collection Physical Activity and Public Health)
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Open AccessArticle
MRSA Point Prevalence among Health Care Workers in German Rehabilitation Centers: A Multi-Center, Cross-Sectional Study in a Non-Outbreak Setting
Int. J. Environ. Res. Public Health 2019, 16(9), 1660; https://doi.org/10.3390/ijerph16091660
Received: 27 March 2019 / Revised: 8 May 2019 / Accepted: 9 May 2019 / Published: 13 May 2019
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Abstract
People working in health care services have an increased risk of being infected with methicillin-resistant Staphylococcus aureus (MRSA), though little is known about the prevalence in rehabilitation centers. This cross-sectional study investigated the MRSA prevalence in employees from different rehabilitation centers and aimed [...] Read more.
People working in health care services have an increased risk of being infected with methicillin-resistant Staphylococcus aureus (MRSA), though little is known about the prevalence in rehabilitation centers. This cross-sectional study investigated the MRSA prevalence in employees from different rehabilitation centers and aimed to identify risk factors for MRSA transmission. We invited all staff (i.e., with and without patient contact from 22 participating rehabilitation centers; n = 2499) to participate. Study participation included a questionnaire on personal characteristics, lifestyle, personal and occupational risk factors for MRSA and nasal swabs taken by the study team. In total, 1005 persons participated in the study (response: 40.2%). Only four participants carried MRSA (0.40 (95% CI 0.00–1.00) per 100). MRSA carriage did not seem to be occupationally related, as it was found in different occupations with and without direct contact with MRSA patients, as well as in different clinics with different indications and patient clientele. We could not find a clear association between MRSA carriage and potential risk factors due to the low number of cases found. Genotyping revealed the spa types t032 (Barnim epidemic strain) and t1223. Our results suggest a low point prevalence of nasal MRSA colonization in a non-outbreak setting in employees from rehabilitation centers. Full article
Open AccessArticle
Environmental Education, Knowledge, and High School Students’ Intention toward Separation of Solid Waste on Campus
Int. J. Environ. Res. Public Health 2019, 16(9), 1659; https://doi.org/10.3390/ijerph16091659
Received: 17 March 2019 / Revised: 22 April 2019 / Accepted: 4 May 2019 / Published: 13 May 2019
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Abstract
To achieve substantial and sustainable levels of separation of municipal solid waste (MSW), it is essential to engage young people as they are important drivers of change and will have a major influence on the future of the world. This study aimed to [...] Read more.
To achieve substantial and sustainable levels of separation of municipal solid waste (MSW), it is essential to engage young people as they are important drivers of change and will have a major influence on the future of the world. This study aimed to understand Chinese high school students’ intention toward the separation of solid waste on campus (SSWC). The study has used the Theory of Planned Behavior (TPB) as its theoretical framework, and further incorporates two additional constructs (environmental education and environmental knowledge) to explain the separation of solid waste (SSW) behavior of 562 high school students. The results indicate that environmental education is essential to ensure that students have required knowledge and positive attitudes toward SSWC. Knowledge was the best predictor of high school students’ separation behavior. Moreover, a lack of subjective norm from the important people could prevent students from participating in this process, regardless of their positive attitudes. The implications for policy and scope for further research are discussed. Full article
(This article belongs to the Section Health Economics)
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Open AccessArticle
Examining the Features of Parks That Children Visit During Three Stages of Childhood
Int. J. Environ. Res. Public Health 2019, 16(9), 1658; https://doi.org/10.3390/ijerph16091658
Received: 6 March 2019 / Revised: 7 May 2019 / Accepted: 8 May 2019 / Published: 13 May 2019
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Abstract
Parks provide an opportunity for children to be physically active, but are rarely fully utilised. A better understanding of which park features attract children of varying ages is needed. This study examined which features are present at parks that children visit most often [...] Read more.
Parks provide an opportunity for children to be physically active, but are rarely fully utilised. A better understanding of which park features attract children of varying ages is needed. This study examined which features are present at parks that children visit most often at different stages throughout childhood. Parents reported the park their child visited most often at three timepoints: T1 = 3–5 years, T2 = 6–8 years, and T3 = 9–11 years. These parks were then audited (using a purposely created audit tool) to capture information relating to access, activity areas and quality. Online mapping tools were also used to determine walking distance to parks and park size. Parks visited at T2 were further from home, larger, and had more road crossings, full courts, other facilities and comfort amenities such as toilets and lights than T1 parks. Parks visited at T3 were larger and had more sports ovals compared to T1 parks, and were significantly less likely to have barbeque facilities than T2 parks. Our findings suggest that as children transition from pre-school (T1), to primary school age (T2 and T3), they visit parks that have more facilities to support sport and active recreation. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle
Pricing Strategies in Dual-Channel Reverse Supply Chains Considering Fairness Concern
Int. J. Environ. Res. Public Health 2019, 16(9), 1657; https://doi.org/10.3390/ijerph16091657
Received: 9 April 2019 / Revised: 8 May 2019 / Accepted: 11 May 2019 / Published: 13 May 2019
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Abstract
The fierce competition in the recycling industry and the rapid development of internet technology has prompted recycling centers to develop a dual-channel reverse supply chain with both offline and online recycling channels. After the introduction of online channels, recycling centers and third-party recyclers [...] Read more.
The fierce competition in the recycling industry and the rapid development of internet technology has prompted recycling centers to develop a dual-channel reverse supply chain with both offline and online recycling channels. After the introduction of online channels, recycling centers and third-party recyclers (TPR) have paid attention to the division of profits in supply chain systems and the behavior of fairness concerns. Therefore, it is necessary to help recycling enterprises make pricing decisions in consideration of fairness concerns. This paper is aimed at answering the following two main questions: (1) When the recycling center or TPR have fairness concerns, how does the optimal pricing and revenue of supply chain members change when both sides are neutral? (2) When the fairness concern coefficient changes, how does the overall revenue of the supply chain system change? How should supply chain members adjust their pricing decisions to maximize their own profits? In order to solve the above problems, Stackelberg game models were made from three aspects: both sides are neutral, only the TPR has fairness concerns, and only the recycling center has fairness concerns. Based on the results of the example analyses for the model, we found that when only the TPR has fairness concerns, the profit of the recycling center and the transfer price of offline channels will decrease, while the profit of TPR is the opposite. Furthermore, when only a recycling center has fairness concerns, it will lead to the reduction of not only the recycling price and transfer price of offline channels, but also the profits of the entire supply chain system. Specially, whether it is for a recycling center or TPR, a lower level of fairness concern coefficient has a stronger impact on pricing and revenue than at high levels. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle
Self-Reported Exposure to ETS (Environmental Tobacco Smoke), Urinary Cotinine, and Oxidative Stress Parameters in Pregnant Women—The Pilot Study
Int. J. Environ. Res. Public Health 2019, 16(9), 1656; https://doi.org/10.3390/ijerph16091656
Received: 14 March 2019 / Revised: 22 April 2019 / Accepted: 9 May 2019 / Published: 13 May 2019
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Abstract
Background: Exposure to ETS (environmental tobacco smoke) is one of the most toxic environmental exposures. Objective: To investigate the association of ETS with physiological, biochemical, and psychological indicators, as well as with urine antioxidant capacity (AC) and oxidative damage to lipids in a [...] Read more.
Background: Exposure to ETS (environmental tobacco smoke) is one of the most toxic environmental exposures. Objective: To investigate the association of ETS with physiological, biochemical, and psychological indicators, as well as with urine antioxidant capacity (AC) and oxidative damage to lipids in a pilot sample of healthy pregnant women. Methods: Exposure to ETS was investigated via a validated questionnaire, and urine cotinine and the marker of oxidative damage to lipids via 8-isoprostane concentrations using an ELISA kit. Urine AC was determined by the spectrophotometric Trolox-equivalent antioxidant capacity (TEAC) method. From a sample of pregnant women (n = 319, average age 30.84 ± 5.09 years) in 80, the levels of cotinine and oxidative stress markers were analyzed. Results: Among the 80 pregnant women, 5% (7.4% confirmed by cotinine) reported being current smokers and 25% reported passive smoking in the household (18.8% confirmed by cotinine). The Kappa was 0.78 for smokers and 0.22 for ETS-exposed nonsmokers. Pregnant women in the ETS-exposed group had significantly reduced AC compared to both the nonsmoker (ETS−) and the smoker groups (p < 0.05). Nonsmokers had significantly lower levels of 8-isoprostane than smokers (p < 0.01) and ETS-exposed nonsmokers (p < 0.05). Correlations between urine levels of cotinine and AC were positive in ETS-exposed nonsmokers. Conclusion: A harmful association of active and passive smoking and oxidative stress parameters among pregnant women has been indicated. Full article
(This article belongs to the Special Issue Maternal and Child Environmental Health and Disease)
Open AccessArticle
Abnormalities on Chest Computed Tomography and Lung Function Following an Intense Dust Exposure: A 17-Year Longitudinal Study
Int. J. Environ. Res. Public Health 2019, 16(9), 1655; https://doi.org/10.3390/ijerph16091655
Received: 15 February 2019 / Revised: 29 April 2019 / Accepted: 9 May 2019 / Published: 13 May 2019
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Abstract
Fire Department of the City of New York (FDNY) firefighters experienced intense dust exposure working at the World Trade Center (WTC) site on and after 11/9/2001 (9/11). We hypothesized that high-intensity WTC exposure caused abnormalities found on chest computed tomography (CT). Between 11/9/2001–10/9/2018, [...] Read more.
Fire Department of the City of New York (FDNY) firefighters experienced intense dust exposure working at the World Trade Center (WTC) site on and after 11/9/2001 (9/11). We hypothesized that high-intensity WTC exposure caused abnormalities found on chest computed tomography (CT). Between 11/9/2001–10/9/2018, 4277 firefighters underwent a clinically-indicated chest CT. Spirometric measurements and symptoms were recorded during routine medical examinations. High-intensity exposure, defined as initial arrival at the WTC on the morning of 9/11, increased the risk of bronchial wall thickening, emphysema, and air trapping. Early post-9/11 symptoms of wheeze and shortness of breath were associated with bronchial wall thickening, emphysema, and air trapping. The risk of accelerated forced expiratory volume at one second (FEV1) decline (>64 mL/year decline) increased with bronchial wall thickening and emphysema, but decreased with air trapping. The risk of airflow obstruction also increased with bronchial wall thickening and emphysema but decreased with air trapping. In a previously healthy occupational cohort, high-intensity WTC exposure increased the risk for CT abnormalities. Bronchial wall thickening and emphysema were associated with respiratory symptoms, accelerated FEV1 decline, and airflow obstruction. Air trapping was associated with respiratory symptoms, although lung function was preserved. Physiologic differences between CT abnormalities suggest that distinct types of airway injury may result from a common exposure. Full article
(This article belongs to the Special Issue Long-Term Health Effects of the 9/11 Disaster)
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Open AccessArticle
Women’s Perceptions of Living a Traumatic Childbirth Experience and Factors Related to a Birth Experience
Int. J. Environ. Res. Public Health 2019, 16(9), 1654; https://doi.org/10.3390/ijerph16091654
Received: 10 April 2019 / Revised: 7 May 2019 / Accepted: 9 May 2019 / Published: 13 May 2019
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Abstract
Although identified by the World Health Organization (WHO) as a global health priority, maternal mental health does not receive much attention even in the health systems of developed countries. With pregnancy monitoring protocols placing priority on the physical health of the mother, there [...] Read more.
Although identified by the World Health Organization (WHO) as a global health priority, maternal mental health does not receive much attention even in the health systems of developed countries. With pregnancy monitoring protocols placing priority on the physical health of the mother, there is a paucity of literature documenting the traumatising effects of the birth process. To address this knowledge gap, this qualitative descriptive study aimed to investigate women perceptions of living a traumatic childbirth experience and the factors related to it. Qualitative data, collected via semi-structured interviews with 32 participants recruited from parent support groups and social media in Spain, were analyzed through a six-phase inductive thematic analysis. Data analysis revealed five major themes―“Birth Plan Compliance”, “Obstetric Problems”, “Mother-Infant Bond”, “Emotional Wounds” and “Perinatal Experiences”—and 13 subthemes. The majority of responses mentioned feelings of being un/misinformed by healthcare personnel, being disrespected and objectified, lack of support, and various problems during childbirth and postpartum. Fear, loneliness, traumatic stress, and depression were recurrent themes in participants’ responses. As the actions of healthcare personnel can substantially impact a birth experience, the study findings strongly suggest the need for proper policies, procedures, training, and support to minimise negative consequences of childbirth. Full article
(This article belongs to the Section Women's Health)
Open AccessArticle
Work Ability among Italian Bank Video Display Terminal Operators: Socio-Demographic, Lifestyle, and Occupational Correlates
Int. J. Environ. Res. Public Health 2019, 16(9), 1653; https://doi.org/10.3390/ijerph16091653
Received: 11 February 2019 / Revised: 6 May 2019 / Accepted: 8 May 2019 / Published: 12 May 2019
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Abstract
Bank employees, especially video display terminal (VDT) operators, are constantly exposed to various occupational risks, such as the adoption of awkward postures, repetitive finger movements, and utilization of software with poor usability, which may lead to computer visual syndrome, tension headache, lower back [...] Read more.
Bank employees, especially video display terminal (VDT) operators, are constantly exposed to various occupational risks, such as the adoption of awkward postures, repetitive finger movements, and utilization of software with poor usability, which may lead to computer visual syndrome, tension headache, lower back pain, and/or stress, which compromises their overall health and work ability (WA). Thus, in this cross-sectional study, we aimed to establish that the determinants among socio-demographic, lifestyle, and occupational characteristics are associated with impaired WA in bank VDT operators. To this end, we administered a set of socio-demographic, lifestyle, occupational, and Work Ability Index (WAI) questionnaires to 2077 Italian bank VDT operators. Univariate linear regression models reveal that their mean WAI score is inversely associated with gender, age, dependent family members, and a part-time job, whereas it is directly associated with the educational level and physical activity. In addition, multivariate analysis shows that their mean WAI score is inversely associated with age and a part-time job, but was directly associated with the educational level, the marital status, and physical activity. Overall, VDT operators working in Italian banks display high WA even though this latter tends to decline with aging. In light of the progressive aging of the workforce in Italy, our results provide the rationale for the design of interventions aimed to mitigate the detrimental effects of aging on WA of bank VDT operators. Full article
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Open AccessConcept Paper
Ending Intimate Partner Violence (IPV) and Locating Men at Stake: An Ecological Approach
Int. J. Environ. Res. Public Health 2019, 16(9), 1652; https://doi.org/10.3390/ijerph16091652
Received: 23 March 2019 / Revised: 8 May 2019 / Accepted: 8 May 2019 / Published: 12 May 2019
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Abstract
Interventions for ending intimate partner violence (IPV) have not usually provided integrated approaches. Legal and social policies have the duty to protect, assist and empower women and to bring offenders to justice. Men have mainly been considered in their role as perpetrators to [...] Read more.
Interventions for ending intimate partner violence (IPV) have not usually provided integrated approaches. Legal and social policies have the duty to protect, assist and empower women and to bring offenders to justice. Men have mainly been considered in their role as perpetrators to be subjected to judicial measures, while child witnesses of violence have not been viewed as a direct target for services. Currently, there is a need for an integrated and holistic theoretical and operational model to understand IPV as gender-based violence and to intervene with the goal of ending the fragmentation of existing measures. The EU project ViDaCS—Violent Dads in Child Shoes—which worked towards the deconstruction and reconstruction of violence’s effects on child witnesses, has given us the opportunity to collect the opinions of social workers and child witnesses regarding violence. Therefore, the article describes measures to deal with IPV, proposing functional connections among different services and specific preventative initiatives. Subsequently, this study will examine intimate partner violence and provide special consideration to interventions at the individual, relational, organizational and community levels. The final goal will be to present a short set of guidelines that take into account the four levels considered by operationalizing the aforementioned ecological principles. Full article
(This article belongs to the Section Health Care Sciences & Services)
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Open AccessArticle
Coping and Anxiety in Caregivers of Dependent Older Adult Relatives
Int. J. Environ. Res. Public Health 2019, 16(9), 1651; https://doi.org/10.3390/ijerph16091651
Received: 16 April 2019 / Revised: 9 May 2019 / Accepted: 11 May 2019 / Published: 12 May 2019
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Abstract
The aim of this study was to analyze the relationship between coping and anxiety in caregivers of dependent older adult relatives. A cross-sectional study was carried out in the province of Jaén (Andalusia, Spain). The convenience sample consisted of 198 family caregivers of [...] Read more.
The aim of this study was to analyze the relationship between coping and anxiety in caregivers of dependent older adult relatives. A cross-sectional study was carried out in the province of Jaén (Andalusia, Spain). The convenience sample consisted of 198 family caregivers of dependent older adults. The main measurements were anxiety (Hamilton scale), coping (Brief COPE), subjective burden (Caregiver Strain Index), objective burden and sex of the caregiver. The main analyses were bivariate analysis using the Pearson correlation coefficient, and multivariate analysis using multiple linear regression. An independent regression model was developed for anxiety and each type of coping, adjusting for sex, subjective burden and objective burden. Our results demonstrate that anxiety was negatively associated with planning (partial r = −0.18), acceptance (partial r = −0.22) and humor (partial r = −0.20), and it was positively associated with self-distraction (partial r = 0.19), venting (partial r = 0.22), denial (partial r = 0.27) and self-blame (partial r = 0.25). Planning, acceptance and humor coping strategies may be protective factors of anxiety. Strategies such self-management, relief, denial and self-blame may be risk factors for anxiety. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle
Microplastic Pollution in Surface Water of Urban Lakes in Changsha, China
Int. J. Environ. Res. Public Health 2019, 16(9), 1650; https://doi.org/10.3390/ijerph16091650
Received: 24 April 2019 / Revised: 8 May 2019 / Accepted: 9 May 2019 / Published: 12 May 2019
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Abstract
As emerging pollutants, microplastics have attracted the attention of scholars from all over the world. However, there is a lack of research on freshwater areas, even in densely populated urban areas. This study investigated eight urban lakes in Changsha, China. It was found [...] Read more.
As emerging pollutants, microplastics have attracted the attention of scholars from all over the world. However, there is a lack of research on freshwater areas, even in densely populated urban areas. This study investigated eight urban lakes in Changsha, China. It was found that microplastic concentrations ranged from 2425 ± 247.5 items/m3 to 7050 ± 1060.66 items/m3 in the surface water of research areas and the maximum concentration was found in Yuejin Lake, a tourist spot in the center of the city. Anthropogenic factors are an important reason for microplastic abundance in urban lakes. The major shape of microplastics was linear and most of the microplastics were transparent. More than 89.5% of the microplastics had a size of less than 2 mm. Polypropylene was the dominant type in the studied waters. This study can provide a valuable reference for a better understanding of microplastic pollution in urban areas of China. Full article
(This article belongs to the Special Issue Plastic Pollution)
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Open AccessReview
Management of STEC Gastroenteritis: Is There a Role for Probiotics?
Int. J. Environ. Res. Public Health 2019, 16(9), 1649; https://doi.org/10.3390/ijerph16091649
Received: 21 March 2019 / Revised: 29 April 2019 / Accepted: 9 May 2019 / Published: 12 May 2019
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Abstract
Shiga toxin-producing Escherichia Coli (STEC) infections routinely run as a common gastroenteritis, but in many cases they may evolve towards hemolytic uremic syndrome (HUS). HUS is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Gut microorganisms have a [...] Read more.
Shiga toxin-producing Escherichia Coli (STEC) infections routinely run as a common gastroenteritis, but in many cases they may evolve towards hemolytic uremic syndrome (HUS). HUS is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Gut microorganisms have a fundamental impact on human physiology, because they modulate normal intestinal functions and play a pivotal role in influencing the local and systemic immune responses. Despite surveillance established in many countries and major progresses in the understanding of STEC-HUS mechanisms, no specific treatment is currently available. Targeting the gut microbiota could represent a new potential therapeutic strategy in STEC infection. In this paper, we reviewed the current knowledge about microbiota characteristics of patients with STEC infections, as well as in vitro and in vivo evidence of probiotic supplementation in managing STEC gastroenteritis and in HUS onset prevention. Full article
(This article belongs to the Section Children Health)
Open AccessArticle
Coupling and Coordination Degrees of the Core Water–Energy–Food Nexus in China
Int. J. Environ. Res. Public Health 2019, 16(9), 1648; https://doi.org/10.3390/ijerph16091648
Received: 9 April 2019 / Revised: 6 May 2019 / Accepted: 7 May 2019 / Published: 11 May 2019
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Abstract
Achieving sustainable development in the water–energy–food (WEF) nexus is gaining global attention. The coupling and coordination degrees are a way to measure sustainable development levels of a complex system. This study assessed the coupling and coordination degrees of the core WEF nexus and [...] Read more.
Achieving sustainable development in the water–energy–food (WEF) nexus is gaining global attention. The coupling and coordination degrees are a way to measure sustainable development levels of a complex system. This study assessed the coupling and coordination degrees of the core WEF nexus and identified key factors that affect sustainable development. First, an index system for assessing coupling and coordination degrees of the core WEF nexus was built. Second, the development levels of three subsystems as well as the coupling and coordination degrees of the core WEF nexus in China were calculated. The results showed that from 2007 to 2016, the mean value of the coupling degree was 0.746 (range (0.01, 1)), which was a high level. This proved that the three resources were interdependent. Hence, it was necessary to study their relationship. However, the mean value of the coordination degree was 0.395 (range (0, 1)), which was a low level. This showed that the coordination development of the core WEF nexus in China was low. It is necessary to take some measures to improve the situation. According to the key factors that affect the development levels of water, energy, and food subsystems, the authors put forward some suggestions to improve the coordination development of the WEF system in China. Full article
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Open AccessArticle
Synergetic Relationship between Urban and Rural Water Poverty: Evidence from Northwest China
Int. J. Environ. Res. Public Health 2019, 16(9), 1647; https://doi.org/10.3390/ijerph16091647
Received: 26 March 2019 / Revised: 7 May 2019 / Accepted: 8 May 2019 / Published: 11 May 2019
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Abstract
Combining the measurement of urban and rural areas to link water and poverty provides a new insight into the fields of water resources management and poverty alleviation. Owing to rapid urban development, water resource conflicts between urban and rural areas are gettingbecoming more [...] Read more.
Combining the measurement of urban and rural areas to link water and poverty provides a new insight into the fields of water resources management and poverty alleviation. Owing to rapid urban development, water resource conflicts between urban and rural areas are gettingbecoming more intensified and more complex. This study details the application of a water poverty index (WPI) using 26 indicators to evaluate urban and rural water poverty in northwest China during the period 2000–2017. This study also analyzes temporal variations of urban and rural water poverty by the kernel density estimation (KDE). We found that the level of water poverty is gradually declining over time and the improvements in urban and rural areas are not harmonious. Additionally, it applies the synergic theory to analyze the relationships between urban and rural water poverty. The correspondence analysis between urban and rural water poverty is significant because of the synergic level results. The results show that there are four primary types in northwest China: synchronous areas, urban-priority areas, rural-priority areas, and conflict areas, and their evolution stages. The results suggest the need for location-specific policy interventions. Furthermore, we put forward corresponding countermeasures. The research findings also provide a theoretical foundation for the evaluation of urban and rural water poverty, and a regional strategy to relieve conflict between urban and rural water poverty. Full article
(This article belongs to the Special Issue Water Resources Systems Quality and Quantity Management)
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Open AccessArticle
Community-Based Participatory Research and Drug Utilization Research to Improve Childhood Diarrhea Case Management in Ujjain, India: A Cross-Sectional Survey
Int. J. Environ. Res. Public Health 2019, 16(9), 1646; https://doi.org/10.3390/ijerph16091646
Received: 17 April 2019 / Revised: 7 May 2019 / Accepted: 9 May 2019 / Published: 11 May 2019
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Abstract
Childhood diarrhea continues to be a major cause of under-five (U-5) mortality globally and in India. In this study, 1571 U-5 children residing in nine rural villages and four urban slums in Ujjain, India were included with the objective to use community participation [...] Read more.
Childhood diarrhea continues to be a major cause of under-five (U-5) mortality globally and in India. In this study, 1571 U-5 children residing in nine rural villages and four urban slums in Ujjain, India were included with the objective to use community participation and drug utilization research to improve diarrheal case management. The mean age was 2.08 years, with 297 (19%), children living in high diarrheal index households. Most mothers (70%) considered stale food, teething (62%), and hot weather (55%) as causes of diarrhea. Water, sanitation, and hygiene (WASH)-related characteristics revealed that most (93%) households had toilets, but only 23% of the children used them. The study identified ineffective household water treatment by filtration through cloth by most (93%) households and dumping of household waste on the streets (89%). The results revealed low community awareness of correct causes of diarrhea (poor hand hygiene, 21%; littering around the household, 15%) and of correct diarrhea treatment (oral rehydration solution (ORS) and zinc use, 29% and 11%, respectively) and a high antibiotic prescription rate by healthcare providers (83%). Based on the results of the present study, context-specific house-to-house interventions will be designed and implemented. Full article
(This article belongs to the Section Infectious Disease Epidemiology)
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Open AccessArticle
Primary Drivers of Willingness to Continue to Participate in Community-Based Health Screening for Chronic Diseases
Int. J. Environ. Res. Public Health 2019, 16(9), 1645; https://doi.org/10.3390/ijerph16091645
Received: 28 March 2019 / Revised: 23 April 2019 / Accepted: 8 May 2019 / Published: 11 May 2019
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Abstract
Background: As the average age of the population continues to rise in the 21st century, chronic illnesses have become the most prominent threats to human health. Research has shown that early screenings for chronic diseases are an effective way of lowering incidence and [...] Read more.
Background: As the average age of the population continues to rise in the 21st century, chronic illnesses have become the most prominent threats to human health. Research has shown that early screenings for chronic diseases are an effective way of lowering incidence and mortality rates. However, low participation rates for health screening is one of the main challenges for preventive medicine. The objective of this study was to determine the primary drivers which: (1) first motivate people to participate in community-based health screening for chronic diseases; and (2) increase their willingness to continue to participate. Methods: A total of 440 individuals between 30 and 75 years of age were invited to undergo a health screening and then complete an interview questionnaire. Screenings and interviews were conducted in four regions in northern Taiwan. The questionnaire was separated into three sections, which explored sociodemographic differences, drivers of willingness to participate, and willingness to continue to participate respectively. Raw data was analyzed using the statistical software package SPSS (SPSS Inc., Chicago, IL, USA). Main Outcome Measures: Effects of sociodemographic factors on health screening participation rate, drivers of willingness to participate, and willingness to continue to participate. Results: Seventy-three percent of participants responded that they would be willing to continue to join in future health screenings. Notably, elderly people and married people were respectively more likely to participate in preventive health screening than were younger people and people who were single, divorced, separated, or widowed. Level of education was another key driver of willingness to participate in health screening for chronic diseases, as were the concern of relatives/friends and the provision of participation incentives. Discussion: Some of our findings, such as the key drivers of willingness to continue to participate in health screening that we identified, were different from findings of many previous studies conducted in other countries. The current study also found that a higher percentage of participants would be willing to join a similar health screening in the future if the service design is considered in advance and is well-implemented. Full article
Open AccessArticle
Morbi-Mortality of the Victims of Internal Conflict and Poor Population in the Risaralda Province, Colombia
Int. J. Environ. Res. Public Health 2019, 16(9), 1644; https://doi.org/10.3390/ijerph16091644
Received: 31 October 2018 / Revised: 28 April 2019 / Accepted: 29 April 2019 / Published: 11 May 2019
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Abstract
This work studies the health status of two populations similar in most social and environmental interactions but one: the individuals from one population are victims of an internal armed conflict. Both populations are located in the Risaralda province, Colombia and the data for [...] Read more.
This work studies the health status of two populations similar in most social and environmental interactions but one: the individuals from one population are victims of an internal armed conflict. Both populations are located in the Risaralda province, Colombia and the data for this study results from a combination of administrative records from the health system, between 2011 and 2016. We implemented a methodology based on graph theory that defines the system as a set of heterogeneous social actors, including individuals as well as organizations, embedded in a biological environment. The model of analysis uses the diagnoses in medical records to detect morbidity and mortality patterns for each individual (ego-networks), and assumes that these patterns contain relevant information about the effects of the actions of social actors, in a given environment, on the status of health. The analysis of the diagnoses and causes of specific mortality, following the Social Network Analysis framework, shows similar morbidity and mortality rates for both populations. However, the diagnoses’ patterns show that victims portray broader interactions between diagnoses, including mental and behavioral disorders, due to the hardships of this population. Full article
(This article belongs to the Special Issue Social Networks and Health)
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Open AccessArticle
The Association between Substance Abuse and Sexual Misconduct among Macau Youths
Int. J. Environ. Res. Public Health 2019, 16(9), 1643; https://doi.org/10.3390/ijerph16091643
Received: 8 February 2019 / Revised: 1 May 2019 / Accepted: 4 May 2019 / Published: 11 May 2019
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Abstract
This study investigates how peer influence, school attachment, and substance abuse are related to sexual behavior, with particular interest in exploring the relationship between substance abuse and sexual misconduct, while using a stratified random sample of adolescents in Macau. Mediation analyses were employed. [...] Read more.
This study investigates how peer influence, school attachment, and substance abuse are related to sexual behavior, with particular interest in exploring the relationship between substance abuse and sexual misconduct, while using a stratified random sample of adolescents in Macau. Mediation analyses were employed. The results show that substance abuse, apart from susceptibility to peer influence and school attachment/commitment, was significantly related to sexual misconduct. Substance abuse was the best predictor of sexual misconduct, and it significantly mediated the relationship between susceptibility to peer influence, as well as school attachment and sexual misconduct. This reflects that the use of substances, including drugs, alcohol, and cigarettes, can be viewed as a catalyst for triggering engagement in sexual misconduct. The implications of this study involve taking measures to reduce the rate of substance abuse as a way of decreasing sexual misconduct in adolescents. Future research directions in exploring the relationship between adolescent substance abuse and risky sexual behavior are discussed. Full article
(This article belongs to the Special Issue Substance Abuse, Environment and Public Health)
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Open AccessArticle
Depressive Symptoms among Industrial Workers in Vietnam and Correlated Factors: A Multi-Site Survey
Int. J. Environ. Res. Public Health 2019, 16(9), 1642; https://doi.org/10.3390/ijerph16091642
Received: 25 March 2019 / Revised: 30 April 2019 / Accepted: 8 May 2019 / Published: 11 May 2019
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Abstract
Depressive disorders have been found to be a significant health issue among industrial workers, resulting from work-related factors and causing serious burdens for the workers as well as their employers. Literature on mental health problems of Vietnamese industrial workers has been limited, despite [...] Read more.
Depressive disorders have been found to be a significant health issue among industrial workers, resulting from work-related factors and causing serious burdens for the workers as well as their employers. Literature on mental health problems of Vietnamese industrial workers has been limited, despite the rapid foreign investment-fueled industrialization process of the country. This study aimed to fill the gap in literature by examining the prevalence of depressive disorders and their potential associated factors among a cohort of Vietnamese industrial workers. A cross-sectional study was conducted in 3 industrial areas in Hanoi and Bac Ninh. A total of 289 workers agreed to participate in the study. Generalized linear mixed models were applied to identify associated factors with depression status of respondents. 38.6% of participants reported suffering depression. Factors found to be positively associated with the possibility of having depression and higher PHQ9 score were long working hours, suffering more health problems, and health hazards exposure at work. Meanwhile, being females, having more children, living with parents, engaging in smoking, and being local workers were found to correlate with lower likelihood of being depressed. The findings suggested the importance of regular health screening, work safety assurance, and social support outside of workplace on the mental health of the workers. Full article
(This article belongs to the Special Issue Adult Psychiatry)
Open AccessArticle
Implementation of 3D Printing Technology in the Field of Prosthetics: Past, Present, and Future
Int. J. Environ. Res. Public Health 2019, 16(9), 1641; https://doi.org/10.3390/ijerph16091641
Received: 24 March 2019 / Revised: 26 April 2019 / Accepted: 6 May 2019 / Published: 10 May 2019
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Abstract
There is an interesting and long history of prostheses designed for those with upper-limb difference, and yet issues still persist that have not yet been solved. Prosthesis needs for children are particularly complex, due in part to their growth rates. Access to a [...] Read more.
There is an interesting and long history of prostheses designed for those with upper-limb difference, and yet issues still persist that have not yet been solved. Prosthesis needs for children are particularly complex, due in part to their growth rates. Access to a device can have a significant impact on a child’s psychosocial development. Often, devices supporting both cosmetic form and user function are not accessible to children due to high costs, insurance policies, medical availability, and their perceived durability and complexity of control. These challenges have encouraged a grassroots effort globally to offer a viable solution for the millions of people living with limb difference around the world. The innovative application of 3D printing for customizable and user-specific hardware has led to open-source Do It Yourself “DIY” production of assistive devices, having an incredible impact globally for families with little recourse. This paper examines new research and development of prostheses by the maker community and nonprofit organizations, as well as a novel case study exploring the development of technology and the training methods available. These design efforts are discussed further in the context of the medical regulatory framework in the United States and highlight new associated clinical studies designed to measure the quality of life impact of such devices. Full article
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Open AccessArticle
High-Performance Work System, Work Well-Being, and Employee Creativity: Cross-Level Moderating Role of Transformational Leadership
Int. J. Environ. Res. Public Health 2019, 16(9), 1640; https://doi.org/10.3390/ijerph16091640
Received: 18 March 2019 / Revised: 26 April 2019 / Accepted: 7 May 2019 / Published: 10 May 2019
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Abstract
Under the new normal, the economic development mode and growth momentum of China has brought about fundamental changes, which means that the development of enterprises has gradually shifted from being factor-and investment-driven to being innovation-and talent-driven. As the foundation of corporate innovation, employee [...] Read more.
Under the new normal, the economic development mode and growth momentum of China has brought about fundamental changes, which means that the development of enterprises has gradually shifted from being factor-and investment-driven to being innovation-and talent-driven. As the foundation of corporate innovation, employee creativity plays an important role in this process. In the field of strategic human resource management, high-performance work system is the embodiment of its core competence. Although some research has begun to try to explore the impact of high-performance work system on employee creativity, the underlying mechanism and the boundary condition is not yet fully understood. According to the Job demands-resources (JD-R) model, this study theorized and examined whether and when high-performance work system stimulate employee creativity. Using a sample of large and medium-sized enterprises in China, we collected data, which are time-lagged and multilevel, from 266 employees in 61 departments. Results of the hierarchical linear model found that (1) High-performance work system is positively related to employee creativity; (2) High-performance work system positively affects employee work well-being; (3) Work well-being positively affects employee creativity; (4) Employee work well-being partially mediates the relationship between high-performance work system and creativity; (5) Transformational leadership, which represents an important contextual variable in the workplace, moderates the relationship between work well-being and employee creativity; (6) Moreover, we have also revealed that transformational leadership can moderate the indirect effect of high-performance work system on employee creativity. We discussed the theoretical and practical implications of these findings. Full article
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Open AccessArticle
Effects of Different Types of Water and Nitrogen Fertilizer Management on Greenhouse Gas Emissions, Yield, and Water Consumption of Paddy Fields in Cold Region of China
Int. J. Environ. Res. Public Health 2019, 16(9), 1639; https://doi.org/10.3390/ijerph16091639
Received: 5 March 2019 / Revised: 30 April 2019 / Accepted: 6 May 2019 / Published: 10 May 2019
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Abstract
Water management and nitrogen (N) fertilizers are the two main driving factors of greenhouse gas emissions. In this paper, two irrigation modes, controlled irrigation (CI) and flood irrigation (FI), and four nitrogen fertilizer levels (N0: 0, N1: 85, N2: 110, and N3: 135 [...] Read more.
Water management and nitrogen (N) fertilizers are the two main driving factors of greenhouse gas emissions. In this paper, two irrigation modes, controlled irrigation (CI) and flood irrigation (FI), and four nitrogen fertilizer levels (N0: 0, N1: 85, N2: 110, and N3: 135 kg·hm−2) were set to study the effect of different irrigation modes and N fertilizer amount on greenhouse-gas emissions of paddy fields in cold region by using the static chamber-gas chromatograph method; yield and water consumption were also analyzed. The results showed that, compared with FI, CI significantly reduced CH4 emissions by 19.42~46.94%, but increased N2O emissions by 5.66~11.85%. Under the two irrigation modes, N fertilizers could significantly increase N2O emissions, but the CH4 emissions of each N treatment showed few differences. Compared with FI, appropriate N application under CI could significantly increase grain number per spike, seed-setting rate, and 1000-grain weight, thus increasing yield. Under the two irrigation modes, water consumption increased with the increase of N application rate, and the total water consumption of CI was significantly lower than that of FI. The global warming potential (GWP) of CI was significantly smaller than that of FI. The trend of GWP in each treatment was similar to that of CH4. Through comprehensive comparison and analysis of water productivity (WP), gas emission intensity (GHGI), and the yield of each treatment, we found that CI+N2 treatment had the highest WP (2.05 kg·m−3) and lowest GHGI (0.37 kg CO2-eq·kg−1), while maintaining high yield (10,224.4 kg·hm−2). The results of this study provide an important basis for guiding high yield, water-savings, and emission reduction of paddy fields in cold regions. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle
Sickle Cell Anaemia Prevalence among Newborns in the Brazilian Amazon-Savanna Transition Region
Int. J. Environ. Res. Public Health 2019, 16(9), 1638; https://doi.org/10.3390/ijerph16091638
Received: 16 April 2019 / Revised: 7 May 2019 / Accepted: 8 May 2019 / Published: 10 May 2019
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Abstract
Sickle cell anaemia is one of the most common hemoglobinopathies worldwide and an important public health problem in Brazil. This study evaluated the prevalence of sickle cell anaemia and its traits in newborns from the Amazon-Savanna Transition Region in the state of Maranhão, [...] Read more.
Sickle cell anaemia is one of the most common hemoglobinopathies worldwide and an important public health problem in Brazil. This study evaluated the prevalence of sickle cell anaemia and its traits in newborns from the Amazon-Savanna Transition Region in the state of Maranhão, Brazil. A cross-sectional study was carried out, based on data from neonatal screening tests performed in 2013–2015 in Maranhão. The Hardy-Weinberg theorem was applied to analyse the frequency of expected homozygotes based on HbSS phenotype. A spatial-temporal distribution analysis was performed to delimit the regions with the greatest number of newborn cases with sickle cell anaemia. Of 283,003 newborns, 162 were found to have sickle cell anaemia, while 10,794 had a sickle cell trait, with a prevalence of 0.05% and 3.8%, respectively. The prevalence of expected homozygotes was higher in the North Region and in the state capital of Maranhão. This study may contribute to existing social and public health actions or the creation of new strategies for sickle cell disease in endemic areas in Brazil to improve the quality of life. Full article
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Open AccessArticle
Direct and Indirect Influences of Objective Socioeconomic Position on Adolescent Health: The Mediating Roles of Subjective Socioeconomic Status and Lifestyles
Int. J. Environ. Res. Public Health 2019, 16(9), 1637; https://doi.org/10.3390/ijerph16091637
Received: 23 March 2019 / Revised: 26 April 2019 / Accepted: 6 May 2019 / Published: 10 May 2019
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Abstract
The use of composite indices and subjective measures to evaluate socioeconomic position, taking into account the effect of inequalities on adolescent health-related behaviors, can contribute to understanding the effect of inequalities on health during adolescence. The aim of this study was to examine [...] Read more.
The use of composite indices and subjective measures to evaluate socioeconomic position, taking into account the effect of inequalities on adolescent health-related behaviors, can contribute to understanding the effect of inequalities on health during adolescence. The aim of this study was to examine the direct and indirect contribution of objective and subjective socioeconomic factors in a broad range of health and lifestyles outcomes. The data come from a representative sample of adolescents (N = 15,340; M age = 13.69) of the Health Behavior in School-aged Children study in Spain. Structural equation modeling was used for data analysis. A global index for evaluating objective socioeconomic position predicted both health and healthy lifestyles. Subjective socioeconomic status mediated the relationship between objective socioeconomic position and health but did not have a significant effect on healthy lifestyles when objective indicators were considered. Lastly, fit indices of the multiple-mediator model—including the direct effect of objective socioeconomic position on health and its indirect effects through the subjective perception of wealth and lifestyles—explained 28.7% of global health variance. Interventions aimed at reducing the impact of health inequalities should address, in addition to material deprivation, the psychological and behavioral consequences of feeling poor. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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