International Journal of Environmental Research and Public Health — Open Access Journal

Electronic cigarette (e-cigarette) vapor comes in contact with the different constituents of the oral cavity, including such microorganisms as Candida albicans. We examined the impact of e-cigarettes on C. albicans growth and expression of different virulent genes, such as secreted aspartic proteases (SAPs), and the effect of e-cigarette vapor-exposed C. albicans on gingival epithelial cell morphology, growth, and lactate dehydrogenase (LDH) activity. An increase in C. albicans growth was observed with nicotine-rich e-cigarettes compared with non-exposed cultures. Following exposure to e-cigarette vapor, C. albicans produced high levels of chitin. E-cigarettes also increased C. albicans hyphal length and the expression of SAP2, SAP3, and SAP9 genes. When in contact with gingival epithelial cells, e-cigarette-exposed C. albicans adhered better to epithelial cells than the control. Indirect contact between e-cigarette-exposed C. albicans and gingival epithelial cells led to epithelial cell differentiation, reduced cell growth, and increased LDH activity. Overall, results indicate that e-cigarettes may interact with C. albicans to promote their pathogenesis, which may increase the risk of oral candidiasis in e-cigarette users. Full article

Previous studies have examined the restorative benefits of soundscapes on adults’ cognitive performance, but it was unclear whether those benefits would be possible for children. In this paper, two experiments applied a before–after design to explore the restorative effects of different soundscapes on children’s sustained attention and short-term memory, respectively, in a simulated classroom situation. In Experiment 1, 46 children aged 8–12 were first mentally fatigued by performing an oral arithmetic task and then were asked to conduct a sustained attention to response test (SART), in order to assess their attention fatigue. After that, a period of 3-min soundscape was presented, and SART was conducted again to examine their attention recovery. In Experiment 2, 45 children participated and the experiment procedure was the same as in Experiment 1, except that a digit span test (DST) was used instead to measure short-term memory. The results showed that music, birdsong, fountain sound, and stream sound facilitated greater recovery than other sounds in reaction time. Participants also showed better performance in short-term memory after exposure to fountain sound and stream sound, followed by music and birdsong. Those results confirmed the actual restorative effects of perceived restorative soundscapes on children’s cognitive performance. Full article

Dietary fibre and polyphenols are both metabolised to short-chain fatty acids (SCFAs) and phenolic acids (PA) by the colonic microbiota. These may alter microbiota growth/diversity, but their interaction is not understood. Interactions between rutin and raftiline, ispaghula or pectin were investigated in human faecal batch cultures (healthy participants; 19–33 years, 4 males, 6 females, BMI 18.4–27.4) after a low (poly)phenol diet three days prior to study. Phenolic acids were measured by gas chromatography-mass spectrometry and SCFAs by gas chromatography-flame ionisation after 2, 4, 6, and 24 h. Rutin fermentation produced Phenyl acetic acid (PAA), 4-Hydroxy benzoic acid (4-OHBA), 3-Hydroxy phenyl acetic acid (3-OHPAA), 4-Hydroxy phenyl acetic acid (4-OHPAA), 3,4-Dihydroxy phenyl acetic acid (3,4-diOHPAA), 3-Hydroxy phenyl propionic acid (3-OHPPA), and 4-Hydroxy phenyl propionic acid (4-OHPPA). 3,4-DiOHPAA and 3-OHPAA were predominant at 6 h (1.9 ± 1.8 µg/mL, 2.9 ± 2.5 µg/mL, and 0.05 ± 0.0 µg/mL, respectively) and 24 h (5.5 ± 3.3 µg/mL, 3.1 ± 4.2 µg/mL, and 1.2 ± 1.6 µg/mL). Production of all PA except 3-OHPPA and 4-OHPPA was reduced by at least one fibre. Inhibition of PA was highest for rutin (8-fold, p < 0.01), then pectin (5-fold, p < 0.01), and ispaghula (2-fold, p = 0.03). Neither rutin nor quercetin had a detectable impact on SCFA production. These interactions should be considered when assessing dietary polyphenols and potential health benefits. Full article

Sleep disorders have reached epidemic proportions worldwide, affecting the youth as well as the elderly, crossing the entire lifespan in both developed and developing countries. “Real-life” behavioral (sensor-based), molecular, digital, and epidemiological big data represent a source of an impressive wealth of information that can be exploited in order to advance the field of sleep research. It can be anticipated that big data will have a profound impact, potentially enabling the dissection of differences and oscillations in sleep dynamics and architecture at the individual level (“sleepOMICS”), thus paving the way for a targeted, “one-size-does-not-fit-all” management of sleep disorders (“precision sleep medicine”). Full article

Green exercise might have positive effects on health and affective states. Little is known about the ideal characteristics of the natural environment, where exercise is conducted in. Thus, the primary aim of the present study was to investigate the effects of anthropogenic elements on acute stress-related physiological responses and affective states in green exercise. Using a crossover field study design, 52 healthy participants were exposed to two different mountain hiking conditions: An environment with less anthropogenic elements and an environment with more anthropogenic elements. Pre and post conditions, affective states and salivary cortisol concentration were measured. Repeated measures ANOVAs were used to analyze if pre-post changes differed between the conditions. Pre-post changes in affective states and salivary cortisol concentration did not significantly differ, partial η² < 0.06. Positive affective states showed significantly higher values post compared to pre-condition, partial η² > 0.13. The present results indicate that anthropogenic elements have a minor role in the influence on affective states and salivary cortisol concentration during mountain hiking. It is concluded that a single bout of mountain hiking independent of anthropogenic elements in the environment is effective in influencing affective states positively. Full article

Migration can be a stressful experience and may lead to poor health and behavioral changes. The immigrant population in Switzerland is disproportionately burdened by several negative health outcomes, chief among these is mental health issues. The aim of the study was to investigate whether sleep disturbances are more prevalent among immigrants compared to non-immigrants and whether emotional distress might explain sleep differences. Based on the Swiss Health Survey 2012 dataset, we analyzed the data of 17,968 people, of which 3406 respondents were immigrants. We examined variables including insomnia symptoms, emotional distress and clinical and socio-demographic data using unadjusted and adjusted generalized linear models. Compared to non-immigrants, immigrants suffer significantly more often from insomnia symptoms. Immigrants also endured higher levels of emotional distress. Higher values of emotional distress are related to other symptoms of sleep disorders. Immigrants with emotional distress were at significant risk of sleep disturbances. Sleep disparities between immigrants and non-immigrants may be influenced by emotional distress. Migration health care should address emotional distress, a more proximal and modifiable factor, as a possible cause of insomnia symptoms in immigrants. Full article

This study reviews and evaluates the national drug formulary system used to improve patient access to new drugs by making reimbursement decisions for new drugs as part of the South Korean national health insurance system. The national health insurance utilizes three methods for improving patient access to costly drugs: risk-sharing agreements, designation of essential drugs, and a waiver of cost-effectiveness analysis. Patients want reimbursement for new drugs to be processed quickly to improve their access to these drugs, whereas payers are careful about listing them given the associated financial burden and the uncertainty in cost-effectiveness. However, pharmaceutical companies are advocating for drug prices above certain thresholds to maintain global pricing strategies, cover the costs of drug development, and fund future investments into research and development. The South Korean government is expected to develop policies that will improve patient access to drugs with unmet needs for broadening health insurance coverage. Simultaneously, the designing of post-listing management methods is warranted for effectively managing the financial resources of the national health insurance system. Full article

Haze pollution has become the most serious environmental risk in China and generated a large amount of public concerns. Influencing almost all the citizens in the polluted area, it is necessary and important to take public perception as an essential element in haze abatement. From the perspective of social psychology, this paper explores haze tolerance in Beijing, Shanghai, and Guangzhou, also the key influential factors on haze tolerance from four dimensions: political trust, perceived risk, cost perception, and haze knowledge. Based on the sample of 517 respondents, the results show that compared with Shanghai and Guangzhou, Beijing residents had the lowest tolerance level of haze pollution but have the highest levels of trust in the government’s capacity to control haze and self-evaluation of their own haze knowledge. People in Shanghai had the lowest cost perception and the strongest willingness to acquire haze knowledge. Meanwhile, the empirical analysis revealed that political trust and cost perception could enhance the public’s haze tolerance while perceived risk and haze knowledge had negative impacts on tolerance. Also, our research could provide some suggestions to government officials when making policies for abating haze pollution from the perspective of social risk control. Policy makers are supposed to launch various policy instruments to control haze effectively and engage the citizens in the decision-making process to improve their political trust, and publicize the knowledge of haze pollution to help the public to acquire objective and scientific knowledge and diminish unnecessary worries. Full article

High or low ambient temperatures pose a risk factor for the worsening or onset of psychiatric disorders. The aim of this study was to investigate the association between ambient temperature and psychiatric emergency visits in an urban region in a temperate climate. The daily number of visits to a psychiatric emergency room (PEVs) at Sahlgrenska University Hospital, Gothenburg, Sweden and the daily mean temperature were extracted for the study period 1 July 2012 to 31 December 2017. Case-crossover analysis with distributed lag non-linear models was used to analyse the data by season. The warm season was defined as May to August and the cold season as November to February. Shorter lags periods were used for the warm season than the cold season. In the analysis, temperatures at the 95th percentile was associated with 14% (95% confidence interval (CI): 2%, 28%) increase in PEVs at lag 0–3 and 22% (95%CI: 6%, 40%) for lags 0–14 during the warm season, relative to the seasonal minimum effect temperature (MET). During the cold season temperatures at the 5th percentile were associated with 25% (95% CI: −8%, 13%) and 18% (95% CI: −30%, 98%) increase in PEVs at lags 0–14 and 0–21 respectively. We observed an increased number of PEVs at high and low temperatures; however, not to a statistically significant extent for low temperatures. Our findings are similar to what has been found for somatic diseases and in studies of other mental health outcomes in regions with more extreme climates. This merits the inclusion of individuals with psychiatric disorders in awareness planning for climate warning systems. Full article

We collected and analysed 58 samples of groundwater from wells in the Barcellona-Milazzo Plain, one of the most important coastal aquifers of Sicily (Italy), to determine major, minor, and trace element concentrations. In this area, geogenic and anthropogenic sources of heavy metals and other pollutants co-act, making the individuation of the main pollution sources difficult. Our work was aimed at the application of geostatistical criteria for discriminating between these pollution sources. We used probability plots for separating anomalous values from background concentrations, which were plotted on maps and related to possible sources of pollutants. Our results indicate that hydrothermal fluid circulation and the water–rock interaction of country rocks that host mineralized ore deposits generate a significant flux of heavy metals to groundwater, as well as anthropogenic sources like intense agriculture and industrial activities. In particular, NO₃, F, and Ni exceed the Maximum Admitted Concentrations (MACs) established by the WHO and Italian legislation for drinking-water. The spatial distributions of geogenic and anthropogenic sources were so deeply interlocked that their separation was not easy, also employing geostatistical tools. This complex scenario makes the implementation of human health risk mitigation actions difficult, since the flow of pollutants is in many cases controlled by simple water–rock interaction processes. Full article

Background/Objective: China is now faced with a serious population aging challenge, and the health of the Chinese elderly is becoming an imminent concern. Consequently, it is critical to establish a lifestyle evaluation system for promoting the health of the Chinese elderly. Methods: Interviews with experts and questionnaire surveys were conducted. Factor analysis, analytic hierarchy process, and statistical analyses were also adopted in this study. Results: Besides evaluation metrics and standards, a two-level category system including 50 indices and associated weights from three level 1 categories (physical and mental health and social wellbeing) and thirteen level 2 categories were obtained. Discussion and Conclusions: Based on the confirmatory factor analysis and Cronbach’s test, such an evaluation system excels in effectiveness and reliability, and is ready to be popularized in Chinese society. We expect that the Chinese elderly will benefit from our system and that it will lead to a healthy lifestyle accordingly. Full article

Food security (FS) during infancy is associated with lifelong outcomes. New Zealand is a developed economy that reports poor childhood nutrition-related health statistics, particularly among minority children, yet has no measure of FS applicable to infancy. The objective was to develop an FS index for New Zealand infants and examine its association with demographic covariates and health outcomes. Within a large (n = 6853) nationally representative cohort, variables describing infant food consumption, breastfeeding, and maternal food-related coping methods were collected from mothers during late infancy. An FS index was derived using confirmatory factor analysis. Associations were assessed by logistic regressions and described using odds ratios (OR) and ≥95% confidence intervals (CI). Fifteen percent of the cohort was highly FS, 43% tenuously food insecure (FIS), and 16% highly food insecure (FIS). Infants from minority ethnic groups had lower odds of being food secure, as did those born to the youngest mothers, mothers who smoked, or those who lived in low-income households. FIS infants had higher odds of morbidity. Interventions to improve infant FS should focus on improving dietary quality, and should give particular consideration to minority infants. We identified that FIS shows wide ethnic and socioeconomic inequity, and is associated with poorer health. The most important driving factors of FIS included poor quality weaning diets, as well as poverty and its proxies. Any interventions to improve infant FS should focus on increasing fruit and vegetable consumption to recommended intake levels, and should give particular consideration to minority infants. Full article

The present study seeks to demonstrate how Bayesian Network analysis can be used to support Total Worker Health^® research on correction workers by (1) revealing the most probable scenario of how psychosocial and behavioral outcome variables in corrections work are interrelated and (2) identifying the key contributing factors of this interdependency relationship within the unique occupational context of corrections work. The data from 353 correction workers from a state department of corrections in the United States were utilized. A Bayesian Network analysis approach was used to probabilistically sort out potential interrelations among various psychosocial and behavioral variables. The identified model revealed that work-related exhaustion may serve as a primary driver of occupational stress and impaired workability, and also that exhaustion limits the ability of correction workers to get regular physical exercise, while their interrelations with depressed mood, a lack of work engagement, and poor work-family balance were also noted. The results suggest the importance of joint consideration of psychosocial and behavioral factors when investigating variables that may impact health and wellbeing of correction workers. Also, they supported the value of adopting the Total Worker Health^® framework, a holistic strategy to integrate prevention of work-related injury and illness and the facilitation of worker well-being, when considering integrated health protection and promotion interventions for workers in high-risk occupations. Full article

Health is correlated to people’s socioeconomic status (SES) and lifestyle. This study examined the impact of SES on respondents’ physical and psychological health. Moreover, we explored the potential mediating effect of lifestyle on the relationship between SES and health. The participants were 986 respondents from the 2015 Chinese General Social Survey (CGSS). Structural equation modeling (SEM) was used to test the hypothesized relationship between the variables. The results indicated that SES had a significant impact on people’s physical health, but the impact of SES on psychological health was not significant. Lifestyle had significant positive effects on both physical and psychological health. In addition, lifestyle mediated the relationship between SES and health. This research is helpful in gaining a better understanding of the relationship and mediating mechanism between SES, lifestyle, and health. It is recommended that research with longitudinal design and comprehensive indicators be undertaken in the future. Full article

This cross-sectional survey has compared subjective outcomes obtained from workers in shared (2–5 occupants) and open-plan (+5 occupants) offices, related to irrelevant speech, which is the noise that is generated from conversations between colleagues, telephone calls and laughter. Answers from 1078 subjects (55% in shared offices and 45% in open-plan offices) have shown that irrelevant speech increases noise annoyance, decreases work performance, and increases symptoms related to mental health and well-being more in open-plan than in shared offices. Workers often use headphones with music to contrast irrelevant speech in open-plan offices, while they take a break, change their working space, close the door or work from home in shared offices. Being female, when there are more than 20 occupants, and working in southern cities without acoustic treatments in the office, make it more likely for the occupants to be annoyed by irrelevant speech noise in open-plan offices. While, working in southern cities and with acoustic treatments in the office makes it more likely that noise annoyance will be reported in shared offices. Finally, more than 70% of the interviewed in open-plan offices were willing to reduce their voice volumes when advised by a noise monitoring system with a lighting feedback. Full article

Intensive greenhouse horticulture can cause various environmental problems. Among these, the management, storage, and processing of crop residues can provoke aquifer contamination, pest proliferation, bad odors, or the abuse of phytosanitary treatments. Biosolarization adds value to any fresh plant residue and is an efficient technique for the control of soil-borne diseases. This study aims to examine an alternative means of managing greenhouse crop residues through biosolarization and to investigate the influence of organic matter on yield and quality of tomato (Solanum lycopersicum, L.) fruit. With this purpose, the following nutritional systems were evaluated: inorganic fertilization with and without brassica pellets (Fert, Fert +, and Fert ++), fresh tomato plant debris with and without brassica pellets (Rest, Rest +, and Rest ++), and no fertilizer application (Control). The addition of organic matter was equal across all the treatments except for the control with regard to yield and quality of the tomato fruit. In light of these results, the application of tomato plant debris to the soil through biosolarization is postulated as an alternative for the management of crop residues, solving an environmental problem and having a favorable impact on the production and quality of tomatoes as a commercial crop. Full article

This study examines the impact of social engagement on elderly health in China. A two-stage residual inclusion (2SRI) regression approach was used to examine the causal relationship. Our dataset comprises 9253 people aged 60 or above from the China Health and Retirement Longitudinal Survey (CHARLS) conducted in 2011 and 2013. Social engagement significantly improved the self-rated health of the elderly and reduced mental distress, but had no effect on chronic disease status. Compared with the rural areas, social engagement played a more important role in promoting the elderly health status in urban areas. Social engagement could affect the health status of the elderly through health behavior change and access to health resources. To improve the health of the elderly in China and promote healthy aging, the government should not only improve access to effective medical care but also encourage greater social engagement of the elderly. Full article

Adolescents spend significant amounts of time engaged in various types of sedentary behaviour (SB). This study examined associations between adolescents’ objectively measured sedentary time, sitting time, specific self-reported SBs and social connectedness. Adolescents (n = 429, 15.5 years, 41% male) completed an online survey reporting time in seven SBs (TV/videos/DVDs, computer/video games, internet, homework, reading, car and bus travel; examined individually and summed for screen time and total SB), and social connectedness using the eight-item Social Connectedness Scale. A subsample (n = 353) also wore an ActiGraph GT3X+ (model GT3X+, Pensacola, FL, USA) accelerometer to measure sedentary time (<100 cpm) and n = 237 wore an activPAL (PAL Technologies Ltd., Glasgow, Scotland) inclinometer to measure sitting time. Multiple linear mixed models determined associations between each SB variable and social connectedness, adjusting for confounders. Adolescents spent on average 7.8 h/day in self-reported total SB, 4.4 h/day in screen time, 9.1 h/day in ActiGraph-measured sedentary time, and 9.5 h/day in activPAL-measured sitting time. After adjusting for age, sex and area level socioeconomic status, total SB (−0.24, 95%CI: −0.37, −0.11), screen time (−0.23, 95%CI: −0.41, −0.05) and two individual SBs (computer/video games (−1.07, 95%CI: −1.53, −0.60), homework (−0.61, 95%CI: −1.04, −0.18) were negatively associated with social connectedness. There were no associations with the objective measures. The relationships may be bi-directional; therefore, future research should involve longitudinal designs and explore other potential contributing factors. Full article

Background: This study aims to explore the relationship between quality of life (QOL) and social capital factors among “people living with HIV/AIDS” (PLWHA), in order to improve their quality of life and help them to release AIDS discrimination. Methods: A cross-sectional survey with 225 PLWHA was done in Nanchang, China, between January and June of 2015. Questionnaires consisted of a socio-demographic questionnaire, Personal Social Capital Scale and Medical Outcomes Study HIV Health Survey. To identify social capital factors influencing QOL among PLWHA, t-test and multiple linear regression were used as statistical tools. The analysis of data was conducted using SPSS 22.0 with a significant value of p < 0.05. Results: The scores of total social capital, bonding social capital and bridging social capital were 23.68 ± 5.55, 14.11 ± 3.40 and 9.46 ± 3.43 respectively. The scores of Physical Health Summary (PHS) and Mental Health Summary (MHS) were 51.88 ± 7.04 and 49.29 ± 6.60. Multiple linear regression analysis showed that age (B = −0.137, p = 0.020), income (B = 0.2170, p ≤ 0.001), employment (B = 0.112, p = 0.043) and bonding social capital (B = 0.178, p = 0.001) had significant effects on PHS. Bonding social capital was the most important influencing factor for MHS (B = 0.506, p < 0.001). There was no significant relationship between bridging social capital and QOL (p > 0.05). Conclusions: The PLWHA community has low social capital and a poor QOL in Nanchang. Bonding social capital had a positive impact on the QOL of PLWHA. There is an urgent need to build a better social support system based on bonding social capital for PLWHA. It is worth further exploring to identify how to make full use of bridging social capital for improving QOL among PLWHA. Full article