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Authors = Lora E. Fleming

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18 pages, 3885 KiB  
Article
A Transdisciplinary Approach to Recovering Natural and Cultural Landscape and Place Identification: A Case Study of Can Moritz Spring (Rubí, Spain)
by Marina Cervera, Simon Bell, Francesc Muñoz, Himansu S. Mishra, Lora E. Fleming, James Grellier, Glòria Carrasco-Turigas, Mark J. Nieuwenhuijsen, Cristina Vert and Mireia Gascon
Int. J. Environ. Res. Public Health 2021, 18(4), 1709; https://doi.org/10.3390/ijerph18041709 - 10 Feb 2021
Cited by 10 | Viewed by 4775
Abstract
The perception of the quality of green and blue spaces can be key in the relationship between a community and its local landscape (i.e., place identification). The lack of transdisciplinary training and social-specific education of landscape architects regarding the complexity of landscape as [...] Read more.
The perception of the quality of green and blue spaces can be key in the relationship between a community and its local landscape (i.e., place identification). The lack of transdisciplinary training and social-specific education of landscape architects regarding the complexity of landscape as a participative cultural artefact limits reaching the general population. Bridging this gap of landscape and place identification and evaluation by a local community was the main objective of the present case study conducted at an abandoned spring and seasonal stream area in Rubí (Spain). The “Steinitz method” of landscape evaluation was used as a participatory method to activate community members to learn about and express their visual preferences regarding this neglected landscape. Bottom-up interventions applying an “urban acupuncture” approach in the area identified as the least attractive by the residents were co-designed and combined with a top-down restoration of a nearby, existing but derelict and hidden, spring. In addition, before and after planning and implementing the intervention, we conducted surveys about the community perception, sense of belonging and use of the space. We observed that the lack of awareness of the inhabitants about this spring was an obstacle preventing the community from embracing the potential for health and wellbeing presented by the spring and adjacent landscape. Following the work, the landscape saw increasing use, and the historic spring was brought back to life as a resource to help people to improve their health and wellbeing. Full article
(This article belongs to the Special Issue Health Impacts of the Built Environment and Transport Planning)
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19 pages, 1976 KiB  
Article
The Roses Ocean and Human Health Chair: A New Way to Engage the Public in Oceans and Human Health Challenges
by Josep Lloret, Rafael Abós-Herràndiz, Sílvia Alemany, Rosario Allué, Joan Bartra, Maria Basagaña, Elisa Berdalet, Mònica Campàs, Arnau Carreño, Montserrat Demestre, Jorge Diogène, Eva Fontdecaba, Mireia Gascon, Sílvia Gómez, Angel Izquierdo, Lluïsa Mas, Montse Marquès, Juan Pedro-Botet, Maria Pery, Francesc Peters, Xavier Pintó, Marta Planas, Ana Sabatés, Joan San, Anna Sanchez-Vidal, Martí Trepat, Cristina Vendrell and Lora E. Flemingadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2020, 17(14), 5078; https://doi.org/10.3390/ijerph17145078 - 14 Jul 2020
Cited by 16 | Viewed by 4706
Abstract
Involving and engaging stakeholders is crucial for studying and managing the complex interactions between marine ecosystems and human health and wellbeing. The Oceans and Human Health Chair was founded in the town of Roses (Catalonia, Spain, NW Mediterranean) in 2018, the fruit of [...] Read more.
Involving and engaging stakeholders is crucial for studying and managing the complex interactions between marine ecosystems and human health and wellbeing. The Oceans and Human Health Chair was founded in the town of Roses (Catalonia, Spain, NW Mediterranean) in 2018, the fruit of a regional partnership between various stakeholders, and for the purpose of leading the way to better health and wellbeing through ocean research and conservation. The Chair is located in an area of the Mediterranean with a notable fishing, tourist, and seafaring tradition and is close to a marine reserve, providing the opportunity to observe diverse environmental conditions and coastal and maritime activities. The Chair is a case study demonstrating that local, collaborative, transdisciplinary, trans-sector, and bottom-up approaches offer tremendous opportunities for engaging coastal communities to help support long-lasting solutions that benefit everyone, and especially those living by the sea or making their living from the goods and services provided by the sea. Furthermore, the Chair has successfully integrated most of its experts in oceans and human health from the most prestigious institutions in Catalonia. The Chair focuses on three main topics identified by local stakeholders: Fish and Health; Leisure, Health, and Wellbeing; and Medicines from the Sea. Led by stakeholder engagement, the Chair can serve as a novel approach within the oceans and human health field of study to tackle a variety of environmental and public health challenges related to both communicable and non-communicable diseases, within the context of sociocultural issues. Drawing on the example provided by the Chair, four principles are established to encourage improved participatory processes in the oceans and human health field: bottom-up, “think local”, transdisciplinary and trans-sectorial, and “balance the many voices”. Full article
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20 pages, 943 KiB  
Review
Ocean Acidification and Human Health
by Laura J. Falkenberg, Richard G.J. Bellerby, Sean D. Connell, Lora E. Fleming, Bruce Maycock, Bayden D. Russell, Francis J. Sullivan and Sam Dupont
Int. J. Environ. Res. Public Health 2020, 17(12), 4563; https://doi.org/10.3390/ijerph17124563 - 24 Jun 2020
Cited by 274 | Viewed by 31113
Abstract
The ocean provides resources key to human health and well-being, including food, oxygen, livelihoods, blue spaces, and medicines. The global threat to these resources posed by accelerating ocean acidification is becoming increasingly evident as the world’s oceans absorb carbon dioxide emissions. While ocean [...] Read more.
The ocean provides resources key to human health and well-being, including food, oxygen, livelihoods, blue spaces, and medicines. The global threat to these resources posed by accelerating ocean acidification is becoming increasingly evident as the world’s oceans absorb carbon dioxide emissions. While ocean acidification was initially perceived as a threat only to the marine realm, here we argue that it is also an emerging human health issue. Specifically, we explore how ocean acidification affects the quantity and quality of resources key to human health and well-being in the context of: (1) malnutrition and poisoning, (2) respiratory issues, (3) mental health impacts, and (4) development of medical resources. We explore mitigation and adaptation management strategies that can be implemented to strengthen the capacity of acidifying oceans to continue providing human health benefits. Importantly, we emphasize that the cost of such actions will be dependent upon the socioeconomic context; specifically, costs will likely be greater for socioeconomically disadvantaged populations, exacerbating the current inequitable distribution of environmental and human health challenges. Given the scale of ocean acidification impacts on human health and well-being, recognizing and researching these complexities may allow the adaptation of management such that not only are the harms to human health reduced but the benefits enhanced. Full article
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18 pages, 1956 KiB  
Article
Health Benefits of Physical Activity Related to an Urban Riverside Regeneration
by Cristina Vert, Mark Nieuwenhuijsen, Mireia Gascon, James Grellier, Lora E. Fleming, Mathew P. White and David Rojas-Rueda
Int. J. Environ. Res. Public Health 2019, 16(3), 462; https://doi.org/10.3390/ijerph16030462 - 5 Feb 2019
Cited by 55 | Viewed by 9542
Abstract
The promotion of physical activity through better urban design is one pathway by which health and well-being improvements can be achieved. This study aimed to quantify health and health-related economic impacts associated with physical activity in an urban riverside park regeneration project in [...] Read more.
The promotion of physical activity through better urban design is one pathway by which health and well-being improvements can be achieved. This study aimed to quantify health and health-related economic impacts associated with physical activity in an urban riverside park regeneration project in Barcelona, Spain. We used data from Barcelona local authorities and meta-analysis assessing physical activity and health outcomes to develop and apply the “Blue Active Tool”. We estimated park user health impacts in terms of all-cause mortality, morbidity (ischemic heart disease; ischemic stroke; type 2 diabetes; cancers of the colon and breast; and dementia), disability-adjusted life years (DALYs) and health-related economic impacts. We estimated that 5753 adult users visited the riverside park daily and performed different types of physical activity (walking for leisure or to/from work, cycling, and running). Related to the physical activity conducted on the riverside park, we estimated an annual reduction of 7.3 deaths (95% CI: 5.4; 10.2), and 6.2 cases of diseases (95% CI: 2.0; 11.6). This corresponds to 11.9 DALYs (95% CI: 3.4; 20.5) and an annual health-economic impact of 23.4 million euros (95% CI: 17.2 million; 32.8 million). The urban regeneration intervention of this riverside park provides health and health-related economic benefits to the population using the infrastructure. Full article
(This article belongs to the Section Environmental Health)
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22 pages, 2425 KiB  
Review
Making the Case for “Whole System” Approaches: Integrating Public Health and Housing
by Richard A. Sharpe, Tim Taylor, Lora E. Fleming, Karyn Morrissey, George Morris and Rachel Wigglesworth
Int. J. Environ. Res. Public Health 2018, 15(11), 2345; https://doi.org/10.3390/ijerph15112345 - 24 Oct 2018
Cited by 54 | Viewed by 12573
Abstract
Housing conditions have been an enduring focus for public health activity throughout the modern public health era. However, the nature of the housing and health challenge has changed in response to an evolution in the understanding of the diverse factors influencing public health. [...] Read more.
Housing conditions have been an enduring focus for public health activity throughout the modern public health era. However, the nature of the housing and health challenge has changed in response to an evolution in the understanding of the diverse factors influencing public health. Today, the traditional public health emphasis on the type and quality of housing merges with other wider determinants of health. These include the neighbourhood, community, and “place” where a house is located, but also the policies which make access to a healthy house possible and affordable for everyone. Encouragingly, these approaches to policy and action on housing have the potential to contribute to the “triple win” of health and well-being, equity, and environmental sustainability. However, more effective housing policies (and in public health in general) that adopt more systemic approaches to addressing the complex interactions between health, housing, and wider environment are needed. This paper illustrates some of the key components of the housing and health challenge in developed countries, and presents a conceptual model to co-ordinate activities that can deliver the “triple win.” This is achieved by offering a perspective on how to navigate more effectively, inclusively and across sectors when identifying sustainable housing interventions. Full article
(This article belongs to the Special Issue Social, Cultural and Economic Context of Health and Social Care)
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13 pages, 1324 KiB  
Article
Association of Infant Eczema with Childhood and Adult Asthma: Analysis of Data from the 1958 Birth Cohort Study
by Ghada Abo-Zaid, Richard A. Sharpe, Lora E. Fleming, Michael Depledge and Nicholas J. Osborne
Int. J. Environ. Res. Public Health 2018, 15(7), 1415; https://doi.org/10.3390/ijerph15071415 - 5 Jul 2018
Cited by 21 | Viewed by 4715
Abstract
The influence of early life exposures on later life disease has for some time provided clues to modifiable risk factors of disease. The “atopic march” is thought to play a role in the progression of allergic diseases and may offer an opportunity to [...] Read more.
The influence of early life exposures on later life disease has for some time provided clues to modifiable risk factors of disease. The “atopic march” is thought to play a role in the progression of allergic diseases and may offer an opportunity to lower asthma’s health and socioeconomic burden, although evidence remains controversial. We aimed to examine the relationship between early life eczema and asthma later in life. Using the National Child Development Study, we examined infant eczema and childhood and adult asthma. Data related to asthma or wheezing bronchitis were available for 13,503 (73%; 95% CI 72–74), 11,503 (61%; 95% CI 60–61), 12,524 (68%; 95% CI 67–69), 11,194 (60%; 95% CI 60–60), 9377 (51%; 95% CI 51–51), and 9760 (53%; 95% CI 52–53) subjects at ages 11, 16, 23, 33, 44, and 50 years, respectively. Logistic regression models were fitted to examine each wave separately before and after adjusting for a range of potential confounders. Generalised estimating equation (GEE) methods were undertaken to examine the associations after pooling all data from questionnaires. The prevalence of self-reported asthma in those that had previously reported infant eczema ranged from 1.0%; 95% CI 0.9–1.4 (age 44 years) to 2.2%; 95% CI 2.1–2.3 (age 33 years). Participants with infant eczema had a 2–3-fold increased risk of reporting asthma in childhood and adulthood; this was 1.6 times at age 44 years when using spirometry measures. Similar effect sizes were observed in the GEE models when considering all participants (OR 2.9; 95% CI 2.6–3.2). Childhood and adult asthma were consistently associated with infant eczema both by using the self-reported data and lung measures. Full article
(This article belongs to the Special Issue The Epidemiology of Allergy)
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22 pages, 803 KiB  
Review
Beyond Climate Change and Health: Integrating Broader Environmental Change and Natural Environments for Public Health Protection and Promotion in the UK
by Lora E. Fleming, Giovanni S. Leonardi, Mathew P. White, Jolyon Medlock, Ian Alcock, Helen L. Macintyre, Kath Maguire, Gordon Nichols, Benedict W. Wheeler, George Morris, Tim Taylor, Deborah Hemming, Gianni Lo Iacono, Emma L. Gillingham, Kayleigh M. Hansford, Clare Heaviside, Angie Bone and Raquel Duarte-Davidson
Atmosphere 2018, 9(7), 245; https://doi.org/10.3390/atmos9070245 - 27 Jun 2018
Cited by 15 | Viewed by 9327
Abstract
Increasingly, the potential short and long-term impacts of climate change on human health and wellbeing are being demonstrated. However, other environmental change factors, particularly relating to the natural environment, need to be taken into account to understand the totality of these interactions and [...] Read more.
Increasingly, the potential short and long-term impacts of climate change on human health and wellbeing are being demonstrated. However, other environmental change factors, particularly relating to the natural environment, need to be taken into account to understand the totality of these interactions and impacts. This paper provides an overview of ongoing research in the Health Protection Research Unit (HPRU) on Environmental Change and Health, particularly around the positive and negative effects of the natural environment on human health and well-being and primarily within a UK context. In addition to exploring the potential increasing risks to human health from water-borne and vector-borne diseases and from exposure to aeroallergens such as pollen, this paper also demonstrates the potential opportunities and co-benefits to human physical and mental health from interacting with the natural environment. The involvement of a Health and Environment Public Engagement (HEPE) group as a public forum of “critical friends” has proven useful for prioritising and exploring some of this research; such public involvement is essential to minimise public health risks and maximise the benefits which are identified from this research into environmental change and human health. Research gaps are identified and recommendations made for future research into the risks, benefits and potential opportunities of climate and other environmental change on human and planetary health. Full article
(This article belongs to the Special Issue Impacts of Climate Change on Human Health)
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41 pages, 421 KiB  
Review
An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management
by Melissa A. Friedman, Mercedes Fernandez, Lorraine C. Backer, Robert W. Dickey, Jeffrey Bernstein, Kathleen Schrank, Steven Kibler, Wendy Stephan, Matthew O. Gribble, Paul Bienfang, Robert E. Bowen, Stacey Degrasse, Harold A. Flores Quintana, Christopher R. Loeffler, Richard Weisman, Donna Blythe, Elisa Berdalet, Ram Ayyar, Danielle Clarkson-Townsend, Karen Swajian, Ronald Benner, Tom Brewer and Lora E. Flemingadd Show full author list remove Hide full author list
Mar. Drugs 2017, 15(3), 72; https://doi.org/10.3390/md15030072 - 14 Mar 2017
Cited by 274 | Viewed by 27582
Abstract
Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or [...] Read more.
Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties. Full article
(This article belongs to the Special Issue Marine Neurotoxins)
22 pages, 456 KiB  
Article
Data Mashups: Potential Contribution to Decision Support on Climate Change and Health
by Lora E. Fleming, Andy Haines, Brian Golding, Anthony Kessel, Anna Cichowska, Clive E. Sabel, Michael H. Depledge, Christophe Sarran, Nicholas J. Osborne, Ceri Whitmore, Nicola Cocksedge and Daniel Bloomfield
Int. J. Environ. Res. Public Health 2014, 11(2), 1725-1746; https://doi.org/10.3390/ijerph110201725 - 4 Feb 2014
Cited by 37 | Viewed by 10021
Abstract
Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This [...] Read more.
Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This paper outlines the challenges and opportunities presented by advances in data collection, storage, analysis, and access, particularly focusing on “data mashups”. These data mashups are integrations of different types and sources of data, frequently using open application programming interfaces and data sources, to produce enriched results that were not necessarily the original reason for assembling the raw source data. As an illustration of this potential, this paper describes a recently funded initiative to create such a facility in the UK for use in decision support around climate change and health, and provides examples of suitable sources of data and the purposes to which they can be directed, particularly for policy makers and public health decision makers. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
24 pages, 697 KiB  
Review
Ciguatera Fish Poisoning: Treatment, Prevention and Management
by Melissa A. Friedman, Lora E. Fleming, Mercedes Fernandez, Paul Bienfang, Kathleen Schrank, Robert Dickey, Marie-Yasmine Bottein, Lorraine Backer, Ram Ayyar, Richard Weisman, Sharon Watkins, Ray Granade and Andrew Reich
Mar. Drugs 2008, 6(3), 456-479; https://doi.org/10.3390/md6030456 - 21 Aug 2008
Cited by 247 | Viewed by 43848
Abstract
Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are [...] Read more.
Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients. Full article
(This article belongs to the Special Issue Marine Toxins)
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25 pages, 360 KiB  
Review
Neurotoxic Shellfish Poisoning
by Sharon M. Watkins, Andrew Reich, Lora E. Fleming and Roberta Hammond
Mar. Drugs 2008, 6(3), 431-455; https://doi.org/10.3390/md6030431 - 12 Jul 2008
Cited by 226 | Viewed by 29353
Abstract
Neurotoxic shellfish poisoning (NSP) is caused by consumption of molluscan shellfish contaminated with brevetoxins primarily produced by the dinoflagellate, Karenia brevis. Blooms of K. brevis, called Florida red tide, occur frequently along the Gulf of Mexico. Many shellfish beds in the [...] Read more.
Neurotoxic shellfish poisoning (NSP) is caused by consumption of molluscan shellfish contaminated with brevetoxins primarily produced by the dinoflagellate, Karenia brevis. Blooms of K. brevis, called Florida red tide, occur frequently along the Gulf of Mexico. Many shellfish beds in the US (and other nations) are routinely monitored for presence of K. brevis and other brevetoxin-producing organisms. As a result, few NSP cases are reported annually from the US. However, infrequent larger outbreaks do occur. Cases are usually associated with recreationally-harvested shellfish collected during or post red tide blooms. Brevetoxins are neurotoxins which activate voltage-sensitive sodium channels causing sodium influx and nerve membrane depolarization. No fatalities have been reported, but hospitalizations occur. NSP involves a cluster of gastrointestinal and neurological symptoms: nausea and vomiting, paresthesias of the mouth, lips and tongue as well as distal paresthesias, ataxia, slurred speech and dizziness. Neurological symptoms can progress to partial paralysis; respiratory distress has been recorded. Recent research has implicated new species of harmful algal bloom organisms which produce brevetoxins, identified additional marine species which accumulate brevetoxins, and has provided additional information on the toxicity and analysis of brevetoxins. A review of the known epidemiology and recommendations for improved NSP prevention are presented. Full article
(This article belongs to the Special Issue Marine Toxins)
12 pages, 201 KiB  
Article
Evaluation of Harmful Algal Bloom Outreach Activities
by Lora E. Fleming, Eva Jerez, Wendy Blair Blair Stephan, Amy Cassedy, Judy A. Bean, Andrew Reich, Barbara Kirkpatrick, Lorraine Backer, Kate Nierenberg, Sharon Watkins, Julie Hollenbeck and Richard Weisman
Mar. Drugs 2007, 5(4), 208-219; https://doi.org/10.3390/md504208 - 14 Dec 2007
Cited by 21 | Viewed by 13955
Abstract
With an apparent increase of harmful algal blooms (HABs) worldwide,healthcare providers, public health personnel and coastal managers are struggling toprovide scientifically-based appropriately-targeted HAB outreach and education. Since1998, the Florida Poison Information Center-Miami, with its 24 hour/365 day/year freeAquatic Toxins Hotline (1-888-232-8635) available in [...] Read more.
With an apparent increase of harmful algal blooms (HABs) worldwide,healthcare providers, public health personnel and coastal managers are struggling toprovide scientifically-based appropriately-targeted HAB outreach and education. Since1998, the Florida Poison Information Center-Miami, with its 24 hour/365 day/year freeAquatic Toxins Hotline (1-888-232-8635) available in several languages, has received over 25,000 HAB-related calls. As part of HAB surveillance, all possible cases of HAB-relatedillness among callers are reported to the Florida Health Department. This pilot studyevaluated an automated call processing menu system that allows callers to access bilingualHAB information, and to speak directly with a trained Poison Information Specialist. Themajority (68%) of callers reported satisfaction with the information, and many provided specific suggestions for improvement. This pilot study, the first known evaluation of use and satisfaction with HAB educational outreach materials, demonstrated that the automated system provided useful HAB-related information for the majority of callers, and decreased the routine informational call workload for the Poison Information Specialists, allowing them to focus on callers needing immediate assistance and their healthcare providers. These results will lead to improvement of this valuable HAB outreach, education and surveillance tool. Formal evaluation is recommended for future HAB outreach and educational materials. Full article
(This article belongs to the Special Issue Marine Toxins)
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