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Int. J. Environ. Res. Public Health, Volume 11, Issue 1 (January 2014), Pages 1-1194

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Open AccessEditorial International Journal of Environmental Research and Public Health Best Paper Award 2014
Int. J. Environ. Res. Public Health 2014, 11(1), 1192-1194; https://doi.org/10.3390/ijerph110101192
Received: 17 December 2013 / Accepted: 17 December 2013 / Published: 22 January 2014
Cited by 1 | PDF Full-text (132 KB) | HTML Full-text | XML Full-text
Abstract
International Journal of Environmental Research and Public Health started to institute an annual award in 2013 to recognize outstanding papers related to environmental health sciences and public health that meet the aims, scope and high standards of this journal. We are pleased to
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International Journal of Environmental Research and Public Health started to institute an annual award in 2013 to recognize outstanding papers related to environmental health sciences and public health that meet the aims, scope and high standards of this journal. We are pleased to announce the second “International Journal of Environmental Research and Public Health Best Paper Award” for 2014. Nominations were solicited from the Editor-in-Chief and Editorial Board members, with all papers published in 2010 eligible for consideration. [...] Full article
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Open AccessArticle Connectedness to Nature and Public (Skin) Health Perspectives: Results of a Representative, Population-Based Survey among Austrian Residents
Int. J. Environ. Res. Public Health 2014, 11(1), 1176-1191; https://doi.org/10.3390/ijerph110101176
Received: 12 October 2013 / Revised: 13 January 2014 / Accepted: 13 January 2014 / Published: 20 January 2014
Cited by 13 | PDF Full-text (135 KB) | HTML Full-text | XML Full-text
Abstract
Connectedness to nature (CN) influences motivation to have contact with outdoor natural environments. Spending leisure time in natural environments is beneficial for human health and well-being. Besides these positive effects, health risks of open-air activities are mainly related to unprotected sun light exposure-associated
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Connectedness to nature (CN) influences motivation to have contact with outdoor natural environments. Spending leisure time in natural environments is beneficial for human health and well-being. Besides these positive effects, health risks of open-air activities are mainly related to unprotected sun light exposure-associated acute and chronic skin hazards. Thus, we conducted a cross-sectional, representative telephone survey among Austrian residents to study the association of perceived CN level with sun-exposure knowledge, tanning habits, and sun protective behaviour. In total, 1,500 study subjects (50.5% females) participated in this questionnaire survey. Although knowledge about tanning and motives to tan were similar among genders, females performed more photoprotective measures and were more connected to nature (all p < 0.001) compared to males. Older age and outdoor sport were significant gender-independent predictor variables influencing perceived CN level. Additionally, level of education was relevant in male CN, whereas non-smoking and higher knowledge were predictive of female CN. This survey provides so far unreported empirical data on the relationship between nature connectedness and skin health-relevant recreational habits of Austrian residents. The findings suggest to integrate hitherto neglected gender-specific Public (Skin) Health promotion when counselling on the manifold health advantages of outdoor activities. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
Open AccessArticle Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care
Int. J. Environ. Res. Public Health 2014, 11(1), 1161-1175; https://doi.org/10.3390/ijerph110101161
Received: 11 October 2013 / Revised: 13 January 2014 / Accepted: 13 January 2014 / Published: 20 January 2014
Cited by 12 | PDF Full-text (208 KB) | HTML Full-text | XML Full-text
Abstract
The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment
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The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics—Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience—are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff’s perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment. Full article
Open AccessArticle Estimating Cyanobacteria Community Dynamics and its Relationship with Environmental Factors
Int. J. Environ. Res. Public Health 2014, 11(1), 1141-1160; https://doi.org/10.3390/ijerph110101141
Received: 31 October 2013 / Revised: 7 January 2014 / Accepted: 8 January 2014 / Published: 20 January 2014
Cited by 4 | PDF Full-text (415 KB) | HTML Full-text | XML Full-text
Abstract
The cyanobacteria community dynamics in two eutrophic freshwater bodies (Tiegang Reservoir and Shiyan Reservoir) was studied with both a traditional microscopic counting method and a PCR-DGGE genotyping method. Results showed that cyanobacterium Phormidium tenue was the predominant species; twenty-six cyanobacteria species were identified
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The cyanobacteria community dynamics in two eutrophic freshwater bodies (Tiegang Reservoir and Shiyan Reservoir) was studied with both a traditional microscopic counting method and a PCR-DGGE genotyping method. Results showed that cyanobacterium Phormidium tenue was the predominant species; twenty-six cyanobacteria species were identified in water samples collected from the two reservoirs, among which fourteen were identified with the morphological method and sixteen with the PCR-DGGE method. The cyanobacteria community composition analysis showed a seasonal fluctuation from July to December. The cyanobacteria population peaked in August in both reservoirs, with cell abundances of 3.78 × 108 cells L-1 and 1.92 × 108 cells L-1 in the Tiegang and Shiyan reservoirs, respectively. Canonical Correspondence Analysis (CCA) was applied to further investigate the correlation between cyanobacteria community dynamics and environmental factors. The result indicated that the cyanobacteria community dynamics was mostly correlated with pH, temperature and total nitrogen. This study demonstrated that data obtained from PCR-DGGE combined with a traditional morphological method could reflect cyanobacteria community dynamics and its correlation with environmental factors in eutrophic freshwater bodies. Full article
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Open AccessArticle On Robust Methodologies for Managing Public Health Care Systems
Int. J. Environ. Res. Public Health 2014, 11(1), 1106-1140; https://doi.org/10.3390/ijerph110101106
Received: 6 September 2013 / Revised: 7 January 2014 / Accepted: 8 January 2014 / Published: 17 January 2014
Cited by 4 | PDF Full-text (1286 KB) | HTML Full-text | XML Full-text
Abstract
Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used
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Authors focus on ontology-based multidimensional data warehousing and mining methodologies, addressing various issues on organizing, reporting and documenting diabetic cases and their associated ailments, including causalities. Map and other diagnostic data views, depicting similarity and comparison of attributes, extracted from warehouses, are used for understanding the ailments, based on gender, age, geography, food-habits and other hereditary event attributes. In addition to rigor on data mining and visualization, an added focus is on values of interpretation of data views, from processed full-bodied diagnosis, subsequent prescription and appropriate medications. The proposed methodology, is a robust back-end application, for web-based patient-doctor consultations and e-Health care management systems through which, billions of dollars spent on medical services, can be saved, in addition to improving quality of life and average life span of a person. Government health departments and agencies, private and government medical practitioners including social welfare organizations are typical users of these systems. Full article
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Open AccessArticle Biocontrol of Fusarium graminearum Growth and Deoxynivalenol Production in Wheat Kernels with Bacterial Antagonists
Int. J. Environ. Res. Public Health 2014, 11(1), 1094-1105; https://doi.org/10.3390/ijerph110101094
Received: 18 November 2013 / Revised: 6 January 2014 / Accepted: 8 January 2014 / Published: 16 January 2014
Cited by 17 | PDF Full-text (765 KB) | HTML Full-text | XML Full-text
Abstract
Fusarium graminearum is the main causal pathogen affecting small-grain cereals, and it produces deoxynivalenol, a kind of mycotoxin, which displays a wide range of toxic effects in human and animals. Bacterial strains isolated from peanut shells were investigated for their activities against F.
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Fusarium graminearum is the main causal pathogen affecting small-grain cereals, and it produces deoxynivalenol, a kind of mycotoxin, which displays a wide range of toxic effects in human and animals. Bacterial strains isolated from peanut shells were investigated for their activities against F. graminearum by dual-culture plate and tip-culture assays. Among them, twenty strains exhibited potent inhibition to the growth of F. graminearum, and the inhibition rates ranged from 41.41% to 54.55% in dual-culture plate assay and 92.70% to 100% in tip-culture assay. Furthermore, eighteen strains reduced the production of deoxynivalenol by 16.69% to 90.30% in the wheat kernels assay. Finally, the strains with the strongest inhibitory activity were identified by morphological, physiological, biochemical methods and also 16S rDNA and gyrA gene analysis as Bacillus amyloliquefaciens. The current study highlights the potential application of antagonistic microorganisms and their metabolites in the prevention of fungal growth and mycotoxin production in wheat kernels. As a biological strategy, it might avoid safety problems and nutrition loss which always caused by physical and chemical strategies. Full article
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Open AccessArticle Does Participation in Physical Education Reduce Sedentary Behaviour in School and throughout the Day among Normal-Weight and Overweight-to-Obese Czech Children Aged 9–11 Years?
Int. J. Environ. Res. Public Health 2014, 11(1), 1076-1093; https://doi.org/10.3390/ijerph110101076
Received: 26 November 2013 / Revised: 7 January 2014 / Accepted: 8 January 2014 / Published: 16 January 2014
Cited by 10 | PDF Full-text (221 KB) | HTML Full-text | XML Full-text
Abstract
Participation of 9 to 11-year-old children in physical education lessons (PEL) contributes to a significantly higher duration of moderate-to-vigorous physical activity (MVPA) during the school day and, in overweight/obese girls and normal-weight boys, to an increase in overall daily MVPA as shown by
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Participation of 9 to 11-year-old children in physical education lessons (PEL) contributes to a significantly higher duration of moderate-to-vigorous physical activity (MVPA) during the school day and, in overweight/obese girls and normal-weight boys, to an increase in overall daily MVPA as shown by previous research. However, it is not known whether this increase in MVPA is at the expense of light physical activity (LPA) or sedentary behaviour (SED). SED, LPA, and MVPA were assessed in 338 schoolchildren aged 9–11 years (50.3% girls; 29.6% overweight/obese) over two school days (with and without a PEL) using a triaxial accelerometer during various segments of the school day. SED, LPA, and MVPA were quantified based on the duration of the activity (minutes). Participation in PEL led to significantly higher school MVPA in the overweight/obese and normal-weight girls and boys (p < 0.005) compared to MVPA of those children on the school day without PEL. Participation in PEL led to a significantly higher overall daily MVPA duration compared to that during the day without PEL for the overweight/obese girls (p < 0.05), normal-weight girls (p < 0.05) and boys (p < 0.005). Participation in PEL contributed not only to significantly higher LPA in the normal-weight girls and boys (p < 0.01) during the school day but also reduced school-time SED in the overweight/obese children (p < 0.01) and normal-weight girls (p < 0.005). Moreover, participation in PEL significantly reduced the overall daily SED in the normal-weight children and overweight/obese boys (p < 0.05). Adding one PEL to the daily school routine appears to be a promising strategy for effectively reducing SED in children. Full article
Open AccessArticle An Evaluation of Healthcare Information on the Internet: The Case of Colorectal Cancer Prevention
Int. J. Environ. Res. Public Health 2014, 11(1), 1058-1075; https://doi.org/10.3390/ijerph110101058
Received: 3 December 2013 / Revised: 6 January 2014 / Accepted: 7 January 2014 / Published: 14 January 2014
Cited by 6 | PDF Full-text (647 KB) | HTML Full-text | XML Full-text
Abstract
Health information, provided through the Internet, has recently received attention from consumers and healthcare providers as an efficient method of motivating people to get screened for colorectal cancer (CRC). In this study, the primary purpose was to investigate the extent to which consumers
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Health information, provided through the Internet, has recently received attention from consumers and healthcare providers as an efficient method of motivating people to get screened for colorectal cancer (CRC). In this study, the primary purpose was to investigate the extent to which consumers were better educated about CRC screening information because of the information available on the Internet. Another purpose was to identify how better-informed consumers, with reliable and trustworthy health information, were enabled to make sound decisions regarding CRC screening. The data used in this study was taken from the 2003 Health Information National Trends Survey. People aged 55 and older were classified based on their compliance with recommended CRC screening. The study applied the PRECEDE-PROCEED model to evaluate the effects of health information taken from the Internet regarding CRC screening. The credibility and reliance of cancer related information on the Internet was significantly associated with patient compliance to be screened for CRC. Experience and knowledge of Internet use had a significant impact on the utilization of CRC screening. This analysis suggests that the design and publishing websites concerning CRC should emphasize credibility and reliance. Websites providing information about CRC must also contain the most current information so that people are able to make educated decisions about CRC screening. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
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Open AccessReview Setting the Research Agenda on the Health Effects of Chemicals
Int. J. Environ. Res. Public Health 2014, 11(1), 1049-1057; https://doi.org/10.3390/ijerph110101049
Received: 6 November 2013 / Revised: 8 January 2014 / Accepted: 8 January 2014 / Published: 14 January 2014
Cited by 3 | PDF Full-text (198 KB) | HTML Full-text | XML Full-text
Abstract
In 2011, World Health Organization (WHO) scientists reported that a significant percentage of global deaths and disability-adjusted life years (DALYs) in 2004 could be attributed to chemicals. The 2011 review focused only on certain chemicals, however, and concluded that the global burden of
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In 2011, World Health Organization (WHO) scientists reported that a significant percentage of global deaths and disability-adjusted life years (DALYs) in 2004 could be attributed to chemicals. The 2011 review focused only on certain chemicals, however, and concluded that the global burden of disease was underestimated because of serious data gaps. While various chemical assessment documents have identified research needs for individual chemicals, a systematic review of such documents to identify research themes that could be applied to the multitude of chemicals for which there is little information has not been done. Even for chemicals for which there are considerable data, the information is not sufficient to make an estimate of the chemical’s contribution to the burden of disease. The WHO Environmental Health Criteria (EHC) documents and Concise International Chemical Assessment Documents (CICADs) identify research needs or data gaps in our knowledge of chemicals. We identified several common themes in these documents and in documents prepared by WHO on 10 chemicals of major public health concern. These themes include biomarkers, longitudinal epidemiological studies, mechanisms of disease, reproductive and developmental effects and exposure assessment. Specific examples of data gaps culled from more than 300 WHO documents provide researchers with specific topics for further research. Full article
Open AccessArticle The Impact of Climate Change on Ozone-Related Mortality in Sydney
Int. J. Environ. Res. Public Health 2014, 11(1), 1034-1048; https://doi.org/10.3390/ijerph110101034
Received: 6 October 2013 / Revised: 30 December 2013 / Accepted: 31 December 2013 / Published: 13 January 2014
Cited by 4 | PDF Full-text (649 KB) | HTML Full-text | XML Full-text
Abstract
Coupled global, regional and chemical transport models are now being used with relative-risk functions to determine the impact of climate change on human health. Studies have been carried out for global and regional scales, and in our paper we examine the impact of
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Coupled global, regional and chemical transport models are now being used with relative-risk functions to determine the impact of climate change on human health. Studies have been carried out for global and regional scales, and in our paper we examine the impact of climate change on ozone-related mortality at the local scale across an urban metropolis (Sydney, Australia). Using three coupled models, with a grid spacing of 3 km for the chemical transport model (CTM), and a mortality relative risk function of 1.0006 per 1 ppb increase in daily maximum 1-hour ozone concentration, we evaluated the change in ozone concentrations and mortality between decades 1996–2005 and 2051–2060. The global model was run with the A2 emissions scenario. As there is currently uncertainty regarding a threshold concentration below which ozone does not impact on mortality, we calculated mortality estimates for the three daily maximum 1-hr ozone concentration thresholds of 0, 25 and 40 ppb. The mortality increase for 2051–2060 ranges from 2.3% for a 0 ppb threshold to 27.3% for a 40 ppb threshold, although the numerical increases differ little. Our modeling approach is able to identify the variation in ozone-related mortality changes at a suburban scale, estimating that climate change could lead to an additional 55 to 65 deaths across Sydney in the decade 2051–2060. Interestingly, the largest increases do not correspond spatially to the largest ozone increases or the densest population centres. The distribution pattern of changes does not seem to vary with threshold value, while the magnitude only varies slightly. Full article
(This article belongs to the Special Issue Climate Change and Human Health)
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Open AccessArticle Maize Purple Plant Pigment Protects Against Fluoride-Induced Oxidative Damage of Liver and Kidney in Rats
Int. J. Environ. Res. Public Health 2014, 11(1), 1020-1033; https://doi.org/10.3390/ijerph110101020
Received: 13 November 2013 / Revised: 1 January 2014 / Accepted: 7 January 2014 / Published: 13 January 2014
Cited by 9 | PDF Full-text (340 KB) | HTML Full-text | XML Full-text
Abstract
Anthocyanins are polyphenols and well known for their biological antioxidative benefits. Maize purple plant pigment (MPPP) extracted and separated from maize purple plant is rich in anthocyanins. In the present study, MPPP was used to alleviate the adverse effects generated by fluoride on
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Anthocyanins are polyphenols and well known for their biological antioxidative benefits. Maize purple plant pigment (MPPP) extracted and separated from maize purple plant is rich in anthocyanins. In the present study, MPPP was used to alleviate the adverse effects generated by fluoride on liver and kidney in rats. The results showed that the ultrastructure of the liver and kidney in fluoride treated rats displayed shrinkage of nuclear and cell volume, swollen mitochondria and endoplasmic reticulum and vacuols formation in the liver and kidney cells. MPPP significantly attenuated these fluoride-induced pathological changes. The MDA levels in serum and liver tissue of fluoride alone treated group were significantly higher than those of the control group (p < 0.05). The presence of 5 g/kg MPPP in the diet reduced the elevation of MDA levels in blood and liver, and increased the SOD and GSH-Px activities in kidney and GSH level in liver and kidney compared with the fluoride alone treated group (p < 0.05). In addition, MPPP alleviated the decrease of Bcl-2 protein expression and the increase of Bax protein expression induced by fluoride. This study demonstrated the protective role of MPPP against fluoride-induced oxidative stress in liver and kidney of rats. Full article
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Open AccessArticle The Portrayal of Natural Environment in the Evolution of the Ecological Public Health Paradigm
Int. J. Environ. Res. Public Health 2014, 11(1), 1005-1019; https://doi.org/10.3390/ijerph110101005
Received: 5 November 2013 / Revised: 19 December 2013 / Accepted: 20 December 2013 / Published: 10 January 2014
Cited by 12 | PDF Full-text (897 KB) | HTML Full-text | XML Full-text
Abstract
This paper explores the conceptualization of the natural environment in an evolving ecological public health paradigm. The natural environment has long been recognized as essential to supporting life, health, and wellbeing. Our understanding of the relationship between the natural environment and health has
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This paper explores the conceptualization of the natural environment in an evolving ecological public health paradigm. The natural environment has long been recognized as essential to supporting life, health, and wellbeing. Our understanding of the relationship between the natural environment and health has steadily evolved from one of an undynamic environment to a more sophisticated understanding of ecological interactions. This evolution is reflected in a number of ecological public health models which demonstrate the many external and overlapping determinants of human health. Six models are presented here to demonstrate this evolution, each model reflecting an increasingly ecological appreciation for the fundamental role of the natural environment in supporting human health. We conclude that after decades of public health’s acceptance of the ecological paradigm, we are only now beginning to assemble knowledge of sophisticated ecological interdependencies and apply this knowledge to the conceptualization and study of the relationship between the natural environment and the determinants of human health. Full article
(This article belongs to the Special Issue Health Benefits of Nature)
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Open AccessEditorial Ninth International Symposium on Recent Advances in Environmental Health Research
Int. J. Environ. Res. Public Health 2014, 11(1), 1001-1004; https://doi.org/10.3390/ijerph110101001
Received: 4 November 2013 / Accepted: 6 November 2013 / Published: 10 January 2014
Cited by 3 | PDF Full-text (140 KB) | HTML Full-text | XML Full-text
Abstract
This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from
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This special issue of International Journal of Environmental Research and Public Health is dedicated to the publication of selected papers presented at the Eighth International Symposium on Recent Advances in Environmental Health Research. The Symposium was organized by Jackson State University (JSU) from 16–19 September, 2012 at the Marriott Hotel in Jackson, Mississippi, USA. It was built upon the overwhelming success of seven previous symposia hosted by JSU. [...] Full article
Open AccessArticle Geospatial Interpolation and Mapping of Tropospheric Ozone Pollution Using Geostatistics
Int. J. Environ. Res. Public Health 2014, 11(1), 983-1000; https://doi.org/10.3390/ijerph110100983
Received: 14 November 2013 / Revised: 17 December 2013 / Accepted: 19 December 2013 / Published: 10 January 2014
Cited by 4 | PDF Full-text (5344 KB) | HTML Full-text | XML Full-text
Abstract
Tropospheric ozone (O3) pollution is a major problem worldwide, including in the United States of America (USA), particularly during the summer months. Ozone oxidative capacity and its impact on human health have attracted the attention of the scientific community. In the USA, sparse
[...] Read more.
Tropospheric ozone (O3) pollution is a major problem worldwide, including in the United States of America (USA), particularly during the summer months. Ozone oxidative capacity and its impact on human health have attracted the attention of the scientific community. In the USA, sparse spatial observations for O3 may not provide a reliable source of data over a geo-environmental region. Geostatistical Analyst in ArcGIS has the capability to interpolate values in unmonitored geo-spaces of interest. In this study of eastern Texas O3 pollution, hourly episodes for spring and summer 2012 were selectively identified. To visualize the O3 distribution, geostatistical techniques were employed in ArcMap. Using ordinary Kriging, geostatistical layers of O3 for all the studied hours were predicted and mapped at a spatial resolution of 1 kilometer. A decent level of prediction accuracy was achieved and was confirmed from cross-validation results. The mean prediction error was close to 0, the root mean-standardized-prediction error was close to 1, and the root mean square and average standard errors were small. O3 pollution map data can be further used in analysis and modeling studies. Kriging results and O3 decadal trends indicate that the populace in Houston-Sugar Land-Baytown, Dallas-Fort Worth-Arlington, Beaumont-Port Arthur, San Antonio, and Longview are repeatedly exposed to high levels of O3-related pollution, and are prone to the corresponding respiratory and cardiovascular health effects. Optimization of the monitoring network proves to be an added advantage for the accurate prediction of exposure levels. Full article
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Open AccessArticle Human Leptospirosis on Reunion Island: Past and Current Burden
Int. J. Environ. Res. Public Health 2014, 11(1), 968-982; https://doi.org/10.3390/ijerph110100968
Received: 26 November 2013 / Revised: 30 December 2013 / Accepted: 7 January 2014 / Published: 10 January 2014
Cited by 13 | PDF Full-text (499 KB) | HTML Full-text | XML Full-text
Abstract
Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data
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Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data and the assessment of 9 years of leptospirosis surveillance. From 2004 to 2012, 414 hospitalized cases were reported. Cases of leptospirosis occurred mostly during the rainy season from December to May. Approximately 41% of infections occurred at home, 12% of infections occurred during aquatic leisure and 5% of cases were linked to professional activities. Furthermore, for 41% of cases, the place of infection could not be determined due to the accumulation of residential and non-residential exposure. Most of the cases of leptospirosis were linked to rural areas or traditional, rural occupations. We did not observe a shift to recreational leptospirosis as described in some developed countries. According to the new surveillance system, the number of reported cases has regularly increased since 2004. This situation is in part due to the improvement of the system in the first years but also to a real increase in the number of detected cases due to the introduction of molecular methods and to increased biological investigation into the Dengue-like syndrome by medical practitioners on the island since the Chikungunya crisis in 2006. This increase is probably due to surveillance and diagnosis biases but need to be carefully monitored. Nevertheless, the possibility of an outbreak is always present due to climatic events, such as after the “hyacinth” hurricane in 1980. Full article
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
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