Int. J. Environ. Res. Public Health, Volume 12, Issue 10 (October 2015) – 104 articles , Pages 11988-13661

The growth of the bacterial community harbored in indoor drinking water taps is regulated by external environmental factors, such as indoor temperature. However, the effect of indoor heating on bacterial regrowth associated with indoor drinking water taps is poorly understood. In the present work, flow cytometry and community-level sole-carbon-source utilization techniques were combined to explore the effects of indoor heating on water bacterial cell concentrations and community carbon metabolic profiles in building tap pipes during the winter season. The results showed that the temperature of water stagnated overnight (“before”) in the indoor water pipes was 15–17 °C, and the water temperature decreased to 4–6 °C after flushing for 10 min (“flushed”). The highest bacterial cell number was observed in water stagnated overnight, and was 5–11 times higher than that of flushed water. Meanwhile, a significantly higher bacterial community metabolic activity (AWCD_590nm) was also found in overnight stagnation water samples. The significant “flushed” and “taps” values indicated that the AWCD_590nm, and bacterial cell number varied among the taps within the flushed group (p < 0.01). Heatmap fingerprints and principle component analyses (PCA) revealed a significant discrimination bacterial community functional metabolic profiles in the water stagnated overnight and flushed water. Serine, threonine, glucose-phosphate, ketobutyric acid, phenylethylamine, glycerol, putrescine were significantly used by “before” water samples. The results suggested that water stagnated at higher temperature should be treated before drinking because of bacterial regrowth. The data from this work provides useful information on reasonable utilization of drinking water after stagnation in indoor pipes during indoor heating periods. Full article

The Mental Health Commission of Canada’s (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O’Malley (Int J Soc Res Methodol 8:19–32, 2005). Over two decades of relevant literature on immigrants’ health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed. Full article

There is a critical need for safe water in healthcare facilities (HCF) in low-income countries. HCF rely on water supplies that may require additional on-site treatment, and need sustainable technologies that can deliver sufficient quantities of water. Water treatment systems (WTS) that utilize ultrafiltration membranes for water treatment can be a useful technology in low-income countries, but studies have not systematically examined the feasibility of this technology in low-income settings. We monitored 22 months of operation of 10 WTS, including pre-filtration, membrane ultrafiltration, and chlorine residual disinfection that were donated to and operated by rural HCF in Rwanda. The systems were fully operational for 74% of the observation period. The most frequent reasons for interruption were water shortage (8%) and failure of the chlorination mechanism (7%). When systems were operational, 98% of water samples collected from the HCF taps met World Health Organization (WHO) guidelines for microbiological water quality. Water quality deteriorated during treatment interruptions and when water was stored in containers. Sustained performance of the systems depended primarily on organizational factors: the ability of the HCF technician to perform routine servicing and repairs, and environmental factors: water and power availability and procurement of materials, including chlorine and replacement parts in Rwanda. Full article

Associations between contaminated land and socio demographics are well documented in high-income countries. In low- and middle-income countries, however, little is known about the extent of contaminated land and possible demographic correlations. This is an important yet sparsely researched topic with potentially significant public health implications as exposure to pollution remains a leading source of morbidity and mortality in low-income countries. In this study, we review the associations between several socio demographic factors (population, population density, unemployment, education, and literacy) and contaminated sites in Ghana. Within this context, both correlation and association intend to show the relationship between two variables, namely contaminated sites and socio demographics. Aggregated district level 2010 census data from Ghana Statistical Service and contaminated site location data from Pure Earth’s Toxic Sites Identification Program (TSIP) were spatially evaluated using the number of sites per kilometer squared within districts as the unit of measurement. We found a low to medium positive correlation (ρ range: 0.285 to 0.478) between contaminated sites and the following socio demographics: higher population density, higher unemployment, greater education, and higher literacy rate. These results support previous studies and suggest that several socio demographic factors may be reasonably accurate predictors of contaminated site locations. More research and targeted data collection is needed to better understand these associations with the ultimate goal of developing a predictive model. Full article

Thermal adaptation studies provide researchers great insight to help understand how people respond to thermal discomfort. This research aims to assess outdoor urban plaza conditions in hot and humid regions of Asia by conducting an evaluation of thermal adaptation. We also propose that questionnaire items are appropriate for determining thermal adaptation strategies adopted by urban plaza users. A literature review was conducted and first hand data collected by field observations and interviews used to collect information on thermal adaptation strategies. Item analysis—Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA)—were applied to refine the questionnaire items and determine the reliability of the questionnaire evaluation procedure. The reliability and validity of items and constructing process were also analyzed. Then, researchers facilitated an evaluation procedure for assessing the thermal adaptation strategies of urban plaza users in hot and humid regions of Asia and formulated a questionnaire survey that was distributed in Taichung’s Municipal Plaza in Taiwan. Results showed that most users responded with behavioral adaptation when experiencing thermal discomfort. However, if the thermal discomfort could not be alleviated, they then adopted psychological strategies. In conclusion, the evaluation procedure for assessing thermal adaptation strategies and the questionnaire developed in this study can be applied to future research on thermal adaptation strategies adopted by urban plaza users in hot and humid regions of Asia. Full article

Slight changes in the abundance of certain lipid species in the brain may drastically alter normal neurodevelopment via membrane stability, cell signalling, and cell survival. Previous findings have demonstrated that postnatal exposure to di (2-ethylhexyl) phthalate (DEHP) disrupts normal axonal and neural development in the hippocampus. The goal of the current study was to determine whether postnatal exposure to DEHP alters the lipid profile in the hippocampus during postnatal development. Systemic treatment with 10 mg/kg DEHP during postnatal development led to elevated levels of phosphatidylcholine and sphingomyelin in the hippocampus of female rats. There was no effect of DEHP exposure on the overall abundance of phosphatidylcholine or sphingomyelin in male rats or of lysophosphatidylcholine in male or female rats. Individual analyses of each identified lipid species revealed 10 phosphatidylcholine and six sphingomyelin lipids in DEHP-treated females and a single lysophosphatidylcholine in DEHP-treated males with a two-fold or higher increase in relative abundance. Our results are congruent with previous work that found that postnatal exposure to DEHP had a near-selective detrimental effect on hippocampal development in males but not females. Together, results suggest a neuroprotective effect of these elevated lipid species in females. Full article

Arsenic contamination in drinking water has become an increasingly important issue due to its high toxicity to humans. The present study focuses on the development of the yttrium-based adsorbents, with basic yttrium carbonate (BYC), Ti-loaded basic yttrium carbonate (Ti-loaded BYC) and yttrium hydroxide prepared using a co-precipitation method. The Langmuir isotherm results confirmed the maximum adsorption capacity of Ti-loaded BYC (348.5 mg/g) was 25% higher than either BYC (289.6 mg/g) or yttrium hydroxide (206.5 mg/g) due to its increased specific surface area (82 m²/g) and surface charge (PZC: 8.4). Pseudo first- and second-order kinetic models further confirmed that the arsenate removal rate of Ti-loaded BYC was faster than for BYC and yttrium hydroxide. It was subsequently posited that the dominant removal mechanism of BYC and Ti-loaded BYC was the carbonate-arsenate ion exchange process, whereas yttrium hydroxide was regarded to be a co-precipitation process. The Ti-loaded BYC also displayed the highest adsorption affinity for a wide pH range (3–11) and in the presence of coexisting anionic species such as phosphate, silicate, and bicarbonate. Therefore, it is expected that Ti-loaded BYC can be used as an effective and practical adsorbent for arsenate remediation in drinking water. Full article

A bacterial strain W-1, isolated from rural domestic wastewater, can utilize the environmental hormone di-n-butyl phthalate (DBP) as the sole carbon and energy source. The isolated bacterium species was confirmed to belong to the genus Achromobacter based on its 16S rRNA gene sequence. The results of substrate utilization tests showed that the strain W-1 could utilize other common phthalates and phenol. High-performance liquid chromatography analysis revealed that the optimal conditions for DBP degradation were pH 7.0, 35 °C, and an agitation rate of 175 rpm. Under these conditions, 500 mg/L of DBP was completely degraded within 30 h. The effects of heavy metals (50 mg/L Cu²⁺ and 500 mg/L Pb²⁺) and surfactants (100 mg/L SDS and 500 mg/L Tween 20) on DBP degradation were investigated. The results demonstrated that Cu²⁺ and SDS severely inhibited DBP degradation and Pb²⁺ weakly inhibited DBP degradation, while Tween 20 greatly enhanced DBP degradation. Furthermore, phthalate degradation genes were found to be located on a plasmid present in Achromobacter sp. W-1. Full article

This study aimed to assess the prevalence of probable post-traumatic stress disorder (PTSD), and its associated risk factors in a general household population in Kenya. Data were drawn from a cross-sectional household survey of mental disorders and their associated risk factors. The participants received a structured epidemiological assessment of common mental disorders, and symptoms of PTSD, accompanied by additional sections on socio-demographic data, life events, social networks, social supports, disability/activities of daily living, quality of life, use of health services, and service use. The study found that 48% had experienced a severe trauma, and an overall prevalence rate of 10.6% of probable PTSD, defined as a score of six or more on the trauma screening questionnaire (TSQ). The conditional probability of PTSD was 0.26. Risk factors include being female, single, self-employed, having experienced recent life events, having a common mental disorder (CMD)and living in an institution before age 16. The study indicates that probable PTSD is prevalent in this rural area of Kenya. The findings are relevant for the training of front line health workers, their support and supervision, for health management information systems, and for mental health promotion in state boarding schools. Full article

With rising concerns of heavy metal exposure in pregnancy and early childhood, this study was conducted to assess the relationship between the lead, cadmium, mercury, and methylmercury blood levels in pregnancy and neonatal period. The study population included 104 mothers and their children pairs who completed both baseline maternal blood sampling at the second trimester and umbilical cord blood sampling at birth. The geometric mean maternal blood levels of lead, cadmium, total mercury, and methylmercury at the second trimester were 1.02 ± 1.39 µg/dL, 0.61 ± 1.51 µg/L, 2.97 ± 1.45 µg/L, and 2.39 ± 1.45 µg/L, respectively, and in the newborns, these levels at birth were 0.71 ± 1.42 µg/dL, 0.01 ± 5.31 µg/L, 4.44 ± 1.49 µg/L, and 3.67 ± 1.51 µg/L, respectively. The mean ratios of lead, cadmium, total mercury, and methylmercury levels in the newborns to those in the mothers were 0.72, 0.04, 1.76, and 1.81, respectively. The levels of most heavy metals in pregnant women and infants were higher in this study than in studies from industrialized western countries. The placenta appears to protect fetuses from cadmium; however, total mercury and methylmercury were able to cross the placenta and accumulate in fetuses. Full article

The influence of traffic-related air pollution on indoor residential exposure is not well characterized in homes with high natural ventilation in low-income countries. Additionally, domestic allergen exposure is unknown in such populations. We conducted a pilot study of 25 homes in peri-urban Lima, Peru to estimate the effects of roadway proximity and season on residential concentrations. Indoor and outdoor concentrations of particulate matter (PM_2.5), nitrogen dioxide (NO₂), and black carbon (BC) were measured OPEN ACCESS Int. J. Environ. Res. Public Health 2015, 12 13467 during two seasons, and allergens were measured in bedroom dust. Allergen levels were highest for dust mite and mouse allergens, with concentrations above clinically relevant thresholds in over a quarter and half of all homes, respectively. Mean indoor and outdoor pollutant concentrations were similar (PM_2.5: 20.0 vs. 16.9 μg/m3, BC: 7.6 vs. 8.1 μg/m3, NO₂: 7.3 vs. 7.5 ppb), and tended to be higher in the summer compared to the winter. Road proximity was significantly correlated with overall concentrations of outdoor PM_2.5 (rs = −0.42, p = 0.01) and NO2 (r_s = −0.36, p = 0.03), and outdoor BC concentrations in the winter (rs = −0.51, p = 0.03). Our results suggest that outdoor-sourced pollutants significantly influence indoor air quality in peri-urban Peruvian communities, and homes closer to roadways are particularly vulnerable. Full article

The increasing prevalence of dyslipidemia has become a worldwide public health problem, and the prevalence varies widely according to socioeconomic, cultural and ethnic characteristics. Chongqing has experienced rapid economic development and is now the economic center of Southwestern China. There are scant data on serum lipid profile of residents in Chongqing, the largest municipality directly under the Central Government in China. We conducted a cross-sectional study in a representative sample of 5375 residents of Chongqing, aged ≥18 years, and estimated the prevalence of dyslipidemia and its associated risk factors. According to the National Cholesterol Education Program-Adult Treatment Panel III criteria, the age-standardized prevalence of dyslipidemia was 35.5% (34.4% among men and 37.6% among women). Among the 2009 patients with dyslipidemia, 44.2% had isolated hypertriglyceridemia, 14.7% had isolated hypercholesterolemia, 13.2% had mixed hyperlipidemia, and 28.0% had isolated low high-density lipoprotein cholesterol. The peak prevalence of dyslipidemia in men was between 30 and 39 years (48.2%), and then declined gradually; in women, the prevalence of dyslipidemia increased with age, with the peak prevalence occurring after age 60 (46.3%). Multivariable logistic regression analysis revealed that dyslipidemia was associated with age, education level, physical activity, obesity and central obesity for both men and women. In conclusion, the results indicated dyslipidemia, particularly hypertriglyceridemia and low high-density lipoprotein cholesterol, are very common in Chongqing. To prevent dyslipidemia, it is essential to conduct appropriate intervention programs aimed at risk factor reduction and implement routine screening programs for blood lipid levels in Chongqing, China. Full article

Although it has been reported that fluorescent quantum dots (QDs) have obvious acute toxic effects in vitro, their toxic effects at low doses or threshold doses are still unknown. Therefore, we evaluated the biological histocompatibility and in vitro toxicity of three types of QDs at threshold doses. Also, we compared the toxic effects of QDs with different raw chemical compositions and sizes. The results showed that low concentrations of QDs (≤7 μg/mL) had no obvious effect on cell viability and cell membrane damage, oxidative damage, cell apoptosis or DNA damage. However, QD exposure led to a significant cytotoxicity at higher doses (≥14 μg/mL) and induced abnormal cellular morphology. In addition, when comparing the three types of QDs, 2.2 nm CdTe QDs exposure showed a significantly increased proportion of apoptotic cells and significant DNA damage, suggesting that size and composition contribute to the toxic effects of QDs. Based on these discussions, it was concluded that the concentration (7 μg/mL) may serve as a threshold level for these three types of QDs only in L929 fibroblasts, whereas high concentrations (above 14 μg/mL) may be toxic, resulting in inhibition of proliferation, induction of apoptosis and DNA damage in L929 fibroblasts. Full article

Physicochemical properties of chemicals affect their exposure, toxicokinetics/fate and hazard, and for nanomaterials, the variation of these properties results in a wide variety of materials with potentially different risks. To limit the amount of testing for risk assessment, the information gathering process for nanomaterials needs to be efficient. At the same time, sufficient information to assess the safety of human health and the environment should be available for each nanomaterial. Grouping and read-across approaches can be utilised to meet these goals. This article presents different possible applications of grouping and read-across for nanomaterials within the broader perspective of the MARINA Risk Assessment Strategy (RAS), as developed in the EU FP7 project MARINA. Firstly, nanomaterials can be grouped based on limited variation in physicochemical properties to subsequently design an efficient testing strategy that covers the entire group. Secondly, knowledge about exposure, toxicokinetics/fate or hazard, for example via properties such as dissolution rate, aspect ratio, chemical (non-)activity, can be used to organise similar materials in generic groups to frame issues that need further attention, or potentially to read-across. Thirdly, when data related to specific endpoints is required, read-across can be considered, using data from a source material for the target nanomaterial. Read-across could be based on a scientifically sound justification that exposure, distribution to the target (fate/toxicokinetics) and hazard of the target material are similar to, or less than, the source material. These grouping and read-across approaches pave the way for better use of available information on nanomaterials and are flexible enough to allow future adaptations related to scientific developments. Full article

The final effluents of two wastewater treatment plants (WWTPs) in the Eastern Cape Province of South Africa were evaluated for their physicochemical and microbiological qualities over a period of 12 months. The physicochemical parameters assessed ranged as follows both plants. The ranges of values for the physicochemical are: pH (3.9–8.6), total dissolved solids (86.50–336.3 mg/L), electrical conductivity (13.57–52.50 mS/m), temperature (13–28 °C), nitrate (0–21.73 mg/L), nitrite (0.01–0.60 mg/L), orthophosphate (1.29–20.57 mg/L), turbidity (4.02–43.20 NTU), free chlorine (0.05–7.18 mg/L), dissolve oxygen (3.91–9.60 mg/L), biochemical oxygen demand (0.1–9.0 mg/L) and chemical oxygen demand (4.67–211 mg/L). The microbiological assessment for both WWTPs revealed the presence of E. coli in counts ranging between 0 and 1.86 × 10⁴ CFU/100 mL and Vibrio counts ranging between 0 and 9.93 × 10³ CFU/100 mL. We conclude that these WWTPs are important point sources of pollution in surface water with potential public health and ecological risks. Full article

The environment plays a key role in supporting children’s participation and can serve as a focus of intervention. This study aimed to elicit the perceptions and experiences of occupational therapists who had applied the PREP approach—Pathways and Resources for Engagement and Participation. PREP is a novel 12-week intervention for youth with physical disabilities, aimed at improving participation in leisure community-based activities by modifying aspects of the environment. Using a qualitative post-intervention only design, 12 therapists took part in individual semi-structured interviews, in which the therapists reflected on their experience using PREP to enable participation. A thematic analysis was conducted. Four themes emerged from the data; two of which were informative in nature, describing elements of the PREP intervention that target multi-layered composition of the environment and use strategies that involve leveraging resources and problem solving. The two remaining themes were reflective in nature, illustrating a new take on the Occupational Therapy role and re-positioning the concept of participation in therapy practices. Results emphasize aspects of the environment that can serve as effective targets of intervention, guided by the PREP approach. Findings can broaden the scope and focus of occupational therapy practice by redefining views on participation and the environment. Full article

Express roads are a potential source of heavy metal contamination in the surrounding environment. The Warsaw Expressway (E30) is one of the busiest roads in the capital of Poland and cuts through the ecologically valuable area (Mazowiecki Natural Landscape Park). Soil samples were collected at distances of 0.5, 4.5 and 25 m from the expressway. The concentrations of cadmium (Cd), copper (Cu), nickel (Ni), lead (Pb), and zinc (Zn) were determined in the soils by the flame atomic absorption spectrometry method (FAAS). Soils located in the direct proximity of the analyzed stretch of road were found to have the highest values of pH and electrical conductivity (EC), which decreased along with an increase in the distance from the expressway. The contents of Cd, Cu and Zn were found to be higher than Polish national averages, whereas the average values of Ni and Pb were not exceeded. The pollution level was estimated based on the geo-accumulation index (I_geo), and the pollution index (PI). The results of I_geo and PI indexes revealed the following orders: Cu < Zn < Ni < Cd < Pb and Cu < Ni < Cd < Zn < Pb, and comparison with geochemical background values showed higher concentration of zinc, lead and cadmium. Full article

The aim of this study was to test whether there is an association between elevation and cognitive function among elderly residents in rural mountainous areas. Data were collected in 2012 from a cross-sectional study conducted in Ohnan Town, which is located in a rural mountainous area in the southern part of Shimane Prefecture, Japan. Cognitive function was evaluated using CADi (Cognitive Assessment for Dementia, iPad version) and elevation was estimated by using Geographic Information Systems according to the participant’s address. After excluding subjects with missing data, 866 participants were analyzed. After adjustment for potential confounding factors, higher elevation was significantly associated with decreased cognitive function. This finding suggests that it is important to consider the physical environment, i.e., elevation, that would affect accessibility to health-promoting goods, services, and resources when seeking to maintain cognitive function in elderly people living in rural mountainous areas. Full article

Although associations between a person’s neighborhood and their health have been studied internationally, most studies have been limited to a few cities or towns. Therefore, we used a nationally representative sample to explore whether perceived and objective neighborhood walkability was associated with the physical activity of residents. Data were analyzed from the Japanese General Social Surveys of 2010 (n = 2395; 1114 men and 1281 women). Perceived walkability was scored using factor analysis for the respondents’ perceptions of neighborhood conditions, while objective walkability was measured using the geographic information system approach. Finally, multilevel logistic regression analysis was performed to examine whether neighborhood walkability was associated with the frequency of leisure-time physical activity (LTPA) among respondents. We found that perceived walkability was positively associated with the frequency of LTPA (odds ratio of the highest quartile was 1.53 (1.14–2.05) compared with the lowest quartile); however, objective walkability showed no association. When stratified by gender, an association between perceived walkability and LTPA was observed among women, but only a marginally significant association was present between objective walkability and LTPA among men. We conclude that the association between neighborhood walkability and LTPA can be partially generalized across Japan. Full article

Human vulnerability to heat varies at a range of spatial scales, especially within cities where there can be noticeable intra-urban differences in heat risk factors. Mapping and visualizing intra-urban heat vulnerability offers opportunities for presenting information to support decision-making. For example the visualization of the spatial variation of heat vulnerability has the potential to enable local governments to identify hot spots of vulnerability and allocate resources and increase assistance to people in areas of greatest need. Recently there has been a proliferation of heat vulnerability mapping studies, all of which, to varying degrees, justify the process of vulnerability mapping in a policy context. However, to date, there has not been a systematic review of the extent to which the results of vulnerability mapping studies have been applied in decision-making. Accordingly we undertook a comprehensive review of 37 recently published papers that use geospatial techniques for assessing human vulnerability to heat. In addition, we conducted an anonymous survey of the lead authors of the 37 papers in order to establish the level of interaction between the researchers as science information producers and local authorities as information users. Both paper review and author survey results show that heat vulnerability mapping has been used in an attempt to communicate policy recommendations, raise awareness and induce institutional networking and learning, but has not as yet had a substantive influence on policymaking or preventive action. Full article

Although people will most likely adjust to warmer temperatures, it is still difficult to assess what this adaptation will look like. This scenario-based integrated health impacts assessment explores baseline (1981–2010) and future (2050) population attributable fractions (PAF) of mortality due to heat (PAF_heat) and cold (PAF_cold), by combining observed temperature–mortality relationships with the Dutch KNMI’14 climate scenarios and three adaptation scenarios. The 2050 model results without adaptation reveal a decrease in PAF_cold (8.90% at baseline; 6.56%–7.85% in 2050) that outweighs the increase in PAF_heat (1.15% at baseline; 1.66%–2.52% in 2050). When the 2050 model runs applying the different adaptation scenarios are considered as well, however, the PAF_heat ranges between 0.94% and 2.52% and the PAF_cold between 6.56% and 9.85%. Hence, PAF_heat and PAF_cold can decrease as well as increase in view of climate change (depending on the adaptation scenario). The associated annual mortality burdens in 2050—accounting for both the increasing temperatures and mortality trend—show that heat-related deaths will range between 1879 and 5061 (1511 at baseline) and cold-related deaths between 13,149 and 19,753 (11,727 at baseline). Our results clearly illustrate that model outcomes are not only highly dependent on climate scenarios, but also on adaptation assumptions. Hence, a better understanding of (the impact of various) plausible adaptation scenarios is required to advance future integrated health impact assessments. Full article

Objectives: The present study aimed to investigate the knowledge of Middle East Respiratory Syndrome (MERS) among Chinese medical students. Methods: A structured questionnaire on MERS was conducted among 214 medical students in China. Results: The average correction of the single question varied from 36.0% to 89.7%. There is a significant difference on MERS knowledge among different majors of medical students (p < 0.05). Management students scored significantly higher than students of other majors (p < 0.05). Conclusion: Chinese medical students had good knowledge of MERS. The MERS knowledge score varied among students of different majors. Education on disease control should be included in the school curriculum. Full article

Currency notes have been implicated as a vehicle for transmitting community-acquired bacterial infections. However, the overall diversity of the bacterial population residing on banknotes is still unknown in Brazil. In this study, we aimed to investigate the overall bacterial population from 150 different Brazilian Rial (R$) notes in circulation using a culture-independent Illumina massively parallel sequencing approach of the 16S rRNA genes. Samples were randomly collected from three different street markets or “feiras” in the metropolitan region of São Paulo. Taxonomical composition revealed the abundance of Proteobacteria phyla, followed by Firmicutes and Streptophyta, with a total of 1193 bacterial families and 3310 bacterial genera. Most of these bacterial genera are of human, animal, and environmental origins. Also, our analysis revealed the presence of some potential pathogenic bacterial genera including Salmonella, Staphylococcus, and Klebsiella. The results demonstrate that there is a tremendous diversity of bacterial contamination on currency notes, including organisms known to be opportunistic pathogens. One of the factors that may contribute to the richness of bacterial diversity in currency notes is personal hygiene. Thus, our results underscore the need to increase public awareness of the importance of personal hygiene of money handlers who also handle food. Full article

Little is understood about the long term, indirect health consequences of drought (a period of abnormally dry weather). In particular, the implications of drought for mental health via pathways such as loss of livelihood, diminished social support, and rupture of place bonds have not been extensively studied, leaving a knowledge gap for practitioners and researchers alike. A systematic review of literature was performed to examine the mental health effects of drought. The systematic review results were synthesized to create a causal process diagram that illustrates the pathways linking drought effects to mental health outcomes. Eighty-two articles using a variety of methods in different contexts were gathered from the systematic review. The pathways in the causal process diagram with greatest support in the literature are those focusing on the economic and migratory effects of drought. The diagram highlights the complexity of the relationships between drought and mental health, including the multiple ways that factors can interact and lead to various outcomes. The systematic review and resulting causal process diagram can be used in both practice and theory, including prevention planning, public health programming, vulnerability and risk assessment, and research question guidance. The use of a causal process diagram provides a much needed avenue for integrating the findings of diverse research to further the understanding of the mental health implications of drought. Full article

The associations between Bisphenol-A (BPA) exposure and reproductive hormone levels among women are unclear. A cross-sectional study was conducted among female workers from BPA-exposed and unexposed factories in China. Women’s blood samples were collected for assay of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β-Estradiol (E2), prolactin (PRL), and progesterone (PROG). Their urine samples were collected for BPA measurement. In the exposed group, time weighted average exposure to BPA for an 8-h shift (TWA8), a measure incorporating historic exposure level, was generated based on personal air sampling. Multiple linear regression analyses were used to examine linear associations between urine BPA concentration and reproductive hormones after controlling for potential confounders. A total of 106 exposed and 250 unexposed female workers were included in this study. A significant positive association between increased urine BPA concentration and higher PRL and PROG levels were observed. Similar associations were observed after the analysis was carried out separately among the exposed and unexposed workers. In addition, a positive association between urine BPA and E2 was observed among exposed workers with borderline significance, while a statistically significant inverse association between urine BPA and FSH was observed among unexposed group. The results suggest that BPA exposure may lead to alterations in female reproductive hormone levels. Full article

The Drug Resource Enhancement against AIDS and Malnutrition Program (DREAM) gathered professionals in the field of Elimination of HIV-Mother-To-Child Transmission (EMTCT) in Maputo in 2013 to discuss obstacles and solutions for the elimination of HIV vertical transmission in sub-Saharan Africa. During this workshop, the benefits of administrating combined antiretroviral therapy (cART) to HIV positive women from pregnancy throughout breastfeeding were reviewed. cART is capable of reducing vertical transmission to less than 5% at 24 months of age, as well as maternal mortality and infant mortality in both HIV infected and exposed populations to levels similar to those of uninfected individuals. The challenge for programs targeting eMTCT in developing countries is retention in care and treatment adherence. Both are intrinsically related to the model of care. The drop-out from eMTCT programs before cART initiation ranges from 33%–88% while retention rates at 18–24 months are less than 50%. Comprehensive strategies including peer-to-peer education, social support and laboratory monitoring can reduce refusals to less than 5% and attain retention rates approaching 90%. Several components of the model of care for reduction of HIV-1 MTCT are feasible and implementable in scale-up strategies. A review of this model of care for HIV eMTCT is provided. Full article

Background: Non-communicable chronic diseases (NCDs) have become the top threat in China. This study aimed to estimate the prevalence of major NCDs among the elderly population in rural areas in southern China and explore its associated social determinants. Methods: A multistage cluster random sampling methodology was adopted to select a total of 9245 rural elderly people from 3860 rural households in Guangdong Province. Interviews and physical examinations were performed to collect patient information. Descriptive and logistic regression analyses were conducted to explore factors associated with the presence of major NCDs. Results: Over one-third (38.5%) of the study population suffered from five major NCDs. The grade of activities of daily living (ADL), mental status, and social relationship of elderly people without NCDs were better than those with NCDs. The major factors associated with the presence of NCDs among the elderly people included age (70–79 years group and 80–89 years group), education level (senior high/technical secondary school and junior college and above), mental status (concentration, enrichment and happy life and memory), relationship with neighbours, activities of daily living (ADL) (being able to climb three floors and bend over), physical activity, marital status (bereft), and living conditions (with offspring and family members). Conclusions: The study identified several social determinants associated with the presence of major NCDs. A higher level of family support and physical exercise might contribute to improved physical condition, mental status, and ADL among the elderly people in rural areas in southern China. Full article

The Message Impact Framework suggests that social interactions may offer smokers the opportunity to process pictorial warnings on cigarette packs more deeply. We aimed to describe adult smokers’ social interactions about pictorial cigarette pack warnings in two longitudinal pilot studies. In Pilot Study 1, 30 smokers used cigarette packs with one of nine pictorial warnings for two weeks. In Pilot Study 2, 46 smokers used cigarette packs with one of five pictorial warnings for four weeks. Nearly all smokers (97%/96% in Pilot Study 1/2) talked about the warnings with other people, with the most common people being friends (67%/87%) and spouses/significant others (34%/42%). Pilot Study 2 found that 26% of smokers talked about the warnings with strangers. Discussions about the health effects of smoking and quitting smoking were more frequent during the first week of exposure to pictorial warnings than in the week prior to beginning the study (both p < 0.05). Pictorial warnings sparked social interactions about the warnings, the health effects of smoking, and quitting smoking, indicating that pictorial warnings may act as a social intervention reaching beyond the individual. Future research should examine social interactions as a potential mediator of the impact of pictorial warnings on smoking behavior. Full article

It is widely accepted that characterizing the spatio-temporal trends of water quality parameters and identifying correlated variables with water quality are indispensable for the management and protection of water resources. In this study, cluster analysis was used to classify 56 typical drinking water reservoirs in Zhejiang Province into three groups representing different water quality levels, using data of four water quality parameters for the period 2006–2010. Then, the spatio-temporal trends in water quality were analyzed, assisted by geographic information systems (GIS) technology and statistical analysis. The results indicated that the water quality showed a trend of degradation from southwest to northeast, and the overall water quality level was exacerbated during the study period. Correlation analysis was used to evaluate the relationships between water quality parameters and ten independent variables grouped into four categories (land use, socio-economic factors, geographical features, and reservoir attributes). According to the correlation coefficients, land use and socio-economic indicators were identified as the most significant factors related to reservoir water quality. The results offer insights into the spatio-temporal variations of water quality parameters and factors impacting the water quality of drinking water reservoirs in Zhejiang Province, and they could assist managers in making effective strategies to better protect water resources. Full article