Next Issue
Previous Issue

E-Mail Alert

Add your e-mail address to receive forthcoming issues of this journal:

Journal Browser

Journal Browser

Table of Contents

Int. J. Environ. Res. Public Health, Volume 13, Issue 12 (December 2016)

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
View options order results:
result details:
Displaying articles 1-96
Export citation of selected articles as:

Editorial

Jump to: Research, Review, Other

Open AccessEditorial Spatiotemporal Frameworks for Infectious Disease Diffusion and Epidemiology
Int. J. Environ. Res. Public Health 2016, 13(12), 1261; doi:10.3390/ijerph13121261
Received: 9 December 2016 / Revised: 9 December 2016 / Accepted: 15 December 2016 / Published: 20 December 2016
PDF Full-text (237 KB) | HTML Full-text | XML Full-text
Abstract Emerging infectious diseases, and the resurgence of previously controlled infectious disease (e.g., malaria, tuberculosis), are a major focus for public health concern, as well as providing challenges for establishing aetiology and transmission. [...]
Full article
(This article belongs to the Special Issue Spatio-temporal Frameworks for Infectious Disease Epidemiology)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Ecosystem Services Insights into Water Resources Management in China: A Case of Xi’an City
Int. J. Environ. Res. Public Health 2016, 13(12), 1169; doi:10.3390/ijerph13121169
Received: 10 May 2016 / Revised: 13 November 2016 / Accepted: 17 November 2016 / Published: 24 November 2016
Cited by 1 | PDF Full-text (3309 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Global climate and environmental changes are endangering global water resources; and several approaches have been tested to manage and reduce the pressure on these decreasing resources. This study uses the case study of Xi’an City in China to test reasonable and effective methods
[...] Read more.
Global climate and environmental changes are endangering global water resources; and several approaches have been tested to manage and reduce the pressure on these decreasing resources. This study uses the case study of Xi’an City in China to test reasonable and effective methods to address water resource shortages. The study generated a framework combining ecosystem services and water resource management. Seven ecosystem indicators were classified as supply services, regulating services, or cultural services. Index values for each indicator were calculated, and based on questionnaire results, each index’s weight was calculated. Using the Likert method, we calculated ecosystem service supplies in every region of the city. We found that the ecosystem’s service capability is closely related to water resources, providing a method for managing water resources. Using Xi’an City as an example, we apply the ecosystem services concept to water resources management, providing a method for decision makers. Full article
Figures

Figure 1

Open AccessArticle Research on the Relationship between Reaction Ability and Mental State for Online Assessment of Driving Fatigue
Int. J. Environ. Res. Public Health 2016, 13(12), 1174; doi:10.3390/ijerph13121174
Received: 21 September 2016 / Revised: 3 November 2016 / Accepted: 18 November 2016 / Published: 24 November 2016
PDF Full-text (1373 KB) | HTML Full-text | XML Full-text
Abstract
Background: Driving fatigue affects the reaction ability of a driver. The aim of this research is to analyze the relationship between driving fatigue, physiological signals and driver’s reaction time. Methods: Twenty subjects were tested during driving. Data pertaining to reaction time and physiological
[...] Read more.
Background: Driving fatigue affects the reaction ability of a driver. The aim of this research is to analyze the relationship between driving fatigue, physiological signals and driver’s reaction time. Methods: Twenty subjects were tested during driving. Data pertaining to reaction time and physiological signals including electroencephalograph (EEG) were collected from twenty simulation experiments. Grey correlation analysis was used to select the input variable of the classification model. A support vector machine was used to divide the mental state into three levels. The penalty factor for the model was optimized using a genetic algorithm. Results: The results show that α/β has the greatest correlation to reaction time. The classification results show an accuracy of 86%, a sensitivity of 87.5% and a specificity of 85.53%. The average increase of reaction time is 16.72% from alert state to fatigued state. Females have a faster decrease in reaction ability than males as driving fatigue accumulates. Elderly drivers have longer reaction times than the young. Conclusions: A grey correlation analysis can be used to improve the classification accuracy of the support vector machine (SVM) model. This paper provides basic research that online detection of fatigue can be performed using only a simple device, which is more comfortable for users. Full article
(This article belongs to the Special Issue Traffic Safety and Injury Prevention)
Figures

Figure 1

Open AccessArticle English Stop-Smoking Services: One-Year Outcomes
Int. J. Environ. Res. Public Health 2016, 13(12), 1175; doi:10.3390/ijerph13121175
Received: 27 September 2016 / Revised: 8 November 2016 / Accepted: 17 November 2016 / Published: 24 November 2016
PDF Full-text (294 KB) | HTML Full-text | XML Full-text
Abstract
The UK is a global leader in stop-smoking support—providing free behavioral support and cessation medication via stop smoking services (SSS) without charge to smokers. This study aimed to explore the client and service characteristics associated with abstinence 52 weeks after quitting. A prospective
[...] Read more.
The UK is a global leader in stop-smoking support—providing free behavioral support and cessation medication via stop smoking services (SSS) without charge to smokers. This study aimed to explore the client and service characteristics associated with abstinence 52 weeks after quitting. A prospective cohort study of 3057 SSS clients in nine different areas of England who began their quit attempt between March 2012 and March 2013 was conducted. Important determinants of long-term quitting were assessed through quit rates and multivariable logistic regression. Our results showed that the overall weighted carbon monoxide validated quit rate for clients at 52 weeks was 7.7% (95% confidence interval (CI) 6.6–9.0). The clients of advisors, whose main role was providing stop-smoking support, were more likely to quit long-term than advisors who had a generalist role in pharmacies or general practices (odds ratio (OR) 2.3 (95% CI 1.2–4.6)). Clients were more likely to achieve abstinence through group support than one-to-one support (OR 3.4 (95% CI 1.7–6.7)). Overall, one in thirteen people who set a quit date with the National Health Service (NHS) Stop-Smoking Service maintain abstinence for a year. Improving abstinence is likely to require a greater emphasis on providing specialist smoking cessation support. Results from this study suggest that over 18,000 premature deaths were prevented through longer-term smoking cessation achieved by smokers who accessed SSS in England from March 2012 to April 2013, but outcomes varied by client characteristic and the type of support provided. Full article
(This article belongs to the Special Issue Tobacco Control and Priority Groups)
Open AccessArticle A Robot-Based Tool for Physical and Cognitive Rehabilitation of Elderly People Using Biofeedback
Int. J. Environ. Res. Public Health 2016, 13(12), 1176; doi:10.3390/ijerph13121176
Received: 14 September 2016 / Revised: 9 November 2016 / Accepted: 16 November 2016 / Published: 24 November 2016
Cited by 1 | PDF Full-text (4054 KB) | HTML Full-text | XML Full-text
Abstract
This publication presents a complete description of a technological solution system for the physical and cognitive rehabilitation of elderly people through a biofeedback system, which is combined with a Lego robot. The technology used was the iOS’s (iPhone Operating System) Objective-C programming language
[...] Read more.
This publication presents a complete description of a technological solution system for the physical and cognitive rehabilitation of elderly people through a biofeedback system, which is combined with a Lego robot. The technology used was the iOS’s (iPhone Operating System) Objective-C programming language and its XCode programming environment; and SQLite in order to create the database. The biofeedback system is implemented by the use of two biosensors which are, in fact, a Microsoft band 2 in order to register the user’s heart rate and a MYO sensor to detect the user’s arm movement. Finally, the system was tested with seven elderly people from La Santa y Real Casa de la Misericordia nursing home in Bilbao. The statistical assessment has shown that the users are satisfied with the usability of the system, with a mean score of 79.29 on the System Usability Scale (SUS) questionnaire. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
Figures

Figure 1

Open AccessArticle Time Trend in Psychotropic Medication Use in Spain: A Nationwide Population-Based Study
Int. J. Environ. Res. Public Health 2016, 13(12), 1177; doi:10.3390/ijerph13121177
Received: 9 October 2016 / Revised: 10 November 2016 / Accepted: 22 November 2016 / Published: 24 November 2016
PDF Full-text (286 KB) | HTML Full-text | XML Full-text
Abstract
Background: We performed an epidemiologic study to analyze nationwide time trends in adult psychotropic drug use over a period from 2006 to 2012, and to identify those factors associated with the likelihood of consumption of these drugs during the study period; Methods: Cross-sectional
[...] Read more.
Background: We performed an epidemiologic study to analyze nationwide time trends in adult psychotropic drug use over a period from 2006 to 2012, and to identify those factors associated with the likelihood of consumption of these drugs during the study period; Methods: Cross-sectional study on psychotropic medication in the Spanish adult population. We used secondary individualized data drawn from the 2006 and 2012 Spanish National Health Surveys (SNHS). The dependent variable was the use of psychotropic drugs in the previous two weeks. Independent variables included socio-demographic characteristics, comorbidity, lifestyles and healthcare resource utilization. Using logistic multivariate regression models, we analyzed the temporal evolution of psychotropic medication consumption between 2006 and 2012 in both sexes; Results: The prevalence of psychotropic drug use was significantly greater in women (18.14% vs. 8.08% in 2012 (p < 0.05). In Spanish women, the variables associated with a greater probability of psychotropic use were, age, unemployment (adjusted odds ratio (AOR), 1.60; 95% CI, 1.24–2.07), negative perception of health or taking non-psychotropic drugs. Among men, psychotropic use is associated with presence of chronic disease, negative perception of health (AOR, 3.27; 95% CI, 2.62–4.07 in 2012) or inactive status; Conclusions: Between 2006 and 2012, the probability of having taken psychotropic drugs increased by 16% among women. Unemployed women aged ≥45 years with a negative perception of their health constitute a clear risk profile in terms of psychotropic drug use. Inactive men who have a negative perception of their health are the group most likely to consume psychotropic drugs. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Older Adults’ Outdoor Walking: Inequalities in Neighbourhood Safety, Pedestrian Infrastructure and Aesthetics
Int. J. Environ. Res. Public Health 2016, 13(12), 1179; doi:10.3390/ijerph13121179
Received: 27 July 2016 / Revised: 8 November 2016 / Accepted: 21 November 2016 / Published: 25 November 2016
PDF Full-text (2675 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Older adults living in high-deprivation areas walk less than those living in low-deprivation areas. Previous research has shown that older adults’ outdoor walking levels are related to the neighbourhood built environment. This study examines inequalities in perceived built environment attributes (i.e., safety, pedestrian
[...] Read more.
Older adults living in high-deprivation areas walk less than those living in low-deprivation areas. Previous research has shown that older adults’ outdoor walking levels are related to the neighbourhood built environment. This study examines inequalities in perceived built environment attributes (i.e., safety, pedestrian infrastructure and aesthetics) and their possible influences on disparities in older adults’ outdoor walking levels in low- and high-deprivation areas of Birmingham, United Kingdom. It applied a mixed-method approach, included 173 participants (65 years and over), used GPS technology to measure outdoor walking levels, used questionnaires (for all participants) and conducted walking interviews (with a sub-sample) to collect data on perceived neighbourhood built environment attributes. The results show inequalities in perceived neighbourhood safety, pedestrian infrastructure and aesthetics in high- versus low-deprivation areas and demonstrate that they may influence disparities in participants’ outdoor walking levels. Improvements of perceived neighbourhood safety, pedestrian infrastructure and aesthetic in high-deprivation areas are encouraged. Full article
(This article belongs to the Special Issue Aging and Health Promotion)
Figures

Figure 1

Open AccessArticle Health Effects Due to Radionuclides Content of Solid Minerals within Port of Richards Bay, South Africa
Int. J. Environ. Res. Public Health 2016, 13(12), 1180; doi:10.3390/ijerph13121180
Received: 14 August 2016 / Revised: 7 November 2016 / Accepted: 10 November 2016 / Published: 25 November 2016
PDF Full-text (1302 KB) | HTML Full-text | XML Full-text
Abstract
This study assessed the radiological health hazards to various body organs of workers working within Transnet Precinct in Richards Bay in Kwazulu-Natal, South Africa due to radionuclide content of mineral ores often stored within the facility. Thirty samples were collected from five mineral
[...] Read more.
This study assessed the radiological health hazards to various body organs of workers working within Transnet Precinct in Richards Bay in Kwazulu-Natal, South Africa due to radionuclide content of mineral ores often stored within the facility. Thirty samples were collected from five mineral ores (rock phosphate, rutile, zircon, coal and hematite) and analyzed for 238U, 234U, 226Ra, 210Pb, 235U, 232Th, 228Ra, 228Th and 40K using delayed neutron activation analysis and low energy gamma spectroscopy. Rutile was found to be the most radioactive mineral ore within the facility with 210Pb concentration of 759.00 ± 106.00 Bq·kg−1. Effective annual dose rate in (mSv·y−1) delivered to different organs of the body: testes, bone marrow, whole body, lungs and ovaries from mineral ores were such that dose from mineral ores decreased in the order coal > rutile > rock phosphate > hematite > zircon. The organs with the highest received dose rate were the testes and this received dose was from coal. However, all of the calculated absorbed dose rates to organs of the body were below the maximum permissible safety limits. Full article
Figures

Figure 1

Open AccessArticle Assessment of Macro-Level Socioeconomic Factors That Impact Waterborne Diseases: The Case of Jordan
Int. J. Environ. Res. Public Health 2016, 13(12), 1181; doi:10.3390/ijerph13121181
Received: 12 October 2016 / Revised: 18 November 2016 / Accepted: 21 November 2016 / Published: 25 November 2016
PDF Full-text (1353 KB) | HTML Full-text | XML Full-text
Abstract
The Hashemite Kingdom of Jordan is an example of a country that suffers from high water scarcity. Additionally, due to the economic drivers in the country, such as phosphate and potash extraction and pharmaceutical production, the little fresh water that remains is generally
[...] Read more.
The Hashemite Kingdom of Jordan is an example of a country that suffers from high water scarcity. Additionally, due to the economic drivers in the country, such as phosphate and potash extraction and pharmaceutical production, the little fresh water that remains is generally polluted. The infrastructure, often antiquated in urban areas and non-existent in rural areas, also contributes to poor water conditions and to the spread of waterborne diseases. This paper examines the socioeconomic factors that contribute to diarrhea and hepatitis A on a macro level in Jordan and discusses the public-policies that government officials could use to abate those problems. Ordinary least squares time series models are used to understand the macro-level variables that impact the incidence of these diseases in Jordan. Public health expenditure has a significant impact on reducing their incidence. Furthermore, investment in sanitation facilities in rural regions is likely to reduce the number of cases of hepatitis A. Perhaps the most surprising outcome is that importation of goods and services likely results in a decrease in cases of hepatitis A. However, income has little impact on the incidence of diarrhea and hepatitis A. Full article
Figures

Figure 1

Open AccessArticle Association between Family and Friend Smoking Status and Adolescent Smoking Behavior and E-Cigarette Use in Korea
Int. J. Environ. Res. Public Health 2016, 13(12), 1183; doi:10.3390/ijerph13121183
Received: 26 September 2016 / Revised: 17 November 2016 / Accepted: 22 November 2016 / Published: 25 November 2016
PDF Full-text (278 KB) | HTML Full-text | XML Full-text
Abstract
Smoking is harmful to the health of adolescents because their bodies are still growing. The aim of this study was to analyze the association between the smoking status of Korean adolescents’ parents and friends and their own smoking behavior. The study assessed a
[...] Read more.
Smoking is harmful to the health of adolescents because their bodies are still growing. The aim of this study was to analyze the association between the smoking status of Korean adolescents’ parents and friends and their own smoking behavior. The study assessed a nationwide sample of 72,060 middle and high students from the 10th Korea Youth Risk Behavior Web-based Survey (2014). Descriptive analysis, chi-square tests, and multiple logistic regression analysis were used to probe the association between family and friend smoking status and adolescent smoking behavior. The current cigarette smoking rates were 13.3% of boys and 4.1% of girls. The corresponding rates for electronic cigarette smoking were 4.1% and 1.5%, respectively. Higher exposure to secondhand smoke, smoking by any family member, more friends smoking, and witnessed smoking at school were associated with current smoking and electronic smoking. The smoking status of family and friends was significantly related to adolescent smoking behavior. These results should be considered in designing programs to control adolescent smoking. Full article
Open AccessArticle Factors that Affect Suicide Attempts of Adolescents in Multicultural Families in Korea
Int. J. Environ. Res. Public Health 2016, 13(12), 1184; doi:10.3390/ijerph13121184
Received: 17 August 2016 / Revised: 16 November 2016 / Accepted: 21 November 2016 / Published: 28 November 2016
Cited by 1 | PDF Full-text (281 KB) | HTML Full-text | XML Full-text
Abstract
We examined the factors that affect suicide attempts adolescents multicultural families in South Korea. The participants were 727 adolescents whose mothers and/or fathers were born outside of South Korea (376 males and 351 females). Among them, 41 (weighted prevalence 6.2%) had attempted suicide
[...] Read more.
We examined the factors that affect suicide attempts adolescents multicultural families in South Korea. The participants were 727 adolescents whose mothers and/or fathers were born outside of South Korea (376 males and 351 females). Among them, 41 (weighted prevalence 6.2%) had attempted suicide during the last 12 months. Female gender, residence in large cities (compared with in rural areas), living with relatives/alone/with friends/in a dormitory or living in a facility (compared with living with family), high and low socio-economic status (compared with a middle level), high and low academic performance (compared with a middle level), severe perceived stress (compared with non-severe stress), conflicts with a teacher (compared with conflicts with parent), and foreign-father/-parent families (compared with foreign-mother family) were associated with increased odds of suicide attempt. The results indicate that greater awareness of the possibility of suicidal behavior is prudent for adolescents in multicultural families with certain risk factors, such as being from a foreign-parents family, living separately from the family, and having conflicts with a teacher. Full article
(This article belongs to the Special Issue From Understanding Suicide Risk to Preventing Suicide)
Open AccessArticle Anthropometric Measurements, Serum Reproductive Hormonal Levels and Sexual Development among Boys in the Rural Western Cape, South Africa
Int. J. Environ. Res. Public Health 2016, 13(12), 1185; doi:10.3390/ijerph13121185
Received: 23 September 2016 / Revised: 22 November 2016 / Accepted: 24 November 2016 / Published: 29 November 2016
PDF Full-text (294 KB) | HTML Full-text | XML Full-text
Abstract
Data on growth and sexual maturation among boys from the rural Western Cape in South Africa is limited. A cross-sectional study of 269 school boys was conducted testing for serum luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, sex hormone binding globulin (SHBG)
[...] Read more.
Data on growth and sexual maturation among boys from the rural Western Cape in South Africa is limited. A cross-sectional study of 269 school boys was conducted testing for serum luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, sex hormone binding globulin (SHBG) and estradiol (E2); height, weight and body mass index (BMI); sexual maturity (using Tanner Stages) and a questionnaire (demographic and medical history). The median age at pubertal onset (Tanner Stage 2) and Tanner Stage 5 was 11.6 and 14.7 years, respectively. The median testicular volume was 5.5 mL at Tanner Stage 2 increasing from 2.5 mL at Tanner Stage 1 to 14.7 mL at Tanner Stage 5. Height and weight measurements were <25th & 50th percentile references at Tanner Stages 1–3. Controlling for confounders, serum FSH and LH increased (p < 0.05) from Tanner Stage 1 to 4 (by 4.1 and 3 mL respectively), and serum testosterone and estradiol increased after Tanner Stage 2 (by 12.7 nmol/L and 59.5 pmol/L respectively). These results indicate some delays in pubertal development of boys in the rural Western Cape when compared to boys from other settings possibly due to nutritional, socio-economic and environmental exposures. Changes in serum hormone levels were consistent with other populations. Initiatives to improve nutrition amongst Western Cape rural communities are recommended. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Sleep in a Gymnasium: A Study to Examine the Psychophysiological and Environmental Conditions in Shelter-Analogue Settings
Int. J. Environ. Res. Public Health 2016, 13(12), 1186; doi:10.3390/ijerph13121186
Received: 27 August 2016 / Revised: 15 November 2016 / Accepted: 25 November 2016 / Published: 30 November 2016
PDF Full-text (1399 KB) | HTML Full-text | XML Full-text
Abstract
We aimed to examine sleep in shelter-analogue settings to determine the sleep and environmental conditions in evacuation shelters. A summer social/educational event was conducted in an elementary school, wherein children and their parents (n = 109) spent one night in the school
[...] Read more.
We aimed to examine sleep in shelter-analogue settings to determine the sleep and environmental conditions in evacuation shelters. A summer social/educational event was conducted in an elementary school, wherein children and their parents (n = 109) spent one night in the school gymnasium; a total of 15 children and 7 adults completed the study. Data were recording using wrist actigraphy and questionnaires, from two days before the event to two days after the event. During the night in the gymnasium, sleep initiation in the children was found to be significantly delayed, whereas adults did not show any significant change in actigraphic sleep parameters. Although 57% of adults complained of stiffness of the floor, only 7% of children had the same complaint. The nocturnal noise recorded at four locations in the gymnasium showed that the percentage of 1-min data epochs with a noise level >40 dB ranged from 53% to 74% during lights-out. The number of subjects that woke up during the night showed a similar pattern with the changes in the noise level. The changes in sleep might represent event-specific responses, such as to a noisy environment, and the different complaints between adults and children could be useful in shelter management. Full article
(This article belongs to the Special Issue The Evolving Relationship between Science and Disaster Risk Reduction)
Figures

Figure 1

Open AccessArticle Aniline Induces Oxidative Stress and Apoptosis of Primary Cultured Hepatocytes
Int. J. Environ. Res. Public Health 2016, 13(12), 1188; doi:10.3390/ijerph13121188
Received: 12 August 2016 / Revised: 17 November 2016 / Accepted: 26 November 2016 / Published: 30 November 2016
PDF Full-text (2379 KB) | HTML Full-text | XML Full-text
Abstract
The toxicity and carcinogenicity of aniline in humans and animals have been well documented. However, the molecular mechanism involved in aniline-induced liver toxicity and carcinogenesis remains unclear. In our research, primary cultured hepatocytes were exposed to aniline (0, 1.25, 2.50, 5.0 and 10.0
[...] Read more.
The toxicity and carcinogenicity of aniline in humans and animals have been well documented. However, the molecular mechanism involved in aniline-induced liver toxicity and carcinogenesis remains unclear. In our research, primary cultured hepatocytes were exposed to aniline (0, 1.25, 2.50, 5.0 and 10.0 μg/mL) for 24 h in the presence or absence of N-acetyl-l-cysteine (NAC). Levels of reactive oxygen species (ROS), malondialdehyde (MDA), and glutathione (GSH), activities of superoxide dismutase (SOD) and catalase (CAT), mitochondrial membrane potential, DNA damage, cell viability, and apoptosis were detected. Levels of ROS and MDA were significantly increased and levels of GSH and CAT, activity of SOD, and mitochondrial membrane potential in hepatocytes were significantly decreased by aniline compared with the negative control group. The tail moment and DNA content of the tail in exposed groups were significantly higher than those in the negative control group. Cell viability was reduced and apoptotic death was induced by aniline in a concentration-dependent manner. The phenomena of ROS generation, oxidative damage, loss of mitochondrial membrane potential, DNA damage and apoptosis could be prevented if ROS inhibitor NAC was added. ROS generation is involved in the loss of mitochondrial membrane potential and DNA injury, which may play a role in aniline-induced apoptosis in hepatocytes. Our study provides insight into the mechanism of aniline-induced toxicity and apoptosis of hepatocytes. Full article
Figures

Figure 1

Open AccessArticle Comparing Sanitation Delivery Modalities in Urban Informal Settlement Schools: A Randomized Trial in Nairobi, Kenya
Int. J. Environ. Res. Public Health 2016, 13(12), 1189; doi:10.3390/ijerph13121189
Received: 23 September 2016 / Revised: 31 October 2016 / Accepted: 25 November 2016 / Published: 30 November 2016
PDF Full-text (600 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The provision of safely managed sanitation in informal settlements is a challenge, especially in schools that require durable, clean, sex-segregated facilities for a large number of children. In informal settlements in Nairobi, school sanitation facilities demand considerable capital costs, yet are prone to
[...] Read more.
The provision of safely managed sanitation in informal settlements is a challenge, especially in schools that require durable, clean, sex-segregated facilities for a large number of children. In informal settlements in Nairobi, school sanitation facilities demand considerable capital costs, yet are prone to breakage and often unhygienic. The private sector may be able to provide quality facilities and services to schools at lower costs as an alternative to the sanitation that is traditionally provided by the government. We conducted a randomized trial comparing private sector service delivery (PSSD) of urine-diverting dry latrines with routine waste collection and maintenance and government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. The primary outcomes were facility maintenance, use, exposure to fecal contamination, and cost. Schools were followed for one school year. There were few differences in maintenance and pathogen exposure between PSSD and GSD toilets. Use of the PSSD toilets was 128% higher than GSD toilets, as measured with electronic motion detectors. The initial cost of private sector service delivery was USD 2053 (KES 210,000) per school, which was lower than the average cost of rehabilitating the government standard flush-type toilets (USD 9306 (KES 922,638)) and constructing new facilities (USD 114,889 (KES 1,169,668)). The private sector delivery of dry sanitation provided a feasible alternative to the delivery of sewage sanitation in Nairobi informal settlements and might elsewhere in sub-Saharan Africa. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Subchronic Toxicities of HZ1006, a Hydroxamate-Based Histone Deacetylase Inhibitor, in Beagle Dogs and Sprague-Dawley Rats
Int. J. Environ. Res. Public Health 2016, 13(12), 1190; doi:10.3390/ijerph13121190
Received: 21 September 2016 / Revised: 22 November 2016 / Accepted: 25 November 2016 / Published: 30 November 2016
PDF Full-text (8216 KB) | HTML Full-text | XML Full-text
Abstract
Histone deacetylase inhibitors (HDACIs), such as vorinostat and panobinostat, have been shown to have active effects on many hematologic malignancies, including multiple myeloma and cutaneous T-cell lymphoma. Hydroxamate-based (Hb) HDACIs have very good toxicity profiles and are currently being tested in phases I
[...] Read more.
Histone deacetylase inhibitors (HDACIs), such as vorinostat and panobinostat, have been shown to have active effects on many hematologic malignancies, including multiple myeloma and cutaneous T-cell lymphoma. Hydroxamate-based (Hb) HDACIs have very good toxicity profiles and are currently being tested in phases I and II clinical trials with promising results in selected neoplasms, such as bladder carcinoma. One of the Hb-HDACIs, HZ1006, has been demonstrated to be a promising drug for clinical use. The aim of our study was to determine the possible target of toxicity and to identify a non-toxic dose of HZ1006 for clinical use. In our studies, the repeated dosage toxicity of HZ1006 in Beagle dogs and Sprague Dawley (SD) rats was identified. Dogs and rats received HZ1006 orally (0–80 and 0–120 mg/kg/day, respectively) on a continuous daily dosing agenda for 28 days following a 14-day dosage-free period. HZ1006’s NOAEL (No Observed Adverse Effect Level) by daily oral administration for dogs and rats was 5 mg/kg and 60 mg/kg, respectively, and the minimum toxic dose was 20 and 120 mg/kg, respectively. All the side effects indicated that the digestive tract, the male reproductive tract, the respiratory tract and the hematological systems might be HZ1006 toxic targets in humans. HZ1006 could be a good candidate or a safe succedaneum to other existing HDACIs for the treatment of some solid tumor and hematologic malignancies. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle A Rapid, Accurate, and Efficient Method to Map Heavy Metal-Contaminated Soils of Abandoned Mine Sites Using Converted Portable XRF Data and GIS
Int. J. Environ. Res. Public Health 2016, 13(12), 1191; doi:10.3390/ijerph13121191
Received: 17 October 2016 / Revised: 22 November 2016 / Accepted: 25 November 2016 / Published: 1 December 2016
Cited by 1 | PDF Full-text (4816 KB) | HTML Full-text | XML Full-text
Abstract
The use of portable X-ray fluorescence (PXRF) and inductively coupled plasma atomic emission spectrometry (ICP-AES) increases the rapidity and accuracy of soil contamination mapping, respectively. In practice, it is often necessary to repeat the soil contamination assessment and mapping procedure several times during
[...] Read more.
The use of portable X-ray fluorescence (PXRF) and inductively coupled plasma atomic emission spectrometry (ICP-AES) increases the rapidity and accuracy of soil contamination mapping, respectively. In practice, it is often necessary to repeat the soil contamination assessment and mapping procedure several times during soil management within a limited budget. In this study, we have developed a rapid, inexpensive, and accurate soil contamination mapping method using a PXRF data and geostatistical spatial interpolation. To obtain a large quantity of high quality data for interpolation, in situ PXRF data analyzed at 40 points were transformed to converted PXRF data using the correlation between PXRF and ICP-AES data. The method was applied to an abandoned mine site in Korea to generate a soil contamination map for copper and was validated for investigation speed and prediction accuracy. As a result, regions that required soil remediation were identified. Our method significantly shortened the time required for mapping compared to the conventional mapping method and provided copper concentration estimates with high accuracy similar to those measured by ICP-AES. Therefore, our method is an effective way of mapping soil contamination if we consistently construct a database based on the correlation between PXRF and ICP-AES data. Full article
(This article belongs to the Special Issue Heavy Metals: Environmental and Human Health)
Figures

Figure 1

Open AccessArticle Health-Related Quality of Life and Associated Factors of Frontline Railway Workers: A Cross-Sectional Survey in the Ankang Area, Shaanxi Province, China
Int. J. Environ. Res. Public Health 2016, 13(12), 1192; doi:10.3390/ijerph13121192
Received: 12 September 2016 / Revised: 19 November 2016 / Accepted: 23 November 2016 / Published: 30 November 2016
PDF Full-text (692 KB) | HTML Full-text | XML Full-text
Abstract
After validation of the widely used health-related quality of life (HRQOL) generic measure, the Short Form 36 version 2 (SF-36v2), we investigated the HRQOL and associated factors of frontline railway workers in China. Ground workers, conductors, and train drivers were selected from Ankang
[...] Read more.
After validation of the widely used health-related quality of life (HRQOL) generic measure, the Short Form 36 version 2 (SF-36v2), we investigated the HRQOL and associated factors of frontline railway workers in China. Ground workers, conductors, and train drivers were selected from Ankang Precinct by using a stratified cluster sampling technique. A total of 784 frontline railway workers participated in the survey. The reliability and validity of SF-36v2 was satisfactory. The physical component summary (PCS) scores of three subgroups attained the average range for the USA general population, whereas the mental component summary (MCS) scores were well below the range. Most domains scored below the norm, except for the physical functioning (PF) domain. Among three subgroups, train drivers reported significantly lower scores on MCS and six health domains (excluding PF and bodily pain (BP)). After controlled confounders, conductors had significantly higher PCS and MCS scores than ground workers. There is heterogeneity on risk factors among three subgroups, but having long or irregular working schedules was negatively associated with HRQOL in all subgroups. SF-36v2 is a reliable and valid HRQOL measurement in railway workers in China. The frontline railway workers’ physical health was comparative to American norms, whilst mental health was relatively worse. Long or irregular working schedules were the most important factors. Full article
Figures

Figure 1

Open AccessArticle Associations between Meteorological Factors and Aseptic Meningitis in Six Metropolitan Provinces of the Republic of Korea
Int. J. Environ. Res. Public Health 2016, 13(12), 1193; doi:10.3390/ijerph13121193
Received: 2 October 2016 / Revised: 21 November 2016 / Accepted: 22 November 2016 / Published: 30 November 2016
PDF Full-text (3256 KB) | HTML Full-text | XML Full-text
Abstract
We assessed the association between climate factors and a number of aseptic meningitis cases in six metropolitan provinces of the Republic of Korea using a weekly number of cases from January 2002 to December 2012. Generalized linear quasi-Poisson models were applied to estimate
[...] Read more.
We assessed the association between climate factors and a number of aseptic meningitis cases in six metropolitan provinces of the Republic of Korea using a weekly number of cases from January 2002 to December 2012. Generalized linear quasi-Poisson models were applied to estimate the effects of climate factors on the weekly number of aseptic meningitis cases. We used generalized additive and generalized additive mixed models to assess dose–response relationships. A 1 °C increase in mean temperature was associated with an 11.4% (95% confidence interval (CI): 9.6%–13.3%) increase in aseptic meningitis with a 0-week lag; a 10 mm rise in rainfall was associated with an 8.0% (95% CI: 7.2%–8.8%) increase in aseptic meningitis with a 7-week lag; and a 1 mJ/m2 increase of solar radiation was associated with a 5.8% (95% CI: 3.0%–8.7%) increase in aseptic meningitis with a 10-week lag. Nino3 showed positive effects in all lags, and its one unit increase was associated with an 18.9% (95% CI: 15.3%–22.6%) increase of aseptic meningitis at lag 9. The variability in the relationship between climate factors and aseptic meningitis could be used to initiate preventive measures for climate determinants of aseptic meningitis. Full article
(This article belongs to the Special Issue Emerging Infectious Diseases and Environmental Threats)
Figures

Figure 1

Open AccessArticle Immunogenetic Markers Definition in Latvian Patients with Lyme Borreliosis and Lyme Neuroborreliosis
Int. J. Environ. Res. Public Health 2016, 13(12), 1194; doi:10.3390/ijerph13121194
Received: 3 October 2016 / Revised: 16 November 2016 / Accepted: 22 November 2016 / Published: 1 December 2016
PDF Full-text (300 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this study was to determine the human leukocyte antigen (HLA)-DRB1 alleles in two groups of patients in Latvia: patients with Lyme borreliosis and patients with Lyme neuroborreliosis. The study included 216 patients with Lyme borreliosis, 29 patients with Lyme neuroborreliosis
[...] Read more.
The aim of this study was to determine the human leukocyte antigen (HLA)-DRB1 alleles in two groups of patients in Latvia: patients with Lyme borreliosis and patients with Lyme neuroborreliosis. The study included 216 patients with Lyme borreliosis, 29 patients with Lyme neuroborreliosis and 282 control persons. All surveyed persons were residents of Latvia. The HLA-DR genotyping was performed by polymerase chain reaction- sequence specific primer (PCR-SSP). The predisposition to the Lyme borreliosis is associated with the HLA-DRB1*07, -DRB1*17(03), -DRB1*04, -DRB1*15(02) alleles. The allele -DRB1*11(05), -DRB1*14(06) and -DRB1*13(06) were significantly more frequent in controls. In-group with Lyme neuroborreliosis differences were found for the -DRB1*07 and -DRB1*04 alleles, but only HLA-DRB1*07 allele was statistically significant after Bonferroni correction and associated with Lyme neuroborreliosis in Latvian patients. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey
Int. J. Environ. Res. Public Health 2016, 13(12), 1195; doi:10.3390/ijerph13121195
Received: 28 September 2016 / Revised: 11 November 2016 / Accepted: 23 November 2016 / Published: 2 December 2016
Cited by 1 | PDF Full-text (539 KB) | HTML Full-text | XML Full-text
Abstract
Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households
[...] Read more.
Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48%) had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women’s perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups–older unmarried women, smokers, those less educated and who are generally not much concerned with their health. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Parity, Age at First Birth, and Risk of Death from Bladder Cancer: A Population-Based Cohort Study in Taiwan
Int. J. Environ. Res. Public Health 2016, 13(12), 1197; doi:10.3390/ijerph13121197
Received: 11 October 2016 / Revised: 23 November 2016 / Accepted: 23 November 2016 / Published: 2 December 2016
PDF Full-text (517 KB) | HTML Full-text | XML Full-text
Abstract
The evidence is limited on the relationship between reproductive factors and bladder cancer (BC). We studied 1,292,462 women who had a first and singleton delivery between 1 January 1978 and 31 December 1987. Each woman in the study cohort was tracked from their
[...] Read more.
The evidence is limited on the relationship between reproductive factors and bladder cancer (BC). We studied 1,292,462 women who had a first and singleton delivery between 1 January 1978 and 31 December 1987. Each woman in the study cohort was tracked from their first childbirth to 31 December 2009. Vital status of the women was determined by crosswalking records with a computerized mortality database. We used Cox proportional hazard regression models to estimate the hazard ratios (HRs) of death from BC associated with maternal age at first birth and parity. The data showed 63 BC deaths during 34,980,246 person-years of follow-up. BC mortality rate was 0.90 cases for every 100,000 person-years. Compared with women who gave birth under the age of 23, the adjusted HR was 1.24 (95% confidence interval (CI) = 0.66–2.35) for women who gave birth between age 23 and 26 and 2.30 (95% CI = 1.21–4.39) for women who gave birth over the age of 26. Increasing age at first birth (p for trend = 0.01) is associated with a trend in increasing risk of BC mortality. Relative to women who had a single childbirth, the adjusted HRs were 1.17 (95% CI = 0.51–2.69) for women who gave birth to two children, and 1.31 (95% CI = 0.56–3.10) for women with three or more childbirths, respectively. These results were not statistically significant. Study results suggests that giving birth at an early age may confer a protective effect on the risk of death from BC. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Evaluating a Website to Teach Children Safety with Dogs: A Randomized Controlled Trial
Int. J. Environ. Res. Public Health 2016, 13(12), 1198; doi:10.3390/ijerph13121198
Received: 31 August 2016 / Revised: 3 November 2016 / Accepted: 23 November 2016 / Published: 2 December 2016
Cited by 1 | PDF Full-text (12318 KB) | HTML Full-text | XML Full-text
Abstract
Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A
[...] Read more.
Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A randomized controlled trial was conducted with 69 children aged 4–5 randomly assigned to use the dog safety website or a control transportation safety website for ~3 weeks. Assessment of dog safety knowledge and behavior plus skill in three relevant cognitive constructs (impulse control, noticing details, and perspective-taking) was conducted both at baseline and following website use. The dog safety website incorporated interactive games, instructional videos including testimonials, a motivational rewards system, and messaging to parents concerning child lessons. Our results showed that about two-thirds of the intervention sample was not adherent to website use at home, so both intent-to-treat and per-protocol analyses were conducted. Intent-to-treat analyses yielded mostly null results. Per-protocol analyses suggested children compliant to the intervention protocol scored higher on knowledge and recognition of safe behavior with dogs following the intervention compared to the control group. Adherent children also had improved scores post-intervention on the cognitive skill of noticing details compared to the control group. We concluded that young children’s immature cognition can lead to dog bites. Interactive eHealth training on websites shows potential to teach children relevant cognitive and safety skills to reduce risk. Compliance to website use is a challenge, and some relevant cognitive skills (e.g., noticing details) may be more amenable to computer-based training than others (e.g., impulse control). Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle The Current Situation of Hypertension among Rural Minimal Assurance Family Participants in Liaoning (China): A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2016, 13(12), 1199; doi:10.3390/ijerph13121199
Received: 4 September 2016 / Revised: 8 November 2016 / Accepted: 28 November 2016 / Published: 2 December 2016
PDF Full-text (1727 KB) | HTML Full-text | XML Full-text
Abstract
In China, the prevalence of hypertension is increasing and is showing an epidemic accelerating trend. However, there is a lack of studies reporting the hypertension status of rural residents with minimum living allowances. We performed a cross-sectional study including 11,435 (5285 men and
[...] Read more.
In China, the prevalence of hypertension is increasing and is showing an epidemic accelerating trend. However, there is a lack of studies reporting the hypertension status of rural residents with minimum living allowances. We performed a cross-sectional study including 11,435 (5285 men and 6150 women) from the general population aged ≥35 years in the Liaoning Province of China from 2012 to 2013, of which 1258 (11.0%) participants came from minimal assurance families. Anthropometric measurements, laboratory examinations and self-reported lifestyle factor information were collected by trained personnel. Multivariate logistic regression was used to detect the association between socioeconomic status (SES) and the risk of hypertension. We found that the prevalence of hypertension was as high as 61.9% in participants from minimal assurance families and the odd ratio for hypertension was 1.32 (95% CI: 1.15–1.52). The awareness, treatment, and control rates among treated hypertensive participants did not increase with higher level of income and education. In the total sample, the lower income levels increased the risk for hypertension, but education didn’t show a significant association with hypertension. Thus, there is a severe hypertension situation in the Liaoning rural population of minimal assurance families, which need more attention and prevention and control measures for hypertension. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Indoor Air Quality in the Metro System in North Taiwan
Int. J. Environ. Res. Public Health 2016, 13(12), 1200; doi:10.3390/ijerph13121200
Received: 26 September 2016 / Revised: 28 November 2016 / Accepted: 29 November 2016 / Published: 2 December 2016
Cited by 2 | PDF Full-text (1261 KB) | HTML Full-text | XML Full-text
Abstract
Indoor air pollution is an increasing health concern, especially in enclosed environments such as underground subway stations because of increased global usage by urban populations. This study measured the indoor air quality of underground platforms at 10 metro stations of the Taipei Rapid
[...] Read more.
Indoor air pollution is an increasing health concern, especially in enclosed environments such as underground subway stations because of increased global usage by urban populations. This study measured the indoor air quality of underground platforms at 10 metro stations of the Taipei Rapid Transit system (TRTS) in Taiwan, including humidity, temperature, carbon monoxide (CO), carbon dioxide (CO2), formaldehyde (HCHO), total volatile organic compounds (TVOCs), ozone (O3), airborne particulate matter (PM10 and PM2.5), bacteria and fungi. Results showed that the CO2, CO and HCHO levels met the stipulated standards as regulated by Taiwan’s Indoor Air Quality Management Act (TIAQMA). However, elevated PM10 and PM2.5 levels were measured at most stations. TVOCs and bacterial concentrations at some stations measured in summer were higher than the regulated standards stipulated by Taiwan’s Environmental Protection Administration. Further studies should be conducted to reduce particulate matters, TVOCs and bacteria in the air of subway stations. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
Figures

Figure 1a

Open AccessArticle Hazard Management Dealt by Safety Professionals in Colleges: The Impact of Individual Factors
Int. J. Environ. Res. Public Health 2016, 13(12), 1201; doi:10.3390/ijerph13121201
Received: 30 August 2016 / Revised: 24 November 2016 / Accepted: 28 November 2016 / Published: 3 December 2016
PDF Full-text (319 KB) | HTML Full-text | XML Full-text
Abstract
Identifying, evaluating, and controlling workplace hazards are important functions of safety professionals (SPs). The purpose of this study was to investigate the content and frequency of hazard management dealt by safety professionals in colleges. The authors also explored the effects of organizational factors/individual
[...] Read more.
Identifying, evaluating, and controlling workplace hazards are important functions of safety professionals (SPs). The purpose of this study was to investigate the content and frequency of hazard management dealt by safety professionals in colleges. The authors also explored the effects of organizational factors/individual factors on SPs’ perception of frequency of hazard management. The researchers conducted survey research to achieve the objective of this study. The researchers mailed questionnaires to 200 SPs in colleges after simple random sampling, then received a total of 144 valid responses (response rate = 72%). Exploratory factor analysis indicated that the hazard management scale (HMS) extracted five factors, including physical hazards, biological hazards, social and psychological hazards, ergonomic hazards, and chemical hazards. Moreover, the top 10 hazards that the survey results identified that safety professionals were most likely to deal with (in order of most to least frequent) were: organic solvents, illumination, other chemicals, machinery and equipment, fire and explosion, electricity, noise, specific chemicals, human error, and lifting/carrying. Finally, the results of one-way multivariate analysis of variance (MANOVA) indicated there were four individual factors that impacted the perceived frequency of hazard management which were of statistical and practical significance: job tenure in the college of employment, type of certification, gender, and overall job tenure. SPs within colleges and industries can now discuss plans revolving around these five areas instead of having to deal with all of the separate hazards. Full article
(This article belongs to the Special Issue Effecting a Safe and Healthy Environment in Construction)
Open AccessArticle High Contributions of Secondary Inorganic Aerosols to PM2.5 under Polluted Levels at a Regional Station in Northern China
Int. J. Environ. Res. Public Health 2016, 13(12), 1202; doi:10.3390/ijerph13121202
Received: 26 October 2016 / Revised: 28 November 2016 / Accepted: 30 November 2016 / Published: 15 December 2016
Cited by 1 | PDF Full-text (3615 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Daily PM2.5 samples were collected at Shangdianzi (SDZ) regional site in Beijing–Tianjin–Hebei (BTH) region in 2015. Samples were subject to chemical analysis for organic carbon (OC), elemental carbon (EC), and major water-soluble inorganic ions. The annual average PM2.5 mass concentration was
[...] Read more.
Daily PM2.5 samples were collected at Shangdianzi (SDZ) regional site in Beijing–Tianjin–Hebei (BTH) region in 2015. Samples were subject to chemical analysis for organic carbon (OC), elemental carbon (EC), and major water-soluble inorganic ions. The annual average PM2.5 mass concentration was 53 ± 36 μg·m−3 with the highest seasonal average concentration in spring and the lowest in summer. Water-soluble inorganic ions and carbonaceous aerosols accounted for 34% ± 15% and 33% ± 9%, respectively, of PM2.5 mass on annual average. The excellent, good, lightly polluted, moderately polluted, and heavily polluted days based on the Air Quality Index (AQI) of PM2.5 accounted for 40%, 42%, 11%, 4%, and 3%, respectively, of the year. The sum of the average concentration of sulfate, nitrate, and ammonium (SNA) increased from 4.2 ± 2.9 μg·m−3 during excellent days to 85.9 ± 22.4 μg·m−3 during heavily polluted days, and their contributions to PM2.5 increased from 15% ± 8% to 49% ± 10% accordingly. In contrast, the average concentration of carbonaceous aerosols increased from 9.2 ± 2.8 μg·m−3 to 51.2 ± 14.1 μg·m−3, and their contributions to PM2.5 decreased from 34% ± 6% to 29% ± 7%. Potential source contribution function (PSCF) analysis revealed that the major sources for high PM2.5 and its dominant chemical components were within the area mainly covering Shandong, Henan, and Hebei provinces. Regional pollutant transport from Shanxi province and Inner Mongolia autonomous region located in the west direction of SDZ was also important during the heating season. Full article
(This article belongs to the Special Issue Environmental Pollution and Human Health Risk)
Figures

Figure 1

Open AccessArticle Association between the Osteoporosis Self-Assessment Tool for Asians Score and Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis
Int. J. Environ. Res. Public Health 2016, 13(12), 1203; doi:10.3390/ijerph13121203
Received: 18 October 2016 / Revised: 30 November 2016 / Accepted: 30 November 2016 / Published: 3 December 2016
PDF Full-text (536 KB) | HTML Full-text | XML Full-text
Abstract
Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study
[...] Read more.
Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014. Patients were categorized as high-risk (OSTA score < −4; n = 849), medium-risk (−4 ≤ OSTA score ≤ −1; n = 1647), or low-risk (OSTA score > −1; n = 5359). Two-sided Pearson’s chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann-Whitney U test were performed to analyze normally and non-normally distributed continuous data, respectively. Propensity score-matching in a 1:1 ratio was performed using NCSS software, with adjustment for covariates. Results: Compared to low-risk patients, high- and medium-risk patients were significantly older and injured more severely. The high- and medium-risk patients had significantly higher mortality rates, longer hospital length of stay, and a higher proportion of admission to the intensive care unit than low-risk patients. Analysis of propensity score-matched patients with adjusted covariates, including gender, co-morbidity, blood alcohol concentration level, Glasgow Coma Scale score, and Injury Severity Score revealed that high- and medium-risk patients still had a 2.4-fold (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.39–4.15; p = 0.001) and 1.8-fold (OR, 1.8; 95% CI, 1.19–2.86; p = 0.005) higher mortality, respectively, than low-risk patients. However, further addition of age as a covariate for the propensity score-matching demonstrated that there was no significant difference between high-risk and low-risk patients or between medium-risk and low-risk patients, implying that older age may contribute to the significantly higher mortality associated with a lower OSTA score. Conclusions: Older age may be able to explain the association of lower OSTA score and higher mortality rates in patients with isolated moderate and severe TBI. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Regional Correlates of Psychiatric Inpatient Treatment
Int. J. Environ. Res. Public Health 2016, 13(12), 1204; doi:10.3390/ijerph13121204
Received: 21 September 2016 / Revised: 13 November 2016 / Accepted: 30 November 2016 / Published: 5 December 2016
PDF Full-text (1106 KB) | HTML Full-text | XML Full-text
Abstract
Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient
[...] Read more.
Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Parks and Green Areas Are Associated with Decreased Risk for Hyperlipidemia
Int. J. Environ. Res. Public Health 2016, 13(12), 1205; doi:10.3390/ijerph13121205
Received: 28 July 2016 / Revised: 10 November 2016 / Accepted: 21 November 2016 / Published: 3 December 2016
Cited by 1 | PDF Full-text (1090 KB) | HTML Full-text | XML Full-text
Abstract
This study aimed to investigate the association between parks and green areas and hyperlipidemia in adults with groups stratified by moderate physical activity as a behavioral modification using the 2009 Korean Community Health Survey data and 212,584 participants enrolled in this study. The
[...] Read more.
This study aimed to investigate the association between parks and green areas and hyperlipidemia in adults with groups stratified by moderate physical activity as a behavioral modification using the 2009 Korean Community Health Survey data and 212,584 participants enrolled in this study. The geographical codes of study participants were all matched on the basis of the amount of parks and green areas in each administrative district. Compared with participants living in the highest quartile of parks and green areas (Quartile 4), those living in the lowest quartile of green and park area (Quartile 1) were at an increased risk of physician-diagnosed hyperlipidemia and hyperlipidemia currently under treatment. Participants in the lowest quartile of parks and green areas were likely not to engage in any moderate physical activity. After classifying hyperlipidemia risk depending on the presence of moderate physical activity, those participating in moderate physical activity were less likely to have hyperlipidemia in all quartiles of parks and green areas than those not engaging in moderate physical activity. We found that parks and green areas were associated with decreased hyperlipidemia risk. Physical activity, which may benefit from the presence of parks and green areas, may reduce hyperlipidemia risk. Full article
Figures

Figure 1

Open AccessArticle Antenatal Dexamethasone Exposure in Preterm Infants Is Associated with Allergic Diseases and the Mental Development Index in Children
Int. J. Environ. Res. Public Health 2016, 13(12), 1206; doi:10.3390/ijerph13121206
Received: 6 October 2016 / Revised: 16 November 2016 / Accepted: 1 December 2016 / Published: 3 December 2016
Cited by 1 | PDF Full-text (545 KB) | HTML Full-text | XML Full-text
Abstract
Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to
[...] Read more.
Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to investigate the association between antenatal dexamethasone and T cell expression in childhood allergic diseases. Methods: We recruited a cohort of preterm infants born at Kaohsiung Chang Gung Memorial Hospital between 2007 and 2010 with a gestational age of less than 35 weeks and body weight at birth of less than 1500 g. The status of antenatal exposure to steroids and allergic diseases were surveyed using a modified ISAAC questionnaire for subjects aged 2–5 years old. We analyzed Th1/Th2/Th17 expression of mRNA, cytokines (using the Magpix® my-system), and mental development index (MDI). Results: Among the 40 patients that were followed, the data showed that the antenatal dexamethasone exposure group (N = 24) had a significantly higher incidence of allergic diseases (75.0% vs. 18.8%, p < 0.0001) when compared to the non-dexamethasone exposure group (N = 16), especially with regard to asthma (41.7% vs. 0.0%, p = 0.003) and allergic rhinitis (58.3% vs. 18.8%, p = 0.013), but not atopic dermatitis. No statistical difference was observed in the mRNA expression levels of total white blood cell count between the dexamethasone exposure and non-exposure groups (p > 0.05). However, the asthma group had higher IL-5 levels (p = 0.009), and the MDI was shown to be significantly higher in the dexamethasone exposure group (90.38 ± 3.31 vs. 79.94 ± 3.58, p = 0.043) while no significant difference was found between the PDI of the two groups. Conclusions: Exposure to antenatal dexamethasone in preterm infants will increase their susceptibility to allergic diseases, particularly asthma and allergic rhinitis. Preterm infants’ exposure to antenatal dexamethasone also results in higher MDI scores. Such increases in allergic diseases may be related to increased IL-5 and IL-10 levels. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Figures

Figure 1

Open AccessArticle Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men
Int. J. Environ. Res. Public Health 2016, 13(12), 1208; doi:10.3390/ijerph13121208
Received: 23 September 2016 / Revised: 10 November 2016 / Accepted: 30 November 2016 / Published: 5 December 2016
PDF Full-text (3860 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for
[...] Read more.
Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1a

Open AccessArticle Association among Complement Factor H Autoantibodies, Deletions of CFHR, and the Risk of Atypical Hemolytic Uremic Syndrome
Int. J. Environ. Res. Public Health 2016, 13(12), 1209; doi:10.3390/ijerph13121209
Received: 19 September 2016 / Revised: 22 November 2016 / Accepted: 25 November 2016 / Published: 5 December 2016
PDF Full-text (1374 KB) | HTML Full-text | XML Full-text
Abstract
To evaluate the association among complement factor H-related (CFHRs) gene deficiency, complement factor H (CFH) autoantibodies, and atypical hemolytic uremic syndrome (aHUS) susceptibility. EMBASE, PubMed, and the ISI Web of Science databases were searched for all eligible studies on the relationship
[...] Read more.
To evaluate the association among complement factor H-related (CFHRs) gene deficiency, complement factor H (CFH) autoantibodies, and atypical hemolytic uremic syndrome (aHUS) susceptibility. EMBASE, PubMed, and the ISI Web of Science databases were searched for all eligible studies on the relationship among CFHRs deficiency, anti-FH autoantibodies, and aHUS risk. Eight case-control studies with 927 cases and 1182 controls were included in this study. CFHR1 deficiency was significantly associated with an increased risk of aHUS (odds ratio (OR) = 3.61, 95% confidence interval (95% CI), 1.96, 6.63, p < 0.001), while no association was demonstrated in individuals with only CFHR1/R3 deficiency (OR = 1.32, 95% CI, 0.50, 3.50, p = 0.56). Moreover, a more significant correlation was observed in people with both FH-anti autoantibodies and CFHR1 deficiency (OR = 11.75, 95% CI, 4.53, 30.44, p < 0.001) in contrast to those with only CFHR1 deficiency. In addition, the results were essentially consistent among subgroups stratified by study quality, ethnicity, and gene detection methods. The present meta-analysis indicated that CFHR1 deletion was significantly associated with the risk of aHUS, particularly when combined with anti-FH autoantibodies, indicating that potential interactions among CFHR1 deficiency and anti-FH autoantibodies might impact the risk of aHUS. Full article
Figures

Figure 1

Open AccessArticle The Self-Regulation Model of Illness: Comparison between Zika and Dengue and Its Application to Predict Mosquito Prevention Behaviours in Malaysia, a Dengue-Endemic Country
Int. J. Environ. Res. Public Health 2016, 13(12), 1210; doi:10.3390/ijerph13121210
Received: 6 October 2016 / Revised: 11 November 2016 / Accepted: 21 November 2016 / Published: 6 December 2016
Cited by 2 | PDF Full-text (307 KB) | HTML Full-text | XML Full-text
Abstract
Perceptions about illnesses may influence self-care and preventive health behaviours. Illness perceptions of the Zika virus (ZIKV) infection were investigated under the framework of the Self-Regulation Model of Illness. Illness perception differences between ZIKV and dengue fever were also examined. Lastly, associations between
[...] Read more.
Perceptions about illnesses may influence self-care and preventive health behaviours. Illness perceptions of the Zika virus (ZIKV) infection were investigated under the framework of the Self-Regulation Model of Illness. Illness perception differences between ZIKV and dengue fever were also examined. Lastly, associations between illness perceptions of ZIKV with mosquito prevention practices were studied. Samples were drawn from landline telephone numbers using computer-assisted telephone interviewing in Malaysia. A total of 567 respondents completed the survey occurred over a 4-month period between February and May 2016. The median and interquartile range (IQR) for the total six dimensions of illness perceptions score was higher for dengue (23.0 (IQR 17.0–28.0)) than ZIKV (20.0 (IRQ 11.0–28.0)), p < 0.001. Respondents who planned to have children (OR 1.670, 95% CI 1.035–2.694 vs. no intention to have children) and had friends or acquaintances who died of dengue (OR 2.372, 95% CI 1.300–4.327 vs. no friends who died of dengue) were more likely to have a higher total score for six illness perceptions for ZIKV compared to dengue. Multivariate analysis indicated that the best predictors for mosquito control practices after the ZIKV outbreak was declared a Public Health Emergency of International Concern, in descending order, were causes, control, timeline, and consequences dimensions of illness perception. Understanding the context in which a person perceives ZIKV may contribute to developing interventions that influence prevention behaviours. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Oxidative Stress and Genotoxicity of Long-Term Occupational Exposure to Low Levels of BTEX in Gas Station Workers
Int. J. Environ. Res. Public Health 2016, 13(12), 1212; doi:10.3390/ijerph13121212
Received: 6 September 2016 / Revised: 13 November 2016 / Accepted: 17 November 2016 / Published: 6 December 2016
Cited by 1 | PDF Full-text (290 KB) | HTML Full-text | XML Full-text
Abstract
Atmospheric benzene, toluene, ethylbenzene, and xylenes (BTEX) can lead to multiple health injuries. However, what remains uncertain is the effect of long-term exposure to low levels of BTEX. Thus, we determined the BTEX levels in the air from the refueling and office areas
[...] Read more.
Atmospheric benzene, toluene, ethylbenzene, and xylenes (BTEX) can lead to multiple health injuries. However, what remains uncertain is the effect of long-term exposure to low levels of BTEX. Thus, we determined the BTEX levels in the air from the refueling and office areas in gas stations. Then we collected workers’ (200 refueling vs. 52 office workers) peripheral blood samples to analyze the serum total-superoxide dismutase (T-SOD), glutathione (GSH), malondialdehyde (MDA), and 8-hydroxydeoxyguanosine (8-OHdG) levels. DNA damage was analyzed by the comet assay and micronucleus test in buccal epithelial cells. We found that the levels of BTEX in refueling areas were significantly higher than those in office areas (p < 0.001). The serum T-SOD and GSH of refueling workers were significantly lower than those in office workers (p < 0.001). By contrast, the serum MDA and 8-OHdG of refueling workers were significantly higher than those of office workers (p < 0.001, MDA; p = 0.025, 8-OHdG). Furthermore, tail and Olive tail moments in refueling workers were longer (p = 0.004, tail moment; p = 0.001, Olive tail moment), and the micronucleus rate was higher (p < 0.001) than those in office workers. Taken together, long-term exposure to low levels of BTEX may reduce the antioxidant ability and increase the risk of DNA damage in refueling workers of gas stations. Full article
Open AccessArticle Predicting Driver Behavior during the Yellow Interval Using Video Surveillance
Int. J. Environ. Res. Public Health 2016, 13(12), 1213; doi:10.3390/ijerph13121213
Received: 31 August 2016 / Revised: 21 November 2016 / Accepted: 29 November 2016 / Published: 6 December 2016
PDF Full-text (2297 KB) | HTML Full-text | XML Full-text
Abstract
At a signalized intersection, drivers must make a stop/go decision at the onset of the yellow signal. Incorrect decisions would lead to red light running (RLR) violations or crashes. This study aims to predict drivers’ stop/go decisions and RLR violations during yellow intervals.
[...] Read more.
At a signalized intersection, drivers must make a stop/go decision at the onset of the yellow signal. Incorrect decisions would lead to red light running (RLR) violations or crashes. This study aims to predict drivers’ stop/go decisions and RLR violations during yellow intervals. Traffic data such as vehicle approaching speed, acceleration, distance to the intersection, and occurrence of RLR violations are gathered by a Vehicle Data Collection System (VDCS). An enhanced Gaussian Mixture Model (GMM) is used to extract moving vehicles from target lanes, and the Kalman Filter (KF) algorithm is utilized to acquire vehicle trajectories. The data collected from the VDCS are further analyzed by a sequential logit model, and the relationship between drivers’ stop/go decisions and RLR violations is identified. The results indicate that the distance of vehicles to the stop line at the onset of the yellow signal is an important predictor for both drivers’ stop/go decisions and RLR violations. In addition, vehicle approaching speed is a contributing factor for stop/go decisions. Furthermore, the accelerations of vehicles after the onset of the yellow signal are positively related to RLR violations. The findings of this study can be used to predict the probability of drivers’ RLR violations and improve traffic safety at signalized intersections. Full article
(This article belongs to the Special Issue Traffic Safety and Injury Prevention)
Figures

Figure 1

Open AccessArticle Knowledge, Attitudes and Behaviours of Healthcare Workers in the Kingdom of Saudi Arabia to MERS Coronavirus and Other Emerging Infectious Diseases
Int. J. Environ. Res. Public Health 2016, 13(12), 1214; doi:10.3390/ijerph13121214
Received: 21 September 2016 / Revised: 14 November 2016 / Accepted: 25 November 2016 / Published: 6 December 2016
PDF Full-text (884 KB) | HTML Full-text | XML Full-text
Abstract
Background: The Kingdom of Saudi Arabia has experienced a prolonged outbreak of Middle East Respiratory Syndrome (MERS) coronavirus since 2012. Healthcare workers (HCWs) form a significant risk group for infection. Objectives: The aim of this survey was to assess the knowledge,
[...] Read more.
Background: The Kingdom of Saudi Arabia has experienced a prolonged outbreak of Middle East Respiratory Syndrome (MERS) coronavirus since 2012. Healthcare workers (HCWs) form a significant risk group for infection. Objectives: The aim of this survey was to assess the knowledge, attitudes, infection control practices and educational needs of HCWs in the Kingdom of Saudi Arabia to MERS coronavirus and other emerging infectious diseases. Methods: 1500 of HCWs from Saudi Ministry of Health were invited to fill a questionnaire developed to cover the survey objectives from 9 September 2015 to 8 November 2015. The response rate was about 81%. Descriptive statistics was used to summarise the responses. Results: 1216 HCWs were included in this survey. A total of 56.5% were nurses and 22% were physicians. The most common sources of MERS-coronavirus (MERS-CoV) information were the Ministry of Health (MOH) memo (74.3%). Only (47.6%) of the physicians, (30.4%) of the nurses and (29.9%) of the other HCWs were aware that asymptomatic MERS-CoV was described. Around half of respondents who having been investigated for MERS-CoV reported that their work performance decreased while they have suspicion of having MERS-CoV and almost two thirds reported having psychological problems during this period. Almost two thirds of the HCWs (61.2%) reported anxiety about contracting MERS-CoV from patients. Conclusions: The knowledge about emerging infectious diseases was poor and there is need for further education and training programs particularly in the use of personal protective equipment, isolation and infection control measures. The self-reported infection control practices were sub-optimal and seem to be overestimated. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Ground Level PM2.5 Estimates over China Using Satellite-Based Geographically Weighted Regression (GWR) Models Are Improved by Including NO2 and Enhanced Vegetation Index (EVI)
Int. J. Environ. Res. Public Health 2016, 13(12), 1215; doi:10.3390/ijerph13121215
Received: 21 September 2016 / Revised: 30 November 2016 / Accepted: 5 December 2016 / Published: 7 December 2016
Cited by 2 | PDF Full-text (3442 KB) | HTML Full-text | XML Full-text
Abstract
Highly accurate data on the spatial distribution of ambient fine particulate matter (<2.5 μm: PM2.5) is currently quite limited in China. By introducing NO2 and Enhanced Vegetation Index (EVI) into the Geographically Weighted Regression (GWR) model, a newly developed GWR
[...] Read more.
Highly accurate data on the spatial distribution of ambient fine particulate matter (<2.5 μm: PM2.5) is currently quite limited in China. By introducing NO2 and Enhanced Vegetation Index (EVI) into the Geographically Weighted Regression (GWR) model, a newly developed GWR model combined with a fused Aerosol Optical Depth (AOD) product and meteorological parameters could explain approximately 87% of the variability in the corresponding PM2.5 mass concentrations. There existed obvious increase in the estimation accuracy against the original GWR model without NO2 and EVI, where cross-validation R2 increased from 0.77 to 0.87. Both models tended to overestimate when measurement is low and underestimate when high, where the exact boundary value depended greatly on the dependent variable. There was still severe PM2.5 pollution in many residential areas until 2015; however, policy-driven energy conservation and emission reduction not only reduced the severity of PM2.5 pollution but also its spatial range, to a certain extent, from 2014 to 2015. The accuracy of satellite-derived PM2.5 still has limitations for regions with insufficient ground monitoring stations and desert areas. Generally, the use of NO2 and EVI in GWR models could more effectively estimate PM2.5 at the national scale than previous GWR models. The results in this study could provide a reasonable reference for assessing health impacts, and could be used to examine the effectiveness of emission control strategies under implementation in China. Full article
Figures

Figure 1

Open AccessArticle Estimation of Saliva Cotinine Cut-Off Points for Active and Passive Smoking during Pregnancy—Polish Mother and Child Cohort (REPRO_PL)
Int. J. Environ. Res. Public Health 2016, 13(12), 1216; doi:10.3390/ijerph13121216
Received: 18 October 2016 / Revised: 23 November 2016 / Accepted: 28 November 2016 / Published: 8 December 2016
Cited by 1 | PDF Full-text (561 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women
[...] Read more.
A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women from the Polish Mother and Child Cohort. Saliva cotinine concentrations were assessed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS). The saliva cotinine cut-off value for active smoking was established at 10 ng/mL (sensitivity 96%, specificity 95%) and for passive smoking at 1.5 ng/mL (sensitivity 63%, specificity 71%). About 5% of the self-reported non-smoking women were classified as smokers based on the cotinine cut-off value. Significantly more younger, single, and less educated self-reported non-smokers had a cotinine concentration higher than 10 ng/mL compared to those who were older, married, and who had a university degree. Close to 30% of the non-smokers who indicated that smoking was not allowed in their home could be classified as exposed to passive smoking based on the cut-off value. The study suggests that self-reported smoking status is a valid measure of active smoking, whereas in the case of passive smoking, a combination of questionnaire data and biomarker verification may be required. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
Figures

Figure 1

Open AccessArticle The Impact of Greenspace on Thermal Comfort in a Residential Quarter of Beijing, China
Int. J. Environ. Res. Public Health 2016, 13(12), 1217; doi:10.3390/ijerph13121217
Received: 11 September 2016 / Revised: 22 November 2016 / Accepted: 25 November 2016 / Published: 8 December 2016
Cited by 3 | PDF Full-text (5270 KB) | HTML Full-text | XML Full-text
Abstract
With the process of urbanization, a large number of residential quarters, which is the main dwelling form in the urban area of Beijing, have been developed in last three decades to accommodate the rising population. In the context of intensification of urban heat
[...] Read more.
With the process of urbanization, a large number of residential quarters, which is the main dwelling form in the urban area of Beijing, have been developed in last three decades to accommodate the rising population. In the context of intensification of urban heat island (UHI), the potential degradation of the thermal environment of residential quarters can give rise to a variety of problems affecting inhabitants’ health. This paper reports the results of a numerical study of the thermal conditions of a residential quarter on a typical summertime day under four greening modification scenarios, characterized by different leaf area density (LAD) profiles. The modelling results demonstrated that vegetation could evidently reduce near-surface air temperature, with the combination of grass and mature trees achieving as much as 1.5 °C of air temperature decrease compared with the non-green scenario. Vegetation can also lead to smaller air temperature fluctuations, which contribute to a more stable microclimate. The Universal Thermal Climate Index (UTCI) was then calculated to represent the variation of thermal environment of the study area. While grass is helpful in improving outdoor thermal comfort, trees are more effective in reducing the duration and expansion of suffering from severe heat stress. The results of this study showed that proper maintenance of vegetation, especially trees, is significant to improving the outdoor thermal environment in the summer season. In consideration of the deficiency of the current code in the management of greenspace in residential areas, we hope the results reported here will help promote the improvement of the code and related regulations for greenspace management. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Effects of Indoor Air Pollutants on Atopic Dermatitis
Int. J. Environ. Res. Public Health 2016, 13(12), 1220; doi:10.3390/ijerph13121220
Received: 15 June 2016 / Revised: 1 December 2016 / Accepted: 2 December 2016 / Published: 9 December 2016
Cited by 1 | PDF Full-text (435 KB) | HTML Full-text | XML Full-text
Abstract
The increasing prevalence of atopic dermatitis (AD) is associated with variations in indoor environments. In Korea, many inner walls of homes are covered with wallpaper: such walls emit indoor air pollutants, including volatile organic compounds (VOCs) and formaldehyde. This randomized, double-blind study investigated
[...] Read more.
The increasing prevalence of atopic dermatitis (AD) is associated with variations in indoor environments. In Korea, many inner walls of homes are covered with wallpaper: such walls emit indoor air pollutants, including volatile organic compounds (VOCs) and formaldehyde. This randomized, double-blind study investigated the effects of wallpaper on indoor air quality and AD. Thirty-one children (aged three to eight years) with moderate AD were assigned to environmentally-friendly (EF) and polyvinyl chloride (PVC) wallpaper groups. Indoor air concentrations of VOCs, natural VOCs (NVOCs), formaldehyde, and total suspended bacteria were measured before and two (W2) and eight weeks (W8) after wallpapering. Scoring Atopic Dermatitis (SCORAD) evaluations and blood tests were performed during the same period. The EF wallpaper and PVC wallpaper groups showed similar trends in the changes in total VOCs (TVOC) and formaldehyde content in the indoor air. However, the EF wallpaper group showed more improvement on the SCORAD at W2 and W8 than the PVC wallpaper group. The SCORAD index was positively correlated with several indoor air pollutants. Further, the SCORAD index and NVOC % were negatively correlated. Improved SCORAD index and effects of wallpapering on indoor air quality improvements occurred within a short period of time in both groups. We believe that NVOCs in indoor air after EF wallpapering have a beneficial effect on health. Full article
Figures

Figure 1

Open AccessArticle Spatial Characteristics and Driving Factors of Provincial Wastewater Discharge in China
Int. J. Environ. Res. Public Health 2016, 13(12), 1221; doi:10.3390/ijerph13121221
Received: 9 August 2016 / Revised: 21 November 2016 / Accepted: 24 November 2016 / Published: 9 December 2016
PDF Full-text (4023 KB) | HTML Full-text | XML Full-text
Abstract
Based on the increasing pressure on the water environment, this study aims to clarify the overall status of wastewater discharge in China, including the spatio-temporal distribution characteristics of wastewater discharge and its driving factors, so as to provide reference for developing “emission reduction”
[...] Read more.
Based on the increasing pressure on the water environment, this study aims to clarify the overall status of wastewater discharge in China, including the spatio-temporal distribution characteristics of wastewater discharge and its driving factors, so as to provide reference for developing “emission reduction” strategies in China and discuss regional sustainable development and resources environment policies. We utilized the Exploratory Spatial Data Analysis (ESDA) method to analyze the characteristics of the spatio-temporal distribution of the total wastewater discharge among 31 provinces in China from 2002 to 2013. Then, we discussed about the driving factors, affected the wastewater discharge through the Logarithmic Mean Divisia Index (LMDI) method and classified those driving factors. Results indicate that: (1) the total wastewater discharge steadily increased, based on the social economic development, with an average growth rate of 5.3% per year; the domestic wastewater discharge is the main source of total wastewater discharge, and the amount of domestic wastewater discharge is larger than the industrial wastewater discharge. There are many spatial differences of wastewater discharge among provinces via the ESDA method. For example, provinces with high wastewater discharge are mainly the developed coastal provinces such as Jiangsu Province and Guangdong Province. Provinces and their surrounding areas with low wastewater discharge are mainly the undeveloped ones in Northwest China; (2) The dominant factors affecting wastewater discharge are the economy and technological advance; The secondary one is the efficiency of resource utilization, which brings about the unstable effect; population plays a less important role in wastewater discharge. The dominant driving factors affecting wastewater discharge among 31 provinces are divided into three types, including two-factor dominant type, three-factor leading type and four-factor antagonistic type. In addition, the proposals aimed at reducing the wastewater discharge are provided on the basis of these three types. Full article
Figures

Figure 1

Open AccessArticle Perfluorinated Compounds in Greenhouse and Open Agricultural Producing Areas of Three Provinces of China: Levels, Sources and Risk Assessment
Int. J. Environ. Res. Public Health 2016, 13(12), 1224; doi:10.3390/ijerph13121224
Received: 23 September 2016 / Revised: 24 November 2016 / Accepted: 30 November 2016 / Published: 10 December 2016
PDF Full-text (2021 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Field investigations on perfluoroalkyl acid (PFAA) levels in various environmental matrixes were reported, but there is still a lack of PFAA level data for agricultural environments, especially agricultural producing areas, so we collected soil, irrigation water and agricultural product samples from agricultural producing
[...] Read more.
Field investigations on perfluoroalkyl acid (PFAA) levels in various environmental matrixes were reported, but there is still a lack of PFAA level data for agricultural environments, especially agricultural producing areas, so we collected soil, irrigation water and agricultural product samples from agricultural producing areas in the provinces of Liaoning, Shandong and Sichuan in China. The background pollution from instruments was removed and C4–C18 PFAAs were detected by LC-MS/MS. The concentrations of PFAAs in the top and deep layers of soil were compared, and the levels of PFAAs in different agricultural environments (greenhouses and open agriculture) were analyzed. We found the order of PFAA levels by province was Shandong > Liaoning > Sichuan. A descending trend of PFAA levels from top to deep soil and open to greenhouse agriculture was shown and perfluorobutanoic acid (PFBA) was considered as a marker for source analysis. Bean vegetables contribute highly to the overall PFAA load in vegetables. A significant correlation was shown between irrigation water and agricultural products. The EDI (estimated daily intake) from vegetables should be of concern in China. Full article
Figures

Figure 1

Open AccessArticle Heat or Cold: Which One Exerts Greater Deleterious Effects on Health in a Basin Climate City? Impact of Ambient Temperature on Mortality in Chengdu, China
Int. J. Environ. Res. Public Health 2016, 13(12), 1225; doi:10.3390/ijerph13121225
Received: 22 August 2016 / Revised: 24 November 2016 / Accepted: 5 December 2016 / Published: 10 December 2016
PDF Full-text (3317 KB) | HTML Full-text | XML Full-text
Abstract
Background: Although studies from many countries have estimated the impact of ambient temperature on mortality, few have compared the relative impacts of heat and cold on health, especially in basin climate cities. We aimed to quantify the impact of ambient temperature on
[...] Read more.
Background: Although studies from many countries have estimated the impact of ambient temperature on mortality, few have compared the relative impacts of heat and cold on health, especially in basin climate cities. We aimed to quantify the impact of ambient temperature on mortality, and to compare the contributions of heat and cold in a large basin climate city, i.e., Chengdu (Sichuan Province, China); Methods: We estimated the temperature-mortality association with a distributed lag non-linear model (DLNM) with a maximum lag-time of 21 days while controlling for long time trends and day of week. We calculated the mortality risk attributable to heat and cold, which were defined as temperatures above and below an “optimum temperature” that corresponded to the point of minimum mortality. In addition, we explored effects of individual characteristics; Results: The analysis provides estimates of the overall mortality burden attributable to temperature, and then computes the components attributable to heat and cold. Overall, the total fraction of deaths caused by both heat and cold was 10.93% (95%CI: 7.99%–13.65%). Taken separately, cold was responsible for most of the burden (estimate 9.96%, 95%CI: 6.90%–12.81%), while the fraction attributable to heat was relatively small (estimate 0.97%, 95%CI: 0.46%–2.35%). The attributable risk (AR) of respiratory diseases was higher (19.69%, 95%CI: 14.45%–24.24%) than that of cardiovascular diseases (11.40%, 95%CI: 6.29%–16.01%); Conclusions: In Chengdu, temperature was responsible for a substantial fraction of deaths, with cold responsible for a higher proportion of deaths than heat. Respiratory diseases exert a larger effect on death than other diseases especially on cold days. There is potential to reduce respiratory-associated mortality especially among the aged population in basin climate cities when the temperature deviates beneath the optimum. The result may help to comprehensively assess the impact of ambient temperature in basin cities, and further facilitate an appropriate estimate of the health consequences of various climate-change scenarios. Full article
(This article belongs to the collection Climate Change and Human Health)
Figures

Figure 1

Open AccessArticle The Influence of Urbanization Modes on the Spatial Circulation of Flaviviruses within Ouagadougou (Burkina Faso)
Int. J. Environ. Res. Public Health 2016, 13(12), 1226; doi:10.3390/ijerph13121226
Received: 20 October 2016 / Revised: 30 November 2016 / Accepted: 7 December 2016 / Published: 10 December 2016
PDF Full-text (3608 KB) | HTML Full-text | XML Full-text
Abstract
Dengue is an emerging infectious disease of global significance. Although this virus has been reported for a long time, its significance within the burden of diseases in West Africa is not obvious, especially in Burkina Faso. Our objective was to evaluate flavivirus presence
[...] Read more.
Dengue is an emerging infectious disease of global significance. Although this virus has been reported for a long time, its significance within the burden of diseases in West Africa is not obvious, especially in Burkina Faso. Our objective was to evaluate flavivirus presence in Ouagadougou (Burkina Faso) and the link between anti-flavivirus antibody seroprevalence and urbanization modes. A population-based cross-sectional survey was conducted and 3015 children were enrolled from Ouagadougou districts with different types and degrees of urbanization (with/without equipment and high/low building density). Flavivirus (FLAV) IgM MAC-ELISA and FLAV indirect IgG ELISA were performed. Associations between FLAV IgG presence (sign of past infection) and various independent variables were assessed using the chi-square test and a multivariate logistic regression analysis. The apparent prevalence of past flavivirus infections among the enrolled children was 22.7% (95% CI: 22.4–26.7) (n = 685). Eleven children (0.4%; 95% CI: 0.61–2.14) were positive for FLAV IgM, indicating active transmission. Factors associated with flavivirus infection were identified among the enrolled children (age, sex), householders (educational level, asset index) and in the environment (building density, water access, waste management and house appearance); however, they showed great variability according to the city districts. The water access modality did not significantly influence FLAV IgG positivity. Conversely, apparently good practices of waste management had unexpected consequences (increased risk related to municipal dumpsters). Given the scale of ongoing urbanization and the spread of arboviral diseases, close collaboration between health and city stakeholders is needed. Full article
(This article belongs to the Special Issue Urban Place and Health Equity)
Figures

Figure 1

Open AccessArticle Impact of an 8-Month Trial Using Height-Adjustable Desks on Children’s Classroom Sitting Patterns and Markers of Cardio-Metabolic and Musculoskeletal Health
Int. J. Environ. Res. Public Health 2016, 13(12), 1227; doi:10.3390/ijerph13121227
Received: 1 September 2016 / Revised: 30 November 2016 / Accepted: 6 December 2016 / Published: 10 December 2016
PDF Full-text (314 KB) | HTML Full-text | XML Full-text
Abstract
During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children’s cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure)
[...] Read more.
During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children’s cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children’s overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort. Full article
(This article belongs to the Section Global Health)
Open AccessArticle The Role of Soundscape in Nature-Based Rehabilitation: A Patient Perspective
Int. J. Environ. Res. Public Health 2016, 13(12), 1229; doi:10.3390/ijerph13121229
Received: 29 September 2016 / Revised: 17 November 2016 / Accepted: 1 December 2016 / Published: 11 December 2016
PDF Full-text (886 KB) | HTML Full-text | XML Full-text
Abstract
Nature-based rehabilitation (NBR) has convincing support in research, yet the underlying mechanisms are not fully understood. The present study sought to increase understanding of the role of soundscapes in NBR, an aspect paid little attention thus far. Transcribed interviews with 59 patients suffering
[...] Read more.
Nature-based rehabilitation (NBR) has convincing support in research, yet the underlying mechanisms are not fully understood. The present study sought to increase understanding of the role of soundscapes in NBR, an aspect paid little attention thus far. Transcribed interviews with 59 patients suffering from stress-related mental disorders and undergoing a 12-week therapy programme in the rehabilitation garden in Alnarp, Sweden, were analysed using Interpretative Phenomenology Analysis (IPA). Described sounds were categorised as natural, technological or human. The results showed that patients frequently referred to natural sounds as being part of a pleasant and “quiet” experience that supported recovery and induced “soft fascination”. Technological sounds were experienced as disturbing, while perception of human sounds varied depending on loudness and the social context. The study further uncovered how sound influenced patients’ behaviour and experiences in the garden, through examination of three cross-theme dimensions that materialised in the study; sound in relation to overall perception, sound in relation to garden usage, and increased susceptibility to sound. The findings are discussed in relation to NBR; the need for a more nuanced understanding of susceptibility to sound among people suffering from mental fatigue was identified and design considerations for future rehabilitation gardens were formulated. Full article
(This article belongs to the Special Issue Landscapes and Human Health)
Figures

Figure 1

Open AccessArticle Visceral Adiposity Index and Lipid Accumulation Product Index: Two Alternate Body Indices to Identify Chronic Kidney Disease among the Rural Population in Northeast China
Int. J. Environ. Res. Public Health 2016, 13(12), 1231; doi:10.3390/ijerph13121231
Received: 21 September 2016 / Revised: 5 December 2016 / Accepted: 7 December 2016 / Published: 13 December 2016
Cited by 1 | PDF Full-text (917 KB) | HTML Full-text | XML Full-text
Abstract
We aimed to compare the relative strength of the association between anthropometric obesity indices and chronic kidney disease (CKD). Another objective was to examine whether the visceral adiposity index (VAI) and lipid accumulation product index (LAPI) can identify CKD in the rural population
[...] Read more.
We aimed to compare the relative strength of the association between anthropometric obesity indices and chronic kidney disease (CKD). Another objective was to examine whether the visceral adiposity index (VAI) and lipid accumulation product index (LAPI) can identify CKD in the rural population of China. There were 5168 males and 6024 females involved in this cross-sectional study, and 237 participants (2.12%) suffered from CKD. Obesity indices included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), VAI and LAPI. VAI and LAPI were calculated with triglyceride (TG), high-density lipoprotein (HDL), BMI and WC. VAI = [WC/39.68 + (1.88 × BMI)] × (TG /1.03) × (1.31/ HDL) for males; VAI = [WC/36.58 + (1.89 × BMI)] × (TG/0.81) × (1.52/HDL) for females. LAPI = (WC-65) × TG for males, LAPI = (WC-58) × TG for females. CKD was defined as an estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.73 m2. The prevalence of CKD increased across quartiles for WHtR, VAI and LAPI. A multivariate logistic regression analysis of the presence of CKD for the highest quartile vs. the lowest quartile of each anthropometric measure showed that the VAI was the best predictor of CKD in females (OR: 4.21, 95% CI: 2.09–8.47, p < 0.001). VAI showed the highest AUC for CKD (AUC: 0.68, 95% CI: 0.65–0.72) and LAPI came second (AUC: 0.66, 95% CI: 0.61–0.70) in females compared with BMI (both p-values < 0.001). However, compared with the traditional index of the BMI, the anthropometric measures VAI, LAPI, WC, and WHtR had no statistically significant capacity to predict CKD in males. Our results showed that both VAI and LAPI were significantly associated with CKD in the rural population of northeast China. Furthermore, VAI and LAPI were superior to BMI, WC and WHtR for predicting CKD only in females. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Health Profile of Construction Workers in Hong Kong
Int. J. Environ. Res. Public Health 2016, 13(12), 1232; doi:10.3390/ijerph13121232
Received: 22 September 2016 / Revised: 25 November 2016 / Accepted: 6 December 2016 / Published: 13 December 2016
PDF Full-text (890 KB) | HTML Full-text | XML Full-text
Abstract
Construction is a manual, heavy, and complex sector concerning the most fatal accidents and high incidence of occupational illnesses and injuries resulting in days away from work. In Hong Kong, “Pilot Medical Examination Scheme for Construction Workers” was launched in 2014 to detect
[...] Read more.
Construction is a manual, heavy, and complex sector concerning the most fatal accidents and high incidence of occupational illnesses and injuries resulting in days away from work. In Hong Kong, “Pilot Medical Examination Scheme for Construction Workers” was launched in 2014 to detect the health problems of their construction workforce. All registered workers under the Construction Workers Registration Board are eligible to join the scheme. The purpose of this paper is to assess the physical condition, physiological status, and musculoskeletal disorders of 942 construction workers in Hong Kong. This study adopted a two-phase design, which includes a basic medical examination to measure the workers’ physiological parameters, such as blood pressure, resting heart rate, glucose, cholesterol, uric acid, liver function test, and renal function test; as well as a face-to-face interview following the medical examination to collect their demographic information and pain experience. Individual characteristics, including gender, age, obesity, alcohol drinking habit, and sleeping habit influenced the health condition of construction workers. Among the participants, 36.1% and 6.5% of them were overweight and obese, respectively. In addition, 43.0%, 38.4%, 16.2%, and 13.9% of the participants exceeded the thresholds of cholesterol, blood pressure, urea nitrogen, and uric urea, correspondingly. Moreover, 41.0% of the participants suffered musculoskeletal pain, where the most frequent painful parts occur in the lower back, shoulder, knees, leg, and neck. Through these findings, a series of important issues that need to be addressed is pointed out in terms of maintaining the physical well-being and reducing musculoskeletal disorders of construction workers. The finding may have implications for formulating proper intervention strategies for the sustainable development of Hong Kong’s construction industry. Full article
(This article belongs to the Special Issue Effecting a Safe and Healthy Environment in Construction)
Figures

Figure 1

Open AccessArticle The Association of Hypertriglyceridemic Waist Phenotype with Chronic Kidney Disease and Its Sex Difference: A Cross-Sectional Study in an Urban Chinese Elderly Population
Int. J. Environ. Res. Public Health 2016, 13(12), 1233; doi:10.3390/ijerph13121233
Received: 23 September 2016 / Revised: 2 December 2016 / Accepted: 6 December 2016 / Published: 13 December 2016
PDF Full-text (290 KB) | HTML Full-text | XML Full-text
Abstract
Background: The primary objective of this study was to explore the association of hypertriglyceridemic waist (HTGW) phenotype with chronic kidney disease (CKD) and its sex difference in an urban Chinese elderly population. Methods: In a cross-sectional study, a total of 2102
[...] Read more.
Background: The primary objective of this study was to explore the association of hypertriglyceridemic waist (HTGW) phenotype with chronic kidney disease (CKD) and its sex difference in an urban Chinese elderly population. Methods: In a cross-sectional study, a total of 2102 participants aged 60–95 years were recruited and classified into four phenotypes: normal waist-normal triglyceride (NWNT), normal waist-elevated triglycerides (NWET), elevated waist-normal triglycerides (EWNT), and HTGW. Logistic regression analysis was used to estimate the associations of interest. Results: Total prevalence of CKD was 12.6%, and the CKD prevalence in participants with EWNT and HTGW was higher than with NWNT and NWET without regard to sex. Compared to NWNT phenotype, the adjusted OR for CKD was 1.95 (95% CI: 1.32–2.88) in HTGW groups. In contrast with the null findings (OR: 1.66; 95% CI: 0.94–2.94) in women after additional adjustment for diabetes and hypertension, the OR with HTGW remained strong (OR: 1.88; 95% CI: 1.04–3.39) in men. Similar findings appeared with the EWNT phenotype. Conclusions: The HTGW phenotype is positively associated with CKD among Chinese community elderly and may have a greater impact on men. More attention should be paid to the association between triglycerides and waist circumference in clinical practice and to the further identification this uncertain sex-related association. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Association of School District Policies for Radon Testing and Radon-Resistant New Construction Practices with Indoor Radon Zones
Int. J. Environ. Res. Public Health 2016, 13(12), 1234; doi:10.3390/ijerph13121234
Received: 27 October 2016 / Revised: 5 December 2016 / Accepted: 7 December 2016 / Published: 13 December 2016
PDF Full-text (242 KB) | HTML Full-text | XML Full-text
Abstract
Radon is a naturally occurring, colorless, odorless, and tasteless radioactive gas. Without testing, its presence is unknown. Using nationally representative data from the 2012 School Health Policies and Practices Study, we examined whether the prevalence of school district policies for radon testing and
[...] Read more.
Radon is a naturally occurring, colorless, odorless, and tasteless radioactive gas. Without testing, its presence is unknown. Using nationally representative data from the 2012 School Health Policies and Practices Study, we examined whether the prevalence of school district policies for radon testing and for radon-resistant new construction practices varied by district location in relation to the U.S. Environmental Protection Agency Map of Radon Zones. Among school districts located in counties with high predicted average indoor radon, 42.4% had policies for radon testing and 37.5% had policies for radon-resistant new construction practices. These findings suggest a critical need for improved awareness among policy makers regarding potential radon exposure for both students and school staff. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Minimizing Spatial Variability of Healthcare Spatial Accessibility—The Case of a Dengue Fever Outbreak
Int. J. Environ. Res. Public Health 2016, 13(12), 1235; doi:10.3390/ijerph13121235
Received: 2 October 2016 / Revised: 24 November 2016 / Accepted: 2 December 2016 / Published: 13 December 2016
PDF Full-text (3118 KB) | HTML Full-text | XML Full-text
Abstract
Outbreaks of infectious diseases or multi-casualty incidents have the potential to generate a large number of patients. It is a challenge for the healthcare system when demand for care suddenly surges. Traditionally, valuation of heath care spatial accessibility was based on static supply
[...] Read more.
Outbreaks of infectious diseases or multi-casualty incidents have the potential to generate a large number of patients. It is a challenge for the healthcare system when demand for care suddenly surges. Traditionally, valuation of heath care spatial accessibility was based on static supply and demand information. In this study, we proposed an optimal model with the three-step floating catchment area (3SFCA) to account for the supply to minimize variability in spatial accessibility. We used empirical dengue fever outbreak data in Tainan City, Taiwan in 2015 to demonstrate the dynamic change in spatial accessibility based on the epidemic trend. The x and y coordinates of dengue-infected patients with precision loss were provided publicly by the Tainan City government, and were used as our model’s demand. The spatial accessibility of heath care during the dengue outbreak from August to October 2015 was analyzed spatially and temporally by producing accessibility maps, and conducting capacity change analysis. This study also utilized the particle swarm optimization (PSO) model to decrease the spatial variation in accessibility and shortage areas of healthcare resources as the epidemic went on. The proposed method in this study can help decision makers reallocate healthcare resources spatially when the ratios of demand and supply surge too quickly and form clusters in some locations. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Effect of Attitudinal, Situational and Demographic Factors on Annoyance Due to Environmental Vibration and Noise from Construction of a Light Rapid Transit System
Int. J. Environ. Res. Public Health 2016, 13(12), 1237; doi:10.3390/ijerph13121237
Received: 15 August 2016 / Revised: 11 November 2016 / Accepted: 1 December 2016 / Published: 14 December 2016
PDF Full-text (771 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this paper is to determine what non-exposure factors influence the relationship between vibration and noise exposure from the construction of a Light Rapid Transit (LRT) system and the annoyance of nearby residents. Noise and vibration from construction sites are known
[...] Read more.
The aim of this paper is to determine what non-exposure factors influence the relationship between vibration and noise exposure from the construction of a Light Rapid Transit (LRT) system and the annoyance of nearby residents. Noise and vibration from construction sites are known to annoy residents, with annoyance increasing as a function of the magnitude of the vibration and noise. There is not a strong correlation between exposure and levels of annoyance suggesting that factors not directly related to the exposure may have an influence. A range of attitudinal, situational and demographic factors are investigated with the aim of understanding the wide variation in annoyance for a given vibration exposure. A face-to-face survey of residents (n = 350) near three sites of LRT construction was conducted, and responses were compared to semi-empirical estimates of the internal vibration within the buildings. It was found that annoyance responses due to vibration were strongly influenced by two attitudinal variables, concern about property damage and sensitivity to vibration. Age, ownership of the property and the visibility of the construction site were also important factors. Gender, time at home and expectation of future levels of vibration had much less influence. Due to the measurement methods used, it was not possible to separate out the effects of noise and vibration on annoyance; as such, this paper focusses on annoyance due to vibration exposure. This work concludes that for the most cost-effective reduction of the impact of construction vibration and noise on the annoyance felt by a community, policies should consider attitudinal factors. Full article
(This article belongs to the Special Issue The Combined Health Effects of Environmental Exposures)
Figures

Figure 1

Open AccessArticle Hispanic and Immigrant Paradoxes in U.S. Breast Cancer Mortality: Impact of Neighborhood Poverty and Hispanic Density
Int. J. Environ. Res. Public Health 2016, 13(12), 1238; doi:10.3390/ijerph13121238
Received: 22 August 2016 / Revised: 9 December 2016 / Accepted: 9 December 2016 / Published: 14 December 2016
Cited by 1 | PDF Full-text (703 KB) | HTML Full-text | XML Full-text
Abstract
To test the Hispanic and Immigrant Paradoxes—i.e., survival advantages despite a worse risk factor profile—and the modifying role of neighborhood context, we examined associations between patient ethnicity, birthplace, neighborhood Hispanic density and neighborhood poverty among 166,254 female breast cancer patients diagnosed 1995–2009 in
[...] Read more.
To test the Hispanic and Immigrant Paradoxes—i.e., survival advantages despite a worse risk factor profile—and the modifying role of neighborhood context, we examined associations between patient ethnicity, birthplace, neighborhood Hispanic density and neighborhood poverty among 166,254 female breast cancer patients diagnosed 1995–2009 in Texas, U.S. Of all, 79.9% were non-Hispanic White, 15.8% Hispanic U.S.-born, and 4.2% Hispanic foreign-born. We imputed birthplace for the 60.7% of Hispanics missing birthplace data using multiple imputation. Shared frailty Cox proportional hazard models (patients nested within census tracts) adjusted for age, diagnosis year, stage, grade, histology, urban/rural residence, and local mammography capacity. Whites (vs. U.S.-born Hispanics) had increased all-cause and breast cancer mortality. Foreign-born (vs. U.S.-born) Hispanics had increased all-cause and breast cancer mortality. Living in higher Hispanic density neighborhoods was generally associated with increased mortality, although associations differed slightly in magnitude and significance by ethnicity, birthplace, and neighborhood poverty. We found no evidence of an Immigrant Paradox and some evidence of a Hispanic Paradox where protective effects were limited to U.S.-born Hispanics. Contrary to prior studies, foreign birthplace and residence in higher Hispanic density neighborhoods were associated with increased mortality. More research on intersections between ethnicity, birthplace and neighborhood context are needed. Full article
(This article belongs to the Special Issue Geographical Variation in Breast Cancer Outcomes)
Figures

Figure 1

Open AccessArticle Removal and Biodegradation of Nonylphenol by Four Freshwater Microalgae
Int. J. Environ. Res. Public Health 2016, 13(12), 1239; doi:10.3390/ijerph13121239
Received: 19 September 2016 / Revised: 1 December 2016 / Accepted: 8 December 2016 / Published: 14 December 2016
PDF Full-text (1358 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The removal and biodegradation of nonylphenol (NP) by four freshwater microalgae, including three green algae (Scendesmus quadriauda, Chlorella vulgaris, and Ankistrodesmus acicularis) and one cyanobacterium (Chroococcus minutus) were studied in bacteria-free cultures exposed to different concentrations of
[...] Read more.
The removal and biodegradation of nonylphenol (NP) by four freshwater microalgae, including three green algae (Scendesmus quadriauda, Chlorella vulgaris, and Ankistrodesmus acicularis) and one cyanobacterium (Chroococcus minutus) were studied in bacteria-free cultures exposed to different concentrations of NP for 5 days. All four algal species showed a rapid and high ability to remove NP (including bioaccumulation and biodegradation). Among these species, A. acicularis (Ankistrodesmus acicularis) had the highest NP removal rate (83.77%) at 120 h when exposed to different NP treatments (0.5–2.5 mg·L−1), followed by C. vulgaris (Chlorella vulgaris) (80.80%), S. quadriauda (Scendesmus quadriauda) (70.96%) and C. minutus (Chroococcus minutus) (64.26%). C. vulgaris had the highest NP biodegradation percentage (68.80%) at 120 h, followed by A. acicularis (65.63%), S. quadriauda (63.10%); and C. minutus (34.91%). The extracellular NP contents were lower than the intracellular NP contents in all tested algae. The ratio of the extracellular NP content and the intracellular NP content ranged from 0.04 to 0.85. Therefore, the removal of NP from the medium was mainly due to the algal degradation. These results indicate that A. acicularis and C. vulgaris are more tolerant to NP and could be used for treatment of NP contaminated aqueous systems effectively by bioremoval and biodegradation. Full article
Figures

Figure 1

Open AccessArticle Evaluation of Indoor Air Quality Screening Strategies: A Step-Wise Approach for IAQ Screening
Int. J. Environ. Res. Public Health 2016, 13(12), 1240; doi:10.3390/ijerph13121240
Received: 18 October 2016 / Revised: 2 December 2016 / Accepted: 7 December 2016 / Published: 14 December 2016
PDF Full-text (925 KB) | HTML Full-text | XML Full-text
Abstract
Conducting a full indoor air quality (IAQ) assessment in air-conditioned offices requires large-scale material and manpower resources. However, an IAQ index can be adopted as a handy screening tool to identify any premises (with poor IAQ) that need more comprehensive IAQ assessments to
[...] Read more.
Conducting a full indoor air quality (IAQ) assessment in air-conditioned offices requires large-scale material and manpower resources. However, an IAQ index can be adopted as a handy screening tool to identify any premises (with poor IAQ) that need more comprehensive IAQ assessments to prioritize IAQ improvements. This study proposes a step-wise IAQ screening protocol to facilitate its cost-effective management among building owners and managers. The effectiveness of three IAQ indices, namely θ1 (with one parameter: CO2), θ2 (with two parameters: CO2 and respirable suspended particulates, RSP) and θ3 (with three parameters: CO2, RSP, and total volatile organic compounds, TVOC) are evaluated. Compared in a pairwise manner with respect to the minimum satisfaction levels as stated in the IAQ Certification Scheme by the Hong Kong Environmental Protection Department, the results show that a screening test with more surrogate IAQ parameters is good at identifying both lower and higher risk groups for unsatisfactory IAQ, and thus offers higher resolution. Through the sensitivity and specificity for identifying IAQ problems, the effectiveness of alternative IAQ screening methods with different monitoring parameters is also reported. Full article
(This article belongs to the Special Issue Indoor Air Quality and Health 2016)
Figures

Figure 1

Open AccessArticle Latino and Non-Latino Perceptions of the Air Quality in California’s San Joaquin Valley
Int. J. Environ. Res. Public Health 2016, 13(12), 1242; doi:10.3390/ijerph13121242
Received: 26 September 2016 / Revised: 29 November 2016 / Accepted: 30 November 2016 / Published: 15 December 2016
Cited by 1 | PDF Full-text (273 KB) | HTML Full-text | XML Full-text
Abstract
The San Joaquin Valley (SJV) of California has poor air quality, high rates of asthma, and high rates of obesity. Informational campaigns aimed at increasing awareness of the health impacts of poor air quality and promoting behavior change need to be tailored to
[...] Read more.
The San Joaquin Valley (SJV) of California has poor air quality, high rates of asthma, and high rates of obesity. Informational campaigns aimed at increasing awareness of the health impacts of poor air quality and promoting behavior change need to be tailored to the specific target audiences. The study examined perceptions of air quality, perceived health impacts, and methods of accessing information about air quality between Latinos and other groups in the SJV. Residents of the SJV (n = 744) where surveyed via one of three methods: community organizations (256), public locations (251), and an internet panel (237). The results suggest that people perceive the air quality in their region to be generally unhealthy, particularly for sensitive groups. The air quality is more likely to be reported as being unhealthy by people with health problems and less unhealthy by Latinos and people who report regularly exercising. Latinos are more likely to report working outdoors regularly, but also more likely to report being able to reduce their exposure if the air quality is unhealthy. The results report differences in informational sources about air quality, suggesting that informational campaigns should target high risk groups using a variety of media. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Additive Interaction of MTHFR C677T and MTRR A66G Polymorphisms with Being Overweight/Obesity on the Risk of Type 2 Diabetes
Int. J. Environ. Res. Public Health 2016, 13(12), 1243; doi:10.3390/ijerph13121243
Received: 16 October 2016 / Revised: 1 December 2016 / Accepted: 2 December 2016 / Published: 15 December 2016
PDF Full-text (301 KB) | HTML Full-text | XML Full-text
Abstract
Although both methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G polymorphisms have been associated with type 2 diabetes (T2D), their interactions with being overweight/obesity on T2D risk remain unclear. To evaluate the associations of the two polymorphisms
[...] Read more.
Although both methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G polymorphisms have been associated with type 2 diabetes (T2D), their interactions with being overweight/obesity on T2D risk remain unclear. To evaluate the associations of the two polymorphisms with T2D and their interactions with being overweight/obesity on T2D risk, a case-control study of 180 T2D patients and 350 healthy controls was conducted in northern China. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). After adjustments for age and gender, borderline significant associations of the MTHFR C677T and MTRR A66G polymorphisms with T2D were observed under recessive (OR = 1.43, 95% CI: 0.98–2.10) and dominant (OR = 1.43, 95% CI: 1.00–2.06) models, respectively. There was a significant interaction between the MTHFR 677TT genotype and being overweight/obesity on T2D risk (AP = 0.404, 95% CI: 0.047–0.761), in addition to the MTRR 66AG/GG genotypes (RERI = 1.703, 95% CI: 0.401–3.004; AP = 0.528, 95% CI: 0.223–0.834). Our findings suggest that individuals with the MTHFR 677TT or MTRR 66AG/GG genotypes are more susceptible to the detrimental effect of being overweight/obesity on T2D. Further large-scale studies are still needed to confirm our findings. Full article
(This article belongs to the Section Global Health)
Open AccessArticle No Ifs, No Butts: Compliance with Smoking Cessation in Secondary Care Guidance (NICE PH48) by Providers of Cancer Therapies (Radiotherapy and Chemotherapy) in the UK
Int. J. Environ. Res. Public Health 2016, 13(12), 1244; doi:10.3390/ijerph13121244
Received: 30 October 2016 / Revised: 9 December 2016 / Accepted: 9 December 2016 / Published: 15 December 2016
Cited by 1 | PDF Full-text (287 KB) | HTML Full-text | XML Full-text
Abstract
Background: Legislation preventing smoking in public places was introduced in England in July 2007. Since then, smoke-free policies have been extended to the majority of hospitals including those providing cancer therapies. Whilst studies have been conducted on the impact and effectiveness of
[...] Read more.
Background: Legislation preventing smoking in public places was introduced in England in July 2007. Since then, smoke-free policies have been extended to the majority of hospitals including those providing cancer therapies. Whilst studies have been conducted on the impact and effectiveness of hospital smoke-free policy in the UK and other countries, there have not been any studies with a focus on cancer care providers. Cancer patients are a priority group for smoking cessation and support and this study aimed to examine implementation of the National Institute Clinical Excellence (NICE) guidance (PH48) in acute cancer care trusts in the UK. Methods: Participants were recruited from UK radiotherapy and chemotherapy departments (total 80 sites, 65 organisations) and asked to complete a 15 min online questionnaire exploring the implementation of NICE guidance at their hospital site. Results: Considerable variability in implementation of the NICE guidance was observed. A total of 79.1% trusts were smoke-free in theory; however, only 18.6% were described as smoke-free in practice. Areas of improvement were identified in information and support for patients and staff including in Nicotine Replacement Therapy (NRT) provision, staff training and clarity on e-cigarette policies. Conclusions: While some trusts have effective smoke-free policies and provide valuable cessation support services for patients, improvements are required to ensure that all sites fully adopt the NICE guidance. Full article
(This article belongs to the Section Global Health)
Open AccessArticle Problem Formulation in Knowledge Discovery via Data Analytics (KDDA) for Environmental Risk Management
Int. J. Environ. Res. Public Health 2016, 13(12), 1245; doi:10.3390/ijerph13121245
Received: 5 September 2016 / Revised: 3 December 2016 / Accepted: 6 December 2016 / Published: 15 December 2016
PDF Full-text (1159 KB) | HTML Full-text | XML Full-text
Abstract
With the growing popularity of data analytics and data science in the field of environmental risk management, a formalized Knowledge Discovery via Data Analytics (KDDA) process that incorporates all applicable analytical techniques for a specific environmental risk management problem is essential. In this
[...] Read more.
With the growing popularity of data analytics and data science in the field of environmental risk management, a formalized Knowledge Discovery via Data Analytics (KDDA) process that incorporates all applicable analytical techniques for a specific environmental risk management problem is essential. In this emerging field, there is limited research dealing with the use of decision support to elicit environmental risk management (ERM) objectives and identify analytical goals from ERM decision makers. In this paper, we address problem formulation in the ERM understanding phase of the KDDA process. We build a DM3 ontology to capture ERM objectives and to inference analytical goals and associated analytical techniques. A framework to assist decision making in the problem formulation process is developed. It is shown how the ontology-based knowledge system can provide structured guidance to retrieve relevant knowledge during problem formulation. The importance of not only operationalizing the KDDA approach in a real-world environment but also evaluating the effectiveness of the proposed procedure is emphasized. We demonstrate how ontology inferencing may be used to discover analytical goals and techniques by conceptualizing Hazardous Air Pollutants (HAPs) exposure shifts based on a multilevel analysis of the level of urbanization (and related economic activity) and the degree of Socio-Economic Deprivation (SED) at the local neighborhood level. The HAPs case highlights not only the role of complexity in problem formulation but also the need for integrating data from multiple sources and the importance of employing appropriate KDDA modeling techniques. Challenges and opportunities for KDDA are summarized with an emphasis on environmental risk management and HAPs. Full article
(This article belongs to the Special Issue Ecological Economics, Environmental Health Policy and Climate Change)
Figures

Figure 1

Open AccessArticle Fine Particulate Matter in Urban Environments: A Trigger of Respiratory Symptoms in Sensitive Children
Int. J. Environ. Res. Public Health 2016, 13(12), 1246; doi:10.3390/ijerph13121246
Received: 18 August 2016 / Revised: 1 December 2016 / Accepted: 6 December 2016 / Published: 15 December 2016
Cited by 3 | PDF Full-text (3792 KB) | HTML Full-text | XML Full-text
Abstract
The overall objective of this research was to study children’s respiratory illness levels in Targoviste (Romania) in relationship to the outdoor concentrations of airborne particulate matter with an aerodynamic diameter below 2.5 µm (PM2.5). We monitored and analysed the PM2.5
[...] Read more.
The overall objective of this research was to study children’s respiratory illness levels in Targoviste (Romania) in relationship to the outdoor concentrations of airborne particulate matter with an aerodynamic diameter below 2.5 µm (PM2.5). We monitored and analysed the PM2.5 concentrations according to a complex experimental protocol. The health trial was conducted over three months (October–December 2015) and required the active cooperation of the children’s parents to monitor carefully the respiratory symptoms of the child, i.e., coughing, rhinorrhoea, wheezing, and fever, as well as their outdoor program. We selected the most sensitive children (n = 25; age: 2–10 years) with perturbed respiratory health, i.e., wheezing, asthma, and associated symptoms. The estimated average PM2.5 doses were 0.8–14.5 µg·day−1 for weekdays, and 0.4–6.6 µg·day−1 for the weekend. The frequency and duration of the symptoms decreased with increasing age. The 4- to 5-year old children recorded the longest duration of symptoms, except for rhinorrhoea, which suggested that this age interval is the most vulnerable to exogenous trigger agents (p < 0.01) compared to the other age groups. PM2.5 air pollution was found to have a direct positive correlation with the number of wheezing episodes (r = 0.87; p < 0.01) in November 2015. Monitoring of wheezing occurrences in the absence of fever can provide a reliable assessment of the air pollution effect on the exacerbation of asthma and respiratory disorders in sensitive children. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle Increased Urinary Phthalate Levels in Women with Uterine Leiomyoma: A Case-Control Study
Int. J. Environ. Res. Public Health 2016, 13(12), 1247; doi:10.3390/ijerph13121247
Received: 28 September 2016 / Revised: 9 December 2016 / Accepted: 11 December 2016 / Published: 15 December 2016
PDF Full-text (321 KB) | HTML Full-text | XML Full-text
Abstract
We assessed the urinary concentration of 16 phthalate metabolites in 57 women with and without uterine leiomyoma (n = 30 and 27; respectively) to determine the association between phthalate exposure and uterine leiomyoma. To evaluate exposure to di-(2-ethylhexyl) phthalate (DEHP); we calculated
[...] Read more.
We assessed the urinary concentration of 16 phthalate metabolites in 57 women with and without uterine leiomyoma (n = 30 and 27; respectively) to determine the association between phthalate exposure and uterine leiomyoma. To evaluate exposure to di-(2-ethylhexyl) phthalate (DEHP); we calculated the molar sum of DEHP metabolites; ∑3-DEHP (combining mono-(2-ethylhexyl) phthalate (MEHP); mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP); and mono-(2-ethyl-5-oxohexyl) phthalate); ∑4-DEHP (∑3-DEHP plus mono-(2-ethyl-5-carboxypentyl) phthalate); and ∑5-DEHP (∑4-DEHP plus mono (2-(carboxylmethyl)hexyl) phthalate (2cx-MMHP)). The log transformed urinary levels of MEHP; MEHHP; 2cx-MMHP; ∑3-DEHP; ∑4-DEHP; and ∑5-DEHP in the leiomyoma group were significantly higher than those of controls. When we adjusted for age; waist circumference; and parity using multiple logistic regression analyses; we found log ∑3-DEHP (OR = 10.82; 95% CI = 1.25; 93.46) and ∑4-DEHP (OR = 8.78; 95% CI = 1.03; 75.29) were significantly associated with uterine leiomyoma. Our findings suggest an association between phthalate exposure and uterine leiomyoma. However; larger studies are needed to investigate potential interactions between phthalate exposure and uterine leiomyoma. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Sustainable Lifestyle Change—Participatory Design of Support Together with Persons with Obesity in the Third Age
Int. J. Environ. Res. Public Health 2016, 13(12), 1248; doi:10.3390/ijerph13121248
Received: 14 September 2016 / Revised: 5 December 2016 / Accepted: 12 December 2016 / Published: 16 December 2016
PDF Full-text (289 KB) | HTML Full-text | XML Full-text
Abstract
Sustainable lifestyle changes due to obesity are difficult to achieve regardless methods used. We need to know more about the lived experience of obesity and older persons’ needs for support to make a sustainable change. This paper focuses on the need-finding process in
[...] Read more.
Sustainable lifestyle changes due to obesity are difficult to achieve regardless methods used. We need to know more about the lived experience of obesity and older persons’ needs for support to make a sustainable change. This paper focuses on the need-finding process in designing support for a sustainable lifestyle change. Multistage focus group interviews were conducted with persons aged 61–72 living in Northern Sweden. A participatory and appreciative reflection and action (PAAR) approach was used in the group-sessions. Probes were used to increase reflections and achieve a deeper knowledge about the participants’ needs of support. Data were analysed using qualitative thematic content analysis. Our findings revealed that to be able to succeed with a lifestyle change a focus has to be on a converted way of thinking, managing vulnerability, and achieving an emotional balance. To achieve a sustainable lifestyle change due to obesity in the third age the focus has to be on a health identity instead of a weight identity. Personalised support with enjoyable physical activities should be designed and developed. Strategies for emotional balance based on autonomy and self-empowerment must be included. This knowledge is important when designing support for sustainable change. Full article
(This article belongs to the Special Issue Health Informatics and Public Health)
Open AccessArticle Exploration of Pedestrian Head Injuries—Collision Parameter Relationships through a Combination of Retrospective Analysis and Finite Element Method
Int. J. Environ. Res. Public Health 2016, 13(12), 1250; doi:10.3390/ijerph13121250
Received: 30 August 2016 / Revised: 18 October 2016 / Accepted: 22 November 2016 / Published: 16 December 2016
PDF Full-text (3814 KB) | HTML Full-text | XML Full-text
Abstract
There are a very limited number of reports concerning the relationship between pedestrian head injuries and collision parameters through a combination of statistical analysis methods and finite element method (FEM). This study aims to explore the characteristics of pedestrian head injuries in car–pedestrian
[...] Read more.
There are a very limited number of reports concerning the relationship between pedestrian head injuries and collision parameters through a combination of statistical analysis methods and finite element method (FEM). This study aims to explore the characteristics of pedestrian head injuries in car–pedestrian collisions at different parameters by using the two means above. A retrospective analysis of pedestrian head injuries was performed based on detailed investigation data of 61 car–pedestrian collision cases. The head damage assessment parameters (head injury criterion (HIC), peak stress on the skull, maximal principal strain for the brain) in car–pedestrian simulation experiments with four contact angles and three impact velocities were obtained by FEM. The characteristics of the pedestrian head injuries were discussed by comparing and analyzing the statistical analysis results and finite element analysis results. The statistical analysis results demonstrated a significant difference in skull fractures, contusion and laceration of brain and head injuries on the abbreviated injury scale (AIS)3+ was found at different velocities (p < 0.05) and angles (p < 0.05). The simulation results showed that, in pedestrian head-to-hood impacts, the values of head damage assessment parameters increased with impact velocities. At the same velocity, these values from the impact on the pedestrian’s back were successively greater than on the front or the side. Furthermore, head injury reconstruction and prediction results of two selected cases were consistent with the real injuries. Overall, it was further spelled out that, for shorter stature pedestrians, increased head impact velocity results in greater head injury severity in car–pedestrian collision, especially in pedestrian head-to-hood impacts. Under a back impact, the head has also been found to be at greater damage risk for shorter stature pedestrians, which may have implications on automotive design and pedestrian protection research if prevention and treatment of these injuries is to be prioritized over head injuries under a front or side impact. Full article
(This article belongs to the Special Issue Traffic Safety and Injury Prevention)
Figures

Figure 1

Open AccessArticle Recruiting Diverse Smokers: Enrollment Yields and Cost
Int. J. Environ. Res. Public Health 2016, 13(12), 1251; doi:10.3390/ijerph13121251
Received: 11 October 2016 / Revised: 21 November 2016 / Accepted: 21 November 2016 / Published: 16 December 2016
PDF Full-text (274 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
To help tobacco control research better include vulnerable populations, we sought to identify effective ways to recruit diverse smokers. In 2014–2015, we recruited 2149 adult cigarette smokers in California and North Carolina, United States, to participate in a randomized trial of pictorial cigarette
[...] Read more.
To help tobacco control research better include vulnerable populations, we sought to identify effective ways to recruit diverse smokers. In 2014–2015, we recruited 2149 adult cigarette smokers in California and North Carolina, United States, to participate in a randomized trial of pictorial cigarette pack warnings. The most effective means of recruiting smokers were the classified advertising website Craigslist (28% of participants), word of mouth (23%), Facebook (16%), and flyers or postcards (14%). Low-income and African American smokers were more likely to respond to interpersonal contact (including staff in-person recruitment and word of mouth) than were high-income and non-African American smokers (all p < 0.05). Hispanic and gay, lesbian, and bisexual smokers were more likely to be recruited by Craigslist than non-Hispanic and straight smokers (both p < 0.05). Of the recruitment methods requiring cost, the cheapest was Craigslist ($3–7 per smoker). The most expensive methods were newspaper ads in California ($375 per smoker) and staff in-person recruiting in North Carolina ($180 per smoker). Successfully recruiting diverse smokers requires using multiple methods including interpersonal, online, and other media. Craigslist and word of mouth are especially useful and low-cost ways to recruit diverse smokers. Full article
(This article belongs to the Special Issue Tobacco Control and Priority Groups)
Open AccessArticle Spatiotemporal Variations in Lung Cancer Mortality in China between 2006 and 2012: A Multilevel Analysis
Int. J. Environ. Res. Public Health 2016, 13(12), 1252; doi:10.3390/ijerph13121252
Received: 6 October 2016 / Revised: 15 November 2016 / Accepted: 21 November 2016 / Published: 16 December 2016
PDF Full-text (863 KB) | HTML Full-text | XML Full-text
Abstract
We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression
[...] Read more.
We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. Lung cancer mortality increased in China over the study period from 78.77 to 85.63 (1/100,000), with higher mortality rates evident in men compared to women. Median rate ratios (MRRs) indicated important geographical variation in lung cancer mortality between provinces (MRR = 1.622) and counties/districts (MRR = 1.447). On average, lung cancer mortality increased over time and was positively associated with county-level urbanization (relative risk (RR) = 1.15). Lung cancer mortality seemed to decrease in urban and increase in rural areas. Compared to the northwest, mortality was higher in the north (RR = 1.98), east (RR = 1.87), central (RR = 1.87), and northeast (RR = 2.44). Regional differences and county-level urbanization accounted for 49.4% and 8.7% of provincial and county variation, respectively. Reductions in lung cancer mortality in urban areas may reflect improvements in access to preventive healthcare and treatment services. Rising mortality in rural areas may reflect a clustering of risk factors associated with rapid urbanization. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Control of Pollutants in the Trans-Boundary Area of Taihu Basin, Yangtze Delta
Int. J. Environ. Res. Public Health 2016, 13(12), 1253; doi:10.3390/ijerph13121253
Received: 2 November 2016 / Revised: 9 December 2016 / Accepted: 12 December 2016 / Published: 17 December 2016
PDF Full-text (2427 KB) | HTML Full-text | XML Full-text
Abstract
This work focuses on pollution control in the trans-boundary area of Taihu Basin. Considering the unique characteristics of the river network in the study area, a new methodology of pollution control is proposed aiming at improving the water quality in the trans-boundary area
[...] Read more.
This work focuses on pollution control in the trans-boundary area of Taihu Basin. Considering the unique characteristics of the river network in the study area, a new methodology of pollution control is proposed aiming at improving the water quality in the trans-boundary area and reducing conflicts between up and downstream regions. Based on monitoring data and statistical analysis, important trans-boundary cross sections identified by the regional government were selected as important areas for consideration in developing management objectives; using a 1-D mathematicmodel and an effective weight evaluation model, the trans-boundary effective control scope (TECS) of the study area was identified as the scope for pollutant control; the acceptable pollution load was then estimated using an established model targeting bi-directional flow. The results suggest that the water environmental capacity for chemical oxygen demand (COD), in order to guarantee reaching the target water quality standard in the TECS, is 160,806 t/year, and amounts to 16,098 t/year, 3493 t/year, and 39,768 t/year for ammonia nitrogen, total nitrogen, and total phosphorus, respectively. Our study method and results have been incorporated into the local government management project, and have been proven to be useful in designing a pollution control strategy and management policy. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle On-Line Monitoring the Growth of E. coli or HeLa Cells Using an Annular Microelectrode Piezoelectric Biosensor
Int. J. Environ. Res. Public Health 2016, 13(12), 1254; doi:10.3390/ijerph13121254
Received: 17 September 2016 / Revised: 27 November 2016 / Accepted: 30 November 2016 / Published: 18 December 2016
PDF Full-text (3448 KB) | HTML Full-text | XML Full-text
Abstract
Biological information is obtained from the interaction between the series detection electrode and the organism or the physical field of biological cultures in the non-mass responsive piezoelectric biosensor. Therefore, electric parameter of the electrode will affect the biosensor signal. The electric field distribution
[...] Read more.
Biological information is obtained from the interaction between the series detection electrode and the organism or the physical field of biological cultures in the non-mass responsive piezoelectric biosensor. Therefore, electric parameter of the electrode will affect the biosensor signal. The electric field distribution of the microelectrode used in this study was simulated using the COMSOL Multiphysics analytical tool. This process showed that the electric field spatial distribution is affected by the width of the electrode finger or the space between the electrodes. In addition, the characteristic response of the piezoelectric sensor constructed serially with an annular microelectrode was tested and applied for the continuous detection of Escherichia coli culture or HeLa cell culture. Results indicated that the piezoelectric biosensor with an annular microelectrode meets the requirements for the real-time detection of E. coli or HeLa cells in culture. Moreover, this kind of piezoelectric biosensor is more sensitive than the sensor with an interdigital microelectrode. Thus, the piezoelectric biosensor acts as an effective analysis tool for acquiring online cell or microbial culture information. Full article
Figures

Open AccessArticle Perception of Environmental Risks and Health Promotion Attitudes of French Perinatal Health Professionals
Int. J. Environ. Res. Public Health 2016, 13(12), 1255; doi:10.3390/ijerph13121255
Received: 7 November 2016 / Revised: 12 December 2016 / Accepted: 13 December 2016 / Published: 18 December 2016
Cited by 1 | PDF Full-text (2819 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The exposure of pregnant women to environmental contaminants is a subject of international concern. However, the risk perception of these contaminants by health professionals (HP) has not been extensively investigated. The main objective of the PERI–HELPE study (Perception of Risk–HEaLth Professionals & Environment
[...] Read more.
The exposure of pregnant women to environmental contaminants is a subject of international concern. However, the risk perception of these contaminants by health professionals (HP) has not been extensively investigated. The main objective of the PERI–HELPE study (Perception of Risk–HEaLth Professionals & Environment Study) was to assess the risk perception of environmental exposure of pregnant women by perinatal HPs. The secondary objectives were to describe the preventive attitudes of perinatal HPs concerning chemicals exposure of pregnant women and to identify the barriers to preventive attitude. A cross-sectional study was performed in 2015 in France. One hundred eighty-nine HPs (obstetricians, midwives, and general practitioners) replied to an online self-administered questionnaire (participation rate: 11%). Carbon monoxide, pesticides and lead were the contaminants most frequently perceived as a high risk for pregnant women. A minority of HPs asked women about their chemical exposure and advised them to reduce exposure. The lack of information, training and scientific evidence in environmental health were the main difficulties declared by the HPs to advise pregnant women. Despite the low response rate, our findings provide important information to encourage French health authorities to take into account the difficulties encountered by HPs and set up appropriate training programs in Environmental health. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle Effect of 5-HT2A Receptor Polymorphisms, Work Stressors, and Social Support on Job Strain among Petroleum Workers in Xinjiang, China
Int. J. Environ. Res. Public Health 2016, 13(12), 1258; doi:10.3390/ijerph13121258
Received: 31 August 2016 / Revised: 3 December 2016 / Accepted: 14 December 2016 / Published: 19 December 2016
Cited by 1 | PDF Full-text (293 KB) | HTML Full-text | XML Full-text
Abstract
Previous studies have shown that work stressors and social support influence job strain. However, few studies have examined the impact of individual differences on job strain. In Xinjiang, there are a large number of petroleum workers in arid deserts. The present study investigated
[...] Read more.
Previous studies have shown that work stressors and social support influence job strain. However, few studies have examined the impact of individual differences on job strain. In Xinjiang, there are a large number of petroleum workers in arid deserts. The present study investigated the effects of work stressors, social support, and 5-hydroxytryptamine receptor (5-HTR2A) genotype on the etiology of job strain among petroleum workers in Xinjiang. A cross-sectional study was carried out between January and August 2013. A total of 700 workers were selected by a three-stage stratified sampling method. 5-HTR2A genotypes were determined with the SNaPshot single nucleotide polymorphism assay. Work stressors and job strain were evaluated with the Occupational Stress Inventory-Revised questionnaire. Social support was assessed with the Chinese Social Support Rating Scale. Work overload and responsibility were significantly associated with job strain. Low social support was associated with severe vocational and interpersonal strain. High social support was a protective factor against job strain (odds ratio (OR) = 0.32, 95% confidence interval (CI): 0.14–0.76). The CC genotype of rs6313 and the AA genotype of rs2070040 were linked to severe vocational strain. Ordinal logistic regression analysis revealed that the CC genotype of rs6313 was linked to higher risk of job strain than the TT genotype (OR = 1.88, 95% CI: 1.10–3.23). These data provide evidence that work stressors, low social support, and 5-HTR2A gene polymorphism contributes to the risk of job strain. Full article
(This article belongs to the Section Global Health)
Open AccessArticle The Detoxification and Degradation of Benzothiazole from the Wastewater in Microbial Electrolysis Cells
Int. J. Environ. Res. Public Health 2016, 13(12), 1259; doi:10.3390/ijerph13121259
Received: 7 October 2016 / Revised: 9 December 2016 / Accepted: 15 December 2016 / Published: 20 December 2016
PDF Full-text (2935 KB) | HTML Full-text | XML Full-text
Abstract
In this study, the high-production-volume chemical benzothiazole (BTH) from synthetic water was fully degraded into less toxic intermediates of simple organic acids using an up-flow internal circulation microbial electrolysis reactor (UICMER) under the hydraulic retention time (HRT) of 24 h. The bioelectrochemical system
[...] Read more.
In this study, the high-production-volume chemical benzothiazole (BTH) from synthetic water was fully degraded into less toxic intermediates of simple organic acids using an up-flow internal circulation microbial electrolysis reactor (UICMER) under the hydraulic retention time (HRT) of 24 h. The bioelectrochemical system was operated at 25 ± 2 °C and continuous-flow mode. The BTH loading rate varied during experiments from 20 g·m−3·day−1 to 110 g·m−3·day−1. BTH and soluble COD (Chemical Oxygen Demand) removal efficiency reached 80% to 90% under all BTH loading rates. Bioluminescence based Shewanella oneidensis strain MR-1 ecotoxicity testing demonstrated that toxicity was largely decreased compared to the BTH wastewater influent and effluent of two control experiments. The results indicated that MEC (Microbial Electrolysis Cell) was useful and reliable for improving BTH wastewater treatment efficiency, enabling the microbiological reactor to more easily respond to the requirements of higher loading rate, which is meaningful for economic and efficient operation in future scale-up. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle Wargame Simulation Theory and Evaluation Method for Emergency Evacuation of Residents from Urban Waterlogging Disaster Area
Int. J. Environ. Res. Public Health 2016, 13(12), 1260; doi:10.3390/ijerph13121260
Received: 28 November 2016 / Revised: 28 November 2016 / Accepted: 1 December 2016 / Published: 21 December 2016
PDF Full-text (4921 KB) | HTML Full-text | XML Full-text
Abstract
Urban waterlogging seriously threatens the safety of urban residents and properties. Wargame simulation research on resident emergency evacuation from waterlogged areas can determine the effectiveness of emergency response plans for high risk events at low cost. Based on wargame theory and emergency evacuation
[...] Read more.
Urban waterlogging seriously threatens the safety of urban residents and properties. Wargame simulation research on resident emergency evacuation from waterlogged areas can determine the effectiveness of emergency response plans for high risk events at low cost. Based on wargame theory and emergency evacuation plans, we used a wargame exercise method, incorporating qualitative and quantitative aspects, to build an urban waterlogging disaster emergency shelter using a wargame exercise and evaluation model. The simulation was empirically tested in Daoli District of Harbin. The results showed that the wargame simulation scored 96.40 points, evaluated as good. From the simulation results, wargame simulation of urban waterlogging emergency procedures for disaster response can improve the flexibility and capacity for command, management and decision-making in emergency management departments. Full article
Figures

Figure 1

Open AccessArticle Evaluation of the Treatment Process of Landfill Leachate Using the Toxicity Assessment Method
Int. J. Environ. Res. Public Health 2016, 13(12), 1262; doi:10.3390/ijerph13121262
Received: 31 October 2016 / Revised: 13 December 2016 / Accepted: 14 December 2016 / Published: 21 December 2016
PDF Full-text (1924 KB) | HTML Full-text | XML Full-text
Abstract
Landfill leachate is composed of a complex composition with strong biological toxicity. The combined treatment process of coagulation and sedimentation, anaerobics, electrolysis, and aerobics was set up to treat landfill leachate. This paper explores the effect of different operational parameters of coagulation and
[...] Read more.
Landfill leachate is composed of a complex composition with strong biological toxicity. The combined treatment process of coagulation and sedimentation, anaerobics, electrolysis, and aerobics was set up to treat landfill leachate. This paper explores the effect of different operational parameters of coagulation and sedimentation tanks and electrolytic cells, while investigating the combined process for the removal efficiency of physicochemical indices after processing the landfill leachate. Meanwhile, a battery of toxicity tests with Vibrio fischeri, zebrafish larvae, and embryos were conducted to evaluate acute toxicity and calculated the toxicity reduction efficiency after each treatment process. The combined treatment process resulted in a 100% removal efficiency of Cu, Cd and Zn, and a 93.50% and an 87.44% removal efficiency of Ni and Cr, respectively. The overall removal efficiency of chemical oxygen demand (COD), ammonium nitrogen (NH4+-N), and total nitrogen (TN) were 93.57%, 97.46% and 73.60%, respectively. In addition, toxicity test results showed that the acute toxicity of landfill leachate had also been reduced significantly: toxicity units (TU) decreased from 84.75 to 12.00 for zebrafish larvae, from 82.64 to 10.55 for zebrafish embryos, and from 3.41 to 0.63 for Vibrio fischeri. The combined treatment process was proved to be an efficient treatment method to remove heavy metals, COD, NH4+-N, and acute bio-toxicity of landfill leachate. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessArticle Social Disparities in Exposure to Point-of-Sale Cigarette Marketing
Int. J. Environ. Res. Public Health 2016, 13(12), 1263; doi:10.3390/ijerph13121263
Received: 27 October 2016 / Revised: 15 December 2016 / Accepted: 15 December 2016 / Published: 21 December 2016
PDF Full-text (273 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette
[...] Read more.
While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions were combined to create a summated scale. We estimated ordered logistic regression models to examine the association of sociodemographic variables with exposure to POS cigarette marketing. Adjusted results showed that having a lower income (p < 0.003) and belonging to a race/ethnicity other than “non-Hispanic White” (p = 0.011) were associated with higher levels of exposure to POS cigarette marketing. The results highlight social disparities in exposure to POS cigarette marketing in the United States, which can potentially be eliminated by banning all forms of cigarette marketing. Full article
(This article belongs to the Special Issue Tobacco Control and Priority Groups)
Open AccessArticle The Relationship between Multiple Substance Use, Perceived Academic Achievements, and Selected Socio-Demographic Factors in a Polish Adolescent Sample
Int. J. Environ. Res. Public Health 2016, 13(12), 1264; doi:10.3390/ijerph13121264
Received: 14 October 2016 / Revised: 7 December 2016 / Accepted: 14 December 2016 / Published: 21 December 2016
Cited by 2 | PDF Full-text (656 KB) | HTML Full-text | XML Full-text
Abstract
Predictors of high-risk patterns of substance use are often analysed in relation to demographic and school-related factors. The interaction between these factors and the additional impact of family wealth are still new areas of research. The aim of this study was to find
[...] Read more.
Predictors of high-risk patterns of substance use are often analysed in relation to demographic and school-related factors. The interaction between these factors and the additional impact of family wealth are still new areas of research. The aim of this study was to find determinants of the most common patterns of psychoactive substance use in mid-adolescence, compared to non-users. A sample of 1202 Polish students (46.1% boys, mean age of 15.6 years) was surveyed in 2013/2014. Four patterns of psychoactive substance use were defined using cluster analysis: non-users—71.9%, mainly tobacco and alcohol users—13.7%, high alcohol and cannabis users—7.2%, poly-users—7.2%. The final model contained the main effects of gender and age, and one three-way (perceived academic achievement × gender × family affluence) interaction. Girls with poor perception of school performance (as compared to girls with better achievements) were at significantly higher risk of being poly-users, in both less and more affluent families (adjusted odds ratio (OR) = 5.55 and OR = 3.60, respectively). The impact of family affluence was revealed only in interaction with other factors. Patterns of substance use in mid-adolescence are strongly related to perceived academic achievements, and these interact with selected socio-demographic factors. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessArticle Modeling Driver Behavior near Intersections in Hidden Markov Model
Int. J. Environ. Res. Public Health 2016, 13(12), 1265; doi:10.3390/ijerph13121265
Received: 31 August 2016 / Revised: 15 December 2016 / Accepted: 15 December 2016 / Published: 21 December 2016
PDF Full-text (1435 KB) | HTML Full-text | XML Full-text
Abstract
Intersections are one of the major locations where safety is a big concern to drivers. Inappropriate driver behaviors in response to frequent changes when approaching intersections often lead to intersection-related crashes or collisions. Thus to better understand driver behaviors at intersections, especially in
[...] Read more.
Intersections are one of the major locations where safety is a big concern to drivers. Inappropriate driver behaviors in response to frequent changes when approaching intersections often lead to intersection-related crashes or collisions. Thus to better understand driver behaviors at intersections, especially in the dilemma zone, a Hidden Markov Model (HMM) is utilized in this study. With the discrete data processing, the observed dynamic data of vehicles are used for the inference of the Hidden Markov Model. The Baum-Welch (B-W) estimation algorithm is applied to calculate the vehicle state transition probability matrix and the observation probability matrix. When combined with the Forward algorithm, the most likely state of the driver can be obtained. Thus the model can be used to measure the stability and risk of driver behavior. It is found that drivers’ behaviors in the dilemma zone are of lower stability and higher risk compared with those in other regions around intersections. In addition to the B-W estimation algorithm, the Viterbi Algorithm is utilized to predict the potential dangers of vehicles. The results can be applied to driving assistance systems to warn drivers to avoid possible accidents. Full article
(This article belongs to the Special Issue Traffic Safety and Injury Prevention)
Figures

Figure 1

Open AccessArticle Parental Perceptions of the Social Environment Are Inversely Related to Constraint of Adolescents’ Neighborhood Physical Activity
Int. J. Environ. Res. Public Health 2016, 13(12), 1266; doi:10.3390/ijerph13121266
Received: 7 November 2016 / Revised: 12 December 2016 / Accepted: 14 December 2016 / Published: 21 December 2016
PDF Full-text (1457 KB) | HTML Full-text | XML Full-text
Abstract
Background: The current study examined relationships between the neighborhood social environment (parental perceived collective efficacy (PCE)), constrained behaviors (e.g., avoidance or defensive behaviors) and adolescent offspring neighborhood physical activity in low- versus high-incivility neighborhoods. Methods: Adolescents (n = 71; 11–18 years (14.2,
[...] Read more.
Background: The current study examined relationships between the neighborhood social environment (parental perceived collective efficacy (PCE)), constrained behaviors (e.g., avoidance or defensive behaviors) and adolescent offspring neighborhood physical activity in low- versus high-incivility neighborhoods. Methods: Adolescents (n = 71; 11–18 years (14.2, SD ± 1.6); male = 37 (52%); non-white = 24 (33.8%); low-income = 20 (29%); overweight/obese = 40 (56%)) and their parents/guardians enrolled in the Molecular and Social Determinants of Obesity in Developing Youth study were included in the current study. Questionnaires measured parents’/guardians’ PCE, constrained outdoor play practices and offspring neighborhood physical activity. Systematic social observation performed at the parcel-level using Google Street View assessed neighborhood incivilities. t-tests and chi-square tests determined differences by incivilities. Multilevel regression models examined relationships between PCE and: (1) constrained behaviors; and (2) neighborhood physical activity. The Hayes (2013) macro determined the mediating role of constrained behaviors. Results: Parents who had higher PCE reported lower levels of avoidance (p = 0.04) and defensive (p = 0.05) behaviors. However, demographic variables (i.e., gender, race and annual household income) limited these results. The direct relationship between PCE and parent-reported neighborhood physical activity was statistically significant in high-incivility neighborhoods only. Neither avoidance nor defensive behavior mediated the relationship between PCE and neighborhood physical activity. Conclusions: PCE influences parenting behaviors related to youth physical activity. Community-based programs that seek to facilitate social cohesion and control may be needed to increase adolescents’ physical activity. Full article
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
Figures

Figure 1

Open AccessArticle What Contributes to the Regularity of Patients with Hypertension or Diabetes Seeking Health Services? A Pilot Follow-Up, Observational Study in Two Sites in Hubei Province, China
Int. J. Environ. Res. Public Health 2016, 13(12), 1268; doi:10.3390/ijerph13121268
Received: 29 September 2016 / Revised: 15 December 2016 / Accepted: 16 December 2016 / Published: 21 December 2016
PDF Full-text (494 KB) | HTML Full-text | XML Full-text
Abstract
Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in
[...] Read more.
Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in 2015 on diabetic and hypertensive patients in Hubei Province. We used binary logistic regression models to determine specific factors associated with diabetic and hypertensive patients that sought healthcare services for their conditions in accordance with current Chinese Centers for Disease Prevention and Control (CDC) guidelines. Our findings show that 42.16% of 510 people living with chronic conditions (PLCDs) sought health services in line with existing guidelines. Findings also show a higher probability (8.418 times) for PLCDs seeking healthcare services at higher-tiered hospitals (secondary and tertiary hospitals) than for PLCDs seeking care at primary hospitals (odds ratio (OR) = 8.418, 95% confidence interval (CI) = 4.82, 14.27, p < 0.001). These analyses underscore the importance of having patient advocates who can provide support, where necessary, and encourage positive health-seeking behavior. The study also shows a negative impact on regular maintenance for PLCDs in households with high financial constraints. In contrast, the study shows positive impacts for increased household income, age, and residency in rural locations. In sum, this study underscores the importance of primary hospitals as key points of care and critical players in care coordination for PLCDs. The study provides more evidence for Chinese policymakers seeking to contain costs and improve population health. The findings also underscore the need for community-based interventions, specifically interventions that link local primary hospitals, friends/family members, and PLCDs. Full article
(This article belongs to the Special Issue Chronic Diseases and Multimorbidity in Primary Care)
Figures

Figure 1

Review

Jump to: Editorial, Research, Other

Open AccessReview Recent Advances on Inorganic Nanoparticle-Based Cancer Therapeutic Agents
Int. J. Environ. Res. Public Health 2016, 13(12), 1182; doi:10.3390/ijerph13121182
Received: 25 September 2016 / Revised: 21 November 2016 / Accepted: 22 November 2016 / Published: 25 November 2016
PDF Full-text (3459 KB) | HTML Full-text | XML Full-text
Abstract
Inorganic nanoparticles have been widely investigated as therapeutic agents for cancer treatments in biomedical fields due to their unique physical/chemical properties, versatile synthetic strategies, easy surface functionalization and excellent biocompatibility. This review focuses on the discussion of several types of inorganic nanoparticle-based cancer
[...] Read more.
Inorganic nanoparticles have been widely investigated as therapeutic agents for cancer treatments in biomedical fields due to their unique physical/chemical properties, versatile synthetic strategies, easy surface functionalization and excellent biocompatibility. This review focuses on the discussion of several types of inorganic nanoparticle-based cancer therapeutic agents, including gold nanoparticles, magnetic nanoparticles, upconversion nanoparticles and mesoporous silica nanoparticles. Several cancer therapy techniques are briefly introduced at the beginning. Emphasis is placed on how these inorganic nanoparticles can provide enhanced therapeutic efficacy in cancer treatment through site-specific accumulation, targeted drug delivery and stimulated drug release, with elaborations on several examples to highlight the respective strategies adopted. Finally, a brief summary and future challenges are included. Full article
Figures

Figure 1

Open AccessReview Air Quality Strategies on Public Health and Health Equity in Europe—A Systematic Review
Int. J. Environ. Res. Public Health 2016, 13(12), 1196; doi:10.3390/ijerph13121196
Received: 9 September 2016 / Revised: 2 November 2016 / Accepted: 25 November 2016 / Published: 2 December 2016
PDF Full-text (484 KB) | HTML Full-text | XML Full-text
Abstract
Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to
[...] Read more.
Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO2) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessReview Air Pollution Control Policies in China: A Retrospective and Prospects
Int. J. Environ. Res. Public Health 2016, 13(12), 1219; doi:10.3390/ijerph13121219
Received: 1 November 2016 / Revised: 4 December 2016 / Accepted: 5 December 2016 / Published: 9 December 2016
Cited by 3 | PDF Full-text (1201 KB) | HTML Full-text | XML Full-text
Abstract
With China’s significant role on pollution emissions and related health damage, deep and up-to-date understanding of China’s air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China,
[...] Read more.
With China’s significant role on pollution emissions and related health damage, deep and up-to-date understanding of China’s air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1) The early policies, until 2005, were ineffective at reducing emissions; (2) During 2006–2012, new instruments which interact with political incentives were introduced in the 11th Five-Year Plan, and the national goal of reducing total sulfur dioxide (SO2) emissions by 10% was achieved. However, regional compound air pollution problems dominated by fine particulate matter (PM2.5) and ground level ozone (O3) emerged and worsened; (3) After the winter-long PM2.5 episode in eastern China in 2013, air pollution control policies have been experiencing significant changes on multiple fronts. In this work we analyze the different policy changes, the drivers of changes and key factors influencing the effectiveness of policies in these three stages. Lessons derived from the policy evolution have implications for future studies, as well as further reforming the management scheme towards air quality and health risk oriented directions. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessReview How Do Households Respond to Unreliable Water Supplies? A Systematic Review
Int. J. Environ. Res. Public Health 2016, 13(12), 1222; doi:10.3390/ijerph13121222
Received: 23 September 2016 / Revised: 22 November 2016 / Accepted: 30 November 2016 / Published: 9 December 2016
PDF Full-text (501 KB) | HTML Full-text | XML Full-text
Abstract
Although the Millennium Development Goal (MDG) target for drinking water was met, in many developing countries water supplies are unreliable. This paper reviews how households in developing countries cope with unreliable water supplies, including coping costs, the distribution of coping costs across socio-economic
[...] Read more.
Although the Millennium Development Goal (MDG) target for drinking water was met, in many developing countries water supplies are unreliable. This paper reviews how households in developing countries cope with unreliable water supplies, including coping costs, the distribution of coping costs across socio-economic groups, and effectiveness of coping strategies in meeting household water needs. Structured searches were conducted in peer-reviewed and grey literature in electronic databases and search engines, and 28 studies were selected for review, out of 1643 potentially relevant references. Studies were included if they reported on strategies to cope with unreliable household water supplies and were based on empirical research in developing countries. Common coping strategies include drilling wells, storing water, and collecting water from alternative sources. The choice of coping strategies is influenced by income, level of education, land tenure and extent of unreliability. The findings of this review highlight that low-income households bear a disproportionate coping burden, as they often engage in coping strategies such as collecting water from alternative sources, which is labour and time-intensive, and yields smaller quantities of water. Such alternative sources may be of lower water quality, and pose health risks. In the absence of dramatic improvements in the reliability of water supplies, a point of critical avenue of enquiry should be what coping strategies are effective and can be readily adopted by low income households. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessReview The Adverse Effects of Heavy Metals with and without Noise Exposure on the Human Peripheral and Central Auditory System: A Literature Review
Int. J. Environ. Res. Public Health 2016, 13(12), 1223; doi:10.3390/ijerph13121223
Received: 17 August 2016 / Revised: 22 November 2016 / Accepted: 7 December 2016 / Published: 9 December 2016
PDF Full-text (477 KB) | HTML Full-text | XML Full-text
Abstract
Exposure to some chemicals in the workplace can lead to occupational chemical-induced hearing loss. Attention has mainly focused on the adverse auditory effects of solvents. However, other chemicals such as heavy metals have been also identified as ototoxic agents. The aim of this
[...] Read more.
Exposure to some chemicals in the workplace can lead to occupational chemical-induced hearing loss. Attention has mainly focused on the adverse auditory effects of solvents. However, other chemicals such as heavy metals have been also identified as ototoxic agents. The aim of this work was to review the current scientific knowledge about the adverse auditory effects of heavy metal exposure with and without co-exposure to noise in humans. PubMed and Medline were accessed to find suitable articles. A total of 49 articles met the inclusion criteria. Results from the review showed that no evidence about the ototoxic effects in humans of manganese is available. Contradictory results have been found for arsenic, lead and mercury as well as for the possible interaction between heavy metals and noise. All studies found in this review have found that exposure to cadmium and mixtures of heavy metals induce auditory dysfunction. Most of the studies investigating the adverse auditory effects of heavy metals in humans have investigated human populations exposed to lead. Some of these studies suggest peripheral and central auditory dysfunction induced by lead exposure. It is concluded that further evidence from human studies about the adverse auditory effects of heavy metal exposure is still required. Despite this issue, audiologists and other hearing health care professionals should be aware of the possible auditory effects of heavy metals. Full article
(This article belongs to the Special Issue The Combined Health Effects of Environmental Exposures)
Figures

Figure 1

Open AccessReview Facilitators and Barriers of Smokers’ Compliance with Smoking Bans in Public Places: A Systematic Review of Quantitative and Qualitative Literature
Int. J. Environ. Res. Public Health 2016, 13(12), 1228; doi:10.3390/ijerph13121228
Received: 15 August 2016 / Revised: 17 November 2016 / Accepted: 28 November 2016 / Published: 11 December 2016
PDF Full-text (598 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim:
[...] Read more.
Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim: To identify facilitators and barriers that influenced smokers’ compliance with smoking bans in public places. Methods: Using PubMed, MEDLINE, and the Web of Science database, we conducted a systematic search of English articles published before June 2015 on factors of smokers’ compliance with the smoking bans in public places. Results: A total of 390 references were identified, among which seventeen articles (twelve quantitative studies, two qualitative studies, three mixed-method studies) were included in this review. These studies focused on four types of public places including recreational venues (n = 7), hospital (n = 5), school (n = 4), and workplace (n = 1). Factors at the individual-, interpersonal-, and organizational-level were identified: at the individual level, nicotine dependence, insufficiency of tobacco-related knowledge, and the negative attitudes towards smoking bans were the most commonly identified barriers; at the interpersonal level, the smoking behaviors of people around, close relatives, and friends’ approval were the main barriers; and at the organizational level, the main barriers were inefficient implementation of the bans and the inconvenience of the designative smoking areas. Conclusions: This synthesis of the literature provided evidence of the identified barriers and facilitators of smokers’ compliance with the smoking bans. It will be beneficial for the policy-maker to consider interventions on multiple levels of factors to overcome the barriers and enhance smokers’ compliance with the smoking bans in public places. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
Figures

Figure 1

Open AccessReview Overview of Cotinine Cutoff Values for Smoking Status Classification
Int. J. Environ. Res. Public Health 2016, 13(12), 1236; doi:10.3390/ijerph13121236
Received: 4 September 2016 / Revised: 10 November 2016 / Accepted: 14 November 2016 / Published: 14 December 2016
Cited by 1 | PDF Full-text (452 KB) | HTML Full-text | XML Full-text
Abstract
While cotinine is commonly used as a biomarker to validate self-reported smoking status, the selection of an optimal cotinine cutoff value for distinguishing true smokers from true nonsmokers shows a lack of standardization among studies. This review describes how the cutoff values have
[...] Read more.
While cotinine is commonly used as a biomarker to validate self-reported smoking status, the selection of an optimal cotinine cutoff value for distinguishing true smokers from true nonsmokers shows a lack of standardization among studies. This review describes how the cutoff values have been derived, and explains the issues involved in the generalization of a cutoff value. In this study, we conducted an English-language literature search in PubMed using the keywords “cotinine” and “cutoff” or “self-reported” and “smoking status” and “validation” for the years 1985–2014. We obtained 104 articles, 32 of which provided (1) sensitivity and specificity of a cutoff value and (2) determination methods for the given cutoff value. We found that the saliva cotinine cutoff value range of 10–25 ng/mL, serum and urine cotinine cutoff of 10–20 ng/mL and 50–200 ng/mL, respectively, have been commonly used to validate self-reported smoking status using a 2 × 2 table or a receiver operating characteristics (ROC) curve. We also found that recent large population-based studies in the U.S. and UK reported lower cutoff values for cotinine in serum (3 ng/mL) and saliva (12 ng/mL), compared to the traditionally accepted ones (15 and 14 ng/mg, respectively). Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessReview HIV, Other Blood-Borne Viruses and Sexually Transmitted Infections amongst Expatriates and Travellers to Low- and Middle-Income Countries: A Systematic Review
Int. J. Environ. Res. Public Health 2016, 13(12), 1249; doi:10.3390/ijerph13121249
Received: 12 October 2016 / Revised: 1 December 2016 / Accepted: 12 December 2016 / Published: 16 December 2016
PDF Full-text (804 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
In some high-income countries, a proportion of human immunodeficiency virus (HIV), other blood-borne virus (BBV) or sexually transmitted infection (STI) diagnoses have been reported as acquired overseas in low- and middle-income countries. A review was conducted to explore HIV, other BBV or STI
[...] Read more.
In some high-income countries, a proportion of human immunodeficiency virus (HIV), other blood-borne virus (BBV) or sexually transmitted infection (STI) diagnoses have been reported as acquired overseas in low- and middle-income countries. A review was conducted to explore HIV, other BBV or STI related knowledge, risk behavior and acquisition amongst expatriates and travelers, particularly males, travelling from high to low- and middle-income countries. Seven academic databases were searched for 26 peer reviewed articles that met inclusion criteria. Significant variability in the studies was noted, in age, travel duration and frequency and outcomes/risk factors measured and reported on. Risk factors described included longer duration of stay; being single; travel for romance or sex; alcohol and other drug use; lack of travel advice; being male; higher number of sexual partners; and inconsistent condom use. Vaccination, pre-travel health advice, and having fewer sexual partners were described as protective. Studies are needed focusing on the social context in which risk-taking occurs. Better collaboration is essential to deliver comprehensive health promotion interventions alongside more consistent pre- and post- travel testing and advice. Policy measures are crucial, including consistent evaluation indicators to assess impacts of HIV, other BBVs or STIs in the context of mobility. Risks and responses for these epidemics are shared globally. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessReview Artificial Diets for Mosquitoes
Int. J. Environ. Res. Public Health 2016, 13(12), 1267; doi:10.3390/ijerph13121267
Received: 19 November 2016 / Revised: 14 December 2016 / Accepted: 19 December 2016 / Published: 21 December 2016
Cited by 1 | PDF Full-text (809 KB) | HTML Full-text | XML Full-text
Abstract
Mosquito-borne diseases are responsible for more than a million human deaths every year. Modern mosquito control strategies such as sterile insect technique (SIT), release of insects carrying a dominant lethal (RIDL), population replacement strategies (PR), and Wolbachia-based strategies require the rearing of
[...] Read more.
Mosquito-borne diseases are responsible for more than a million human deaths every year. Modern mosquito control strategies such as sterile insect technique (SIT), release of insects carrying a dominant lethal (RIDL), population replacement strategies (PR), and Wolbachia-based strategies require the rearing of large numbers of mosquitoes in culture for continuous release over an extended period of time. Anautogenous mosquitoes require essential nutrients for egg production, which they obtain through the acquisition and digestion of a protein-rich blood meal. Therefore, mosquito mass production in laboratories and other facilities relies on vertebrate blood from live animal hosts. However, vertebrate blood is expensive to acquire and hard to store for longer times especially under field conditions. This review discusses older and recent studies that were aimed at the development of artificial diets for mosquitoes in order to replace vertebrate blood. Full article
(This article belongs to the Special Issue Mosquito Control Innovations into The 21st Century)
Figures

Other

Jump to: Editorial, Research, Review

Open AccessBrief Report Neonatal Diesel Exhaust Particulate Exposure Does Not Predispose Mice to Adult Cardiac Hypertrophy or Heart Failure
Int. J. Environ. Res. Public Health 2016, 13(12), 1178; doi:10.3390/ijerph13121178
Received: 14 October 2016 / Revised: 11 November 2016 / Accepted: 22 November 2016 / Published: 24 November 2016
PDF Full-text (1202 KB) | HTML Full-text | XML Full-text
Abstract
Background: We have previously reported that in utero and early life exposure to diesel exhaust particulates predisposes mice to adult heart failure, and that in utero exposure alone is sufficient to confer this predisposition. This follow up study addresses whether neonatal exposure alone
[...] Read more.
Background: We have previously reported that in utero and early life exposure to diesel exhaust particulates predisposes mice to adult heart failure, and that in utero exposure alone is sufficient to confer this predisposition. This follow up study addresses whether neonatal exposure alone can also confer this predisposition. Methods: Newborn male C57BL/6 mice were exposed to diesel exhaust (DE) particulates immediately after birth until weaning at 21 days of age, whereupon they were transferred to filtered air (FA) conditions. At the age of 12 weeks, transverse aortic constriction (TAC) was performed followed by weekly echocardiography for three weeks. After the last echocardiogram, mice were euthanized for organ harvest, gravimetry and histology. Results: Neonatal exposure to DE particulates did not increase susceptibility to cardiac hypertrophy or heart failure after TAC when compared to FA exposed controls (ventricular weight/body weight ratio 7.505 vs. 7.517 mg/g, p = Not Significant (NS)). The left ventricular ejection fraction after TAC was similar between groups at one week, two weeks, and three weeks after procedure. Histological analysis showed no difference in the degree of cardiac hypertrophy or fibrosis. Conclusions: Neonatal exposure to DE particulates does not predispose mice to TAC-induced cardiac hypertrophy and heart failure in adulthood, in contrast to previously published results showing susceptibility due to in utero exposure. Full article
(This article belongs to the Section Environmental Health)
Figures

Figure 1

Open AccessConcept Paper Development and Preliminary Validation of a Comprehensive Questionnaire to Assess Women’s Knowledge and Perception of the Current Weight Gain Guidelines during Pregnancy
Int. J. Environ. Res. Public Health 2016, 13(12), 1187; doi:10.3390/ijerph13121187
Received: 21 September 2016 / Revised: 9 November 2016 / Accepted: 22 November 2016 / Published: 30 November 2016
PDF Full-text (452 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this study was to develop and validate an electronic questionnaire, the Electronic Maternal Health Survey (EMat Health Survey), related to women’s knowledge and perceptions of the current gestational weight gain guidelines (GWG), as well as pregnancy-related health behaviours.
[...] Read more.
The aim of this study was to develop and validate an electronic questionnaire, the Electronic Maternal Health Survey (EMat Health Survey), related to women’s knowledge and perceptions of the current gestational weight gain guidelines (GWG), as well as pregnancy-related health behaviours. Constructs addressed within the questionnaire include self-efficacy, locus of control, perceived barriers, and facilitators of physical activity and diet, outcome expectations, social environment and health practices. Content validity was examined using an expert panel (n = 7) and pilot testing items in a small sample (n = 5) of pregnant women and recent mothers (target population). Test re-test reliability was assessed among a sample (n = 71) of the target population. Reliability scores were calculated for all constructs (r and intra-class correlation coefficients (ICC)), those with a score of >0.5 were considered acceptable. The content validity of the questionnaire reflects the degree to which all relevant components of excessive GWG risk in women are included. Strong test-retest reliability was found in the current study, indicating that responses to the questionnaire were reliable in this population. The EMat Health Survey adds to the growing body of literature on maternal health and gestational weight gain by providing the first comprehensive questionnaire that can be self-administered and remotely accessed. The questionnaire can be completed in 15–25 min and collects useful data on various social determinants of health and GWG as well as associated health behaviours. This online tool may assist researchers by providing them with a platform to collect useful information in developing and tailoring interventions to better support women in achieving recommended weight gain targets in pregnancy. Full article
(This article belongs to the Section Global Health)
Figures

Figure 1

Open AccessComment Comments on Quaak, et al. The Dynamics of Autism Spectrum Disorders: How Neurotoxic Compounds and Neurotransmitters Interact. Int. J. Environ. Res. Public Health 2013, 10, 3384–3408
Int. J. Environ. Res. Public Health 2016, 13(12), 1207; doi:10.3390/ijerph13121207
Received: 14 November 2016 / Revised: 14 November 2016 / Accepted: 21 November 2016 / Published: 3 December 2016
PDF Full-text (231 KB) | HTML Full-text | XML Full-text
Abstract I have read the article entitled “The dynamics of autism spectrum disorders: how neurotoxic compounds and neurotransmitters interact”. There are some errors in the interpretation of results obtained from our previous studies that should be explained. Full article
Open AccessEssay Community Capitals as Community Resilience to Climate Change: Conceptual Connections
Int. J. Environ. Res. Public Health 2016, 13(12), 1211; doi:10.3390/ijerph13121211
Received: 19 September 2016 / Revised: 21 November 2016 / Accepted: 25 November 2016 / Published: 6 December 2016
Cited by 1 | PDF Full-text (647 KB) | HTML Full-text | XML Full-text
Abstract
In the last few decades, disaster risk reduction programs and climate initiatives across the globe have focused largely on the intimate connections between vulnerability, recovery, adaptation, and coping mechanisms. Recent focus, however, is increasingly paid to community resilience. Community, placed at the intersection
[...] Read more.
In the last few decades, disaster risk reduction programs and climate initiatives across the globe have focused largely on the intimate connections between vulnerability, recovery, adaptation, and coping mechanisms. Recent focus, however, is increasingly paid to community resilience. Community, placed at the intersection between the household and national levels of social organization, is crucial in addressing economic, social, or environmental disturbances disrupting human security. Resilience measures a community’s capability of bouncing back—restoring the original pre-disaster state, as well as bouncing forward—the capacity to cope with emerging post-disaster situations and changes. Both the ‘bouncing back’ and ‘moving forward’ properties of a community are shaped and reshaped by internal and external shocks such as climate threats, the community’s resilience dimensions, and the intensity of economic, social, and other community capitals. This article reviews (1) the concept of resilience in relation to climate change and vulnerability; and (2) emerging perspectives on community-level impacts of climate change, resilience dimensions, and community capitals. It argues that overall resilience of a place-based community is located at the intersection of the community’s resilience dimensions, community capitals, and the level of climate disruptions. Full article
(This article belongs to the Special Issue The Evolving Relationship between Science and Disaster Risk Reduction)
Figures

Figure 1

Open AccessCommentary Australian Food Safety Policy Changes from a “Command and Control” to an “Outcomes-Based” Approach: Reflection on the Effectiveness of Its Implementation
Int. J. Environ. Res. Public Health 2016, 13(12), 1218; doi:10.3390/ijerph13121218
Received: 11 October 2016 / Revised: 1 December 2016 / Accepted: 6 December 2016 / Published: 8 December 2016
PDF Full-text (276 KB) | HTML Full-text | XML Full-text
Abstract
Foodborne illness is a global public health burden. Over the past decade in Australia, despite advances in microbiological detection and control methods, there has been an increase in the incidence of foodborne illness. Therefore improvements in the regulation and implementation of food safety
[...] Read more.
Foodborne illness is a global public health burden. Over the past decade in Australia, despite advances in microbiological detection and control methods, there has been an increase in the incidence of foodborne illness. Therefore improvements in the regulation and implementation of food safety policy are crucial for protecting public health. In 2000, Australia established a national food safety regulatory system, which included the adoption of a mandatory set of food safety standards. These were in line with international standards and moved away from a “command and control” regulatory approach to an “outcomes-based” approach using risk assessment. The aim was to achieve national consistency and reduce foodborne illness without unnecessarily burdening businesses. Evidence demonstrates that a risk based approach provides better protection for consumers; however, sixteen years after the adoption of the new approach, the rates of food borne illness are still increasing. Currently, food businesses are responsible for producing safe food and regulatory bodies are responsible for ensuring legislative controls are met. Therefore there is co-regulatory responsibility and liability and implementation strategies need to reflect this. This analysis explores the challenges facing food regulation in Australia and explores the rationale and evidence in support of this new regulatory approach. Full article
(This article belongs to the Section Global Health)
Open AccessCommentary Disadvantaged Social Groups and the Cigarette Epidemic: Limits of the Diffusion of Innovations Vision
Int. J. Environ. Res. Public Health 2016, 13(12), 1230; doi:10.3390/ijerph13121230
Received: 28 October 2016 / Revised: 2 December 2016 / Accepted: 7 December 2016 / Published: 11 December 2016
Cited by 1 | PDF Full-text (572 KB) | HTML Full-text | XML Full-text
Abstract
The original four-stage model of the cigarette epidemic has been extended with diffusion of innovations theory to reflect socio-economic differences in cigarette use. Recently, two revisions of the model have been proposed: (1) separate analysis of the epidemic stages for men and women,
[...] Read more.
The original four-stage model of the cigarette epidemic has been extended with diffusion of innovations theory to reflect socio-economic differences in cigarette use. Recently, two revisions of the model have been proposed: (1) separate analysis of the epidemic stages for men and women, in order to improve generalization to developing countries, and; (2) addition of a fifth stage to the smoking epidemic, in order to account for the persistence of smoking in disadvantaged social groups. By developing a cohort perspective spanning a 35-year time period in France and the USA, we uncover distinctive features which challenge the currently held vision on the evolution of smoking inequalities within the framework of the cigarette epidemic. We argue that the reason for which the model may not be fit to the lower educated is that the imitation mechanism underlying the diffusion of innovations works well with regard to adoption of the habit, but is much less relevant with regard to its rejection. Based on those observations, we support the idea that the nature and timing of the epidemic differs enough to treat the stages separately for high and low education groups, and discuss policy implications. Full article
(This article belongs to the Special Issue Tobacco Control and Priority Groups)
Figures

Figure 1

Open AccessConcept Paper Synergising Public Health Concepts with the Sendai Framework for Disaster Risk Reduction: A Conceptual Glossary
Int. J. Environ. Res. Public Health 2016, 13(12), 1241; doi:10.3390/ijerph13121241
Received: 31 August 2016 / Revised: 5 December 2016 / Accepted: 6 December 2016 / Published: 14 December 2016
PDF Full-text (331 KB) | HTML Full-text | XML Full-text
Abstract
The Sendai Framework for Disaster Risk Reduction (2015) is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that
[...] Read more.
The Sendai Framework for Disaster Risk Reduction (2015) is a global strategy for addressing disaster risk and resilience that has been ratified by member countries of the United Nations. Its guiding principles emphasise building resilience through inter-sectoral collaboration, as well as partnerships that facilitate community empowerment and address underlying risk factors. Both public health and the emergency management sector face similar challenges related to developing and implementing strategies that involve structural change, facilitating community resilience and addressing individual risk factors. Familiarity with public health principles enables an understanding of the holistic approach to risk reduction that is outlined within the Sendai Framework. We present seven concepts that resonate with contemporary public health practice, namely: the social determinants of health; inequality and inequity; the inverse care law; community-based and community development approaches; hard to reach communities and services; the prevention paradox; and the inverse prevention law. These ideas from public health provide a useful conceptual base for the ”new” agenda in disaster risk management that underpins the 2015 Sendai Framework. The relevance of these ideas to disaster risk management and research is illustrated through drawing on the Sendai Framework, disaster literature and exemplars from the 2010–2011 earthquakes in Canterbury, New Zealand. Full article
(This article belongs to the Special Issue The Evolving Relationship between Science and Disaster Risk Reduction)
Open AccessComment Exploring the Role of Vitamin D. Comments on Fleury et al. Sun Exposure and Its Effects on Human Health: Mechanisms through Which Sun Exposure Could Reduce the Risk of Developing Obesity and Cardiometabolic Dysfunction. Int. J. Environ. Res. Public Health 2016, 13, 999
Int. J. Environ. Res. Public Health 2016, 13(12), 1256; doi:10.3390/ijerph13121256
Received: 19 November 2016 / Revised: 9 December 2016 / Accepted: 9 December 2016 / Published: 18 December 2016
Cited by 1 | PDF Full-text (228 KB) | HTML Full-text | XML Full-text
(This article belongs to the Section Global Health)
Open AccessReply Response to the Boucher et al. Comments on Fleury et al. Sun Exposure and Its Effects on Human Health: Mechanisms through Which Sun Exposure Could Reduce the Risk of Developing Obesity and Cardiometabolic Dysfunction. Int. J. Environ. Res. Public Health 2016, 13, 999
Int. J. Environ. Res. Public Health 2016, 13(12), 1257; doi:10.3390/ijerph13121257
Received: 28 November 2016 / Revised: 9 December 2016 / Accepted: 9 December 2016 / Published: 18 December 2016
PDF Full-text (229 KB) | HTML Full-text | XML Full-text
Abstract We thank Boucher et al. [1] for their interest in our recently published review [2]. [...] Full article
(This article belongs to the Section Environmental Health)

Journal Contact

MDPI AG
IJERPH Editorial Office
St. Alban-Anlage 66, 4052 Basel, Switzerland
E-Mail: 
Tel. +41 61 683 77 34
Fax: +41 61 302 89 18
Editorial Board
Contact Details Submit to IJERPH Edit a special issue Review for IJERPH
loading...
Back to Top