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Int. J. Environ. Res. Public Health, Volume 15, Issue 3 (March 2018)

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Cover Story (view full-size image) Adolescents’ deaths by suicide are tragedies which touch the lives of large numbers of people. How [...] Read more.
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Editorial

Jump to: Research, Review, Other

Open AccessEditorial Burden of Injuries in Bangladesh: A Population-Based Assessment
Int. J. Environ. Res. Public Health 2018, 15(3), 409; doi:10.3390/ijerph15030409
Received: 13 February 2018 / Revised: 23 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
Injuries claim over 5 million lives, with more than 90% of those occurring in low- and middle-income countries (LMICS) [...] Full article
Open AccessEditorial Ageing, Health and Equity—Broad Perspectives Are Needed to Understand and Tackle Health Challenges of Ageing Societies
Int. J. Environ. Res. Public Health 2018, 15(3), 457; doi:10.3390/ijerph15030457
Received: 26 February 2018 / Revised: 26 February 2018 / Accepted: 1 March 2018 / Published: 6 March 2018
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Abstract
Demographic change and the evolving demands on healthcare systems, especially in the provision of healthcare and long-term care for a growing number of older people, are among the greatest social challenges of the next decades.[...] Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
Open AccessEditorial Work Stress and the Development of Chronic Diseases
Int. J. Environ. Res. Public Health 2018, 15(3), 536; doi:10.3390/ijerph15030536
Received: 11 March 2018 / Revised: 13 March 2018 / Accepted: 13 March 2018 / Published: 16 March 2018
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Abstract
In modern societies, major changes have occurred in the world of work and employment in the recent past.
Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
Open AccessEditorial Sustainable Transportation and Health
Int. J. Environ. Res. Public Health 2018, 15(3), 542; doi:10.3390/ijerph15030542
Received: 14 March 2018 / Revised: 16 March 2018 / Accepted: 16 March 2018 / Published: 18 March 2018
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Abstract
We are experiencing a shift in thinking about Transportation and Mobility, which makes this Special Issue on Sustainable Transportation and Health in the International Journal of Environmental Research and Public Health especially timely.[...] Full article
(This article belongs to the Special Issue Sustainable Transportation and Health)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Content of Heavy Metal in the Dust of Leisure Squares and Its Health Risk Assessment—A Case Study of Yanta District in Xi’an
Int. J. Environ. Res. Public Health 2018, 15(3), 394; doi:10.3390/ijerph15030394
Received: 2 January 2018 / Revised: 3 February 2018 / Accepted: 14 February 2018 / Published: 25 February 2018
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Abstract
Taking Yanta District in Xi’an as the research object, the present study measures the contents of Cadmium (Cd), Lead (Pb), Copper (Cu), Nickel (Ni), and Chromium (Cr) in dust samples and further assesses the health risk of heavy metals intake through dust based
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Taking Yanta District in Xi’an as the research object, the present study measures the contents of Cadmium (Cd), Lead (Pb), Copper (Cu), Nickel (Ni), and Chromium (Cr) in dust samples and further assesses the health risk of heavy metals intake through dust based on the assessment method of human exposure risk proposed by U.S. EPA, with an aim to investigate the content of heavy metal in the dust of leisure squares and its exposure risk. As the results indicate, the average contents of five heavy metals are obviously higher than the soil background value in Shaanxi Province. Therefore, Cd, Ni, Cu, Pb, and Cr are obviously enriched in urban surface dust in Shaanxi Province, due to the influence of human activities. In addition, it can also be found that the non-carcinogen exposure risk in children is significantly higher than that in adults with the risk values of these five heavy metals all one order of magnitude higher than those of adults. Irrespective of whether addressing the results for children or adults, the non-carcinogen exposure doses of five heavy metals are sorted as Cr > Pb > Cu > Ni > Cd. According to the present situation, for a child, the total non-carcinogenic risk values of five heavy metals have exceeded the safety limit in 11 of the 20 leisure squares in Yanta District of Xi’an. That means the leisure squares are no longer suitable for physical and recreational activities. For the five heavy metals, the average non-carcinogenic risk value of Cr is largest, and causes the largest threat to health in Yanta District, Xi’an. The carcinogenic exposure doses of the heavy metals Cr, Cd, and Ni are very low in respiratory pathways and there is no carcinogenic health risk. In general, the Cr content in dust in domestic cities is higher than that of foreign cities; however, the Pb content is much lower. Full article
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Open AccessArticle Epidemiological Characteristics and Space-Time Analysis of the 2015 Dengue Outbreak in the Metropolitan Region of Tainan City, Taiwan
Int. J. Environ. Res. Public Health 2018, 15(3), 396; doi:10.3390/ijerph15030396
Received: 9 February 2018 / Revised: 23 February 2018 / Accepted: 23 February 2018 / Published: 26 February 2018
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Abstract
The metropolitan region of Tainan City in southern Taiwan experienced a dengue outbreak in 2015. This manuscript describes basic epidemiological features of this outbreak and uses spatial and temporal analysis tools to understand the spread of dengue during the outbreak. The analysis found
[...] Read more.
The metropolitan region of Tainan City in southern Taiwan experienced a dengue outbreak in 2015. This manuscript describes basic epidemiological features of this outbreak and uses spatial and temporal analysis tools to understand the spread of dengue during the outbreak. The analysis found that, independently of gender, dengue incidence rate increased with age, and proportionally affected more males below the age of 40 years but females above the age of 40 years. A spatial scan statistic was applied to detect clusters of disease transmission. The scan statistic found that dengue spread in a north-south diffusion direction, which is across the North, West-Central and South districts of Tainan City. Spatial regression models were used to quantify factors associated with transmission. This analysis indicated that neighborhoods with high proportions of residential area (or low wetland cover) were associated with dengue transmission. However, these association patterns were non-linear. The findings presented here can help Taiwanese public health agencies to understand the fundamental epidemiological characteristics and diffusion patterns of the 2015 dengue outbreak in Tainan City. This type of information is fundamental for policy making to prevent future uncontrolled dengue outbreaks, given that results from this study suggest that control interventions should be emphasized in the North and West-Central districts of Tainan city, in areas with a moderate percentage of residential land cover. Full article
(This article belongs to the Special Issue Spatio-Temporal Analysis of Infectious Diseases)
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Open AccessArticle Stress-Preventive Management Competencies, Psychosocial Work Environments, and Affective Well-Being: A Multilevel, Multisource Investigation
Int. J. Environ. Res. Public Health 2018, 15(3), 397; doi:10.3390/ijerph15030397
Received: 29 January 2018 / Revised: 19 February 2018 / Accepted: 22 February 2018 / Published: 26 February 2018
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Abstract
The Management Competencies for Preventing and Reducing Stress at Work framework represents one of the few tailored models of leadership for work stress prevention purposes, but it has never been empirically evaluated. The aim of this study was to investigate whether supervisors’ stress-preventive
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The Management Competencies for Preventing and Reducing Stress at Work framework represents one of the few tailored models of leadership for work stress prevention purposes, but it has never been empirically evaluated. The aim of this study was to investigate whether supervisors’ stress-preventive management competencies, as measured by the Stress Management Competencies Indicator Tool (SMCIT), are related to employees’ affective well-being through psychosocial work environmental factors. To this end, multilevel structural equation modelling (MSEM) was developed and tested, including data provided by both supervisors and employees. Supervisors (n = 84) self-assessed their stress-preventive management competencies (i.e., being respectful and responsible, managing and communicating existing and future work, reasoning and managing difficult situations, and managing the individual within the team) with a previously validated reduced version of the SMCIT. The supervised employees (n = 584) rated job content (e.g., job demands) and work context (e.g., role clarity) psychosocial factors and their job-related affective well-being. Supervisors’ job-related affective well-being was also included in the tested model. The results revealed that the stress-preventive competencies factor was related to employees’ affective well-being through the psychosocial work environment only when the latter was operationalized by means of contextual work factors. Supervisors’ affective well-being was related to their stress-preventive competencies, but it was not related to employees’ affective well-being. We discuss the implications of the results obtained. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle The Cost of Inadequate Sleep among On-Call Workers in Australia: A Workplace Perspective
Int. J. Environ. Res. Public Health 2018, 15(3), 398; doi:10.3390/ijerph15030398
Received: 27 December 2017 / Revised: 7 February 2018 / Accepted: 14 February 2018 / Published: 26 February 2018
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Abstract
On-call or stand-by is becoming an increasingly prevalent form of work scheduling. However, on-call arrangements are typically utilised when workloads are low, for example at night, which can result in inadequate sleep. It is a matter of concern that on-call work is associated
[...] Read more.
On-call or stand-by is becoming an increasingly prevalent form of work scheduling. However, on-call arrangements are typically utilised when workloads are low, for example at night, which can result in inadequate sleep. It is a matter of concern that on-call work is associated with an increased risk of workplace injury. This study sought to determine the economic cost of injury due to inadequate sleep in Australian on-call workers. The prevalence of inadequate sleep among on-call workers was determined using an online survey, and economic costs were estimated using a previously validated costing methodology. Two-thirds of the sample (66%) reported obtaining inadequate sleep on weekdays (work days) and over 80% reported inadequate sleep while on-call. The resulting cost of injury is estimated at $2.25 billion per year ($1.71–2.73 billion). This equates to $1222 per person per incident involving a short-term absence from work; $2.53 million per incident classified as full incapacity, and $1.78 million for each fatality. To the best of our knowledge this is the first study to quantify the economic cost of workplace injury due to inadequate sleep in on-call workers. Well-rested employees are critical to safe and productive workplace operations. Therefore, it is in the interest of both employers and governments to prioritise and invest far more into the management of inadequate sleep in industries which utilise on-call work arrangements. Full article
(This article belongs to the Special Issue Sleep Health)
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Open AccessArticle Correlation between Changes in Local Earth’s Magnetic Field and Cases of Acute Myocardial Infarction
Int. J. Environ. Res. Public Health 2018, 15(3), 399; doi:10.3390/ijerph15030399
Received: 17 January 2018 / Revised: 19 February 2018 / Accepted: 23 February 2018 / Published: 26 February 2018
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Abstract
The impact of changes in the geomagnetic field on the human body remains the subject of studies across the world, yet there is no consensus. Current studies are observing effects that require further work by researchers in order to find out the mechanisms
[...] Read more.
The impact of changes in the geomagnetic field on the human body remains the subject of studies across the world, yet there is no consensus. Current studies are observing effects that require further work by researchers in order to find out the mechanisms that would allow a proper assessment of the correlations between the Earth‘s magnetic field variations and changes in human organisms. The main purpose of this study was to investigate possible correlations between the strength of time-varying aspects of the local Earth’s magnetic field and incidence of myocardial infarctions. Study participants included 435 males and 268 females who had diagnosis of myocardial infarction during the period of 1 January 2016 to 31 December 2016 and attended the Department of Cardiology at the Hospital of Lithuanian University of Health Sciences (LUHS), Kauno klinikos. Time varying magnetic field data was collected at the magnetometer site located in Lithuania. After mathematical analysis, the results support the hypothesis that the Earth’s magnetic field has a relationship between the number of acute myocardial infarction with ST segment elevation (STEMI) cases per week and the average weekly geomagnetic field strength in different frequency ranges. Correlations varied in different age groups as well as in males and females, which may indicate diverse organism sensitivity to the Earth’s magnetic field. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Does Electronic Cigarette Use Predict Abstinence from Conventional Cigarettes among Smokers in Hong Kong?
Int. J. Environ. Res. Public Health 2018, 15(3), 400; doi:10.3390/ijerph15030400
Received: 22 December 2017 / Revised: 21 February 2018 / Accepted: 21 February 2018 / Published: 26 February 2018
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Abstract
Objectives: To investigate the effects of ever use of electronic cigarettes (ECs), many of which lack nicotine, on abstinence from convention cigarettes among Hong Kong adult smokers. Methods: We collected data from 956 daily smokers in 2014–2015 regarding ever EC use and smoking
[...] Read more.
Objectives: To investigate the effects of ever use of electronic cigarettes (ECs), many of which lack nicotine, on abstinence from convention cigarettes among Hong Kong adult smokers. Methods: We collected data from 956 daily smokers in 2014–2015 regarding ever EC use and smoking behaviors at baseline, any and past 30-day EC use at the 3-month follow-up. Outcomes measured at 6 months included past 7-day point prevalence abstinence (PPA), biochemically validated quitting, smoking reduction (≥50% from baseline) and cessation attempt. Logistic regression yielded adjusted odds ratios (AOR) for quitting in relation to EC use, adjusting for socio-demographic characteristics and smoking profile. Complete case, missing observation as smoking and propensity score analyses were conducted. Results: By complete case, ever EC use at baseline did not predict self-reported PPA (AOR 0.99, 95% CI 0.57–1.73), biochemically validated quitting (AOR 1.22, 95% CI 0.64–2.34), cessation attempt (AOR 0.74, 95% CI 0.48–1.14), or smoking reduction (AOR 0.89, 95% CI 0.54–1.47). EC use during the first 3 months did not predict quitting (AOR 1.02, 95% CI 0.22–4.71). Similar results were observed for missing observations as smoking and propensity score analyses. Conclusions: Any use of ECs, many of which lack nicotine, did not predict smoking abstinence among Hong Kong adult smokers. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Exploring Heat Stress Relief Measures among the Australian Labour Force
Int. J. Environ. Res. Public Health 2018, 15(3), 401; doi:10.3390/ijerph15030401
Received: 23 January 2018 / Revised: 15 February 2018 / Accepted: 23 February 2018 / Published: 26 February 2018
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Abstract
Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor
[...] Read more.
Australia experiences frequent heat waves and generally high average temperatures throughout the continent with substantial impacts on human health and the economy. People adapt to heat by adopting various relief measures in their daily lives including changing their behaviour. Many labour intensive outdoor industries implement standards for heat stress management for their workforce. However, little is known about how people cope with heat at their workplaces apart from studies targeting some specific industries where labourers are exposed to extreme heat. Here, we analysed responses from 1719 people in the Australian labour force to self-reported heat stress and associated coping mechanisms. Three quarters of respondents experienced heat stress at their workplace with fatigue and headache being the two most frequently stated symptoms. Almost all of those who were affected by heat would hydrate (88%), 67% would cool, and 44% would rest as a strategy for coping with heat. About 10% intended to change their jobs because of heat stress in the workplace. We found differences in heat relief measures across gender, education, health, level of physical intensity of job, and time spent working outside. People working in jobs that were not very demanding physically were more likely to choose cooling down as a relief measure, while those in labour intensive jobs and jobs that required considerable time outside were more likely to rest. This has potential consequences for their productivity and work schedules. Heat affects work in Australia in many types of industry with impact dependent on workforce acclimatisation, yet public awareness and work relief plans are often limited to outdoor and labour intensive industries. Industries and various levels of government in all sectors need to implement standards for heat management specific to climate zones to help people cope better with high temperatures as well as plan strategies in anticipation of projected temperature increases. Full article
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Open AccessArticle A Text Structuring Method for Chinese Medical Text Based on Temporal Information
Int. J. Environ. Res. Public Health 2018, 15(3), 402; doi:10.3390/ijerph15030402
Received: 30 December 2017 / Revised: 10 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
Chinese Electronic Medical Records (EMRs) contains a large number of complex medical free text which includes a variety of information, such as temporal information, patients’ symptoms and laboratory data. However, as an important knowledge base, these unstructured text data in EMR are hard
[...] Read more.
Chinese Electronic Medical Records (EMRs) contains a large number of complex medical free text which includes a variety of information, such as temporal information, patients’ symptoms and laboratory data. However, as an important knowledge base, these unstructured text data in EMR are hard to process directly by computer to support further medical research. This paper proposes a novel text structuring method to extract knowledge from EMR texts and reorganize them in chronological order according to the temporal information in the text. By implementing some entropy-based algorithms as contrast, experiments evaluate the performance of the proposed method, which indicates the new method can significantly reduce the complexity of EMR text. This work is significant in structuring the EMR free text into temporal-structured data for further medical analysis. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Prolonged Screen Viewing Times and Sociodemographic Factors among Pregnant Women: A Cross-Sectional Survey in China
Int. J. Environ. Res. Public Health 2018, 15(3), 403; doi:10.3390/ijerph15030403
Received: 2 January 2018 / Revised: 10 February 2018 / Accepted: 19 February 2018 / Published: 27 February 2018
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Abstract
Objectives: This study aimed to assess the prevalence of prolonged television, computer, and mobile phone viewing times and examined related sociodemographic factors among Chinese pregnant women. Methods: In this study, a cross-sectional survey was implemented among 2400 Chinese pregnant women in 16 hospitals
[...] Read more.
Objectives: This study aimed to assess the prevalence of prolonged television, computer, and mobile phone viewing times and examined related sociodemographic factors among Chinese pregnant women. Methods: In this study, a cross-sectional survey was implemented among 2400 Chinese pregnant women in 16 hospitals of 5 provinces from June to August in 2015, and the response rate of 97.76%. We excluded women with serious complications and cognitive disorders. The women were asked about their television, computer, and mobile phone viewing during pregnancy. Prolonged television watching or computer viewing was defined as spending more than two hours on television or computer viewing per day. Prolonged mobile phone viewing was watching more than one hour on mobile phone per day. Results: Among 2345 pregnant women, about 25.1% reported prolonged television viewing, 20.6% reported prolonged computer viewing, and 62.6% reported prolonged mobile phone viewing. Pregnant women with long mobile phone viewing times were likely have long TV (Estimate = 0.080, Standard Error (SE) = 0.016, p < 0.001) and computer viewing times (Estimate = 0.053, SE = 0.022, p = 0.015). Pregnant women with long TV (Estimate = 0.134, SE = 0.027, p < 0.001) and long computer viewing times (Estimate = 0.049, SE = 0.020, p = 0.015) were likely have long mobile phone viewing times. Pregnant women with long TV viewing times were less likely to have long computer viewing times (Estimate = −0.032, SE = 0.015, p = 0.035), and pregnant women with long computer viewing times were less likely have long TV viewing times (Estimate = −0.059, SE = 0.028, p = 0.035). Pregnant women in their second pregnancy had lower prolonged computer viewing times than those in their first pregnancy (Odds Ratio (OR) 0.56, 95% Confidence Interval (CI) 0.42–0.74). Pregnant women in their second pregnancy were more likely have longer prolonged mobile phone viewing times than those in their first pregnancy (OR 1.25, 95% CI 1.01–1.55). Conclusions: The high prevalence rate of prolonged TV, computer, and mobile phone viewing times was common for pregnant women in their first and second pregnancy. This study preliminarily explored the relationship between sociodemographic factors and prolonged screen time to provide some indication for future interventions related to decreasing screen-viewing times during pregnancy in China. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle A Geographical Information System Based Approach for Integrated Strategies of Tick Surveillance and Control in the Peri-Urban Natural Reserve of Monte Pellegrino (Palermo, Southern Italy)
Int. J. Environ. Res. Public Health 2018, 15(3), 404; doi:10.3390/ijerph15030404
Received: 30 January 2018 / Revised: 21 February 2018 / Accepted: 21 February 2018 / Published: 27 February 2018
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Abstract
Ticks (Acari: Ixodidae) are bloodsucking arthropods involved in pathogen transmission in animals and humans. Tick activity depends on various ecological factors such as vegetation, hosts, and temperature. The aim of this study was to analyse the spatial/temporal distribution of ticks in six sites
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Ticks (Acari: Ixodidae) are bloodsucking arthropods involved in pathogen transmission in animals and humans. Tick activity depends on various ecological factors such as vegetation, hosts, and temperature. The aim of this study was to analyse the spatial/temporal distribution of ticks in six sites within a peri-urban area of Palermo (Natural Reserve of Monte Pellegrino) and correlate it with field data using Geographical Information System (GIS) data. A total of 3092 ticks were gathered via dragging method from June 2012 to May 2014. The species collected were: Ixodes ventalloi (46.09%), Hyalomma lusitanicum (19.99%), Rhipicephalus sanguineus (17.34%), Rhipicephalus pusillus (16.11%), Haemaphisalis sulcata (0.36%), Dermacentor marginatus (0.10%), and Rhipicephalus turanicus (0.03%). GIS analysis revealed environmental characteristics of each site, and abundance of each tick species was analysed in relation to time (monthly trend) and space (site-specific abundance). A relevant presence of I. ventalloi in site 2 and H. lusitanicum in site 5 was observed, suggesting the possible exposure of animals and humans to tick-borne pathogens. Our study shows the importance of surveillance of ticks in peri-urban areas and the useful implementation of GIS analysis in vector ecology; studies on temporal and spatial distribution of ticks correlated to GIS-based ecological analysis represent an integrated strategy for decision support in public health. Full article
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Open AccessArticle Using Individual GPS Trajectories to Explore Foodscape Exposure: A Case Study in Beijing Metropolitan Area
Int. J. Environ. Res. Public Health 2018, 15(3), 405; doi:10.3390/ijerph15030405
Received: 13 January 2018 / Revised: 24 February 2018 / Accepted: 25 February 2018 / Published: 27 February 2018
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Abstract
With the growing interest in studying the characteristics of people’s access to the food environment and its influence upon individual health, there has been a focus on assessing individual food exposure based on GPS trajectories. However, existing studies have largely focused on the
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With the growing interest in studying the characteristics of people’s access to the food environment and its influence upon individual health, there has been a focus on assessing individual food exposure based on GPS trajectories. However, existing studies have largely focused on the overall activity space using short-period trajectories, which ignores the complexity of human movements and the heterogeneity of the spaces that are experienced by the individual over daily life schedules. In this study, we propose a novel framework to extract the exposure areas consisting of the localized activity spaces around daily life centers and non-motorized commuting routes from long-term GPS trajectories. The newly proposed framework is individual-specific and can incorporate the internal heterogeneity of individual activities (spatial extent, stay duration, and timing) in different places as well as the dynamics of the context. A pilot study of the GeoLife dataset suggests that there are significant variations in the magnitude as well as the composition of the food environment in different parts of the individual exposure area, and residential environment is not representative of the overall foodscape exposure. Full article
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Open AccessArticle Regional Assessment of Temperature-Related Mortality in Finland
Int. J. Environ. Res. Public Health 2018, 15(3), 406; doi:10.3390/ijerph15030406
Received: 1 February 2018 / Revised: 20 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
The aim of this study was to assess regional differences in temperature–mortality relationships across 21 hospital districts in Finland. The temperature dependence of the daily number of all-cause, all-aged deaths during 2000–2014 was studied in each hospital district by using daily mean temperatures,
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The aim of this study was to assess regional differences in temperature–mortality relationships across 21 hospital districts in Finland. The temperature dependence of the daily number of all-cause, all-aged deaths during 2000–2014 was studied in each hospital district by using daily mean temperatures, spatially averaged across each hospital district, to describe exposure to heat stress and cold stress. The relationships were modelled using distributed lag non-linear models (DLNM). In a simple model version, no delayed impacts of heat and cold on mortality were taken into account, whereas a more complex version included delayed impacts up to 25 days. A meta-analysis with selected climatic and sociodemographic covariates was conducted to study differences in the relationships between hospital districts. A pooled mortality-temperature relationship was produced to describe the average relationship in Finland. The simple DLNM model version without lag gave U-shaped dependencies of mortality on temperature almost without exception. The outputs of the model version with a 25-day lag were also U-shaped in most hospital districts. According to the meta-analysis, the differences in the temperature-mortality relationships between hospital districts were not statistically significant on the absolute temperature scale, meaning that the pooled mortality–temperature relationship can be applied to the whole country. However, on a relative temperature scale, heterogeneity was found, and the meta-regression suggested that morbidity index and population in the hospital districts might explain some of this heterogeneity. The pooled estimate for the relative risk (RR) of mortality at a daily mean temperature of 24 °C was 1.16 (95% CI 1.12–1.20) with reference at 14 °C, which is the minimum mortality temperature (MMT) of the pooled relationship. On the cold side, the RR at a daily mean temperature of −20 °C was 1.14 (95% CI 1.12–1.16). On a relative scale of daily mean temperature, the MMT was found at the 79th percentile. Full article
(This article belongs to the Section Climate Change and Health)
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Open AccessArticle Resilience of an Earthquake-Stricken Rural Community in Southwest China: Correlation with Disaster Risk Reduction Efforts
Int. J. Environ. Res. Public Health 2018, 15(3), 407; doi:10.3390/ijerph15030407
Received: 2 January 2018 / Revised: 10 February 2018 / Accepted: 21 February 2018 / Published: 27 February 2018
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Abstract
Disaster risk reduction (DRR) activities have given growing attention to building community resilience, but the effects of such efforts on community resilience are still under-investigated, especially in China where the concept of community resilience has only just emerged. Using the Communities Advancing Resilience
[...] Read more.
Disaster risk reduction (DRR) activities have given growing attention to building community resilience, but the effects of such efforts on community resilience are still under-investigated, especially in China where the concept of community resilience has only just emerged. Using the Communities Advancing Resilience Toolkit Assessment Survey, data on self-perceived community resilience were collected in 2017 from a post-disaster Chinese rural community in Yingxiu Town, which was the epicenter of the Wenchuan earthquake (Magnitude = 8.0) in the year 2008. Linear regression analyses were conducted to explore the correlations between residents’ DRR behaviors and perceived community resilience with the control of their socio-demographic characteristics including age, ethnicity, gender, education, income level, employment status and marital status. Results indicate that residents who volunteered for DRR activities, received geological disaster education, participated in evacuation drills, and reported higher income levels had a perception of higher community resilience. Practice research is suggested to help clarify the cause and effect of DRR work on the enhancement of community resilience to disasters in China and abroad. Attention is also called to the development of a Chinese indigenous community resilience concept and assessment instrument. Full article
(This article belongs to the Special Issue Public Health and Disasters)
Open AccessArticle Exposure to Toxoplasma gondii in the Roma and Non-Roma Inhabitants of Slovakia: A Cross-Sectional Seroprevalence Study
Int. J. Environ. Res. Public Health 2018, 15(3), 408; doi:10.3390/ijerph15030408
Received: 29 December 2017 / Revised: 19 February 2018 / Accepted: 20 February 2018 / Published: 27 February 2018
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Abstract
The lifestyle, health and social status of the Roma are generally below the standards characteristic for the non-Roma population. This study aimed to find out the seropositivity to Toxoplasma gondii (T. gondii) in the population of Roma living in segregated settlements
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The lifestyle, health and social status of the Roma are generally below the standards characteristic for the non-Roma population. This study aimed to find out the seropositivity to Toxoplasma gondii (T. gondii) in the population of Roma living in segregated settlements and to compare it with the prevalence of antibodies in the non-Roma population from the catchment area of eastern Slovakia. The seroprevalence of antibodies to T. gondii was significantly higher in the Roma group (45.0%) than in non-Roma inhabitants (24.1%). A statistically significant difference was also recorded between the two non-Roma groups in the study, 30.4% of those from the catchment area and 19.7% from the non-catchment area were seropositive. Univariate logistic regression confirmed poverty and higher age to be significant risk factors influencing the seropositivity to T. gondii. Of the clinical symptoms analyzed in the study, only muscle and back pain were associated with seropositivity to T. gondii. The close contact of Roma with an environment contaminated by different infectious agents and the insufficient hygiene, lower level of education, poverty, lack of water and household equipment and high number of domestic animals increase the risk of infectious diseases in the Roma settlements and subsequently the spread of communicable diseases at the national or even international level. Full article
(This article belongs to the Special Issue Roma Health)
Open AccessArticle Dramatic Reduction in Diarrhoeal Diseases through Implementation of Cost-Effective Household Drinking Water Treatment Systems in Makwane Village, Limpopo Province, South Africa
Int. J. Environ. Res. Public Health 2018, 15(3), 410; doi:10.3390/ijerph15030410
Received: 16 January 2018 / Revised: 16 February 2018 / Accepted: 20 February 2018 / Published: 27 February 2018
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Abstract
The main purpose of this study was to implement cost-effective household water treatment systems in every household of Makwane Village for the reduction of diarrhoeal diseases. These household water treatment systems were constructed with locally available materials and consisted of the biosand zeolite-silver
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The main purpose of this study was to implement cost-effective household water treatment systems in every household of Makwane Village for the reduction of diarrhoeal diseases. These household water treatment systems were constructed with locally available materials and consisted of the biosand zeolite-silver impregnated granular clay filters and the silver-impregnated porous pot filters. During the study period (April 2015 to September 2015), the entire village had 88 households with a population size of 480. Prior to the implementation, a survey was conducted and results revealed that 75% (360/480) of the Makwane residents suffered from diarrhoeal disease and the majority of the cases were reported in children that were less than five years of age. Out of the 480 participants, 372 (77.5%) from 70 households accepted the installation of the systems (intervention group) and 108 (25.5%) from 18 households were reluctant to use the systems (the control group). To date, in the intervention group, only 3.8% (14/372) of participants reported cases of diarrhoea. In the control group, 57.4% (62/108) participants reported cases of diarrhoea and most of the episodes of diarrhoea were reported in children of less than five years old (85%), followed by the group aged ≥56 years (75%). The findings of the current study unequivocally demonstrated that the BSZ-SICG and SIPP filters were able to reduce the incidence of diarrhoea by 96.2%. These findings further demonstrate the importance of household water treatment systems (HWTS) interventions in rural areas to bring about meaningful reductions in diarrhoeal diseases by providing safe potable water. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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Open AccessArticle Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered
Int. J. Environ. Res. Public Health 2018, 15(3), 411; doi:10.3390/ijerph15030411
Received: 13 December 2017 / Revised: 8 February 2018 / Accepted: 25 February 2018 / Published: 27 February 2018
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Abstract
Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women
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Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered (n = 235), pregnant women (n = 121) and childless women (n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values “positive mental attitude” and “health practices”, in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was “a successful family life”, while the most appreciated symbol of happiness was “love and friendship”. Our results suggest that the system of values and the perception of happiness symbols may influence women’s health behaviors. Positioning “health” in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed. Full article
(This article belongs to the collection Health Behavior and Public Health)
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Open AccessArticle Individual and School Correlates of Adolescent Leisure Time Physical Activity in Quebec, Canada
Int. J. Environ. Res. Public Health 2018, 15(3), 412; doi:10.3390/ijerph15030412
Received: 9 December 2017 / Revised: 20 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
Background: Leisure time physical activity (LTPA) correlates have been mostly studied in relation to adolescents’ home neighbourhoods, but not so much in relation to the environment of their schools’ neighbourhoods. We sought to investigate how objective environmental measures of the schools’ vicinity
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Background: Leisure time physical activity (LTPA) correlates have been mostly studied in relation to adolescents’ home neighbourhoods, but not so much in relation to the environment of their schools’ neighbourhoods. We sought to investigate how objective environmental measures of the schools’ vicinity are related to adolescents’ self-reported LTPA. Methods: Individual data from the Quebec High School Students Health Survey (QHSSHS) were matched with schools’ socioeconomic indicators, as well as geographic information system-based indicators of their built environments. Self-reported levels of LTPA during the school year were assessed according to intensity, frequency and index of energy expenditure. Associations per gender between covariates and LTPA were estimated using ordinal multilevel regression with multiple imputations. Results: Boys (21% of which were highly active) were more active than girls (16% of which were highly active) (p ≤ 0.01). The incremental variance between schools explained by the contextual variables in the final models was higher among girls (7.8%) than boys (2.8%). The number of parks or green spaces within 750 m around their schools was positively associated with student LTPA in both genders. Conclusions: The promotion of parks around schools seems to be an avenue to be strengthened. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessFeature PaperArticle Valuing a Lifestyle Intervention for Middle Eastern Immigrants at Risk of Diabetes
Int. J. Environ. Res. Public Health 2018, 15(3), 413; doi:10.3390/ijerph15030413
Received: 29 December 2017 / Revised: 8 February 2018 / Accepted: 25 February 2018 / Published: 27 February 2018
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Abstract
Willingness-to-pay (WTP) techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants
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Willingness-to-pay (WTP) techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants living in Malmö, Sweden, who are at high risk of type 2 diabetes. We used the contingent valuation method to evaluate WTP. The questionnaire was designed following the payment-scale approach, and administered at the end of the trial, giving an ex-post perspective. We performed logistic regression and linear regression techniques to identify the factors associated with zero WTP value and positive WTP values. The intervention group had significantly higher average WTP than the control group (216 SEK vs. 127 SEK; p = 0.035; 1 U.S.$ = 8.52 SEK, 2015 price year) per month. The regression models demonstrated that being in the intervention group, acculturation, and self-employment were significant factors associated with positive WTP values. Male participants and lower-educated participants had a significantly higher likelihood of zero WTP. In this era of increased migration, our findings can help policy makers to take informed decisions to implement lifestyle interventions for immigrant populations. Full article
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Open AccessArticle Sodium Dodecyl Sulphate-Supported Nanocomposite as Drug Carrier System for Controlled Delivery of Ondansetron
Int. J. Environ. Res. Public Health 2018, 15(3), 414; doi:10.3390/ijerph15030414
Received: 29 December 2017 / Revised: 19 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
Sodium dodecyl sulphate-supported iron silicophosphate (SDS/FeSP) nanocomposite was successfully fabricated by the co-precipitation method. The SDS/FeSP nanocomposite was investigated as a drug carrier for ondansetron. The cumulative drug release of ondansetron was observed at various pH values for different time intervals, i.e., from
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Sodium dodecyl sulphate-supported iron silicophosphate (SDS/FeSP) nanocomposite was successfully fabricated by the co-precipitation method. The SDS/FeSP nanocomposite was investigated as a drug carrier for ondansetron. The cumulative drug release of ondansetron was observed at various pH values for different time intervals, i.e., from 20 min to 48 h. A ranking of the drug release was observed at different pHs; pH 2.2 > saline (pH 5.5) > pH 7.4 > pH 9.4 > distilled water. Maximum release of encapsulated drug was found to be about 45.38% at pH 2.2. The cell viability tests of SDS/FeSP nanocomposite concluded that SDS/FeSP nanocomposite was non-cytotoxic in nature. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Predicting Circulatory Diseases from Psychosocial Safety Climate: A Prospective Cohort Study from Australia
Int. J. Environ. Res. Public Health 2018, 15(3), 415; doi:10.3390/ijerph15030415
Received: 12 January 2018 / Revised: 13 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
Circulatory diseases (CDs) (including myocardial infarction, angina, stroke or hypertension) are among the leading causes of death in the world. In this paper, we explore for the first time the impact of a specific aspect of organizational climate, Psychosocial Safety Climate (PSC), on
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Circulatory diseases (CDs) (including myocardial infarction, angina, stroke or hypertension) are among the leading causes of death in the world. In this paper, we explore for the first time the impact of a specific aspect of organizational climate, Psychosocial Safety Climate (PSC), on CDs. We used two waves of interview data from Australia, with an average lag of 5 years (excluding baseline CDs, final n = 1223). Logistic regression was conducted to estimate the prospective associations between PSC at baseline on incident CDs at follow-up. It was found that participants in low PSC environments were 59% more likely to develop new CD than those in high PSC environments. Logistic regression showed that high PSC at baseline predicts lower CD risk at follow-up (OR = 0.98, 95% CI 0.96–1.00) and this risk remained unchanged even after additional adjustment for known job design risk factors (effort reward imbalance and job strain). These results suggest that PSC is an independent risk factor for CDs in Australia. Beyond job design this study implicates organizational climate and prevailing management values regarding worker psychological health as the genesis of CDs. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
Open AccessArticle Biotoxicity of TiO2 Nanoparticles on Raphidocelis subcapitata Microalgae Exemplified by Membrane Deformation
Int. J. Environ. Res. Public Health 2018, 15(3), 416; doi:10.3390/ijerph15030416
Received: 23 January 2018 / Revised: 14 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
TiO2 nanoparticles (NPs), which are mainly used in consumer products (mostly cosmetics), have been found to cause ecotoxic effects in the aquatic environment. The green algae Raphidocelis subcapitata, as a representative of primary producers of the freshwater ecosystem, has been frequently
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TiO2 nanoparticles (NPs), which are mainly used in consumer products (mostly cosmetics), have been found to cause ecotoxic effects in the aquatic environment. The green algae Raphidocelis subcapitata, as a representative of primary producers of the freshwater ecosystem, has been frequently used to study the effects of metal oxide NPs. An ecotoxicity study was conducted herein to investigate the effects of TiO2 NPs on survival and membrane deformation of algal cells. Five different concentrations of nano-TiO2 particles (1, 10, 50, 100 and 500 mg/L) were prepared in synthetic surface water samples with five different water quality characteristics (pH 6.4–8.4, hardness 10–320 mg CaCO3/L, ionic strength 0.2–8 mM, and alkalinity 10–245 mg CaCO3/L). Results showed a significant increase in the hydrodynamic diameter of NPs with respect to both NP concentrations and ionic content of the test system. A soft synthetic freshwater system at pH 7.3 ± 0.2 appeared to provide the most effective water type, with more than 95% algal mortality observed at 50, 100 and 500 mg/L NP concentrations. At high exposure concentrations, increased malondialdehyde formations were observed. Moreover, due to membrane deformation, TEM images correlated the uptake of the NPs. Full article
(This article belongs to the Special Issue Nano-Bio Interactions: Nanomedicine and Nanotoxicology)
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Open AccessArticle Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis
Int. J. Environ. Res. Public Health 2018, 15(3), 418; doi:10.3390/ijerph15030418
Received: 11 January 2018 / Revised: 14 February 2018 / Accepted: 23 February 2018 / Published: 27 February 2018
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Abstract
The Osteoporosis Self-assessment Tool for Asians (OSTA) is a validated index based on age and weight to predict the risk of osteoporosis in women. This cross-sectional study was designed to evaluate the impact of sexual dimorphism on the trauma patterns and the clinical
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The Osteoporosis Self-assessment Tool for Asians (OSTA) is a validated index based on age and weight to predict the risk of osteoporosis in women. This cross-sectional study was designed to evaluate the impact of sexual dimorphism on the trauma patterns and the clinical outcomes of patients with high-risk OSTA scores. Trauma data of patients with high-risk OSTA scores between 1 January 2009 and 31 December 2015 were retrieved from the trauma registry system of a level I trauma center. A total of 2248 patients including 1585 women and 663 men were included in this study. In-hospital mortality was assessed as the primary outcome in the propensity score-matched analyses of the female and male patients, which were created in a 1:1 ratio under the adjustment of potential confounders, including age, co-morbidity, mechanism and injury-severity score (ISS). Female patients with a high-risk OSTA score had significantly lower mortality rates than their male counterparts. Among the propensity score-matched population, female patients had lower odds of having cerebral contusion and pneumothorax, but higher odds of presenting with radial, ulnar and femoral fractures than male patients. In addition, the female patients still had significantly lower odds of mortality (odds ratio (OR), 0.5; 95% confidence interval (CI), 0.29–0.90; p = 0.019) than the male patients. However, no significant differences were noted in the length of stay (LOS) in hospital, intensive-care unit (ICU) admission, and LOS in the ICU between the sexes. Female patients with high-risk OSTA scores showed different injury patterns and significantly lower mortality rates than their male counterparts, even after controlling for potential confounding factors. Full article
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Open AccessArticle The National and Regional Prevalence Rates of Disability, Type, of Disability and Severity in Saudi Arabia—Analysis of 2016 Demographic Survey Data
Int. J. Environ. Res. Public Health 2018, 15(3), 419; doi:10.3390/ijerph15030419
Received: 15 January 2018 / Revised: 21 February 2018 / Accepted: 23 February 2018 / Published: 28 February 2018
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Abstract
The prevalence of disability varies between countries ranging from less than 1% to up to 30% in some countries, thus, the estimated global disability prevalence is about 15%. However, it is unknown what the current estimate of disability and its types and severity
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The prevalence of disability varies between countries ranging from less than 1% to up to 30% in some countries, thus, the estimated global disability prevalence is about 15%. However, it is unknown what the current estimate of disability and its types and severity are in Saudi Arabia. Thus, the objective of this study is to estimate national and regional prevalence rates of any disability, types of disability, and their severity among Saudi populations. Data on disability status were extracted from the national demographic survey conducted in 2016 as reported by the General Authority for Statistics, Saudi Arabia (N = 20,064,970). Prevalence rates per a population of 100,000 of any disability, type of disability, and its severity were calculated at the national level and in all 13 regions. Out of 20,064,970 Saudi citizens surveyed, 667,280 citizens reported disabilities, accounting for a prevalence rate of 3326 per a population of 100,000 (3.3%). Individuals aged 60 years and above (11,014) and males (3818) had a higher prevalence rate of disability compared with females (2813). The Tabuk region has the highest rate of reported disability, at 4.3%. The prevalence rates of extreme disabilities in mobility and sight were higher in Madinah (57,343) and Northern border (41,236) regions, respectively. In Saudi Arabia, more than half a million Saudi citizens (1 out of every 30 individuals) reported the presence of disability during the year 2016. A higher prevalence rate of disability was seen among those aged 60 years and above, and males. Targeted efforts are required at the national and regional levels to expand and improve rehabilitation and social services for all people with disabilities. Full article
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Open AccessFeature PaperArticle Food Insecurity in Homeless Families in the Paris Region (France): Results from the ENFAMS Survey
Int. J. Environ. Res. Public Health 2018, 15(3), 420; doi:10.3390/ijerph15030420
Received: 13 December 2017 / Revised: 6 February 2018 / Accepted: 23 February 2018 / Published: 28 February 2018
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Abstract
The number of families living in shelters in the Paris region (France) has increased by a factor of three in 10 years. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs, and the
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The number of families living in shelters in the Paris region (France) has increased by a factor of three in 10 years. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs, and the developmental problems in children. This probability survey was conducted in 17 languages among 801 homeless families sheltered in emergency centers for asylum-seekers, emergency housing centers, social rehabilitation centers, and social hotels in the Paris region. Among the 772 families that provided data on food security only 14.0% were with food security, whereas 43.3% were with low food security and 9.8% with very low food security (a situation where children are also affected). Stratified multivariate robust Poisson models showed that some characteristics are associated with a higher risk of food insecurity and/or of falling into very low food security, such as residential instability, single parenthood, having more than three children, depressive symptoms, housing in social hostels, and difficult access to cheap or free food locally. Given the wealth of the Paris region, resources and programs should be concentrated on improving the living situation of this vulnerable population. It needs better detection of these families, a closer social follow-up, and an increase in food aid. Full article
(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)
Open AccessArticle Global Evidence on the Association between Cigarette Graphic Warning Labels and Cigarette Smoking Prevalence and Consumption
Int. J. Environ. Res. Public Health 2018, 15(3), 421; doi:10.3390/ijerph15030421
Received: 28 December 2017 / Revised: 15 February 2018 / Accepted: 22 February 2018 / Published: 28 February 2018
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Abstract
Background: In 2011, the courts ruled in favor of tobacco companies in preventing the implementation of graphic warning labels (GWLs) in the US, stating that FDA had not established the effectiveness of GWLs in reducing smoking. Methods: Data came from various
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Background: In 2011, the courts ruled in favor of tobacco companies in preventing the implementation of graphic warning labels (GWLs) in the US, stating that FDA had not established the effectiveness of GWLs in reducing smoking. Methods: Data came from various sources: the WHO MPOWER package (GWLs, MPOWER policy measures, cigarette prices), Euromonitor International (smoking prevalence, cigarette consumption), and the World Bank database (countries’ demographic characteristics). The datasets were aggregated and linked using country and year identifiers. Fractional logit regressions and OLS regressions were applied to examine the associations between GWLs and smoking prevalence and cigarette consumption, controlling for MPOWER policy scores, cigarette prices, GDP per capita, unemployment, population aged 15–64 (%), aged 65 and over (%), year indicators, and country fixed effects. Results: GWLs were associated with a 0.9–3 percentage point decrease in adult smoking prevalence and were significantly associated with a reduction of 230–287 sticks in per capita cigarette consumption, compared to countries without GWLs. However, the association between GWLs and cigarette consumption became statistically insignificant once country indicators were included in the models. Conclusions: The implementation of GWLs may be associated with reduced cigarette smoking. Full article
(This article belongs to the Special Issue Reducing Exposure to Second-Hand Tobacco Smoke)
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Open AccessArticle Suicidal Ideation among the Chinese Elderly and Its Correlates: A Comparison between the Rural and Urban Populations
Int. J. Environ. Res. Public Health 2018, 15(3), 422; doi:10.3390/ijerph15030422
Received: 27 November 2017 / Revised: 8 February 2018 / Accepted: 25 February 2018 / Published: 28 February 2018
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Abstract
Background: As China is going through a profound aging process, the mental health of the elderly is becoming an issue. As in many other societies, the elderly in China is a population at high risk of suicide; Methods: Data for the study were
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Background: As China is going through a profound aging process, the mental health of the elderly is becoming an issue. As in many other societies, the elderly in China is a population at high risk of suicide; Methods: Data for the study were taken from the Sample Survey of the Aged Population in Urban/Rural China (SSAPUR) accomplished in 2010 by the China Ministry of Civil Affairs. The valid sample for this study was composed of 18,683 individuals, including 9416 urban residents and 9267 rural residents both aged 60 or more years; Results: Logistic regression analyses showed that household income and expenditure, the number of children, chronic diseases, disability of daily living, depression, the frequency of visiting neighbors and having friends or relatives who can help or not had remarkable effects on the suicidal ideation among urban and rural old people. Gender, education, political affiliation, marital status and self-rated health status did not work on the dependent variable. However, some risk factors for suicidal ideation among the Chinese elderly were different between rural and urban regions; Conclusions: We should take different measures when facing the different groups of the elderly. Full article
(This article belongs to the Special Issue Suicide Risk and Mental Disorders)
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Open AccessArticle Experimental and Numerical Modeling of Aerosol Delivery for Preterm Infants
Int. J. Environ. Res. Public Health 2018, 15(3), 423; doi:10.3390/ijerph15030423
Received: 20 November 2017 / Revised: 12 February 2018 / Accepted: 23 February 2018 / Published: 28 February 2018
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Abstract
Respiratory distress syndrome (RDS) represents one of the major causes of mortality among preterm infants, and the best approach to treat it is an open research issue. The use of perfluorocarbons (PFC) along with non-invasive respiratory support techniques has proven the usefulness of
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Respiratory distress syndrome (RDS) represents one of the major causes of mortality among preterm infants, and the best approach to treat it is an open research issue. The use of perfluorocarbons (PFC) along with non-invasive respiratory support techniques has proven the usefulness of PFC as a complementary substance to achieve a more homogeneous surfactant distribution. The aim of this work was to study the inhaled particles generated by means of an intracorporeal inhalation catheter, evaluating the size and mass distribution of different PFC aerosols. In this article, we discuss different experiments with the PFC perfluorodecalin (PFD) and FC75 with a driving pressure of 4–5 bar, evaluating properties such as the aerodynamic diameter (Da), since its value is directly linked to particle deposition in the lung. Furthermore, we develop a numerical model with computational fluid dynamics (CFD) techniques. The computational results showed an accurate prediction of the airflow axial velocity at different downstream positions when compared with the data gathered from the real experiments. The numerical validation of the cumulative mass distribution for PFD particles also confirmed a closer match with the experimental data measured at the optimal distance of 60 mm from the catheter tip. In the case of FC75, the cumulative mass fraction for particles above 10 µm was considerable higher with a driving pressure of 5 bar. These numerical models could be a helpful tool to assist parametric studies of new non-invasive devices for the treatment of RDS in preterm infants. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle Epidemiological Study on Metal Pollution of Ningbo in China
Int. J. Environ. Res. Public Health 2018, 15(3), 424; doi:10.3390/ijerph15030424
Received: 17 January 2018 / Revised: 23 February 2018 / Accepted: 24 February 2018 / Published: 28 February 2018
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Abstract
Background: In order to search for effective control and prevention measures, the status of metal pollution in Ningbo, China was investigated. Methods: Nine of the most common contaminating metals including lead (Pb), cadmium (Cd), copper (Cu), iron (Fe), manganese (Mn), chromium
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Background: In order to search for effective control and prevention measures, the status of metal pollution in Ningbo, China was investigated. Methods: Nine of the most common contaminating metals including lead (Pb), cadmium (Cd), copper (Cu), iron (Fe), manganese (Mn), chromium (Cr), nickel (Ni), zinc (Zn), and mercury (Hg) in samples of vegetables, rice, soil, irrigation water, and human hair were detected using inductively coupled plasma-mass spectrometry (ICP-MS). Three different districts including industrial, suburban and rural areas in Ningbo were studied through a stratified random sample method. Results: (1) Among all of the detected vegetable samples, Cd exceeded the standard limit rates in industrial, suburban and rural areas as high as 43.9%, 27.5% and 5.0%, respectively; indicating the severity of Cd pollution in Ningbo. (2) The pollution index (PI) of Cd and Zn in soil (1.069, 1.584, respectively) suggests that soil is slightly polluted by Cd and Zn. Among all samples, metal contamination levels in soil were all relatively high. (3) A positive correlation was found between the concentrations of Pb, Cd and Cu in vegetables and soil; Pb, Cu, Cr and Ni in vegetables and irrigation water, as well as, Cu and Ni in rice and irrigation water; and, (4) Higher Pb and Cd concentrations were found in student scalp hair in both industrial and suburban areas compared to rural areas. (5) Hg and Pb that are found in human scalp hair may be more easily absorbed from food than any of the other metals. Conclusions: In general, certain harmful metal pollutions were detected in both industrial and suburban areas of Ningbo in China. Full article
Open AccessArticle The Impact of Ambient Air Pollution on Daily Hospital Visits for Various Respiratory Diseases and the Relevant Medical Expenditures in Shanghai, China
Int. J. Environ. Res. Public Health 2018, 15(3), 425; doi:10.3390/ijerph15030425
Received: 5 January 2018 / Revised: 26 February 2018 / Accepted: 26 February 2018 / Published: 28 February 2018
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Abstract
The evidence concerning the acute effects of ambient air pollution on various respiratory diseases was limited in China, and the attributable medical expenditures were largely unknown. From 2013 to 2015, we collected data on the daily visits to the emergency- and outpatient-department for
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The evidence concerning the acute effects of ambient air pollution on various respiratory diseases was limited in China, and the attributable medical expenditures were largely unknown. From 2013 to 2015, we collected data on the daily visits to the emergency- and outpatient-department for five main respiratory diseases and their medical expenditures in Shanghai, China. We used the overdispersed generalized additive model together with distributed lag models to fit the associations of criteria air pollutants with hospital visits, and used the linear models to fit the associations with medical expenditures. Generally, we observed significant increments in emergency visits (8.81–17.26%) and corresponding expenditures (0.33–25.81%) for pediatric respiratory diseases, upper respiratory infection (URI), and chronic obstructive pulmonary disease (COPD) for an interquartile range increase of air pollutant concentrations over four lag days. As a comparison, there were significant but smaller increments in outpatient visits (1.36–4.52%) and expenditures (1.38–3.18%) for pediatric respiratory diseases and upper respiratory infection (URI). No meaningful changes were observed for asthma and lower respiratory infection. Our study suggested that short-term exposure to outdoor air pollution may induce the occurrences or exacerbation of pediatric respiratory diseases, URI, and COPD, leading to considerable medical expenditures upon the patients. Full article
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Open AccessFeature PaperArticle Evaluation of the Quebec Healthy Enterprise Standard: Effect on Adverse Psychosocial Work Factors and Psychological Distress
Int. J. Environ. Res. Public Health 2018, 15(3), 426; doi:10.3390/ijerph15030426
Received: 11 December 2017 / Revised: 16 February 2018 / Accepted: 23 February 2018 / Published: 28 February 2018
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Abstract
Adverse psychosocial work factors are recognized as a significant source of psychological distress, resulting in a considerable socioeconomic burden. The impact of occupational health standards that aim to reduce these adverse work factors, such as the Quebec Healthy Enterprise Standard (QHES), is of
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Adverse psychosocial work factors are recognized as a significant source of psychological distress, resulting in a considerable socioeconomic burden. The impact of occupational health standards that aim to reduce these adverse work factors, such as the Quebec Healthy Enterprise Standard (QHES), is of great interest for public health. The aim of this study was to evaluate, for the first time, the effect of QHES interventions targeting adverse psychosocial work factors on the prevalence of these factors and of psychological distress among ten Quebec organizations. These outcomes were assessed by questionnaire using validated instruments before (T1, n = 2849) and 2–3 years following (T2, n = 2560) QHES implementation. Beneficial effects of interventions were observed for two adverse psychosocial work factors: low rewards (ratio of prevalence ratios (PRs) = 0.77, 95% CI = 0.66–0.91) and low social support at work (ratio of PRs = 0.89, 95% CI = 0.77–1.03). Moreover, beneficial effects of interventions were also observed on the prevalence of high psychological distress (ratio of PRs = 0.86, 95% CI = 0.75–0.998). Psychosocial interventions implemented in the context of this standard improved the psychosocial work environment and had beneficial effects on workers’ mental health. Full article
(This article belongs to the Special Issue Work Stress and the Development of Chronic Diseases)
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Open AccessArticle An Interoperable System toward Cardiac Risk Stratification from ECG Monitoring
Int. J. Environ. Res. Public Health 2018, 15(3), 428; doi:10.3390/ijerph15030428
Received: 25 January 2018 / Revised: 25 February 2018 / Accepted: 26 February 2018 / Published: 1 March 2018
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Abstract
Many indices have been proposed for cardiovascular risk stratification from electrocardiogram signal processing, still with limited use in clinical practice. We created a system integrating the clinical definition of cardiac risk subdomains from ECGs and the use of diverse signal processing techniques. Three
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Many indices have been proposed for cardiovascular risk stratification from electrocardiogram signal processing, still with limited use in clinical practice. We created a system integrating the clinical definition of cardiac risk subdomains from ECGs and the use of diverse signal processing techniques. Three subdomains were defined from the joint analysis of the technical and clinical viewpoints. One subdomain was devoted to demographic and clinical data. The other two subdomains were intended to obtain widely defined risk indices from ECG monitoring: a simple-domain (heart rate turbulence (HRT)), and a complex-domain (heart rate variability (HRV)). Data provided by the three subdomains allowed for the generation of alerts with different intensity and nature, as well as for the grouping and scrutinization of patients according to the established processing and risk-thresholding criteria. The implemented system was tested by connecting data from real-world in-hospital electronic health records and ECG monitoring by considering standards for syntactic (HL7 messages) and semantic interoperability (archetypes based on CEN/ISO EN13606 and SNOMED-CT). The system was able to provide risk indices and to generate alerts in the health records to support decision-making. Overall, the system allows for the agile interaction of research and clinical practice in the Holter-ECG-based cardiac risk domain. Full article
(This article belongs to the Section Health Services and Health Economics Research)
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Open AccessArticle Comparison of Airway Responses Induced in a Mouse Model by the Gas and Particulate Fractions of Gasoline Direct Injection Engine Exhaust
Int. J. Environ. Res. Public Health 2018, 15(3), 429; doi:10.3390/ijerph15030429
Received: 17 January 2018 / Revised: 14 February 2018 / Accepted: 22 February 2018 / Published: 1 March 2018
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Abstract
Diesel exhaust has been associated with asthma, but its response to other engine emissions is not clear. The increasing prevalence of vehicles with gasoline direct injection (GDI) engines motivated this study, and the objective was to evaluate pulmonary responses induced by acute exposure
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Diesel exhaust has been associated with asthma, but its response to other engine emissions is not clear. The increasing prevalence of vehicles with gasoline direct injection (GDI) engines motivated this study, and the objective was to evaluate pulmonary responses induced by acute exposure to GDI engine exhaust in an allergic asthma murine model. Mice were sensitized with an allergen to induce airway hyperresponsiveness or treated with saline (non-allergic group). Animals were challenged for 2-h to exhaust from a laboratory GDI engine operated at conditions equivalent to a highway cruise. Exhaust was filtered to assess responses induced by the particulate and gas fractions. Short-term exposure to particulate matter from GDI engine exhaust induced upregulation of genes related to polycyclic aromatic hydrocarbon (PAH) metabolism (Cyp1b1) and inflammation (TNFα) in the lungs of non-allergic mice. High molecular weight PAHs dominated the particulate fraction of the exhaust, and this response was therefore likely attributable to the presence of these PAHs. The particle fraction of GDI engine exhaust further contributed to enhanced methacholine responsiveness in the central and peripheral tissues in animals with airway hyperresponsiveness. As GDI engines gain prevalence in the vehicle fleet, understanding the health impacts of their emissions becomes increasingly important. Full article
(This article belongs to the Special Issue Transportation-Related Air Pollution and Human Health)
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Open AccessArticle Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries
Int. J. Environ. Res. Public Health 2018, 15(3), 430; doi:10.3390/ijerph15030430
Received: 4 January 2018 / Revised: 12 February 2018 / Accepted: 27 February 2018 / Published: 1 March 2018
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Abstract
Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years
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Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation. Full article
(This article belongs to the Special Issue Social Determinants of Health Inequities and Prevention)
Open AccessArticle An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health
Int. J. Environ. Res. Public Health 2018, 15(3), 431; doi:10.3390/ijerph15030431
Received: 12 January 2018 / Revised: 12 February 2018 / Accepted: 27 February 2018 / Published: 1 March 2018
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Abstract
In this research we explore the current state of chronic diseases in the United States, using data from the Centers for Disease Control and Prevention and applying visualization and descriptive analytics techniques. Five main categories of variables are studied, namely chronic disease conditions,
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In this research we explore the current state of chronic diseases in the United States, using data from the Centers for Disease Control and Prevention and applying visualization and descriptive analytics techniques. Five main categories of variables are studied, namely chronic disease conditions, behavioral health, mental health, demographics, and overarching conditions. These are analyzed in the context of regions and states within the U.S. to discover possible correlations between variables in several categories. There are widespread variations in the prevalence of diverse chronic diseases, the number of hospitalizations for specific diseases, and the diagnosis and mortality rates for different states. Identifying such correlations is fundamental to developing insights that will help in the creation of targeted management, mitigation, and preventive policies, ultimately minimizing the risks and costs of chronic diseases. As the population ages and individuals suffer from multiple conditions, or comorbidity, it is imperative that the various stakeholders, including the government, non-governmental organizations (NGOs), policy makers, health providers, and society as a whole, address these adverse effects in a timely and efficient manner. Full article
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Open AccessFeature PaperArticle Violent and Non-Violent Criminal Behavior among Young Chinese Drug Users: A Mixed Methods Study
Int. J. Environ. Res. Public Health 2018, 15(3), 432; doi:10.3390/ijerph15030432
Received: 30 January 2018 / Revised: 22 February 2018 / Accepted: 27 February 2018 / Published: 2 March 2018
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Abstract
Young drug users are found to be increasingly involved in criminal justice issues. This exploratory and descriptive study aims to analyze the criminal behaviors among young Chinese drug users through a mixed methods research design. Quantitative analysis indicates that young drug users with
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Young drug users are found to be increasingly involved in criminal justice issues. This exploratory and descriptive study aims to analyze the criminal behaviors among young Chinese drug users through a mixed methods research design. Quantitative analysis indicates that young drug users with and without a history of criminality show significant differences in terms of several features. Male drug users, particularly, those who are older, with religious beliefs, and initiated into drug use at younger age were most likely to commit crimes. Among drug users with criminal experiences, those who committed crimes prior to drug initiation have a greater likelihood of committing violent crimes. Furthermore, young drug users with severe depression are more likely to commit crimes, especially violent ones. Qualitative analysis further illustrates that young male drug users often get involved in criminal conduct of the youth gang nature with propensity for engaging in violent crimes as compared to their female counterparts who are more likely to turn into drug dealers and traffickers, in addition to engaging in larceny. The research findings are consistent with developmental theories and “victim to offender cycle”. Integrated mental health and substance use services are suggested for crime prevention among young Chinese drug users. Full article
(This article belongs to the Special Issue Youth Violence as a Public Health Issue)
Open AccessArticle Empathy Variation in General Practice: A Survey among General Practitioners in Denmark
Int. J. Environ. Res. Public Health 2018, 15(3), 433; doi:10.3390/ijerph15030433
Received: 3 January 2018 / Revised: 7 February 2018 / Accepted: 28 February 2018 / Published: 2 March 2018
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Abstract
Background: Previous studies have demonstrated that high levels of physician empathy may be correlated with improved patient health outcomes and high physician job satisfaction. Knowledge about variation in empathy and related general practitioner (GP) characteristics may allow for a more informed approach
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Background: Previous studies have demonstrated that high levels of physician empathy may be correlated with improved patient health outcomes and high physician job satisfaction. Knowledge about variation in empathy and related general practitioner (GP) characteristics may allow for a more informed approach to improve empathy among GPs. Objective: Our objective is to measure and analyze variation in physician empathy and its association with GP demographic, professional, and job satisfaction characteristics. Methods: 464 Danish GPs responded to a survey containing the Danish version of the Jefferson Scale of Empathy for Health Professionals (JSE-HP) and questions related to their demographic, professional and job satisfaction characteristics. Descriptive statistics and a quantile plot of the ordered empathy scores were used to describe empathy variation. In addition, random-effect logistic regression analysis was performed to explore the association between empathy levels and the included GP characteristics. Results: Empathy scores were negatively skewed with a mean score of 117.9 and a standard deviation of 10.1 within a range from 99 (p5) to 135 (p95). GPs aged 45–54 years and GPs who are not employed outside of their practice were less likely to have high empathy scores (≥120). Neither gender, nor length of time since specialization, length of time in current practice, practice type, practice location, or job satisfaction was associated with odds of having high physician empathy. However, odds of having a high empathy score were higher for GPs who stated that the physician-patient relationship and interaction with colleagues has a high contribution to job satisfaction compared to the reference groups (low and medium contribution of these factors). This was also the trend for GPs who stated a high contribution to job satisfaction from intellectual stimulation. In contrast, high contribution of economic profit and prestige did not contribute to increased odds of having a high empathy score. Conclusions: Albeit generally high, we observed substantial variation in physician empathy levels among this population of Danish GPs. This variation is positively associated with values of interpersonal relationships and interaction with colleagues, and negatively associated with middle age (45–54 years) and lack of outside employment. There is room to increase GP physician empathy via educational and organizational interventions, and consequently, to improve healthcare quality and outcomes. Full article
(This article belongs to the Special Issue Quality of Patient-Centered Care)
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Open AccessArticle The Performance of a Self-Flocculating Microalga Chlorococcum sp. GD in Wastewater with Different Ammonia Concentrations
Int. J. Environ. Res. Public Health 2018, 15(3), 434; doi:10.3390/ijerph15030434
Received: 22 January 2018 / Revised: 12 February 2018 / Accepted: 27 February 2018 / Published: 2 March 2018
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Abstract
The performance of a self-flocculating microalga Chlorococcum sp. GD on the flocculation, growth, and lipid accumulation in wastewater with different ammonia nitrogen concentrations was investigated. It was revealed that relative high ammonia nitrogen concentration (20–50 mg·L−1) was beneficial to the flocculation
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The performance of a self-flocculating microalga Chlorococcum sp. GD on the flocculation, growth, and lipid accumulation in wastewater with different ammonia nitrogen concentrations was investigated. It was revealed that relative high ammonia nitrogen concentration (20–50 mg·L−1) was beneficial to the flocculation of Chlorococcum sp. GD, and the highest flocculating efficiency was up to 84.4%. It was also found that the highest flocculating efficiency occurred in the middle of the culture (4–5 days) regardless of initial ammonia concentration in wastewater. It was speculated that high flocculating efficiency was likely related to the production of extracellular proteins. 20 mg·L−1 of ammonia was found to be a preferred concentration for both biomass production and lipid accumulation. 92.8% COD, 98.8% ammonia, and 69.4% phosphorus were removed when Chlorococcum sp. GD was cultivated in wastewater with 20 mg·L−1 ammonia. The novelty and significance of the investigation was the integration of flocculation, biomass production, wastewater treatment, and lipid accumulation, simultaneously, which made Chlorococcum sp. GD a potential candidate for wastewater treatment and biodiesel production if harvested in wastewater with suitable ammonia nitrogen concentration. Full article
(This article belongs to the Special Issue Municipal Wastewater Treatment)
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Open AccessArticle Incidence and Characteristics of Cataract Surgery in Poland, during 2010–2015
Int. J. Environ. Res. Public Health 2018, 15(3), 435; doi:10.3390/ijerph15030435
Received: 17 February 2018 / Revised: 27 February 2018 / Accepted: 28 February 2018 / Published: 2 March 2018
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Abstract
Background: To assess the incidence and characteristic of cataract surgery in Poland from 2010 to 2015 and to interpret these findings. Patients and methods: Data from all patients who underwent cataract surgery alone or in combined procedures in Poland between January 2010 and
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Background: To assess the incidence and characteristic of cataract surgery in Poland from 2010 to 2015 and to interpret these findings. Patients and methods: Data from all patients who underwent cataract surgery alone or in combined procedures in Poland between January 2010 and December 2015 were evaluated. Patient data were from the national database of hospitalizations maintained by National Health Fund. Data on the population of Poland were obtained from Central Statistical Office of Poland. Results: In total, 1,218,777 cataract extractions (alone or combined with other procedures) were performed in 1,081,345 patients during 2010–2015. Overall, the incidence of cataract surgery increased from 5.22/1000 person-years in 2010 to 6.17/1000 person-years in 2015. Phacoemulsification was performed in 97.46% of cataract extractions, and 3.02% of cataract extractions were combined procedures. The rate of one-day procedures increased from 28.3% in 2010 to 43.1% in 2015. The probability of second-eye surgery 12 months after the first-eye surgery increased from 44% in 2010 to 73% in 2015 (log-rank test p < 0.0001). Conclusion: In Poland, from 2010 to 2015, the total incidence of cataract surgery, the number of people who underwent surgery, and the number of one-day cataract surgeries increased significantly. Full article
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Open AccessArticle Grey Language Hesitant Fuzzy Group Decision Making Method Based on Kernel and Grey Scale
Int. J. Environ. Res. Public Health 2018, 15(3), 436; doi:10.3390/ijerph15030436
Received: 29 January 2018 / Revised: 26 February 2018 / Accepted: 27 February 2018 / Published: 2 March 2018
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Abstract
Based on grey language multi-attribute group decision making, a kernel and grey scale scoring function is put forward according to the definition of grey language and the meaning of the kernel and grey scale. The function introduces grey scale into the decision-making method
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Based on grey language multi-attribute group decision making, a kernel and grey scale scoring function is put forward according to the definition of grey language and the meaning of the kernel and grey scale. The function introduces grey scale into the decision-making method to avoid information distortion. This method is applied to the grey language hesitant fuzzy group decision making, and the grey correlation degree is used to sort the schemes. The effectiveness and practicability of the decision-making method are further verified by the industry chain sustainable development ability evaluation example of a circular economy. Moreover, its simplicity and feasibility are verified by comparing it with the traditional grey language decision-making method and the grey language hesitant fuzzy weighted arithmetic averaging ( G L H W A A ) operator integration method after determining the index weight based on the grey correlation. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
Open AccessArticle Arsenic Concentration in the Surface Water of a Former Mining Area: The La Junta Creek, Baja California Sur, Mexico
Int. J. Environ. Res. Public Health 2018, 15(3), 437; doi:10.3390/ijerph15030437
Received: 31 December 2017 / Revised: 11 February 2018 / Accepted: 20 February 2018 / Published: 2 March 2018
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Abstract
The mining activity in the San Antonio-El Triunfo district, located in a mountainous region at 60 km southeast of La Paz, occured for more than 250 years and left behind severe contamination of soils and riverbed sediments which led to elevated concentrations of
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The mining activity in the San Antonio-El Triunfo district, located in a mountainous region at 60 km southeast of La Paz, occured for more than 250 years and left behind severe contamination of soils and riverbed sediments which led to elevated concentrations of arsenic and other trace elements in the surface- and groundwater of the region. Although the main mining activity ended around 1911, contamination is still beeing distributed, especially from left behind tailings and mine waste piles. The contamination levels in the groundwater have been reported in several studies, but there is little information available on the surface water quality, and especially the temporal variation. In this study, we analyzed the surface water of the La Junta creek, in the southern part of the San Antonio-El Triunfo mining district. The working hypothesis was that by means of a spatial analysis of surface water and shallow groundwater, in combination with the temporal observation of the concentrations in runoff water, the effects of different sources of arsenic (natural geogene anomalies, due to historic mining activity, and hydrothermal related impact) in the La Junta creek can be recognized. This present study revealed that historic mining activity caused a mojor impact of arsenic but less contamination was observed than in the northern part of the district and elevated arsenic concentrations in stream water generally occurred during times of low streamflow. Full article
(This article belongs to the Special Issue Arsenic Contamination, Bioavailability and Public Health)
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Open AccessArticle Crisis Resource Management in the Delivery Room: Development of Behavioral Markers for Team Performance in Emergency Simulation
Int. J. Environ. Res. Public Health 2018, 15(3), 439; doi:10.3390/ijerph15030439
Received: 14 December 2017 / Revised: 21 February 2018 / Accepted: 27 February 2018 / Published: 3 March 2018
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Abstract
Human factors are the most relevant issues contributing to adverse events in obstetrics. Specific training of Crisis Resource Management (CRM) skills (i.e., problem solving and team management, resource allocation, awareness of environment, and dynamic decision-making) is now widespread and is often based on
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Human factors are the most relevant issues contributing to adverse events in obstetrics. Specific training of Crisis Resource Management (CRM) skills (i.e., problem solving and team management, resource allocation, awareness of environment, and dynamic decision-making) is now widespread and is often based on High Fidelity Simulation. In order to be used as a guideline in simulated scenarios, CRM skills need to be mapped to specific and observable behavioral markers. For this purpose, we developed a set of observable behaviors related to the main elements of CRM in the delivery room. The observational tool was then adopted in a two-days seminar on obstetric hemorrhage where teams working in obstetric wards of six Italian hospitals took part in simulations. The tool was used as a guide for the debriefing and as a peer-to-peer feedback. It was then rated for its usefulness in facilitating the reflection upon one’s own behavior, its ease of use, and its usefulness for the peer-to-peer feedback. The ratings were positive, with a median of 4 on a 5-point scale. The CRM observational tool has therefore been well-received and presents a promising level of inter-rater agreement. We believe the tool could have value in facilitating debriefing and in the peer-to-peer feedback. Full article
(This article belongs to the Special Issue Healthcare Quality and Patient Satisfaction)
Open AccessArticle Toxicity of Beauveria bassiana-28 Mycelial Extracts on Larvae of Culex quinquefasciatus Mosquito (Diptera: Culicidae)
Int. J. Environ. Res. Public Health 2018, 15(3), 440; doi:10.3390/ijerph15030440
Received: 18 December 2017 / Revised: 21 February 2018 / Accepted: 27 February 2018 / Published: 3 March 2018
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Abstract
Microbial-based pest control is an attractive alternative to chemical insecticides. The present study sought to evaluate the toxicity of the entomopathogenic fungus Beauveria bassiana-28 ethyl acetate extracts on different larval stages and pupae of Culex quinquefasciatus mosquitoes. B. bassiana-28 ethyl acetate
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Microbial-based pest control is an attractive alternative to chemical insecticides. The present study sought to evaluate the toxicity of the entomopathogenic fungus Beauveria bassiana-28 ethyl acetate extracts on different larval stages and pupae of Culex quinquefasciatus mosquitoes. B. bassiana-28 ethyl acetate mycelial extracts produced mosquitocidal activity against larvae and pupae which was comparable to that of the commercial insecticide B. bassiana-22 extract. The LC50 (lethal concentration that kills 50% of the exposed larvae) values of B. bassiana-28 extracts for 1st to 4th instar larvae and pupae were 11.538, 6.953, 5.841, 3.581 and 9.041 mg/L respectively. Our results show that B. bassiana-28 ethyl acetate mycelial extract has strong insecticidal activity against larval and pupal stages of Cx. quinquefasciatus. Fourier transform infrared spectrum study of B. bassiana-28 extract shows peaks at 3226.91; 2927.94; 1593.13; 1404.18; 1224.18; 1247.94; 1078.21; 1018.41; 229.69; and 871.82 cm−1. Major spectral peaks were observed at 3226.91 cm−1, assigned to N–H stretching, 2927.94 cm−1 assigned to C–H bonding and 1595.13 cm−1 assigned to C–O stretching. Gas Chromatography-Mass Spectrometry studies of B. bassiana-28 ethyl acetate crude extract showed presence of six major compounds viz. N-hexadecanoic acids (13.6040%); Z,Z-9,12 octadecadienic acid (33.74%); 9-eicosyne (10.832%); heptacosane (5.148%); tetrateracontane (5.801%); and 7 hexyleicosane (5.723%). Histology of mosquito midgut tissue shows tissue lysis as a result of B.bassiana-28 extract exposure. The study shows that bioactive molecules obtained from B. bassiana-28 mycelial extract has insecticidal properties and can be used as alternative for mosquito control. Full article
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Open AccessArticle A Feasibility Study of Ammonia Recovery from Coking Wastewater by Coupled Operation of a Membrane Contactor and Membrane Distillation
Int. J. Environ. Res. Public Health 2018, 15(3), 441; doi:10.3390/ijerph15030441
Received: 27 January 2018 / Revised: 24 February 2018 / Accepted: 28 February 2018 / Published: 3 March 2018
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Abstract
More than 80% of ammonia (NH3) in the steel manufacturing process wastewater is contributed from the coking wastewater, which is usually treated by biological processes. However, the NH3 in the coking wastewater is typically too high for biological treatment due
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More than 80% of ammonia (NH3) in the steel manufacturing process wastewater is contributed from the coking wastewater, which is usually treated by biological processes. However, the NH3 in the coking wastewater is typically too high for biological treatment due to its inhibitory concentration. Therefore, a two-stage process including a hollow fiber membrane contactor (HFMC) and a modified membrane distillation (MD) system was developed and applied to reduce and recover NH3 from coking wastewater. The objectives of this paper are to evaluate different membrane materials, receiving solutions, and operation parameters for the system, remove NH3 from the coking wastewater to less than 300 mg N/L, which is amenable to the biological process, and recover ammonia solution for reuse. As a result, the polytetrafluoroethylene (PTFE) HFMC using sulfuric acid as a receiving solution can achieve a maximum NH3-N transmembrane flux of 1.67 g N/m2·h at pH of 11.5 and reduce NH3 in the coking wastewater to less than 300 mg N/L. The NH3 in the converted ammonium sulfate ((NH4)2SO4) was then recovered by the modified MD using ice water as the receiving solution to produce ≥3% of ammonia solution for reuse. Full article
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Open AccessArticle Exploring the Driving Factors of Construction Industrialization Development in China
Int. J. Environ. Res. Public Health 2018, 15(3), 442; doi:10.3390/ijerph15030442
Received: 25 January 2018 / Revised: 21 February 2018 / Accepted: 26 February 2018 / Published: 3 March 2018
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Abstract
Construction industrialization (CI) has been adopted worldwide because of its potential benefits. However, current research shows the incentives for adopting CI may differ in different regions. While the promotion of CI in China is still at the initial stage, a systematical analysis of
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Construction industrialization (CI) has been adopted worldwide because of its potential benefits. However, current research shows the incentives for adopting CI may differ in different regions. While the promotion of CI in China is still at the initial stage, a systematical analysis of the driving factors would help decision makers get a comprehensive understanding of CI development and select proper strategies to promote CI. This research combines qualitative and quantitative methods to explore the construction industrialization driving factors (CIDFs) in China. The grounded theory method (GTM) was employed to explore CI concepts among 182 CI-related articles published in 10 top-tier journals from 2000 to 2017. A total of 15 CIDFs were identified, including one suggested by professionals during a pre-test questionnaire survey. The analysis showed that the development of CI in China is pushed by macrodevelopment and pulled by the government and is also a self-driven process. The major driving factors for CI adoption in China are the transformation and upgrade of the conventional construction industry and the solution of development dilemmas. Our study also suggests that pilot programs are, currently, the most effective method to promote CI in China and to accumulate experience so to gain recognition by the society. This research is also of value for CI promotion in other developing countries. Full article
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Open AccessFeature PaperArticle Hygiene and Health: Who Do Mothers in Vanuatu Communicate with about Health?
Int. J. Environ. Res. Public Health 2018, 15(3), 443; doi:10.3390/ijerph15030443
Received: 7 February 2018 / Revised: 26 February 2018 / Accepted: 28 February 2018 / Published: 3 March 2018
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Abstract
Health information-seeking behaviour of mothers with children five years of age and younger in Vanuatu was examined using the structural properties of social networks. Data were collected from a rural village from two islands and an urban settlement in the capital, Port Vila,
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Health information-seeking behaviour of mothers with children five years of age and younger in Vanuatu was examined using the structural properties of social networks. Data were collected from a rural village from two islands and an urban settlement in the capital, Port Vila, by face-to-face interviews using a structured questionnaire. Sociometric data on the structure of the network, the characteristics of key informants, and associations with outside sources of health information were analysed as interpersonal predictors of health promotion and behavior change. Rural mothers preferred the health advice of biomedical practitioners for diarrheal disease over traditional custom practitioners. Interpersonal connections were restricted in the urban mother network indicating that mothers were merely acquaintances or do not seek health advice from each other. Our findings suggest that biomedical practitioners are the best option for diffusing health and hygiene information for rural and urban mothers. Traditional healers and paraprofessionals could be strategically used to complete the missing links in network connectedness to optimally spread new information. The novel use of cross-sectional social network data can create a baseline evaluation to purposefully frame a health intervention. Our study provided a unique explanation of how network analysis offers insight into how key players can be identified and the circumstances in which they are likely to be able to influence hygiene practices of their peers. Full article
(This article belongs to the Special Issue Social Networks and Health)
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Open AccessArticle Harmful Cyanobacterial Material Production in the North Han River (South Korea): Genetic Potential and Temperature-Dependent Properties
Int. J. Environ. Res. Public Health 2018, 15(3), 444; doi:10.3390/ijerph15030444
Received: 10 January 2018 / Revised: 27 February 2018 / Accepted: 1 March 2018 / Published: 3 March 2018
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Abstract
Cyanobacteria synthesize various harmful materials, including off-flavor substances and toxins, that are regarded as potential socio-economic and environmental hazards in freshwater systems, however, their production is still not well understood. In this study, we investigated the potential and properties of harmful materials produced
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Cyanobacteria synthesize various harmful materials, including off-flavor substances and toxins, that are regarded as potential socio-economic and environmental hazards in freshwater systems, however, their production is still not well understood. In this study, we investigated the potential and properties of harmful materials produced by cyanobacteria, depending on temperature, and undertook a phylogenetic analysis of cyanobacteria present in the North Han River (South Korea). Production potentials were evaluated using gene-specific probes, and the harmful material production properties of strains showing positive potentials were further characterized at different temperatures in the range 15 to 30 °C. We identified six cyanobacterial strains based on 16S rDNA analysis: two morphological types (coiled and straight type) of Dolichospermum circinale, Aphanizomenon flos-aquae, Oscillatoria limosa, Planktothricoides raciborskii, Pseudanabaena mucicola, and Microcystis aeruginosa. We confirmed that cyanobacterial strains showing harmful material production potential produced the corresponding harmful material, and their production properties varied with temperature. Total harmful material production was maximal at 20~25 °C, a temperature range optimal for cell growth. However, harmful material productivity was highest at 15 °C. These results indicate that the expression of genes related to synthesis of harmful materials can vary depending on environmental conditions, resulting in variable harmful material production, even within the same cyanobacterial strains. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle A Decision-Making Method with Grey Multi-Source Heterogeneous Data and Its Application in Green Supplier Selection
Int. J. Environ. Res. Public Health 2018, 15(3), 446; doi:10.3390/ijerph15030446
Received: 22 January 2018 / Revised: 27 February 2018 / Accepted: 27 February 2018 / Published: 3 March 2018
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Abstract
In view of the multi-attribute decision-making problem that the attribute values are grey multi-source heterogeneous data, a decision-making method based on kernel and greyness degree is proposed. The definitions of kernel and greyness degree of an extended grey number in a grey multi-source
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In view of the multi-attribute decision-making problem that the attribute values are grey multi-source heterogeneous data, a decision-making method based on kernel and greyness degree is proposed. The definitions of kernel and greyness degree of an extended grey number in a grey multi-source heterogeneous data sequence are given. On this basis, we construct the kernel vector and greyness degree vector of the sequence to whiten the multi-source heterogeneous information, then a grey relational bi-directional projection ranking method is presented. Considering the multi-attribute multi-level decision structure and the causalities between attributes in decision-making problem, the HG-DEMATEL method is proposed to determine the hierarchical attribute weights. A green supplier selection example is provided to demonstrate the rationality and validity of the proposed method. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Depression, Suicidal Behaviour, and Mental Disorders in Older Aboriginal Australians
Int. J. Environ. Res. Public Health 2018, 15(3), 447; doi:10.3390/ijerph15030447
Received: 22 December 2017 / Revised: 20 February 2018 / Accepted: 28 February 2018 / Published: 4 March 2018
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Abstract
Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This
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Aboriginal Australians experience higher levels of psychological distress, which may develop from the long-term sequelae of social determinants and adversities in early and mid-life. There is little evidence available on the impact of these on the mental health of older Aboriginal Australians. This study enrolled 336 Aboriginal Australian participants over 60 years from 5 major urban and regional areas in NSW, utilizing a structured interview on social determinants, and life-time history of physical and mental conditions; current psychosocial determinants and mental health. Univariate and multivariate analyses were utilized to examine the link between these determinants and current depressive scores and suicidality. There was a high rate of life-time depression (33.3%), current late-life depression (18.1%), and suicidal ideation (11.1%). Risk factors strongly associated with late-life depression included sleep disturbances, a history of suicidal behaviour, suicidal ideation in late-life and living in a regional location. This study supports certain historical and psychosocial factors predicting later depression in old age, and highlights areas to target for prevention strategies. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
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Open AccessArticle Processing Technology Selection for Municipal Sewage Treatment Based on a Multi-Objective Decision Model under Uncertainty
Int. J. Environ. Res. Public Health 2018, 15(3), 448; doi:10.3390/ijerph15030448
Received: 6 January 2018 / Revised: 20 February 2018 / Accepted: 26 February 2018 / Published: 5 March 2018
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Abstract
This study considers the two factors of environmental protection and economic benefits to address municipal sewage treatment. Based on considerations regarding the sewage treatment plant construction site, processing technology, capital investment, operation costs, water pollutant emissions, water quality and other indicators, we establish
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This study considers the two factors of environmental protection and economic benefits to address municipal sewage treatment. Based on considerations regarding the sewage treatment plant construction site, processing technology, capital investment, operation costs, water pollutant emissions, water quality and other indicators, we establish a general multi-objective decision model for optimizing municipal sewage treatment plant construction. Using the construction of a sewage treatment plant in a suburb of Chengdu as an example, this paper tests the general model of multi-objective decision-making for the sewage treatment plant construction by implementing a genetic algorithm. The results show the applicability and effectiveness of the multi-objective decision model for the sewage treatment plant. This paper provides decision and technical support for the optimization of municipal sewage treatment. Full article
(This article belongs to the Special Issue Municipal Wastewater Treatment)
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Open AccessArticle Impact of the Social and Natural Environment on Preschool-Age Children Weight
Int. J. Environ. Res. Public Health 2018, 15(3), 449; doi:10.3390/ijerph15030449
Received: 10 February 2018 / Revised: 27 February 2018 / Accepted: 2 March 2018 / Published: 5 March 2018
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Abstract
Background: The complex impact of environmental and social factors on preschool children being overweight/obese is unclear. We examined the associations between the levels of green space exposure and the risk of being overweight/obese for 4–6 year-old children and assessed the impact of maternal
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Background: The complex impact of environmental and social factors on preschool children being overweight/obese is unclear. We examined the associations between the levels of green space exposure and the risk of being overweight/obese for 4–6 year-old children and assessed the impact of maternal education on these associations. Methods: This cross-sectional study included 1489 mother-child pairs living in Kaunas, Lithuania, in 2012–2013. We assessed children overweight/obesity by standardized questionnaires using international body mass index cut-off points, and the level of greenness exposures by satellite-derived normalized difference vegetation index (NDVI) of each child’s home and by the distance to a nearest city park. The maternal education was used as the SES indicator. We used logistic regression models to investigate the strength of the associations. Results: Children from families with poorer maternal education, pathological mother-child relations and smoking mothers, and living in areas with less greenness exposure (NDVI-100 m), had significantly higher odds ratios of being overweight/obese. Lower maternal education and distance to a city park modified the effect of greenness cover level exposure on the risk of children being overweight/obese. Conclusions: Higher greenness exposure in the residential settings has beneficial effects on children’s physical development. The green spaces exposures for psychosocial stress management is recommended as a measure to prevent overweight/obesity among children. Full article
Open AccessFeature PaperArticle Demonstrating Impact: Lessons Learned from the Queensland Aboriginal and Islander Health Council’s AOD-Our-Way Program
Int. J. Environ. Res. Public Health 2018, 15(3), 450; doi:10.3390/ijerph15030450
Received: 14 December 2017 / Revised: 20 February 2018 / Accepted: 20 February 2018 / Published: 5 March 2018
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Abstract
In this paper, we describe the innovative way in which the Queensland Aboriginal and Islander Health Council uses “clicker technology” to gather data to report on the key performance indicators of its “AOD-our-way” program, and how, with the subsequent combination of those data
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In this paper, we describe the innovative way in which the Queensland Aboriginal and Islander Health Council uses “clicker technology” to gather data to report on the key performance indicators of its “AOD-our-way” program, and how, with the subsequent combination of those data with other performance measures, it was possible to go beyond the initial evaluation. The paper also illustrates how the application of survey research methods could further enable enhanced reporting of program outcomes and impacts in an Indigenous context where Indigenous community controlled organisations want to build the evidence base for the issues they care about and ultimately drive their own research agendas. Full article
(This article belongs to the Special Issue Indigenous Health and Wellbeing)
Open AccessArticle Assessing the Use of Media Reporting Recommendations by the World Health Organization in Suicide News Published in the Most Influential Media Sources in China, 2003–2015
Int. J. Environ. Res. Public Health 2018, 15(3), 451; doi:10.3390/ijerph15030451
Received: 26 January 2018 / Revised: 28 February 2018 / Accepted: 2 March 2018 / Published: 5 March 2018
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Abstract
Public media reports about suicide are likely to influence the population’s suicidal attempts and completed suicides. Irresponsible reports might trigger copycat suicidal behaviors, while responsible reports may help reduce suicide rates. The World Health Organization (WHO) released recommendations to encourage responsible suicide reports
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Public media reports about suicide are likely to influence the population’s suicidal attempts and completed suicides. Irresponsible reports might trigger copycat suicidal behaviors, while responsible reports may help reduce suicide rates. The World Health Organization (WHO) released recommendations to encourage responsible suicide reports in 2008. However, little is known about whether these recommendations are reflected in the suicide news for most countries, including China. In this study, we assessed the responsibility of suicide stories published in the most influential newspaper and Internet media sources in China from 2003 to 2015, using the media reporting recommendations by the World Health Organization (WHO). In total, 3965 and 1836 eligible stories from newspaper and Internet-based media, respectively, were included in the study. Newspapers and Internet-based media performed similarly in applying WHO recommendations to report suicide news. Three recommendations were applied in over 88% of suicide stories. However, four recommendations were seldom applied, including offering information about where to seek help and linking the suicide event to mental disorders. Government and the journalism industry should work together to improve media reporting of news about suicide in China. Full article
(This article belongs to the Special Issue Suicide Risk and Mental Disorders)
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Open AccessArticle Removal and Biodegradation of 17β-Estradiol and Diethylstilbestrol by the Freshwater Microalgae Raphidocelis subcapitata
Int. J. Environ. Res. Public Health 2018, 15(3), 452; doi:10.3390/ijerph15030452
Received: 29 December 2017 / Revised: 23 February 2018 / Accepted: 26 February 2018 / Published: 5 March 2018
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Abstract
Natural steroidal and synthetic non-steroidal estrogens such as 17β-estradiol (E2) and diethylstilbestrol (DES) have been found in natural water, which can potentially endanger public health and aquatic ecosystems. The removal and biodegradation of E2 and DES by Raphidocelis subcapitata were studied in bacteria-free
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Natural steroidal and synthetic non-steroidal estrogens such as 17β-estradiol (E2) and diethylstilbestrol (DES) have been found in natural water, which can potentially endanger public health and aquatic ecosystems. The removal and biodegradation of E2 and DES by Raphidocelis subcapitata were studied in bacteria-free cultures exposed to single and mixture treatments at different concentrations for 96 h. The results showed that R. subcapitata exhibited a rapid and strong ability to remove E2 and DES in both single and mixture treatments by biodegradation. At the end of 96 h, the removal percentage of single E2 and DES achieved 82.0%, 80.4%, 74.6% and 89.9%, 73.4%, 54.1% in 0.1, 0.5, and 1.5 mg·L−1, respectively. With the exception of the 0.1 mg·L−1 treatment at 96 h, the removal capacity of E2 was more efficient than that of DES by R. subcapitata. Furthermore, the removal percentage of mixture E2 and DES achieved 88.5%, 82.9%, 84.3% and 87.2%, 71.8%, 51.1% in 0.1, 0.5, and 1.5 mg·L−1, respectively. The removal percentage of mixed E2 was significantly higher than that of the single E2. The presence of DES could accelerate the removal of E2 from the mixture treatments in equal concentrations. In addition, the removal was mainly attributed to the biodegradation or biotransformation process by the microalgae cells rather than simple sorption and accumulation in the cells. The microalgae R. subcapitata demonstrated a high capability for the removal of the E2 and DES indicating future prospects for its application. Full article
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Open AccessArticle Community Readiness for the Promotion of Physical Activity in Older Adults—A Cross-Sectional Comparison of Rural and Urban Communities
Int. J. Environ. Res. Public Health 2018, 15(3), 453; doi:10.3390/ijerph15030453
Received: 5 February 2018 / Revised: 24 February 2018 / Accepted: 1 March 2018 / Published: 6 March 2018
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Abstract
Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures
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Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3–5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): −0.02–0.59). The rural communities showed significantly higher CR scores in the ‘Knowledge of efforts’ dimension (0.70, 95% CI: 0.26–1.14) and in the ‘Knowledge of the issue’ (0.37, 95% CI: 0.04–0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels. Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
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Open AccessArticle Assessment of Metalloid and Metal Contamination in Soils from Hainan, China
Int. J. Environ. Res. Public Health 2018, 15(3), 454; doi:10.3390/ijerph15030454
Received: 22 January 2018 / Revised: 20 February 2018 / Accepted: 28 February 2018 / Published: 6 March 2018
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Abstract
The characterization of the concentrations and sources of metals and metalloids in soils is necessary to establish quality standards on a regional level and to assess the potential threat of metals to food safety and human health. A total of 8713 soil samples
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The characterization of the concentrations and sources of metals and metalloids in soils is necessary to establish quality standards on a regional level and to assess the potential threat of metals to food safety and human health. A total of 8713 soil samples throughout Hainan Island, China were collected at a density of one sample per 4 km2, and concentrations of As, Cd, Cr, Cu, Hg, Ni, Pb, Se, and Zn were analyzed. The geometric mean values of the elements were 2.17, 0.60, 26.5, 9.43, 0.033, 8.74, 22.2, 0.26, and 39.6 mg·· kg−1 for As, Cd, Cr, Cu, Hg, Ni, Pb, Se, and Zn, respectively, significantly lower than the background values of Chinese soils with the exception of Se. Principal component analysis (PCA) suggested that multiple anthropogenic sources regulated the elemental compositions of the Hainan environment. Coal combustion and mining are important anthropogenic sources of metals for Hainan. The geochemical maps of elements in Hainan soils were produced using the Geographic Information System (GIS) method, and several hot-spot areas were identified. The ecological impact of As, Cd, Cu, Cr, Hg, Pb, Ni, and Zn pollution to the soils was extremely “low”. Full article
(This article belongs to the collection Environmental Risk Assessment)
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Open AccessArticle Exposure to Suicide in High Schools: Impact on Serious Suicidal Ideation/Behavior, Depression, Maladaptive Coping Strategies, and Attitudes toward Help-Seeking
Int. J. Environ. Res. Public Health 2018, 15(3), 455; doi:10.3390/ijerph15030455
Received: 4 February 2018 / Revised: 22 February 2018 / Accepted: 28 February 2018 / Published: 6 March 2018
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Abstract
Adolescents’ exposure to a peer’s suicide has been found to be associated with, as well as to predict, suicidal ideation and behavior. Although postvention efforts tend to be school-based, little is known about the impact of a schoolmate’s suicide on the school’s student
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Adolescents’ exposure to a peer’s suicide has been found to be associated with, as well as to predict, suicidal ideation and behavior. Although postvention efforts tend to be school-based, little is known about the impact of a schoolmate’s suicide on the school’s student population overall. The present study seeks to determine whether there is excess psychological morbidity among students in a school where a schoolmate has died by suicide, and whether students’ attitudes about coping and help-seeking strategies are more or less problematic in such schools. Students in twelve high schools in Suffolk and Westchester counties in New York State—2865 students at six schools where a student had died by suicide within the past six months, and 2419 students at six schools where no suicide had occurred within the current students’ tenure—completed an assessment of their suicidal ideation and behavior, depressive symptoms, coping and help-seeking attitudes, stressful life events, and friendship with suicide decedent (if applicable). No excess morbidity (i.e., serious suicidal ideation/behavior and depression) was evident among the general student population after a schoolmate’s death by suicide; however, the risk of serious suicidal ideation/behavior was elevated among students at exposed schools who had concomitant negative life events. There was a significant relationship between friendship with the decedent and morbidity, in that students who were friends, but not close friends, of the decedents had the greatest odds of serious suicidal ideation/behavior. Overall, students in exposed schools had more adaptive attitudes toward help-seeking; but this was not true of the decedents’ friends or students with concomitant negative life events. The implications of the findings for postvention strategies are discussed. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
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Open AccessArticle The Emerging Workforce of International University Student Workers: Injury Experience in an Australian University
Int. J. Environ. Res. Public Health 2018, 15(3), 456; doi:10.3390/ijerph15030456
Received: 11 January 2018 / Revised: 13 February 2018 / Accepted: 1 March 2018 / Published: 6 March 2018
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Abstract
International university students are a growing section of the workforce and are thought to be at greater risk of injury. Qualitative studies have highlighted vulnerabilities, but there is a shortage of quantitative research exploring the injury experience and associated risk factors of this
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International university students are a growing section of the workforce and are thought to be at greater risk of injury. Qualitative studies have highlighted vulnerabilities, but there is a shortage of quantitative research exploring the injury experience and associated risk factors of this emerging issue. In this study, a total of 466 university student workers across a range of study programs in a single Australian university completed an online survey, with questions relating to their background, working experience, training and injury experience. Risk factors for injury were explored in a multivariate statistical model. More than half had not received any safety training before they started work, and 10% reported having had a work injury. About half of these injuries occurred after training. Statistically significant risk factors for injury included working more than 20 h per week (adjusted odds ratio 2.20 (95% CI 1.03–4.71) and lack of confidence in discussing safety issues (AOR 2.17; 95% CI 1.13–4.16). The findings suggest the need for a more engaging and effective approach to safety education and a limit on working hours. This situation is a moral challenge for universities, in that they are effectively sponsoring young workers in the community. It is recommended that longitudinal studies of international student workers be conducted. Full article
(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)
Open AccessArticle The Relationship between Impulsivity and Internet Gaming Disorder in Young Adults: Mediating Effects of Interpersonal Relationships and Depression
Int. J. Environ. Res. Public Health 2018, 15(3), 458; doi:10.3390/ijerph15030458
Received: 25 January 2018 / Revised: 23 February 2018 / Accepted: 2 March 2018 / Published: 6 March 2018
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Abstract
Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD) symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for
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Background: This study aimed to explore relationships between impulsivity, interpersonal relationships, depression, and Internet Gaming Disorder (IGD) symptoms. Methods: A total of 118 young adults participated in this study: 67 IGD patients who met five or more of the DSM-5 diagnostic criteria for IGD and 56 healthy controls. We administered questionnaires to assess IGD symptoms (Young’s Internet Addiction Test; Y-IAT), impulsivity (Barratt Impulsiveness Scale; BIS-11), interpersonal relationship (Relationship Change Scale; RCS), and depression (Beck Depression Inventory; BDI). We used PROCESS macro in SPSS to perform mediation analysis. Results: IGD symptom was positively related to depression and impulsivity, and negatively related to the quality of interpersonal relationships. Mediation analysis revealed full mediation effects of interpersonal relationships and depression on the association between impulsivity and IGD symptoms in the IGD group. Specifically, even after adjusting for gender as a covariate, high impulsivity was associated with greater difficulty with interpersonal relationships; which further affected depression and increased the risk of IGD. Conclusions: These results demonstrate the importance of early intervention in IGD patients, particularly in young adults with high impulsivity. When intervening in adults’ IGD, we should consider not only individual factors (e.g., depression) but also socioenvironmental factors (e.g., interpersonal relationships). Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
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Open AccessArticle What Can We Learn about Workplace Heat Stress Management from a Safety Regulator Complaints Database?
Int. J. Environ. Res. Public Health 2018, 15(3), 459; doi:10.3390/ijerph15030459
Received: 7 February 2018 / Revised: 24 February 2018 / Accepted: 1 March 2018 / Published: 6 March 2018
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Abstract
Heat exposure can be a health hazard for many Australian workers in both outdoor and indoor situations. With many heat-related incidents left unreported, it is often difficult to determine the underlying causal factors. This study aims to provide insights into perceptions of potentially
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Heat exposure can be a health hazard for many Australian workers in both outdoor and indoor situations. With many heat-related incidents left unreported, it is often difficult to determine the underlying causal factors. This study aims to provide insights into perceptions of potentially unsafe or uncomfortably hot working conditions that can affect occupational health and safety using information provided by the public and workers to the safety regulator in South Australia (SafeWork SA). Details of complaints regarding heat exposure to the regulator’s “Help Centre” were assembled in a dataset and the textual data analysed thematically. The findings showed that the majority of calls relate to indoor work environments such as kitchens, factories, and warehouses. The main themes identified were work environment, health effects, and organisational issues. Impacts of hot working conditions ranged from discomfort to serious heat-related illnesses. Poor management practices and inflexibility of supervisors featured strongly amongst callers’ concerns. With temperatures predicted to increase and energy prices escalating, this timely study, using naturalistic data, highlights accounts of hot working conditions that can compromise workers’ health and safety and the need for suitable measures to prevent heat stress. These could include risk assessments to assess the likelihood of heat stress in workplaces where excessively hot conditions prevail. Full article
(This article belongs to the Special Issue Emerging Issues in Occupational Safety and Health)
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Open AccessArticle Socio-Economic Disparities in Attitude and Preference for Menu Labels among Vietnamese Restaurant Customers
Int. J. Environ. Res. Public Health 2018, 15(3), 460; doi:10.3390/ijerph15030460
Received: 19 January 2018 / Revised: 28 February 2018 / Accepted: 28 February 2018 / Published: 6 March 2018
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Abstract
Calories and nutrition labeling on restaurant menus are powerful policy interventions to reduce the burden of obesity epidemic. However, the success of this policy requires an assurance of equal benefits among customers with different characteristics, especially people at a higher risk of poor
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Calories and nutrition labeling on restaurant menus are powerful policy interventions to reduce the burden of obesity epidemic. However, the success of this policy requires an assurance of equal benefits among customers with different characteristics, especially people at a higher risk of poor health outcomes and eating habits. This study examined the sociodemographic disparities in the attitude and preference for calories and nutrition labeling on menus among customers in various food facilities. A cross-sectional study was conducted with 1746 customers of food facilities in Hanoi, Vietnam, who were recruited by using a multistage sampling method. Socio-economic characteristics, attitudes regarding the necessity and preferences for calories, and nutrition labeling on menus were analyzed. Multivariate logistic regression was employed to determine the associated factors with attitudes and preferences. Results show that most of the sample understood the necessity to have calories and nutrition labeling (59.8%), and 71.8% preferred to have calories and nutrition labeling. People who often visited food facilities (Odd Ratio (OR) = 1.36; 95% confident interval (CI) = 1.06–1.74) and had higher education and were more likely to understand the necessity of calories and nutrition labeling. Factors such as being homemakers, often going to dine-in restaurants, and perceiving that labeling was unnecessary were negatively associated with preferences for calories and nutrition labeling. The results of this study encourage policymakers to implement calories and nutrition labeling in the future. Health education interventions to improve knowledge and attitude as regards calories and nutrition labeling on menus are important, particularly for males, less-educated individuals, and high-income people. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Comparative Analysis of GF-1 and HJ-1 Data to Derive the Optimal Scale for Monitoring Heavy Metal Stress in Rice
Int. J. Environ. Res. Public Health 2018, 15(3), 461; doi:10.3390/ijerph15030461
Received: 6 February 2018 / Revised: 1 March 2018 / Accepted: 4 March 2018 / Published: 6 March 2018
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Abstract
Remote sensing can actively monitor heavy metal contamination in crops, but with the increase of satellite sensors, the optimal scale for monitoring heavy metal stress in rice is still unknown. This study focused on identifying the optimal scale by comparing the ability to
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Remote sensing can actively monitor heavy metal contamination in crops, but with the increase of satellite sensors, the optimal scale for monitoring heavy metal stress in rice is still unknown. This study focused on identifying the optimal scale by comparing the ability to detect heavy metal stress in rice at various spatial scales. The 2 m, 8 m, and 16 m resolution GF-1 (China) data and the 30 m resolution HJ-1 (China) data were used to invert leaf area index (LAI). The LAI was the input parameter of the World Food Studies (WOFOST) model, and we obtained the dry weight of storage organs (WSO) and dry weight of roots (WRT) through the assimilation method; then, the mass ratio of rice storage organs and roots (SORMR) was calculated. Through the comparative analysis of SORMR at each spatial scale of data, we determined the optimal scale to monitor heavy metal stress in rice. The following conclusions were drawn: (1) SORMR could accurately and effectively monitor heavy metal stress; (2) the 8 m and 16 m images from GF-1 were suitable for monitoring heavy metal stress in rice; (3) 16 m was considered the optimal scale to assess heavy metal stress in rice. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Analysis of Occupational Accidents in Underground and Surface Mining in Spain Using Data-Mining Techniques
Int. J. Environ. Res. Public Health 2018, 15(3), 462; doi:10.3390/ijerph15030462
Received: 24 January 2018 / Revised: 26 February 2018 / Accepted: 2 March 2018 / Published: 7 March 2018
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Abstract
An analysis of occupational accidents in the mining sector was conducted using the data from the Spanish Ministry of Employment and Social Safety between 2005 and 2015, and data-mining techniques were applied. Data was processed with the software Weka. Two scenarios were chosen
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An analysis of occupational accidents in the mining sector was conducted using the data from the Spanish Ministry of Employment and Social Safety between 2005 and 2015, and data-mining techniques were applied. Data was processed with the software Weka. Two scenarios were chosen from the accidents database: surface and underground mining. The most important variables involved in occupational accidents and their association rules were determined. These rules are composed of several predictor variables that cause accidents, defining its characteristics and context. This study exposes the 20 most important association rules in the sector—either surface or underground mining—based on the statistical confidence levels of each rule as obtained by Weka. The outcomes display the most typical immediate causes, along with the percentage of accidents with a basis in each association rule. The most important immediate cause is body movement with physical effort or overexertion, and the type of accident is physical effort or overexertion. On the other hand, the second most important immediate cause and type of accident are different between the two scenarios. Data-mining techniques were chosen as a useful tool to find out the root cause of the accidents. Full article
(This article belongs to the Special Issue Workplace Health Promotion 2018)
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Open AccessArticle Assessing the Association of Food Preferences and Self-Reported Psychological Well-Being among Middle-Aged and Older Adults in Contemporary China-Results from the China Health and Nutrition Survey
Int. J. Environ. Res. Public Health 2018, 15(3), 463; doi:10.3390/ijerph15030463
Received: 2 February 2018 / Revised: 4 March 2018 / Accepted: 5 March 2018 / Published: 7 March 2018
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Abstract
China has undergone rapid social transitions within the last few decades. However, mental health issues, challenges to psychological well-being, and poor dietary choices have gradually surfaced. These health concerns are related to the rapid growth of the aging population and of the fast-paced
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China has undergone rapid social transitions within the last few decades. However, mental health issues, challenges to psychological well-being, and poor dietary choices have gradually surfaced. These health concerns are related to the rapid growth of the aging population and of the fast-paced industrialized society. Nevertheless, there is little knowledge about food preferences and psychological well-being measurements in contemporary China. Applying the 2011 China Health and Nutrition Survey (CHNS) with a cross-sectional study design (n = 7970), we conducted multinomial logistic regression models to investigate the associations of food preferences, including fast food, salty snacks, fruits, vegetables, and sweetened beverages, with psychological well-being among Chinese middle-aged and older adults (age ≥ 45). Food preferences are mostly associated with psychological well-being (p < 0.05). However, respondents’ preferences regarding fast food, salty snacks, and sweetened beverages are associated not only with poorer psychological health status, but also with positive psychological well-being. We speculate that Chinese older adults may consume Westernized fast food and salty snacks as pleasure to the palate due to the recent Westernization in modern China. We also provide practical implications of results from this preliminary study. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Open AccessArticle Neighborhood Variation of Sustainable Urban Morphological Characteristics
Int. J. Environ. Res. Public Health 2018, 15(3), 465; doi:10.3390/ijerph15030465
Received: 27 December 2017 / Revised: 20 February 2018 / Accepted: 28 February 2018 / Published: 7 March 2018
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Abstract
Compact cities and their urban forms have implications on sustainable city development because of high density urban settlement, increased accessibility, and a balanced land use mix. This paper uses quantitative means of understanding urban morphological characteristics with reference to the differing qualities of
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Compact cities and their urban forms have implications on sustainable city development because of high density urban settlement, increased accessibility, and a balanced land use mix. This paper uses quantitative means of understanding urban morphological characteristics with reference to the differing qualities of the urban form (i.e., street patterns, building volumes, land uses and greenery). The results, based on 89 neighborhood communities of Hong Kong, show varying degrees of regional differences in the urban built form supported by numerical statistics and graphical illustrations. This paper offers empirical evidence on some morphological characteristics that can be estimated objectively using modern geospatial technologies and applied universally to inform urban planning. However, more studies linking these quantifiable measures of the physical form with sustainable urban living are needed to account for human comfort in the totality of environmental, social, and economic responsibilities. Full article
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Open AccessArticle Wetlands and Malaria in the Amazon: Guidelines for the Use of Synthetic Aperture Radar Remote-Sensing
Int. J. Environ. Res. Public Health 2018, 15(3), 468; doi:10.3390/ijerph15030468
Received: 15 December 2017 / Revised: 27 February 2018 / Accepted: 1 March 2018 / Published: 7 March 2018
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Abstract
The prevention and control of mosquito-borne diseases, such as malaria, are important health issues in tropical areas. Malaria transmission is a multi-scale process strongly controlled by environmental factors, and the use of remote-sensing data is suitable for the characterization of its spatial and
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The prevention and control of mosquito-borne diseases, such as malaria, are important health issues in tropical areas. Malaria transmission is a multi-scale process strongly controlled by environmental factors, and the use of remote-sensing data is suitable for the characterization of its spatial and temporal dynamics. Synthetic aperture radar (SAR) is well-adapted to tropical areas, since it is capable of imaging independent of light and weather conditions. In this study, we highlight the contribution of SAR sensors in the assessment of the relationship between vectors, malaria and the environment in the Amazon region. More specifically, we focus on the SAR-based characterization of potential breeding sites of mosquito larvae, such as man-made water collections and natural wetlands, providing guidelines for the use of SAR capabilities and techniques in order to optimize vector control and malaria surveillance. In light of these guidelines, we propose a framework for the production of spatialized indicators and malaria risk maps based on the combination of SAR, entomological and epidemiological data to support malaria risk prevention and control actions in the field. Full article
(This article belongs to the Special Issue Malaria Epidemiology and Control: Current Situation and Perspectives)
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Open AccessArticle Water Bacterial and Fungal Community Compositions Associated with Urban Lakes, Xi’an, China
Int. J. Environ. Res. Public Health 2018, 15(3), 469; doi:10.3390/ijerph15030469
Received: 15 January 2018 / Revised: 22 February 2018 / Accepted: 4 March 2018 / Published: 7 March 2018
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Abstract
Urban lakes play a vital role in the sustainable development of urbanized areas. In this freshwater ecosystem, massive microbial communities can drive the recycling of nutrients and regulate the water quality. However, water bacterial and fungal communities in the urban lakes are not
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Urban lakes play a vital role in the sustainable development of urbanized areas. In this freshwater ecosystem, massive microbial communities can drive the recycling of nutrients and regulate the water quality. However, water bacterial and fungal communities in the urban lakes are not well understood. In the present work, scanning electron microscopy (SEM) was combined with community level physiological profiles (CLPPs) and Illumina Miseq sequence techniques to determine the diversity and composition of the water bacterial and fungal community in three urban lakes, namely Xingqing lake (LX), Geming lake (LG) and Lianhu lake (LL), located in Xi’an City (Shaanxi Province, China). The results showed that these three lakes were eutrophic water bodies. The highest total nitrogen (TN) was observed in LL, with a value of 12.1 mg/L, which is 2 times higher than that of LG. The permanganate index (CODMn) concentrations were 21.6 mg/L, 35.4 mg/L and 28.8 mg/L in LG, LL and LX, respectively (p < 0.01). Based on the CLPPs test, the results demonstrated that water bacterial communities in the LL and LX urban lakes had higher carbon source utilization ability. A total of 62,742 and 55,346 high quality reads were grouped into 894 and 305 operational taxonomic units (OTUs) for bacterial and fungal communities, respectively. Water bacterial and fungal community was distributed across 14 and 6 phyla. The most common phyla were Proteobacteriaand Cyanobacteria. Cryptomycota was particularly dominant in LL, while Chytridiomycota and Entomophthormycota were the most abundant fungal phyla, accounting for 95% of the population in the LL and 56% in the LG. Heat map and redundancy analysis (RDA) highlighted the dramatic differences of water bacterial communities among three urban lakes. Meanwhile, the profiles of fungal communities were significantly correlated with the water quality parameters (e.g., CODMn and total nitrogen, TN). Several microbes (Legionella sp. and Streptococcus sp.) related to human diseases, such as infectious diseases, were also found. The results from this study provides useful information related to the water quality and microbial community compositions harbored in the aquatic ecosystems of urban lakes. Full article
(This article belongs to the Special Issue Aquatic Ecosystem Health)
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Open AccessArticle The NLS-Based Nonlinear Grey Multivariate Model for Forecasting Pollutant Emissions in China
Int. J. Environ. Res. Public Health 2018, 15(3), 471; doi:10.3390/ijerph15030471
Received: 28 January 2018 / Revised: 24 February 2018 / Accepted: 2 March 2018 / Published: 8 March 2018
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Abstract
The relationship between pollutant discharge and economic growth has been a major research focus in environmental economics. To accurately estimate the nonlinear change law of China’s pollutant discharge with economic growth, this study establishes a transformed nonlinear grey multivariable (TNGM (1, N))
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The relationship between pollutant discharge and economic growth has been a major research focus in environmental economics. To accurately estimate the nonlinear change law of China’s pollutant discharge with economic growth, this study establishes a transformed nonlinear grey multivariable (TNGM (1, N)) model based on the nonlinear least square (NLS) method. The Gauss–Seidel iterative algorithm was used to solve the parameters of the TNGM (1, N) model based on the NLS basic principle. This algorithm improves the precision of the model by continuous iteration and constantly approximating the optimal regression coefficient of the nonlinear model. In our empirical analysis, the traditional grey multivariate model GM (1, N) and the NLS-based TNGM (1, N) models were respectively adopted to forecast and analyze the relationship among wastewater discharge per capita (WDPC), and per capita emissions of SO2 and dust, alongside GDP per capita in China during the period 1996–2015. Results indicated that the NLS algorithm is able to effectively help the grey multivariable model identify the nonlinear relationship between pollutant discharge and economic growth. The results show that the NLS-based TNGM (1, N) model presents greater precision when forecasting WDPC, SO2 emissions and dust emissions per capita, compared to the traditional GM (1, N) model; WDPC indicates a growing tendency aligned with the growth of GDP, while the per capita emissions of SO2 and dust reduce accordingly. Full article
(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)
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Open AccessArticle Individual and Neighborhood Stressors, Air Pollution and Cardiovascular Disease
Int. J. Environ. Res. Public Health 2018, 15(3), 472; doi:10.3390/ijerph15030472
Received: 22 January 2018 / Revised: 28 February 2018 / Accepted: 1 March 2018 / Published: 8 March 2018
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Abstract
Psychosocial and environmental stress exposures across the life course have been shown to be relevant in the development of cardiovascular disease (CVD). Assessing more than one stressor from different domains (e.g., individual and neighborhood) and across the life course moves us towards a
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Psychosocial and environmental stress exposures across the life course have been shown to be relevant in the development of cardiovascular disease (CVD). Assessing more than one stressor from different domains (e.g., individual and neighborhood) and across the life course moves us towards a more integrated picture of how stress affects health and well-being. Furthermore, these individual and neighborhood psychosocial stressors act on biologic pathways, including immune function and inflammatory response, which are also impacted by ubiquitous environmental exposures such as air pollution. The objective of this study is to evaluate the interaction between psychosocial stressors, at both the individual and neighborhood level, and air pollution on CVD. This study used data from the 2009–2011 Behavioral Risk Factor Surveillance System (BRFSS) from Washington State. Adverse childhood experiences (ACEs) measured at the individual level, and neighborhood deprivation index (NDI) measured at the zip code level, were the psychosocial stressors of interest. Exposures to three air pollutants—particulate matter (both PM2.5 and PM10) and nitrogen dioxide (NO2)—were also calculated at the zip code level. Outcome measures included several self-reported CVD-related health conditions. Both multiplicative and additive interaction quantified using the relative excess risk due to interaction (RERI), were evaluated. This study included 32,151 participants in 502 unique zip codes. Multiplicative and positive additive interactions were observed between ACEs and PM10 for diabetes, in models adjusted for NDI. The prevalence of diabetes was 1.58 (95% CI: 1.40, 1.79) times higher among those with both high ACEs and high PM10 compared to those with low ACEs and low PM10 (p-value = 0.04 for interaction on the multiplicative scale). Interaction was also observed between neighborhood-level stressors (NDI) and air pollution (NO2) for the stroke and diabetes outcomes on both multiplicative and additive scales. Modest interaction was observed between NDI and air pollution, supporting prior literature on the importance of neighborhood-level stressors in cardiovascular health and reinforcing the importance of NDI on air pollution health effects. ACEs may exert health effects through selection into disadvantaged neighborhoods and more work is needed to understand the accumulation of risk in multiple domains across the life course. Full article
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Open AccessArticle Modeling Pediatric Body Mass Index and Neighborhood Environment at Different Spatial Scales
Int. J. Environ. Res. Public Health 2018, 15(3), 473; doi:10.3390/ijerph15030473
Received: 17 December 2017 / Revised: 11 February 2018 / Accepted: 3 March 2018 / Published: 8 March 2018
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Abstract
In public health research, it has been well established that geographic location plays an important role in influencing health outcomes. In recent years, there has been an increased emphasis on the impact of neighborhood or contextual factors as potential risk factors for childhood
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In public health research, it has been well established that geographic location plays an important role in influencing health outcomes. In recent years, there has been an increased emphasis on the impact of neighborhood or contextual factors as potential risk factors for childhood obesity. Some neighborhood factors relevant to childhood obesity include access to food sources, access to recreational facilities, neighborhood safety, and socioeconomic status (SES) variables. It is common for neighborhood or area-level variables to be available at multiple spatial scales (SS) or geographic units, such as the census block group and census tract, and selection of the spatial scale for area-level variables can be considered as a model selection problem. In this paper, we model the variation in body mass index (BMI) in a study of pediatric patients of the Virginia Commonwealth University (VCU) Medical Center, while considering the selection of spatial scale for a set of neighborhood-level variables available at multiple spatial scales using four recently proposed spatial scale selection algorithms: SS forward stepwise regression, SS incremental forward stagewise regression, SS least angle regression (LARS), and SS lasso. For pediatric BMI, we found evidence of significant positive associations with visit age and black race at the individual level, percent Hispanic white at the census block group level, percent Hispanic black at the census tract level, and percent vacant housing at the census tract level. We also found significant negative associations with population density at the census tract level, median household income at the census tract level, percent renter at the census tract level, and exercise equipment expenditures at the census block group level. The SS algorithms selected covariates at different spatial scales, producing better goodness-of-fit in comparison to traditional models, where all area-level covariates were modeled at the same scale. These findings underscore the importance of considering spatial scale when performing model selection. Full article
(This article belongs to the collection Methodological Innovations and Reflections)
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Open AccessArticle An Optimization Study on Listening Experiments to Improve the Comparability of Annoyance Ratings of Noise Samples from Different Experimental Sample Sets
Int. J. Environ. Res. Public Health 2018, 15(3), 474; doi:10.3390/ijerph15030474
Received: 2 January 2018 / Revised: 6 March 2018 / Accepted: 6 March 2018 / Published: 8 March 2018
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Abstract
Annoyance ratings obtained from listening experiments are widely used in studies on health effect of environmental noise. In listening experiments, participants usually give the annoyance rating of each noise sample according to its relative annoyance degree among all samples in the experimental sample
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Annoyance ratings obtained from listening experiments are widely used in studies on health effect of environmental noise. In listening experiments, participants usually give the annoyance rating of each noise sample according to its relative annoyance degree among all samples in the experimental sample set if there are no reference sound samples, which leads to poor comparability between experimental results obtained from different experimental sample sets. To solve this problem, this study proposed to add several pink noise samples with certain loudness levels into experimental sample sets as reference sound samples. On this basis, the standard curve between logarithmic mean annoyance and loudness level of pink noise was used to calibrate the experimental results and the calibration procedures were described in detail. Furthermore, as a case study, six different types of noise sample sets were selected to conduct listening experiments using this method to examine the applicability of it. Results showed that the differences in the annoyance ratings of each identical noise sample from different experimental sample sets were markedly decreased after calibration. The determination coefficient (R2) of linear fitting functions between psychoacoustic annoyance (PA) and mean annoyance (MA) of noise samples from different experimental sample sets increased obviously after calibration. The case study indicated that the method above is applicable to calibrating annoyance ratings obtained from different types of noise sample sets. After calibration, the comparability of annoyance ratings of noise samples from different experimental sample sets can be distinctly improved. Full article
(This article belongs to the Special Issue Noise-Related Annoyance)
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Open AccessFeature PaperArticle Problematic Use of the Internet and Smartphones in University Students: 2006–2017
Int. J. Environ. Res. Public Health 2018, 15(3), 475; doi:10.3390/ijerph15030475
Received: 24 January 2018 / Revised: 5 March 2018 / Accepted: 7 March 2018 / Published: 8 March 2018
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Abstract
It has been more than a decade since a concern about the addictive use of the Internet and mobile phones was first expressed, and its possible inclusion into the lists of mental disorders has recently become a popular topic of scientific discussion. Thus,
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It has been more than a decade since a concern about the addictive use of the Internet and mobile phones was first expressed, and its possible inclusion into the lists of mental disorders has recently become a popular topic of scientific discussion. Thus, it seems to be a fitting moment to investigate the prevalence of this issue over time. The aim of the present study was to analyze the prevalence of the perception of problematic Internet and smartphone use in young people over the period 2006–2017. To this end, a questionnaire on Internet use habits and two questionnaires on the negative consequences of Internet and smartphone use were administered to a sample of 792 university students. The scores were then compared with the results of former studies that had used these questionnaires. The perception of problematic Internet and mobile phone use has increased over the last decade, social networks are considered responsible for this increase, and females are perceived to be more affected than males. The current study shows how strong smartphone and Internet addiction and social media overlap. Participants from 2017 report higher negative consequences of both Internet and mobile phone use than those from 2006, but long-term observations show a decrease in problematic use after a sharp increase in 2013. We conclude that the diagnosis of technological addictions is influenced by both time and social and culture changes. Full article
(This article belongs to the Special Issue Internet and Mobile Phone Addiction: Health and Educational Effects)
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Open AccessArticle Pilot-Scale Hydrolysis-Aerobic Treatment for Actual Municipal Wastewater: Performance and Microbial Community Analysis
Int. J. Environ. Res. Public Health 2018, 15(3), 477; doi:10.3390/ijerph15030477
Received: 30 January 2018 / Revised: 26 February 2018 / Accepted: 27 February 2018 / Published: 9 March 2018
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Abstract
Low-energy cost wastewater treatment is required to change its current energy-intensive status. Although promising, the direct anaerobic digestion of municipal wastewater treatment faces challenges such as low organic content and low temperature, which require further development. The hydrolysis-aerobic system investigated in this study
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Low-energy cost wastewater treatment is required to change its current energy-intensive status. Although promising, the direct anaerobic digestion of municipal wastewater treatment faces challenges such as low organic content and low temperature, which require further development. The hydrolysis-aerobic system investigated in this study utilized the two well-proven processes of hydrolysis and aerobic oxidation. These have the advantages of efficient COD removal and biodegradability improvement with limited energy cost due to their avoidance of aeration. A pilot-scale hydrolysis-aerobic system was built for performance evaluation with actual municipal wastewater as feed. Results indicated that as high as 39–47% COD removal was achieved with a maximum COD load of 1.10 kg/m3·d. The dominant bacteria phyla included Proteobacteria (36.0%), Planctomycetes (15.4%), Chloroflexi (9.7%), Bacteroidetes (7.7%), Firmicutes (4.4%), Acidobacteria (2.5%), Actinobacteria (1.8%) and Synergistetes (1.3%), while the dominant genera included Thauera (3.42%) and Dechloromonas (3.04%). The absence of methanogens indicates that the microbial community was perfectly retained in the hydrolysis stage instead of in the methane-producing stage. Full article
(This article belongs to the Special Issue Municipal Wastewater Treatment)
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Open AccessArticle Multiresistant Bacteria Isolated from Activated Sludge in Austria
Int. J. Environ. Res. Public Health 2018, 15(3), 479; doi:10.3390/ijerph15030479
Received: 15 December 2017 / Revised: 28 February 2018 / Accepted: 5 March 2018 / Published: 9 March 2018
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Abstract
Wastewater contains different kinds of contaminants, including antibiotics and bacterial isolates with human-generated antibiotic resistances. In industrialized countries most of the wastewater is processed in wastewater treatment plants which do not only include commercial wastewater, but also wastewater from hospitals. Three multiresistant pathogens—extended
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Wastewater contains different kinds of contaminants, including antibiotics and bacterial isolates with human-generated antibiotic resistances. In industrialized countries most of the wastewater is processed in wastewater treatment plants which do not only include commercial wastewater, but also wastewater from hospitals. Three multiresistant pathogens—extended spectrum β-lactamase (ESBL)-harbouring Enterobacteriaceae (Gram negative bacilli), methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococci (VRE)—were chosen for screening in a state of the art wastewater treatment plant in Austria. Over an investigation period of six months all three multiresistant pathogens could be isolated from activated sludge. ESBL was the most common resistance mechanism, which was found in different species of Enterobacteriaceae, and in one Aeromonas spp. Sequencing of ESBL genes revealed the dominance of genes encoding members of CTX-M β-lactamases family and a gene encoding for PER-1 ESBL was detected for the first time in Austria. MRSA and VRE could be isolated sporadically, including one EMRSA-15 isolate. Whereas ESBL is well documented as a surface water contaminant, reports of MRSA and VRE are rare. The results of this study show that these three multiresistant phenotypes were present in activated sludge, as well as species and genes which were not reported before in the region. The ESBL-harbouring Gram negative bacilli were most common. Full article
(This article belongs to the Special Issue Antimicrobials and Antimicrobial Resistance in the Environment)
Open AccessArticle Internet Use and Psychological Well-Being at Advanced Age: Evidence from the English Longitudinal Study of Aging
Int. J. Environ. Res. Public Health 2018, 15(3), 480; doi:10.3390/ijerph15030480
Received: 2 February 2018 / Revised: 4 March 2018 / Accepted: 7 March 2018 / Published: 9 March 2018
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Abstract
This work explores the connection between psychological well-being and Internet use in older adults. The study is based on a sample of 2314 participants in the English Longitudinal Study of Aging. The subjects, aged 50 years and older, were interviewed every two years
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This work explores the connection between psychological well-being and Internet use in older adults. The study is based on a sample of 2314 participants in the English Longitudinal Study of Aging. The subjects, aged 50 years and older, were interviewed every two years over the 2006–2007 to 2014–2015 period. The connection between the use of Internet/Email and the main dimensions of psychological well-being (evaluative, hedonic and eudaimonic) was analyzed by means of three generalized estimating equation models that were fitted on 2-year lagged repeated measurements. The outcome variables, the scores on three well-being scales, were explained in terms of Internet/Email use, controlling for covariates that included health and socioeconomic indicators. The results support the existence of a direct relationship between Internet/Email use and psychological well-being. The connection between the main predictor and the score of the participants on the scale used to measure the eudaimonic aspect was positive and statistically significant at conventional levels (p-value: 0.015). However, the relevance of digital literacy on the evaluative and the hedonic components could not be confirmed (p-values for evaluative and hedonic dimensions were 0.078 and 0.192, respectively). Full article
(This article belongs to the Special Issue Interventions for Healthy Aging)
Open AccessArticle Reanalysis of Epidemiological Investigation of Cancer Risk among People Residing near Nuclear Power Plants in South Korea
Int. J. Environ. Res. Public Health 2018, 15(3), 481; doi:10.3390/ijerph15030481
Received: 26 January 2018 / Revised: 1 March 2018 / Accepted: 2 March 2018 / Published: 9 March 2018
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Abstract
Background: A 20-year follow-up study on cancer incidence among people living near nuclear power plants in South Korea ended in 2011 with a finding of significantly, but inconsistently, elevated thyroid cancer risk for females. Reanalysis of the original study was carried out
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Background: A 20-year follow-up study on cancer incidence among people living near nuclear power plants in South Korea ended in 2011 with a finding of significantly, but inconsistently, elevated thyroid cancer risk for females. Reanalysis of the original study was carried out to examine the dose–response relationship further, and to investigate any evidence of detection bias. Methods: In addition to replicating the original Cox proportional hazards models, nested case-control analysis was carried out for all subjects and for four different birth cohorts to examine the effects of excluding participants with pre-existing cancer history at enrollment. The potential for detection bias was investigated using the records of medical utilization and voluntary health checks of comparison groups. Results: The overall risk profile of the total sample was similar to that of the original study. However, in the stratified analysis of four birth cohorts, the cancer risk among people living near nuclear power plants became higher in younger birth cohorts. This was especially true for thyroid cancers of females (hazard ratio (HR) 3.38) and males (HR 1.74), female breast cancers (HR 2.24), and radiation-related cancers (HR 1.59 for males, HR 1.77 for females), but not for radiation-insensitive cancers (HR 0.59 for males, HR 0.98 for females). Based on medical records and health check reports, we found no differences between comparison groups that could have led to detection bias. Conclusions: The overall results suggest elevated risk of radiation-related cancers among residents living near nuclear power plants, controlling for the selective survival effect. This is further supported by the lack of evidence of detection bias and by records of environmental exposure from radiation waste discharge. Full article
(This article belongs to the Section Environmental Health)
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Open AccessArticle A Computational Fluid Dynamic (CFD) Simulation of PM10 Dispersion Caused by Rail Transit Construction Activity: A Real Urban Street Canyon Model
Int. J. Environ. Res. Public Health 2018, 15(3), 482; doi:10.3390/ijerph15030482
Received: 24 January 2018 / Revised: 25 February 2018 / Accepted: 8 March 2018 / Published: 9 March 2018
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Abstract
Particle emissions derived from construction activities have a significant impact on the local air quality, while the canyon effect with reduced natural ventilation contributes to the highest particulate pollution in urban environments. This study attempted to examine the effect of PM10 emissions
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Particle emissions derived from construction activities have a significant impact on the local air quality, while the canyon effect with reduced natural ventilation contributes to the highest particulate pollution in urban environments. This study attempted to examine the effect of PM10 emissions derived from the construction of a rail transit system in an urban street canyon. Using a 3D computational fluid dynamic (CFD) model based on a real street canyon with different height ratios, this study formulates the impact of height ratio and wind directions on the dispersion and concentration of PM10. The results indicate that parallel flow would cause the concentration of PM10 at the end of the street canyons in all height ratios, and the trends in horizontal, vertical and lateral planes in all street canyons are similar. While in the condition of perpendicular flow, double-eddy circulations occur and lead to the concentration of PM10 in the middle part of the street canyon and leeward of backwind buildings in all height ratios. Furthermore, perpendicular flow will cause the concentration of PM10 to increase if the upwind buildings are higher than the backwind ones. This study also shows that the dispersion of PM10 is strongly associated with wind direction in and the height ratios of the street canyons. Certain measures could, therefore, be taken to prevent the impact on people in terms of the PM10 concentration and the heights of street canyons identified in this research. Potential mitigation strategies are suggested, include measurements below 4 m according to governmental regulations, dust shields, and atomized water. Full article
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Open AccessArticle Use of Iodine-131 to Tellurium-132 Ratios for Assessing the Relationships between Human Inhaled Radioactivity and Environmental Monitoring after the Accident in Fukushima
Int. J. Environ. Res. Public Health 2018, 15(3), 483; doi:10.3390/ijerph15030483
Received: 11 January 2018 / Revised: 7 March 2018 / Accepted: 8 March 2018 / Published: 9 March 2018
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Abstract
Significant differences in findings were seen between the intake amounts of iodine-131 that were derived from direct measurements and the estimated intake from environmental monitoring data at the Fukushima accident. To clarify these discrepancies, we have investigated the iodine-131 and tellurium-132 body burdens
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Significant differences in findings were seen between the intake amounts of iodine-131 that were derived from direct measurements and the estimated intake from environmental monitoring data at the Fukushima accident. To clarify these discrepancies, we have investigated the iodine-131 and tellurium-132 body burdens of five human subjects, who after being exposed to a radioactive plume, underwent 21.5 h whole body counter measurements at Fukui Prefectural Hospital, so clear intake scenario and thyroid counter measurement data were available. To determine the iodine-131 and tellurium-132 body burdens, we introduced a new method of whole body counter calibration composed of a self-consistent approach with the time-dependent correction efficiency factors concept. The ratios of iodine-131 to tellurium-132, ranging from 0.96 ± 0.05 to 2.29 ± 0.38, were consistent with results of the environmental measurements. The 24 h iodine uptake values ranging from 12.1–16.0% were within euthyroid range in Japanese people. These results suggest, even if the relatively low thyroid iodine uptake in the Japanese population was taken into consideration, that there is no doubt about the consistency between direct measurements and environmental monitoring data. Adequate intake scenario is suggested to be principally important to estimate the inhaled radioactivity in areas in or around nuclear accidents. Full article
(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)
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Open AccessArticle Relationships among Safety Climate, Safety Behavior, and Safety Outcomes for Ethnic Minority Construction Workers
Int. J. Environ. Res. Public Health 2018, 15(3), 484; doi:10.3390/ijerph15030484
Received: 31 January 2018 / Revised: 24 February 2018 / Accepted: 7 March 2018 / Published: 9 March 2018
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Abstract
In many countries, it is common practice to attract and employ ethnic minority (EM) or migrant workers in the construction industry. This primarily occurs in order to alleviate the labor shortage caused by an aging workforce with a lack of new entrants. Statistics
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In many countries, it is common practice to attract and employ ethnic minority (EM) or migrant workers in the construction industry. This primarily occurs in order to alleviate the labor shortage caused by an aging workforce with a lack of new entrants. Statistics show that EM construction workers are more likely to have occupational fatal and nonfatal injuries than their local counterparts; however, the mechanism underlying accidents and injuries in this vulnerable population has been rarely examined. This study aims to investigate relationships among safety climate, safety behavior, and safety outcomes for EM construction workers. To this end, a theoretical research model was developed based on a comprehensive review of the current literature. In total, 289 valid questionnaires were collected face-to-face from 223 Nepalese construction workers and 56 Pakistani construction workers working on 15 construction sites in Hong Kong. Structural equation modelling was employed to validate the constructs and test the hypothesized model. Results show that there were significant positive relationships between safety climate and safety behaviors, and significant negative relationships between safety behaviors and safety outcomes for EM construction workers. This research contributes to the literature regarding EM workers by providing empirical evidence of the mechanisms by which safety climate affects safety behaviors and outcomes. It also provides insights in order to help the key stakeholders formulate safety strategies for EM workers in many areas where numerous EM workers are employed, such as in the U.S., the UK, Australia, Singapore, Malaysia, and the Middle East. Full article
(This article belongs to the Special Issue Improving Safety, Health, and Wellbeing in Construction)
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Open AccessFeature PaperArticle Accidents of Electrical and Mechanical Works for Public Sector Projects in Hong Kong
Int. J. Environ. Res. Public Health 2018, 15(3), 485; doi:10.3390/ijerph15030485
Received: 17 January 2018 / Revised: 26 February 2018 / Accepted: 6 March 2018 / Published: 10 March 2018
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Abstract
A study on electrical and mechanical (E&M) works-related accidents for public sector projects provided the opportunity to gain a better understanding of the causes of accidents by analyzing the circumstances of all E&M works accidents. The research aims to examine accidents of E&M
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A study on electrical and mechanical (E&M) works-related accidents for public sector projects provided the opportunity to gain a better understanding of the causes of accidents by analyzing the circumstances of all E&M works accidents. The research aims to examine accidents of E&M works which happened in public sector projects. A total of 421 E&M works-related accidents in the “Public Works Programme Construction Site Safety and Environmental Statistics” (PCSES) system were extracted for analysis. Two-step cluster analysis was conducted to classify the E&M accidents into different groups. The results identified three E&M accidents groups: (1) electricians with over 15 years of experience were prone to ‘fall of person from height’; (2) electricians with zero to five years of experience were prone to ‘slip, trip or fall on same level’; (3) air-conditioning workers with zero to five years of experience were prone to multiple types of accidents. Practical measures were recommended for each specific cluster group to avoid recurrence of similar accidents. The accident analysis would be vital for industry practitioners to enhance the safety performance of public sector projects. This study contributes to filling the knowledge gap of how and why E&M accidents occur and promulgating preventive measures for E&M accidents which have been under researched. Full article
(This article belongs to the Special Issue Improving Safety, Health, and Wellbeing in Construction)
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Open AccessArticle Spatiotemporal Variation in Environmental Vibrio cholerae in an Estuary in Southern Coastal Ecuador
Int. J. Environ. Res. Public Health 2018, 15(3), 486; doi:10.3390/ijerph15030486
Received: 29 January 2018 / Revised: 4 March 2018 / Accepted: 5 March 2018 / Published: 10 March 2018
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Abstract
Cholera emergence is strongly linked to local environmental and ecological context. The 1991–2004 pandemic emerged in Perú and spread north into Ecuador’s El Oro province, making this a key site for potential re-emergence. Machala, El Oro, is a port city of 250,000 inhabitants,
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Cholera emergence is strongly linked to local environmental and ecological context. The 1991–2004 pandemic emerged in Perú and spread north into Ecuador’s El Oro province, making this a key site for potential re-emergence. Machala, El Oro, is a port city of 250,000 inhabitants, near the Peruvian border. Many livelihoods depend on the estuarine system, from fishing for subsistence and trade, to domestic water use. In 2014, we conducted biweekly sampling for 10 months in five estuarine locations, across a gradient of human use, and ranging from inland to ocean. We measured water-specific environmental variables implicated in cholera growth and persistence: pH, temperature, salinity, and algal concentration, and evaluated samples in five months for pathogenic and non-pathogenic Vibrio cholerae, by polymerase chain reaction (PCR). We found environmental persistence of pandemic strains O1 and O139, but no evidence for toxigenic strains. Vibrio cholerae presence was coupled to algal and salinity concentration, and sites exhibited considerable seasonal and spatial heterogeneity. This study indicates that environmental conditions in Machala are optimal for cholera re-emergence, with risk peaking during September, and higher risk near urban periphery low-income communities. This highlights a need for surveillance of this coupled cholera–estuarine system to anticipate potential future cholera outbreaks. Full article
(This article belongs to the Section Global Health)
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Open AccessArticle A National County-Level Assessment of U.S. Nursing Facility Characteristics Associated with Long-Term Exposure to Traffic Pollution in Older Adults
Int. J. Environ. Res. Public Health 2018, 15(3), 487; doi:10.3390/ijerph15030487
Received: 11 December 2017 / Revised: 21 February 2018 / Accepted: 7 March 2018 / Published: 10 March 2018
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Abstract
Long-term exposure to ambient air pollution increases disease risk in older adults. Nursing facilities located near major roadways potentially expose older adults to traffic pollution. No studies, however, have described the association between nursing facilities and traffic pollution. We obtained data on facility-
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Long-term exposure to ambient air pollution increases disease risk in older adults. Nursing facilities located near major roadways potentially expose older adults to traffic pollution. No studies, however, have described the association between nursing facilities and traffic pollution. We obtained data on facility- and census-tract-level characteristics of 15,706 U.S. facilities from the Medicare Nursing Home Compare datasets. We calculated distance to major roadways and traffic density for each facility. In the contiguous U.S. (as of 2014), 345,792 older adults, about 27% of residents in non-hospital facilities, lived within 150 m major roadways (A1 or A2) in 3876 (28% of sampled) facilities. Nationally, for-profit facilities, high-occupancy facilities, and facilities in census tracts with higher percentages of minorities were more likely to have higher exposure to traffic. Counties in Virginia, New York City, and Rhode Island have the highest percent of residents and facilities near major roads. Nationally, over one-quarter of sampled facilities are located near major roadways. Attributes potentially associated with higher exposure to traffic included “for-profit” and “higher minority census tract”. Proximity to major roadways may be an important factor to consider in siting nursing facilities. Our results inform potential intervention strategy at both county and facility level. Full article
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Open AccessArticle Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study
Int. J. Environ. Res. Public Health 2018, 15(3), 488; doi:10.3390/ijerph15030488
Received: 19 January 2018 / Revised: 26 February 2018 / Accepted: 5 March 2018 / Published: 10 March 2018
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Abstract
Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother–offspring cohort study in Singapore. The diets of infants were assessed
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Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother–offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760), 9 (n = 893) and 12 (n = 907) months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD)) of these infants were 640 (158) at 6 months, 675 (173) at 9 months, and 761 (208) at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies. Full article
(This article belongs to the Special Issue Nutrition in the First 1000 Days)
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Open AccessArticle Social Frailty Leads to the Development of Physical Frailty among Physically Non-Frail Adults: A Four-Year Follow-Up Longitudinal Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(3), 490; doi:10.3390/ijerph15030490
Received: 8 February 2018 / Revised: 2 March 2018 / Accepted: 10 March 2018 / Published: 10 March 2018
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Abstract
Social frailty domains may play an important role in preventing physical decline and disability. The aim of this study is to examine the impact of social frailty as a risk factor for the future development of physical frailty among community-dwelling older adults who
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Social frailty domains may play an important role in preventing physical decline and disability. The aim of this study is to examine the impact of social frailty as a risk factor for the future development of physical frailty among community-dwelling older adults who are not yet physically frail. A total of 1226 physically non-frail older adults were analyzed to provide a baseline. Participants completed a longitudinal assessment of their physical frailty 48 months later. Their baseline social frailty was determined based on their responses to five questions, which identified participants who went out less frequently, rarely visited friends, felt less like helping friends or family, lived alone and did not talk to another person every day. Participants with none of these characteristics were considered not to be socially frail; those with one characteristic were considered socially pre-frail; and those with two or more characteristics were considered socially frail. At the four-year follow-up assessment, 24 participants (2.0%) had developed physical frailty and 440 (35.9%) had developed physical pre-frailty. The rates of developing physical frailty and pre-frailty were 1.6% and 34.2%, respectively, in the socially non-frail group; 2.4% and 38.8%, respectively, in the socially pre-frail group; and 6.8% and 54.5%, respectively, in the socially frail group. Participants classified as socially frail at the baseline had an increased risk of developing physical frailty, compared with participants who were not socially frail (OR = 3.93, 95% CI = 1.02–15.15). Participants who were socially frail at the baseline also had an increased risk of developing physical pre-frailty (OR = 2.50, 95% CI = 1.30–4.80). Among independent community-dwelling older adults who are not physically frail, those who are socially frail may be at greater risk of developing physical frailty in the near future. Social frailty may precede (and lead to the development of) physical frailty. Full article
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Open AccessArticle Copycats in Pilot Aircraft-Assisted Suicides after the Germanwings Incident
Int. J. Environ. Res. Public Health 2018, 15(3), 491; doi:10.3390/ijerph15030491
Received: 18 January 2018 / Revised: 7 March 2018 / Accepted: 8 March 2018 / Published: 11 March 2018
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Abstract
Aircraft-assisted pilot suicide is a rare but serious phenomenon. The aim of this study was to evaluate changes in pilot aircraft-assisted suicide risks, i.e., a copycat effect, in the U.S. and Germany after the Germanwings 2015 incident in the French Alps. Aircraft-assisted pilot
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Aircraft-assisted pilot suicide is a rare but serious phenomenon. The aim of this study was to evaluate changes in pilot aircraft-assisted suicide risks, i.e., a copycat effect, in the U.S. and Germany after the Germanwings 2015 incident in the French Alps. Aircraft-assisted pilot suicides were searched in the U.S. National Transportation Safety Board (NTSB) accident investigation database and in the German Bundestelle für Flugunfalluntersuchung (BFU) Reports of Investigation database five years before and two years after the deliberate crash of the Germanwings flight into the French Alps in 2015. The relative risk (RR) of the aircraft-assisted pilot suicides was calculated. Two years after the incident, three out of 454 (0.66%) fatal incidents were aircraft-assisted suicides compared with six out of 1292 (0.46%) in the prior five years in the NTSB database. There were no aircraft-assisted pilot suicides in the German database during the two years after or five years prior to the Germanwings crash. The relative aircraft-assisted pilot suicide risk for the U.S. was 1.4 (95% CI 0.3–4.2) which was not statistically significant. Six of the pilots who died by suicide had told someone of their suicidal intentions. We consider changes in the rate to be within a normal variation. Responsible media coverage of aircraft incidents is important due to the large amount of publicity that these events attract. Full article
(This article belongs to the Special Issue Advances in Suicide Research)
Open AccessArticle The Burden of COPD Morbidity Attributable to the Interaction between Ambient Air Pollution and Temperature in Chengdu, China
Int. J. Environ. Res. Public Health 2018, 15(3), 492; doi:10.3390/ijerph15030492
Received: 24 January 2018 / Revised: 2 March 2018 / Accepted: 8 March 2018 / Published: 11 March 2018
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Abstract
Evidence on the burden of chronic obstructive pulmonary disease (COPD) morbidity attributable to the interaction between ambient air pollution and temperature has been limited. This study aimed to examine the modification effect of temperature on the association of ambient air pollutants (including particulate
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Evidence on the burden of chronic obstructive pulmonary disease (COPD) morbidity attributable to the interaction between ambient air pollution and temperature has been limited. This study aimed to examine the modification effect of temperature on the association of ambient air pollutants (including particulate matter (PM) with aerodynamic diameter <10 μm (PM10) and <2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3)) with risk of hospital admissions (HAs) for COPD, as well as the associated morbidity burden in urban areas of Chengdu, China, from 2015 to 2016. Based on the generalized additive model (GAM) with quasi-Poisson link, bivariate response surface model and stratification parametric model were developed to investigate the potential interactions between ambient air pollution and temperature on COPD HAs. We found consistent interactions between ambient air pollutants (PM2.5, PM10 and SO2) and low temperature on COPD HAs, demonstrated by the stronger associations between ambient air pollutants and COPD HAs at low temperatures than at moderate temperatures. Subgroup analyses showed that the elderly (≥80 years) and males were more vulnerable to this interaction. The joint effect of PM and low temperature had the greatest impact on COPD morbidity burden. Using WHO air quality guidelines as reference concentration, about 17.30% (95% CI: 12.39%, 22.19%) and 14.72% (95% CI: 10.38%, 19.06%) of COPD HAs were attributable to PM2.5 and PM10 exposures on low temperature days, respectively. Our findings suggested that low temperature significantly enhanced the effects of PM and SO2 on COPD HAs in urban Chengdu, resulting in increased morbidity burden. This evidence has important implications for developing interventions to reduce the risk effect of COPD morbidity. Full article
(This article belongs to the Special Issue Climate Change, Extreme Temperatures, Air Pollution, and Health)
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Open AccessArticle Policy Guidelines for Effective Inclusion and Reintegration of People with Chronic Diseases in the Workplace: National and European Perspectives
Int. J. Environ. Res. Public Health 2018, 15(3), 493; doi:10.3390/ijerph15030493
Received: 31 January 2018 / Revised: 25 February 2018 / Accepted: 7 March 2018 / Published: 11 March 2018
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Abstract
The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim
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The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets. Full article
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Open AccessArticle Potential of Cassia alata L. Coupled with Biochar for Heavy Metal Stabilization in Multi-Metal Mine Tailings
Int. J. Environ. Res. Public Health 2018, 15(3), 494; doi:10.3390/ijerph15030494
Received: 20 January 2018 / Revised: 13 February 2018 / Accepted: 23 February 2018 / Published: 12 March 2018
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Abstract
To explore the effect of different biochars on Cassia alata L. growth and heavy metal immobilization in multi-metal mine tailings, a 100-day pot experiment was conducted. Three biochars derived from Hibiscus cannabinus core (HB), sewage sludge (SB) and chicken manure (MB), were added
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To explore the effect of different biochars on Cassia alata L. growth and heavy metal immobilization in multi-metal mine tailings, a 100-day pot experiment was conducted. Three biochars derived from Hibiscus cannabinus core (HB), sewage sludge (SB) and chicken manure (MB), were added to mine tailings at rates of 0.4%, 1% and 3% (w/w). The results showed that the root biomass, shoot biomass, plant height and root length were 1.2–2.8, 1.7–3.2, 1–1.5 and 1.6–3.3 times of those in the control group, respectively. Pb, Zn, Cu, Cd and As contents in the shoot decreased by 63.9–89.5%, 46.9–66.0%, 32.7–62.4%, 40.4–76.4% and 54.9–77.5%, respectively. The biochar significantly increased the pH and decreased the mild acid-soluble Pb and Cu concentrations in the mine tailings. Specifically, SB immobilized Pb and Cu better than MB and HB did, although it did not immobilize As, Zn or Cd. Meanwhile, more attention should be paid to the potential As release as the biochar application rate increases. In conclusion, Cassia alata L. coupled with 3% of SB could be an effective measure for restoring multi-metal mine tailings. This study herein provided a promising ecological restoration technique for future practice of heavy metal stabilization in mine tailings. Full article
(This article belongs to the Special Issue Soil Pollution and Remediation)
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Open AccessArticle Geochemical Assessment and Spatial Analysis of Heavy Metals in the Surface Sediments in the Eastern Beibu Gulf: A Reflection on the Industrial Development of the South China Coast
Int. J. Environ. Res. Public Health 2018, 15(3), 496; doi:10.3390/ijerph15030496
Received: 10 February 2018 / Revised: 10 March 2018 / Accepted: 10 March 2018 / Published: 12 March 2018
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Abstract
The Beibu Gulf (also named the Gulf of Tonkin), located in the northwest of the South China Sea, is representative of a bay suffering from turbulence and contamination associated with rapid industrialization and urbanization. In this study, we aim to provide the novel
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The Beibu Gulf (also named the Gulf of Tonkin), located in the northwest of the South China Sea, is representative of a bay suffering from turbulence and contamination associated with rapid industrialization and urbanization. In this study, we aim to provide the novel baseline levels of heavy metals for the research area. Concentrations of five heavy metals (i.e., Cu, Pb, Zn, Cd and Cr) were determined in surface sediments from 35 sites in the eastern Beibu Gulf. The heavy metal content varied from 6.72 to 25.95 mg/kg for Cu, 16.99 to 57.98 mg/kg for Pb, 73.15 to 112.25 mg/kg for Zn, 0.03 to 0.12 mg/kg for Cd, and 20.69 to 56.47 mg/kg for Cr, respectively. With respect to the Chinese sediment quality criteria, sediments in the eastern Beibu Gulf have not been significantly affected by coastal metal pollutions. The results deduced from the geoaccumulation index (Igeo) showed that the study area has been slightly polluted by Pb, which might be caused by non-point sources. Relatively high concentrations of Cu, Pb and Cd were found around the coastal areas of Guangxi province, the Leizhou Peninsula and the northwest coast of Hainan Island, whereas the highest concentrations of Zn and Cr were found on the northwest coast of Hainan Island. Spatial distribution patterns of the heavy metals showed that bioavailable fractions of Pb were higher than in the residual fractions, while Cu and Cd concentrations in exchangeable and carbonate fractions were relatively higher than those in the bioavailable fractions. Hierarchical clustering analysis suggested that the sampling stations could be separated into three groups with different geographical distributions. Accompanying their similar spatial distribution in the study area, significant correlation coefficients among Cu, Cd and Pb were also found, indicating that these three metals might have had similar sources. Overall, the results indicated that the distribution of these heavy metals in the surface sediments collected from the Beibu Gulf was complex. Full article
(This article belongs to the collection Environmental Risk Assessment)
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Open AccessArticle Work Environment, Stress, and Driving Anger: A Structural Equation Model for Predicting Traffic Sanctions of Public Transport Drivers
Int. J. Environ. Res. Public Health 2018, 15(3), 497; doi:10.3390/ijerph15030497
Received: 5 February 2018 / Revised: 5 March 2018 / Accepted: 9 March 2018 / Published: 12 March 2018
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Abstract
Public transport is an effective and sustainable alternative to private vehicle usage, also helping to reduce the environmental impact of driving. However, the work environment of public transport operators is full of adverse conditions, which, together with their high mileage, may increase the
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Public transport is an effective and sustainable alternative to private vehicle usage, also helping to reduce the environmental impact of driving. However, the work environment of public transport operators is full of adverse conditions, which, together with their high mileage, may increase the occurrence of negative safety outcomes such as traffic accidents, often preceded by risky road behaviors enhanced by stress, anger, and difficult operating conditions. The aims of this study were, first, to determine the association between work-related psychosocial factors and individual characteristics of public transport drivers and the rate of traffic sanctions they are subject to; and second, to assess the mediation of driving anger in this relationship. A sample of professional drivers (57.4% city bus, 17.6% taxi, and 25% inter-urban bus male operators) was used for this cross-sectional study, responding to a five-section survey including demographic data and driving-related factors, psychosocial work factors including job stress, driving stress, risk predisposition, and driving anger. The results of this study showed significant associations between work-related factors: measures of stress and self-reported rates of traffic fines. Second, it was found that driving anger mediates the associations between driving stress, risk predisposition, and traffic sanctions; and partially mediates the association between driving experience, hourly intensity, and job stress. This study supports the idea that traffic penalties reported by public transport rates are preceded by work-related, personality, and other individual factors that, when combined with driving anger, enhance the occurrence of road misbehavior that may affect overall road safety. Full article
(This article belongs to the Section Occupational Safety and Health)
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Open AccessArticle Respiratory Health Symptoms among Schoolchildren in Relation to Possible Food-Related Risk and Protective Factors
Int. J. Environ. Res. Public Health 2018, 15(3), 502; doi:10.3390/ijerph15030502
Received: 2 February 2018 / Revised: 5 March 2018 / Accepted: 10 March 2018 / Published: 13 March 2018
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Abstract
Respiratory health outcomes are among the top five causes of child morbidity and mortality around the world. We aimed to investigate possible food-related risk and protective factors for respiratory health outcomes in children. Structured questionnaires completed by primary caregivers of 10-year old children
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Respiratory health outcomes are among the top five causes of child morbidity and mortality around the world. We aimed to investigate possible food-related risk and protective factors for respiratory health outcomes in children. Structured questionnaires completed by primary caregivers of 10-year old children were used to collect information on demographics, socio-economic status, house characteristics and child respiratory health status. Upper (URIs) and Lower (LRIs) respiratory illnesses comprised hay fever, and wheezing, asthma and bronchitis, respectively. Eight hundred questionnaires were distributed, 648 retrieved and 420 completed in full (52.5% response rate). The hay fever 6-month prevalence was 22.4% and wheezing had the highest 6-month prevalence among the LRIs (13.8%). The majority of children ate vegetables (75.5%), fruit (69.3%) and chicken or fish (81.7%) regularly. Nearly half of the children (45.5%) regularly ate processed food. Eating processed food regularly was statistical significantly associated with wheeze (Adjusted Odds Ratio (OR) = 2.65; 95% CI: 1.38–5.08), hay fever (OR = 1.62; 95% CI: 1.09–2.64) and bronchitis (OR = 1.27; 95% CI: 1.06–2.56). The study found an association between regular consumption of processed foods and wheeze, hay fever and bronchitis among 10 year old children. The regular consumption of processed food plays a role in adverse respiratory health effects among children and healthy eating is emphasized. Full article
(This article belongs to the Section Environmental Health)
Open AccessArticle Prioritizing Type of Industry through Health Risk Assessment of Occupational Exposure to Dimethylformamide in the Workplace
Int. J. Environ. Res. Public Health 2018, 15(3), 503; doi:10.3390/ijerph15030503
Received: 8 December 2017 / Revised: 20 February 2018 / Accepted: 7 March 2018 / Published: 13 March 2018
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Abstract
The purpose of this study was to classify hazards at an industrial level and evaluate the exposure risks of workers exposed to dimethylformamide (DMF) used as a solvent in the workplace and to determine industries that need priority measures in managing DMF exposure.
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The purpose of this study was to classify hazards at an industrial level and evaluate the exposure risks of workers exposed to dimethylformamide (DMF) used as a solvent in the workplace and to determine industries that need priority measures in managing DMF exposure. We calculated hazard quotients at an industrial level. The exposure data of DMF in the workplace were obtained from the work environment monitoring program provided by the Korea Occupational Safety and Health Agency. The evaluation was conducted on textile manufacturing, leather manufacturing, chemical manufacturing, pharmaceutical manufacturing, and rubber manufacturing industries, which have many unit work sites handling DMF. The highest central tendency exposure and reasonable maximum exposure were 2.13 and 18.66 mg/m3 for the rubber product manufacturing industry, respectively. A total of 63.8% of workplaces in the textile manufacturing sector had a hazard quotient higher than 1. The highest risk for exposure to DMF is in the rubber and plastic manufacturing industry, and the lowest risk was in the medical materials and pharmaceutical manufacturing sector. Based on this study, effective management of DMF exposure could be achieved by establishing priority management measures for the textile and rubber and plastic product industries. Full article
Open AccessArticle Maternal Residential Proximity to Major Roadways and Pediatric Embryonal Tumors in Offspring
Int. J. Environ. Res. Public Health 2018, 15(3), 505; doi:10.3390/ijerph15030505
Received: 31 January 2018 / Revised: 3 March 2018 / Accepted: 9 March 2018 / Published: 13 March 2018
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Abstract
The environmental determinants of pediatric embryonal tumors remain unclear. Because of the growing concern over the impact of exposures to traffic-related air pollution on pediatric cancer, we conducted a population-based study evaluating the impact of maternal residential proximity to major roadways on the
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The environmental determinants of pediatric embryonal tumors remain unclear. Because of the growing concern over the impact of exposures to traffic-related air pollution on pediatric cancer, we conducted a population-based study evaluating the impact of maternal residential proximity to major roadways on the risk of pediatric embryonal tumors in offspring. We identified children diagnosed with neuroblastoma, Wilms tumor, retinoblastoma, or hepatoblastoma at <5 years of age from the Texas Cancer Registry and selected unaffected controls from birth certificates. Two residential proximity measures were used: (1) distance to the nearest major roadway, and (2) within 500 m of a major roadway. Logistic regression was used to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) for each proximity measure on pediatric embryonal tumors. The odds of an embryonal tumor were increased in children born to mothers living within 500 m of a major roadway (aOR = 1.24, 95% CI: 1.00, 1.54). This was consistent for most tumor subtypes, with the strongest associations observed for unilateral retinoblastoma (aOR = 2.57, 95% CI: 1.28, 5.15, for every kilometer closer the mother lived to the nearest major roadway). These findings contribute to the growing evidence that traffic-related air pollution may increase risk for certain pediatric tumors. Full article
(This article belongs to the Section Environmental Science and Engineering)
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Open AccessArticle Acute Stress and Anxiety in Medical Residents on the Emergency Department Duty
Int. J. Environ. Res. Public Health 2018, 15(3), 506; doi:10.3390/ijerph15030506
Received: 15 February 2018 / Revised: 6 March 2018 / Accepted: 6 March 2018 / Published: 13 March 2018
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Abstract
The objectives of this longitudinal study were to compare salivary cortisol release patterns in medical residents and their self-perceived anxiety levels between a regular working day and a day when on call in the emergency department (ED-duty day) and to determine any differences
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The objectives of this longitudinal study were to compare salivary cortisol release patterns in medical residents and their self-perceived anxiety levels between a regular working day and a day when on call in the emergency department (ED-duty day) and to determine any differences in cortisol release pattern as a function of years of residency or sex. The study included 35 residents (physicians-in-training) of the Granada University Hospital, Granada, Spain. Acute stress was measured on a regular working day and an ED-duty day, evaluating anxiety-state with the Spanish version of the State-Trait Anxiety Inventory. Physiological stress assessment was based on salivary cortisol levels. Cortisol release concentrations were higher on an ED-duty day than on a regular working day, with a significantly increased area under the curve (AUC) (p < 0.006). This difference slightly attenuated with longer residency experience. No gender difference in anxiety levels was observed (p < 0.001). According to these findings, the hypothalamic-pituitary-adrenal axis activity and anxiety levels of medical residents are higher on an ED-duty day than on a regular working day. Full article
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Open AccessArticle Evaluation of Regional Vulnerability to Disasters by People of Ishikawa, Japan: A Cross Sectional Study Using National Health Insurance Data
Int. J. Environ. Res. Public Health 2018, 15(3), 507; doi:10.3390/ijerph15030507
Received: 4 January 2018 / Revised: 14 February 2018 / Accepted: 14 February 2018 / Published: 13 March 2018
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Abstract
The 2013 Partial Amendment of the Disaster Countermeasures Basic Law mandated that a roster of vulnerable persons during disasters be created, and further development of evacuation support is expected. In this study, the number of vulnerable people living in target analytical areas are
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The 2013 Partial Amendment of the Disaster Countermeasures Basic Law mandated that a roster of vulnerable persons during disasters be created, and further development of evacuation support is expected. In this study, the number of vulnerable people living in target analytical areas are identified in terms of neighborhood units by using the National Health Insurance Database to create a realistic and efficient evacuation support plan. Later, after considering the “vulnerability” of an area to earthquake disaster damage, a quantitative evaluation of the state of the disaster is performed using a principle component analysis that further divided the analytical target areas into neighborhood units to make a detailed determination of the number of disaster-vulnerable persons, the severity of the disaster, etc. The results of the disaster evaluation performed after considering the vulnerability of an area are that 628 disaster-vulnerable persons live in areas with a relatively higher disaster evaluation value. Full article
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Open AccessArticle Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals
Int. J. Environ. Res. Public Health 2018, 15(3), 508; doi:10.3390/ijerph15030508
Received: 30 January 2018 / Revised: 10 March 2018 / Accepted: 12 March 2018 / Published: 13 March 2018
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Abstract
Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes
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Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation) mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma. Full article
(This article belongs to the Special Issue Breakthroughs in LGBT Health Research)
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Open AccessArticle Case Study of Airborne Pathogen Dispersion Patterns in Emergency Departments with Different Ventilation and Partition Conditions
Int. J. Environ. Res. Public Health 2018, 15(3), 510; doi:10.3390/ijerph15030510
Received: 30 December 2017 / Revised: 2 March 2018 / Accepted: 10 March 2018 / Published: 13 March 2018
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Abstract
The prevention of airborne infections in emergency departments is a very important issue. This study investigated the effects of architectural features on airborne pathogen dispersion in emergency departments by using a CFD (computational fluid dynamics) simulation tool. The study included three architectural features
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The prevention of airborne infections in emergency departments is a very important issue. This study investigated the effects of architectural features on airborne pathogen dispersion in emergency departments by using a CFD (computational fluid dynamics) simulation tool. The study included three architectural features as the major variables: increased ventilation rate, inlet and outlet diffuser positions, and partitions between beds. The most effective method for preventing pathogen dispersion and reducing the pathogen concentration was found to be increasing the ventilation rate. Installing partitions between the beds and changing the ventilation system’s inlet and outlet diffuser positions contributed only minimally to reducing the concentration of airborne pathogens. Full article
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Open AccessFeature PaperArticle Social Network Analysis as a Methodological Approach to Explore Health Systems: A Case Study Exploring Support among Senior Managers/Executives in a Hospital Network
Int. J. Environ. Res. Public Health 2018, 15(3), 511; doi:10.3390/ijerph15030511
Received: 29 January 2018 / Revised: 9 March 2018 / Accepted: 9 March 2018 / Published: 13 March 2018
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Abstract
Health systems research recognizes the complexity of healthcare, and the interacting and interdependent nature of components of a health system. To better understand such systems, innovative methods are required to depict and analyze their structures. This paper describes social network analysis as a
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Health systems research recognizes the complexity of healthcare, and the interacting and interdependent nature of components of a health system. To better understand such systems, innovative methods are required to depict and analyze their structures. This paper describes social network analysis as a methodology to depict, diagnose, and evaluate health systems and networks therein. Social network analysis is a set of techniques to map, measure, and analyze social relationships between people, teams, and organizations. Through use of a case study exploring support relationships among senior managers in a newly established hospital group, this paper illustrates some of the commonly used network- and node-level metrics in social network analysis, and demonstrates the value of these maps and metrics to understand systems. Network analysis offers a valuable approach to health systems and services researchers as it offers a means to depict activity relevant to network questions of interest, to identify opinion leaders, influencers, clusters in the network, and those individuals serving as bridgers across clusters. The strengths and limitations inherent in the method are discussed, and the applications of social network analysis in health services research are explored. Full article
(This article belongs to the Special Issue Health Systems and Services)
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Open AccessFeature PaperArticle Focus on Chronic Exposure for Deriving Drinking Water Guidance Underestimates Potential Risk to Infants
Int. J. Environ. Res. Public Health 2018, 15(3), 512; doi:10.3390/ijerph15030512
Received: 20 February 2018 / Revised: 9 March 2018 / Accepted: 11 March 2018 / Published: 14 March 2018
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Abstract
In 2007, the Minnesota Department of Health (MDH) developed new risk assessment methods for deriving human health-based water guidance (HBG) that incorporated the assessment of multiple exposure durations and life stages. The methodology is based on US Environmental Protection Agency recommendations for protecting
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In 2007, the Minnesota Department of Health (MDH) developed new risk assessment methods for deriving human health-based water guidance (HBG) that incorporated the assessment of multiple exposure durations and life stages. The methodology is based on US Environmental Protection Agency recommendations for protecting children’s health (US EPA 2002). Over the last 10 years, the MDH has derived multiple duration (e.g., short-term, subchronic, and chronic) water guidance for over 60 chemicals. This effort involved derivation of multiple duration reference doses (RfDs) and selection of corresponding water intake rates (e.g., infant, child, and lifetime). As expected, RfDs typically decreased with increasing exposure duration. However, the corresponding HBG frequently did not decrease with increasing duration. For more than half of the chemicals, the shorter duration HBG was lower than chronic HBG value. Conventional wisdom has been that chronic-based values will be the most conservative and will therefore be protective of less than chronic exposures. However, the MDH’s experience highlights the importance of evaluating short-term exposures. For many chemicals, elevated intake rates early in life, coupled with short-term RfDs, resulted in the lowest HBG. Drinking water criteria based on chronic assessments may not be protective of short-term exposures in highly exposed populations such as formula-fed infants. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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Open AccessArticle Association between Inflammatory Bowel Disease and Cholelithiasis: A Nationwide Population-Based Cohort Study
Int. J. Environ. Res. Public Health 2018, 15(3), 513; doi:10.3390/ijerph15030513
Received: 30 January 2018 / Revised: 5 March 2018 / Accepted: 12 March 2018 / Published: 14 March 2018
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Abstract
We assessed the subsequent risk of cholelithiasis development in patients with inflammatory bowel diseases (IBDs) such as Crohn’s disease (CD) or ulcerative colitis (UC). We identified 8186 patients who aged ≥20 years and were diagnosed with IBD between 2000 and 2010 as the
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We assessed the subsequent risk of cholelithiasis development in patients with inflammatory bowel diseases (IBDs) such as Crohn’s disease (CD) or ulcerative colitis (UC). We identified 8186 patients who aged ≥20 years and were diagnosed with IBD between 2000 and 2010 as the study cohort. A total of 8186 patients without IBD were selected by frequency-matching according to age, sex, comorbidities, and the index date of diagnosis, and they were identified as the control cohort. To measure the incidence of cholelithiasis, all patients were followed up until the end of 2011. The risk of developing cholelithiasis, either gallbladder stone disease (GSD; adjusted hazard ratio (aHR) = 1.76, 95% CI = 1.34–2.61) or common bile duct (CBD) stones and intrahepatic stones (IHSs; aHR = 2.78, 95% CI = 1.18–6.51), was higher for the CD cohort than for the non-IBD cohort after adjusting for age, sex, and comorbidities of hyperlipidemia, diabetes, liver cirrhosis, hypertension, chronic obstructive pulmonary disease, stroke, coronary artery disease, and hepatitis C virus infection. However, UC was related to the development of GSD (aHR = 1.44, 95% CI = 1.19–1.75) but not to CBD stones and IHSs (aHR = 1.70, 95% CI = 0.99–2.91). Our population-based cohort study demonstrated that CD is related to the development of cholelithiasis, including GSD alone and non-GSD-associated cholelithiasis. However, UC is only related to the development of GSD alone. Full article
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Open AccessArticle Reflections on Health Promotion and Disability in Low and Middle-Income Countries: Case Study of Parent-Support Programmes for Children with Congenital Zika Syndrome
Int. J. Environ. Res. Public Health 2018, 15(3), 514; doi:10.3390/ijerph15030514
Received: 11 December 2017 / Revised: 5 March 2018 / Accepted: 6 March 2018 / Published: 14 March 2018
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Abstract
Universal health coverage (UHC) has been adopted by many countries as a national target for 2030. People with disabilities need to be included within efforts towards UHC, as they are a large group making up 15% of the world’s population and are more
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Universal health coverage (UHC) has been adopted by many countries as a national target for 2030. People with disabilities need to be included within efforts towards UHC, as they are a large group making up 15% of the world’s population and are more vulnerable to poor health. UHC focuses both on covering the whole population as well as providing all the services needed and must include an emphasis on health promotion, as well as disease treatment and cure. Health promotion often focusses on tackling individual behaviours, such as encouraging exercise or good nutrition. However, these activities are insufficient to improve health without additional efforts to address poverty and inequality, which are the underlying drivers of poor health. In this article, we identify common challenges, opportunities and examples for health promotion for people with disabilities, looking at both individual behaviour change as well as addressing the drivers of poor health. We present a case study of a carer support programme for parents of children with Congenital Zika Syndrome in Brazil as an example of a holistic programme for health promotion. This programme operates both through improving skills of caregivers to address the health needs of their child and tackling poverty and exclusion. Full article
(This article belongs to the Special Issue Health Promotion Interventions for People with Disabilities)
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Open AccessArticle Mobile Healthcare and People with Disabilities: Current State and Future Needs
Int. J. Environ. Res. Public Health 2018, 15(3), 515; doi:10.3390/ijerph15030515
Received: 8 December 2017 / Revised: 16 February 2018 / Accepted: 12 March 2018 / Published: 14 March 2018
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Abstract
Significant health disparities exist between the general population and people with disabilities, particularly with respect to chronic health conditions. Mobile healthcare—the delivery of healthcare via mobile communication devices—is witnessing tremendous growth and has been touted as an important new approach for management of
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Significant health disparities exist between the general population and people with disabilities, particularly with respect to chronic health conditions. Mobile healthcare—the delivery of healthcare via mobile communication devices—is witnessing tremendous growth and has been touted as an important new approach for management of chronic health conditions. At present, little is known about the current state of mobile healthcare for people with disabilities. Early evidence suggests they are not well represented in the growth of mobile healthcare, and particularly the proliferation of mobile health software applications (mHealth apps) for smartphones. Their omission in mHealth could lead to further health disparities. This article describes our research investigating the current state of mHealth apps targeting people with disabilities. Based on a multi-modal approach (literature review, Internet search, survey of disabled smartphone users), we confirm that people with disabilities are under-represented in the growth of mHealth. We identify several areas of future research and development needed to support the inclusion of people with disabilities in the mHealth revolution. Full article
(This article belongs to the Special Issue Health Promotion Interventions for People with Disabilities)
Open AccessArticle Social Capital Enhanced Disaster Preparedness and Health Consultations after the 2011 Great East Japan Earthquake and Nuclear Power Station Accident
Int. J. Environ. Res. Public Health 2018, 15(3), 516; doi:10.3390/ijerph15030516
Received: 10 January 2018 / Revised: 7 March 2018 / Accepted: 10 March 2018 / Published: 14 March 2018
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Abstract
After the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Station accident in 2011, there was a strong demand to promote disaster preparedness approaches and health checkups for the prevention of lifestyle diseases. This study examined the yearly change in
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After the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Station accident in 2011, there was a strong demand to promote disaster preparedness approaches and health checkups for the prevention of lifestyle diseases. This study examined the yearly change in the percentage of those who prepared for disasters and who utilized health checkups in Fukushima Prefecture, and identified the factors governing disaster preparedness and utilization of health checkups. We used the public opinion survey from 2011 to 2015 (n = 677–779 each year) on prefectural policies that is conducted every year by the Fukushima Prefecture government Public Consultation Unit. We found that the percentage of those who prepare for disasters decreased, while that for health checkups did not significantly change. With regard to disaster preparedness, experiences of disaster enhance disaster preparedness, while bonds with other local people help to maintain preparedness. For health checkups, familiarity with the welfare service was the most important factor governing such consultations. The findings suggest that social capital should be promoted in order to improve disaster preparedness. The findings also suggest that residents’ accessibility to medical and welfare services is also important in promoting the utilization of health checkups. Full article
(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)
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Open AccessArticle Access to Street Markets and Consumption of Fruits and Vegetables by Adolescents Living in São Paulo, Brazil
Int. J. Environ. Res. Public Health 2018, 15(3), 517; doi:10.3390/ijerph15030517
Received: 15 February 2018 / Revised: 9 March 2018 / Accepted: 11 March 2018 / Published: 14 March 2018
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Abstract
Food environment and income act as determinants of diet, and consequently, of the consumption of fruits and vegetables. The objective of this study is to investigate the association between fruit and vegetable consumption, income, and street market density in adolescents living in São
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Food environment and income act as determinants of diet, and consequently, of the consumption of fruits and vegetables. The objective of this study is to investigate the association between fruit and vegetable consumption, income, and street market density in adolescents living in São Paulo, Brazil. Data from 521 adolescents (12 to 19 years) participating in the 2015 Health Survey of São Paulo were used. Buffers (500, 1000, and 1500 m) were drawn around the households and the street markets were counted in each zone. Multilevel logistic regression models were used to evaluate the association between fruit and vegetable consumption, income, and street market density. The main results showed that the presence of a street market in the zone closest to the households (500 m) was associated with higher consumption of fruits and vegetables (OR: 1.73; CI 95% 1.01–3.00). Higher family income was associated with a higher consumption of fruits and vegetables for models of 500 m buffer (OR: 2.56; CI 95% 1.47–4.45), 1000 m (OR: 2.30; CI 95% 1.33–3.96), and 1500 m (OR: 2.32; CI 95% 1.35–4.00). These results support the implementation of public policies that jointly consider income and the availability of street markets or healthy food environments. Full article
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Open AccessArticle Bread and Shoulders: Reversing the Downward Spiral, a Qualitative Analyses of the Effects of a Housing First-Type Program in France
Int. J. Environ. Res. Public Health 2018, 15(3), 520; doi:10.3390/ijerph15030520
Received: 19 December 2017 / Revised: 11 February 2018 / Accepted: 23 February 2018 / Published: 14 March 2018
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Abstract
This paper is a qualitative analysis of the effects of accompagnement, a support framework, on recovery trajectories of people with long-term homelessness and severe psychiatric disorders during 24 months in a Housing First-type program in France. A comprehensive methodology based on grounded
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This paper is a qualitative analysis of the effects of accompagnement, a support framework, on recovery trajectories of people with long-term homelessness and severe psychiatric disorders during 24 months in a Housing First-type program in France. A comprehensive methodology based on grounded theory was used to construct an interview guide, conduct multiple interviews with 35 Housing First participants sampled for heterogeneity, and produce memos on their trajectories before and after entering the program based on interview information. Thematic analysis of a representative subsample (n = 13) of memos identified 12 objective factors and 6 subjective factors key to the recovery process. An in-depth re-analysis of the memos generated four recovery themes: (1) the need for secure space favorable to self-reflexivity; (2) a “honeymoon” effect; (3) the importance of even weak social ties; (4) support from and hope among peers. Three challenges to recovery were identified: (1) finding a balance between protection and risk; (2) breaking downward spirals; (3) bifurcating the trajectory. This study provides new insight into the recovery process, understood as a non-linear transformation of an experience—the relationship between objective life conditions and subjective perception of those conditions—which reinforces protective support over risk elements. Full article
(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)
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Open AccessArticle The Spatial Distributions and Variations of Water Environmental Risk in Yinma River Basin, China
Int. J. Environ. Res. Public Health 2018, 15(3), 521; doi:10.3390/ijerph15030521
Received: 24 February 2018 / Revised: 8 March 2018 / Accepted: 10 March 2018 / Published: 15 March 2018
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Abstract
Water environmental risk is the probability of the occurrence of events caused by human activities or the interaction of human activities and natural processes that will damage a water environment. This study proposed a water environmental risk index (WERI) model to assess the
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Water environmental risk is the probability of the occurrence of events caused by human activities or the interaction of human activities and natural processes that will damage a water environment. This study proposed a water environmental risk index (WERI) model to assess the water environmental risk in the Yinma River Basin based on hazards, exposure, vulnerability, and regional management ability indicators in a water environment. The data for each indicator were gathered from 2000, 2005, 2010, and 2015 to assess the spatial and temporal variations in water environmental risk using particle swarm optimization and the analytic hierarchy process (PSO-AHP) method. The results showed that the water environmental risk in the Yinma River Basin decreased from 2000 to 2015. The risk level of the water environment was high in Changchun, while the risk levels in Yitong and Yongji were low. The research methods provide information to support future decision making by the risk managers in the Yinma River Basin, which is in a high-risk water environment. Moreover, water environment managers could reduce the risks by adjusting the indicators that affect water environmental risks. Full article
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Open AccessArticle Combining Community Engagement and Scientific Approaches in Next-Generation Monitor Siting: The Case of the Imperial County Community Air Network
Int. J. Environ. Res. Public Health 2018, 15(3), 523; doi:10.3390/ijerph15030523
Received: 24 January 2018 / Revised: 21 February 2018 / Accepted: 7 March 2018 / Published: 15 March 2018
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Abstract
Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with
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Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities. By engaging community residents in the project design, monitor siting processes, data dissemination, and other key activities, the resulting air monitoring network data are relevant, trusted, understandable, and used by community residents. Integration of spatial analysis and air monitoring best practices into the network development process ensures that the data are reliable and appropriate for use in research activities. This combined approach results in a community air monitoring network that is better able to inform community residents, support research activities, guide public policy, and improve public health. Here we detail the monitor siting process and outline the advantages and challenges of this approach. Full article
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Open AccessArticle The Acute Effects of Intermittent Light Exposure in the Evening on Alertness and Subsequent Sleep Architecture
Int. J. Environ. Res. Public Health 2018, 15(3), 524; doi:10.3390/ijerph15030524
Received: 22 January 2018 / Revised: 28 February 2018 / Accepted: 13 March 2018 / Published: 15 March 2018
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Abstract
Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent
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Exposure to bright light is typically intermittent in our daily life. However, the acute effects of intermittent light on alertness and sleep have seldom been explored. To investigate this issue, we employed within-subject design and compared the effects of three light conditions: intermittent bright light (30-min pulse of blue-enriched bright light (~1000 lux, ~6000 K) alternating with 30-min dim normal light (~5 lux, ~3600 K) three times); continuous bright light; and continuous dim light on subjective and objective alertness and subsequent sleep structure. Each light exposure was conducted during the three hours before bedtime. Fifteen healthy volunteers (20 ± 3.4 years; seven males) were scheduled to stay in the sleep laboratory for four separated nights (one for adaptation and the others for the light exposures) with a period of at least one week between nights. The results showed that when compared with dim light, both intermittent light and continuous bright light significantly increased subjective alertness and decreased sleep efficiency (SE) and total sleep time (TST). Intermittent light significantly increased objective alertness than dim light did during the second half of the light-exposure period. Our results suggested that intermittent light was as effective as continuous bright light in their acute effects in enhancing subjective and objective alertness and in negatively impacting subsequent sleep. Full article
(This article belongs to the Special Issue Sleep Health)
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Open AccessArticle Effect of a Conditional Cash Transfer Program on Nutritional Knowledge and Food Practices among Caregivers of 3–5-Year-Old Left-Behind Children in the Rural Hunan Province
Int. J. Environ. Res. Public Health 2018, 15(3), 525; doi:10.3390/ijerph15030525
Received: 13 December 2017 / Revised: 8 March 2018 / Accepted: 13 March 2018 / Published: 15 March 2018
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Abstract
Left-behind children (LBC) are a unique population in China, whose numbers have increased dramatically in recent years. Most caregivers of left-behind children (CLBC) are grandparents who lack knowledge about proper nutrition and food practice, putting LBC at greater risk for malnutrition. A cluster
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Left-behind children (LBC) are a unique population in China, whose numbers have increased dramatically in recent years. Most caregivers of left-behind children (CLBC) are grandparents who lack knowledge about proper nutrition and food practice, putting LBC at greater risk for malnutrition. A cluster randomized controlled trial was carried to assess the effectiveness of the conditional cash transfer (CCT) program. Forty rural villages from Fenghuang County and Pingjiang County of Hunan province were selected. The villages were randomized into the intervention and control groups. In the intervention group, caregivers received a cash transfer conditional on bimonthly health education attendance, bringing LBC in for vaccinations, and on-time annual health checks. The control group received routine health services only. Two rounds of questionnaire surveys were conducted in March 2015 and July 2016. Questionnaires and in-person interviews were used to assess the changes in nutritional knowledge and food practices among CLBC. Among 447 valid subjects, CLBC in the intervention group were significantly more likely to correctly understand the importance of children’s height and weight measurements, food variety, inclusion of eggs and dairy in the diet, and anemia identification and prevention. Intervention group CLBC were also significantly more likely to prepare dairy products and eggs for their children. Generalized liner mixed model (GLMM) analysis showed that CLBC nutrition knowledge was improved significantly in the intervention group (adjusted p value = 0.01), and there were also positive changes in their food practice (adjusted p value = 0.047). This CCT intervention turned to be effective with respect to rural caregivers’ nutritional knowledge and food practice behavior. The findings from this project could be helpful for future health strategies targeting rural children, in particular the LBC group. Full article
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Open AccessArticle Pesticide Use and Asthma in Alberta Grain Farmers
Int. J. Environ. Res. Public Health 2018, 15(3), 526; doi:10.3390/ijerph15030526
Received: 9 March 2018 / Revised: 9 March 2018 / Accepted: 13 March 2018 / Published: 15 March 2018
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Abstract
A study of the respiratory health of grain farmers in Alberta, Canada was carried out in March 2002. Two populations were identified: members, in 1983, of a province-wide farm organisation, and grain farmers registered with the provincial agriculture department. A telephone interview addressed
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A study of the respiratory health of grain farmers in Alberta, Canada was carried out in March 2002. Two populations were identified: members, in 1983, of a province-wide farm organisation, and grain farmers registered with the provincial agriculture department. A telephone interview addressed pesticide use (using pre-circulated trade names), chronic disease and respiratory symptoms. Pesticide ingredients were identified from provincial crop protection guides. Total years of use were calculated for seven chemical groups. Consent for linkage to administrative health records was obtained in 2009. A likelihood score (Lscore) is computed, relating symptoms to asthma diagnosis. Self-reported asthma and the Lscore are examined against duration of pesticide exposures. Of the 10,767 farmers listed, 2426 were still living, had farmed grain and were interviewed; 1371 were re-contacted and matched to health records. After allowance for confounders, years of exposure to phenoxy compounds are related to self-reported asthma and Lscore. Compared to no exposure, the adjusted odds ratios (95% Confidence Intervals for self-reported asthma for short, medium and long exposure to phenoxy compounds are 1.29 (0.66–2.52), 2.52 (1.25–5.09), and 3.18 (1.54–6.58), and for Lscore are 1.19 (0.91–1.55), 1.50 (1.13–1.99), and 1.58 (1.18–2.12). We conclude that lifetime exposure to phenoxy herbicides is associated with an increased risk of asthma. Full article
(This article belongs to the Special Issue Occupational Pesticides Exposure)
Open AccessArticle The Relationship between Obesity, Sleep and Physical Activity in Chinese Preschool Children
Int. J. Environ. Res. Public Health 2018, 15(3), 527; doi:10.3390/ijerph15030527
Received: 22 January 2018 / Revised: 12 March 2018 / Accepted: 13 March 2018 / Published: 15 March 2018
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Abstract
Background: Pediatric overweight and obesity has become a major public health problem in China. The goal of this study is to understand overweight and obesity in preschool children in Changsha City in the context of their sleep and physical activity. These results offer
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Background: Pediatric overweight and obesity has become a major public health problem in China. The goal of this study is to understand overweight and obesity in preschool children in Changsha City in the context of their sleep and physical activity. These results offer feasible proposals to reduce levels of overweight and obesity among preschool children. Methods: A total of 112 preschoolers aged three to six years old were investigated using multiple stage stratified cluster sampling and simple random sampling. Questionnaires were used to collect general information about children and their families. Body mass index (BMI) was used as an indicator of overweight and obesity. Age- and sex-specific cutoff values for Chinese children and adolescents were used to determine child weight status. Children’s sedentary time was reported by caregivers, while physical activity and sleep were recorded using fitness bracelets (Misfit Shine 2). Results: The prevalence of childhood overweight and obesity were 15.2% and 9.8% respectively. Preschool-aged children travelled 11,111 ± 3357 and 10,350 ± 2973 steps per day on weekdays and weekends respectively. The number of daily steps was not statistically different between weekdays and weekends. The amount of time spent daily doing vigorous activity on weekdays and weekends was significantly different, with an average time of 20.5 ± 31.6 min and 10.3 ± 15.3 min respectively (p = 0.002). Furthermore, 10.7% and 50.9% of children used screens for more than two hours on weekdays and weekends respectively (p < 0.001). Children slept for significantly longer on weekends (8.3 ± 0.9 h) than on weekdays (8.1 ± 0.7 h) (p = 0.037). A significantly higher proportion of students also fell asleep before 10:00 p.m. on weekends (26.8%) compared to weekdays (15.2%) (p < 0.001). Parent’s BMI values were positively correlated with child BMI, the monthly household income was negatively associated with child BMI. Male children were more likely to have a higher BMI than female children. Children who were obese were also more likely to have shorter sleep times compared to children of normal weight (p = 0.047). Conclusions: There was a high prevalence of overweight and obesity among the Chinese preschool children in this study. Students also demonstrated poor sleep and physical activity habits. Future research is necessary to explore the relationship between sleep, physical activity and weight status for young children in China. Full article
(This article belongs to the Special Issue Eating and Exercise in Children and Adolescents)
Open AccessArticle Biocapture of CO2 by Different Microalgal-Based Technologies for Biogas Upgrading and Simultaneous Biogas Slurry Purification under Various Light Intensities and Photoperiods
Int. J. Environ. Res. Public Health 2018, 15(3), 528; doi:10.3390/ijerph15030528
Received: 24 January 2018 / Revised: 13 March 2018 / Accepted: 13 March 2018 / Published: 15 March 2018
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Abstract
Co-cultivation of microalgae and microbes for pollutant removal from sewage is considered as an effective wastewater treatment method. The aim of this study is to screen the optimal photoperiod, light intensity and microalgae co-cultivation method for simultaneously removing nutrients in biogas slurry and
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Co-cultivation of microalgae and microbes for pollutant removal from sewage is considered as an effective wastewater treatment method. The aim of this study is to screen the optimal photoperiod, light intensity and microalgae co-cultivation method for simultaneously removing nutrients in biogas slurry and capturing CO2 in biogas. The microalgae–fungi pellets are deemed to be a viable option because of their high specific growth rate and nutrient and CO2 removal efficiency under the photoperiod of 14 h light:10 h dark. The order of both the biogas slurry purification and biogas upgrading is ranked the same, that is Chlorella vulgarisGanoderma lucidum > Chlorella vulgaris–activated sludge > Chlorella vulgaris under different light intensities. For all cultivation methods, the moderate light intensity of 450 μmol m−2 s−1 is regarded as the best choice. This research revealed that the control of photoperiod and light intensity can promote the biological treatment process of biogas slurry purification and biogas upgrading using microalgal-based technology. Full article
(This article belongs to the Special Issue Remediation and Analysis of Soil, Air, and Water Pollution)
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Open AccessArticle Estimation of PM2.5 Concentration Efficiency and Potential Public Mortality Reduction in Urban China
Int. J. Environ. Res. Public Health 2018, 15(3), 529; doi:10.3390/ijerph15030529
Received: 14 February 2018 / Revised: 9 March 2018 / Accepted: 12 March 2018 / Published: 15 March 2018
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Abstract
The particulate matter 2.5 (PM2.5) is a serious air-pollutant emission in China, which has caused serious risks to public health. To reduce the pollution and corresponding public mortality, this paper proposes a method by incorporating slacks-based data envelopment analysis (DEA) and
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The particulate matter 2.5 (PM2.5) is a serious air-pollutant emission in China, which has caused serious risks to public health. To reduce the pollution and corresponding public mortality, this paper proposes a method by incorporating slacks-based data envelopment analysis (DEA) and an integrated exposure risk (IER) model. By identifying the relationship between the PM2.5 concentration and mortality, the potential PM2.5 concentration efficiency and mortality reduction were measured. The proposed method has been applied to China’s 243 cities in 2015. Some implications are achieved. (1) There are urban disparities in estimated results around China. The geographic distribut