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Int. J. Environ. Res. Public Health, Volume 6, Issue 12 (December 2009), Pages 2919-3234

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Research

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Open AccessArticle The Role of Endocarditis, Myocarditis and Pericarditis in Qualitative and Quantitative Data Analysis
Int. J. Environ. Res. Public Health 2009, 6(12), 2919-2933; doi:10.3390/ijerph6122919
Received: 2 November 2009 / Accepted: 18 November 2009 / Published: 26 November 2009
Cited by 4 | PDF Full-text (1071 KB) | HTML Full-text | XML Full-text
Abstract
The current study is the first scientometric analysis of research activity and output in the field of inflammatory disorders of the heart (endo-, myo- and pericarditis). Scientometric methods are used to compare scientific performance on national and on international scale to identify [...] Read more.
The current study is the first scientometric analysis of research activity and output in the field of inflammatory disorders of the heart (endo-, myo- and pericarditis). Scientometric methods are used to compare scientific performance on national and on international scale to identify single areas of research interest. Interest and research productivity in inflammatory diseases of the heart have increased since 1990. The majority of publications about inflammatory heart disorders were published in Western Europe and North America. The United States of America had a leading position in terms of research productivity and quality; half of the most productive authors in this study came from American institutions. The analysis of international cooperation revealed research activity in countries that are less established in the field of inflammatory heart disorder research, such as Brazil, Saudi Arabia and Tunisia. These results indicate that future research of heart inflammation may no longer be influenced predominantly by a small number of countries. Furthermore, this study revealed weaknesses in currently established scientometric parameters (i.e., h-index, impact factor) that limit their suitability as measures of research quality. In this respect, self-citations should be generally excluded from calculations of h-index and impact factor. Full article
Open AccessArticle Chronic Stress and the Development of Early Atherosclerosis: Moderating Effect of Endothelial Dysfunction and Impaired Arterial Elasticity
Int. J. Environ. Res. Public Health 2009, 6(12), 2934-2949; doi:10.3390/ijerph6122934
Received: 15 September 2009 / Accepted: 20 November 2009 / Published: 27 November 2009
Cited by 2 | PDF Full-text (298 KB) | HTML Full-text | XML Full-text
Abstract
This study aims to explore the interactive effect of vital exhaustion (VE) and endothelial dysfunction on preclinical atherosclerosis, assessed by carotid intima-media thickness (IMT). Furthermore, interaction between VE and carotid elasticity is examined. Participants were 1,596 young healthy adults from the Cardiovascular [...] Read more.
This study aims to explore the interactive effect of vital exhaustion (VE) and endothelial dysfunction on preclinical atherosclerosis, assessed by carotid intima-media thickness (IMT). Furthermore, interaction between VE and carotid elasticity is examined. Participants were 1,596 young healthy adults from the Cardiovascular Risk in Young Finns study. Endothelial dysfunction was measured by brachial flow-mediated dilatation (FMD), and carotid elasticity by carotid artery compliance (CAC). Significant interactions between FMD and VE, and between CAC and VE, for IMT were found in participants with the very lowest FMD and CAC. Thus, VE may be harmful if the endothelium is not working properly. Full article
Open AccessArticle Musculoskeletal Disorders Among Cosmetologists
Int. J. Environ. Res. Public Health 2009, 6(12), 2967-2979; doi:10.3390/ijerph6122967
Received: 27 September 2009 / Accepted: 23 November 2009 / Published: 27 November 2009
Cited by 12 | PDF Full-text (207 KB) | HTML Full-text | XML Full-text
Abstract
A cross-sectional study was performed to investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of low back, neck, shoulder, hand/wrist and knee musculoskeletal complaints among cosmetologists in Athens, Greece. The study population consisted of 95 female and seven [...] Read more.
A cross-sectional study was performed to investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of low back, neck, shoulder, hand/wrist and knee musculoskeletal complaints among cosmetologists in Athens, Greece. The study population consisted of 95 female and seven male beauty therapists (response rate 90%) with a mean age and duration of employment of 38 and 16 years, respectively. Neck pain was the most prevalent musculoskeletal complaint, reported by 58% of the subjects, while hand/wrist and low back complaints resulted more frequently in self-reported consequences (chronicity, care seeking and absenteeism). Significant relationships were found between self-reported physical risk factors like prolonged sitting, use of vibrating tools, reaching far and awkward body postures and the occurrence of musculoskeletal disorders at various body sites. Among psychosocial variables co-worker support and skill discretion seem to be the most important reflecting organizational problems and cognitive-behavioral aspects. The study results also suggest that effective intervention strategies most likely have to take into account both ergonomic improvements and organizational aspects. Full article
Open AccessArticle “This Is Public Health: Recycling Counts!” Description of a Pilot Health Communications Campaign
Int. J. Environ. Res. Public Health 2009, 6(12), 2980-2991; doi:10.3390/ijerph6122980
Received: 29 September 2009 / Accepted: 25 November 2009 / Published: 30 November 2009
Cited by 2 | PDF Full-text (263 KB) | HTML Full-text | XML Full-text
Abstract
This paper describes the development, implementation, and evaluation of a pilot recycling campaign. The goal of the campaign was to increase people’s awareness and knowledge about recycling and the link between a healthy environment and the public’s health. A total of 258 individuals attended campaign week events and completed an initial survey. Results identified inconvenience of recycling facility locations as a key barrier to recycling. Post-campaign survey results revealed increased recycling of paper, plastic, glass, and cans (p < 0.05). The majority of participants “agreed” or “strongly agreed” that as a result of campaign messages they had greater awareness about recycling (88.4%) and their recycling efforts increased (61.6%). Full article
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Open AccessArticle Gender Differences in Interpersonal Problems of Alcohol-Dependent Patients and Healthy Controls
Int. J. Environ. Res. Public Health 2009, 6(12), 3010-3022; doi:10.3390/ijerph6123010
Received: 6 November 2009 / Accepted: 26 November 2009 / Published: 1 December 2009
Cited by 12 | PDF Full-text (175 KB) | HTML Full-text | XML Full-text
Abstract
Alcohol dependence is a heavy burden on patients, their families, and society. Epidemiological studies indicate that alcohol dependence will affect many individuals at some time in their lives, with men affected more frequently than women. Since alcohol-dependent patients often exhibit a lack [...] Read more.
Alcohol dependence is a heavy burden on patients, their families, and society. Epidemiological studies indicate that alcohol dependence will affect many individuals at some time in their lives, with men affected more frequently than women. Since alcohol-dependent patients often exhibit a lack of social skills and suffer from interpersonal problems, the aim of this study is to elucidate whether men and women experience the same interpersonal problems. Eighty-five alcohol-dependent patients (48 men; 37 women) after detoxification and 62 healthy controls (35 men; 27 women) were recruited. Interpersonal problems were measured with the Inventory of Interpersonal Problems (IIP-64). Additionally, alcohol-dependent patients were interviewed with the Alcohol Use Disorders Identification Test (AUDIT) and were subtyped according to Lesch’s Alcohol Typology (LAT). There were no significant gender differences in the AUDIT and LAT between alcohol-dependent men and women. Interpersonal problems of alcohol-dependent men differed significantly in one out of eight dimensions from controls; alcohol-dependent men perceive themselves as colder than male controls. Alcohol-dependent women differed in four out of eight interpersonal dimensions from female controls. Alcohol-dependent women rated themselves as significantly more vindictive, more introverted, more overly accommodating and more intrusive than female controls. Results suggest that alcohol-dependent men and women suffer from different interpersonal problems and furthermore alcohol-dependent women perceive more interpersonal problems, whereas the severity of alcohol dependence did not differ between the groups. Our findings indicate that alcohol-dependent women may profit more from a gender-specific treatment approach aimed at improving treatment outcome than alcohol-dependent men. Full article
(This article belongs to the Special Issue Alcohol and Public Health)
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Open AccessArticle Natural Environment Suitability of China and Its Relationship with Population Distributions
Int. J. Environ. Res. Public Health 2009, 6(12), 3025-3039; doi:10.3390/ijerph6123025
Received: 28 October 2009 / Accepted: 25 November 2009 / Published: 1 December 2009
Cited by 11 | PDF Full-text (686 KB) | HTML Full-text | XML Full-text
Abstract
The natural environment factor is one of the main indexes for evaluating human habitats, sustained economic growth and ecological health status. Based on Geographic Information System (GIS) technology and an analytic hierarchy process method, this article presents the construction of the Natural [...] Read more.
The natural environment factor is one of the main indexes for evaluating human habitats, sustained economic growth and ecological health status. Based on Geographic Information System (GIS) technology and an analytic hierarchy process method, this article presents the construction of the Natural Environment Suitability Index (NESI) model of China by using natural environment data including climate, hydrology, surface configuration and ecological conditions. The NESI value is calculated in grids of 1 km by 1 km through ArcGIS. The spatial regularity of NESI is analyzed according to its spatial distribution and proportional structure. The relationship of NESI with population distribution and economic growth is also discussed by analyzing NESI results with population distribution data and GDP data in 1 km by 1 km grids. The study shows that: (1) the value of NESI is higher in the East and lower in the West in China; The best natural environment area is the Yangtze River Delta region and the worst are the northwest of Tibet and southwest of Xinjiang. (2) There is a close correlation among natural environment, population distribution and economic growth; the best natural environment area, the Yangtze River Delta region, is also the region with higher population density and richer economy. The worst natural environment areas, Northwest and Tibetan Plateau, are also regions with lower population density and poorer economies. Full article
Open AccessArticle Mapping Environmental Dimensions of Dengue Fever Transmission Risk in the Aburrá Valley, Colombia
Int. J. Environ. Res. Public Health 2009, 6(12), 3040-3055; doi:10.3390/ijerph6123040
Received: 21 September 2009 / Accepted: 18 November 2009 / Published: 2 December 2009
Cited by 15 | PDF Full-text (1015 KB) | HTML Full-text | XML Full-text
Abstract
Dengue fever (DF) is endemic in Medellín, the second largest Colombian city, and surrounding municipalities. We used DF case and satellite environmental data to investigate conditions associated with suitable areas for DF occurrence in 2008 in three municipalities (Bello, Medellín and Itagüí). [...] Read more.
Dengue fever (DF) is endemic in Medellín, the second largest Colombian city, and surrounding municipalities. We used DF case and satellite environmental data to investigate conditions associated with suitable areas for DF occurrence in 2008 in three municipalities (Bello, Medellín and Itagüí). We develop spatially stratified tests of ecological niche models, and found generally good predictive ability, with all model tests yielding results significantly better than random expectations. We concluded that Bello and Medellín present ecological conditions somewhat different from, and more suitable for DF than, those of Itagüí. We suggest that areas predicted by our models as suitable for DF could be considered as at-risk, and could be used to guide campaigns for DF prevention in these municipalities. Full article
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Open AccessArticle Assessment of Japanese Stimulant Control Law Offenders Using the Addiction Severity Index—Japanese Version: Comparison with Patients in Treatment Settings
Int. J. Environ. Res. Public Health 2009, 6(12), 3056-3069; doi:10.3390/ijerph6123056
Received: 9 November 2009 / Accepted: 29 November 2009 / Published: 3 December 2009
Cited by 1 | PDF Full-text (214 KB) | HTML Full-text | XML Full-text
Abstract
The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005–2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The χ2 and Mann-Whitney-Wilcoxon [...] Read more.
The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005–2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The χ2 and Mann-Whitney-Wilcoxon tests showed that the inmates had a significantly lower education level, more frequently had full-time jobs, had more experience living with a sexual partner, and more frequently had a history of juvenile delinquency and criminal records than patients. Although psychiatric symptoms, such as depression, anxiety, and hallucinations, were not common among inmates, suicidal behavior and trouble controlling violence were common in both groups. Full article
Open AccessArticle Sudden Unexpected Death in Alcohol Misuse—An Unrecognized Public Health Issue?
Int. J. Environ. Res. Public Health 2009, 6(12), 3070-3081; doi:10.3390/ijerph6123070
Received: 29 October 2009 / Accepted: 29 November 2009 / Published: 4 December 2009
Cited by 6 | PDF Full-text (91 KB) | HTML Full-text | XML Full-text
Abstract
Sudden arrhythmic cardiac death can occur in chronic misusers of alcohol. The only findings at post mortem are fatty liver and a negative or low blood alcohol. This is an under-recognized entity. Coroner‘s post mortems in a typical UK city were studied. [...] Read more.
Sudden arrhythmic cardiac death can occur in chronic misusers of alcohol. The only findings at post mortem are fatty liver and a negative or low blood alcohol. This is an under-recognized entity. Coroner‘s post mortems in a typical UK city were studied. Seven out of 1,292 (0.5%) post mortems were deemed to have died of alcohol associated arrhythmic death. Applying this study to the UK as a whole, alcohol related arrhythmic death or as we have termed it SUDAM (Sudden Unexpected Death in Alcohol Misuse) probably accounts for around 1,000 deaths, many of which are misattributed to other causes Full article
(This article belongs to the Special Issue Alcohol and Public Health)
Open AccessArticle Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area
Int. J. Environ. Res. Public Health 2009, 6(12), 3082-3096; doi:10.3390/ijerph6123082
Received: 26 October 2009 / Accepted: 1 December 2009 / Published: 4 December 2009
Cited by 14 | PDF Full-text (225 KB) | HTML Full-text | XML Full-text
Abstract
Introduction: Cardiovascular Disease (CVD) has been linked to \"neighbourhood\" socioeconomic status (nSES), often operationalized as a composite index of aggregate income, occupation and education within predefined administrative boundaries. The role of specific, non-composite socioeconomic markers has not been clearly explained. It is [...] Read more.
Introduction: Cardiovascular Disease (CVD) has been linked to \"neighbourhood\" socioeconomic status (nSES), often operationalized as a composite index of aggregate income, occupation and education within predefined administrative boundaries. The role of specific, non-composite socioeconomic markers has not been clearly explained. It is also unclear whether the relationship between nSES and CVD varies according to sex. We sought to determine whether area-level unemployment (ALU) was associated with CVD risk, and whether this association differed by sex. Methods: 342 individuals from the Montreal Neighbourhood Survey of Lifestyle and Health provided self-reported behavioural and socioeconomic information. A nurse collected biochemical and anthropometric data. ALU, a weighted average of the proportion of persons 15-years and older available for but without work, was measured using a Geographic Information System for a 250 m buffer centred on individual residence. Generalized Estimating Equations were used to estimate the associations between ALU, body mass index (BMI) and a cumulative score for total cardiometabolic risk (TCR). Results: After confounder adjustments, the mean 4th minus 1st quartile difference in BMI was 3.19 kg/m2 (95% CI: 2.39, 3.99), while the prevalence ratio for the 4th relative to 1st quartile for TCR was 2.20 (95 % CI: 1.53, 3.17). Sex interacted with ALU; women relative to men had greater mean 3.97 kg/m2 (95% CI: 2.08, 5.85) BMI and greater mean TCR 1.51 (95% CI: 0.78, 2.90), contrasted at mean ALU. Conclusions: Area-level unemployment is associated with greater CVD risk, and this association is stronger for women. Full article
(This article belongs to the Special Issue Cardiovascular Diseases and Public Health)
Open AccessArticle Very Low Dose Fetal Exposure to Chernobyl Contamination Resulted in Increases in Infant Leukemia in Europe and Raises Questions about Current Radiation Risk Models
Int. J. Environ. Res. Public Health 2009, 6(12), 3105-3114; doi:10.3390/ijerph6123105
Received: 13 October 2008 / Accepted: 25 November 2009 / Published: 7 December 2009
Cited by 14 | PDF Full-text (163 KB) | HTML Full-text | XML Full-text | Correction | Supplementary Files
Abstract
Following contamination from the Chernobyl accident in April 1986 excess infant leukemia (0–1 y) was reported from five different countries, Scotland, Greece, Germany, Belarus and Wales and Scotland combined. The cumulative absorbed doses to the fetus, as conventionally assessed, varied from 0.02 mSv in the UK through 0.06 mSv in Germany, 0.2 mSv in Greece and 2 mSv in Belarus, where it was highest. Nevertheless, the effect was real and given the specificity of the cohort raised questions about the safety of applying the current radiation risk model of the International Commission on Radiological Protection (ICRP) to these internal exposures, a matter which was discussed in 2000 by Busby and Cato [7,8] and also in the reports of the UK Committee examining Radiation Risk from Internal Emitters. Data on infant leukemia in the United Kingdom, chosen on the basis of the cohorts defined by the study of Greece were supplied by the UK Childhood Cancer Research Group. This has enabled a study of leukemia in the combined infant population of 15,466,845 born in the UK, Greece, and Germany between 1980 and 1990. Results show a statistically significant excess risk RR = 1.43 (95% CI 1.13 < RR < 1.80 (2-tailed); p = 0.0025) in those born during the defined peak exposure period of 01/07/86 to 31/12/87 compared with those born between 01/01/80 and 31/12/85 and 01/01/88 and 31/12/90. The excess risks in individual countries do not increase monotonically with the conventionally calculated doses, the relation being biphasic, increasing sharply at low doses and falling at high doses. This result is discussed in relation to fetal/cell death at higher doses and also to induction of DNA repair. Since the cohort is chosen specifically on the basis of exposure to internal radionuclides, the result can be expressed as evidence for a significant error in the conventional modeling for such internal fetal exposures. Full article
(This article belongs to the Special Issue Advances in Epidemiology)
Open AccessArticle Examining the Dynamic Association of BMI and Mortality in the Framingham Heart Study
Int. J. Environ. Res. Public Health 2009, 6(12), 3115-3126; doi:10.3390/ijerph6123115
Received: 6 November 2009 / Accepted: 3 December 2009 / Published: 7 December 2009
Cited by 12 | PDF Full-text (257 KB) | HTML Full-text | XML Full-text
Abstract
Based on the 40-year follow-up of the Framingham Heart Study (FHS), we used logistic regression models to demonstrate that different designs of an observational study may lead to different results about the association between BMI and all-cause mortality. We also used dynamic [...] Read more.
Based on the 40-year follow-up of the Framingham Heart Study (FHS), we used logistic regression models to demonstrate that different designs of an observational study may lead to different results about the association between BMI and all-cause mortality. We also used dynamic survival models to capture the time-varying relationships between BMI and mortality in FHS. The results consistently show that the association between BMI and mortality is dynamic, especially for men. Our analysis suggests that the dynamic property may explain part of the heterogeneity observed in the literature about the association of BMI and mortality. Full article
(This article belongs to the Special Issue Advances in Epidemiology)
Open AccessArticle Toxicological Assessment of Toxic Element Residues in Swine Kidney and Its Role in Public Health Risk Assessment
Int. J. Environ. Res. Public Health 2009, 6(12), 3127-3142; doi:10.3390/ijerph6123127
Received: 28 October 2009 / Revised: 18 November 2009 / Accepted: 26 November 2009 / Published: 8 December 2009
Cited by 10 | PDF Full-text (471 KB) | HTML Full-text | XML Full-text
Abstract
In order to ensure the safety of consumers in Serbia the prevalence of toxic elements (As, Cd, Hg, Pb) in swine kidney collected from three different areas in Serbia (n = 90) was determined by atomic absorption spectrometry. Also, in order to [...] Read more.
In order to ensure the safety of consumers in Serbia the prevalence of toxic elements (As, Cd, Hg, Pb) in swine kidney collected from three different areas in Serbia (n = 90) was determined by atomic absorption spectrometry. Also, in order to find information on the effects of accumulation of toxic elements on swine kidney, pathohistological examination of the kidneys was performed. The presence of mercury was found in 33.3% of kidney samples in the range of 0.005–0.055 mg/kg, while the presence of cadmium was detected less often (27.7%) but in larger amounts (0.05–1.23 mg/kg). The presence of arsenic was found only in one sample, while no lead was found. The results of the metal-to-metal correlation analysis supported there were the result of different sources of contamination. Pathohistological examination of kidneys confirms tubulopathies with oedema and cell vacuolization. In addition, haemorrhages and necrosis of proximal kidney tubule cells were found. This study demonstrates that toxic elements in Serbian slaughtered pigs are found at levels comparable to those reported in other countries, and consequently the levels reported in this study do not represent a concern from a consumer safety point of view. The lack of a strong correlation between histopathological changes and the incidence of toxic elements found in this study might be explained as the result of synergism among toxic elements and other nephrotoxic compounds which enhance the toxicity of the individual toxins even at the relatively low mean concentrations observed in this study. Full article
(This article belongs to the Special Issue Heavy Metals and Health)
Open AccessArticle Effect of Medicaid Coverage of Tobacco-Dependence Treatments on Smoking Cessation
Int. J. Environ. Res. Public Health 2009, 6(12), 3143-3155; doi:10.3390/ijerph6123143
Received: 20 October 2009 / Accepted: 4 December 2009 / Published: 9 December 2009
Cited by 4 | PDF Full-text (209 KB) | HTML Full-text | XML Full-text
Abstract
Smoking cessation aids (nicotine replacement products and anti-depressant medication) have been proven to double quitting rates compared to placebo in several randomized controlled trials. But the high initial cost of cessation aids might create a financial barrier to cessation for low-income smokers. [...] Read more.
Smoking cessation aids (nicotine replacement products and anti-depressant medication) have been proven to double quitting rates compared to placebo in several randomized controlled trials. But the high initial cost of cessation aids might create a financial barrier to cessation for low-income smokers. In the U.S., Medicaid provides health insurance coverage to low-income people, and in some states covers smoking cessation products. This paper uses nationally representative data of the U.S. to examine how the Medicaid coverage of cessation aids affect smoking behavior. The results indicate the Medicaid coverage of cessation products is positively associated with successful quitting among women aged 18–44. Full article
(This article belongs to the Special Issue Health Behavior and Public Health)
Open AccessArticle Seasonal and Spatial Variations of Indoor Pollen in a Hospital
Int. J. Environ. Res. Public Health 2009, 6(12), 3169-3178; doi:10.3390/ijerph6123169
Received: 19 November 2009 / Accepted: 5 December 2009 / Published: 10 December 2009
Cited by 13 | PDF Full-text (228 KB) | HTML Full-text | XML Full-text
Abstract
The airborne indoor pollen in a hospital of Badajoz (Spain) was monitored over two years using a personal Burkard sampler. The air was sampled in four places indoors—one closed room and one open ward on each of the ground and the third [...] Read more.
The airborne indoor pollen in a hospital of Badajoz (Spain) was monitored over two years using a personal Burkard sampler. The air was sampled in four places indoors—one closed room and one open ward on each of the ground and the third floors—and one place outdoors at the entrance to the hospital. The results were compared with data from a continuous volumetric sampler. While 32 pollen types were identified, nearly 75% of the total counts were represented by just five of them. These were: Quercus, Cupressaceae, Poaceae, Olea, and Plantago. The average indoor concentration was 25.2 grains/m3, and the average indoor/outdoor ratio was 0.27. A strong seasonal pattern was found, with the highest levels in spring and winter, and the indoor concentrations were correlated with the outdoor one. Indoor air movement led to great homogeneity in the airborne pollen presence: the indoor results were not influenced by whether or not the room was isolated, the floor level, or the number of people in or transiting the site during sampling. The presence of ornamental vegetation in the area surrounding the building affected the indoor counts directly as sources of the pollen. Full article
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Open AccessArticle An Exploratory Study of Diabetes in a First Nation Community with Respect to Serum Concentrations of p,p’-DDE and PCBs and Fish Consumption
Int. J. Environ. Res. Public Health 2009, 6(12), 3179-3189; doi:10.3390/ijerph6123179
Received: 4 November 2009 / Accepted: 2 December 2009 / Published: 11 December 2009
Cited by 38 | PDF Full-text (189 KB) | HTML Full-text | XML Full-text
Abstract
This study examined the association between self-reported diabetes, fish consumption and serum levels of organochlorines in a First Nation community. One quarter of the 101 participants reported diabetes. Serum PCBs, but not p,p’-DDE, were positively correlated to consumption frequency of total [...] Read more.
This study examined the association between self-reported diabetes, fish consumption and serum levels of organochlorines in a First Nation community. One quarter of the 101 participants reported diabetes. Serum PCBs, but not p,p’-DDE, were positively correlated to consumption frequency of total fish, walleye and pike, but not trout. Reported diabetes was positively associated to p,p’-DDE and some PCB congeners. Odds Ratios (OR) for reported diabetes for those in the upper 75th percentile for serum p,p’-DDE compared to the others were 3.5 (95% CI 1–13.8) and 6.1 (95% CI 1.4–27.3) (weight wet and lipid-standardized values, respectively) and for total sum of PCBs: 4.91 (95% CI 1.4–19.0) and 5.51 (95% CI 1.3–24.1). For participants who were in the upper 50th percentile for trout and white fish intake, reported diabetes was respectively 6 and 4 times lower compared to the others. These findings support the hypothesis that environmental exposure to elevated p,p’-DDE and PCBs is associated with increased risk of diabetes. Consumption of trout and white fish may be beneficial to reduce risk. Full article
Open AccessArticle Geo-Relationship between Cancer Cases and the Environment by GIS: A Case Study of Trabzon in Turkey
Int. J. Environ. Res. Public Health 2009, 6(12), 3190-3204; doi:10.3390/ijerph6123190
Received: 30 October 2009 / Accepted: 5 December 2009 / Published: 11 December 2009
Cited by 9 | PDF Full-text (947 KB) | HTML Full-text | XML Full-text
Abstract
Cancer is an important health issue in Turkey because it ranks as the second cause of death in the country. Examination of the relationships between the distribution of cancer cases and geo-environmental factors is significant in determining the causes of cancer. In [...] Read more.
Cancer is an important health issue in Turkey because it ranks as the second cause of death in the country. Examination of the relationships between the distribution of cancer cases and geo-environmental factors is significant in determining the causes of cancer. In this study, GIS were used to provide data about the distribution of cancer types in Trabzon province, Turkey. To determine the cancer occurrence density, the cancer incidence rates were calculated according to local census data, then a cancer density map was produced, and correlations between cancer types and geographical factors were examined. Full article
Open AccessArticle Externalities from Alcohol Consumption in the 2005 US National Alcohol Survey: Implications for Policy
Int. J. Environ. Res. Public Health 2009, 6(12), 3205-3224; doi:10.3390/ijerph6123205
Received: 19 October 2009 / Accepted: 5 December 2009 / Published: 11 December 2009
Cited by 21 | PDF Full-text (219 KB) | HTML Full-text | XML Full-text
Abstract
A subsample (n = 2,550) of the 2005 US National Alcohol Survey of adults was used to estimate prevalence and correlates of six externalities from alcohol abuse—family problems, assaults, accompanying intoxicated driver, vehicular accident, financial problems and vandalized property—all from another‘s drinking. [...] Read more.
A subsample (n = 2,550) of the 2005 US National Alcohol Survey of adults was used to estimate prevalence and correlates of six externalities from alcohol abuse—family problems, assaults, accompanying intoxicated driver, vehicular accident, financial problems and vandalized property—all from another‘s drinking. On a lifetime basis, 60% reported externalities, with a lower 12-month rate (9%). Women reported more family/marital and financial impacts and men more assaults, accompanying drunk drivers, and accidents. Being unmarried, older, white and ever having monthly heavy drinking or alcohol problems was associated with more alcohol externalities. Publicizing external costs of drinking could elevate political will for effective alcohol controls. Full article
(This article belongs to the Special Issue Environmental Research on Alcohol: Public Health Perspectives)
Open AccessArticle Access to Health Care and Religion among Young American Men
Int. J. Environ. Res. Public Health 2009, 6(12), 3225-3234; doi:10.3390/ijerph6123225
Received: 21 October 2009 / Accepted: 16 December 2009 / Published: 18 December 2009
Cited by 3 | PDF Full-text (191 KB) | HTML Full-text | XML Full-text
Abstract
In order to elucidate cultural correlates of utilization of primary health services by young adult men, we investigated religion in which one was raised and service utilization. Using data from a national survey we tested the hypothesis that religion raised predicts access to and utilization of a regular medical care provider, examinations, HIV and other STD testing and counseling at ages 18–44 years in men born between 1958 and 1984. We also hypothesized that religion raised would be more predictive of utilization for Hispanic Americans and non-Hispanic Black Americans than for non-Hispanic White Americans. The study included a national sample of 4276 men aged 18–44 years. Descriptive and multivariate statistics were used to assess the hypotheses using data on religion raised and responses to 14 items assessing health care access and utilization. Compared to those raised in no religion, those raised mainline Protestant were more likely (p < 0.01) to report a usual source of care (67% vs. 79%), health insurance coverage (66% vs. 80%) and physical examination (43% vs. 48%). Religion raised was not associated with testicular exams, STD counseling or HIV testing. In multivariate analyses controlling for confounders, significant associations of religion raised with insurance coverage, a physician as usual source of care and physical examination remained which varied by race/ethnicity. In conclusion, although religion is a core aspect of culture that deserves further study as a possible determinant of health care utilization, we were not able to document any consistent pattern of significant association even in a population with high rates of religious participation. Full article

Review

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Open AccessReview Health Economic Assessment: A Methodological Primer
Int. J. Environ. Res. Public Health 2009, 6(12), 2950-2966; doi:10.3390/ijerph6122950
Received: 12 October 2009 / Accepted: 23 November 2009 / Published: 27 November 2009
Cited by 29 | PDF Full-text (228 KB) | HTML Full-text | XML Full-text
Abstract
This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying [...] Read more.
This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments. Full article
(This article belongs to the Special Issue Health Economics)
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Open AccessReview Dental Caries Risk Studies Revisited: Causal Approaches Needed for Future Inquiries
Int. J. Environ. Res. Public Health 2009, 6(12), 2992-3009; doi:10.3390/ijerph6122992
Received: 30 September 2009 / Accepted: 25 November 2009 / Published: 30 November 2009
Cited by 7 | PDF Full-text (247 KB) | HTML Full-text | XML Full-text
Abstract
Prediction of high-risk individuals and the multi-risk approach are common inquiries in caries risk epidemiology. These studies prepared the ground for future studies; specific hypotheses about causal patterns can now be formulated and tested applying advanced statistical methods designed for causal studies, [...] Read more.
Prediction of high-risk individuals and the multi-risk approach are common inquiries in caries risk epidemiology. These studies prepared the ground for future studies; specific hypotheses about causal patterns can now be formulated and tested applying advanced statistical methods designed for causal studies, such as structural equation modeling, path analysis and multilevel modeling. Causal studies should employ measurements, analyses and interpretation of findings, which are in accordance to causal aims. Examples of causal empirical studies from medical and oral research are presented. Full article
(This article belongs to the Special Issue Advances in Epidemiology)
Open AccessReview Deadly Partners: Interdependence of Alcohol and Trauma in the Clinical Setting
Int. J. Environ. Res. Public Health 2009, 6(12), 3097-3104; doi:10.3390/ijerph6123097
Received: 23 October 2009 / Accepted: 2 December 2009 / Published: 4 December 2009
Cited by 6 | PDF Full-text (175 KB) | HTML Full-text | XML Full-text
Abstract
Trauma is the leading cause of death for Americans aged 1 to 45. Over a third of all fatal motor vehicle collisions and nearly eighty percent of completed suicides involve alcohol. Alcohol can be both a cause of traumatic injury as well [...] Read more.
Trauma is the leading cause of death for Americans aged 1 to 45. Over a third of all fatal motor vehicle collisions and nearly eighty percent of completed suicides involve alcohol. Alcohol can be both a cause of traumatic injury as well as a confounding factor in the diagnosis and treatment of the injured patient. Fortunately, brief interventions after alcohol-related traumatic events have been shown to decrease both trauma recidivism and long-term alcohol use. This review will address the epidemiology of alcohol-related trauma, the influence of alcohol on mortality and other outcomes, and the role of prevention in alcohol-related trauma, within the confines of the clinical setting. Full article
(This article belongs to the Special Issue Alcohol and Public Health)
Open AccessReview Alcoholism and Intimate Partner Violence: Effects on Children’s Psychosocial Adjustment
Int. J. Environ. Res. Public Health 2009, 6(12), 3156-3168; doi:10.3390/ijerph6123156
Received: 10 October 2009 / Accepted: 4 December 2009 / Published: 10 December 2009
Cited by 4 | PDF Full-text (171 KB) | HTML Full-text | XML Full-text
Abstract
It is widely recognized that alcoholism and relationship violence often have serious consequences for adults; however, children living with alcoholic parents are susceptible to the deleterious familial environments these caregivers frequently create. Given the prevalence of IPV among patients entering substance abuse [...] Read more.
It is widely recognized that alcoholism and relationship violence often have serious consequences for adults; however, children living with alcoholic parents are susceptible to the deleterious familial environments these caregivers frequently create. Given the prevalence of IPV among patients entering substance abuse treatment, coupled with the negative familial consequences associated with these types of behavior, this review explores what have been, to this point, two divergent lines of research: (a) the effects of parental alcoholism on children, and (b) the effects of children’s exposure to intimate partner violence. In this article, the interrelationship between alcoholism and IPV is examined, with an emphasis on the developmental impact of these behaviors (individually and together) on children living in the home and offers recommendations for future research directions. Full article
(This article belongs to the Special Issue Environmental Research on Alcohol: Public Health Perspectives)

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Open AccessCommentary Occupational Noise Exposure and Age Correction: The Problem of Selection Bias
Int. J. Environ. Res. Public Health 2009, 6(12), 3023-3024; doi:10.3390/ijerph6123023
Received: 10 September 2009 / Accepted: 29 November 2009 / Published: 1 December 2009
PDF Full-text (33 KB) | HTML Full-text | XML Full-text
Abstract
Selection bias often invalidates conclusions about populations based on clinical convenience samples. A recent paper in this journal [1] makes two surprising assertions about noise-induced permanent threshold shift (NIPTS): first, that there is more NIPTS at 2 kHz than at higher frequencies; [...] Read more.
Selection bias often invalidates conclusions about populations based on clinical convenience samples. A recent paper in this journal [1] makes two surprising assertions about noise-induced permanent threshold shift (NIPTS): first, that there is more NIPTS at 2 kHz than at higher frequencies; second, that NIPTS declines with advancing age. Neither assertion can be supported with the data presented, which were obtained from a clinical sample; both are consistent with the hypothesis that people who choose to attend an audiology clinic have worse hearing, especially at 2 kHz, than people of the same age and gender who choose not to attend. Full article

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