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Int. J. Environ. Res. Public Health, Volume 9, Issue 5 (May 2012), Pages 1523-1996

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Open AccessArticle High Prevalence of Metabolic Syndrome among Kuwaiti Adults —A Wake-Up Call for Public Health Intervention
Int. J. Environ. Res. Public Health 2012, 9(5), 1984-1996; https://doi.org/10.3390/ijerph9051984
Received: 20 April 2012 / Revised: 4 May 2012 / Accepted: 15 May 2012 / Published: 23 May 2012
Cited by 21 | PDF Full-text (270 KB) | HTML Full-text | XML Full-text
Abstract
The socio-economic development which followed the discovery of oil resources brought about considerable changes in the food habits and lifestyle of the Kuwaiti population. Excessive caloric intake and decreased energy expenditure due to a sedentary lifestyle have led to a rapid increase in
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The socio-economic development which followed the discovery of oil resources brought about considerable changes in the food habits and lifestyle of the Kuwaiti population. Excessive caloric intake and decreased energy expenditure due to a sedentary lifestyle have led to a rapid increase in obesity, diabetes and other non-communicable chronic diseases in the population. In this paper, we examine the prevalence of the Metabolic Syndrome (MetS) among Kuwaiti adults (≥20 years) using data from the first national nutrition survey conducted between July 2008 and November 2009. The prevalence of MetS was 37.7% in females and 34.2% in males by NCEP criteria, whereas the values were 40.1% in females and 41.7% in males according to IDF criteria. Prevalence of MetS increased with age and was higher in females than males. The high prevalence of the MetS in Kuwaiti adults warrants urgent public health measures to prevent morbidity and mortality due to cardiovascular complications in the future. Full article
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Open AccessArticle Using Physiologically-Based Pharmacokinetic Models to Incorporate Chemical and Non-Chemical Stressors into Cumulative Risk Assessment: A Case Study of Pesticide Exposures
Int. J. Environ. Res. Public Health 2012, 9(5), 1971-1983; https://doi.org/10.3390/ijerph9051971
Received: 26 March 2012 / Accepted: 11 April 2012 / Published: 22 May 2012
Cited by 5 | PDF Full-text (277 KB) | HTML Full-text | XML Full-text
Abstract
Cumulative risk assessment has been proposed as an approach to evaluate the health risks associated with simultaneous exposure to multiple chemical and non-chemical stressors. Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) models can allow for the inclusion and evaluation of multiple stressors, including non-chemical stressors, but
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Cumulative risk assessment has been proposed as an approach to evaluate the health risks associated with simultaneous exposure to multiple chemical and non-chemical stressors. Physiologically based pharmacokinetic/pharmacodynamic (PBPK/PD) models can allow for the inclusion and evaluation of multiple stressors, including non-chemical stressors, but studies have not leveraged PBPK/PD models to jointly consider these disparate exposures in a cumulative risk context. In this study, we focused on exposures to organophosphate (OP) pesticides for children in urban low-income environments, where these children would be simultaneously exposed to other pesticides (including pyrethroids) and non-chemical stressors that may modify the effects of these exposures (including diet). We developed a methodological framework to evaluate chemical and non-chemical stressor impacts on OPs, utilizing an existing PBPK/PD model for chlorpyrifos. We evaluated population-specific stressors that would influence OP doses or acetylcholinesterase (AChE) inhibition, the relevant PD outcome. We incorporated the impact of simultaneous exposure to pyrethroids and dietary factors on OP dose through the compartments of metabolism and PD outcome within the PBPK model, and simulated combinations of stressors across multiple exposure ranges and potential body weights. Our analyses demonstrated that both chemical and non-chemical stressors can influence the health implications of OP exposures, with up to 5-fold variability in AChE inhibition across combinations of stressor values for a given OP dose. We demonstrate an approach for modeling OP risks in the presence of other population-specific environmental stressors, providing insight about co-exposures and variability factors that most impact OP health risks and contribute to children’s cumulative health risk from pesticides. More generally, this framework can be used to inform cumulative risk assessment for any compound impacted by chemical and non-chemical stressors through metabolism or PD outcomes. Full article
(This article belongs to the Special Issue Cumulative Health Risk Assessment)
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Open AccessReview Smokefree Policies in Latin America and the Caribbean: Making Progress
Int. J. Environ. Res. Public Health 2012, 9(5), 1954-1970; https://doi.org/10.3390/ijerph9051954
Received: 18 March 2012 / Revised: 17 April 2012 / Accepted: 19 April 2012 / Published: 21 May 2012
Cited by 9 | PDF Full-text (179 KB) | HTML Full-text | XML Full-text
Abstract
We reviewed the adoption and implementation of smokefree policies in all Latin American and the Caribbean (LAC) countries. Significant progress has been achieved among LAC countries since the WHO Framework Convention on Tobacco Control (FCTC) was adopted in 2005. Both national and sub-national
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We reviewed the adoption and implementation of smokefree policies in all Latin American and the Caribbean (LAC) countries. Significant progress has been achieved among LAC countries since the WHO Framework Convention on Tobacco Control (FCTC) was adopted in 2005. Both national and sub-national legislation have provided effective mechanisms to increase the fraction of the population protected from secondhand tobacco smoke. Civil society has actively promoted these policies and played a main role in enacting them and monitoring their enforcement. The tobacco industry, while continuing to oppose the approval and regulation of the laws at legislative and executive levels, has gone a step further by litigating against them in the Courts. As in the US and elsewhere, this litigation has failed to stop the legislation. Full article
Open AccessArticle The Aryl Hydrocarbon Receptor Pathway: A Key Component of the microRNA-Mediated AML Signalisome
Int. J. Environ. Res. Public Health 2012, 9(5), 1939-1953; https://doi.org/10.3390/ijerph9051939
Received: 21 March 2012 / Revised: 27 April 2012 / Accepted: 8 May 2012 / Published: 18 May 2012
Cited by 10 | PDF Full-text (429 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Recent research has spotlighted the role of microRNAs (miRNAs) as critical epigenetic regulators of hematopoietic stem cell differentiation and leukemia development. Despite the recent advances in knowledge surrounding epigenetics and leukemia, the mechanisms underlying miRNAs’ influence on leukemia development have yet to be
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Recent research has spotlighted the role of microRNAs (miRNAs) as critical epigenetic regulators of hematopoietic stem cell differentiation and leukemia development. Despite the recent advances in knowledge surrounding epigenetics and leukemia, the mechanisms underlying miRNAs’ influence on leukemia development have yet to be clearly elucidated. Our aim was to identify high ranking biological pathways altered at the gene expression level and under epigenetic control. Specifically, we set out to test the hypothesis that miRNAs dysregulated in acute myeloid leukemia (AML) converge on a common pathway that can influence signaling related to hematopoiesis and leukemia development. We identified genes altered in AML patients that are under common regulation of seven key miRNAs. By mapping these genes to a global interaction network, we identified the “AML Signalisome”. The AML Signalisome comprises 53 AML-associated molecules, and is enriched for proteins that play a role in the aryl hydrocarbon receptor (AhR) pathway, a major regulator of hematopoiesis. Furthermore, we show biological enrichment for hematopoiesis-related proteins within the AML Signalisome. These findings provide important insight into miRNA-regulated pathways in leukemia, and may help to prioritize targets for disease prevention and treatment. Full article
(This article belongs to the Special Issue Leukemia Arising from Chemical Exposures and Chemotherapeutic Drugs)
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Open AccessArticle Wars and Suicides in Israel, 1948–2006
Int. J. Environ. Res. Public Health 2012, 9(5), 1927-1938; https://doi.org/10.3390/ijerph9051927
Received: 13 March 2012 / Accepted: 11 May 2012 / Published: 18 May 2012
Cited by 6 | PDF Full-text (87 KB) | HTML Full-text | XML Full-text
Abstract
This paper reports the characteristics of suicides which occurred during the existential and the non-existential wars in Israel. It provides a first approximation of whether the suicide patterns in each war are consistent with the findings of Morselli and Durkheim, and whether their
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This paper reports the characteristics of suicides which occurred during the existential and the non-existential wars in Israel. It provides a first approximation of whether the suicide patterns in each war are consistent with the findings of Morselli and Durkheim, and whether their theoretical interpretations can serve as a preliminary guideline to explaining the Israeli case, which is characterized by short periods of war, social integration during some of the non-existential wars, and a sharp rise in post-war male suicide rates following all of the existential wars. Implications for further studies on the subject in Israel and elsewhere are discussed. Full article
(This article belongs to the Special Issue Suicide Prevention and Public Health)
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Open AccessArticle Childhood and Adult Trauma Experiences of Incarcerated Persons and Their Relationship to Adult Behavioral Health Problems and Treatment
Int. J. Environ. Res. Public Health 2012, 9(5), 1908-1926; https://doi.org/10.3390/ijerph9051908
Received: 27 March 2012 / Revised: 28 April 2012 / Accepted: 2 May 2012 / Published: 18 May 2012
Cited by 39 | PDF Full-text (192 KB) | HTML Full-text | XML Full-text
Abstract
Rates of childhood and adult trauma are high among incarcerated persons. In addition to criminality, childhood trauma is associated with the risk for emotional disorders (e.g., depression and anxiety) and co-morbid conditions such as alcohol and drug abuse and antisocial behaviors in adulthood.
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Rates of childhood and adult trauma are high among incarcerated persons. In addition to criminality, childhood trauma is associated with the risk for emotional disorders (e.g., depression and anxiety) and co-morbid conditions such as alcohol and drug abuse and antisocial behaviors in adulthood. This paper develops rates of childhood and adult trauma and examines the impact of age-of-onset and type-specific trauma on emotional problems and behavior for a sample of incarcerated males (N~4,000). Prevalence estimates for types of trauma were constructed by age at time of trauma, race and types of behavioral health treatment received while incarcerated. HLM models were used to explore the association between childhood and adult trauma and depression, anxiety, substance use, interpersonal problems, and aggression problems (each model estimated separately and controlling for age, gender, race, time incarcerated, and index offense). Rates of physical, sexual, and emotional trauma were higher in childhood than adulthood and ranged from 44.7% (physical trauma in childhood) to 4.5% (sexual trauma in adulthood). Trauma exposure was found to be strongly associated with a wide range of behavioral problems and clinical symptoms. Given the sheer numbers of incarcerated men and the strength of these associations, targeted intervention is critical. Full article
(This article belongs to the Special Issue Trauma, Addiction and Criminality)
Open AccessArticle Assessment of Runoff and Sediment Yields Using the AnnAGNPS Model in a Three-Gorge Watershed of China
Int. J. Environ. Res. Public Health 2012, 9(5), 1887-1907; https://doi.org/10.3390/ijerph9051887
Received: 6 February 2012 / Revised: 26 March 2012 / Accepted: 29 April 2012 / Published: 16 May 2012
Cited by 7 | PDF Full-text (1461 KB) | HTML Full-text | XML Full-text
Abstract
Soil erosion has been recognized as one of the major threats to our environment and water quality worldwide, especially in China. To mitigate nonpoint source water quality problems caused by soil erosion, best management practices (BMPs) and/or conservation programs have been adopted. Watershed
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Soil erosion has been recognized as one of the major threats to our environment and water quality worldwide, especially in China. To mitigate nonpoint source water quality problems caused by soil erosion, best management practices (BMPs) and/or conservation programs have been adopted. Watershed models, such as the Annualized Agricultural Non-Point Source Pollutant Loading model (AnnAGNPS), have been developed to aid in the evaluation of watershed response to watershed management practices. The model has been applied worldwide and proven to be a very effective tool in identifying the critical areas which had serious erosion, and in aiding in decision-making processes for adopting BMPs and/or conservation programs so that cost/benefit can be maximized and non-point source pollution control can be achieved in the most efficient way. The main goal of this study was to assess the characteristics of soil erosion, sediment and sediment delivery of a watershed so that effective conservation measures can be implemented. To achieve the overall objective of this study, all necessary data for the 4,184 km2 Daning River watershed in the Three-Gorge region of the Yangtze River of China were assembled. The model was calibrated using observed monthly runoff from 1998 to 1999 (Nash-Sutcliffe coefficient of efficiency of 0.94 and R2 of 0.94) and validated using the observed monthly runoff from 2003 to 2005 (Nash-Sutcliffe coefficient of efficiency of 0.93 and R2 of 0.93). Additionally, the model was validated using annual average sediment of 2000–2002 (relative error of −0.34) and 2003–2004 (relative error of 0.18) at Wuxi station. Post validation simulation showed that approximately 48% of the watershed was under the soil loss tolerance released by the Ministry of Water Resources of China (500 t·km−2·y−1). However, 8% of the watershed had soil erosion of exceeding 5,000 t·km−2·y−1. Sloping areas and low coverage areas are the main source of soil loss in the watershed. Full article
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Open AccessArticle Mapping of Cu and Pb Contaminations in Soil Using Combined Geochemistry, Topography, and Remote Sensing: A Case Study in the Le’an River Floodplain, China
Int. J. Environ. Res. Public Health 2012, 9(5), 1874-1886; https://doi.org/10.3390/ijerph9051874
Received: 11 March 2012 / Revised: 20 April 2012 / Accepted: 23 April 2012 / Published: 16 May 2012
Cited by 7 | PDF Full-text (1158 KB) | HTML Full-text | XML Full-text
Abstract
Heavy metal pollution in soil is becoming a widely concerning environmental problem in China. The aim of this study is to integrate multiple sources of data, namely total Cu and Pb contents, digital elevation model (DEM) data, remote sensing image and interpreted land-use
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Heavy metal pollution in soil is becoming a widely concerning environmental problem in China. The aim of this study is to integrate multiple sources of data, namely total Cu and Pb contents, digital elevation model (DEM) data, remote sensing image and interpreted land-use data, for mapping the spatial distribution of total Cu and Pb contamination in top soil along the Le’an River and its branches. Combined with geographical analyses and watershed delineation, the source and transportation route of pollutants are identified. Regions at high risk of Cu or Pb pollution are suggested. Results reveal that topography is the major factor that controls the spatial distribution of Cu and Pb. Watershed delineation shows evidence that the streamflow resulting from rainfall is the major carrier of metal pollutants. Full article
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Open AccessArticle Seasonal and Diurnal Variations of Atmospheric Non-Methane Hydrocarbons in Guangzhou, China
Int. J. Environ. Res. Public Health 2012, 9(5), 1859-1873; https://doi.org/10.3390/ijerph9051859
Received: 4 April 2012 / Revised: 28 April 2012 / Accepted: 30 April 2012 / Published: 11 May 2012
Cited by 12 | PDF Full-text (310 KB) | HTML Full-text | XML Full-text
Abstract
In recent decades, high ambient ozone concentrations have become one of the major regional air quality issues in the Pearl River Delta (PRD) region. Non-methane hydrocarbons (NMHCs), as key precursors of ozone, were found to be the limiting factor in photochemical ozone formation
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In recent decades, high ambient ozone concentrations have become one of the major regional air quality issues in the Pearl River Delta (PRD) region. Non-methane hydrocarbons (NMHCs), as key precursors of ozone, were found to be the limiting factor in photochemical ozone formation for large areas in the PRD. For source apportioning of NMHCs as well as ozone pollution control strategies, it is necessary to obtain typical seasonal and diurnal patterns of NMHCs with a large pool of field data. To date, few studies have focused on seasonal and diurnal variations of NMHCs in urban areas of Guangzhou. This study explored the seasonal variations of most hydrocarbons concentrations with autumn maximum and spring minimum in Guangzhou. The diurnal variations of most anthropogenic NMHCs typically showed two-peak pattern with one at 8:00 in the morning and another at 20:00 in the evening, both corresponding to traffic rush hours in Guangzhou, whereas isoprene displayed a different bimodal diurnal curve. Propene, ethene, m, p-xylene and toluene were the four largest contributors to ozone formation in Guangzhou, based on the evaluation of individual NMHCs’ photochemical reactivity. Therefore, an effective strategy for controlling ozone pollution may be achieved by the reduction of vehicle emissions in Guangzhou. Full article
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Open AccessCommunication Breast Cancer Risk, Fungicide Exposure and CYP1A1*2A Gene-Environment Interactions in a Province-Wide Case Control Study in Prince Edward Island, Canada
Int. J. Environ. Res. Public Health 2012, 9(5), 1846-1858; https://doi.org/10.3390/ijerph9051846
Received: 27 February 2012 / Revised: 16 April 2012 / Accepted: 7 May 2012 / Published: 11 May 2012
Cited by 8 | PDF Full-text (191 KB) | HTML Full-text | XML Full-text
Abstract
Scientific certainty regarding environmental toxin-related etiologies of breast cancer, particularly among women with genetic polymorphisms in estrogen metabolizing enzymes, is lacking. Fungicides have been recognized for their carcinogenic potential, yet there is a paucity of epidemiological studies examining the health risks of these
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Scientific certainty regarding environmental toxin-related etiologies of breast cancer, particularly among women with genetic polymorphisms in estrogen metabolizing enzymes, is lacking. Fungicides have been recognized for their carcinogenic potential, yet there is a paucity of epidemiological studies examining the health risks of these agents. The association between agricultural fungicide exposure and breast cancer risk was examined in a secondary analysis of a province-wide breast cancer case-control study in Prince Edward Island (PEI) Canada. Specific objectives were: (1) to derive and examine the level of association between estimated fungicide exposures, and breast cancer risk among women in PEI; and (2) to assess the potential for gene-environment interactions between fungicide exposure and a CYP1A1 polymorphism in cases versus controls. After 1:3 matching of 207 cases to 621 controls by age, family history of breast cancer and menopausal status, fungicide exposure was not significantly associated with an increased risk of breast cancer (OR = 0.74; 95% CI: 0.46–1.17). Moreover, no statistically significant interactions between fungicide exposure and CYP1A1*2A were observed. Gene-environment interactions were identified. Though interpretations of findings are challenged by uncertainty of exposure assignment and small sample sizes, this study does provide grounds for further research. Full article
Open AccessArticle Patient Follow-Up After Participating in a Beach-Based Skin Cancer Screening Program
Int. J. Environ. Res. Public Health 2012, 9(5), 1836-1845; https://doi.org/10.3390/ijerph9051836
Received: 16 March 2012 / Revised: 25 April 2012 / Accepted: 2 May 2012 / Published: 10 May 2012
Cited by 1 | PDF Full-text (140 KB) | HTML Full-text | XML Full-text
Abstract
Many skin cancer screenings occur in non-traditional community settings, with the beach being an important setting due to beachgoers being at high risk for skin cancer. This study is a secondary analysis of data from a randomized trial of a skin cancer intervention
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Many skin cancer screenings occur in non-traditional community settings, with the beach being an important setting due to beachgoers being at high risk for skin cancer. This study is a secondary analysis of data from a randomized trial of a skin cancer intervention in which participants (n = 312) had a full-body skin examination by a clinician and received a presumptive diagnosis (abnormal finding, no abnormal finding). Participants’ pursuit of follow-up was assessed post-intervention (n = 283). Analyses examined: (1) participant’s recall of screening results; and (2) whether cognitive and behavioral variables were associated with follow-up being as advised. Just 12% of participants (36/312) did not correctly recall the results of their skin examination. One-third (33%, 93/283) of participants’ follow-up was classified as being not as advised (recommend follow-up not pursued, unadvised follow-up pursued). Among participants whose follow-up was not as advised, 71% (66/93) did not seek recommended care. None of the measured behavioral and cognitive variables were significantly associated with recall of screening examination results or whether follow-up was as advised. Research is needed to determine what factors are associated with follow-up being as advised and to develop messages that increase receipt of advised follow-up care. Full article
(This article belongs to the Special Issue Sunbathing Habits and Skin Cancer)
Open AccessArticle Application of a Novel Method for Assessing Cumulative Risk Burden by County
Int. J. Environ. Res. Public Health 2012, 9(5), 1820-1835; https://doi.org/10.3390/ijerph9051820
Received: 31 March 2012 / Revised: 28 April 2012 / Accepted: 2 May 2012 / Published: 10 May 2012
Cited by 9 | PDF Full-text (1811 KB) | HTML Full-text | XML Full-text
Abstract
The purpose of this study is to apply the Human Security Index (HSI) as a tool to detect social and economic cumulative risk burden at a county-level in the state of Texas. The HSI is an index comprising a network of three sub-components
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The purpose of this study is to apply the Human Security Index (HSI) as a tool to detect social and economic cumulative risk burden at a county-level in the state of Texas. The HSI is an index comprising a network of three sub-components or “fabrics”; the Economic, Environmental, and Social Fabrics. We hypothesized that the HSI will be a useful instrument for identifying and analyzing socioeconomic conditions that contribute to cumulative risk burden in vulnerable counties. We expected to identify statistical associations between cumulative risk burden and (a) ethnic concentration and (b) geographic proximity to the Texas-Mexico border. Findings from this study indicate that the Texas-Mexico border region did not have consistently higher total or individual fabric scores as would be suggested by the high disease burden and low income in this region. While the Economic, Environmental, Social Fabrics (including the Health subfabric) were highly associated with Hispanic ethnic concentration, the overall HSI and the Crime subfabric were not. In addition, the Education, Health and Crime subfabrics were associated with African American racial composition, while Environment, Economic and Social Fabrics were not. Application of the HSI to Texas counties provides a fuller and more nuanced understanding of socioeconomic and environmental conditions, and increases awareness of the role played by environmental, economic, and social factors in observed health disparities by race/ethnicity and geographic region. Full article
(This article belongs to the Special Issue Cumulative Health Risk Assessment)
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Open AccessArticle Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors
Int. J. Environ. Res. Public Health 2012, 9(5), 1810-1819; https://doi.org/10.3390/ijerph9051810
Received: 7 March 2012 / Revised: 20 April 2012 / Accepted: 26 April 2012 / Published: 9 May 2012
Cited by 31 | PDF Full-text (177 KB) | HTML Full-text | XML Full-text
Abstract
Association between common mental disorders (CMDs), equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and
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Association between common mental disorders (CMDs), equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. This paper reports a population-based epidemiological survey of a rural area in Kenya. A random sample of 2% of all adults living in private households in Maseno, Kisumu District of Nyanza Province, Kenya (50,000 population), were studied. The Clinical Interview Schedule-Revised (CIS-R) was used to determine the prevalence of common mental disorders (CMDs). Associations with socio-demographic and economic characteristics were explored. A CMD prevalence of 10.8% was found, with no gender difference. Higher rates of illness were found in those who were of older age and those in poor physical health. We conclude that CMDs are common in Kenya and rates are elevated among people who are older, and those in poor health. Full article
Open AccessReview Is Early Puberty Triggered by Catch-Up Growth Following Undernutrition?
Int. J. Environ. Res. Public Health 2012, 9(5), 1791-1809; https://doi.org/10.3390/ijerph9051791
Received: 23 March 2012 / Revised: 19 April 2012 / Accepted: 30 April 2012 / Published: 9 May 2012
Cited by 11 | PDF Full-text (210 KB) | HTML Full-text | XML Full-text
Abstract
Undernutrition during fetal and postnatal life is still a major problem in many low- and middle-income countries. Even in high-income countries malnutrition may exist in cases of intrauterine growth retardation, as well as in chronic conditions such as anorexia nervosa and inflammatory bowel
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Undernutrition during fetal and postnatal life is still a major problem in many low- and middle-income countries. Even in high-income countries malnutrition may exist in cases of intrauterine growth retardation, as well as in chronic conditions such as anorexia nervosa and inflammatory bowel disease. Children adopted from developing countries are often chronically malnourished. Nutritional rehabilitation, resulting in catch-up growth, is often complicated by influences originating in fetal life as well as during postnatal growth. This may result in hormonal and metabolic changes as well as alterations in pubertal development. The present review focuses on fetal, postnatal and fetal-postnatal undernutrition and subsequent catch-up growth as well as catch-up growth in relation to pubertal development. Catch-up growth in children can be associated with early puberty following fetal or combined fetal-postnatal undernutrition. However, early puberty does not seem to occur following catch-up growth after isolated postnatal undernutrition. Gonadotropins have been reported to be elevated in prepubertal adopted girls as well as during catch-up growth in animals. Even if other factors may contribute, linear catch-up growth seems to be associated with the timing of pubertal development. The mechanisms behind this are still unknown. Future research may elucidate how to carry out nutritional rehabilitation without risk for early pubertal development. Full article
(This article belongs to the Special Issue Malnutrition and Public Health)
Open AccessArticle Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River
Int. J. Environ. Res. Public Health 2012, 9(5), 1771-1790; https://doi.org/10.3390/ijerph9051771
Received: 30 March 2012 / Revised: 12 April 2012 / Accepted: 20 April 2012 / Published: 7 May 2012
Cited by 6 | PDF Full-text (1738 KB) | HTML Full-text | XML Full-text
Abstract
Waterborne gastrointestinal (GI) illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be
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Waterborne gastrointestinal (GI) illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be used as proxy for drinking water contamination. We compare seasonal patterns of GI illnesses in the elderly (65 years and older) along the Ohio River for a 14-year period (1991–2004) to seasonal patterns of streamflow. Focusing on six counties in close proximity to the river, we compiled weekly time series of hospitalizations for GI illnesses and streamflow data. Seasonal patterns were explored using Poisson annual harmonic regression with and without adjustment for streamflow. GI illnesses demonstrated significant seasonal patterns with peak timing preceding peak timing of streamflow for all six counties. Seasonal patterns of illness remain consistent after adjusting for streamflow. This study found that the time of peak GI illness precedes the peak of streamflow, suggesting either an indirect relationship or a more direct path whereby pathogens enter water supplies prior to the peak in streamflow. Such findings call for interdisciplinary research to better understand associations among streamflow, pathogen loading, and rates of gastrointestinal illnesses. Full article
(This article belongs to the Special Issue Drinking Water and Health)
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