International Journal of Environmental Research and Public Health

10 pages, 561 KiB

Open AccessConference Report

The Oglala Sioux Tribe CHOICES Program: Modifying an Existing Alcohol-Exposed Pregnancy Intervention for Use in an American Indian Community

by Jessica D. Hanson^1,* and Susan Pourier²

¹ Sanford Research, 2301 E. 60th St North, Sioux Falls, SD 57104, USA

² OST CHOICES Program, PO Box 824, Pine Ridge, SD 57770, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 1; https://doi.org/10.3390/ijerph13010001 - 22 Dec 2015

Cited by 23 | Viewed by 5082

Abstract

Alcohol-exposed pregnancies are a health issue for many American Indian communities. The goal of this manuscript is to outline how an existing alcohol-exposed pregnancy prevention program with non-pregnant women (Project CHOICES) was modified to fit the needs and norms of an American Indian [...] Read more.

Alcohol-exposed pregnancies are a health issue for many American Indian communities. The goal of this manuscript is to outline how an existing alcohol-exposed pregnancy prevention program with non-pregnant women (Project CHOICES) was modified to fit the needs and norms of an American Indian community. The Oglala Sioux Tribe CHOICES Program was developed and implemented using community feedback through initial meetings, reviewing materials, gathering input into recruitment and intervention logistics, and conducting interviews to evaluate the program. The intervention was implemented and has been enrolling non-pregnant American Indian women for the past several years. While data collection is ongoing, it has shown preliminary success in changing behaviors and in impacting how the community views the prevention of alcohol-exposed pregnancies. Overall, this study highlights the potential to expand this prevention program to other sites and with other populations, such as adolescents. By the end of this article, readers will comprehend the steps necessary to replicate such a program at other tribal and rural sites. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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11 pages, 800 KiB

Open AccessArticle

Statistical Validation of a Web-Based GIS Application and Its Applicability to Cardiovascular-Related Studies

by Jae Eun Lee^1,2,*, Jung Hye Sung^1,2 and Mohamad Malouhi¹

¹ Research Centers in Minority Institutions Translational Research Network Data Coordinating Center, 1230 Raymond Road, Jackson, MS 39204, USA

² Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, 350 W. Woodrow Wilson Drive Jackson Medical Mall, Suite 301, Jackson, MS 39213, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 2; https://doi.org/10.3390/ijerph13010002 - 22 Dec 2015

Cited by 11 | Viewed by 5071

Abstract

Purpose: There is abundant evidence that neighborhood characteristics are significantly linked to the health of the inhabitants of a given space within a given time frame. This study is to statistically validate a web-based GIS application designed to support cardiovascular-related research developed by [...] Read more.

Purpose: There is abundant evidence that neighborhood characteristics are significantly linked to the health of the inhabitants of a given space within a given time frame. This study is to statistically validate a web-based GIS application designed to support cardiovascular-related research developed by the NIH funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) and discuss its applicability to cardiovascular studies. Methods: Geo-referencing, geocoding and geospatial analyses were conducted for 500 randomly selected home addresses in a U.S. southeastern Metropolitan area. The correlation coefficient, factor analysis and Cronbach’s alpha (α) were estimated to quantify measures of the internal consistency, reliability and construct/criterion/discriminant validity of the cardiovascular-related geospatial variables (walk score, number of hospitals, fast food restaurants, parks and sidewalks). Results: Cronbach’s α for CVD GEOSPATIAL variables was 95.5%, implying successful internal consistency. Walk scores were significantly correlated with number of hospitals (r = 0.715; p < 0.0001), fast food restaurants (r = 0.729; p < 0.0001), parks (r = 0.773; p < 0.0001) and sidewalks (r = 0.648; p < 0.0001) within a mile from homes. It was also significantly associated with diversity index (r = 0.138, p = 0.0023), median household incomes (r = −0.181; p < 0.0001), and owner occupied rates (r = −0.440; p < 0.0001). However, its non-significant correlation was found with median age, vulnerability, unemployment rate, labor force, and population growth rate. Conclusion: Our data demonstrates that geospatial data generated by the web-based application were internally consistent and demonstrated satisfactory validity. Therefore, the GIS application may be useful to apply to cardiovascular-related studies aimed to investigate potential impact of geospatial factors on diseases and/or the long-term effect of clinical trials. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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13 pages, 460 KiB

Open AccessArticle

Improving the Neighborhood Environment for Urban Older Adults: Social Context and Self-Rated Health

by Arlesia Mathis^1,*, Ronica Rooks² and Daniel Kruger³

¹ Institute of Public Health, Florida A&M University, 1515 MLK Boulevard, Tallahassee, FL 32307, USA

² Department of Health and Behavioral Sciences, University of Colorado Denver, P.O. Box 173364, CB 188, Denver, CO 80217, USA

³ Prevention Research Center of Michigan, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI 48109, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 3; https://doi.org/10.3390/ijerph13010003 - 22 Dec 2015

Cited by 19 | Viewed by 5838

Abstract

Objective: By 2030, older adults will account for 20% of the U.S. population. Over 80% of older adults live in urban areas. This study examines associations between neighborhood environment and self-rated health (SRH) among urban older adults. Methods: We selected 217 [...] Read more.

Objective: By 2030, older adults will account for 20% of the U.S. population. Over 80% of older adults live in urban areas. This study examines associations between neighborhood environment and self-rated health (SRH) among urban older adults. Methods: We selected 217 individuals aged 65+ living in a deindustrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and self-rated health (SRH) was analyzed using regression and GIS models. Neighborhood variables included social support and participation, perceived racism and crime. Additional models included actual crime indices to compare differences between perceived and actual crime. Results: Seniors who have poor SRH are 21% more likely to report fear of crime than seniors with excellent SRH (p = 0.01). Additional analyses revealed Black seniors are 7% less likely to participate in social activities (p = 0.005) and 4% more likely to report experiencing racism (p < 0.001). Discussion: Given the increasing numbers of older adults living in urban neighborhoods, studies such as this one are important for well-being among seniors. Mitigating environmental influences in the neighborhood which are associated with poor SRH may allow urban older adults to maintain health and reduce disability. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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10 pages, 219 KiB

Open AccessArticle

Community-Based Participatory Research Integrates Behavioral and Biological Research to Achieve Health Equity for Native Hawaiians

by Claire K. M. Townsend^1,*, Adrienne Dillard^2,†, Kelsea K. Hosoda^1,†, Gregory G. Maskarinec¹, Alika K. Maunakea¹, Sheryl R. Yoshimura³, Claire Hughes⁴, Donna-Marie Palakiko⁵, Bridget Puni Kehauoha² and Joseph Keawe‘aimoku Kaholokula¹

¹ Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Mānoa, 651 Ilalo Street, MEB 307L, Honolulu, HI 96813, USA

² Kula no na Po‘e Hawai‘i, P.O. Box 2368, Honolulu, HI 96823, USA

³ Kōkua Kalihi Valley Comprehensive Family Services, 2239 N. School Street, Honolulu, HI 96819, USA

⁴ Hawai‘i Maoli, Association of Hawaiian Civic Clubs, P.O. Box 3866 Honolulu, HI 96812, USA

⁵ Ke Ola Mamo, Dillingham Plaza, 1505 Dillingham Blvd #205, Honolulu, HI 96817, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 4; https://doi.org/10.3390/ijerph13010004 - 22 Dec 2015

Cited by 22 | Viewed by 6127

Abstract

Native Hawaiians bear a disproportionate burden of type-2 diabetes and related complications compared to all other groups in Hawai‘i (e.g., Whites, Japanese, Korean). Distrust in these communities is a significant barrier to participation in epigenetic research studies seeking to better understand disease processes. [...] Read more.

Native Hawaiians bear a disproportionate burden of type-2 diabetes and related complications compared to all other groups in Hawai‘i (e.g., Whites, Japanese, Korean). Distrust in these communities is a significant barrier to participation in epigenetic research studies seeking to better understand disease processes. The purpose of this paper is to describe the community-based participatory research (CBPR) approach and research process we employed to integrate behavior and biological sciences with community health priorities. A CBPR approach was used to test a 3-month evidence-based, diabetes self-management intervention (N = 65). To investigate the molecular mechanisms linking inflammation with glucose homeostasis, a subset of participants (n = 16) provided peripheral blood mononuclear cells. Community and academic researchers collaborated on research design, assessment protocols, and participant recruitment, prioritizing participants’ convenience and education and strictly limiting the use of the data collected. Preliminary results indicate significant changes in DNA methylation at gene regions associated with inflammation and diabetes signaling pathways and significant improvements in hemoglobin A1c, self-care activities, and diabetes distress and understanding. This study integrates community, behavioral, and epigenomic expertise to better understand the outcomes of a diabetes self-management intervention. Key lessons learned suggest the studies requiring biospecimen collection in indigenous populations require community trust of the researchers, mutual benefits for the community and researchers, and for the researchers to prioritize the community’s needs. CBPR may be an important tool in providing communities the voice and protections to participate in studies requiring biospecimens. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

11 pages, 992 KiB

Open AccessReview

Cellular Mechanisms of Action of Drug Abuse on Olfactory Neurons

by Thomas Heinbockel^*

and Ze-Jun Wang

Department of Anatomy, College of Medicine, Howard University, Washington, DC 20059, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 5; https://doi.org/10.3390/ijerph13010005 - 22 Dec 2015

Cited by 8 | Viewed by 6208

Abstract

Cannabinoids (Δ9-tetrahydrocannabinol) are the active ingredient of marijuana (cannabis) which is the most commonly abused illicit drug in the USA. In addition to being known and used as recreational drugs, cannabinoids are produced endogenously by neurons in the brain (endocannabinoids) and serve as [...] Read more.

Cannabinoids (Δ9-tetrahydrocannabinol) are the active ingredient of marijuana (cannabis) which is the most commonly abused illicit drug in the USA. In addition to being known and used as recreational drugs, cannabinoids are produced endogenously by neurons in the brain (endocannabinoids) and serve as important signaling molecules in the nervous system and the rest of the body. Cannabinoids have been implicated in bodily processes both in health and disease. Recent pharmacological and physiological experiments have described novel aspects of classic brain signaling mechanisms or revealed unknown mechanisms of cellular communication involving the endocannabinoid system. While several forms of signaling have been described for endocannabinoids, the most distinguishing feature of endocannabinoids is their ability to act as retrograde messengers in neural circuits. Neurons in the main olfactory bulb express high levels of cannabinoid receptors. Here, we describe the cellular mechanisms and function of this novel brain signaling system in regulating neural activity at synapses in olfactory circuits. Results from basic research have the potential to provide the groundwork for translating the neurobiology of drug abuse to the realm of the pharmacotherapeutic treatment of addiction, specifically marijuana substance use disorder. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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15 pages, 346 KiB

Open AccessArticle

African American Women: Surviving Breast Cancer Mortality against the Highest Odds

by Shelley White-Means^1,*, Muriel Rice², Jill Dapremont³, Barbara Davis⁴ and Judy Martin⁵

¹ Department of Clinical Pharmacy, University of Tennessee Health Science Center, 881 Madison, Suite 202, Memphis, TN 38163, USA

² Mustard Seed, Inc., 653 Mississippi Blvd, Memphis, TN 38126, USA

³ Loewenberg School of Nursing, University of Memphis, 3567 Community Health Building, Memphis, TN 38152, USA

⁴ Department of Management, Fogelman College of Business and Economics, University of Memphis, Memphis, TN 38152, USA

⁵ Shelby County Health Department, Memphis, TN 38105, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 6; https://doi.org/10.3390/ijerph13010006 - 22 Dec 2015

Cited by 13 | Viewed by 6601

Abstract

Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during [...] Read more.

Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings) would impact how women cope with breast cancer and respond to information about its diagnosis. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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15 pages, 370 KiB

Open AccessArticle

“That’s True Love:” Lived Experiences of Puerto Rican Perinatally HIV-Infected Youth within Their Families’ Context

by Georgina Silva-Suárez^1,*

, Elena Bastida², Silvia E. Rabionet³, Consuelo Beck-Sagué², Irma Febo⁴ and Carmen D. Zorrilla⁵

¹ Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University, 00926 San Juan, Puerto Rico

² Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL 33199, USA

³ Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University, 33314, Fort Lauderdale, FL & Department of Social Science, School of Public Health, University of Puerto Rico, Medical Sciences Campus, 00921 San Juan, Puerto Rico

⁴ Department of Pediatrics, University of Puerto Rico, Medical Sciences Campus, 00921 San Juan, Puerto Rico

⁵ Department of Obstetrics and Gynecology, University of Puerto Rico, Medical Sciences Campus, 00921 San Juan, Puerto Rico

Int. J. Environ. Res. Public Health 2016, 13(1), 7; https://doi.org/10.3390/ijerph13010007 - 22 Dec 2015

Cited by 8 | Viewed by 6267

Abstract

The burden of HIV affects not only HIV-infected patients but also their families and caregivers. It is also known that family support is crucial for people living with HIV. A qualitative study was conducted to explore the life experiences, within the family context, [...] Read more.

The burden of HIV affects not only HIV-infected patients but also their families and caregivers. It is also known that family support is crucial for people living with HIV. A qualitative study was conducted to explore the life experiences, within the family context, of perinatally HIV-infected (pHIV-I) youth in Puerto Rico. Twenty in-depth interviews were performed and audio-recorded. Within the family context, study participants experienced acceptance, love and support but also stigma and discrimination. They reported that family is an essential component in their lives and treatment. Losing one or both parents at a young age was considered more difficult than having HIV. Most participants who lost their parents lived with other family members. This was a challenging situation for both pHIV-I youth and their caregivers. Participants described their healthcare providers as part of their families and would like to keep in touch as they transition to adult care. Despite the challenges, participants expressed a desire to have children. Services targeted to this population should stress social support, incorporate family members into the medical process, provide special guidance and support while transitioning to adult care, and provide them with the latest information regarding HIV and reproductive options. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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13 pages, 1542 KiB

Open AccessArticle

Ethnic Differences in Maternal Adipokines during Normal Pregnancy

by Xinhua Chen^*

and Theresa O. Scholl

Department of Obstetrics and Gynecology, School of Osteopathic Medicine, Rowan University, Two Medical Center Drive, Suite 390, Stratford, NJ 08084, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 8; https://doi.org/10.3390/ijerph13010008 - 22 Dec 2015

Cited by 12 | Viewed by 4546

Abstract

Two adipokines (adiponectin and resistin) have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood [...] Read more.

Two adipokines (adiponectin and resistin) have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood pressure and anthropometric parameters. Pregnant women (n = 1634) were from a large prospective cohort study in Camden NJ (African-American 36.8%; Hispanic 47.6%; Caucasian 15.6%). Serum adiponectin and resistin were measured at entry (week 16.8) and the 3rd trimester (week 30.7) using the Luminex xMapTechnology. Significant differences were observed among ethnic groups, controlling for confounding variables. African American women were exceptional in that they had decreased adiponectin and increased resistin throughout the course of pregnancy (p < 0.05 to p < 0.0001) and a greater than two fold risk of simultaneously exhibiting low adiponectin (lowest tertile) and high resistin (highest tertile) compared to Caucasians and/or Hispanics. The cohort as a whole and each ethnic group showed similar negative correlations between adiponectin, and glucose homeostasis, blood pressure and anthropometric parameters but there was lesser correspondence with resistin. Our data underscore the need for further research on ethnic variation in adipokines and other physiologic biomarkers during complicated and uncomplicated pregnancy. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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13 pages, 373 KiB

Open AccessArticle

Black–White Latino Racial Disparities in HIV Survival, Florida, 2000–2011

by Diana M. Sheehan^1,†, Mary Jo Trepka^1,*,†, Kristopher P. Fennie^2,†, Guillermo Prado³, Miguel Ángel Cano²

and Lorene M. Maddox⁴

¹ Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD) and Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA

² Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., Miami, FL 33199, USA

³ Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th St., Miami, FL 33136, USA

⁴ HIV/AIDS Section, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 9; https://doi.org/10.3390/ijerph13010009 - 22 Dec 2015

Cited by 13 | Viewed by 5333

Abstract

This research aimed to estimate Black/White racial disparities in all-cause mortality risk among HIV-positive Latinos. Florida surveillance data for Latinos diagnosed with HIV (2000–2008) were merged with 2007–2011 American Community Survey data. Crude and adjusted hazard ratios (aHR) were calculated using multi-level Cox [...] Read more.

This research aimed to estimate Black/White racial disparities in all-cause mortality risk among HIV-positive Latinos. Florida surveillance data for Latinos diagnosed with HIV (2000–2008) were merged with 2007–2011 American Community Survey data. Crude and adjusted hazard ratios (aHR) were calculated using multi-level Cox regression. Of 10,903 HIV-positive Latinos, 8.2% were Black and 91.9% White. Black Latinos were at increased mortality risk compared with White Latinos after controlling for individual and neighborhood factors (aHR 1.40, 95% confidence interval (CI) 1.21–1.62). In stratified analyses, risk factors for Black Latinos included: age ≥60 years compared with ages 13–19 (aHR 4.63, 95% CI 1.32–16.13); US birth compared with foreign birth (aHR 1.56, 95% CI 1.16–2.11); diagnosis of AIDS within three months of HIV diagnosis (aHR 3.53, 95% CI 2.64–4.74); residence in the 3rd (aHR 1.82, 95% CI 1.13–2.94) and 4th highest quartiles (aHR 1.79, 95% CI 1.12–2.86) of neighborhood poverty compared with the lowest quartile; and residence in neighborhood with 25%–49% (aHR 1.59, 95% CI 1.07–2.42) and ≥50% Latinos compared with <25% Latinos (aHR 1.58, 95% CI 1.03–2.42). Significant racial disparities in HIV survival exist among Latinos. Differential access to—and quality of—care and perceived/experienced racial discrimination may be possible explanations. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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17 pages, 3613 KiB

Open AccessArticle

Glyceollin I Reverses Epithelial to Mesenchymal Transition in Letrozole Resistant Breast Cancer through ZEB1

by Patrick P. Carriere^1,†, Shawn D. Llopis^1,†, Anna C. Naiki¹, Gina Nguyen¹, Tina Phan¹, Mary M. Nguyen¹, Lynez C. Preyan¹, Letitia Yearby¹, Jamal Pratt¹, Hope Burks², Ian R. Davenport³, Thu A. Nguyen¹, KiTani Parker-Lemieux¹, Florastina Payton-Stewart⁴, Christopher C. Williams¹, Stephen M. Boué⁵, Matthew E. Burow², Bridgette Collins-Burow², Aaron Hilliard⁶, A. Michael Davidson⁶ and Syreeta L. Tilghman^6,* Show full author list Hide full author list

¹ College of Pharmacy, Xavier University of Louisiana, 1 Drexel Drive, New Orleans, LA 70125, USA

² Tulane University Health Sciences Center, 1430 Tulane Ave, New Orleans, LA 70112, USA

³ Division of Biological and Public Health Sciences, College of Arts and Sciences, Xavier University of Louisiana, 1 Drexel Drive, New Orleans, LA 70125, USA

⁴ Division of Mathematical and Physical Sciences, College of Arts and Sciences, Xavier University of Louisiana, 1 Drexel Drive, New Orleans, LA 70125, USA

⁵ Southern Regional Research Center, United States Department of Agriculture, New Orleans, LA 70124, USA

⁶ Division of Basic Sciences, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, 1415 S. Martin L. King Jr. Blvd., Tallahassee, FL 32307, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 10; https://doi.org/10.3390/ijerph13010010 - 22 Dec 2015

Cited by 19 | Viewed by 5893

Abstract

Although aromatase inhibitors are standard endocrine therapy for postmenopausal women with early-stage metastatic estrogen-dependent breast cancer, they are limited by the development of drug resistance. A better understanding of this process is critical towards designing novel strategies for disease management. Previously, we demonstrated [...] Read more.

Although aromatase inhibitors are standard endocrine therapy for postmenopausal women with early-stage metastatic estrogen-dependent breast cancer, they are limited by the development of drug resistance. A better understanding of this process is critical towards designing novel strategies for disease management. Previously, we demonstrated a global proteomic signature of letrozole-resistance associated with hormone-independence, enhanced cell motility and implications of epithelial mesenchymal transition (EMT). Letrozole-resistant breast cancer cells (LTLT-Ca) were treated with a novel phytoalexin, glyceollin I, and exhibited morphological characteristics synonymous with an epithelial phenotype and decreased proliferation. Letrozole-resistance increased Zinc Finger E-Box Binding Homeobox 1 (ZEB1) expression (4.51-fold), while glyceollin I treatment caused a −3.39-fold reduction. Immunofluorescence analyses resulted of glyceollin I-induced increase and decrease in E-cadherin and ZEB1, respectively. In vivo studies performed in ovariectomized, female nude mice indicated that glyceollin treated tumors stained weakly for ZEB1 and N-cadherin and strongly for E-cadherin. Compared to letrozole-sensitive cells, LTLT-Ca cells displayed enhanced motility, however in the presence of glyceollin I, exhibited a 68% and 83% decrease in invasion and migration, respectively. These effects of glyceollin I were mediated in part by inhibition of ZEB1, thus indicating therapeutic potential of glyceollin I in targeting EMT in letrozole resistant breast cancer. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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24 pages, 6073 KiB

Open AccessArticle

Application of Citizen Science Risk Communication Tools in a Vulnerable Urban Community

by Yuqin Jiao¹, Julie K. Bower², Wansoo Im³, Nicholas Basta⁴, John Obrycki⁴, Mohammad Z. Al-Hamdan⁵, Allison Wilder¹, Claire E. Bollinger¹, Tongwen Zhang¹, Luddie Sr. Hatten⁶, Jerrie Hatten⁶ and Darryl B. Hood^1,*

¹ Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA

² Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA

³ VERTICES, LLC 303 George Street Suite 406, New Brunswick, NJ 08901, USA

⁴ Environmental Science Graduate Program, School of Environment and Natural Resources, The Ohio State University, Columbus, OH 43210, USA

⁵ Universities Space Research Association at NASA Marshall Space Flight Center, Huntsville, AL 35805, USA

⁶ Stambaugh-Elwood Citizens for the Environment, LLC Columbus, OH 43207, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 11; https://doi.org/10.3390/ijerph13010011 - 22 Dec 2015

Cited by 24 | Viewed by 8191

Abstract

A public participatory geographical information systems (PPGIS) demographic, environmental, socioeconomic, health status portal was developed for the Stambaugh-Elwood (SE) community in Columbus, OH. We hypothesized that soil at SE residences would have metal concentrations above natural background levels. Three aims were developed that [...] Read more.

A public participatory geographical information systems (PPGIS) demographic, environmental, socioeconomic, health status portal was developed for the Stambaugh-Elwood (SE) community in Columbus, OH. We hypothesized that soil at SE residences would have metal concentrations above natural background levels. Three aims were developed that allowed testing of this hypothesis. Aim 1 focused on establishing partnerships between academia, state agencies and communities to assist in the development of a community voice. Aim 2 was to design and conduct soil sampling for residents of the SE community. Aim 3 was to utilize our interactive, customized portal as a risk communication tool by allowing residents to educate themselves as to the potential risks from industrial sources in close proximity to their community. Multiple comparisons of means were used to determine differences in soil element concentration by sampling location at p < 0.05. The results demonstrated that eight metals (As, Cd, Cu, Pb, Mo, Se, Tl, Zn) occurred at statistically-significantly greater levels than natural background levels, but most were below risk-based residential soil screening levels. Results were conveyed to residents via an educational, risk-communication informational card. This study demonstrates that community-led coalitions in collaboration with academic teams and state agencies can effectively address environmental concerns. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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13 pages, 2401 KiB

Open AccessArticle

PVT1 Exon 9: A Potential Biomarker of Aggressive Prostate Cancer?

by Adeodat Ilboudo¹, Jyoti Chouhan², Brian K. McNeil², Joseph R. Osborne³ and Olorunseun O. Ogunwobi^1,4,*

¹ Department of Biological Sciences, Hunter College, The City University of New York, New York, NY 10065, USA

² Department of Urology, State University of New York Downstate Medical Center, New York, NY 11203, USA

³ Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA

⁴ Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY 10065, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 12; https://doi.org/10.3390/ijerph13010012 - 22 Dec 2015

Cited by 26 | Viewed by 5244

Abstract

Prostate cancer (PCa) is the most commonly diagnosed cancer as well as the greatest source of cancer-related mortality in males of African ancestry (MoAA). Interestingly, this has been shown to be associated with single nucleotide polymorphisms around regions 2 and 3 of the [...] Read more.

Prostate cancer (PCa) is the most commonly diagnosed cancer as well as the greatest source of cancer-related mortality in males of African ancestry (MoAA). Interestingly, this has been shown to be associated with single nucleotide polymorphisms around regions 2 and 3 of the 8q24 human chromosomal region. The non-protein coding gene locus Plasmacytoma Variant Translocation 1 (PVT1) is located at 8q24 and is overexpressed in PCa and, therefore, is also a candidate biomarker to explain the well-known disparity in this group. PVT1 has at least 12 exons that make separate transcripts which may have different functions, all of which are at present unknown in PCa. Our aim was to determine if any PVT1 transcripts play a role in aggressiveness and racial disparity in PCa. We used a panel of seven PCa cell lines including three derived from MoAA. Ribonucleic acid extraction, complementary deoxyribonucleic acid synthesis, and quantitative polymerase chain reaction (qPCR) were performed to evaluate expression of all 12 PVT1 exons. Each qPCR was performed in quadruplicates. At least four separate qPCR experiments were performed. Expression of PVT1 exons was inconsistent except for exon 9. There was no significant difference in exon 9 expression between cell lines derived from Caucasian males (CM), and an indolent cell line derived from MoAA. However, exon 9 expression in the aggressive MDA PCa 2b and E006AA-hT cell lines derived from MoAA was significantly higher than in other cell lines. Consequently, we observed differential expression of exon 9 of PVT1 in a manner that suggests that PVT1 exon 9 may be associated with aggressive PCa in MoAA. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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14 pages, 3390 KiB

Open AccessArticle

Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research

by Tonny J. Oyana^1,*

, Patricia Matthews-Juarez^2,3, Stephania A. Cormier², Xiaoran Xu² and Paul D. Juarez^2,3

¹ Research Center on Health Disparities, Equity & the Exposome, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA

² Pediatrics, Infectious Disease and Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Le Bonheur Children’s Medical Center, Memphis, TN 36163, USA

³ Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 13; https://doi.org/10.3390/ijerph13010013 - 22 Dec 2015

Cited by 13 | Viewed by 7745

Abstract

Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We [...] Read more.

Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We identified counties in the 48 contiguous USA where observed low birthweight (LBW) rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. Results: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke) in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter). Conclusions: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying “hotspots” with implications for designing targeted interventions and control measures to reduce and eliminate health disparities. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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10 pages, 223 KiB

Open AccessArticle

Cultural Competence in Pediatrics: Health Care Provider Knowledge, Awareness, and Skills

by Kirk Dabney¹, Lavisha McClarin^1,2, Emily Romano^1,3, Diane Fitzgerald⁴, Lynn Bayne⁴, Patricia Oceanic¹, Arie L. Nettles⁵ and Laurens Holmes^1,6,*

¹ Nemours Office of Health Equity and Inclusion, Wilmington, DE 19803, USA

² Epidemiology and Biostatistics Department, University of Maryland-College Park, College Park, MD 20742, USA

³ College and Graduate School of Arts & Sciences, University of Virginia, Charlottesville, VA 22904, USA

⁴ Nursing Department, Nemours/A. I. DuPont Hospital for Children, Wilmington, DE 19803, USA

⁵ Office of Inclusion and Health Equity, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN 37232, USA

⁶ Biological Sciences Department, University of Delaware, Newark, DE 19716, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 14; https://doi.org/10.3390/ijerph13010014 - 22 Dec 2015

Cited by 16 | Viewed by 8727

Abstract

The purpose of this study was to assess the effects of a cultural competence training (CCT) program on pediatric health care providers’ self-reported ability to provide culturally competent care to a diverse pediatric patient population. This quantitative, nested ecologic level study design used [...] Read more.

The purpose of this study was to assess the effects of a cultural competence training (CCT) program on pediatric health care providers’ self-reported ability to provide culturally competent care to a diverse pediatric patient population. This quantitative, nested ecologic level study design used a repeated measure in the form of pre-test and post-test data to assess percent change in providers’ cultural awareness, experience working or learning about different cultures, and preparedness and skills in working with different cultures before and after CCT. The study was conducted between 2011 and 2012 in a pediatric hospital and associated outpatient offices. The sample consisted of pediatric health care providers from various departments, mainly physicians and nurses (n = 69). Participants completed a pre-intervention cultural competence assessment and then were subjected to a cultural competence-training program, after which they completed the assessment a second time. The baseline and post-intervention data were collected in the form of Likert scales and transformed into a quintile or quartile scale as appropriate. Data were assessed using paired t-tests or Wilcoxon’s signed-rank tests. Providers indicated a 13% increase in knowledge (53.9% vs. 66.7%, t = 3.4, p = 0.001), 8.7% increase in awareness (46.7% vs. 55.4%, t = 3.0, p = 0.002), and 8% statistically marginal increase in skills (66.4% vs. 74.5%, z = 1.8, p = 0.06). Culturally competent training in a pediatric environment significantly enhances knowledge, awareness and to some extent skills in providing care to culturally diverse patient population. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

11 pages, 235 KiB

Open AccessArticle

When Free Is Not for Me: Confronting the Barriers to Use of Free Quitline Telephone Counseling for Tobacco Dependence

by Christine Sheffer^1,2,*, Sharon Brackman^2,†, Charnette Lercara^1,†, Naomi Cottoms^3,†, Mary Olson^3,†, Luana Panissidi^1,†, Jami Pittman^1,† and Helen Stayna^1,†

¹ Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA

² Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA

³ Walnut Street Works, Inc., Helena-West Helena, AR 72342, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 15; https://doi.org/10.3390/ijerph13010015 - 22 Dec 2015

Cited by 13 | Viewed by 4633

Abstract

Remarkable disparities in smoking rates in the United States contribute significantly to socioeconomic and minority health disparities. Access to treatment for tobacco use can help address these disparities, but quitlines, our most ubiquitous treatment resource, reach just 1%–2% of smokers. We used community-based [...] Read more.

Remarkable disparities in smoking rates in the United States contribute significantly to socioeconomic and minority health disparities. Access to treatment for tobacco use can help address these disparities, but quitlines, our most ubiquitous treatment resource, reach just 1%–2% of smokers. We used community-based participatory methods to develop a survey instrument to assess barriers to use of the quitline in the Arkansas Mississippi delta. Barriers were quitline specific and barriers to cessation more broadly. Over one-third (34.9%) of respondents (n = 799) did not have access to a telephone that they could use for the quitline. Respondents reported low levels of knowledge about the quitline, quitting, and trust in tobacco treatment programs as well as considerable ambivalence about quitting including significant concerns about getting sick if they quit and strong faith-based beliefs about quitting. These findings suggest quitlines are not accessible to all lower socioeconomic groups and that significant barriers to use include barriers to cessation. These findings suggest targets for providing accessible tobacco use treatment services and addressing concerns about cessation among lower income, ethnic minority, and rural groups. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

11 pages, 244 KiB

Open AccessArticle

Dietary Acculturation among Filipino Americans

by Persephone Vargas^* and Leo-Felix Jurado

Department of Nursing, William Paterson University 300 Pompton Rd., Wayne, NJ 07470, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 16; https://doi.org/10.3390/ijerph13010016 - 22 Dec 2015

Cited by 43 | Viewed by 10804

Abstract

Acculturation, the subsequent changes that occur in one culture after continuous first hand contact with another culture, impacts the dietary habits and health risks of individuals. This study examines the acculturation, dietary habits and anthropometric measurements in a sample of 210 first generation [...] Read more.

Acculturation, the subsequent changes that occur in one culture after continuous first hand contact with another culture, impacts the dietary habits and health risks of individuals. This study examines the acculturation, dietary habits and anthropometric measurements in a sample of 210 first generation Filipino American immigrants in New Jersey (NJ). Acculturation was measured using the Short Acculturation Scale for Filipino Americans (ASASFA). Dietary acculturation was measured using the Dietary Acculturation Questionnaire for Filipino Americans (DAQFA) and dietary intake was determined using the Block’s Brief Food Frequency Questionnaire (BFFQ). Anthropometric measurements were obtained including weight, height and waist circumference. Acculturation had a significant negative relationship with Filipino Dietary acculturation. Western dietary acculturation was significantly correlated with caloric intake (r(208) = 0.193, p < 0.01), percentage fat intake (r(208) = 0.154, p < 0.05), percentage carbohydrate intake (r(208) = −0.172, p < 0.05), Body Mass Index (BMI) (r(208) = 0.216, p < 0.01) and waist circumference (r(208) = 0.161, p < 0.01). There was no significant correlation between Filipino dietary acculturation, dietary intake and anthropometric measurements. The results showed that Filipino American immigrants have increased risks including increased BMI, waist circumference and increased fat intake. Over all, this research highlighted some dietary changes and their effects on dietary intake and health status. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

13 pages, 1110 KiB

Open AccessArticle

Genistein and Glyceollin Effects on ABCC2 (MRP2) and ABCG2 (BCRP) in Caco-2 Cells

by Chandler Schexnayder and Robert E. Stratford^*,†

¹ Department of Basic Pharmaceutical Sciences, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA

^† Current Address: Graduate School of Pharmaceutical Sciences, Mylan School of Pharmacy, Room 425 Mellon Hall, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 17; https://doi.org/10.3390/ijerph13010017 - 22 Dec 2015

Cited by 23 | Viewed by 6206

Abstract

The goal of the present study was to determine the effects of glyceollins on intestinal ABCC2 (ATP Binding Cassette C2, multidrug resistance protein 2, MRP2) and ABCG2 (ATP Binding Cassette G2, breast cancer resistance protein, BCRP) function using the Caco-2 cell intestinal epithelial [...] Read more.

The goal of the present study was to determine the effects of glyceollins on intestinal ABCC2 (ATP Binding Cassette C2, multidrug resistance protein 2, MRP2) and ABCG2 (ATP Binding Cassette G2, breast cancer resistance protein, BCRP) function using the Caco-2 cell intestinal epithelial cell model. Glyceollins are soy-derived phytoestrogens that demonstrate anti-proliferative activity in several sources of cancer cells. 5 (and 6)-carboxy-2′,7′-dichloroflourescein (CDF) was used as a prototypical MRP2 substrate; whereas BODIPY-prazosin provided an indication of BCRP function. Comparison studies were conducted with genistein. Glyceollins were shown to inhibit MRP2-mediated CDF transport, with activity similar to the MRP2 inhibitor, MK-571. They also demonstrated concentration-dependent inhibition BCRP-mediated efflux of BODIPY-prazosin, with a potency similar to that of the recognized BCRP inhibitor, Ko143. In contrast, genistein did not appear to alter MRP2 activity and even provided a modest increase in BCRP efflux of BODIPY-prazosin. In particular, glyceollin inhibition of these two important intestinal efflux transporters suggests the potential for glyceollin to alter the absorption of other phytochemicals with which it might be co-administered as a dietary supplement, as well as alteration of the absorption of pharmaceuticals that may be administered concomitantly. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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5 pages, 887 KiB

Open AccessConference Report

SalHUD—A Graphical Interface to Public Health Data in Puerto Rico

by Humberto G. Ortiz-Zuazaga^1,*, Roberto Arce-Corretjer¹, Juan M. Solá-Sloan² and José G. Conde³

¹ Department of Computer Science, University of Puerto Rico, Río Piedras Campus, San Juan 00936, Puerto Rico

² Department of Computer Science, University of Puerto Rico, Bayamón Campus, Bayamón 00959, Puerto Rico

³ School of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan 00936, Puerto Rico

Int. J. Environ. Res. Public Health 2016, 13(1), 18; https://doi.org/10.3390/ijerph13010018 - 22 Dec 2015

Cited by 1 | Viewed by 4179

Abstract

Purpose: This paper describes SalHUD, a prototype web-based application for visualizing health data from Puerto Rico. Our initial focus was to provide interactive maps displaying years of potential life lost (YPLL). Methods: The public-use mortality file for year 2008 was downloaded from the [...] Read more.

Purpose: This paper describes SalHUD, a prototype web-based application for visualizing health data from Puerto Rico. Our initial focus was to provide interactive maps displaying years of potential life lost (YPLL). Methods: The public-use mortality file for year 2008 was downloaded from the Puerto Rico Institute of Statistics website. Data was processed with R, Python and EpiInfo to calculate years of potential life lost for the leading causes of death on each of the 78 municipalities in the island. Death records were classified according to ICD-10 codes. YPLL for each municipality was integrated into AtlasPR, a D3 Javascript map library. Additional Javascript, HTML and CSS programing was required to display maps as a web-based interface. Results: YPLL for all municipalities are displayed on a map of Puerto Rico for each of the ten leading causes of death and for all causes combined, so users may dynamically explore the impact of premature mortality. Discussion: This work is the first step in providing the general public in Puerto Rico with user-friendly, interactive, visual access to public health data that is usually published in numerical, text-based media. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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10 pages, 461 KiB

Open AccessArticle

Racial and Ethnic Heterogeneity in the Association Between Total Cholesterol and Pediatric Obesity

by Laurens Holmes^1,2,*, Alex LaHurd^1,2, Emily Wasson³, Lavisha McClarin⁴ and Kirk Dabney¹

¹ Nemours/A.I. duPont Children’s Hospital, Nemours Office of Health Equity & Inclusion, 2200 Concord Pike, 8th Floor, Wilmington, DE 19803, USA

² Biological Sciences Department, University of Delaware, Newark, DE 19711, USA

³ Biology Department, Gettysburg College, 300 North Washington Street, Gettysburg, PA 17325, USA

⁴ Epidemiology and Biostatistics Department, School of Public Health, University of Maryland-College Park, College Park, MD 20742, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 19; https://doi.org/10.3390/ijerph13010019 - 23 Dec 2015

Cited by 12 | Viewed by 28297

Abstract

Total cholesterol (TC) directly correlates with overweight/obesity, but it remains unclear if this association varies by race and ethnicity. We assessed the association as well as the racial/ethnic heterogeneity in this relationship. Data on 63,863 children were assessed using electronic medical records between [...] Read more.

Total cholesterol (TC) directly correlates with overweight/obesity, but it remains unclear if this association varies by race and ethnicity. We assessed the association as well as the racial/ethnic heterogeneity in this relationship. Data on 63,863 children were assessed using electronic medical records between 2010 and 2011. A cross-sectional design was utilized with log-binomial regression model and chi-squared statistic to examine the data. Overall, abnormal total cholesterol (ATC) was 7.5% (4812). Significant racial variability in ATC was observed: Black/African American (AA) (7.4%), White (7.0%), Asian (5.1%) and some other race (SOR) children (11.3%), χ² (5) = 141.5, p < 0.0001. Black/AA (34.7%) and SOR children (41.2%) were predominantly overweight/obese, unlike the Asian children, (25.8%), χ² (5) = 324.6, p < 0.0001. The BMI percentile was highest among SOR (69.0 ± 28.6) and Black/AA children (65.2 ± 29.1), but lowest among Asian children (55.7 ± 31.5). A significant racial variability was also observed in weight, with the highest mean among Black/AA children (36.8kg ± 23.0) and the lowest among Asian children (28.7kg ± 16.8), f = 7.2, p < 0.001. Relative to normal TC, children with ATC were 2.6 times as likely to have abnormal BMI, relative risk (RR) =2.60, 99% CI, 2.54–2.68). Compared to non-Hispanic (RR = 2.62, 99% CI, 2.54–2.69), the risk was lower among Hispanics (RR = 2.34, 99%, 2.21–2.48). Among children with ATC, risk for abnormal BMI was highest among Asians, adjusted RR = 2.91, 99% CI, 2.34–3.62), intermediate among AA (ARR = 2.68, 99% CI, 2.59–2.77), but lowest among Whites (ARR = 2.40, 99% CI, 2.39–2.64), and SOR (ARR = 2.33, 99% CI, 2.19–2.50). In a large sample of children, total cholesterol directly correlates with BMI, with an observed racial and ethnic heterogeneity. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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12 pages, 306 KiB

Open AccessReview

Health Policy Training: A Review of the Literature

by Harry J. Heiman^1,*, L. Lerissa Smith^1,†, Marissa McKool^2,†, Denise N. Mitchell^3,† and Carey Roth Bayer^4,†

¹ Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA

² Hubert Department of Global Health, Rollins School of Public Health, Emory University, GA 30322, USA

³ Health Policy Research and Innovation Program, American Institutes for Research, 1000 Thomas 19 Jefferson Street NW, Washington, DC 20007, USA

⁴ Departments of Community Health and Preventive Medicine/Medical Education, Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 20; https://doi.org/10.3390/ijerph13010020 - 23 Dec 2015

Cited by 35 | Viewed by 11634

Abstract

The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, [...] Read more.

The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s), health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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7 pages, 204 KiB

Open AccessArticle

Barriers for Compliance to Breast, Colorectal, and Cervical Screening Cancer Tests among Hispanic Patients

by Christine Miranda-Diaz^*, Elba Betancourt, Yelitza Ruiz-Candelaria and Robert F. Hunter-Mellado

Universidad Central del Caribe, School of Medicine, Cancer Research Unit, Internal Medicine Department, P.O. BOX 60327, Bayamon 00960-6032, Puerto Rico

Int. J. Environ. Res. Public Health 2016, 13(1), 21; https://doi.org/10.3390/ijerph13010021 - 22 Dec 2015

Cited by 33 | Viewed by 5322

Abstract

Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT), colonoscopy, and cervical smears (PAP) and barriers for compliance were studied. A descriptive study was performed with 194 [...] Read more.

Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT), colonoscopy, and cervical smears (PAP) and barriers for compliance were studied. A descriptive study was performed with 194 ambulatory patients while they attended routine medical visits. Women are more likely than men to undergo a colonoscopy. Conversely, FOBT was most likely reported by men. Reasons for compliance with FOBT differed by gender. Men were most likely to avoid FOBT due to lack of knowledge whereas women reported that physicians do not recommend the procedure. Both men and women reported that lack of physician’s recommendation was their primary reason for not undergoing a colonoscopy. Men tend to report lack of knowledge about colonoscopy procedure. A higher mammogram utilization rate was reported by women older than 40 years. PAP smears were reported by 74% of women older than 21 years. The major reasons for avoiding mammography and PAP tests were having a busy schedule, fear, and feeling uncomfortable during the procedure. In a multivariate regression analysis, occupational status was found to be a predictor for compliance with FOBT and colonoscopy. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

14 pages, 3752 KiB

Open AccessArticle

Hot Spot Mutation in TP53 (R248Q) Causes Oncogenic Gain-of-Function Phenotypes in a Breast Cancer Cell Line Derived from an African American patient

by Nataly Shtraizent^1,2, Hiroshi Matsui³, Alla Polotskaia¹ and Jill Bargonetti^1,*

¹ Department of Biological Sciences, Hunter College, City University of New York, New York, NY 10065, USA

² Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA

³ Department of Chemistry, Hunter College, City University of New York, New York, NY 10065, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 22; https://doi.org/10.3390/ijerph13010022 - 22 Dec 2015

Cited by 18 | Viewed by 6289

Abstract

African American (AA) breast cancer patients often have triple negative breast cancer (TNBC) that contains mutations in the TP53 gene. The point mutations at amino acid residues R273 and R248 both result in oncogenic gain-of-function (GOF) phenotypes. Expression of mutant p53 (mtp53) R273H [...] Read more.

African American (AA) breast cancer patients often have triple negative breast cancer (TNBC) that contains mutations in the TP53 gene. The point mutations at amino acid residues R273 and R248 both result in oncogenic gain-of-function (GOF) phenotypes. Expression of mutant p53 (mtp53) R273H associates with increased cell elasticity, survival under serum deprivation conditions, and increased Poly (ADP ribose) polymerase 1 (PARP1) on the chromatin in the AA-derived TNBC breast cancer cell line MDA-MB-468. We hypothesized that GOF mtp53 R248Q expression could stimulate a similar phenotype in the AA-derived TNBC cell line HCC70. To test this hypothesis we depleted the R248Q protein in the HCC70 cell line using shRNA-mediated knockdown. Using impedance-based real-time analysis we correlated the expression of mtp53 R248Q with increased cell deformability. We also documented that depletion of mtp53 R248Q increased PARP1 in the cytoplasm and decreased PARP1 on the chromatin. We conclude that in the AA-derived TNBC HCC70 cells mtp53 R248Q expression results in a causative tumor associated phenotype. This study supports using the biological markers of high expression of mtp53 R273H or R248Q as additional diagnostics for TNBC resistant subtypes often found in the AA community. Each mtp53 protein must be considered separately and this work adds R248Q to the increasing list of p53 mutations that can be used for diagnostics and drug targeting. Here we report that when R248Q mtp53 proteins are expressed in TNBC, then targeting the gain-of-function pathways may improve treatment efficacy. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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9 pages, 205 KiB

Open AccessArticle

Identification of Barriers to Stroke Awareness and Risk Factor Management Unique to Hispanics

by Marina Martinez^*, Nitin Prabhakar, Kendra Drake, Bruce Coull, Jenny Chong, Leslie Ritter and Chelsea Kidwell

Department of Neurology, University of Arizona College of Medicine, 1501 N. Campbell Avenue Tucson, AZ 85724, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 23; https://doi.org/10.3390/ijerph13010023 - 22 Dec 2015

Cited by 24 | Viewed by 6433

Abstract

Barriers to risk factor control may differ by race/ethnicity. The goal of this study was to identify barriers to stroke awareness and risk factor management unique to Hispanics as compared to non-Hispanic whites (NHWs). We performed a prospective study of stroke patients from [...] Read more.

Barriers to risk factor control may differ by race/ethnicity. The goal of this study was to identify barriers to stroke awareness and risk factor management unique to Hispanics as compared to non-Hispanic whites (NHWs). We performed a prospective study of stroke patients from an academic Stroke Center in Arizona and surveyed members of the general community. Questionnaires included: the Duke Social Support Index (DSSI), the Multidimensional Health Locus of Control (MHLC) Scale, a stroke barriers questionnaire, and a Stroke Awareness Test. Of 145 stroke patients surveyed (72 Hispanic; 73 NHW), Hispanics scored lower on the Stroke Awareness Test compared to NHWs (72.5% vs. 79.1%, p = 0.029). Hispanic stroke patients also reported greater barriers related to medical knowledge, medication adherence, and healthcare access (p < 0.05 for all). Hispanics scored higher on the “powerful others” sub-scale (11.3 vs. 10, p < 0.05) of the MHLC. Of 177 members of the general public surveyed, Hispanics had lower stroke awareness compared to NHWs and tended to have lower awareness than Hispanic stroke patients. These results suggest that Hispanic stroke patients perceive less control over their health, experience more healthcare barriers, and demonstrate lower rates of stroke literacy. Interventions for stroke prevention and education in Hispanics should address these racial/ethnic differences in stroke awareness and barriers to risk factor control. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

12 pages, 503 KiB

Open AccessArticle

Fostering Social Determinants of Health Transdisciplinary Research: The Collaborative Research Center for American Indian Health

by Amy J. Elliott^*,†, Emily R. White Hat^†, Jyoti Angal, Victoria Grey Owl, Susan E. Puumala and DenYelle Baete Kenyon

¹ Center for Health Outcomes and Prevention Research, Sanford Research, Department of Pediatrics and Ob-Gyn, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 24; https://doi.org/10.3390/ijerph13010024 - 22 Dec 2015

Cited by 14 | Viewed by 7440

Abstract

The Collaborative Research Center for American Indian Health (CRCAIH) was established in September 2012 as a unifying structure to bring together tribal communities and health researchers across South Dakota, North Dakota and Minnesota to address American Indian/Alaska Native (AI/AN) health disparities. CRCAIH is [...] Read more.

The Collaborative Research Center for American Indian Health (CRCAIH) was established in September 2012 as a unifying structure to bring together tribal communities and health researchers across South Dakota, North Dakota and Minnesota to address American Indian/Alaska Native (AI/AN) health disparities. CRCAIH is based on the core values of transdisciplinary research, sustainability and tribal sovereignty. All CRCAIH resources and activities revolve around the central aim of assisting tribes with establishing and advancing their own research infrastructures and agendas, as well as increasing AI/AN health research. CRCAIH is comprised of three divisions (administrative; community engagement and innovation; research projects), three technical cores (culture, science and bioethics; regulatory knowledge; and methodology), six tribal partners and supports numerous multi-year and one-year pilot research projects. Under the ultimate goal of improving health for AI/AN, this paper describes the overarching vision and structure of CRCAIH, highlighting lessons learned in the first three years. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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9 pages, 346 KiB

Open AccessArticle

Building Collaborative Health Promotion Partnerships: The Jackson Heart Study

by Clifton C. Addison^*

, Brenda W. Campbell Jenkins, Darcel Odom, Marty Fortenberry, Gregory Wilson, Lavon Young and Donna Antoine-LaVigne

Jackson Heart Study, School of Public Health, Jackson State University, 350 W. Woodrow Wilson Drive, Jackson, MS 39213, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 25; https://doi.org/10.3390/ijerph13010025 - 22 Dec 2015

Cited by 13 | Viewed by 5844

Abstract

Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR) involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to [...] Read more.

Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR) involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS) Community Outreach Center (CORC) to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD). This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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11 pages, 188 KiB

Open AccessArticle

Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study

by Brenda W. Campbell Jenkins, Clifton Addison^*

, Gregory Wilson, Lavon Young, Regina Fields, Clevette Woodberry and Marinelle Payton

Jackson Heart Study, School of Public Health, Jackson State University, 350 West Woodrow Wilson Drive, Suite 2900B, Jackson, MS 39213, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 26; https://doi.org/10.3390/ijerph13010026 - 22 Dec 2015

Viewed by 5502

Abstract

The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students [...] Read more.

The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

17 pages, 231 KiB

Open AccessArticle

Depression, a Hidden Mental Health Disparity in an Asian Indian Immigrant Community

by Lisa R. Roberts^1,2,*, Semran K. Mann² and Susanne B. Montgomery²

¹ School of Nursing, Loma Linda University, 11262 Campus Street West Hall #1327, Loma Linda, CA 92350, USA

² School of Behavioral Health, Division of Interdisciplinary Studies, Loma Linda University, 11065 Campus Street, Loma Linda, CA 92350, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 27; https://doi.org/10.3390/ijerph13010027 - 23 Dec 2015

Cited by 14 | Viewed by 9240

Abstract

Cultural influences are deeply rooted, and continue to affect the lives of Asian-Indian (AI) immigrants living in Western culture. Emerging literature suggests the powerful nature of traditions and culture on the lives, mental and physical health of AI immigrants, particularly women. The purpose [...] Read more.

Cultural influences are deeply rooted, and continue to affect the lives of Asian-Indian (AI) immigrants living in Western culture. Emerging literature suggests the powerful nature of traditions and culture on the lives, mental and physical health of AI immigrants, particularly women. The purpose of this study was to explore depression among AI women in Central California (CC). This mixed-methods research was conducted in collaboration with the CC Punjabi community and the support of local religious leaders. All interviews were conducted in Punjabi and English. Whenever possible we utilized validated scales aligned with emerging themes from the qualitative data, which also provided contextualization to survey responses. In all we conducted 11 key informant interviews, four focus groups (n = 47) and a rigorously developed anonymous survey (n = 350). Social dynamics and traditional expectations including gendered roles significantly affected mental health among women participants. Subgroups along the lines of language choice (Punjabi vs. English) experience and report depression differently in part due to the highly stigmatized nature of mental health issues in this model minority community. The findings of this study highlight the importance of utilizing mixed methods to access hard to reach populations regarding sensitive topics such as mental health. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

9 pages, 183 KiB

Open AccessArticle

Nutrition and Health Disparities: The Role of Dairy in Improving Minority Health Outcomes

by Constance Brown-Riggs

Nutrition Consultant CBR Nutrition Enterprises, Massapequa 11758, NY, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 28; https://doi.org/10.3390/ijerph13010028 - 22 Dec 2015

Cited by 23 | Viewed by 9488

Abstract

Consuming a balanced diet, such as the food groups represented on MyPlate, is key to improving health disparities. Despite the best of intentions, however, the dietary guidelines can be culturally challenging, particularly when it comes to dairy consumption. Many African and Hispanic Americans [...] Read more.

Consuming a balanced diet, such as the food groups represented on MyPlate, is key to improving health disparities. Despite the best of intentions, however, the dietary guidelines can be culturally challenging, particularly when it comes to dairy consumption. Many African and Hispanic Americans avoid milk and dairy products—key contributors of three shortfall nutrients (calcium, potassium and vitamin D)—because many people in these populations believe they are lactose intolerant. However, avoiding dairy can have significant health effects. An emerging body of evidence suggests that yogurt and other dairy products may help support reduced risk of heart disease, hypertension, obesity, and type 2 diabetes—conditions that disproportionately impact people of color. For this reason, the National Medical Association and the National Hispanic Medical Association issued a joint consensus statement recommending African Americans consume three to four servings of low-fat dairy every day. Cultured dairy products could play an important role in addressing these recommendations. Because of the presence of lactase-producing cultures, yogurt is often a more easily digestible alternative to milk, and thus more palatable to people who experience symptoms of lactose intolerance. This was a key factor cited in the final rule to include yogurt in the Special Supplemental Nutrition Program for Women, Infants, and Children. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

15 pages, 597 KiB

Open AccessArticle

Inpatient Hospitalization Costs: A Comparative Study of Micronesians, Native Hawaiians, Japanese, and Whites in Hawai‘i

by Megan Hagiwara^1,*, Deborah Taira Juarez², Seiji Yamada³, Jill Miyamura⁴ and Tetine Sentell⁵

¹ Office of Public Health Studies, University of Hawai‘i at Manoa, 1960 East-West Road, Honolulu, HI 96822, USA

² Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, 677 Ala Moana Boulevard, Suite 1025, Honolulu, HI 96813, USA

³ Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai‘i, 95-390 Kuahelani Avenue, Mililani, Hawai‘i 96789, USA

⁴ Hawaii Health Information Corporation, 733 Bishop St # 1870, Honolulu, HI 96813, USA

⁵ Office of Public Health Studies, University of Hawai‘i, 1960 East-West Road, Honolulu, HI 96822, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 29; https://doi.org/10.3390/ijerph13010029 - 22 Dec 2015

Cited by 2 | Viewed by 5369

Abstract

Considerable interest exists in health care costs for the growing Micronesian population in the United States (US) due to their significant health care needs, poor average socioeconomic status, and unique immigration status, which impacts their access to public health care coverage. Using Hawai‘i [...] Read more.

Considerable interest exists in health care costs for the growing Micronesian population in the United States (US) due to their significant health care needs, poor average socioeconomic status, and unique immigration status, which impacts their access to public health care coverage. Using Hawai‘i statewide impatient data from 2010 to 2012 for Micronesians, whites, Japanese, and Native Hawaiians (N = 162,152 hospitalizations), we compared inpatient hospital costs across racial/ethnic groups using multivariable models including age, gender, payer, residence location, and severity of illness (SOI). We also examined total inpatient hospital costs of Micronesians generally and for Medicaid specifically. Costs were estimated using standard cost-to-charge metrics overall and within nine major disease categories determined by All Patient Refined Diagnosis Related Groups. Micronesians had higher unadjusted hospitalization costs overall and specifically within several disease categories (including infectious and heart diseases). Higher SOI in Micronesians explained some, but not all, of these higher costs. The total cost of the 3486 Micronesian hospitalizations in the three-year study period was $58.1 million and 75% was covered by Medicaid; 23% of Native Hawaiian, 3% of Japanese, and 15% of white hospitalizations costs were covered by Medicaid. These findings may be of particular interests to hospitals, Medicaid programs, and policy makers. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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9 pages, 1039 KiB

Open AccessArticle

Characterizing the HIV/AIDS Epidemic in the United States and China

by Ming-Bo Huang^1,†, Li Ye^2,†, Bing-Yu Liang², Chuan-Yi Ning², William W. Roth¹, Jun-Jun Jiang², Jie-Gang Huang², Bo Zhou³, Ning Zang³, Michael D. Powell¹, Hao Liang^2,3,* and Vincent C. Bond^1,*

¹ Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA

² Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China

³ Guangxi Medical Research Center, Guangxi Medical University, Nanning, Guangxi 530021, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 30; https://doi.org/10.3390/ijerph13010030 - 22 Dec 2015

Cited by 75 | Viewed by 10304

Abstract

The HIV/AIDS data from the national surveillance systems of China and the United States from 1985 to 2014 were compared to characterize the HIV/AIDS epidemic in both countries. The current estimated national HIV prevalence rate in China and the United States are 0.0598% [...] Read more.

The HIV/AIDS data from the national surveillance systems of China and the United States from 1985 to 2014 were compared to characterize the HIV/AIDS epidemic in both countries. The current estimated national HIV prevalence rate in China and the United States are 0.0598% and 0.348%, respectively. In the United States, the annual number of new HIV infections has remained relatively stable (~50,000 each year) and has shown a downward trend in recent years. The Chinese national HIV prevalence is still low, and new HIV infections have been contained at a low level (50,000–100,000 each year). However, the epidemic has showed an increasing trend since 2012. By risk group, in both countries, men who have sex with men (MSM), heterosexual sex, and injection drug use (IDU) are the most common modes of transmission of new HIV infections. However, in the United States, MSM is the dominant transmission route, accounting for >60% of new infections; whereas in China, heterosexual sex has now become the dominant route, also accounting for >60% of new infections. A rapid increase in the proportion of HIV cases that were attributed to MSM and an obvious decrease in the proportion of HIV cases attributed to IDU in China in recent years imply that the China’s epidemic is still evolving, to some extent, copying what was experienced in the United States. By age group, the proportions of HIV cases that were attributed to the age group 25–59 were comparable between the two countries. However, the United States had a higher proportion of cases that were attributed to age groups 15–19 and 20–24 than China, indicating that youth account for more infections in the United States. One other fact worth noting: in China there is a significant increase in the number of HIV new infections in individuals over 50 years of age, which results in much higher proportion of cases that were attributed to age groups 60–64 and over 65 in China than those in the United States. By race/ethnicity, in the United States, Blacks/African Americans continue to experience the most severe HIV burden, followed by Hispanics/Latinos. In China, no official data on race/ethnicity disparities are currently available. Thus, region, risk group, age are important factors in the HIV epidemics in both countries. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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14 pages, 1687 KiB

Open AccessCommunication

A Multidisciplinary Intervention Utilizing Virtual Communication Tools to Reduce Health Disparities: A Pilot Randomized Controlled Trial

by John F. Emerson^1,*, Madelyn Welch¹, Whitney E. Rossman², Stephen Carek¹, Thomas Ludden¹, Megan Templin², Charity G. Moore², Hazel Tapp¹, Michael Dulin^1,2 and Andrew McWilliams^1,2

¹ Department of Family Medicine, Carolinas HealthCare System, 2001 Vail Ave. Charlotte, NC 28205, USA

² Dickson Advanced Analytics, 720 E. Morehead Street, Charlotte, NC 28202, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 31; https://doi.org/10.3390/ijerph13010031 - 22 Dec 2015

Cited by 15 | Viewed by 7857

Abstract

Advances in technology are likely to provide new approaches to address healthcare disparities for high-risk populations. This study explores the feasibility of a new approach to health disparities research using a multidisciplinary intervention and advanced communication technology to improve patient access to care [...] Read more.

Advances in technology are likely to provide new approaches to address healthcare disparities for high-risk populations. This study explores the feasibility of a new approach to health disparities research using a multidisciplinary intervention and advanced communication technology to improve patient access to care and chronic disease management. A high-risk cohort of uninsured, poorly-controlled diabetic patients was identified then randomized pre-consent with stratification by geographic region to receive either the intervention or usual care. Prior to enrollment, participants were screened for readiness to make a behavioral change. The primary outcome was the feasibility of protocol implementation, and secondary outcomes included the use of patient-centered medical home (PCMH) services and markers of chronic disease control. The intervention included a standardized needs assessment, individualized care plan, intensive management by a multidisciplinary team, including health coach-facilitated virtual visits, and the use of a cloud-based glucose monitoring system. One-hundred twenty-seven high-risk, potentially eligible participants were randomized. Sixty-one met eligibility criteria after an in-depth review. Due to limited resources and time for the pilot, we only attempted to contact 36 participants. Of these, we successfully reached 20 (32%) by phone and conducted a readiness to change screen. Ten participants screened in as ready to change and were enrolled, while the remaining 10 were not ready to change. Eight enrolled participants completed the final three-month follow-up. Intervention feasibility was demonstrated through successful implementation of 13 out of 14 health coach-facilitated virtual visits, and 100% of participants indicated that they would recommend the intervention to a friend. Protocol feasibility was demonstrated as eight of 10 participants completed the entire study protocol. At the end of the three-month intervention, participants had a median of nine total documented contacts with PCMH providers compared to four in the control group. Three intervention and two control participants had controlled diabetes (hemoglobin A1C <9%). Multidisciplinary care that utilizes health coach-facilitated virtual visits is an intervention that could increase access to intensive primary care services in a vulnerable population. The methods tested are feasible and should be tested in a pragmatic randomized controlled trial to evaluate the impact on patient-relevant outcomes across multiple chronic diseases. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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9 pages, 851 KiB

Open AccessArticle

Micro RNA in Exosomes from HIV-Infected Macrophages

by William W. Roth^*,†, Ming Bo Huang^†, Kateena Addae Konadu, Michael D. Powell and Vincent C. Bond

¹ Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310-1495, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 32; https://doi.org/10.3390/ijerph13010032 - 22 Dec 2015

Cited by 36 | Viewed by 6462

Abstract

Exosomes are small membrane-bound vesicles secreted by cells that function to shuttle RNA and proteins between cells. To examine the role of exosomal micro RNA (miRNA) during the early stage of HIV-1 infection we characterized miRNA in exosomes from HIV-infected macrophages, compared with [...] Read more.

Exosomes are small membrane-bound vesicles secreted by cells that function to shuttle RNA and proteins between cells. To examine the role of exosomal micro RNA (miRNA) during the early stage of HIV-1 infection we characterized miRNA in exosomes from HIV-infected macrophages, compared with exosomes from non-infected macrophages. Primary human monocytes from uninfected donors were differentiated to macrophages (MDM) which were either mock-infected or infected with the macrophage-tropic HIV-1 BaL strain. Exosomes were recovered from culture media and separated from virus particles by centrifugation on iodixanol density gradients. The low molecular weight RNA fraction was prepared from purified exosomes. After pre-amplification, RNA was hybridized to microarrays containing probes for 1200 miRNA species of known and unknown function. We observed 48 miRNA species in both infected and uninfected MDM exosomes. Additionally, 38 miRNAs were present in infected-cell exosomes but not uninfected-cell exosomes. Of these, 13 miRNAs were upregulated in exosomes from HIV-infected cells, including 4 miRNA species that were increased by more than 10-fold. Though numerous miRNA species have been identified in HIV-infected cells, relatively little is known about miRNA content in exosomes from these cells. In the future, we plan to investigate whether the upregulated miRNA species we identified are increased in exosomes from HIV-1-positive patients. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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10 pages, 212 KiB

Open AccessArticle

Factors Associated with Providers’ Perceptions of Mental Health Care in Santa Luzia’s Family Health Strategy, Brazil

by Angela R. Ghesquiere^1,*, Rogerio M. Pinto², Rahbel Rahman³ and Anya Y. Spector⁴

¹ Brookdale Center for Healthy Aging, Hunter College of the City University of New York, 2180 Third Ave, New York, NY 10035, USA

² School of Social Work, University of Michigan, Room 3792 SSWB, 1080 S. University Ave., Ann Arbor, MI 48109, USA

³ School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA

⁴ New York City Department of Health and Mental Hygiene, 42-09 28th St, Long Island City, NY 11101, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 33; https://doi.org/10.3390/ijerph13010033 - 23 Dec 2015

Cited by 3 | Viewed by 4914

Abstract

Brazil has a unique mental health care system, characterized by universal coverage delivered by interdisciplinary teams both in the community and in specialized centros de atenção psicossocial (CAPS—psychosocial care centers). Provision of patient-centered mental health care is an important principle of Brazilian mental [...] Read more.

Brazil has a unique mental health care system, characterized by universal coverage delivered by interdisciplinary teams both in the community and in specialized centros de atenção psicossocial (CAPS—psychosocial care centers). Provision of patient-centered mental health care is an important principle of Brazilian mental health care, but this topic has not been well-studied. We analyzed data from a cross-sectional survey of 151 community health workers (CHWs), nurses, and physicians in Santa Luzia, Minas Gerais State, Brazil. Chi-squares, t-tests and multivariate regression analyses examined differences in socio-demographics, caseload, engagement in evidence-based practices (EBPs), and transdisciplinary collaboration between providers who reported providing high levels of patient-centered mental health care and those who did not. In multivariate regression models, components of transdisciplinary collaboration were significantly associated with providers’ perceptions of patient-centered mental health care (p < 0.05). CHWs were also significantly more likely to report providing patient-centered care than physicians and nurses. EBP engagement and sociodemographics were not associated with perceptions. Results suggest that training efforts to improve patient-centered mental health care in Brazil could build upon CHWs’ skills and focus on transdisciplinary collaboration. Findings may inform practice in other countries with similar health care systems. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

15 pages, 454 KiB

Open AccessArticle

User-Friendly Data-Sharing Practices for Fostering Collaboration within a Research Network: Roles of a Vanguard Center for a Community-Based Study

by Jae Eun Lee^1,2,*, Jung Hye Sung², M. Edwina Barnett¹ and Keith Norris³

¹ Research Centers in Minority Institutions Translational Research Network Data Coordinating Center, Mississippi e-Center, Jackson State University, 1230 Raymond Rd., Jackson, MS 39204, USA

² Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, 350 W. Woodrow Wilson Drive Jackson Medical Mall, Jackson, MS 39213, USA

³ Department of Medicine, David Geffen School of Medicine, UCLA, 911 Broxton Ave, Los Angeles, CA 90024, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 34; https://doi.org/10.3390/ijerph13010034 - 22 Dec 2015

Cited by 4 | Viewed by 5999

Abstract

Although various attempts have been made to build collaborative cultures for data sharing, their effectiveness is still questionable. The Jackson Heart Study (JHS) Vanguard Center (JHSVC) at the NIH-funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) [...] Read more.

Although various attempts have been made to build collaborative cultures for data sharing, their effectiveness is still questionable. The Jackson Heart Study (JHS) Vanguard Center (JHSVC) at the NIH-funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) may be a new concept in that the data are being shared with a research network where a plethora of scientists/researchers are working together to achieve their common goal. This study describes the current practices to share the JHS data through the mechanism of JHSVC. The JHS is the largest single-site cohort study to prospectively investigate the determinants of cardiovascular disease among African-Americans. It has adopted a formal screened access method through a formalized JHSVC mechanism, in which only a qualified scientist(s) can access the data. The role of the DCC was to help RTRN researchers explore hypothesis-driven ideas to enhance the output and impact of JHS data through customized services, such as feasibility tests, data querying, manuscript proposal development and data analyses for publication. DCC has implemented these various programs to facilitate data utility. A total of 300 investigators attended workshops and/or received training booklets. DCC provided two online and five onsite workshops and developed/distributed more than 250 copies of the booklet to help potential data users understand the structure of and access to the data. Information on data use was also provided through the RTRN website. The DCC efforts led to the production of five active manuscript proposals, seven completed publications, 11 presentations and four NIH grant proposals. These outcomes resulted from activities during the first four years; over the last couple of years, there were few new requests. Our study suggested that DCC-customized services enhanced the accessibility of JHS data and their utility by RTRN researchers and helped to achieve the principal goal of JHSVC of scientific productivity. In order to achieve long-term success, the following, but not limited to these, should be addressed in the current data sharing practices: preparation of new promotional strategies in response to changes in technology and users’ needs, collaboration with the Network statisticians, harmonization of the JHS data with the other local-based heart datasets to meet the needs of the potential users from the broader geographical areas, adoption of the RTRN comprehensive data-sharing policy to broaden the variety of research topics and implementation of an ongoing monitoring program to evaluate its success. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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13 pages, 365 KiB

Open AccessProject Report

Bringing Community and Academic Scholars Together to Facilitate and Conduct Authentic Community Based Participatory Research: Project UNITED

by Dwight Lewis¹, Lea Yerby^1,2, Melanie Tucker³, Pamela Payne Foster^1,2, Kara C. Hamilton¹, Matthew M. Fifolt⁴, Lisle Hites^4,5, Mary Katherine Shreves⁶, Susan B. Page¹, Kimberly L. Bissell⁶, Felecia L. Lucky⁷ and John C. Higginbotham^1,2,*

¹ Institute for Rural Health Research, The University of Alabama, Tuscaloosa, AL 35487, USA

² Department of Community and Rural Medicine, The University of Alabama, Tuscaloosa, AL 35487, USA

³ Department of Family Medicine, The University of Alabama, Tuscaloosa, AL 35487, USA

⁴ Evaluation and Assessment Unit, The University of Alabama at Birmingham, Birmingham, AL 35294, USA

⁵ Department of Health Care Organization and Policy, The University of Alabama at Birmingham, Birmingham, AL 35294, USA

⁶ Institute for Communication and Information Research, The University of Alabama, Tuscaloosa, AL 35487, USA

⁷ Black Belt Community Foundation, Selma, AL 36701, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 35; https://doi.org/10.3390/ijerph13010035 - 22 Dec 2015

Cited by 12 | Viewed by 5520

Abstract

Cultural competency, trust, and research literacy can affect the planning and implementation of sustainable community-based participatory research (CBPR). The purpose of this manuscript is to highlight: (1) the development of a CBPR pilot grant request for application; and (2) a comprehensive program supporting [...] Read more.

Cultural competency, trust, and research literacy can affect the planning and implementation of sustainable community-based participatory research (CBPR). The purpose of this manuscript is to highlight: (1) the development of a CBPR pilot grant request for application; and (2) a comprehensive program supporting CBPR obesity-related grant proposals facilitated by activities designed to promote scholarly collaborations between academic researchers and the community. After a competitive application process, academic researchers and non-academic community leaders were selected to participate in activities where the final culminating project was the submission of a collaborative obesity-related CBPR grant application. Teams were comprised of a mix of academic researchers and non-academic community leaders, and each team submitted an application addressing obesity-disparities among rural predominantly African American communities in the US Deep South. Among four collaborative teams, three (75%) successfully submitted a grant application to fund an intervention addressing rural and minority obesity disparities. Among the three submitted grant applications, one was successfully funded by an internal CBPR grant, and another was funded by an institutional seed funding grant. Preliminary findings suggest that the collaborative activities were successful in developing productive scholarly relationships between researchers and community leaders. Future research will seek to understand the full-context of our findings. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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9 pages, 1512 KiB

Open AccessArticle

Protein Kinase CK2 Expression Predicts Relapse Survival in ERα Dependent Breast Cancer, and Modulates ERα Expression in Vitro

by Marlon D. Williams¹, Thu Nguyen¹, Patrick P. Carriere¹, Syreeta L. Tilghman² and Christopher Williams^1,*

¹ College of Pharmacy, Xavier University of Louisiana, 1 Drexel Dr, New Orleans, LA 70125, USA

² Division of Basic Sciences, College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural & Mechanical University, 1415 S. Martin L. King Jr. Blvd., Tallahassee, FL 32307

Int. J. Environ. Res. Public Health 2016, 13(1), 36; https://doi.org/10.3390/ijerph13010036 - 22 Dec 2015

Cited by 10 | Viewed by 4769

Abstract

The heterotetrameric protein kinase CK2 has been associated with oncogenic transformation, and our previous studies have shown that it may affect estrogenic signaling. Here, we investigate the role of the protein kinase CK2 in regulating ERα (estrogen receptor α) signaling in breast cancer. [...] Read more.

The heterotetrameric protein kinase CK2 has been associated with oncogenic transformation, and our previous studies have shown that it may affect estrogenic signaling. Here, we investigate the role of the protein kinase CK2 in regulating ERα (estrogen receptor α) signaling in breast cancer. We determined the correlation of CK2α expression with relapse free breast cancer patient survival utilizing Kaplan Meier Plotter (kmplot.com/analysis/) to mine breast cancer microarrays repositories. Patients were stratified according to ERα status, histological grade, and hormonal therapy. Luciferase reporter assays and flow cytometry were implemented to determine the impact of CK2 inhibition on ERE-mediated gene expression and expression of ERα protein. CK2α expression is associated with shorter relapse free survival among ERα (+) patients with grade 1 or 2 tumors, as well as among those patients receiving hormonal therapy. Biochemical inhibition of CK2 activity results in increased ER-transactivation as well as increased expression among ERα (+) and ERα (−) breast cancer cell lines. These findings suggest that CK2 may contribute to estrogen-independent cell proliferation and breast tumor progression, and may potentially serve as a biomarker and pharmacological target in breast cancer. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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13 pages, 218 KiB

Open AccessCommunication

Reducing Health Disparities and Improving Health Equity in Saint Lucia

by Kisha Holden^1,*,†, Lisa Charles^2,†, Stephen King^3,†, Brian McGregor^1,†, David Satcher^1,† and Allyson Belton^1,†

¹ Satcher Health Leadership Institute, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310, USA

² Victoria Hospital, Hospital Road, Castries P.O. Box 1750, St. Lucia

³ Tapion Hospital, Tapion Road, Castries P.O. Box 1780, St. Lucia

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 37; https://doi.org/10.3390/ijerph13010037 - 22 Dec 2015

Cited by 2 | Viewed by 5533

Abstract

St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, [...] Read more.

St. Lucia is an island nation in the Eastern Caribbean, with a population of 179,000 people, where chronic health conditions, such as hypertension and diabetes, are significant. The purpose of this pilot study is to create a model for community health education, tracking, and monitoring of these health conditions, research training, and policy interventions in St. Lucia, which may apply to other Caribbean populations, including those in the U.S. This paper reports on phase one of the study, which utilized a mixed method analytic approach. Adult clients at risk for, or diagnosed with, diabetes (n = 157), and health care providers/clinic administrators (n = 42), were recruited from five healthcare facilities in St. Lucia to assess their views on health status, health services, and improving health equity. Preliminary content analyses indicated that patients and providers acknowledge the relatively high prevalence of diabetes and other chronic illnesses, recognize the impact that socioeconomic status has on health outcomes, and desire improved access to healthcare and improvements to healthcare infrastructures. These findings could inform strategies, such as community education and workforce development, which may help improve health outcomes among St. Lucians with chronic health conditions, and inform similar efforts among other selected populations. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

7 pages, 530 KiB

Open AccessArticle

Profile of HIV-Infected Hispanics with Pancytopenia

by Eduardo J. Santiago-Rodríguez^*, Angel M. Mayor, Diana M. Fernández-Santos and Robert F. Hunter-Mellado

Retrovirus Research Center, Internal Medicine Department, School of Medicine, Universidad Central del Caribe, Bayamón, Puerto Rico 00960, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 38; https://doi.org/10.3390/ijerph13010038 - 22 Dec 2015

Cited by 11 | Viewed by 5874

Abstract

Pancytopenia is seen in late HIV infection; it is associated with medical complications and with decreased survival. We determined the prevalence of pancytopenia at baseline in a cohort of HIV-positive Hispanics living in Puerto Rico, and compared their socio-demographic, immunological and clinical characteristics. [...] Read more.

Pancytopenia is seen in late HIV infection; it is associated with medical complications and with decreased survival. We determined the prevalence of pancytopenia at baseline in a cohort of HIV-positive Hispanics living in Puerto Rico, and compared their socio-demographic, immunological and clinical characteristics. A total of 1202 patients enrolled between 2000 and 2010 were included. They were grouped according to pancytopenia status, defined by having: platelets <150,000 μL, white cell count <4000 μL, and hemoglobin <12 g/dL (women) or <13 g/dL (men). Differences were evaluated using Student’s t-test, Chi-square test and Kaplan-Meier method. The prevalence of pancytopenia was 8.7%. Patients with pancytopenia had lower BMI and lower CD4 count, as well as higher HIV viral load and higher proportions of unemployment, clinical AIDS and antiretroviral treatment (ART) use (p < 0.05). One-year mortality rate was significantly higher in patients with pancytopenia (18.1% vs. 5.1%, p < 0.001). When stratifying for ART this association persisted for patients who did not receive ART (41.4% vs. 5.2%, p < 0.001), but it was not seen in patients who received treatment (9.2% vs. 5.6%, p = 0.196). Pancytopenia was associated with elements of advanced stages of HIV. ART could reduce the mortality of HIV-patients with pancytopenia to levels comparable to patients without the disorders. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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6 pages, 174 KiB

Open AccessArticle

A Pilot Study to Examine the Disparities in Water Quality between Predominantly Haitian Neighborhoods and Dominican Neighborhoods in Two Cities in the Dominican Republic

by Jessica Rogers-Brown^*, Ryan Johnson^†, Dominique Smith^† and Kim Ramsey-White^†

¹ Center for Excellence on Health Disparities Research, School of Public Health, Georgia State University, Atlanta, GA 30302, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 39; https://doi.org/10.3390/ijerph13010039 - 22 Dec 2015

Cited by 6 | Viewed by 4767

Abstract

Worldwide, diarrheal disease is a leading cause of death affecting over 1.7 million individuals annually. Much of this can be attributed to lack of clean water, sanitation and hygiene. Nearly all of these deaths occur in countries with developing economies. This public health [...] Read more.

Worldwide, diarrheal disease is a leading cause of death affecting over 1.7 million individuals annually. Much of this can be attributed to lack of clean water, sanitation and hygiene. Nearly all of these deaths occur in countries with developing economies. This public health problem is apparent in the island of Hispaniola; the island that is shared by Haiti and the Dominican Republic. Significant gaps in income between the countries have resulted in Haitians migrating into the Dominican Republic. While there has been increased migration into the Dominican Republic, many of the neighborhoods remain segregated. A cross-sectional analysis was conducted at 49 sites in the Dominican Republic. Samples were classified as being from a Haitian neighborhood or Dominican neighborhood and analyzed for microbial contamination. Overall, Haitian neighborhoods were found to have statistically significantly higher levels of contamination of both coliform and E. coli. The odds of having E. coli contaminated water in Haitian neighborhoods are 4.25 times as high as Dominican neighborhoods. The odds of having coliform contaminated water in Haitian neighborhoods are 4.78 times as high as Dominican neighborhoods. This study provides evidence of the disparity in access to clean drinking water for Haitian immigrants and highlights the need for further investigation. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

12 pages, 209 KiB

Open AccessArticle

Minority College Women’s Views on Condom Negotiation

by TyWanda McLaurin-Jones^1,*, Maudry-Beverly Lashley² and Vanessa Marshall¹

¹ Department of Community & Family Medicine, Howard University College of Medicine, 520 W Street, NW, Washington, DC 20059, USA

² Department of Psychology, Medgar Evers College, 1650 Bedford Avenue, Brooklyn, NY 11235, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 40; https://doi.org/10.3390/ijerph13010040 - 22 Dec 2015

Cited by 18 | Viewed by 5228

Abstract

This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black [...] Read more.

This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black Colleges and Universities (HBCU) completed a questionnaire that included the Condom Influence Strategies Scale (CIS) and participated in a focus group. An ANOVA was conducted to compare differences between never, inconsistent, and consistent condom users. Consistent condom users scored higher than never users on the “withholding sex” subscale of the CIS (4.88 vs. 3.55; p < 0.001) as well as endorsed items more strongly on the “direct request” subscale of the CIS (4.63 vs. 3.82, p < 0.05) than never users. A thematic analysis of open discussions identified overarching themes. Similarly, refusing sex and/or having direct communications with partner emerged as primary strategies. Threats to negotiation included deciding the “right timing” of discussion and having a previous history of sexual intercourse without a condom with their partner. Other key concepts that contribute to condom negotiation are the views that condoms are a male’s responsibility and stigma of women who carry condoms. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

12 pages, 289 KiB

Open AccessArticle

Results of a Community Randomized Study of a Faith-Based Education Program to Improve Clinical Trial Participation among African Americans

by Paula M. Frew^1,2,3,*, Jay T. Schamel¹, Kelli A. O’Connell⁴, Laura A. Randall^1,2 and Sahithi Boggavarapu^1,5

¹ Department of Medicine, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA 30322, USA

² Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

³ Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

⁴ Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

⁵ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 41; https://doi.org/10.3390/ijerph13010041 - 22 Dec 2015

Cited by 13 | Viewed by 5392

Abstract

This is a report of a cluster randomized clinical trial evaluating the effectiveness of a church-based educational intervention aimed at improving African Americans’ (AA) participation in clinical trials. Two hundred and twenty-one AA subjects ages ≥50 years from six predominantly AA churches were [...] Read more.

This is a report of a cluster randomized clinical trial evaluating the effectiveness of a church-based educational intervention aimed at improving African Americans’ (AA) participation in clinical trials. Two hundred and twenty-one AA subjects ages ≥50 years from six predominantly AA churches were randomized to intervention or control condition. The intervention included three educational sessions about clinical trials and health disparities; control participants completed questionnaires. Primary endpoints of the study were differences in individual subjects' intentions to obtain clinical trial information and intention to join a clinical trial, as determined by 10 point scale items at baseline, three and six months. A statistically significant increase in the intention to obtain clinical trial information at the three and six month time points was observed in the intervention group, but not the control group. Older participants (65–95 years) were less likely than younger participants (50–64 years) to increase their motivation to seek clinical trial information by the three and six month time points. No significant increases were observed in intention to join clinical trials. This randomized trial shows that AA church-based educational interventions are likely to increase the motivation of AA subjects to obtain clinical trial information and are therefore potentially effective at ameliorating the underrepresentation of AA subjects in clinical trials. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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13 pages, 518 KiB

Open AccessArticle

The Impact of Educational Attainment on Observed Race/Ethnic Disparities in Inflammatory Risk in the 2001–2008 National Health and Nutrition Examination Survey

by Gniesha Y. Dinwiddie^1,2,*, Ruth E. Zambrana^3,4, Lauren A. Doamekpor⁵ and Lenny Lopez⁶

¹ African American Studies Department, University of Maryland, College Park, MD 20742, USA

² Maryland Population Research Center, University of Maryland, College Park, MD 20742, USA

³ Women’s Studies Department, University of Maryland, College Park, MD 20742, USA

⁴ Consortium on Race, Gender and Ethnicity, University of Maryland, College Park, MD 20742, USA

⁵ National Center for Health Research, Washington, DC 20036, USA

⁶ Department of Medicine, University of California, San Francisco, CA 94121, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 42; https://doi.org/10.3390/ijerph13010042 - 22 Dec 2015

Cited by 17 | Viewed by 6546

Abstract

Inflammation has shown to be an independent predictor of cardiovascular disease (CVD) and growing evidence suggests Non-Hispanic Blacks (NHBs) and certain Hispanic subgroups have higher inflammation burden compared to Non-Hispanic Whites (NHWs). Socioeconomic status (SES) is a hypothesized pathway that may account for [...] Read more.

Inflammation has shown to be an independent predictor of cardiovascular disease (CVD) and growing evidence suggests Non-Hispanic Blacks (NHBs) and certain Hispanic subgroups have higher inflammation burden compared to Non-Hispanic Whites (NHWs). Socioeconomic status (SES) is a hypothesized pathway that may account for the higher inflammation burden for race/ethnic groups yet little is known about the biological processes by which SES “gets under the skin” to affect health and whether income and education have similar or distinct influences on elevated inflammation levels. The current study examines SES (income and education) associations with multiple levels of C-Reactive Protein (CRP), an important biomarker of inflammation, in a sample of 13,362 NHWs, 7696 NHBs and 4545 Mexican Americans (MAs) in the United States from the 2001 to 2008 National Health and Nutrition Examination Survey. After adjusting for age, sex, and statin use, NHBs and MAs had higher intermediate and high CRP levels compared to NHWs. Income lessened the magnitude of the association for both race/ethnic groups. The greater intermediate and high CRP burden for NHBs and MAs was strongly explained by educational attainment. MAs were more vulnerable to high CRP levels for the lowest (i.e., less than nine years) and post high school (i.e., associates degree) educational levels. After additional adjustment for smoking, heavy drinking, high waist circumference, high blood pressure, diabetes and statin use, the strength of the association between race/ethnicity and inflammation was reduced for NHBs with elevated intermediate (RR = 1.31; p ≤ 0.001) and high CRP levels (RR = 1.14; p ≤ 0.001) compared to NHWs but the effect attenuated for MAs for both intermediate (RR = 0.74; p ≤ 0.001) and high CRP levels (RR = 0.38; p ≤ 0.001). These findings suggest educational attainment is a powerful predictor of elevated CRP levels in race/ethnic populations and challenges studies to move beyond examining income as a better predictor in the SES-inflammation pathway. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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8 pages, 888 KiB

Open AccessArticle

Beta-Arrestin1 Levels in Mononuclear Leukocytes Support Depression Scores for Women with Premenstrual Dysphoric Disorder

by Farzana Alam, Sanket Nayyar, William Richie, Anthony Archibong and Tultul Nayyar^*

Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd, Nashville, TN 37208, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 43; https://doi.org/10.3390/ijerph13010043 - 22 Dec 2015

Cited by 5 | Viewed by 4272

Abstract

Depression is very common in reproductive women particularly with premenstrual dysphoric disorder (PMDD), which is a severe form of premenstrual syndrome (PMS). Beta-arrestins were previously implicated in the pathophysiology, diagnosis and treatment for mood disorders. This study examined whether a measurement for beta-arrestin1 [...] Read more.

Depression is very common in reproductive women particularly with premenstrual dysphoric disorder (PMDD), which is a severe form of premenstrual syndrome (PMS). Beta-arrestins were previously implicated in the pathophysiology, diagnosis and treatment for mood disorders. This study examined whether a measurement for beta-arrestin1 levels in peripheral blood mononuclear leukocytes (PBMC), could aid to distinguish between PMDD and PMS. Study participants (n = 25) were non-pregnant women between 18–42 years of age with the symptoms of PMS/PMDD, but not taking any antidepressants/therapy and at the luteal phase of menstruation. The levels of beta-arrestin1 protein in the PBMCs were determined by ELISA using human beta-arrestin1 kit. The beta-arrestin1 levels were compared with the Hamilton Depression Rating Scale scores among these women. The magnitude of the different parameters for Axis 1 mental disorders were significantly higher and beta arrestin1 protein levels in PBMCs were significantly lower in women with PMDD as compared to PMS women. The reduction in beta arrestin1 protein levels was significantly correlated with the severity of depressive symptoms. Beta-arrestin1 measurements in women may potentially serve for biochemical diagnostic purposes for PMDD and might be useful as evidence-based support for questionnaires. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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12 pages, 212 KiB

Open AccessArticle

Local Health Departments’ Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?

by Gulzar H. Shah^* and John P. Sheahan

Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 44; https://doi.org/10.3390/ijerph13010044 - 23 Dec 2015

Cited by 23 | Viewed by 7991

Abstract

Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with [...] Read more.

Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement. Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities. Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four activities. LHD characteristics significantly associated (p≤0.05) with the increased likelihood of performing activities to address health disparities were: recent completion of community health assessment, community health improvement plan and agency wide strategic plan. Other significant positive impacts on such activities included per capita expenditures, local governance, having one or more local boards of health, larger population size and metropolitan status of the LHD jurisdiction. Conclusions: Reduced infrastructural capacity of LHDs has resulted in fewer LHDs addressing health disparities in their jurisdictions. LHD characteristics associated with higher performance of activities for health disparity reduction identified by this research have important policy implications. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

7 pages, 183 KiB

Open AccessArticle

Harnessing Data to Assess Equity of Care by Race, Ethnicity and Language

by Amber Gracia^1,*, Jorge Cheirif², Juana Veliz³, Melissa Reyna³, Mara Vecchio⁴ and Subhash Aryal⁵

¹ Cinco Strategy Group, 937 Kessler Parkway, Dallas, TX 75208, USA

² Presbyterian Heart & Vascular Group, 8440 Walnut Hill Lane, #610, Dallas, TX 75231, USA

³ Texas Health Resources, 612 E. Lamar Blvd, Suite 1000, Arlington, TX 76011, USA

⁴ Texas Health Research & Education Institute, 8400 Walnut Hill Lane, Suite 220, Dallas, TX 75231, USA

⁵ Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 45; https://doi.org/10.3390/ijerph13010045 - 22 Dec 2015

Cited by 1 | Viewed by 4446

Abstract

Objective: Determine any disparities in care based on race, ethnicity and language (REaL) by utilizing inpatient (IP) core measures at Texas Health Resources, a large, faith-based, non-profit health care delivery system located in a large, ethnically diverse metropolitan area in Texas. These measures, [...] Read more.

Objective: Determine any disparities in care based on race, ethnicity and language (REaL) by utilizing inpatient (IP) core measures at Texas Health Resources, a large, faith-based, non-profit health care delivery system located in a large, ethnically diverse metropolitan area in Texas. These measures, which were established by the U.S. Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC), help to ensure better accountability for patient outcomes throughout the U.S. health care system. Methods: Sample analysis to understand the architecture of race, ethnicity and language (REaL) variables within the Texas Health clinical database, followed by development of the logic, method and framework for isolating populations and evaluating disparities by race (non-Hispanic White, non-Hispanic Black, Native American/Native Hawaiian/Pacific Islander, Asian and Other); ethnicity (Hispanic and non-Hispanic); and preferred language (English and Spanish). The study is based on use of existing clinical data for four inpatient (IP) core measures: Acute Myocardial Infarction (AMI), Congestive Heart Failure (CHF), Pneumonia (PN) and Surgical Care (SCIP), representing 100% of the sample population. These comprise a high number of cases presenting in our acute care facilities. Findings are based on a sample of clinical data (N = 19,873 cases) for the four inpatient (IP) core measures derived from 13 of Texas Health’s wholly-owned facilities, formulating a set of baseline data. Results: Based on applied method, Texas Health facilities consistently scored high with no discernable race, ethnicity and language (REaL) disparities as evidenced by a low percentage difference to the reference point (non-Hispanic White) on IP core measures, including: AMI (0.3%–1.2%), CHF (0.7%–3.0%), PN (0.5%–3.7%), and SCIP (0–0.7%). Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

11 pages, 210 KiB

Open AccessArticle

Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors

by Benjamin Ansa^1,*

, Wonsuk Yoo^1,2

, Mary Whitehead³, Steven Coughlin⁴ and Selina Smith^1,5

¹ Institute of Public & Preventive Health, Georgia Regents University, CJ-2300 1120 15th Street Augusta, GA 30912, USA

² College of Dental Medicine, Georgia Regents University, Augusta, GA 30912, USA

³ SISTAAH Talk Breast Cancer Support Group, Miami, FL 33169, USA

⁴ Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, Lowell, MA 01854, USA

⁵ Department of Family Medicine, Medical College of Georgia, Augusta, GA 30912, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 46; https://doi.org/10.3390/ijerph13010046 - 23 Dec 2015

Cited by 15 | Viewed by 6178

Abstract

A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs). Study participants included 191 AA [...] Read more.

A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs). Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%), lack of physical activity (48.7%), and a high fat diet (63.2%) are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5%) agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9%) believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M² reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M² (p = 0.06); nearly all of the women (99.2%) answered “yes” to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05). These results provide information about AA BCSs’ beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

17 pages, 3041 KiB

Open AccessArticle

Computer Optimization of Biodegradable Nanoparticles Fabricated by Dispersion Polymerization

by Emmanuel O. Akala^*

, Simeon Adesina and Oluwaseun Ogunwuyi

Center for Drug Research and Development, Department of Pharmaceutical Sciences, College of Pharmacy, Howard University, 2300 4th Street NW, Washington, DC 20059, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 47; https://doi.org/10.3390/ijerph13010047 - 22 Dec 2015

Cited by 12 | Viewed by 4616

Abstract

Quality by design (QbD) in the pharmaceutical industry involves designing and developing drug formulations and manufacturing processes which ensure predefined drug product specifications. QbD helps to understand how process and formulation variables affect product characteristics and subsequent optimization of these variables vis-à-vis final [...] Read more.

Quality by design (QbD) in the pharmaceutical industry involves designing and developing drug formulations and manufacturing processes which ensure predefined drug product specifications. QbD helps to understand how process and formulation variables affect product characteristics and subsequent optimization of these variables vis-à-vis final specifications. Statistical design of experiments (DoE) identifies important parameters in a pharmaceutical dosage form design followed by optimizing the parameters with respect to certain specifications. DoE establishes in mathematical form the relationships between critical process parameters together with critical material attributes and critical quality attributes. We focused on the fabrication of biodegradable nanoparticles by dispersion polymerization. Aided by a statistical software, d-optimal mixture design was used to vary the components (crosslinker, initiator, stabilizer, and macromonomers) to obtain twenty nanoparticle formulations (PLLA-based nanoparticles) and thirty formulations (poly-ɛ-caprolactone-based nanoparticles). Scheffe polynomial models were generated to predict particle size (nm), zeta potential, and yield (%) as functions of the composition of the formulations. Simultaneous optimizations were carried out on the response variables. Solutions were returned from simultaneous optimization of the response variables for component combinations to (1) minimize nanoparticle size; (2) maximize the surface negative zeta potential; and (3) maximize percent yield to make the nanoparticle fabrication an economic proposition. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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8 pages, 180 KiB

Open AccessArticle

Differences in Colorectal Cancer Outcomes by Race and Insurance

by Rima Tawk^1,*, Adrian Abner², Alicestine Ashford¹ and Clyde Perry Brown¹

¹ Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA

² Residential Services Administrator, Marianna, FL 32448, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 48; https://doi.org/10.3390/ijerph13010048 - 22 Dec 2015

Cited by 66 | Viewed by 6210

Abstract

Colorectal cancer (CRC) is the second most common cancer among African American women and the third most common cancer for African American men. The mortality rate from CRC is highest among African Americans compared to any other racial or ethnic group. Much of [...] Read more.

Colorectal cancer (CRC) is the second most common cancer among African American women and the third most common cancer for African American men. The mortality rate from CRC is highest among African Americans compared to any other racial or ethnic group. Much of the disparity in mortality is likely due to diagnosis at later stages of the disease, which could result from unequal access to screening. The purpose of this study is to determine the impact of race and insurance status on CRC outcomes among CRC patients. Data were drawn from the Surveillance, Epidemiology, and End Results database. Logistic regressions models were used to examine the odds of receiving treatment after adjusting for insurance, race, and other variables. Cox proportional hazard models were used to measure the risk of CRC death after adjusting for sociodemographic and tumor characteristics when associating race and insurance with CRC-related death. Blacks were diagnosed at more advanced stages of disease than whites and had an increased risk of death from both colon and rectal cancers. Lacking insurance was associated with an increase in CRC related-deaths. Findings from this study could help profile and target patients with the greatest disparities in CRC health outcomes. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

14 pages, 738 KiB

Open AccessArticle

Epidemiologic, Racial and Healthographic Mapping of Delaware Pediatric Cancer: 2004–2014

by Laurens Holmes^1,2,*, Jonathan Vandenberg^1,3,†, Lavisha McClarin^1,4,† and Kirk Dabney¹

¹ Nemours/Alfred I. duPont Hospital for Children, Office of Health Equity and Inclusion, 2200 Concord Pike, Wilmington, DE 19803, USA

² Biological Sciences Department, University of Delaware, 118 Wolf Hall, Newark, DE 19716, USA

³ Biological Sciences Department, Furman University, 3300 Poinsett Hwy, Greenville, SC 29613, USA

⁴ Epidemiology & Biostatistics Department, University of Maryland-College Park, 255 Campus Drive, College Park, MD 20740, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 49; https://doi.org/10.3390/ijerph13010049 - 22 Dec 2015

Cited by 14 | Viewed by 6584

Abstract

Childhood cancer remains the leading cause of disease-related death among children 0 to 14 years and incidence varies by race, ethnicity, sex, geographic locale, and age at onset. However, data are unavailable in some regions, indicative of a need for such information for [...] Read more.

Childhood cancer remains the leading cause of disease-related death among children 0 to 14 years and incidence varies by race, ethnicity, sex, geographic locale, and age at onset. However, data are unavailable in some regions, indicative of a need for such information for cancer awareness, education and prevention program. We utilized retrospective epidemiologic design to assess and characterize pediatric tumors in the Nemours Electronic Medical Records, between 2004 and 2014. Tumor frequency and children population size were used to determine the period prevalence as cumulative incidence (CI) proportion, as well as chi-square and Poisson Regression. The CI for overall childhood cancer in Delaware was 234 per 100,000 children, and varied by race, black (273 per 100,000), white (189 per 100,000). Similarly, sex variability was observed in CI, boys (237 per 100,000) and girls (230 per 100,000). The most commonly diagnosed malignancies were acute lymphoblastic leukemia (ALL), Central Nervous System (CNS)/brain and renal cancer. The geographic locales with relatively higher cancer CI in the state of DE were zip codes 19804 and 19960, but this does not imply cancer clustering. Differences in overall childhood cancer distribution occurred by race, sex, geography, and age. These findings are indicative of the need for cancer-specific health education, awareness and prevention programs in reducing the observed disparities in Delaware. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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8 pages, 535 KiB

Open AccessArticle

Persistent HIV Viremia: Description of a Cohort of HIV Infected Individuals with ART Failure in Puerto Rico

by Gerónimo Maldonado-Martínez^1,*,†, Robert F. Hunter-Mellado^2,†, Diana Fernández-Santos¹ and Eddy Ríos-Olivares³

¹ Data Management and Statistical Research Support Unit, Universidad Central del Caribe, Bayamón 00960, Puerto Rico

² Internal Medicine Department, Universidad Central del Caribe, Bayamón 00960, Puerto Rico

³ Microbiology Department, Universidad Central del Caribe, Bayamón 00960, Puerto Rico

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 50; https://doi.org/10.3390/ijerph13010050 - 22 Dec 2015

Cited by 5 | Viewed by 4600

Abstract

The introduction of antiretroviral therapy (ART) has allowed human immunodeficiency virus (HIV) suppression in patients. We present data of a cohort of Puerto Rican patients with HIV who were under treatment with a steady regime of ART across a time horizon of eleven [...] Read more.

The introduction of antiretroviral therapy (ART) has allowed human immunodeficiency virus (HIV) suppression in patients. We present data of a cohort of Puerto Rican patients with HIV who were under treatment with a steady regime of ART across a time horizon of eleven years. The time periods were categorized into four year stratums: 2000 to 2002; 2003 to 2005; 2006 to 2008 and 2009 to 2011. Socio-demographic profile, HIV risk factors, co-morbid conditions were included as study variables. One year mortality was defined. The p value was set at ≤0.05. The cohort consisted of 882 patients with 661 subjects presenting with persistent HIV viral load after a self-reported 12 month history of ART use. In this sub-cohort a higher viral load was seen across time (p < 0.05). Illicit drug use, IV drug use, alcohol use, loss of work were associated to having higher viral load means (p < 0.05). HIV viral load mean was lower as BMI increased (p < 0.001). It is imperative to readdress antiretroviral adherence protocols and further study ART tolerance and compliance. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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11 pages, 313 KiB

Open AccessArticle

Color It Real: A Program to Increase Condom Use and Reduce Substance Abuse and Perceived Stress

by Tiffany Zellner^1,*, Jennie Trotter², Shelia Lenoir², Kelvin Walston², L’dia Men-Na’a², Tabia Henry-Akintobi¹

and Assia Miller³

¹ Department of Community Health and Preventive Medicine, Morehouse School of Medicine Prevention Research Center, 720 Westview Drive SW, Atlanta, GA 30310, USA

² Wholistic Stress Control Institute, Incorporated, 2545 Benjamin E Mays Drive, Atlanta, GA 30311, USA

³ McKing Consulting Corporation, 2900 Chamblee Tucker Road, Building 10, Suite 100, Atlanta, GA 30341, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 51; https://doi.org/10.3390/ijerph13010051 - 22 Dec 2015

Cited by 18 | Viewed by 7278

Abstract

Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide [...] Read more.

Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122) and comparison (n = 70) groups completing a pre- and post-intervention survey. A series of Analysis of Variance (ANOVA) tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70) = 2.38, p = 0.020), condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360), intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245), and to use clean needles when injecting the drug (F = 36.99, p = 0.0001). This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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10 pages, 214 KiB

Open AccessArticle

The Ala54Thr Polymorphism of the Fatty Acid Binding Protein 2 Gene Modulates HDL Cholesterol in Mexican-Americans with Type 2 Diabetes

by Lorena M. Salto¹

, Liming Bu¹, W. Lawrence Beeson^1,2

, Anthony Firek³, Zaida Cordero-MacIntyre^1,2

and Marino De Leon^1,*

¹ Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA

² Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA

³ Endocrinology Section, JL Pettis Memorial VA Medical Center, Loma Linda, CA 92357, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 52; https://doi.org/10.3390/ijerph13010052 - 23 Dec 2015

Cited by 8 | Viewed by 4550

Abstract

The alanine to threonine amino acid substitution at codon 54 (Ala54Thr) of the intestinal fatty acid binding protein (FABP2) has been associated with elevated levels of insulin and blood glucose as well as with dyslipidemia. The aim of this study was [...] Read more.

The alanine to threonine amino acid substitution at codon 54 (Ala54Thr) of the intestinal fatty acid binding protein (FABP2) has been associated with elevated levels of insulin and blood glucose as well as with dyslipidemia. The aim of this study was to characterize the effect of this FABP2 polymorphism in Mexican-Americans with type 2 diabetes (T2D) in the context of a three-month intervention to determine if the polymorphism differentially modulates selected clinical outcomes. For this study, we genotyped 43 participant samples and performed post-hoc outcome analysis of the profile changes in fasting blood glucose, HbA1c, insulin, lipid panel and body composition, stratified by the Ala54Thr polymorphism. Our results show that the Thr54 allele carriers (those who were heterozygous or homozygous for the threonine-encoding allele) had lower HDL cholesterol and higher triglyceride levels at baseline compared to the Ala54 homozygotes (those who were homozygous for the alanine-encoding allele). Both groups made clinically important improvements in lipid profiles and glycemic control as a response to the intervention. Whereas the Ala54 homozygotes decreased HDL cholesterol in the context of an overall total cholesterol decrease, Thr54 allele carriers increased HDL cholesterol as part of an overall total cholesterol decrease. We conclude that the Ala54Thr polymorphism of FABP2 modulates HDL cholesterol in Mexican-Americans with T2D and that Thr54 allele carriers may be responsive in interventions that include dietary changes. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

11 pages, 374 KiB

Open AccessArticle

Increasing Cervical Cancer Awareness and Screening in Jamaica: Effectiveness of a Theory-Based Educational Intervention

by Evelyn Coronado Interis^1,*,†, Chidinma P. Anakwenze^2,†, Maug Aung³ and Pauline E. Jolly¹

¹ School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA

² School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA

³ Epidemiology and Research Unit, Western Regional Health Authority, Montego Bay, Jamaica

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 53; https://doi.org/10.3390/ijerph13010053 - 22 Dec 2015

Cited by 46 | Viewed by 9603

Abstract

Despite declines in cervical cancer mortality in developed countries, cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening. Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to [...] Read more.

Despite declines in cervical cancer mortality in developed countries, cervical cancer incidence and mortality rates remain high in Jamaica due to low levels of screening. Effective interventions are needed to decrease barriers to preventive behaviors and increase adoption of behaviors and services to improve prospects of survival. We enrolled 225 women attending health facilities in an intervention consisting of a pre-test, educational presentation and post-test. The questionnaires assessed attitudes, knowledge, risk factors, and symptoms of cervical cancer among women. Changes in knowledge and intention to screen were assessed using paired t-tests and tests for correlated proportions. Participants were followed approximately six months post-intervention to determine cervical cancer screening rates. We found statistically significant increases from pre-test to post-test in the percentage of questions correctly answered and in participants’ intention to screen for cervical cancer. The greatest improvements were observed in responses to questions on knowledge, symptoms and prevention, with some items increasing up to 62% from pre-test to post-test. Of the 123 women reached for follow-up, 50 (40.7%) screened for cervical cancer. This theory-based education intervention significantly increased knowledge of and intention to screen for cervical cancer, and may be replicated in similar settings to promote awareness and increase screening rates. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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9 pages, 513 KiB

Open AccessArticle

Associations of Adiponectin with Adiposity, Insulin Sensitivity, and Diet in Young, Healthy, Mexican Americans and Non-Latino White Adults

by Rocio I. Pereira^1,2,*, Cecilia C. Low Wang¹, Pamela Wolfe¹, Edward P. Havranek², Carlin S. Long² and Daniel H. Bessesen^1,2

¹ Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA

² Denver Health Medical Center, Denver, CO 80204, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 54; https://doi.org/10.3390/ijerph13010054 - 22 Dec 2015

Cited by 7 | Viewed by 4807

Abstract

Low circulating adiponectin levels may contribute to higher diabetes risk among Mexican Americans (MA) compared to non-Latino whites (NLW). Our objective was to determine if among young healthy adult MAs have lower adiponectin than NLWs, independent of differences in adiposity. In addition, we [...] Read more.

Low circulating adiponectin levels may contribute to higher diabetes risk among Mexican Americans (MA) compared to non-Latino whites (NLW). Our objective was to determine if among young healthy adult MAs have lower adiponectin than NLWs, independent of differences in adiposity. In addition, we explored associations between adiponectin and diet. This was an observational, cross-sectional study of healthy MA and NLW adults living in Colorado (U.S.A.). We measured plasma total adiponectin, adiposity (BMI, and visceral adipose tissue), insulin sensitivity (IVGTT), and self-reported dietary intake in 43 MA and NLW adults. Mean adiponectin levels were 40% lower among MA than NLW (5.8 ± 3.3 vs. 10.7 ± 4.2 µg/mL, p = 0.0003), and this difference persisted after controlling for age, sex, BMI, and visceral adiposity. Lower adiponectin in MA was associated with lower insulin sensitivity (R² = 0.42, p < 0.01). Lower adiponectin was also associated with higher dietary glycemic index, lower intake of vegetables, higher intake of trans fat, and higher intake of grains. Our findings confirm that ethnic differences in adiponectin reflect differences in insulin sensitivity, but suggest that these are not due to differences in adiposity. Observed associations between adiponectin and diet support the need for future studies exploring the regulation of adiponectin by diet and other environmental factors. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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8 pages, 3890 KiB

Open AccessBrief Report

The Genetic Diversity and Evolution of HIV-1 Subtype B Epidemic in Puerto Rico

by Pablo López, Vanessa Rivera-Amill, Nayra Rodríguez, Freddie Vargas and Yasuhiro Yamamura^*

AIDS Research Program, Ponce Health Sciences University-School of Medicine/Ponce Research Institute, 395 Industrial Reparada 2, Ponce, PR 00716-2348, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 55; https://doi.org/10.3390/ijerph13010055 - 23 Dec 2015

Cited by 4 | Viewed by 5204

Abstract

HIV-1 epidemics in Caribbean countries, including Puerto Rico, have been reported to be almost exclusively associated with the subtype B virus (HIV-1B). However, while HIV infections associated with other clades have been only sporadically reported, no organized data exist to accurately assess the [...] Read more.

HIV-1 epidemics in Caribbean countries, including Puerto Rico, have been reported to be almost exclusively associated with the subtype B virus (HIV-1B). However, while HIV infections associated with other clades have been only sporadically reported, no organized data exist to accurately assess the prevalence of non-subtype B HIV-1 infection. We analyzed the nucleotide sequence data of the HIV pol gene associated with HIV isolates from Puerto Rican patients. The sequences (n = 945) were obtained from our “HIV Genotyping” test file, which has been generated over a period of 14 years (2001–2014). REGA subtyping tool found the following subtypes: B (90%), B-like (3%), B/D recombinant (6%), and D/B recombinant (0.6%). Though there were fewer cases, the following subtypes were also found (in the given proportions): A1B (0.3%), BF1 (0.2%), subtype A (01-AE) (0.1%), subtype A (A2) (0.1%), subtype F (12BF) (0.1%), CRF-39 BF-like (0.1%), and others (0.1%). Some of the recombinants were identified as early as 2001. Although the HIV epidemic in Puerto Rico is primarily associated with HIV-1B virus, our analysis uncovered the presence of other subtypes. There was no indication of subtype C, which has been predominantly associated with heterosexual transmission in other parts of the world. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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12 pages, 2167 KiB

Open AccessArticle

DNA Damage, Cell Cycle Arrest, and Apoptosis Induction Caused by Lead in Human Leukemia Cells

by Clement G. Yedjou^*

, Hervey M. Tchounwou and Paul B. Tchounwou

Natural Chemotherapeutics Research Laboratory, NIH-Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, 1400 Lynch Street, P.O. Box 18540, Jackson, MS 39217, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 56; https://doi.org/10.3390/ijerph13010056 - 22 Dec 2015

Cited by 39 | Viewed by 6998

Abstract

In recent years, the industrial use of lead has been significantly reduced from paints and ceramic products, caulking, and pipe solder. Despite this progress, lead exposure continues to be a significant public health concern. The main goal of this research was to determine [...] Read more.

In recent years, the industrial use of lead has been significantly reduced from paints and ceramic products, caulking, and pipe solder. Despite this progress, lead exposure continues to be a significant public health concern. The main goal of this research was to determine the in vitro mechanisms of lead nitrate [Pb(NO₃)₂] to induce DNA damage, apoptosis, and cell cycle arrest in human leukemia (HL-60) cells. To reach our goal, HL-60 cells were treated with different concentrations of Pb(NO₃)₂ for 24 h. Live cells and necrotic death cells were measured by the propidium idiode (PI) assay using the cellometer vision. Cell apoptosis was measured by the flow cytometry and DNA laddering. Cell cycle analysis was evaluated by the flow cytometry. The result of the PI demonstrated a significant (p < 0.05) increase of necrotic cell death in Pb(NO₃)₂-treated cells, indicative of membrane rupture by Pb(NO₃)₂ compared to the control. Data generated from the comet assay indicated a concentration-dependent increase in DNA damage, showing a significant increase (p < 0.05) in comet tail-length and percentages of DNA cleavage. Data generated from the flow cytometry assessment indicated that Pb(NO₃)₂ exposure significantly (p < 0.05) increased the proportion of caspase-3 positive cells (apoptotic cells) compared to the control. The flow cytometry assessment also indicated Pb(NO₃)₂ exposure caused cell cycle arrest at the G₀/G₁ checkpoint. The result of DNA laddering assay showed presence of DNA smear in the agarose gel with little presence of DNA fragments in the treated cells compared to the control. In summary, Pb(NO₃)₂ inhibits HL-60 cells proliferation by not only inducing DNA damage and cell cycle arrest at the G₀/G₁ checkpoint but also triggering the apoptosis through caspase-3 activation and nucleosomal DNA fragmentation accompanied by secondary necrosis. We believe that our study provides a new insight into the mechanisms of Pb(NO₃)₂ exposure and its associated adverse health effects. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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4 pages, 166 KiB

Open AccessEditorial

The 2014 Minority Health and Health Disparities Grantees’ Conference

by Mark Edberg¹, Barbara E. Hayes², Valerie Montgomery-Rice³ and Paul B. Tchounwou^4,*

¹ Department of Anthropology, Columbian College of Arts & Science, George Washington University, 2110 G St. NW, Washington, DC 20052, USA

² College of Pharmacy and Health Sciences, Texas Southern University, Gray Hall, 3100 Cleburne Street, Houston, TX 77004, USA

³ Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310, USA

⁴ RCMI Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, 1400 Lynch Street, Box 18750, Jackson, MS 39217, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 57; https://doi.org/10.3390/ijerph13010057 - 22 Dec 2015

Cited by 1 | Viewed by 3925

Abstract

Health disparities have been defined as a particular type of health difference closely linked with social, economic and/or environmental disadvantage. The National Institute on Minority Health and Health Disparities (NIMHD) at the National Institutes of Health, has a comprehensive portfolio of grants that [...] Read more.

Health disparities have been defined as a particular type of health difference closely linked with social, economic and/or environmental disadvantage. The National Institute on Minority Health and Health Disparities (NIMHD) at the National Institutes of Health, has a comprehensive portfolio of grants that fund scientific research to improve racial/ethnic minority health and eliminate health disparities. The 2014 Minority Health and Health Disparities Grantees’ Conference highlighted excellence and innovation in biological, environmental, sociocultural, clinical and behavioral research supported by NIMHD. This special issue of the International Journal of Environmental Research and Public Health includes peer-reviewed publications from investigators who participated in this conference. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

8 pages, 215 KiB

Open AccessArticle

Legionella pneumophila Seropositivity-Associated Factors in Latvian Blood Donors

by Olga Valciņa^1,*, Daina Pūle¹, Irina Lucenko², Dita Krastiņa¹, Žanete Šteingolde¹, Angelika Krūmiņa³ and Aivars Bērziņš¹

¹ Institute of Food Safety, Animal Health and Environment “BIOR”, Riga LV-1076, Latvia

² Centre for Disease Prevention and Control, Riga LV-1005, Latvia

³ Department of Infectology and Dermatology, Riga Stradiņš University, Riga LV-1007, Latvia

Int. J. Environ. Res. Public Health 2016, 13(1), 58; https://doi.org/10.3390/ijerph13010058 - 22 Dec 2015

Cited by 10 | Viewed by 4752

Abstract

Continuous environmental exposure of humans to Legionella may induce immune responses and generation of antibodies. The aim of this study was to investigate the seroprevalence of Legionella pneumophila serogroups (SG) 1–6 in the general healthy population and identify the associated host-related and environmental [...] Read more.

Continuous environmental exposure of humans to Legionella may induce immune responses and generation of antibodies. The aim of this study was to investigate the seroprevalence of Legionella pneumophila serogroups (SG) 1–6 in the general healthy population and identify the associated host-related and environmental risk factors. L. pneumophila SG 1–6 seroprevalence among a total of 2007 blood samples collected from healthy donors was 4.8%. Seroprevalence was higher in women (5.9%) than men (3.3%) and in areas with a larger number of inhabitants, ranging from 3.5% in rural regions to 6.8% in the capital, Riga. Blood samples from inhabitants of apartment buildings tested positive for L. pneumophila in more cases (5.8%) compared to those from inhabitants of single-family homes (2.7%). Residents of buildings with a municipal hot water supply system were more likely to be seropositive for L. pneumophila (OR = 3.16, 95% CI 1.26–7.91). Previous episodes of fever were additionally identified as a risk factor (OR = 2.42, 95% CI 1.43–4.1). In conclusion, centralized hot water supply, female gender and previous episodes of fever were determined as the main factors associated with L. pneumophila seropositivity in our study population. Full article

(This article belongs to the Special Issue Arsenic in Drinking Water: Current Perspectives and Future Directions)

10 pages, 752 KiB

Open AccessArticle

Standing Up for Learning: A Pilot Investigation on the Neurocognitive Benefits of Stand-Biased School Desks

by Ranjana K. Mehta^*

, Ashley E. Shortz^† and Mark E. Benden^†

¹ Department of Environmental and Occupational Health, Texas A&M School of Public Health, 1266 TAMU, College Station, TX 77843-1266, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 59; https://doi.org/10.3390/ijerph13010059 - 22 Dec 2015

Cited by 59 | Viewed by 46891

Abstract

Standing desks have proven to be effective and viable solutions to combat sedentary behavior among children during the school day in studies around the world. However, little is known regarding the potential of such interventions on cognitive outcomes in children over time. The [...] Read more.

Standing desks have proven to be effective and viable solutions to combat sedentary behavior among children during the school day in studies around the world. However, little is known regarding the potential of such interventions on cognitive outcomes in children over time. The purpose of this pilot study was to determine the neurocognitive benefits, i.e., improvements in executive functioning and working memory, of stand-biased desks and explore any associated changes in frontal brain function. 34 freshman high school students were recruited for neurocognitive testing at two time points during the school year: (1) in the fall semester and (2) in the spring semester (after 27.57 (1.63) weeks of continued exposure). Executive function and working memory was evaluated using a computerized neurocognitive test battery, and brain activation patterns of the prefrontal cortex were obtained using functional near infrared spectroscopy. Continued utilization of the stand-biased desks was associated with significant improvements in executive function and working memory capabilities. Changes in corresponding brain activation patterns were also observed. These findings provide the first preliminary evidence on the neurocognitive benefits of standing desks, which to date have focused largely on energy expenditure. Findings obtained here can drive future research with larger samples and multiple schools, with comparison groups that may in turn implicate the importance of stand-biased desks, as simple environmental changes in classrooms, on enhancing children’s cognitive functioning that drive their cognitive development and impact educational outcomes. Full article

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6 pages, 457 KiB

Open AccessBrief Report

Impact of ASUMA Intervention on HIV Risk Behaviors among Puerto Rican Adolescents

by Diana M. Fernandez-Santos^*, Christine Miranda-Diaz^†, Wanda I. Figueroa-Cosme^†, Raul O. Ramon^†, Angel M. Mayor^†, Eddy Rios-Olivares^† and Robert F. Hunter-Mellado^†

¹ Internal Medicine Department, Universidad Central del Caribe, School of Medicine, PO BOX 60327, Bayamon 00960-6032, Puerto Rico

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 60; https://doi.org/10.3390/ijerph13010060 - 23 Dec 2015

Cited by 2 | Viewed by 4200

Abstract

The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline [...] Read more.

The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline and at the end of the third year (fourth measure). Descriptive and inferential analyses were performed using SPSS 20.0. About 60% of the students were 14 years old at the fourth measure. The proportion of students that did not report at least one HIV risk behavior at baseline and those that reported any risk behavior at the fourth measure was lower in the intervention group (45.0%) than in the control group (54.5%). The proportion of students that reported at least one HIV risk behavior at baseline and those that did not report any HIV risk behavior at the fourth measure was higher in the intervention group than in the control group (33.3% vs. 8.3%). The proportion of students engaging in HIV risk behaviors was higher in the control group than in the intervention group at the fourth measure, suggesting that A Supportive Model for HIV Risk Reduction in Early Adolescence (ASUMA) intervention might be a promising initiative to reduce adolescents’ engagement in HIV risk behaviors. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

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23 pages, 760 KiB

Open AccessArticle

Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand

by David Briggs^1,*, Kylie Mason^2,† and Barry Borman^2,†

¹ Emeritus Professor, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK

² Centre for Public Health Research, Massey University, Wellington 6140, New Zealand

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 61; https://doi.org/10.3390/ijerph13010061 - 22 Dec 2015

Cited by 23 | Viewed by 10473

Abstract

An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (in)activity, and impacts attributed back to modal source. In [...] Read more.

An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (in)activity, and impacts attributed back to modal source. In total, road transport was found to be responsible for 650 deaths in 2012 (2.1% of annual mortality): 308 from traffic accidents, 283 as a result of air pollution, and 59 from noise. Together with morbidity, these represent a total burden of disease of 26,610 disability-adjusted life years (DALYs). An estimated 40 deaths and 1874 DALYs were avoided through active transport. Cars are responsible for about 52% of attributable deaths, but heavy goods vehicles (6% of vehicle kilometres travelled, vkt) accounted for 21% of deaths. Motorcycles (1 per cent of vkt) are implicated in nearly 8% of deaths. Overall, impacts of traffic-related air pollution and noise are low compared to other developed countries, but road accident rates are high. Results highlight the need for policies targeted at road accidents, and especially at heavy goods vehicles and motorcycles, along with more general action to reduce the reliance on private road transport. The study also provides a framework for national indicator development. Full article

(This article belongs to the Special Issue Cumulative and Integrated Health Impact Assessment)

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24 pages, 1186 KiB

Open AccessReview

Technologies for Arsenic Removal from Water: Current Status and Future Perspectives

by Nina Ricci Nicomel^1,2,3, Karen Leus², Karel Folens¹

, Pascal Van Der Voort²

and Gijs Du Laing^1,*

¹ Laboratory of Analytical Chemistry and Applied Ecochemistry, Ghent University, Coupure Links 653, B-9000 Gent, Belgium

² Department of Inorganic and Physical Chemistry, Center for Ordered Materials, Organometallics and Catalysis (COMOC), Ghent University, Krijgslaan 281-S3, B-9000 Gent, Belgium

³ Department of Engineering Science, College of Engineering and Agro-Industrial Technology, University of the Philippines Los Baños, 4031 Laguna, Philippines

Int. J. Environ. Res. Public Health 2016, 13(1), 62; https://doi.org/10.3390/ijerph13010062 - 22 Dec 2015

Cited by 387 | Viewed by 23484

Abstract

This review paper presents an overview of the available technologies used nowadays for the removal of arsenic species from water. Conventionally applied techniques to remove arsenic species include oxidation, coagulation-flocculation, and membrane techniques. Besides, progress has recently been made on the utility of [...] Read more.

This review paper presents an overview of the available technologies used nowadays for the removal of arsenic species from water. Conventionally applied techniques to remove arsenic species include oxidation, coagulation-flocculation, and membrane techniques. Besides, progress has recently been made on the utility of various nanoparticles for the remediation of contaminated water. A critical analysis of the most widely investigated nanoparticles is presented and promising future research on novel porous materials, such as metal organic frameworks, is suggested. Full article

(This article belongs to the Special Issue Arsenic in Drinking Water: Current Perspectives and Future Directions)

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16 pages, 1087 KiB

Open AccessArticle

Heavy Metal Pollution in a Soil-Rice System in the Yangtze River Region of China

by Zhouping Liu, Qiaofen Zhang, Tiqian Han, Yanfei Ding, Junwei Sun, Feijuan Wang^* and Cheng Zhu^*

College of Life Sciences, China Jiliang University, Hangzhou 310018, China

Int. J. Environ. Res. Public Health 2016, 13(1), 63; https://doi.org/10.3390/ijerph13010063 - 22 Dec 2015

Cited by 91 | Viewed by 9151

Abstract

Heavy metals are regarded as toxic trace elements in the environment. Heavy metal pollution in soil or rice grains is of increasing concern. In this study, 101 pairs of soil and rice samples were collected from the major rice-producing areas along the Yangtze [...] Read more.

Heavy metals are regarded as toxic trace elements in the environment. Heavy metal pollution in soil or rice grains is of increasing concern. In this study, 101 pairs of soil and rice samples were collected from the major rice-producing areas along the Yangtze River in China. The soil properties and heavy metal (i.e., Cd, Hg, Pb and Cr) concentrations in the soil and rice grains were analyzed to evaluate the heavy metal accumulation characteristics of the soil-rice systems. The results showed that the Cd, Hg, Pb and Cr concentrations in the soil ranged from 0.10 to 4.64, 0.01 to 1.46, 7.64 to 127.56, and 13.52 to 231.02 mg·kg⁻¹, respectively. Approximately 37%, 16%, 60% and 70% of the rice grain samples were polluted by Cd, Hg, Pb, and Cr, respectively. The degree of heavy metal contamination in the soil-rice systems exhibited a regional variation. The interactions among the heavy metal elements may also influence the migration and accumulation of heavy metals in soil or paddy rice. The accumulation of heavy metals in soil and rice grains is related to a certain extent to the pH and soil organic matter (SOM). This study provides useful information regarding heavy metal accumulation in soil to support the safe production of rice in China. The findings from this study also provide a robust scientific basis for risk assessments regarding ecological protection and food safety. Full article

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13 pages, 218 KiB

Open AccessArticle

Study on Oxygen Supply Standard for Physical Health of Construction Personnel of High-Altitude Tunnels

by Chun Guo^1,*

, Jianfeng Xu¹, Mingnian Wang¹, Tao Yan¹, Lu Yang² and Zhitao Sun¹

¹ Key Laboratory of Transportation Tunnel Engineering, Ministry of Education, Southwest Jiaotong University, 111 Erhuan Rd, 610031 Chengdu, China

² College of Foreign Languages, Southwest Jiaotong University, 111 Erhuan Rd, 610031 Chengdu, China

Int. J. Environ. Res. Public Health 2016, 13(1), 64; https://doi.org/10.3390/ijerph13010064 - 22 Dec 2015

Cited by 34 | Viewed by 5487

Abstract

The low atmospheric pressure and low oxygen content in high-altitude environment have great impacts on the functions of human body. Especially for the personnel engaged in complicated physical labor such as tunnel construction, high altitude can cause a series of adverse physiological reactions, [...] Read more.

The low atmospheric pressure and low oxygen content in high-altitude environment have great impacts on the functions of human body. Especially for the personnel engaged in complicated physical labor such as tunnel construction, high altitude can cause a series of adverse physiological reactions, which may result in multiple high-altitude diseases and even death in severe cases. Artificial oxygen supply is required to ensure health and safety of construction personnel in hypoxic environments. However, there are no provisions for oxygen supply standard for tunnel construction personnel in high-altitude areas in current tunnel construction specifications. As a result, this paper has theoretically studied the impacts of high-altitude environment on human bodies, analyzed the relationship between labor intensity and oxygen consumption in high-altitude areas and determined the critical oxygen-supply altitude values for tunnel construction based on two different standard evaluation systems, i.e., variation of air density and equivalent PIO₂. In addition, it has finally determined the oxygen supply standard for construction personnel in high-altitude areas based on the relationship between construction labor intensity and oxygen consumption. Full article

(This article belongs to the Special Issue Occupational Safety and Related Impacts on Health and the Environment)

3 pages, 157 KiB

Open AccessComment

Comments on Sabariego et al. Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates. Int. J. Environ. Res. Public Health, 2015, 12, 10329–10351

by Jennifer H. Madans^1,*, Daniel Mont^2,† and Mitchell Loeb^1,†

¹ National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, USA

² Leonard Cheshire Disability and Development Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 65; https://doi.org/10.3390/ijerph13010065 - 22 Dec 2015

Cited by 6 | Viewed by 4148

Abstract

In the article, Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates, in Volume 12 of the Journal International Journal of Environmental Research and Public Health, Carla Sabariego et al. [1] raise several issues regarding the use of the [...] Read more.

In the article, Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates, in Volume 12 of the Journal International Journal of Environmental Research and Public Health, Carla Sabariego et al. [1] raise several issues regarding the use of the short set of questions developed by the Washington Group on Disability Statistics (WG) as compared with the approach to disability measurement proposed through the Model Disability Survey (MDS). We address these below. [...] Full article

(This article belongs to the Special Issue Disability and Public Health)

4 pages, 175 KiB

Open AccessReply

Response to Madans et al. Comments on Sabariego et al. Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates. Int. J. Environ. Res. Public Health, 2015, 12, 10329–10351

by Carla Sabariego^1,*

, Cornelia Oberhauser¹, Aleksandra Posarac², Jerome Bickenbach³, Nenad Kostanjsek⁴, Somnath Chatterji⁵, Alana Officer⁶, Michaela Coenen¹

, Lay Chhan⁷ and Alarcos Cieza⁸

¹ Department of Medical Informatics, Biometry and Epidemiology—IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU), Munich 81377, Germany

² Social Protection and Labor, Human Development Network, The World Bank, Washington, DC 20433, USA

³ Swiss Paraplegic Research, Nottwil 6207, Switzerland

⁴ Data Standards and Informatics (DSI), Department of Information, Evidence and Research (IER), World Health Organization, Geneva 1211, Switzerland

⁵ Department of Health Statistics and Information Systems, World Health Organization, Geneva 1211, Switzerland

⁶ Ageing and Life Course Unit, World Health Organization, Geneva 1211, Switzerland

⁷ National Institute of Statistics, Phnom Penh 12301, Cambodia

⁸ Blindness and Deafness Prevention, Disability and Rehabilitation (BDD), World Health Organization, Geneva 1211, Switzerland

Int. J. Environ. Res. Public Health 2016, 13(1), 66; https://doi.org/10.3390/ijerph13010066 - 22 Dec 2015

Cited by 3 | Viewed by 3815

Abstract

We greatly appreciate and wish to thank Madans, Mont and Loeb for the issues they raise in their Comment [1] on our paper “Measuring Disability: Using the WHO Model Disability Survey to Address the Impact of Screeners on Disability Rates” [2]. [...] Full article

(This article belongs to the Special Issue Disability and Public Health)

6 pages, 730 KiB

Open AccessEditorial

Food Safety, a Global Challenge

by Mieke Uyttendaele^1,*, Eelco Franz² and Oliver Schlüter³

¹ Department of Food Safety and Food Quality, Faculty of Bio-Science Engineering, Ghent University, Coupure Links 653, B-9000 Gent, Belgium

² National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands

³ Leibniz Institute for Agricultural Engineering Postdam-Bornim e.V., Max-Eyth-Allee 100, 14469 Potsdam, Germany

Int. J. Environ. Res. Public Health 2016, 13(1), 67; https://doi.org/10.3390/ijerph13010067 - 22 Dec 2015

Cited by 73 | Viewed by 16522

Abstract

To provide more food and make use of precious water and nutrient resources, communities increasingly value sustainable food production. [...] Full article

(This article belongs to the Special Issue Food Safety)

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13 pages, 213 KiB

Open AccessArticle

Factors Affecting the Quality of Life and the Illness Acceptance of Pregnant Women with Diabetes

by Agnieszka Bień^1,*, Ewa Rzońca¹, Angelika Kańczugowska² and Grażyna Iwanowicz-Palus¹

¹ Independent Obstetric Skills Unit, Faculty of Health Sciences, Medical University of Lublin, 4 Staszica St., 20-081 Lublin, Poland

² Neonatology Ward, Independent Public Teaching Hospital No. 4 in Lublin, 8 Jaczewskiego St., 20-954 Lublin, Poland

Int. J. Environ. Res. Public Health 2016, 13(1), 68; https://doi.org/10.3390/ijerph13010068 - 22 Dec 2015

Cited by 51 | Viewed by 8173

Abstract

The paper contains an analysis of the factors affecting the quality of life (QoL) and the illness acceptance of diabetic pregnant women. The study was performed between January and April, 2013. It included 114 pregnant women with diabetes, hospitalized in the High Risk [...] Read more.

The paper contains an analysis of the factors affecting the quality of life (QoL) and the illness acceptance of diabetic pregnant women. The study was performed between January and April, 2013. It included 114 pregnant women with diabetes, hospitalized in the High Risk Pregnancy Wards of several hospitals in Lublin, Poland. The study used a diagnostic survey with questionnaires. The research instruments used were: The WHOQOL-Bref questionnaire and the Acceptance of Illness Scale (AIS). The women’s general quality of life was slightly higher than their perceived general health. A higher quality of life was reported by women with a very good financial standing, very good perceived health, moderate self-reported knowledge of diabetes, and also by those only treated with diet and stating that the illness did not interfere with their lives (p < 0.05). Women with a very good financial standing (p < 0.009), high self-reported health (p < 0.002), and those treated with by means of a diet (p < 0.04) had a higher acceptance of illness. A higher acceptance of illness contributes to a higher general quality of life and a better perception of one’s health. Full article

(This article belongs to the Collection Health Care and Diabetes)

9 pages, 4134 KiB

Open AccessArticle

Synthesis of Minerals with Iron Oxide and Hydroxide Contents as a Sorption Medium to Remove Arsenic from Water for Human Consumption

by Sofia Garrido-Hoyos^1,* and Lourdes Romero-Velazquez²

¹ Instituto Mexicano de Tecnología del Agua, Paseo Cuahnáhuac 8532, Col. Progreso, Jiutepec, CP. 62550 Morelos, México

² Universidad Politécnica del Estado de Morelos, Paseo Cuauhnáhuac 566, Col. Lomas del Texcal, Jiutepec, CP. 62550 Morelos, México

Int. J. Environ. Res. Public Health 2016, 13(1), 69; https://doi.org/10.3390/ijerph13010069 - 23 Dec 2015

Cited by 11 | Viewed by 5109

Abstract

Arsenic has been classified as a toxic and carcinogenic chemical element. It therefore presents a serious environmental problem in different regions of the country and the world. In the present work, two adsorbent media were developed and evaluated to remove arsenic from water [...] Read more.

Arsenic has been classified as a toxic and carcinogenic chemical element. It therefore presents a serious environmental problem in different regions of the country and the world. In the present work, two adsorbent media were developed and evaluated to remove arsenic from water in the Pájaro Verde mine shaft, Huautla, Tlaquiltenango, Morelos. The media were synthesized and characterized, obtaining a surface area of 43.04 m²·g⁻¹ for the goethite and 2.44 m²·g⁻¹ for silica sand coated with Fe(III). To conduct the sorption kinetics and isotherms, a 2³ factorial design was performed for each medium in order to obtain the optimal conditions for the factors of arsenic concentration, pH and mass of the adsorbent. The best results were obtained for goethite, with a removal efficiency of 98.61% (C₀ of As(V) 0.360 mg·L⁻¹), and an effluent concentration of 0.005 mg·L⁻¹, a value that complies with the modified Official Mexican Standard NOM-127-SSA1-1994 [1] and WHO guidelines (2004) [2]. The kinetic equation that best fit the experimental data was the pseudo-second-order, resulting in the highest values for the constants for synthetic goethite, with a rate constant sorption of 4.019·g·mg⁻¹·min⁻¹. With respect to the sorption isotherms, both media were fitted to the Langmuir-II linear model with a sorption capacity (q_m) of 0.4822 mg·g⁻¹ for goethite and 0.2494 mg·g⁻¹ for silica sand coated with Fe(III). Full article

(This article belongs to the Special Issue Arsenic in Drinking Water: Current Perspectives and Future Directions)

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10 pages, 206 KiB

Open AccessArticle

Risk Factors for Cardiovascular Disease and Their Clustering among Adults in Jilin (China)

by Jianxing Yu, Yonghui Ma, Sen Yang, Kai Pang, Yaqin Yu, Yuchun Tao^*

and Lina Jin^*

Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin 130021, China

Int. J. Environ. Res. Public Health 2016, 13(1), 70; https://doi.org/10.3390/ijerph13010070 - 23 Dec 2015

Cited by 27 | Viewed by 5502

Abstract

Background: Clustering of cardiovascular disease (CVD) risk factors constitutes a major public health challenge. Although a number of researchers have investigated the CVD risk factor clusters in China, little is known about the related prevalence and clustering associated with demographics in Jilin [...] Read more.

Background: Clustering of cardiovascular disease (CVD) risk factors constitutes a major public health challenge. Although a number of researchers have investigated the CVD risk factor clusters in China, little is known about the related prevalence and clustering associated with demographics in Jilin Province in China; this study aims to reveal that relationship. Methods: A cross-sectional survey based on a sample of 16,834 adults aged 18 to 79 years was conducted in Jilin in 2012. The prevalence and clustering of CVD risk factors were analysed through complex weighted computation. Quantitative variables were compared by the t test, and categorical variables were compared by the Rao-Scott-χ² test. Finally, multivariable logistic regression analysis was used to evaluate the CVD risk factor clusters associated with demographics. Results: The prevalences of hypertension, diabetes, dyslipidemia, overweight and smoking were 37.3%, 8.2%, 36.8%, 47.3%, and 31.0%, respectively, and these risk factors were associated with gender, education level, age, occupation and family income (p < 0.05). Overall, compared with females, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors clusters in males were 3.70 (95%CI 3.26 to 4.20), 4.66 (95%CI 4.09 to 5.31), and 5.76 (95%CI 5.01 to 6.63), respectively. In particular, the adjusted ORs of ≥1, ≥2 and ≥3 risk factors increased with age. Conclusions: CVD risk factor clusters are common among adults in northeast China, and they constitute a major public health challenge. More effective attention and interventions should be directed toward the elderly and toward persons with lower incomes and low levels of education. Full article

15 pages, 3605 KiB

Open AccessReview

Integrated Environmental Health Impact Assessment for Risk Governance Purposes; Across What Do We Integrate?

by Erik Lebret^1,2

¹ National Institute of Public Health and the Environment—RIVM, P.O. Box 1, 3720 BA Bilthoven, The Netherlands

² Institute of Risk Assessment Sciences—IRAS, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands

Int. J. Environ. Res. Public Health 2016, 13(1), 71; https://doi.org/10.3390/ijerph13010071 - 23 Dec 2015

Cited by 14 | Viewed by 7654

Abstract

Integrated Environmental Health Impact Assessment (IEHIA) can be considered as an element in the third phase of environmental risk management. Its focus is on providing inclusive descriptions of multiple impacts from multiple stressors in such a way that they can be evaluated against [...] Read more.

Integrated Environmental Health Impact Assessment (IEHIA) can be considered as an element in the third phase of environmental risk management. Its focus is on providing inclusive descriptions of multiple impacts from multiple stressors in such a way that they can be evaluated against the potential societal benefits of the causes of the stressors. This paper emphasises some differences and difficulties in the integration across professional paradigms and scientific fields, across stakeholder perspectives and differences in impact indicators that emanate from these different fields and paradigms. Full article

(This article belongs to the Special Issue Cumulative and Integrated Health Impact Assessment)

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15 pages, 574 KiB

Open AccessArticle

Effects of Co-Worker and Supervisor Support on Job Stress and Presenteeism in an Aging Workforce: A Structural Equation Modelling Approach

by Tianan Yang¹

, Yu-Ming Shen², Mingjing Zhu³, Yuanling Liu⁴, Jianwei Deng⁵, Qian Chen⁶ and Lai-Chu See^7,8,*

¹ Department of Organization and Human Resource Management, School of Management and Economics, Beijing Institute of Technology, Beijing 100081, China

² Institute of Medical Informatics, Biometry and Epidemiology (IBE), Pettenkofer School of Public Health, Faculty of Medicine Ludwig-Maximilians University Munich, Munich 81377, Germany

³ Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China

⁴ Human Resources Department, Guangdong Women and Children Hospital, Guangzhou 511442, China

⁵ Department of Public Administration, School of Management and Economics, Beijing Institute of Technology, Beijing 100081, China

⁶ Medical Affair Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100032, China

⁷ Department of Public Health, Medical College, Chang Gung University, Taoyuan 33302, Taiwan

⁸ Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan

Int. J. Environ. Res. Public Health 2016, 13(1), 72; https://doi.org/10.3390/ijerph13010072 - 23 Dec 2015

Cited by 108 | Viewed by 15048

Abstract

We examined the effects of co-worker and supervisor support on job stress and presenteeism in an aging workforce. Structural equation modelling was used to evaluate data from the 2010 wave of the Health and Retirement Survey in the United States (n = [...] Read more.

We examined the effects of co-worker and supervisor support on job stress and presenteeism in an aging workforce. Structural equation modelling was used to evaluate data from the 2010 wave of the Health and Retirement Survey in the United States (n = 1649). The level of presenteeism was low and the level of job stress was moderate among aging US workers. SEM revealed that co-worker support and supervisor support were strongly correlated (β = 0.67; p < 0.001). Job stress had a significant direct positive effect on presenteeism (β = 0.30; p < 0.001). Co-worker support had a significant direct negative effect on job stress (β = −0.10; p < 0.001) and presenteeism (β = −0.11; p < 0.001). Supervisor support had a significant direct negative effect on job stress (β = −0.40; p < 0.001) but not presenteeism. The findings suggest that presenteeism is reduced by increased respect and concern for employee stress at the workplace, by necessary support at work from colleagues and employers, and by the presence of comfortable interpersonal relationships among colleagues and between employers and employees. Full article

(This article belongs to the Special Issue Occupational Stress, Human Health and Wellbeing)

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12 pages, 216 KiB

Open AccessArticle

Health Risk Behaviour among In-School Adolescents in the Philippines: Trends between 2003, 2007 and 2011, A Cross-Sectional Study

by Karl Peltzer^1,2,3,*

and Supa Pengpid^1,2

¹ ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand

² Department of Research & Innovation, University of Limpopo, Turfloop Campus, Sovenga 0727, South Africa

³ HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Pretoria 0001, South Africa

Int. J. Environ. Res. Public Health 2016, 13(1), 73; https://doi.org/10.3390/ijerph13010073 - 24 Dec 2015

Cited by 42 | Viewed by 13038

Abstract

Intermittent monitoring of health risk behaviours at the population level is important for the planning and evaluation of national health promotion intervention programmes. The study aimed to provide trend estimates on the prevalence of various health risk behaviours assessed in the Global School-based [...] Read more.

Intermittent monitoring of health risk behaviours at the population level is important for the planning and evaluation of national health promotion intervention programmes. The study aimed to provide trend estimates on the prevalence of various health risk behaviours assessed in the Global School-based Health Survey in 2003, 2007 and 2011 in the Philippines. Three waves of cross-sectional data included 18,285 school-going adolescents, 47.4% male and 52.6% female, aged between 11 years or younger and 16 years or older, with a mean age of about 14.7 years (SD = 1.2), and mainly in second to fourth year study Grade. Significant improvements in health risk and risk behaviours (overweight or obese and smokeless tobacco use among boys, being in a physical fight, troubles from alcohol drinking, mental health, oral and hand hygiene among both boys and girls) but also increases in health risk behaviour (bullying victimization, injury and loneliness) among both boys and girls were found in this large study over a period of eight years in the Philippines. High prevalences of health risk behaviours and increases in some of them should call for intensified school health promotion programmes to reduce such risk behaviours. Full article

15 pages, 377 KiB

Open AccessArticle

Transmission of Smoking across Three Generations in Finland

by Salma E. T. El-Amin¹, Jaana M. Kinnunen^1,*

, Hanna Ollila²

, Mika Helminen^1,3, Joana Alves⁴

, Pirjo Lindfors^1,5

and Arja H. Rimpelä^1,5,6

¹ School of Health Sciences, University of Tampere, 33014 Tampere, Finland

² Tobacco, Gambling and Addiction Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland

³ Science Centre, Pirkanmaa Hospital District, 33521 Tampere, Finland

⁴ National School of Public Health, Lisbon NOVA University, P-1600-560 Lisbon, Portugal

⁵ PERLA—Tampere Centre for Childhood, Youth and Family Research, University of Tampere, 33104 Tampere, Finland

⁶ Department of Adolescent Psychiatry, Pitkäniemi Hospital, Tampere University Hospital, 33380 Nokia, Finland

Int. J. Environ. Res. Public Health 2016, 13(1), 74; https://doi.org/10.3390/ijerph13010074 - 24 Dec 2015

Cited by 15 | Viewed by 5384

Abstract

The influence of parents’ smoking on children’s smoking is well known, but few studies have examined the association between grandparents’ and grandchildren’s smoking. We studied the association between paternal and maternal grandparents’ smoking and their grandchildren’s tobacco use and assessed whether parents’ smoking [...] Read more.

The influence of parents’ smoking on children’s smoking is well known, but few studies have examined the association between grandparents’ and grandchildren’s smoking. We studied the association between paternal and maternal grandparents’ smoking and their grandchildren’s tobacco use and assessed whether parents’ smoking is a mediator in this process. Data were obtained from a national survey of 12–18-year-old Finns in 2013 (N = 3535, response rate 38%). Logistic regression and mediation analyses were used. Both boys and girls had higher odds for smoking experimentation, daily smoking and other tobacco or tobacco-like product use if their mother, father or any of the four grandparents were current or former smokers. When parents’ and grandparents’ smoking status were included in the same model, grandparents’ smoking generally lost statistical significance. In the mediation analysis, 73% of the total effect of grandparents’ smoking on grandchildren’s daily smoking was mediated through parents’ smoking, 64% on smoking experimentation and 63% on other tobacco or tobacco-like product use. The indirect effect of a mother’s smoking was higher than that of a father’s. To conclude, paternal and maternal grandparents’ smoking increases grandchildren’s tobacco use. The influence is mainly, but not completely, mediated through parents’ smoking. Full article

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12 pages, 314 KiB

Open AccessArticle

Mercury in Hair Is Inversely Related to Disease Associated Damage in Systemic Lupus Erythematosus

by William Crowe¹, Leanne Doherty¹, Gene Watson², David Armstrong³, Elisabeth Ball⁴, Pamela Magee¹, Philip Allsopp¹

, Aubrey Bell⁴, J. J. Strain¹

and Emeir McSorley^1,*

¹ Northern Ireland Centre for Food & Health (NICHE), University of Ulster, Coleraine BT52 1SA, Northern Ireland

² Departments of Dentistry, Environmental Medicine, and Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA

³ Department of Rheumatology, Altnagelvin Area Hospital, Glenshane Road, Londonderry BT47 6SB, Northern Ireland

⁴ Department of Rheumatology, Musgrave Park Hospital, Stockman’s Lane, Belfast BT9 7JB, Northern Ireland

Int. J. Environ. Res. Public Health 2016, 13(1), 75; https://doi.org/10.3390/ijerph13010075 - 23 Dec 2015

Cited by 12 | Viewed by 5610

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease, and environmental factors are proposed to exacerbate existing symptoms. One such environmental factor is mercury. The aim of this study was to investigate the relationship between exposure to mercury (Hg) and disease activity and [...] Read more.

Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease, and environmental factors are proposed to exacerbate existing symptoms. One such environmental factor is mercury. The aim of this study was to investigate the relationship between exposure to mercury (Hg) and disease activity and disease associated damage in Total Hg concentrations in hair and urine were measured in 52 SLE patients. Dental amalgams were quantified. Disease activity was assessed using three indexes including the British Isles Lupus Assessment Group Index (BILAG). Disease associated damage was measured using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology SLICC/ACR Damage Index. Pearson’s correlation identified a significant negative correlation between hair Hg and BILAG (r = −0.323, p = 0.029) and SLICC/ACR (r = −0.377, p = 0.038). Multiple regression analysis identified hair Hg as a significant predictor of disease associated damage as determined by SLICC/ACR (β = −0.366, 95% confidence interval (CI): −1.769, −0.155 p = 0.019). Urinary Hg was not related to disease activity or damage. Fish consumption is the primary route of MeHg exposure in humans and the inverse association of hair Hg with disease activity observed here might be explained by the anti-inflammatory effects of n-3 long chain polyunsaturated fatty acids also found in fish. Full article

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14 pages, 1077 KiB

Open AccessArticle

Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

by Marlene M. De Vries^1,*, Belinda Joubert¹, Marise Cloete¹, Sumien Roux¹

, Beth A. Baca², Julie M. Hasken³, Ronel Barnard¹, David Buckley², Wendy O. Kalberg², Cudore L. Snell⁴, Anna-Susan Marais¹

, Soraya Seedat¹, Charles D. H. Parry^1,5 and Philip A. May^2,3,*

¹ Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa

² Center on Alcoholism, Substance Abuse, and Additions (CASAA), The University of New Mexico, Albuquerque, NM 87106, USA

³ Gillings School of Global Public Health, Department of Nutrition, Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC 28081, USA

⁴ School of Social Work, Howard University, Washington, DC 20059, USA

⁵ Tobacco & Other Drug Research Unit, Medical Research Council of South Africa, Alcohol, Tygerberg 7505, South Africa

Int. J. Environ. Res. Public Health 2016, 13(1), 76; https://doi.org/10.3390/ijerph13010076 - 23 Dec 2015

Cited by 27 | Viewed by 6999

Abstract

In the Western Cape Province of South Africa (ZA) a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD). FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of [...] Read more.

In the Western Cape Province of South Africa (ZA) a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD). FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM) was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI) techniques and the Community Reinforcement Approach (CRA). Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD. Full article

(This article belongs to the Special Issue Treating Alcoholism between Harm Reduction and Immediate Abstinence)

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14 pages, 4325 KiB

Open AccessArticle

Identifying Watershed Regions Sensitive to Soil Erosion and Contributing to Lake Eutrophication—A Case Study in the Taihu Lake Basin (China)

by Chen Lin^1,2,*, Ronghua Ma¹ and Bin He¹

¹ State Key Laboratory of Lake Science and Environment, Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences, Nanjing 210008, China

² State Key Laboratory of Soil and Sustainable Agriculture, Institute of Soil Science, Chinese Academy of Sciences, Nanjing 210008, China

Int. J. Environ. Res. Public Health 2016, 13(1), 77; https://doi.org/10.3390/ijerph13010077 - 24 Dec 2015

Cited by 16 | Viewed by 4351

Abstract

Taihu Lake in China is suffering from severe eutrophication partly due to non-point pollution from the watershed. There is an increasing need to identify the regions within the watershed that most contribute to lake water degradation. The selection of appropriate temporal scales and [...] Read more.

Taihu Lake in China is suffering from severe eutrophication partly due to non-point pollution from the watershed. There is an increasing need to identify the regions within the watershed that most contribute to lake water degradation. The selection of appropriate temporal scales and lake indicators is important to identify sensitive watershed regions. This study selected three eutrophic lake areas, including Meiliang Bay (ML), Zhushan Bay (ZS), and the Western Coastal region (WC), as well as multiple buffer zones next to the lake boundary as the study sites. Soil erosion intensity was designated as a watershed indicator, and the lake algae area was designated as a lake quality indicator. The sensitive watershed region was identified based on the relationship between these two indicators among different lake divisions for a temporal sequence from 2000 to 2012. The results show that the relationship between soil erosion modulus and lake quality varied among different lake areas. Soil erosion from the two bay areas was more closely correlated with water quality than soil erosion from the WC region. This was most apparent at distances of 5 km to 10 km from the lake, where the r² was as high as 0.764. Results indicate that soil erosion could be used as an indicator for identifying key watershed protection areas. Different lake areas need to be considered separately due to differences in geographical features, land use, and the corresponding effects on lake water quality. Full article

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9 pages, 1756 KiB

Open AccessArticle

Discontinuous and Continuous Indoor Air Quality Monitoring in Homes with Fireplaces or Wood Stoves as Heating System

by Gianluigi De Gennaro^1,2,*

, Paolo Rosario Dambruoso², Alessia Di Gilio², Valerio Di Palma¹, Annalisa Marzocca² and Maria Tutino²

¹ Department of Biology, University of Bari Aldo Moro—Via Orabona 4, Bari 70126, Italy

² Apulia Regional Agency for Environmental Prevention and Protection—Corso Trieste 27, Bari 70126, Italy

Int. J. Environ. Res. Public Health 2016, 13(1), 78; https://doi.org/10.3390/ijerph13010078 - 24 Dec 2015

Cited by 40 | Viewed by 6733

Abstract

Around 50% of the world’s population, particularly in developing countries, uses biomass as one of the most common fuels. Biomass combustion releases a considerable amount of various incomplete combustion products, including particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs). The paper presents the [...] Read more.

Around 50% of the world’s population, particularly in developing countries, uses biomass as one of the most common fuels. Biomass combustion releases a considerable amount of various incomplete combustion products, including particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs). The paper presents the results of Indoor Air Quality (IAQ) measurements in six houses equipped with wood burning stoves or fireplaces as heating systems. The houses were monitored for 48-h periods in order to collect PM₁₀ samples and measure PAH concentrations. The average, the maximum and the lowest values of the 12-h PM₁₀ concentration were 68.6 μg/m³, 350.7 μg/m³ and 16.8 μg/m³ respectively. The average benzo[a]pyrene 12-h concentration was 9.4 ng/m³, while the maximum and the minimum values were 24.0 ng/m³ and 1.5 ng/m³, respectively. Continuous monitoring of PM₁₀, PAHs, Ultra Fine Particle (UFP) and Total Volatile Organic Compounds (TVOC) was performed in order to study the progress of pollution phenomena due to biomass burning, their trends and contributions to IAQ. The results show a great heterogeneity of impacts on IAQ in terms of magnitude and behavior of the considered pollutants’ concentrations. This variability is determined by not only different combustion technologies or biomass quality, but overall by different ignition mode, feeding and flame management, which can also be different for the same house. Moreover, room dimensions and ventilation were significant factors for pollution dispersion. The increase of PM₁₀, UFP and PAH concentrations, during lighting, was always detected and relevant. Continuous monitoring allowed singling out contributions of other domestic sources of considered pollutants such as cooking and cigarettes. Cooking contribution produced an impact on IAQ in same cases higher than that of the biomass heating system. Full article

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9 pages, 703 KiB

Open AccessArticle

A Comparative Study of Scientific Publications in Health Care Sciences and Services from Mainland China, Taiwan, Japan, and India (2007–2014)

by Yipeng Lv^†, Bihan Tang^†, Xu Liu^†, Chen Xue, Yuan Liu, Peng Kang and Lulu Zhang^*

¹ Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai 200433, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 79; https://doi.org/10.3390/ijerph13010079 - 24 Dec 2015

Cited by 2 | Viewed by 4203

Abstract

In this study, we aimed to compare the quantity and quality of publications in health care sciences and services journals from the Chinese mainland, Taiwan, Japan, and India. Journals in this category of the Science Citation Index Expanded were included in the study. [...] Read more.

In this study, we aimed to compare the quantity and quality of publications in health care sciences and services journals from the Chinese mainland, Taiwan, Japan, and India. Journals in this category of the Science Citation Index Expanded were included in the study. Scientific papers were retrieved from the Web of Science online database. Quality was measured according to impact factor, citation of articles, number of articles published in top 10 journals, and the 10 most popular journals by country (area). In the field of health care sciences and services, the annual incremental rates of scientific articles published from 2007 to 2014 were higher than rates of published scientific articles in all fields. Researchers from the Chinese mainland published the most original articles and reviews and had the highest accumulated impact factors, highest total article citations, and highest average citation. Publications from India had the highest average impact factor. In the field of health care sciences and services, China has made remarkable progress during the past eight years in the annual number and percentage of scientific publications. Yet, there is room for improvement in the quantity and quality of such articles. Full article

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10 pages, 203 KiB

Open AccessArticle

Improving Knowledge about Children’s Environmental Health in Northwest China

by Jingping Niu^1,*, Qingshan Qu², Juansheng Li¹, Xingrong Liu¹, Benzhong Zhang¹, Zhilan Li¹, Guowu Ding¹, Yingbiao Sun¹, Yanrong Shi¹, Yaxiong Wan¹, Xiaobin Hu¹, Lung-Chi Chen², Alan Mendelsohn^3,4, Yu Chen^1,4 and Leonardo Trasande^2,3,4,5,6,*

¹ Departments of Environmental Medicine, Lanzhou University School of Public Health, 199 Donggang Xi Lu, Lanzhou, Gansu 730000, China

² Department of Pediatrics, New York University School of Medicine, 227 East 30th Street, Rm 735, New York, NY 10016, USA

³ Department of Population Health, New York University School of Medicine/Bellevue Hospital Center, New York, NY 10016, USA

⁴ New York University School of Medicine, New York, NY 10016, USA

⁵ Wagner School of Public Service, New York University, New York, NY 10012, USA

⁶ Department of Nutrition, Food & Public Health, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY 10003, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 80; https://doi.org/10.3390/ijerph13010080 - 25 Dec 2015

Cited by 5 | Viewed by 4889

Abstract

The main purpose of this study was to identify policy maker opinions and attitudes towards children’s environmental health (CEH), potential barriers to child-specific protective legislation and implementation in northwest China, and evaluate knowledge and attitudes about CEH before and after an educational conference. [...] Read more.

The main purpose of this study was to identify policy maker opinions and attitudes towards children’s environmental health (CEH), potential barriers to child-specific protective legislation and implementation in northwest China, and evaluate knowledge and attitudes about CEH before and after an educational conference. We conducted seventy-two interviews with regional officials, researchers and non-governmental organization representatives from five provinces, and surveyed participants (forty-seven) before and after an educational conference in northwest China about CEH. Interviews identified general consensus among participants of the adverse effects of air pollution on children, yet few participants knew of policies to protect them. Barriers identified included limited funding and enforcement, weak regional governments and absence of child-specific policy-making. After the conference, substantially greater self-efficacy was identified for lead, mercury, air pollution and polychlorinated biphenyls (+0.57–0.72 on a 1–5 Likert scale, p = 0.002–0.013), and the scientific knowledge for the role of environment in children’s health (+0.58, p = 0.015), and health care provider control (+0.52, p = 0.025) were rated more strongly. We conclude that policy makers in Northwest China appreciate that children are uniquely vulnerable, though additional regulations are needed to account for that vulnerability. Further research should examine effectiveness of the intervention on a larger scale and scope, and evaluate the usefulness of such interventions in translating research into improved care/reduced exposure to environmental hazards. Full article

20 pages, 7668 KiB

Open AccessArticle

Medical Hydrogeology of Asian Deltas: Status of Groundwater Toxicants and Nutrients, and Implications for Human Health

by Mohammad A. Hoque^* and Adrian P. Butler

Department of Civil and Environmental Engineering, Imperial College London, South Kensington, London SW7 2AZ, UK

Int. J. Environ. Res. Public Health 2016, 13(1), 81; https://doi.org/10.3390/ijerph13010081 - 26 Dec 2015

Cited by 29 | Viewed by 6557

Abstract

Drinking water, a fluid primarily for human hydration, is also a source of mineral nutrients. Groundwater, a drinking water source for more than 70% of inhabitants living in Asian deltas, has received much attention because of its naturally occurring arsenic, but the linkage [...] Read more.

Drinking water, a fluid primarily for human hydration, is also a source of mineral nutrients. Groundwater, a drinking water source for more than 70% of inhabitants living in Asian deltas, has received much attention because of its naturally occurring arsenic, but the linkage of arsenic toxicity with other water constituents has not been studied. In addition, although nutrients are generally provided by food, in under developed rural settings, where people subsist on low nutrient diets, drinking-water-nutrients may supply quantities critical to human health thereby preventing diseases. Here, we show, using augmented datasets from three Asian deltas (Bengal, Mekong, and Red River), that the chemical content of groundwater is so substantial that in some areas individuals obtain up to 50% or more of the recommended daily intake (RDI) of some nutrients (e.g., calcium, magnesium, iron) from just two litres of drinking water. We also show some indications of a spatial association of groundwater nutrients and health outcome using demographic health data from Bangladesh. We therefore suggest that an understanding of the association of non-communicable disease and poor nutrition cannot be developed, particularly in areas with high levels of dissolved solids in water sources, without considering the contribution of drinking water to nutrient and mineral supply. Full article

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12 pages, 583 KiB

Open AccessArticle

Prevalence and Correlates of Prehypertension and Hypertension among Adults in Northeastern China: A Cross-Sectional Study

by Guang Yang

, Yue Ma, Shibin Wang, Yingying Su, Wenwang Rao

, Yingli Fu, Yaqin Yu and Changgui Kou^*

Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China

Int. J. Environ. Res. Public Health 2016, 13(1), 82; https://doi.org/10.3390/ijerph13010082 - 25 Dec 2015

Cited by 51 | Viewed by 5736

Abstract

Background: Prehypertension is a category between normotension and hypertension that is becoming increasingly common in China. However, limited data are available on the prevalence and correlates of prehypertension in northeastern China. Methods: A cross-sectional study using stratified, clustered multistage, and random [...] Read more.

Background: Prehypertension is a category between normotension and hypertension that is becoming increasingly common in China. However, limited data are available on the prevalence and correlates of prehypertension in northeastern China. Methods: A cross-sectional study using stratified, clustered multistage, and random sampling methods was performed on 17,584 participants. Results: The prevalence of prehypertension and hypertension was 36.0% and 30.8% in northeastern China, respectively. As age increased, the prevalence of prehypertension in males declined (p-trend < 0.001), in parallel to an increase in the prevalence of hypertension (p-trend < 0.001). The prevalence of hypertension for females increased as age increased (p-trend < 0.001). Logistic regression analysis showed that age, gender, location, drinking, Body Mass Index (BMI), abdominal obesity, hypertriglyceridemia, and hypercholesterolemia correlated with prehypertension and hypertension (p-trend < 0.05). Conclusions: This study revealed a high prevalence of prehypertension and hypertension in an adult population of northeastern China and some correlates of prehypertension and hypertension. Full article

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10 pages, 207 KiB

Open AccessArticle

Prevalence and Risk Factors of Overweight and Obesity among Adolescents and Their Parents in Central Greece (FETA Project)

by Anna Patsopoulou^1,*, Zoi Tsimtsiou¹, Antonios Katsioulis¹, George Rachiotis¹, Eleni Malissiova² and Christos Hadjichristodoulou¹

¹ Department of Hygiene and Epidemiology, Medical Faculty, School of Health Science, University of Thessaly, Larissa 41222, Greece

² Food Technology Department, Technological Educational Institute of Thessaly, Karditsa 43100, Greece

Int. J. Environ. Res. Public Health 2016, 13(1), 83; https://doi.org/10.3390/ijerph13010083 - 26 Dec 2015

Cited by 17 | Viewed by 5903

Abstract

The increasing obesity trend in adolescence is a public health concern. The initial phase of Feeding Exercise Trial in Adolescents (FETA) aimed in investigating the prevalence of overweight and obesity in adolescents and their parents and in identifying associated factors among parents’ and [...] Read more.

The increasing obesity trend in adolescence is a public health concern. The initial phase of Feeding Exercise Trial in Adolescents (FETA) aimed in investigating the prevalence of overweight and obesity in adolescents and their parents and in identifying associated factors among parents’ and adolescents’ demographics, eating habits, and parental style. The sample consisted of 816 adolescents, aged 12–18 years old, and their parents from 17 middle and high schools in Larissa, central Greece. During school visits, anthropometric measurements were performed along with examination of blood pressure. The students completed the study tool that comprised of demographics and the modified versions of Parental Authority Questionnaire (PAQ), the Parent-Initiated Motivational Climate Questionnaire-2 (PIMCQ-2) and the Family Eating and Activity Habits Questionnaire (FEAHQ). Their parents completed a questionnaire with demographics, anthropometrics and FEAHQ. Normal Body Mass Index was found in 75.2% of the adolescents, 2.6% of the adolescents were underweight, 18% overweight and 4.2% obese. Regarding the parents, 76.3% of the fathers and 39.2% of the mothers were overweight or obese. The logistic regression analysis revealed that, overweight or obesity in adolescence was associated with gender (boy), maternal overweight or obesity, lower maternal educational level, eating without feeling hungry, eating in rooms other than kitchen and having a father that motivates by worrying about failing. A significant proportion of adolescents and their parents are overweight or obese. Future interventions should focus both on the parents and children, taking into account the role of parental authority style, in preventing adolescents’ obesity. Full article

8 pages, 3171 KiB

Open AccessArticle

In Vitro and in Vivo Inhibitory Effects of Glycyrrhetinic Acid in Mice and Human Cytochrome P450 3A4

by Qiao-Li Lv¹, Gui-Hua Wang², Shu-Hui Chen², Lei Hu¹, Xue Zhang¹, Guo Ying¹, Chong-Zhen Qin^3,* and Hong-Hao Zhou^1,*

¹ Department of Clinical Pharmacology, Xiangya Hospital; Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Central South University, Changsha 410008, China

² Department of Oncology, Changsha Central Hospital, Changsha 410006, China

³ Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Int. J. Environ. Res. Public Health 2016, 13(1), 84; https://doi.org/10.3390/ijerph13010084 - 25 Dec 2015

Cited by 32 | Viewed by 5642

Abstract

Glycyrrhetinic acid (GA) has been used clinically in the treatment of patients with chronic hepatitis. This study evaluated the effect of GA on the activity of five P450(CYP450) cytochrome enzymes: CYP2A6, CYP2C9, CYP2C19, CYP2D6, and CYP3A4, in human liver microsomes (HLMs) and recombinant [...] Read more.

Glycyrrhetinic acid (GA) has been used clinically in the treatment of patients with chronic hepatitis. This study evaluated the effect of GA on the activity of five P450(CYP450) cytochrome enzymes: CYP2A6, CYP2C9, CYP2C19, CYP2D6, and CYP3A4, in human liver microsomes (HLMs) and recombinant cDNA-expressed enzyme systems using a HPLC-MS/MS CYP-specific probe substrate assay. With midazolam as the probe substrate, GA greatly decreased CYP3A4 activity with IC₅₀ values of 8.195 μM in HLMs and 7.498 μM in the recombinant cDNA-expressed CYP3A4 enzyme system, respectively. It significantly decreased CYP3A4 activity in a dose- but not time-dependent manner. Results from Lineweaver–Burk plots showed that GA could inhibit CYP3A4 activity competitively, with a Ki value of 1.57 μM in HLMs. Moreover, CYP2C9 and CYP2C19 could also be inhibited significantly by GA with IC₅₀ of 42.89 and 40.26 μM in HLMs, respectively. Other CYP450 isoforms were not markedly affected by GA. The inhibition was also confirmed by an in vivo study of mice. In addition, it was observed that mRNA expressions of the Cyps2c and 3a family decreased significantly in the livers of mice treated with GA. In conclusion, this study indicates that GA may exert herb-drug interactions by competitively inhibiting CYP3A4. Full article

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14 pages, 573 KiB

Open AccessArticle

Who Benefits—Or Does not—From South Africa’s Old Age Pension? Evidence from Characteristics of Rural Pensioners and Non-Pensioners

by Margaret Ralston^1,*, Enid Schatz^2,3,4, Jane Menken^3,4, Francesc Xavier Gómez-Olivé^4,5 and Stephen Tollman^4,5,6

¹ Department of Sociology, Mississippi State University, P.O. Box C, Mississippi State, MS 39762, USA

² Department of Health Sciences, University of Missouri, 535 Clark Hall, Columbia, MO 65211, USA

³ Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO 80309-0483, USA

⁴ MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa

⁵ INDEPTH Network, P.O. Box KD213 Kanda, Accra, Ghana

⁶ Umeå Centre for Global Health Research, Umeå University, Umeå 90001-90850, Sweden

Int. J. Environ. Res. Public Health 2016, 13(1), 85; https://doi.org/10.3390/ijerph13010085 - 25 Dec 2015

Cited by 38 | Viewed by 7099

Abstract

Social protection grants play a critical role in survival and livelihoods of elderly individuals in South Africa. Rarely is it possible to assess how well a social program reaches its target population. Using a 2010 survey and Agincourt Health Demographic Surveillance System census [...] Read more.

Social protection grants play a critical role in survival and livelihoods of elderly individuals in South Africa. Rarely is it possible to assess how well a social program reaches its target population. Using a 2010 survey and Agincourt Health Demographic Surveillance System census data we conduct multivariate logistic regression to predict pension receipt in rural South Africa. We find only 80% of age-eligible individuals report pension receipt. Pension non-recipients tend to be male, have poor socio-economic status, live in smaller households, be of Mozambican origin, and have poorer physical function; while older persons living in households receiving other grants are more likely to report pension receipt. We conclude that a reservoir of older persons exists who meet eligibility criteria but who are not yet receiving pensions. Ensuring that they and their households are properly linked to all available social services—whether for child or old-age social grants—is likely to have beneficial and synergistic effects. Full article

(This article belongs to the Section Health Economics)

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11 pages, 433 KiB

Open AccessArticle

Adverse Events in Treating Smear-Positive Tuberculosis Patients in China

by Tao Zhang¹, Jian Du^2,3, Xiaoyan Yin⁴, Fuzhong Xue¹, Yanxun Liu¹, Runzi Li¹, Cheng Luo¹, Liang Li^2,3 and Xiujun Li^1,*

¹ Department of Biostatistics, School of Public Health, Shandong University, Jinan 250012, China

² Clinical Center Office, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China

³ Beijing Chest Hospital, Capital Medical University, Beijing 101149, China

⁴ National Heart Lung and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA 01702-5827, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 86; https://doi.org/10.3390/ijerph13010086 - 29 Dec 2015

Cited by 23 | Viewed by 4819

Abstract

This study aimed to estimate the adverse events (AE) rate during anti-tuberculosis treatment and to explore AE-related risk factors. New and previously treated smear-positive tuberculosis (TB) cases were enrolled from eight regions in China between April 2009 and October 2010. The AE rate [...] Read more.

This study aimed to estimate the adverse events (AE) rate during anti-tuberculosis treatment and to explore AE-related risk factors. New and previously treated smear-positive tuberculosis (TB) cases were enrolled from eight regions in China between April 2009 and October 2010. The AE rate was estimated, and AE risk factors during anti-TB treatment were assessed using Cox proportional models. Among 2091 Chinese subjects with anti-TB treatment, 462 (22.1%, 95% confidence interval (CI), 20.3–23.9) patients developed AE, with liver injury and gastrointestinal reactions constituting the most common AE. Specifically, 9.8% (95% CI, 8.5–11.1) and 6.3% (95% CI, 5.3–7.4) developed liver injuries and gastrointestinal reactions, respectively. We found that AE rate differed by regions, TB knowledge score, symptoms score and smoking status. Liver injuries were associated with age, sex and smoking status; gastrointestinal reactions were associated with education level and symptom score. Improving patients’ knowledge on TB could reduce AE rate. Full article

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12 pages, 940 KiB

Open AccessArticle

Electronic Cigarettes on Hospital Campuses

by Clare Meernik^1,*, Hannah M. Baker¹, Karina Paci¹, Isaiah Fischer-Brown^1,†, Daniel Dunlap^2,† and Adam O. Goldstein¹

¹ Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA

² University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA

^† The current affiliation of Isaiah Fischer-Brown is: School of Arts and Sciences, Tufts University, Medford, MA 02155, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 87; https://doi.org/10.3390/ijerph13010087 - 29 Dec 2015

Cited by 5 | Viewed by 6447

Abstract

Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke [...] Read more.

Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62%) completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors. Full article

(This article belongs to the Special Issue Tobacco Control 2015)

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10 pages, 1074 KiB

Open AccessArticle

Cadmium Chloride Induces DNA Damage and Apoptosis of Human Liver Carcinoma Cells via Oxidative Stress

by Anthony Skipper¹, Jennifer N. Sims², Clement G. Yedjou¹

and Paul B. Tchounwou^1,*

¹ Molecular Toxicology Research Laboratory, NIH-Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, 1400 Lynch Street, Box 18540, Jackson, MS 39217, USA

² Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Bookline Avenue, Boston, MA 02215, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 88; https://doi.org/10.3390/ijerph13010088 - 2 Jan 2016

Cited by 128 | Viewed by 8473

Abstract

Cadmium is a heavy metal that has been shown to cause its toxicity in humans and animals. Many documented studies have shown that cadmium produces various genotoxic effects such as DNA damage and chromosomal aberrations. Ailments such as bone disease, renal damage, and [...] Read more.

Cadmium is a heavy metal that has been shown to cause its toxicity in humans and animals. Many documented studies have shown that cadmium produces various genotoxic effects such as DNA damage and chromosomal aberrations. Ailments such as bone disease, renal damage, and several forms of cancer are attributed to overexposure to cadmium. Although there have been numerous studies examining the effects of cadmium in animal models and a few case studies involving communities where cadmium contamination has occurred, its molecular mechanisms of action are not fully elucidated. In this research, we hypothesized that oxidative stress plays a key role in cadmium chloride-induced toxicity, DNA damage, and apoptosis of human liver carcinoma (HepG₂) cells. To test our hypothesis, cell viability was determined by MTT assay. Lipid hydroperoxide content stress was estimated by lipid peroxidation assay. Genotoxic damage was tested by the means of alkaline single cell gel electrophoresis (Comet) assay. Cell apoptosis was measured by flow cytometry assessment (Annexin-V/PI assay). The result of MTT assay indicated that cadmium chloride induces toxicity to HepG₂ cells in a concentration-dependent manner, showing a 48 hr-LD₅₀ of 3.6 µg/mL. Data generated from lipid peroxidation assay resulted in a significant (p < 0.05) increase of hydroperoxide production, specifically at the highest concentration tested. Data obtained from the Comet assay indicated that cadmium chloride causes DNA damage in HepG₂ cells in a concentration-dependent manner. A strong concentration-response relationship (p < 0.05) was recorded between annexin V positive cells and cadmium chloride exposure. In summary, these in vitro studies provide clear evidence that cadmium chloride induces oxidative stress, DNA damage, and programmed cell death in human liver carcinoma (HepG₂) cells. Full article

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13 pages, 470 KiB

Open AccessArticle

Occupational Heat Stress Profiles in Selected Workplaces in India

by Vidhya Venugopal^1,*, Jeremiah S. Chinnadurai¹, Rebekah A. I. Lucas^2,3 and Tord Kjellstrom^2,4

¹ Department of Environmental Health Engineering, No.1, Ramachandra Nagar Porur, Chennai, Tamilnadu 600116, India

² Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeåa University, 901 87 Umeå, Sweden

³ School of Sport, Exercise and Rehabilitation Sciences, The University of Birmingham Edgbaston, Birmingham B15 2TT, UK

⁴ Health and Environment International Trust, 168 Stafford Drive, Mapua 7005, Nelson, New Zealand

Int. J. Environ. Res. Public Health 2016, 13(1), 89; https://doi.org/10.3390/ijerph13010089 - 29 Dec 2015

Cited by 118 | Viewed by 11235

Abstract

Health and productivity impacts from occupational heat stress have significant ramifications for the large workforce of India. This study profiled occupational heat stress impacts on the health and productivity of workers in select organized and unorganized Indian work sectors. During hotter and cooler [...] Read more.

Health and productivity impacts from occupational heat stress have significant ramifications for the large workforce of India. This study profiled occupational heat stress impacts on the health and productivity of workers in select organized and unorganized Indian work sectors. During hotter and cooler seasons, Wet Bulb Globe Temperatures (WBGT) were used to quantify the risk of heat stress, according to International workplace guidelines. Questionnaires assessed workers’ perceived health and productivity impacts from heat stress. A total of 442 workers from 18 Indian workplaces participated (22% and 78% from the organized and unorganized sector, respectively). Overall 82% and 42% of workers were exposed to higher than recommended WBGT during hotter and cooler periods, respectively. Workers with heavy workloads reported more heat-related health issues (chi square = 23.67, p ≤ 0.001) and reduced productivity (chi square = 15.82, p ≤ 0.001), especially the outdoor workers. Heat-rashes, dehydration, heat-syncope and urinogenital symptoms were self-reported health issues. Cited reasons for productivity losses were: extended-work hours due to fatigue/exhaustion, sickness/hospitalization and wages lost. Reducing workplace heat stress will benefit industries and workers via improving worker health and productivity. Adaptation and mitigation measures to tackle heat stress are imperative to protect the present and future workforce as climate change progresses. Full article

(This article belongs to the Special Issue Technology, Data, and the Assessment of Atmospheric Exposure on Finer Scales)

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13 pages, 1732 KiB

Open AccessArticle

Annoyance from Road Traffic, Trains, Airplanes and from Total Environmental Noise Levels

by Martina S. Ragettli^1,2,3,4, Sophie Goudreau², Céline Plante², Stéphane Perron², Michel Fournier² and Audrey Smargiassi^1,5,6,*

¹ Department of Environmental Health and Occupational Health, School of Public Health, University of Montreal, Montreal, QC H3C 3J7, Canada

² Public Health Department of Montreal, Montreal, QC H2L 1M3, Canada

³ Swiss Tropical and Public Health Institute, Basel 4002, Switzerland

⁴ University of Basel, Basel 4003, Switzerland

⁵ National Institute of Public Health of Quebec, Montreal, QC H3C 2B9, Canada

⁶ Public Health Research Institute, University of Montreal, QC H3C 3J7, Canada

Int. J. Environ. Res. Public Health 2016, 13(1), 90; https://doi.org/10.3390/ijerph13010090 - 29 Dec 2015

Cited by 38 | Viewed by 7069

Abstract

There is a lack of studies assessing the exposure-response relationship between transportation noise and annoyance in North America. Our aims were to investigate the prevalence of noise annoyance induced by road traffic, trains and airplanes in relation to distance to transportation noise sources, [...] Read more.

There is a lack of studies assessing the exposure-response relationship between transportation noise and annoyance in North America. Our aims were to investigate the prevalence of noise annoyance induced by road traffic, trains and airplanes in relation to distance to transportation noise sources, and to total environmental noise levels in Montreal, Canada; annoyance was assessed as noise-induced disturbance. A telephone-based survey among 4336 persons aged >18 years was conducted. Exposure to total environmental noise (A-weighted outdoor noise levels—LA_eq24h and day-evening-night equivalent noise levels—L_den) for each study participant was determined using a statistical noise model (land use regression—LUR) that is based on actual outdoor noise measurements. The proportion of the population annoyed by road traffic, airplane and train noise was 20.1%, 13.0% and 6.1%, respectively. As the distance to major roads, railways and the Montreal International Airport increased, the percentage of people disturbed and highly disturbed due to the corresponding traffic noise significantly decreased. When applying the statistical noise model we found a relationship between noise levels and disturbance from road traffic and total environmental noise, with Prevalence Proportion Ratios (PPR) for highly disturbed people of 1.10 (95% CI: 1.07–1.13) and 1.04 (1.02–1.06) per 1 dB(A) L_den, respectively. Our study provides the first comprehensive information on the relationship between transportation noise levels and disturbance in a Canadian city. LUR models are still in development and further studies on transportation noise induced annoyance are consequently needed, especially for sources other than road traffic. Full article

(This article belongs to the Special Issue The Combined Health Effects of Environmental Exposures)

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12 pages, 217 KiB

Open AccessArticle

Heterogeneity of Characteristics among Housing Adaptation Clients in Sweden—Relationship to Participation and Self-Rated Health

by Björg Thordardottir^1,*, Carlos Chiatti^1,2, Lisa Ekstam¹

and Agneta Malmgren Fänge¹

¹ Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund 221 00, Sweden

² Italian National Research Center on Aging, Via S. Margherita 5, Ancona 60124, Italy

Int. J. Environ. Res. Public Health 2016, 13(1), 91; https://doi.org/10.3390/ijerph13010091 - 29 Dec 2015

Cited by 11 | Viewed by 5331

Abstract

The aim of the paper was to explore the heterogeneity among housing adaptation clients. Cluster analysis was performed using baseline data from applicants in three Swedish municipalities. The analysis identified six main groups: “adults at risk of disability”, “young old with disabilities”, “well-functioning [...] Read more.

The aim of the paper was to explore the heterogeneity among housing adaptation clients. Cluster analysis was performed using baseline data from applicants in three Swedish municipalities. The analysis identified six main groups: “adults at risk of disability”, “young old with disabilities”, “well-functioning older adults”, “frail older adults”, “frail older with moderate cognitive impairments” and “resilient oldest old”. The clusters differed significantly in terms of participation frequency and satisfaction in and outside the home as well as in terms of self-rated health. The identification of clusters in a heterogeneous sample served the purpose of finding groups with different characteristics, including participation and self-rated health which could be used to facilitate targeted home-based interventions. The findings indicate that housing adaptions should take person/environment/activity specific characteristics into consideration so that they may fully serve the purpose of facilitating independent living, as well as enhancing participation and health. Full article

13 pages, 1826 KiB

Open AccessArticle

A Modified Hopfield Neural Network Algorithm (MHNNA) Using ALOS Image for Water Quality Mapping

by Ahmed Asal Kzar^1,2,*, Mohd Zubir Mat Jafri¹

, Kussay N. Mutter^1,3 and Saumi Syahreza¹

¹ School of Physics, Universiti Sains Malaysia, Penang 11800, Malaysia

² Physics Department, Faculty of Science, Kufa University, Najaf 31001, Iraq

³ Physics Department, College of Education, Al-Mustansiriya University, Baghdad 10001, Iraq

Int. J. Environ. Res. Public Health 2016, 13(1), 92; https://doi.org/10.3390/ijerph13010092 - 30 Dec 2015

Cited by 7 | Viewed by 4455

Abstract

Decreasing water pollution is a big problem in coastal waters. Coastal health of ecosystems can be affected by high concentrations of suspended sediment. In this work, a Modified Hopfield Neural Network Algorithm (MHNNA) was used with remote sensing imagery to classify the total [...] Read more.

Decreasing water pollution is a big problem in coastal waters. Coastal health of ecosystems can be affected by high concentrations of suspended sediment. In this work, a Modified Hopfield Neural Network Algorithm (MHNNA) was used with remote sensing imagery to classify the total suspended solids (TSS) concentrations in the waters of coastal Langkawi Island, Malaysia. The adopted remote sensing image is the Advanced Land Observation Satellite (ALOS) image acquired on 18 January 2010. Our modification allows the Hopfield neural network to convert and classify color satellite images. The samples were collected from the study area simultaneously with the acquiring of satellite imagery. The sample locations were determined using a handheld global positioning system (GPS). The TSS concentration measurements were conducted in a lab and used for validation (real data), classification, and accuracy assessments. Mapping was achieved by using the MHNNA to classify the concentrations according to their reflectance values in band 1, band 2, and band 3. The TSS map was color-coded for visual interpretation. The efficiency of the proposed algorithm was investigated by dividing the validation data into two groups. The first group was used as source samples for supervisor classification via the MHNNA. The second group was used to test the MHNNA efficiency. After mapping, the locations of the second group in the produced classes were detected. Next, the correlation coefficient (R) and root mean square error (RMSE) were calculated between the two groups, according to their corresponding locations in the classes. The MHNNA exhibited a higher R (0.977) and lower RMSE (2.887). In addition, we test the MHNNA with noise, where it proves its accuracy with noisy images over a range of noise levels. All results have been compared with a minimum distance classifier (Min-Dis). Therefore, TSS mapping of polluted water in the coastal Langkawi Island, Malaysia can be performed using the adopted MHNNA with remote sensing techniques (as based on ALOS images). Full article

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14 pages, 1015 KiB

Open AccessArticle

The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe

by Signe Timm^1,*, Morten Frydenberg¹, Christer Janson², Brittany Campbell³, Bertil Forsberg⁴, Thorarinn Gislason^5,6, Mathias Holm⁷, Rain Jogi⁸, Ernst Omenaas⁹, Torben Sigsgaard¹, Cecilie Svanes⁹

and Vivi Schlünssen^1,10

¹ Department of Public Health, Danish Ramazzini Centre, Aarhus University, DK-8000 Aarhus C, Denmark

² Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, 751 05 Uppsala, Sweden

³ Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3010, Australia

⁴ Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden

⁵ Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik IS-108, Iceland

⁶ Faculty of Medicine, University of Iceland, Reykjavik IS-101, Iceland

⁷ Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg 405 30, Sweden

⁸ Lung Clinic, Tartu University Hospital, Tartu 50406, Estonia

⁹ Institute of Clinical Science, University of Bergen, 5020 Bergen, Norway

¹⁰ National Research Center for Working Environment, Copenhagen DK-2100, Denmark

Int. J. Environ. Res. Public Health 2016, 13(1), 93; https://doi.org/10.3390/ijerph13010093 - 30 Dec 2015

Cited by 54 | Viewed by 8759

Abstract

The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. [...] Read more.

The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE) study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8%) than subjects growing up in inner cities (11%) (hazard ratio 0.72 95% CI 0.57–0.91), and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02). An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population. Full article

(This article belongs to the Special Issue Children’s Exposure to Environmental Contaminants)

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14 pages, 719 KiB

Open AccessArticle

Distribution and Predictors of Pesticides in the Umbilical Cord Blood of Chinese Newborns

by Monica K. Silver¹, Jie Shao², Minjian Chen³, Yankai Xia³, Betsy Lozoff⁴ and John D. Meeker^1,*

¹ Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, MI 48109, USA

² Department of Child Health Care, Children’s Hospital Zhejiang University School of Medicine, Hangzhou 310003, China

³ Institute of Toxicology, Nanjing Medical University, Nanjing 210029, China

⁴ Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, MI 41809, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 94; https://doi.org/10.3390/ijerph13010094 - 30 Dec 2015

Cited by 30 | Viewed by 6297

Abstract

Rates of pesticide use in Chinese agriculture are five times greater than the global average, leading to high exposure via the diet. Many are neurotoxic, making prenatal pesticide exposure a concern. Previous studies of prenatal exposure in China focused almost entirely on organochlorines. [...] Read more.

Rates of pesticide use in Chinese agriculture are five times greater than the global average, leading to high exposure via the diet. Many are neurotoxic, making prenatal pesticide exposure a concern. Previous studies of prenatal exposure in China focused almost entirely on organochlorines. Here the study goals were to characterize the exposure of Chinese newborns to all classes of pesticides and identify predictors of those exposures. Eighty-four pesticides and 12 metabolites were measured in the umbilical cord plasma of 336 infants. Composite variables were created for totals detected overall and by class. Individual pesticides were analyzed as dichotomous or continuous, based on detection rates. Relationships between demographic characteristics and pesticides were evaluated using generalized linear regression. Seventy-five pesticides were detected. The mean number of detects per sample was 15.3. Increased pesticide detects were found in the cord blood of infants born in the summer (β = 2.2, p = 0.01), particularly in July (β = 4.0, p = 0.03). Similar trends were observed for individual insecticide classes. Thus, a summer birth was the strongest predictor of pesticide evidence in cord blood. Associations were more striking for overall pesticide exposure than for individual pesticides, highlighting the importance of considering exposure to mixtures of pesticides, rather than individual agents or classes. Full article

(This article belongs to the Special Issue Children’s Exposure to Environmental Contaminants)

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9 pages, 258 KiB

Open AccessArticle

Racial Differences in Length of Stay for Patients Who Leave Against Medical Advice from U.S. General Hospitals

by Rima Tawk^* and Matthew Dutton

Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 95; https://doi.org/10.3390/ijerph13010095 - 31 Dec 2015

Cited by 6 | Viewed by 4429

Abstract

There is a paucity of published literature on the length of hospital stays (LOS) for patients who leave against medical advice (AMA) and on the factors that predict their LOS. The purpose of the study is to examine the relationship between race and [...] Read more.

There is a paucity of published literature on the length of hospital stays (LOS) for patients who leave against medical advice (AMA) and on the factors that predict their LOS. The purpose of the study is to examine the relationship between race and the LOS for AMA patients after adjusting for patient and hospital characteristics. National Hospital Discharge Survey (NHDS) data were used to describe LOS for AMA patients aged 18 years or older. Patient characteristics included age, sex, race, marital status, insurance, and diagnosis (ICD-9-CM). Hospital characteristics consisted of ownership, region and bed size. LOS was the major outcome measure. Using data from all years 1988–2006, the expected time to AMA discharge was first examined as a function of race, then adjusting for year terms, patient and hospital characteristics, and major medical diagnoses and mental illness. The unadjusted effect of race on the expected time of leaving AMA was about twice the adjusted effect. After controlling for the other covariates, the expected time to AMA discharge is 20% shorter for Blacks than Whites. The most significant predictors included age, insurance coverage, mental illness, gender, and region. Factors identified in this study offer insights into directions for evidence based- health policy to reduce AMA discharges. Full article

(This article belongs to the Special Issue Proceedings from the 2014 Minority Health & Health Disparities Grantees’ Conference (MHHDGC))

18 pages, 1326 KiB

Open AccessArticle

Removal of Fecal Indicators, Pathogenic Bacteria, Adenovirus, Cryptosporidium and Giardia (oo)cysts in Waste Stabilization Ponds in Northern and Eastern Australia

by Maxim Sheludchenko^1,2,*, Anna Padovan³, Mohammad Katouli² and Helen Stratton¹

¹ Smart Water Research Centre, Building G51, Griffith University, Southport, Queensland 4222, Australia

² Genecology Research Centre, University of the Sunshine Coast, Sippy Downs, Queensland 4558, Australia

³ Research Institute for the Environment and Livelihoods, Charles Darwin University, Darwin, Northern Territory 0909, Australia

Int. J. Environ. Res. Public Health 2016, 13(1), 96; https://doi.org/10.3390/ijerph13010096 - 2 Jan 2016

Cited by 25 | Viewed by 7183

Abstract

Maturation ponds are used in rural and regional areas in Australia to remove the microbial loads of sewage wastewater, however, they have not been studied intensively until present. Using a combination of culture-based methods and quantitative real-time PCR, we assessed microbial removal rates [...] Read more.

Maturation ponds are used in rural and regional areas in Australia to remove the microbial loads of sewage wastewater, however, they have not been studied intensively until present. Using a combination of culture-based methods and quantitative real-time PCR, we assessed microbial removal rates in maturation ponds at four waste stabilization ponds (WSP) with (n = 1) and without (n = 3) baffles in rural and remote communities in Australia. Concentrations of total coliforms, E. coli, enterococci, Campylobacter spp., Salmonella spp., F+ RNA coliphage, adenovirus, Cryptosporidium spp. and Giardia (oo) cysts in maturation ponds were measured at the inlet and outlet. Only the baffled pond demonstrated a significant removal of most of the pathogens tested and therefore was subjected to further study by analyzing E. coli and enterococci concentrations at six points along the baffles over five sampling rounds. Using culture-based methods, we found a decrease in the number of E. coli and enterococci from the initial values of 100,000 CFU per 100 mL in the inlet samples to approximately 1000 CFU per 100 mL in the outlet samples for both bacterial groups. Giardia cysts removal was relatively higher than fecal indicators reduction possibly due to sedimentation. Full article

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12 pages, 1621 KiB

Open AccessArticle

A Walk in the Park: The Influence of Urban Parks and Community Violence on Physical Activity in Chelsea, MA

by Judy Y. Ou^1,*, Jonathan I. Levy¹

, Junenette L. Peters¹, Roseann Bongiovanni², Jovanna Garcia-Soto², Rafael Medina² and Madeleine K. Scammell¹

¹ Boston University School of Public Health, Boston University, Boston, MA 02118, USA

² Chelsea Collaborative, Chelsea, MA 02150, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 97; https://doi.org/10.3390/ijerph13010097 - 4 Jan 2016

Cited by 41 | Viewed by 10599

Abstract

Proximity to a park does not necessarily imply access or use, and the social environment may positively or negatively influence the positive intentions of the built environment. To investigate parks, park use and physical activity, and their associations with exposure to community violence, [...] Read more.

Proximity to a park does not necessarily imply access or use, and the social environment may positively or negatively influence the positive intentions of the built environment. To investigate parks, park use and physical activity, and their associations with exposure to community violence, we interviewed residents (n = 354) of a densely populated urban community. Our findings indicate that proximity to any park is not associated with physical activity. However, proximity to the preferred park reported by residents to be conducive for physical activity (with walking paths, large fields, playgrounds for children and tennis courts) was associated with physical activity. Conversely, knowledge of sexual assault or rape in the neighborhood is inversely associated with every type of physical activity (park-based, outdoor, and indoor). Our findings suggest that improvements to the built environment (parks, green spaces) may be hindered by adverse social environments and both are necessary for consideration in the design of public health interventions. Full article

(This article belongs to the Special Issue The Impacts of the Built Environment on Public Health)

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13 pages, 1517 KiB

Open AccessArticle

Evaluation of the Survivability of Microorganisms Deposited on Filtering Respiratory Protective Devices under Varying Conditions of Humidity

by Katarzyna Majchrzycka^1,*

, Małgorzata Okrasa¹

, Justyna Skóra² and Beata Gutarowska²

¹ Department of Personal Protective Equipment, Central Institute for Labour Protection—National Research Institute, Łódź 90-133, Poland

² Institute of Fermentation Technology and Microbiology, Lodz University of Technology, Łódź 90-924, Poland

Int. J. Environ. Res. Public Health 2016, 13(1), 98; https://doi.org/10.3390/ijerph13010098 - 4 Jan 2016

Cited by 42 | Viewed by 6380

Abstract

Bioaerosols are common biological factors in work environments, which require routine use of filtering respiratory protective devices (FRPDs). Currently, no studies link humidity changes in the filter materials of such devices, during use, with microorganism survivability. Our aim was to determine the microclimate [...] Read more.

Bioaerosols are common biological factors in work environments, which require routine use of filtering respiratory protective devices (FRPDs). Currently, no studies link humidity changes in the filter materials of such devices, during use, with microorganism survivability. Our aim was to determine the microclimate inside FRPDs, by simulating breathing, and to evaluate microorganism survivability under varying humidity conditions. Breathing was simulated using commercial filtering facepiece respirators in a model system. Polypropylene melt-blown nonwoven fabrics with moisture contents of 40%, 80%, and 200%, were used for assessment of microorganisms survivability. A modified AATCC 100-2004 method was used to measure the survivability of ATCC and NCAIM microorganisms: Escherichia coli, Staphylococcus aureus, Bacillus subtilis, Candida albicans and Aspergillus niger. During simulation relative humidity under the facepiece increased after 7 min of usage to 84%–92% and temperature increased to 29–30 °C. S. aureus survived the best on filter materials with 40%–200% moisture content. A decrease in survivability was observed for E. coli and C. albicans when mass humidity decreased. We found that B. subtilis and A. niger proliferated for 48–72 h of incubation and then died regardless of the moisture content. In conclusion, our tests showed that the survivability of microorganisms on filter materials depends on the amount of accumulated moisture and microorganism type. Full article

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14 pages, 2918 KiB

Open AccessArticle

Synthesis of High Valence Silver-Loaded Mesoporous Silica with Strong Antibacterial Properties

by Chun-Chi Chen¹, Hsin-Hsien Wu¹, Hsin-Yi Huang¹, Chen-Wei Liu¹ and Yi-Ning Chen^2,*

¹ Green Energy and Environment Research Laboratories, Industrial Technology Research Institute, 195 Chung Hsing Road, Chutung, Hsinchu County 31040, Taiwan

² Department of Bioscience Technology, Chung Yuan Christian University, 200 Chung Pei Road, Chung Li District, Taoyuan City 32023, Taiwan

Int. J. Environ. Res. Public Health 2016, 13(1), 99; https://doi.org/10.3390/ijerph13010099 - 4 Jan 2016

Cited by 21 | Viewed by 7131

Abstract

A simple chemical method was developed for preparing high valence silver (Ag)-loaded mesoporous silica (Ag-ethylenediaminetetraacetic acid (EDTA)-SBA-15), which showed strong antibacterial activity. Ag-EDTA-SBA-15 exhibited stronger and more effective antibacterial activity than commercial Ag nanoparticles did, and it offered high stability of high valence [...] Read more.

A simple chemical method was developed for preparing high valence silver (Ag)-loaded mesoporous silica (Ag-ethylenediaminetetraacetic acid (EDTA)-SBA-15), which showed strong antibacterial activity. Ag-EDTA-SBA-15 exhibited stronger and more effective antibacterial activity than commercial Ag nanoparticles did, and it offered high stability of high valence silver in the porous matrix and long-lasting antibacterial activity. The synthesized materials were characterized using Fourier transform infrared spectroscopy, powder X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) analysis, and transmission electron microscopy (TEM). Ag existed in both surface complexation and Ag particles. EDTA anchored within a porous structure chelated Ag ions in higher oxidation states and prevented their agglomeration and oxidation reduction. The XRD results showed that most Ag in the Ag-EDTA-SBA-15 existed in higher oxidation states such as Ag(II) and Ag(III). However, the XPS and TEM results showed that Ag easily reduced in lower oxidation states and agglomerated as Ag particles on the exterior layer of the SBA-15. Full article

(This article belongs to the Special Issue Nanomaterials-Based New Techniques, New Drugs, and Antibacterial Reagents)

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23 pages, 4699 KiB

Open AccessArticle

Advanced Wastewater Treatment Engineering—Investigating Membrane Fouling in both Rotational and Static Membrane Bioreactor Systems Using Empirical Modelling

by Parneet Paul^1,* and Franck Anderson Jones²

¹ Department of Civil Engineering, School of Natural and Built Environments, Faculty of Science, Engineering and Computing, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey KT1 2EE, UK

² Department of Mechanical, Aerospace and Civil Engineering, College of Engineering, Design and Physical Sciences, Brunel University, Uxbridge, Middlesex UB8 3PH, UK

Int. J. Environ. Res. Public Health 2016, 13(1), 100; https://doi.org/10.3390/ijerph13010100 - 5 Jan 2016

Cited by 4 | Viewed by 5622

Abstract

Advanced wastewater treatment using membranes are popular environmental system processes since they allow reuse and recycling. However, fouling is a key limiting factor and so proprietary systems such as Avanti’s RPU-185 Flexidisks membrane bioreactor (MBR) use novel rotating membranes to assist in ameliorating [...] Read more.

Advanced wastewater treatment using membranes are popular environmental system processes since they allow reuse and recycling. However, fouling is a key limiting factor and so proprietary systems such as Avanti’s RPU-185 Flexidisks membrane bioreactor (MBR) use novel rotating membranes to assist in ameliorating it. In earlier research, this rotating process was studied by creating a simulation model based on first principles and traditional fouling mechanisms. In order to directly compare the potential benefits of this rotational system, this follow-up study was carried out using Avanti’s newly developed static (non-rotating) Flexidisks MBR system. The results from operating the static pilot unit were simulated and modelled using the rotational fouling model developed earlier however with rotational switching functions turned off and rotational parameters set to a static mode. The study concluded that a rotating MBR system could increase flux throughput when compared against a similar static system. It is thought that although the slowly rotating spindle induces a weak crossflow shear, it is still able to even out cake build up across the membrane surface, thus reducing the likelihood of localised critical flux being exceeded at the micro level and lessening the potential of rapid trans-membrane pressure increases at the macro level. Full article

(This article belongs to the Special Issue Environmental Systems Engineering)

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14 pages, 560 KiB

Open AccessArticle

Ethnic Kawasaki Disease Risk Associated with Blood Mercury and Cadmium in U.S. Children

by Deniz Yeter^1,*, Michael A. Portman², Michael Aschner³, Marcelo Farina⁴

, Wen-Ching Chan^1,5, Kai-Sheng Hsieh^1,6,7 and Ho-Chang Kuo^1,6,7,*

¹ Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan

² Division of Cardiology, Department of Pediatrics, Seattle Children’s Research Institute, University of Washington, Seattle, WA 98101, USA

³ Department of Molecular Pharmacology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461, USA

⁴ Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina 88040, Brazil

⁵ Genomics and Proteomics Core Laboratory, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan

⁶ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan

⁷ College of Medicine, Chang Gung University, Gueishan, Taoyuan 33302, Taiwan

Int. J. Environ. Res. Public Health 2016, 13(1), 101; https://doi.org/10.3390/ijerph13010101 - 5 Jan 2016

Cited by 16 | Viewed by 7193

Abstract

Kawasaki disease (KD) primarily affects children <5 years of age (75%–80%) and is currently the leading cause of acquired heart disease in developed nations. Even when residing in the West, East Asian children are 10 to 20 times more likely to develop KD. [...] Read more.

Kawasaki disease (KD) primarily affects children <5 years of age (75%–80%) and is currently the leading cause of acquired heart disease in developed nations. Even when residing in the West, East Asian children are 10 to 20 times more likely to develop KD. We hypothesized cultural variations influencing pediatric mercury (Hg) exposure from seafood consumption may mediate ethnic KD risk among children in the United States. Hospitalization rates of KD in US children aged 0–4 years (n = 10,880) and blood Hg levels in US children aged 1–5 years (n = 713) were determined using separate US federal datasets. Our cohort primarily presented with blood Hg levels <0.1 micrograms (µg) per kg bodyweight (96.5%) that are considered normal and subtoxic. Increased ethnic KD risk was significantly associated with both increasing levels and detection rates of blood Hg or cadmium (Cd) in a linear dose-responsive manner between ethnic African, Asian, Caucasian, and Hispanic children in the US (p ≤ 0.05). Increasing low-dose exposure to Hg or Cd may induce KD or contribute to its later development in susceptible children. However, our preliminary results require further replication in other ethnic populations, in addition to more in-depth examination of metal exposure and toxicokinetics. Full article

(This article belongs to the Special Issue Children’s Exposure to Environmental Contaminants)

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15 pages, 3776 KiB

Open AccessArticle

Experimental Study on Ultrafine Particle Removal Performance of Portable Air Cleaners with Different Filters in an Office Room

by Huan Ma, Henggen Shen^*, Tiantian Shui, Qing Li and Liuke Zhou

School of Environmental Science and Engineering, Donghua University, Shanghai 201620, China

Int. J. Environ. Res. Public Health 2016, 13(1), 102; https://doi.org/10.3390/ijerph13010102 - 5 Jan 2016

Cited by 23 | Viewed by 6269

Abstract

Size- and time-dependent aerodynamic behaviors of indoor particles, including PM_1.0, were evaluated in a school office in order to test the performance of air-cleaning devices using different filters. In-situ real-time measurements were taken using an optical particle counter. The filtration characteristics [...] Read more.

Size- and time-dependent aerodynamic behaviors of indoor particles, including PM_1.0, were evaluated in a school office in order to test the performance of air-cleaning devices using different filters. In-situ real-time measurements were taken using an optical particle counter. The filtration characteristics of filter media, including single-pass efficiency, volume and effectiveness, were evaluated and analyzed. The electret filter (EE) medium shows better initial removal efficiency than the high efficiency (HE) medium in the 0.3–3.5 μm particle size range, while under the same face velocity, the filtration resistance of the HE medium is several times higher than that of the EE medium. During service life testing, the efficiency of the EE medium decreased to 60% with a total purifying air flow of 25 × 10⁴ m³/m². The resistance curve rose slightly before the efficiency reached the bottom, and then increased almost exponentially. The single-pass efficiency of portable air cleaner (PAC) with the pre-filter (PR) or the active carbon granule filter (CF) was relatively poor. While PAC with the pre-filter and the high efficiency filter (PR&HE) showed maximum single-pass efficiency for PM_1.0 (88.6%), PAC with the HE was the most effective at removing PM_1.0. The enhancement of PR with HE and electret filters augmented the single-pass efficiency, but lessened the airflow rate and effectiveness. Combined with PR, the decay constant of large-sized particles could be greater than for PACs without PR. Without regard to the lifetime, the electret filters performed better with respect to resource saving and purification improvement. A most penetrating particle size range (MPPS: 0.4–0.65 μm) exists in both HE and electret filters; the MPPS tends to become larger after HE and electret filters are combined with PR. These results serve to provide a better understanding of the indoor particle removal performance of PACs when combined with different kinds of filters in school office buildings. Full article

(This article belongs to the Special Issue Environmental Systems Engineering)

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8 pages, 593 KiB

Open AccessArticle

Association between CRP and TNF-α genes Variants and Cardiovascular Heart Disease in a Mexican Population: Protocol for a Case-Control Study

by Yazmín Hernández-Díaz¹, Carlos Alfonso Tovilla-Zárate², Isela Juárez-Rojop³, María Lilia López-Narváez⁴, José Francisco Álvarez-Cámara³ and Thelma Beatriz González-Castro^1,*

¹ División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco 86205, México

² División Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco 86650, México

³ División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco Villahermosa, Tabasco 86150, México

⁴ Hospital General de Yajalón. Secretaría de Salud, Yajalón, Chiapas 29932, México

Int. J. Environ. Res. Public Health 2016, 13(1), 103; https://doi.org/10.3390/ijerph13010103 - 6 Jan 2016

Cited by 11 | Viewed by 5020

Abstract

Background: The C-reactive protein (CRP) and the tumor necrosis factor-alpha (TNF-α) are considered markers of inflammation and have been shown to predict the risk of incident cardiovascular events. However, few studies have undertaken a comprehensive examination of SNPs (single [...] Read more.

Background: The C-reactive protein (CRP) and the tumor necrosis factor-alpha (TNF-α) are considered markers of inflammation and have been shown to predict the risk of incident cardiovascular events. However, few studies have undertaken a comprehensive examination of SNPs (single nucleotide polymorphisms) of the CRP and TNF-α genes; due to this, we will present a protocol study to evaluate the role of the CRP and TNF-α genes in Mexican individuals. Methods/design: we will perform a case-control study to explore the CRP and TNF-α genotype distribution as well as the serum influence of rs1800947, rs1130864, rs2794521 and rs1205 (polymorphisms of the CRP gene) and rs361525, rs1800629, rs1799724, rs1800630, rs1799964 (of the TNF-α gene) in Mexican individuals who present coronary artery disease. Ethics and dissemination: a written informed consent will be obtained from all the participating subjects. An article detailing the results of the study will be submitted for publication in an international peer-reviewed journal, in accordance with STROBE criteria. Full article

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21 pages, 982 KiB

Open AccessArticle

Structural Model for the Effects of Environmental Elements on the Psychological Characteristics and Performance of the Employees of Manufacturing Systems

by Arturo Realyvásquez^1,*, Aidé Aracely Maldonado-Macías¹

, Jorge García-Alcaraz^1,2

, Guillermo Cortés-Robles³ and Julio Blanco-Fernández²

¹ Department of Industrial and Manufacturing Engineering, Autonomous University of Ciudad Juarez, Del Charro Ave., 450 N., Ciudad Juárez, Chihuahua, 32310, México

² Department of Mechanical Engineering, University of La Rioja, San José de Calasanz 31, Logroño, La Rioja 26004, Spain

³ Technological Institute of Orizaba, Oriente 9, 852, Orizaba, Veracruz 94320, Mexico

Int. J. Environ. Res. Public Health 2016, 13(1), 104; https://doi.org/10.3390/ijerph13010104 - 5 Jan 2016

Cited by 20 | Viewed by 6490

Abstract

This paper analyzes the effects of environmental elements on the psychological characteristics and performance of employees in manufacturing systems using structural equation modeling. Increasing the comprehension of these effects may help optimize manufacturing systems regarding their employees’ psychological characteristics and performance from a [...] Read more.

This paper analyzes the effects of environmental elements on the psychological characteristics and performance of employees in manufacturing systems using structural equation modeling. Increasing the comprehension of these effects may help optimize manufacturing systems regarding their employees’ psychological characteristics and performance from a macroergonomic perspective. As the method, a new macroergonomic compatibility questionnaire (MCQ) was developed and statistically validated, and 158 respondents at four manufacture companies were considered. Noise, lighting and temperature, humidity and air quality (THAQ) were used as independent variables and psychological characteristics and employees’ performance as dependent variables. To propose and test the hypothetical causal model of significant relationships among the variables, a data analysis was deployed. Results found that the macroergonomic compatibility of environmental elements presents significant direct effects on employees’ psychological characteristics and either direct or indirect effects on the employees’ performance. THAQ had the highest direct and total effects on psychological characteristics. Regarding the direct and total effects on employees’ performance, the psychological characteristics presented the highest effects, followed by THAQ conditions. These results may help measure and optimize manufacturing systems’ performance by enhancing their macroergonomic compatibility and quality of life at work of the employees. Full article

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20 pages, 3717 KiB

Open AccessArticle

Personal Care Product Use in Pregnancy and the Postpartum Period: Implications for Exposure Assessment

by Carly Lang¹, Mandy Fisher^2,*, Angelica Neisa², Leona MacKinnon², Sandra Kuchta², Susan MacPherson², Adam Probert² and Tye E. Arbuckle²

¹ Independent Research Nurse Consultant, Ottawa, ON K1A 0K9, Canada

² Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, 50 Colombine Dr., AL 0801A, Ottawa, ON K1A 0K9, Canada

Int. J. Environ. Res. Public Health 2016, 13(1), 105; https://doi.org/10.3390/ijerph13010105 - 6 Jan 2016

Cited by 36 | Viewed by 6705

Abstract

Concern regarding the potential for developmental health risks associated with certain chemicals (e.g., phthalates, antibacterials) used in personal care products is well documented; however, current exposure data for pregnant women are limited. The objective of this study was to describe the pattern of [...] Read more.

Concern regarding the potential for developmental health risks associated with certain chemicals (e.g., phthalates, antibacterials) used in personal care products is well documented; however, current exposure data for pregnant women are limited. The objective of this study was to describe the pattern of personal care product use in pregnancy and the post-partum period. Usage patterns of personal care products were collected at six different time points during pregnancy and once in the postpartum period for a cohort of 80 pregnant women in Ottawa, Canada. The pattern of use was then described and groups of personal care product groups commonly used together were identified using hierarchical cluster analysis. The results showed that product use varied by income and country of birth. General hygiene products were the most commonly used products and were consistently used over time while cosmetic product use declined with advancing pregnancy and post-delivery. Hand soaps and baby products were reported as used more frequently after birth. This study is the first to track personal care product use across pregnancy and into the postpartum period, and suggests that pregnant populations may be a unique group of personal care product users. This information will be useful for exposure assessments. Full article

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18 pages, 299 KiB

Open AccessArticle

Beyond Smoking Prevalence: Exploring the Variability of Associations between Neighborhood Exposures across Two Nested Spatial Units and Two-Year Smoking Trajectory among Young Adults

by Adrian E. Ghenadenik^1,2,3,*, Katherine L. Frohlich^1,2,† and Lise Gauvin^1,3,†

¹ Département de Médecine Sociale et Préventive, École de Santé Publique (ESPUM), Université de Montréal, 7101, Av. du Parc, Montreal, QC H3N 1X9, Canada

² Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM), 7101, Av. du Parc, Montreal, QC H3N 1X9, Canada

³ Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), 850 Saint Denis Street, Montreal, QC H2X 0A9, Canada

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 106; https://doi.org/10.3390/ijerph13010106 - 6 Jan 2016

Cited by 8 | Viewed by 4888

Abstract

Young adults have the highest prevalence of smoking amongst all age groups. Significant uptake occurs after high school age. Although neighborhood exposures have been found to be associated with smoking behavior, research on neighborhood exposures and the smoking trajectories among young adults, and [...] Read more.

Young adults have the highest prevalence of smoking amongst all age groups. Significant uptake occurs after high school age. Although neighborhood exposures have been found to be associated with smoking behavior, research on neighborhood exposures and the smoking trajectories among young adults, and on the role of geographic scale in shaping findings, is scarce. We examined associations between neighborhood exposures across two nested, increasingly large spatial units and smoking trajectory over two years among young adults living in Montreal, Canada. A sample of 2093 participants aged 18–25 years from the Interdisciplinary Study of Inequalities in Smoking (ISIS) was surveyed. The dependent variable was self-reported smoking trajectory over the course of two years. Residential addresses, data on presence of tobacco retail outlets, and the presence of smoking accommodation facilities were coded and linked to spatial units. Three-level multinomial models were used to examine associations. The likelihood of being a smoker for 2+ years was significantly greater among those living in larger spatial unit neighborhoods that had a greater presence of smoking accommodation. This association was not statistically significant at the smaller spatial units. Our findings highlight the importance of studying young adults’ smoking trajectories in addition to static smoking outcomes, and point to the relevance of considering spatial scale in studies of neighborhoods and smoking. Full article

(This article belongs to the Special Issue Tobacco Control 2015)

19 pages, 314 KiB

Open AccessReview

Water-Food-Nutrition-Health Nexus: Linking Water to Improving Food, Nutrition and Health in Sub-Saharan Africa

by Tafadzwanashe Mabhaudhi^*

, Tendai Chibarabada and Albert Modi

Department of Crop Science, School of Agricultural, Earth and Environmental Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Private Bag X01, Scottsville 3201, Pietermaritzburg, South Africa

Int. J. Environ. Res. Public Health 2016, 13(1), 107; https://doi.org/10.3390/ijerph13010107 - 6 Jan 2016

Cited by 82 | Viewed by 10263

Abstract

Whereas sub-Saharan Africa’s (SSA) water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is [...] Read more.

Whereas sub-Saharan Africa’s (SSA) water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region’s agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible. Full article

3 pages, 227 KiB

Open AccessComment

Comments on Scheffler et al. Cytotoxic Evaluation of E-Liquid Aerosol using Different Lung Derived Cell Models. Int. J. Environ. Res. Public Health, 2015, 12, 12466-12474

by Riccardo Polosa^1,*

, Massimo Caruso¹

and Francesca Guarino²

¹ Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Via Palermo 636, 95121 Catania, Italy

² Dipartimento di Scienze Biomediche e Biotecnologiche, V.le A. Doria 6, 95125 Catania, Italy

Int. J. Environ. Res. Public Health 2016, 13(1), 108; https://doi.org/10.3390/ijerph13010108 - 6 Jan 2016

Cited by 24 | Viewed by 3821

Abstract

There is merit in considering a simple toxicological screening method that evaluates the total cytotoxic potential of e-liquids or electronic cigarettes (ECs) aerosol emissions in one single testing. However, there is growing confusion, with several researchers endorsing their personal solution to the problem. [...] Read more.

There is merit in considering a simple toxicological screening method that evaluates the total cytotoxic potential of e-liquids or electronic cigarettes (ECs) aerosol emissions in one single testing. However, there is growing confusion, with several researchers endorsing their personal solution to the problem. Here, we discuss as an example the recent paper by Scheffler and colleagues, in which the authors suggest that more relevant and well differentiated cell lines from human airways could be the most suitable candidates for toxicological evaluation of ECs aerosol emissions. We advance recommendations for validated protocols and advocate for an international coordinated effort aimed at establishing consensus on methodology. Full article

2 pages, 223 KiB

Open AccessReply

Response to Polosa et al. Comments on Scheffler et al. Cytotoxic Evaluation of E-Liquid Aerosol Using Different Lung Derived Cell Models. Int. J. Environ. Res. Public Health, 2015, 12, 12466-12474

by Stefanie Scheffler^*, Hauke Dieken, Olaf Krischenowski and Michaela Aufderheide

Cultex Laboratories GmbH, Feodor-Lynen-Str. 21, 30625 Hannover, Germany

Int. J. Environ. Res. Public Health 2016, 13(1), 109; https://doi.org/10.3390/ijerph13010109 - 6 Jan 2016

Cited by 2 | Viewed by 4226

Abstract

Referring to the comments of Polosa and colleagues [1] on our latest in vitro e-liquid aerosol testing publication, we would like to give our statements about some points. [...] Full article

14 pages, 1109 KiB

Open AccessArticle

A Longitudinal Study of Association between Heavy Metals and Itchy Eyes, Coughing in Chronic Cough Patients: Related with Non-Immunoglobulin E Mediated Mechanism

by Thao Thi Thu Nguyen¹, Tomomi Higashi², Yasuhiro Kambayashi¹, Enoch Olando Anyenda¹, Yoshimasa Michigami³, Johsuke Hara⁴, Masaki Fujimura^4,5, Hiromasa Tsujiguchi¹, Masami Kitaoka¹, Hiroki Asakura¹, Daisuke Hori¹, Yuri Hibino¹, Tadashi Konoshita⁶ and Hiroyuki Nakamura^1,*

¹ Department of Environmental Health and Preventive Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan

² Department of Hygiene, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan

³ Environment Preservation Center, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan

⁴ Respiratory Medicine, Cellular Transplantation Biology, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan

⁵ Respiratory Medicine, National Hospital Organization Nanao Hospital, 3-1 Mattou-machi Yabe, Nanao, Ishikawa 926-8531, Japan

⁶ Third Department of Internal Medicine, Fukui University School of Medicine, Eiheiji, Fukui 910-1193, Japan

Int. J. Environ. Res. Public Health 2016, 13(1), 110; https://doi.org/10.3390/ijerph13010110 - 7 Jan 2016

Cited by 15 | Viewed by 6091

Abstract

The association between heavy metals exposure and respiratory diseases or allergic sensitization showing high serum immunoglobulin E (IgE) has been suggested. However, previous findings have been inconsistent and the mechanisms responsible remain unclear. We evaluated heavy metal exposure and its association with coughing, [...] Read more.

The association between heavy metals exposure and respiratory diseases or allergic sensitization showing high serum immunoglobulin E (IgE) has been suggested. However, previous findings have been inconsistent and the mechanisms responsible remain unclear. We evaluated heavy metal exposure and its association with coughing, itchy eyes in chronic cough patients with different IgE levels. Ninety outpatients in Kanazawa University Hospital were recruited between January–June 2011. Subjects whose total IgE measured by radioimmunosorbent test were asked to record their daily symptoms. We collected daily total suspended particles (TSP) from which concentrations of calcium (Ca), cadmium (Cd), chromium (Cr), iron (Fe), manganese (Mn), nickel (Ni), and lead (Pb) were determined then divided into high and low level groups. Generalized estimating equations were applied to compute the relationship between concentrations of these metals and symptoms. All metals at high levels were significantly associated with itchy eyes compared with low levels, with exception of Ca, the six others were significant in patients with IgE < 250 IU/mL. Cd, Fe, Mn had association with coughing (odds ratio-OR (95% confidence interval-CI): 1.13 (1.03, 1.24), 1.22 (1.05, 1.42), and 1.13 (1.01, 1.27), respectively), this relationship remained significant for Cd (OR (95% CI): 1.14 (1.03, 1.27)) and Mn (OR (95% CI): 1.15 (1.00, 1.31)) in patients with lower IgE. Our findings demonstrate the relationship between aerial heavy metals and itchy eyes, coughing in chronic cough patients, suggesting these symptoms may be due to a non-IgE mediated mechanism. Full article

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15 pages, 1319 KiB

Open AccessArticle

Housing Stakeholder Preferences for the “Soft” Features of Sustainable and Healthy Housing Design in the UK

by Agne Prochorskaite¹, Chris Couch², Naglis Malys³ and Vida Maliene^1,4,*

¹ Department of the Built Environment, Liverpool John Moores University, Cherie Booth Building, Byrom Street, Liverpool L3 3AF, UK

² School of Environmental Sciences, University of Liverpool, Jane Herdman Building, Liverpool L69 3GP, UK

³ School of Life Sciences, Centre for Biomolecular Science, The University of Nottingham, Nottingham NG7 2RD, UK

⁴ Institute of Land Management and Geomatics, Faculty of Water and Land Management, Aleksandras Stulginskis University, Universiteto 10, Akademija, Kaunas LT-53361, Lithuania

Int. J. Environ. Res. Public Health 2016, 13(1), 111; https://doi.org/10.3390/ijerph13010111 - 7 Jan 2016

Cited by 23 | Viewed by 11025

Abstract

It is widely recognised that the quantity and sustainability of new homes in the UK need to increase. However, it is important that sustainable housing is regarded holistically, and not merely in environmental terms, and incorporates elements that enhance the quality of life, [...] Read more.

It is widely recognised that the quantity and sustainability of new homes in the UK need to increase. However, it is important that sustainable housing is regarded holistically, and not merely in environmental terms, and incorporates elements that enhance the quality of life, health and well-being of its users. This paper focuses on the “soft” features of sustainable housing, that is, the non-technological components of sustainable housing and neighbourhood design that can impact occupants’ health and well-being. Aims of the study are to ascertain the relative level of importance that key housing stakeholders attach to these features and to investigate whether the opinions of housing users and housing providers are aligned with regards to their importance. An online survey was carried out to gauge the level of importance that the key stakeholders, such as housing users, local authorities, housing associations, and developers (n = 235), attach to these features. Results revealed that while suitable indoor space was the feature regarded as most important by all stakeholders, there were also a number of disparities in opinion between housing users and housing providers (and among the different types of providers). This implies a scope for initiatives to achieve a better alignment between housing users and providers. Full article

(This article belongs to the Special Issue The Impacts of the Built Environment on Public Health)

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9 pages, 574 KiB

Open AccessArticle

Association between UGT1A1 Polymorphism and Risk of Laryngeal Squamous Cell Carcinoma

by Hui Huangfu^1,*, Hong Pan¹, Binquan Wang¹, Shuxin Wen¹, Rui Han¹ and Li Li^2,*

¹ Department of ear-nose-throat (ENT), the First Hospital of Shanxi Medical University, 85 Jiefangnan Road, Taiyuan, 030001 Shanxi, China

² Department of biology, the Basic Medical School of Shanxi Medical University, 56 Xinjiannan Road, Taiyuan, 030001 Shanxi, China

Int. J. Environ. Res. Public Health 2016, 13(1), 112; https://doi.org/10.3390/ijerph13010112 - 7 Jan 2016

Cited by 11 | Viewed by 4739

Abstract

Laryngeal cancer is one of the largest subgroups of head and neck cancers. In addition to smoking and alcohol consumption, genetic polymorphisms are also risk factors for the development of laryngeal cancer. However, the exact relation between genetic variants and pathogenesis of laryngeal [...] Read more.

Laryngeal cancer is one of the largest subgroups of head and neck cancers. In addition to smoking and alcohol consumption, genetic polymorphisms are also risk factors for the development of laryngeal cancer. However, the exact relation between genetic variants and pathogenesis of laryngeal cancer has remained elusive. The aim of this study was to examine UGT1A1*6 (rs4148323 A/G) polymorphisms in 103 patients with laryngeal cancer and 220 controls using the high resolution melting curve (HRM) technique and to explore the association between UGT1A1*6 (rs4148323 A/G) polymorphisms and laryngeal cancer. The results showed an association between the rs4148323 G allele and increased risk of laryngeal cancer. While there was no statistically significant difference between rs4148323 genotype frequencies and different histological grades or different clinical stages of laryngeal cancer, stratification analysis indicated smoking or alcohol consumption and rs4148323 G allele combined to increase the risk of laryngeal cancer. In conclusion, the rs4148323 G allele is associated with the high UGT1A1 enzyme activity, and might increase the risk of laryngeal cancer. Furthermore, smoking or alcohol consumption and the rs4148323 G allele act synergistically to increase the risk of laryngeal cancer. Full article

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12 pages, 283 KiB

Open AccessArticle

Unemployment Rate, Smoking in China: Are They Related?

by Qing Wang^1,*, Jay J. Shen² and Chris Cochran³

¹ School of Business, Dalian University of Technology, Panjin 124221, China

² School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89103, USA

³ Department of Health Care Administration, University of Nevada Las Vegas, Las Vegas, NV 89103, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 113; https://doi.org/10.3390/ijerph13010113 - 8 Jan 2016

Cited by 22 | Viewed by 5360

Abstract

Background: Studies on the relationship between unemployment rate and smoking have yielded mixed results. The issue in China has not been studied. This study aims to examine the influence of unemployment rate on smoking in China. Methods: Logit model and two-stage [...] Read more.

Background: Studies on the relationship between unemployment rate and smoking have yielded mixed results. The issue in China has not been studied. This study aims to examine the influence of unemployment rate on smoking in China. Methods: Logit model and two-stage least squares (2SLS) estimation were used to estimate the effects. Estimations were done for 4585 individual over 45 using data from China Health and Retirement Longitudinal Study conducted in Zhejiang and Gansu provinces in 2008 and 2012. Results: A percent increase in the unemployment rate resulted in the increase in the likelihood of smoking by a combined 9.1 percent for those who smoked including a 2.9% increase for those who smoked 1–10 cigarettes per day; a 2.8% increase for those who smoked 11–20 cigarettes per day; and a 3.4% increase for those who smoked 20 cigarettes or more per day. The effects were stronger for those who were employed. Non-drinkers were more likely to engage in smoking with increased unemployment rate. 2SLS estimation revealed the same association. Conclusions: The unemployment rate was positively associated with smoking behavior. Smoking control and intervention strategies should focus on both the individual′s characteristics and the physical environment in which unemployment rate tend to rise. Full article

9 pages, 265 KiB

Open AccessArticle

Changes in Depression and Stress after Release from a Tobacco-Free Prison in the United States

by Jacob J. Van den Berg^1,*, Mary B. Roberts², Beth C. Bock³, Rosemarie A. Martin⁴, L.A.R. Stein⁵, Donna R. Parker², Arthur R. McGovern⁶, Sarah Hart Shuford⁷ and Jennifer G. Clarke²

¹ Division of Infectious Diseases, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA

² Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860, USA

³ Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA

⁴ Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-4, Providence, RI 02912, USA

⁵ Department of Psychology, University of Rhode Island, Chafee Hall, 142 Flagg Road, Kingston, RI 02881, USA

⁶ Department of Psychology, Nichols College, 129 Center Road, Dudley, MA 01571, USA

⁷ Brown University School of Public Health, 121 South Main Street, Providence, RI 02912, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 114; https://doi.org/10.3390/ijerph13010114 - 12 Jan 2016

Cited by 9 | Viewed by 5575

Abstract

Prior research has found high levels of depression and stress among persons who are incarcerated in the United States (U.S.). However, little is known about changes in depression and stress levels among inmates post-incarceration. The aim of this study was to examine changes [...] Read more.

Prior research has found high levels of depression and stress among persons who are incarcerated in the United States (U.S.). However, little is known about changes in depression and stress levels among inmates post-incarceration. The aim of this study was to examine changes in levels of depression and stress during and after incarceration in a tobacco-free facility. Questionnaires that included valid and reliable measures of depression and stress were completed by 208 male and female inmates approximately eight weeks before and three weeks after release from a northeastern U.S. prison. Although most inmates improved after prison, 30.8% had a worsening in levels of depression between baseline and the three-week follow-up. In addition, 29.8% had a worsening in levels of stress after release than during incarceration. While it is not surprising that the majority of inmates reported lower levels of depression and stress post-incarceration, a sizable minority had an increase in symptoms, suggesting that environmental stressors may be worse in the community than in prison for some inmates. Further research is needed to address depression and stress levels during and after incarceration in order for inmates to have a healthier transition back into the community and to prevent repeat incarcerations. Full article

(This article belongs to the Special Issue Correctional Health)

13 pages, 1557 KiB

Open AccessArticle

Descriptive Characteristics of Surface Water Quality in Hong Kong by a Self-Organising Map

by Yan An, Zhihong Zou^* and Ranran Li

School of Economics and Management, Beihang University, Beijing 100191, China

Int. J. Environ. Res. Public Health 2016, 13(1), 115; https://doi.org/10.3390/ijerph13010115 - 8 Jan 2016

Cited by 13 | Viewed by 5380

Abstract

In this study, principal component analysis (PCA) and a self-organising map (SOM) were used to analyse a complex dataset obtained from the river water monitoring stations in the Tolo Harbor and Channel Water Control Zone (Hong Kong), covering the period of 2009–2011. PCA [...] Read more.

In this study, principal component analysis (PCA) and a self-organising map (SOM) were used to analyse a complex dataset obtained from the river water monitoring stations in the Tolo Harbor and Channel Water Control Zone (Hong Kong), covering the period of 2009–2011. PCA was initially applied to identify the principal components (PCs) among the nonlinear and complex surface water quality parameters. SOM followed PCA, and was implemented to analyze the complex relationships and behaviors of the parameters. The results reveal that PCA reduced the multidimensional parameters to four significant PCs which are combinations of the original ones. The positive and inverse relationships of the parameters were shown explicitly by pattern analysis in the component planes. It was found that PCA and SOM are efficient tools to capture and analyze the behavior of multivariable, complex, and nonlinear related surface water quality data. Full article

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10 pages, 278 KiB

Open AccessArticle

Regional Differences in Correlates of Daily Walking among Middle Age and Older Australian Rural Adults: Implications for Health Promotion

by James Dollman^1,*

, Melissa Hull¹, Nicole Lewis¹, Suzanne Carroll² and Dorota Zarnowiecki³

¹ Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia, CEA-14, GPO Box 2471, Adelaide 5001, SA, Australia

² Spatial Epidemiology and Evaluation Research Group, Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, IPC CWE-48, GPO Box 2471, Adelaide 5001, SA, Australia

³ School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide 5001, SA, Australia

Int. J. Environ. Res. Public Health 2016, 13(1), 116; https://doi.org/10.3390/ijerph13010116 - 8 Jan 2016

Cited by 12 | Viewed by 5688

Abstract

Rural Australians are less physically active than their metropolitan counterparts, and yet very little is known of the candidate intervention targets for promoting physical activity in rural populations. As rural regions are economically, socially and environmentally diverse, drivers of regular physical activity are [...] Read more.

Rural Australians are less physically active than their metropolitan counterparts, and yet very little is known of the candidate intervention targets for promoting physical activity in rural populations. As rural regions are economically, socially and environmentally diverse, drivers of regular physical activity are likely to vary between regions. This study explored the region-specific correlates of daily walking among middle age and older adults in rural regions with contrasting dominant primary industries. Participants were recruited through print and electronic media, primary care settings and community organisations. Pedometers were worn by 153 adults for at least four days, including a weekend day. A questionnaire identified potential intra-personal, social and environmental correlates of physical activity, according to a social ecological framework. Regression modelling identified independent correlates of daily walking separately in the two study regions. In one region, there were independent correlates of walking from all levels of the social ecological framework. In the other region, significant correlates of daily walking were almost all demographic (age, education and marital status). Participants living alone were less likely to be physically active regardless of region. This study highlights the importance of considering region-specific factors when designing strategies for promoting regular walking among rural adults. Full article

19 pages, 1406 KiB

Open AccessArticle

Heat and Humidity in the City: Neighborhood Heat Index Variability in a Mid-Sized City in the Southeastern United States

by Alisa L. Hass^1,*

, Kelsey N. Ellis^1,†

, Lisa Reyes Mason^2,†

, Jon M. Hathaway^3,† and David A. Howe^3,†

¹ Department of Geography, The University of Tennessee, 304 Burchfiel Geography Building, Knoxville, TN 37996, USA

² College of Social Work, The University of Tennessee, 408 Henson Hall, Knoxville, TN 37996, USA

³ Department of Civil and Environmental Engineering, The University of Tennessee, 325 John D. Tickle Building, Knoxville, TN 37996, USA

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 117; https://doi.org/10.3390/ijerph13010117 - 11 Jan 2016

Cited by 67 | Viewed by 11587

Abstract

Daily weather conditions for an entire city are usually represented by a single weather station, often located at a nearby airport. This resolution of atmospheric data fails to recognize the microscale climatic variability associated with land use decisions across and within urban neighborhoods. [...] Read more.

Daily weather conditions for an entire city are usually represented by a single weather station, often located at a nearby airport. This resolution of atmospheric data fails to recognize the microscale climatic variability associated with land use decisions across and within urban neighborhoods. This study uses heat index, a measure of the combined effects of temperature and humidity, to assess the variability of heat exposure from ten weather stations across four urban neighborhoods and two control locations (downtown and in a nearby nature center) in Knoxville, Tennessee, USA. Results suggest that trees may negate a portion of excess urban heat, but are also associated with greater humidity. As a result, the heat index of locations with more trees is significantly higher than downtown and areas with fewer trees. Trees may also reduce heat stress by shading individuals from incoming radiation, though this is not considered in this study. Greater amounts of impervious surfaces correspond with reduced evapotranspiration and greater runoff, in terms of overall mass balance, leading to a higher temperature, but lower relative humidity. Heat index and relative humidity were found to significantly vary between locations with different tree cover and neighborhood characteristics for the full study time period as well as for the top 10% of heat index days. This work demonstrates the need for high-resolution climate data and the use of additional measures beyond temperature to understand urban neighborhood exposure to extreme heat, and expresses the importance of considering vulnerability differences among residents when analyzing neighborhood-scale impacts. Full article

(This article belongs to the Special Issue Technology, Data, and the Assessment of Atmospheric Exposure on Finer Scales)

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10 pages, 265 KiB

Open AccessArticle

Self-Exempting Beliefs and Intention to Quit Smoking within a Socially Disadvantaged Australian Sample of Smokers

by Ashleigh Guillaumier^1,*, Billie Bonevski¹, Christine Paul², Catherine D’Este³, Laura Twyman¹, Kerrin Palazzi⁴ and Christopher Oldmeadow⁴

¹ School of Medicine & Public Health, University of Newcastle, P.O. Box 833, Newcastle NSW 2300, Australia

² School of Medicine & Public Health, University of Newcastle & Hunter Medical Research Institute, Newcastle 2305, Australia

³ National Centre for Epidemiology & Population Health, Australian National University, Canberra 0200, Australia

⁴ Clinical Research Design IT and Statistical Support Unit, University of Newcastle & Hunter Medical Research Institute, Newcastle 2305, Australia

Int. J. Environ. Res. Public Health 2016, 13(1), 118; https://doi.org/10.3390/ijerph13010118 - 11 Jan 2016

Cited by 8 | Viewed by 5449

Abstract

An investigation of beliefs used to rationalise smoking will have important implications for the content of anti-smoking programs targeted at socioeconomically disadvantaged groups, who show the lowest rates of cessation in the population. This study aimed to assess the types of self-exempting beliefs [...] Read more.

An investigation of beliefs used to rationalise smoking will have important implications for the content of anti-smoking programs targeted at socioeconomically disadvantaged groups, who show the lowest rates of cessation in the population. This study aimed to assess the types of self-exempting beliefs reported by a sample of socioeconomically disadvantaged smokers, and identify associations between these beliefs and other smoking-related factors with quit intentions. A cross-sectional survey was conducted from March–December 2012 with smokers seeking welfare assistance in New South Wales (NSW), Australia (n = 354; response rate 79%). Responses to a 16-item self-exempting beliefs scale and intention to quit, smoker identity, and enjoyment of smoking were assessed. Most participants earned <AUD$400/week (70%), and had not completed secondary schooling (64%). All “jungle” beliefs (normalising the dangers of smoking due to ubiquity of risk) and selected “skeptic” beliefs were endorsed by 25%–47% of the sample, indicating these smokers may not fully understand the extensive risks associated with smoking. Smokers with limited quit intentions held significantly stronger self-exempting beliefs than those contemplating or preparing to quit (all p < 0.01). After adjusting for smoking-related variables only “skeptic” beliefs were significantly associated with intention to quit (p = 0.02). Some of these beliefs are incorrect and could be addressed in anti-smoking campaigns. Full article

(This article belongs to the Special Issue Tobacco Control 2015)

20 pages, 580 KiB

Open AccessArticle

The Effects of Age, Priming, and Working Memory on Decision-Making

by Meagan Wood, Sheila Black^* and Ansley Gilpin

Psychology Department, University of Alabama, P.O. Box 870348, Tuscaloosa, AL 35487, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 119; https://doi.org/10.3390/ijerph13010119 - 11 Jan 2016

Cited by 11 | Viewed by 6480

Abstract

In the current study, we examined the effects of priming and personality on risky decision-making while playing the Game of Dice Task (GDT). In the GDT, participants decide how risky they wish to be on each trial. In this particular study prior to [...] Read more.

In the current study, we examined the effects of priming and personality on risky decision-making while playing the Game of Dice Task (GDT). In the GDT, participants decide how risky they wish to be on each trial. In this particular study prior to playing the GDT, participants were randomly assigned to one of three priming conditions: Risk-Aversive, Risk-Seeking, or Control. In the Risk-Seeking condition, a fictional character benefitted from risky behavior while in the Risk-Aversive condition, a fictional character benefitted from exercising caution. Although not explicitly stated in the instructions, participants need to make “safe” rather than risky choices to optimize performance on the GDT. Participants were also given Daneman and Carpenter’s assessment of working memory task. Interestingly, although older adults self-reported being more cautious than younger adults on the Domain Specific Risk Attitude scale (DOSPERT), older adults made riskier decisions than younger adults on the GDT. However, after controlling for working memory, the age differences on the GDT became insignificant, indicating that working memory mediated the relation between age and risky decisions on the GDT. Full article

(This article belongs to the Special Issue Aging and Cognition)

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16 pages, 2319 KiB

Open AccessReview

Cigarette Smoking and Electronic Cigarettes Use: A Meta-Analysis

by Meng Wang^1,†, Jian-Wei Wang^2,†, Shuang-Shuang Cao², Hui-Qin Wang³ and Ru-Ying Hu^1,*

¹ Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China

² Yidu Central Hospital of Weifang. 4138 Linglong Road, Qingzhou, 262500, Shandong Province, China

³ Department of Preventative Medicine, School of Medicine, Ningbo University, 818 Fenghua Road, Ningbo 315211, Zhejiang Province, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 120; https://doi.org/10.3390/ijerph13010120 - 12 Jan 2016

Cited by 36 | Viewed by 11945

Abstract

Increasing evidence indicates that cigarette smoking is a strong predictor of electronic cigarettes (e-cigarettes) use, particularly in adolescents, yet the effects has not be systematically reviewed and quantified. Relevant studies were retrieved by searching three databases up to June 2015. The meta-analysis results [...] Read more.

Increasing evidence indicates that cigarette smoking is a strong predictor of electronic cigarettes (e-cigarettes) use, particularly in adolescents, yet the effects has not be systematically reviewed and quantified. Relevant studies were retrieved by searching three databases up to June 2015. The meta-analysis results were presented as pooled odds ratios (ORs) with 95% confidence intervals (CIs) calculated by a random-effects model. Current smokers were more likely to use e-cigarette currently (OR: 14.89, 95% CI: 7.70–28.78) and the probability was greater in adolescents than in adults (39.13 vs. 7.51). The probability of ever e-cigarettes use was significantly increased in smokers (OR: 14.67, 95% CI: 11.04–19.49). Compared with ever smokers and adults, the probabilities were much greater in current smokers (16.10 vs. 9.47) and adolescents (15.19 vs. 14.30), respectively. Cigarette smoking increases the probability of e-cigarettes use, especially in current smokers and adolescents. Full article

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15 pages, 723 KiB

Open AccessArticle

Urban Natural Environments, Obesity, and Health-Related Quality of Life among Hispanic Children Living in Inner-City Neighborhoods

by Jun-Hyun Kim^*, Chanam Lee and Wonmin Sohn

Department of Landscape Architecture and Urban Planning; Texas A&M University, College Station, TX 77843, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 121; https://doi.org/10.3390/ijerph13010121 - 12 Jan 2016

Cited by 68 | Viewed by 10451

Abstract

Although a substantial body of literature has provided evidence supporting the positive effects of natural environments on well-being, little has been known about the specific spatial patterns of urban nature in promoting health-related quality of life (HRQOL) among children. This study assessed the [...] Read more.

Although a substantial body of literature has provided evidence supporting the positive effects of natural environments on well-being, little has been known about the specific spatial patterns of urban nature in promoting health-related quality of life (HRQOL) among children. This study assessed the association that the urban natural environment measured by landscape spatial patterns may have with obesity and HRQOL among Hispanic children. Ninety-two 4th and 5th grade students were recruited from Houston, Texas, and the Pediatric Quality of Life Inventory (PedsQL) was used to capture the children’s HRQOL. The quality of urban natural environments was assessed by quantifying the landscape spatial patterns, using landscape indices generated by Geographic Information Systems and remote sensing. From the bivariate analyses, children’s body mass index showed a significantly negative association with their HRQOL. After controlling for socio-demographic factors, the results revealed that larger and more tree areas were positively correlated with children’s HRQOL. In addition, those children living in areas with tree patches further apart from each other showed higher HRQOL. This research adds to the current multi-disciplinary area of research on environment-health relationships by investigating the roles of urban greeneries and linking their spatial structures with children’s HRQOL. Full article

(This article belongs to the Special Issue The Impacts of the Built Environment on Public Health)

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11 pages, 563 KiB

Open AccessReview

The Impact of the 2008 Economic Crisis on Substance Use Patterns in the Countries of the European Union

by Geert Dom^1,*, Jerzy Samochowiec², Sara Evans-Lacko³, Kristian Wahlbeck⁴

, Guido Van Hal⁵ and David McDaid⁶

¹ Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University, Antwerp 2640, Belgium

² Department of Psychiatry, Pomeranian Medical University, Szczecin 71-460, Poland

³ Health Service and Population Research Department, Institute of Psychiatry, King’s College London, SE5 8AF, UK

⁴ The Finnish Association for Mental Health, Helsinki 00240, Finland

⁵ Medical Sociology and Health Policy, Antwerp University, Antwerp 2640, Belgium

⁶ Personal Social Services Research Unit, London School of Economics and Political Science, London WC2A 2AE, UK

Int. J. Environ. Res. Public Health 2016, 13(1), 122; https://doi.org/10.3390/ijerph13010122 - 13 Jan 2016

Cited by 86 | Viewed by 9800

Abstract

Background: From 2008 on, a severe economic crisis (EC) has characterized the European Union (E.U.). However, changes in substance use behavioral patterns as a result of the economic crisis in Europe, have been poorly reflected upon, and underlying mechanisms remain to be [...] Read more.

Background: From 2008 on, a severe economic crisis (EC) has characterized the European Union (E.U.). However, changes in substance use behavioral patterns as a result of the economic crisis in Europe, have been poorly reflected upon, and underlying mechanisms remain to be identified; Methods: In this review we explore and systematize the available data on the effect of the 2008 economic crisis on patterns of substance use and related disorders, within the E.U. countries; Results: The results show that effects of the recession need to be differentiated. A number of studies point to reductions in population’s overall substance use. In contrast, an increase in harmful use and negative effects is found within specific subgroups within the society. Risk factors include job-loss and long-term unemployment, and pre-existing vulnerabilities. Finally, our findings point to differences between types of substances in their response on economic crisis periods; Conclusions: the effects of the 2008 economic crisis on substance use patterns within countries of the European Union are two-sided. Next to a reduction in a population’s overall substance use, a number of vulnerable subgroups experience serious negative effects. These groups are in need of specific attention and support, given that there is a real risk that they will continue to suffer negative health effects long after the economic downfall has formally been ended. Full article

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3 pages, 216 KiB

Open AccessEditorial

Disability and Public Health

by Jerome E. Bickenbach¹, Alarcos Cieza^1,2,3 and Carla Sabariego^3,*

¹ Swiss Paraplegic Research, Guido A. Zäch-Strasse 4, 6207 Nottwil, Switzerland

² Faculty of Social and Human Sciences, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK

³ Department of Medical Informatics, Biometry and Epidemiology (IBE), Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University Munich, Marchioninistr. 17, 81377 Munich, Germany

Int. J. Environ. Res. Public Health 2016, 13(1), 123; https://doi.org/10.3390/ijerph13010123 - 12 Jan 2016

Cited by 8 | Viewed by 5476

Abstract

People with disabilities comprise approximately 15% of the world’s population. [...] Full article

(This article belongs to the Special Issue Disability and Public Health)

19 pages, 2606 KiB

Open AccessArticle

A Two-Stage Method to Estimate the Contribution of Road Traffic to PM_2.5 Concentrations in Beijing, China

by Xin Fang^1,†

, Runkui Li^2,3,*,†

, Qun Xu⁴, Matteo Bottai¹, Fang Fang⁵ and Yang Cao^1,6,*

¹ Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden

² College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China

³ State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China

⁴ Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing 100005, China

⁵ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden

⁶ Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro 70281, Sweden

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 124; https://doi.org/10.3390/ijerph13010124 - 13 Jan 2016

Cited by 27 | Viewed by 8408

Abstract

Background: Fine particulate matters with aerodynamic diameters smaller than 2.5 micrometers (PM_2.5) have been a critical environmental problem in China due to the rapid road vehicle growth in recent years. To date, most methods available to estimate traffic contributions to [...] Read more.

Background: Fine particulate matters with aerodynamic diameters smaller than 2.5 micrometers (PM_2.5) have been a critical environmental problem in China due to the rapid road vehicle growth in recent years. To date, most methods available to estimate traffic contributions to ambient PM_2.5 concentration are often hampered by the need for collecting data on traffic volume, vehicle type and emission profile. Objective: To develop a simplified and indirect method to estimate the contribution of traffic to PM_2.5 concentration in Beijing, China. Methods: Hourly PM_2.5 concentration data, daily meteorological data and geographic information were collected at 35 air quality monitoring (AQM) stations in Beijing between 2013 and 2014. Based on the PM_2.5 concentrations of different AQM station types, a two-stage method comprising a dispersion model and generalized additive mixed model (GAMM) was developed to estimate separately the traffic and non-traffic contributions to daily PM_2.5 concentration. The geographical trend of PM_2.5 concentrations was investigated using generalized linear mixed model. The temporal trend of PM_2.5 and non-linear relationship between PM_2.5 and meteorological conditions were assessed using GAMM. Results: The medians of daily PM_2.5 concentrations during 2013–2014 at 35 AQM stations in Beijing ranged from 40 to 92 μg/m³. There was a significant increasing trend of PM_2.5 concentration from north to south. The contributions of road traffic to daily PM_2.5 concentrations ranged from 17.2% to 37.3% with an average 30%. The greatest contribution was found at AQM stations near busy roads. On average, the contribution of road traffic at urban stations was 14% higher than that at rural stations. Conclusions: Traffic emissions account for a substantial share of daily total PM_2.5 concentrations in Beijing. Our two-stage method is a useful and convenient tool in ecological and epidemiological studies to estimate the traffic contribution to PM_2.5 concentrations when there is limited information on vehicle number and types and emission profile. Full article

(This article belongs to the Special Issue Technology, Data, and the Assessment of Atmospheric Exposure on Finer Scales)

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9 pages, 403 KiB

Open AccessArticle

The Use of Illegal Drugs and Infectious Contagious Diseases: Knowledge and Intervention among Dockworkers

by Marta Regina Cezar-Vaz^1,*, Clarice Alves Bonow^2,†, Mara Regina Santos da Silva^1,†, Francisca Lucélia Ribeiro de Farias^3,† and Marlise Capa Verde de Almeida^1,†

¹ School of Nursing, Federal University of Rio Grande, Rio Grande, RS 96203, Brazil

² Faculty of Nursing, Federal University of Pelotas, Pelotas, RS 96010, Brazil

³ Graduate Program on Nursing, Fortaleza University, Fortaleza, CE 60811, Brazil

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 125; https://doi.org/10.3390/ijerph13010125 - 12 Jan 2016

Cited by 4 | Viewed by 4753

Abstract

This study’s objective was to analyze the use of illegal drugs by dockworkers and provide risk communication regarding the use of illegal drugs and test for infectious contagious diseases among dockworkers. This cross-sectional study including an intervention addressed to 232 dockworkers, who were [...] Read more.

This study’s objective was to analyze the use of illegal drugs by dockworkers and provide risk communication regarding the use of illegal drugs and test for infectious contagious diseases among dockworkers. This cross-sectional study including an intervention addressed to 232 dockworkers, who were individually interviewed, as well as communication of risk with testing for infectious contagious diseases for 93 dockworkers from a city in the interior of Rio Grande do Sul, Brazil. Poisson regression analysis was used. Twenty-nine workers reported the use of illegal drugs. Poisson regression indicated that being a wharfage worker, smoker, having a high income, and heavier workload increases the prevalence of the use of illegal drugs. During risk communication, two workers were diagnosed with hepatitis B (2.2%), three (3.2%) with hepatitis C, two (2.2%) with syphilis. None of the workers, though, had HIV. This study provides evidence that can motivate further research on the topic and also lead to treatment of individuals to improve work safety, productivity, and the health of workers. Full article

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17 pages, 6946 KiB

Open AccessArticle

Back-Analyses of Landfill Instability Induced by High Water Level: Case Study of Shenzhen Landfill

by Ren Peng^1,*, Yujing Hou², Liangtong Zhan³ and Yangping Yao¹

¹ Department of Civil Engineering, Beihang University, No.37 Xue-Yuan Road, Beijing 100191, China

² Institute of Geotechnical Engineering, China Institute of Water Resources and Hydropower Research, No.20 Che-Gongzhuang West Road, Beijing 100048, China

³ Institute of Geotechnical Engineering, MOE Key Laboratory of Soft Soils and Geo-environmental Engineering, Zhejiang University, No.866 Yu-Hangtang Road, Hangzhou 310058, China

Int. J. Environ. Res. Public Health 2016, 13(1), 126; https://doi.org/10.3390/ijerph13010126 - 12 Jan 2016

Cited by 43 | Viewed by 6724

Abstract

In June 2008, the Shenzhen landfill slope failed. This case is used as an example to study the deformation characteristics and failure mode of a slope induced by high water levels. An integrated monitoring system, including water level gauges, electronic total stations, and [...] Read more.

In June 2008, the Shenzhen landfill slope failed. This case is used as an example to study the deformation characteristics and failure mode of a slope induced by high water levels. An integrated monitoring system, including water level gauges, electronic total stations, and inclinometers, was used to monitor the slope failure process. The field measurements suggest that the landfill landslide was caused by a deep slip along the weak interface of the composite liner system at the base of the landfill. The high water level is considered to be the main factor that caused this failure. To calculate the relative interface shear displacements in the geosynthetic multilayer liner system, a series of numerical direct shear tests were carried out. Based on the numerical results, the composite lining system simplified and the centrifuge modeling technique was used to quantitatively evaluate the effect of water levels on landfill instability. Full article

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12 pages, 917 KiB

Open AccessArticle

Differences in Ambient Polycyclic Aromatic Hydrocarbon Concentrations between Streets and Alleys in New York City: Open Space vs. Semi-Closed Space

by Stephanie Lovinsky-Desir¹, Rachel L. Miller^2,3,4, Joshua Bautista², Eric N. Gil², Steven N. Chillrud⁵, Beizhan Yan⁵, David Camann⁶, Frederica P. Perera³ and Kyung Hwa Jung^2,*

¹ Division of Pulmonology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 3959 Broadway, CHC 7-724, New York, NY 10032, USA

² Division of Pulmonary, Allergy and Critical Care of Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, PH8E-101, 630 W. 168 St., New York, NY 10032, USA

³ Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W. 168 St. New York, NY 10032, USA

⁴ Division of Pediatric Allergy and Immunology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, PH8E-101, 630 W. 168 St. New York, NY 10032, USA

⁵ Lamont-Doherty Earth Observatory, Columbia University, 61 Rt., 9W Palisades, New York, NY 10964, USA

⁶ Chemistry and Chemical Engineering Division, Southwest Research Institute, 6220 Culebra Road, San Antonio, TX 78228, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 127; https://doi.org/10.3390/ijerph13010127 - 12 Jan 2016

Cited by 4 | Viewed by 5549

Abstract

Background: Outdoor ambient polycyclic aromatic hydrocarbon (PAH) concentrations are variable throughout an urban environment. However, little is known about how variation in semivolatile and nonvolatile PAHs related to the built environment (open space vs. semi-closed space) contributes to differences in concentrations. Methods: We [...] Read more.

Background: Outdoor ambient polycyclic aromatic hydrocarbon (PAH) concentrations are variable throughout an urban environment. However, little is known about how variation in semivolatile and nonvolatile PAHs related to the built environment (open space vs. semi-closed space) contributes to differences in concentrations. Methods: We simultaneously collected 14, two-week samples of PAHs from the outside of windows facing the front (adjacent to the street) open side of a New York City apartment building and the alley, semi-closed side of the same apartment unit between 2007 and 2012. We also analyzed samples of PAHs measured from 35 homes across Northern Manhattan and the Bronx, 17 from street facing windows with a median floor level of 4 (range 2–26) and 18 from alley-facing windows with a median floor level of 4 (range 1–15). Results: Levels of nonvolatile ambient PAHs were significantly higher when measured from a window adjacent to a street (an open space), compared to a window 30 feet away, adjacent to an alley (a semi-closed space) (street geometric mean (GM) 1.32 ng/m³, arithmetic mean ± standard deviation (AM ± SD) 1.61 ± 1.04 ng/m³; alley GM 1.10 ng/m³, AM ± SD 1.37 ± 0.94 ng/m³). In the neighborhood-wide comparison, nonvolatile PAHs were also significantly higher when measured adjacent to streets compared with adjacent to alley sides of apartment buildings (street GM 1.10 ng/m³, AM ± SD 1.46 ± 1.24 ng/m³; alley GM 0.61 ng/m³, AM ± SD 0.81 ± 0.80 ng/m³), but not semivolatile PAHs. Conclusions: Ambient PAHs, nonvolatile PAHs in particular, are significantly higher when measured from a window adjacent to a street compared to a window adjacent to an alley, despite both locations being relatively close to street traffic. This study highlights small-scale spatial variations in ambient PAH concentrations that may be related to the built environment (open space vs. semi-closed space) from which the samples are measured, as well as the relative distance from street traffic, that could impact accurate personal exposure assessments. Full article

(This article belongs to the Special Issue The Impacts of the Built Environment on Public Health)

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31 pages, 4992 KiB

Open AccessArticle

Occupants’ Perceptions of Amenity and Efficiency for Verification of Spatial Design Adequacy

by Sangwon Lee^* and Kwangyun Wohn

Graduate School of Culture Technology, Korea Advanced Institute of Science and Technology, Daejeon 34141, Korea

Int. J. Environ. Res. Public Health 2016, 13(1), 128; https://doi.org/10.3390/ijerph13010128 - 14 Jan 2016

Cited by 11 | Viewed by 5740

Abstract

The best spatial design condition to satisfy the occupancy needs of amenity and efficiency is determined through analyzing the spatial design adequacy (SDA). In this study, the relationship between the space design elements and space on future occupants’ perception are analyzed. The thirty-three [...] Read more.

The best spatial design condition to satisfy the occupancy needs of amenity and efficiency is determined through analyzing the spatial design adequacy (SDA). In this study, the relationship between the space design elements and space on future occupants’ perception are analyzed. The thirty-three participants reported their self-evaluated SDA that describes the quality of eight alternative housing living rooms with different spatial factors. The occupants were guided through the perception processing elaboration in order for them to evaluate the actual perception in the real space. The findings demonstrated that the spatial size (e.g., width, depth, and height) is significantly correlated with the overall satisfaction of amenity. It is also found that the spatial shape (e.g., the width-to-depth ratio, the height-to-area ratio, and room shape) may significantly influence the overall satisfaction of efficiency. The findings also demonstrate that the causal relationship between the spatial factors and space is clearly present in the occupants’ perception, reflecting the time-sequential characteristics of the actual experience divided into amenity and efficiency. This result indicates that the correlation between the spatial factors and space of SDA under the occupants’ perception processing elaboration can be a useful guide to predict the occupancy satisfaction of amenity and efficiency in real spaces. Full article

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7 pages, 1547 KiB

Open AccessArticle

Behavior Change without Behavior Change Communication: Nudging Handwashing among Primary School Students in Bangladesh

by Robert Dreibelbis^1,*

, Anne Kroeger¹, Kamal Hossain², Mohini Venkatesh³ and Pavani K. Ram⁴

¹ Center for Applied Social Research, University of Oklahoma, 201 Stephenson Parkway, Suite 4100, Norman, OK 73019, USA

² Save the Children—Bangladesh, House# CWN (A) 35, Road #43, Gulshan 2, Dhaka 1212, Bangladesh

³ Save the Children—USA, 2000 L Street NW, Suite 500, Washington, DC 20036, USA

⁴ Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, 237 Farber Hall, Buffalo, NY 14214, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 129; https://doi.org/10.3390/ijerph13010129 - 14 Jan 2016

Cited by 100 | Viewed by 20196

Abstract

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of [...] Read more.

Behavior change communication for improving handwashing with soap can be labor and resource intensive, yet quality results are difficult to achieve. Nudges are environmental cues engaging unconscious decision-making processes to prompt behavior change. In this proof-of-concept study, we developed an inexpensive set of nudges to encourage handwashing with soap after toilet use in two primary schools in rural Bangladesh. We completed direct observation of behaviors at baseline, after providing traditional handwashing infrastructure, and at multiple time periods following targeted handwashing nudges (1 day, 2 weeks, and 6 weeks). No additional handwashing education or motivational messages were completed. Handwashing with soap among school children was low at baseline (4%), increasing to 68% the day after nudges were completed and 74% at both 2 weeks and 6 weeks post intervention. Results indicate that nudge-based interventions have the potential to improve handwashing with soap among school-aged children in Bangladesh and specific areas of further inquiry are discussed. Full article

(This article belongs to the Special Issue Water Microbial Pollution and Disinfection)

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14 pages, 288 KiB

Open AccessArticle

Built Environment Influences of Children’s Physical Activity: Examining Differences by Neighbourhood Size and Sex

by Christine A. Mitchell, Andrew F. Clark^† and Jason A. Gilliland^*,†

¹ Department of Geography, Western University, 1151 Richmond St., London, ON N6A 5C2, Canada

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 130; https://doi.org/10.3390/ijerph13010130 - 15 Jan 2016

Cited by 74 | Viewed by 9845

Abstract

Neighbourhoods can facilitate or constrain moderate-to-vigorous physical activity (MVPA) among children by providing or restricting opportunities for MVPA. However, there is no consensus on how to define a child’s neighbourhood. This study examines the influence of the neighbourhood built environment on objectively measured [...] Read more.

Neighbourhoods can facilitate or constrain moderate-to-vigorous physical activity (MVPA) among children by providing or restricting opportunities for MVPA. However, there is no consensus on how to define a child’s neighbourhood. This study examines the influence of the neighbourhood built environment on objectively measured MVPA among 435 children (aged 9–14 years) in London (ON, Canada). As there is no consensus on how to delineate a child’s neighbourhood, a geographic information system was used to generate measures of the neighbourhood built environment at two buffer sizes (500 m and 800 m) around each child’s home. Linear regression models with robust standard errors (cluster) were used to analyze the relationship between built environment characteristics and average daily MVPA during non-school hours on weekdays. Sex-stratified models assessed sex-specific relationships. When accounting for individual and neighbourhood socio-demographic variables, park space and multi-use path space were found to influence children’s MVPA. Sex-stratified models found significant associations between MVPA and park space, with the 800 m buffer best explaining boys’ MVPA and the 500 m buffer best explaining girls’ MVPA. Findings emphasize that, when designing built environments, programs, and policies to facilitate physical activity, it is important to consider that the size of the neighbourhood influencing a child’s physical activity may differ according to sex. Full article

(This article belongs to the Special Issue The Impacts of the Built Environment on Public Health)

17 pages, 3548 KiB

Open AccessArticle

Spatiotemporal Pattern Analysis of Scarlet Fever Incidence in Beijing, China, 2005–2014

by Gehendra Mahara^1,2,†, Chao Wang^1,2,†, Da Huo³, Qin Xu^1,2, Fangfang Huang^1,2, Lixin Tao^1,2, Jin Guo^1,2, Kai Cao^1,2, Liu Long^1,2, Jagadish K. Chhetri⁴, Qi Gao^1,2

, Wei Wang^1,2,5, Quanyi Wang^3,* and Xiuhua Guo^1,2,*

¹ Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China

² Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China

³ Institute for Infectious Disease & Endemic Disease Control, Beijing Center for Disease Prevention & Control (CDC), Beijing Center for Preventive Medical Research, Beijing 100069, China

⁴ Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing 100069, China

⁵ Systems and Intervention Research Centre for Health, School of Medical Sciences, Edith Cowan University, Perth 6027, Australia

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 131; https://doi.org/10.3390/ijerph13010131 - 15 Jan 2016

Cited by 28 | Viewed by 8477

Abstract

Objective: To probe the spatiotemporal patterns of the incidence of scarlet fever in Beijing, China, from 2005 to 2014. Methods: A spatiotemporal analysis was conducted at the district/county level in the Beijing region based on the reported cases of scarlet fever [...] Read more.

Objective: To probe the spatiotemporal patterns of the incidence of scarlet fever in Beijing, China, from 2005 to 2014. Methods: A spatiotemporal analysis was conducted at the district/county level in the Beijing region based on the reported cases of scarlet fever during the study period. Moran’s autocorrelation coefficient was used to examine the spatial autocorrelation of scarlet fever, whereas the Getis-Ord Gi* statistic was used to determine the hotspot incidence of scarlet fever. Likewise, the space-time scan statistic was used to detect the space-time clusters, including the relative risk of scarlet fever incidence across all settings. Results: A total of 26,860 scarlet fever cases were reported in Beijing during the study period (2005–2014). The average annual incidence of scarlet fever was 14.25 per 100,000 population (range, 6.76 to 32.03 per 100,000). The incidence among males was higher than that among females, and more than two-thirds of scarlet fever cases (83.8%) were among children 3–8 years old. The seasonal incidence peaks occurred from March to July. A higher relative risk area was mainly in the city and urban districts of Beijing. The most likely space-time clusters and secondary clusters were detected to be diversely distributed in every study year. Conclusions: The spatiotemporal patterns of scarlet fever were relatively unsteady in Beijing from 2005 to 2014. The at-risk population was mainly scattered in urban settings and dense districts with high population, indicating a positive relationship between population density and increased risk of scarlet fever exposure. Children under 15 years of age were the most susceptible to scarlet fever. Full article

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12 pages, 868 KiB

Open AccessArticle

The Impact of Heatwaves on Community Morbidity and Healthcare Usage: A Retrospective Observational Study Using Real-Time Syndromic Surveillance

by Sue Smith¹, Alex J. Elliot^1,*

, Shakoor Hajat²

, Angie Bone³, Chris Bates⁴, Gillian E. Smith¹ and Sari Kovats²

¹ Real-Time Syndromic Surveillance Team, Public Health England, Birmingham B3 2PW, UK

² NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK

³ Extreme Events and Health Protection, Public Health England, London SE1 8UG, UK

⁴ ResearchOne, The Phoenix Partnership, Leeds LS18 5TN, UK

Int. J. Environ. Res. Public Health 2016, 13(1), 132; https://doi.org/10.3390/ijerph13010132 - 16 Jan 2016

Cited by 25 | Viewed by 7737

Abstract

We investigated the impact of a moderate heatwave on a range of presenting morbidities in England. Asthma, difficulty breathing, cerebrovascular accident, and cardiovascular symptoms were analysed using general practitioner in hours (GPIH), out of hours (GPOOH) and emergency department (ED) syndromic surveillance systems. [...] Read more.

We investigated the impact of a moderate heatwave on a range of presenting morbidities in England. Asthma, difficulty breathing, cerebrovascular accident, and cardiovascular symptoms were analysed using general practitioner in hours (GPIH), out of hours (GPOOH) and emergency department (ED) syndromic surveillance systems. Data were stratified by age group and compared between a heatwave year (2013) and non-heatwave years (2012, 2014). Incidence rate ratios were calculated to estimate the differential impact of heatwave compared to non-heatwave summers: there were no apparent differences for the morbidities tested between the 2013 heatwave and non-heatwave years. A subset of GPIH data were used to study individuals at higher risk from heatwaves based on their pre-existing disease. Higher risk patients were not more likely to present at GPs or ED than other individuals. Comparing GPIH consultations and ED attendances for myocardial infarction/ischaemia (MI), there was evidence of a fall in the presentation of MI during the heatwave, which was particularly noted in the 65–74 years age group (and over 75 years in ED attendances). These results indicate the difficulty in identifying individuals at risk from non-fatal health effects of heatwaves and hot weather. Full article

(This article belongs to the Special Issue Climate Change and Human Health)

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14 pages, 3013 KiB

Open AccessArticle

Chronic Arsenic Poisoning Probably Caused by Arsenic-Based Pesticides: Findings from an Investigation Study of a Household

by Yongfang Li^1,†, Feng Ye^2,†, Anwei Wang², Da Wang¹, Boyi Yang¹, Quanmei Zheng¹, Guifan Sun^1,* and Xinghua Gao^3,*

¹ Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning 110122, China

² Yunnan Institute of Endemic Disease Control and Prevention, No. 5 Wen Hua Road, Dali, Yunan 671000, China

³ Department of Dermatology, No. 1 Hospital of China Medical University, Shenyang, Liaoning 110001, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 133; https://doi.org/10.3390/ijerph13010133 - 16 Jan 2016

Cited by 50 | Viewed by 16234

Abstract

In addition to naturally occurring arsenic, man-made arsenic-based compounds are other sources of arsenic exposure. In 2013, our group identified 12 suspected arsenicosis patients in a household (32 living members). Of them, eight members were diagnosed with skin cancer. Interestingly, all of these [...] Read more.

In addition to naturally occurring arsenic, man-made arsenic-based compounds are other sources of arsenic exposure. In 2013, our group identified 12 suspected arsenicosis patients in a household (32 living members). Of them, eight members were diagnosed with skin cancer. Interestingly, all of these patients had lived in the household prior to 1989. An investigation revealed that approximately 2 tons of arsenic-based pesticides had been previously placed near a well that had supplied drinking water to the family from 1973 to 1989. The current arsenic level in the well water was 620 μg/L. No other high arsenic wells were found near the family’s residence. Based on these findings, it is possible to infer that the skin lesions exhibited by these family members were caused by long-term exposure to well water contaminated with arsenic-based pesticides. Additionally, biochemical analysis showed that the individuals exposed to arsenic had higher levels of aspartate aminotransferase and γ-glutamyl transpeptidase than those who were not exposed. These findings might indicate the presence of liver dysfunction in the arsenic-exposed individuals. This report elucidates the effects of arsenical compounds on the occurrence of high levels of arsenic in the environment and emphasizes the severe human health impact of arsenic exposure. Full article

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11 pages, 279 KiB

Open AccessArticle

Occupational Stress, Work-Family Conflict and Depressive Symptoms among Chinese Bank Employees: The Role of Psychological Capital

by Dan Kan¹ and Xiaosong Yu^1,2,*

¹ School of Public Health, Harbin Medical University, Harbin 150081, Heilongjiang, China

² Department of General Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China

Int. J. Environ. Res. Public Health 2016, 13(1), 134; https://doi.org/10.3390/ijerph13010134 - 16 Jan 2016

Cited by 52 | Viewed by 10035

Abstract

Although depression is a major problem affecting the physical and mental health of the occupational population worldwide, little research is available among bank employees. The purpose of the study was to examine the effects of occupational stress and work-family conflict on depressive symptoms [...] Read more.

Although depression is a major problem affecting the physical and mental health of the occupational population worldwide, little research is available among bank employees. The purpose of the study was to examine the effects of occupational stress and work-family conflict on depressive symptoms and the mediating role of psychological capital (PsyCap). A cross-sectional study was performed from May to June in 2013 in Liaoning province, China. The effort-reward imbalance (ERB) scale, the work-family conflict scale, the PsyCap questionnaire and the Center for Epidemiologic Studies Depression scale were completed by 1546 employees in state-owned banks. A total of 1239 effective respondents (467 men and 772 women) became our subjects. Hierarchical regression analysis was carried out to explore the effects of extrinsic effort, reward, overcommitment, work-family conflict, and PsyCap on depressive symptoms. The mediating role of PsyCap was examined using Preacher and Hayes’ asymptotic and resampling strategies. The mean score of depressive symptoms was 18.4 (SD = 7.6) among the Chinese bank employees. Extrinsic effort, overcommitment and work-family conflict were positively associated with depressive symptoms. Reward and PsyCap were negatively associated with depressive symptoms. The significant mediating roles of PsyCap in the associations of extrinsic effort (a*b = 0.046, BCa 95% CI: 0.029, 0.066) and reward (a*b = −0.047, BCa 95% CI: −0.065, −0.030) with depressive symptoms were revealed. There is a high level of depressive symptoms among Chinese bank employees. PsyCap partially mediates the effects of extrinsic effort and reward on depressive symptoms. Investing in PsyCap may provide new approaches to improve mental health among Chinese bank employees. Full article

(This article belongs to the Special Issue Occupational Stress, Human Health and Wellbeing)

12 pages, 280 KiB

Open AccessArticle

Lifestyle and Depression among Hong Kong Nurses

by Teris Cheung^1,2,* and Paul S.F. Yip^2,†

¹ School of Nursing, Hong Kong Polytechnic University, Hong Kong, China

² Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China

^† The author contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 135; https://doi.org/10.3390/ijerph13010135 - 16 Jan 2016

Cited by 62 | Viewed by 8427

Abstract

Recent longitudinal data suggest a close association between depression and lifestyle. Little work to date has estimated the prevalence of depression in the nursing workforce in China, nor considered what lifestyle factors might be correlated with it—a gap filled by the present study. [...] Read more.

Recent longitudinal data suggest a close association between depression and lifestyle. Little work to date has estimated the prevalence of depression in the nursing workforce in China, nor considered what lifestyle factors might be correlated with it—a gap filled by the present study. The study’s web-based cross-sectional survey solicited data from qualified nurses aged between 21 and 65 registered with the Hong Kong Nursing Council. The Depression, Anxiety and Stress Scale 21 was used to measure 850 nurses for depression, anxiety and symptoms of stress; a generalized linear regression model examined associations between lifestyle factors and depression. Mean depression symptom scores show a downward linear trend for male and female participants. Gender and age, however, did not emerge as significant predictors of depression. Three lifestyles factors (sleep, entertainment and hobbies) showed a significant association with depression. Nurses should make therapeutic lifestyle changes to improve their work-life balance and safeguard their functioning at work and personal well-being. Full article

8 pages, 453 KiB

Open AccessArticle

Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study

by Jin-Young Min¹ and Kyoung-Bok Min^2,*

¹ Institute of Health and Environment, Seoul National University, Seoul 110-799, Korea

² Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea

Int. J. Environ. Res. Public Health 2016, 13(1), 136; https://doi.org/10.3390/ijerph13010136 - 18 Jan 2016

Cited by 10 | Viewed by 5204

Abstract

Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adultsusing data [...] Read more.

Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adultsusing data from the 2002–2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults. Full article

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12 pages, 270 KiB

Open AccessArticle

Using a Household Food Inventory to Assess the Availability of Traditional Vegetables among Resettled African Refugees

by Catherine Gichunge^1,*, Shawn Somerset² and Neil Harris³

¹ School of Health Sciences, Mount Kenya University, P.O. Box 342, Thika 01000, Kenya

² School of Allied Health, Australian Catholic University, P.O. Box 456, Virginia, Brisbane 4001, Australia

³ Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia

Int. J. Environ. Res. Public Health 2016, 13(1), 137; https://doi.org/10.3390/ijerph13010137 - 18 Jan 2016

Cited by 12 | Viewed by 6646

Abstract

A cross-sectional sequential explanatory mixed methods study was conducted among household food preparers to examine the association between home availability and consumption of traditional vegetables among resettled African refugees living in Queensland, Australia. Home availability of traditional African vegetables was associated with age, [...] Read more.

A cross-sectional sequential explanatory mixed methods study was conducted among household food preparers to examine the association between home availability and consumption of traditional vegetables among resettled African refugees living in Queensland, Australia. Home availability of traditional African vegetables was associated with age, having a vegetable garden, employment status, and having a supermarket in the local neighborhood. Food preparers from homes with low vegetable availability were less likely to consume the recommended number of vegetable servings. Barriers faced in the food environment included language, lack of availability of traditional vegetables and lack of transport. All of these aspects contributed to the study findings that both individual and food environment characteristics may play a role in access to and availability of food and vegetable consumption of resettled refugees. Consumption of traditional foods among the resettled refugees continues post resettlement. Full article

(This article belongs to the Special Issue Migrant Health)

10 pages, 281 KiB

Open AccessArticle

An Assessment of Radiological Hazards from Gold Mine Tailings in the Province of Gauteng in South Africa

by Caspah Kamunda^1,*

, Manny Mathuthu¹

and Morgan Madhuku²

¹ Center for Applied Radiation Science and Tehnology, North West University (Mafikeng), P.Bag X2046, Mmabatho 2735, South Africa

² iThemba LABS, National Research Foundation, Private Bag X11, WITS 2050, South Africa

Int. J. Environ. Res. Public Health 2016, 13(1), 138; https://doi.org/10.3390/ijerph13010138 - 18 Jan 2016

Cited by 134 | Viewed by 6897

Abstract

Radiological hazards associated with exposure to Naturally Occurring Radionuclides Materials from gold mine tailings in the province of Gauteng in South Africa were evaluated. A comparison was made with soil samples from a control area. In this study, gamma spectroscopy was used to [...] Read more.

Radiological hazards associated with exposure to Naturally Occurring Radionuclides Materials from gold mine tailings in the province of Gauteng in South Africa were evaluated. A comparison was made with soil samples from a control area. In this study, gamma spectroscopy was used to measure the activity concentrations of these radionuclides in 56 soil samples from the mine tailings and 10 soil samples from the control area. The average activity concentrations in Bq∙kg⁻¹ for Uranium-238, Thorium-232, and Potassium-40 from the mine tailings were found to be 785.3 ± 13.7, 43.9 ± 1.0 and 427.0 ± 13.1, respectively. On the other hand, the average activity concentrations in Bq∙kg⁻¹ for Uranium-238, Thorium-232, and Potassium-40 from the control area were found to be 17.0.1 ± 0.4, 22.2 ± 0.5 and 496.8 ± 15.2, respectively. Radiological hazard parameters calculated from these activity concentrations were higher than recommended safe limits. In particular, calculated average values for the external hazard (H_ex) and the internal hazard (H_in) from the mine tailings were found to be 2.4 and 4.5. Both these values were higher than unity, posing a significant health risk to the population in the area. Full article

17 pages, 670 KiB

Open AccessArticle

Human Health Risk Assessment of Artisanal Miners Exposed to Toxic Chemicals in Water and Sediments in the PresteaHuni Valley District of Ghana

by Samuel Obiri^1,2,*, Philip O. Yeboah^1,†, Shiloh Osae^1,†, Sam Adu-kumi^3,†, Samuel J. Cobbina^4,†, Frederick A. Armah^5,†

, Benjamin Ason^6,†, Edward Antwi^7,† and Reginald Quansah^8,†

¹ Department of Nuclear and Environmental Protection, School of Nuclear and Allied Sciences, Ghana Atomic Energy Commission, P.O. Box AE 1, Atomic, Accra, Ghana

² Centre for Environmental Impact Analysis, P.O. Box AD 738, Cape Coast, Ghana

³ Environmental Protection Agency, P.O. Box M. 326, Accra, Ghana

⁴ Department of Ecotourism and Environmental Management, Faculty of Renewable Natural Resources, University for Development Studies, P.O. Box TL 1882, Nyankpala Campus, Tamale, Ghana

⁵ Department of Environmental Science, University of Cape Coast, Cape Coast, Ghana

⁶ CSIR—Soil Research Institute, P.O. Box M. 32, Accra, Ghana

⁷ Department of Chemical Engineering, KNUST, Kumasi, Ghana

⁸ Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health and Allied Sciences, University of Ghana, Legon, Ghana

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 139; https://doi.org/10.3390/ijerph13010139 - 18 Jan 2016

Cited by 50 | Viewed by 9260

Abstract

A human health risk assessment of artisanal miners exposed to toxic metals in water bodies and sediments in the PresteaHuni Valley District of Ghana was carried out in this study, in line with US EPA risk assessment guidelines. A total of 70 water [...] Read more.

A human health risk assessment of artisanal miners exposed to toxic metals in water bodies and sediments in the PresteaHuni Valley District of Ghana was carried out in this study, in line with US EPA risk assessment guidelines. A total of 70 water and 30 sediment samples were collected from surface water bodies in areas impacted by the operations of artisanal small-scale gold mines in the study area and analyzed for physico-chemical parameters such as pH, TDS, conductivity, turbidity as well as metals and metalloids such as As, Cd, Hg and Pb at CSIR—Water Research Institute using standard methods for the examination of wastewater as outlined by American Water Works Association (AWWA). The mean concentrations of As, Cd, Hg and Pb in water samples ranged from 15 μg/L to 325 μg/L (As), 0.17 μg/L to 340 μg/L (Cd), 0.17 μg/L to 122 μg/L (Pb) and 132 μg/L to 866 μg/L (Hg), respectively. These measured concentrations of arsenic (As), mercury (Hg), cadmium (Cd) and lead (Pb) were used as input parameters to calculate the cancer and non-cancer health risks from exposure to these metals in surface water bodies and sediments based on an occupational exposure scenario using central tendency exposure (CTE) and reasonable maximum exposure (RME) parameters. The results of the non-cancer human health risk assessment for small-scale miners working around river Anikoko expressed in terms of hazard quotients based on CTE parameters are as follows: 0.04 (Cd), 1.45 (Pb), 4.60 (Hg) and 1.98 (As); while cancer health risk faced by ASGM miners in Dumase exposed to As in River Mansi via oral ingestion of water is 3.1 × 10⁻³. The hazard quotient results obtained from this study in most cases were above the HQ guidance value of 1.0, furthermore the cancer health risk results were found to be higher than the USEPA guidance value of 1 × 10⁻⁴ to 1 × 10⁻⁶. These findings call for case-control epidemiological studies to establish the relationship between exposure to the aforementioned toxic chemicals and diseases associated with them as identified in other studies conducted in different countries as basis for developing policy interventions to address the issue of ASGM mine workers safety in Ghana. Full article

(This article belongs to the Special Issue Integrated Assessment of Artisanal and Small-Scale Gold Mining (ASGM) in Ghana)

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16 pages, 1762 KiB

Open AccessArticle

Heart Rate, Stress, and Occupational Noise Exposure among Electronic Waste Recycling Workers

by Katrina N. Burns¹, Kan Sun¹, Julius N. Fobil²

and Richard L. Neitzel^1,*

¹ Department of Environmental Health Sciences, University of Michigan, 1415 Washington Heights 6611 SPH I, Ann Arbor, MI 48109, USA

² Department of Biological, Environmental and Occupational Health Sciences, University of Ghana-Legon, P.O. Box LG 13, Legon, Ghana

Int. J. Environ. Res. Public Health 2016, 13(1), 140; https://doi.org/10.3390/ijerph13010140 - 19 Jan 2016

Cited by 67 | Viewed by 10635

Abstract

Electronic waste (e-waste) is a growing occupational and environmental health issue around the globe. E-waste recycling is a green industry of emerging importance, especially in low-and middle-income countries where much of this recycling work is performed, and where many people’s livelihoods depend on [...] Read more.

Electronic waste (e-waste) is a growing occupational and environmental health issue around the globe. E-waste recycling is a green industry of emerging importance, especially in low-and middle-income countries where much of this recycling work is performed, and where many people’s livelihoods depend on this work. The occupational health hazards of e-waste recycling have not been adequately explored. We performed a cross-sectional study of noise exposures, heart rate, and perceived stress among e-waste recycling workers at a large e-waste site in Accra, Ghana. We interviewed 57 workers and continuously monitored their individual noise exposures and heart rates for up to 24 h. More than 40% of workers had noise exposures that exceeded recommended occupational (85 dBA) and community (70 dBA) noise exposure limits, and self-reported hearing difficulties were common. Workers also had moderate to high levels of perceived stress as measured via Cohen’s Perceived Stress Scale, and reported a variety of symptoms that could indicate cardiovascular disease. Noise exposures were moderately and significantly correlated with heart rate (Spearman’s ρ 0.46, p < 0.001). A mixed effects linear regression model indicated that a 1 dB increase in noise exposure was associated with a 0.17 increase in heart rate (p-value = 0.01) even after controlling for work activities, age, smoking, perceived stress, and unfavorable physical working conditions. These findings suggest that occupational and non-occupational noise exposure is associated with elevations in average heart rate, which may in turn predict potential cardiovascular damage. Full article

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11 pages, 273 KiB

Open AccessArticle

Sun Exposure Prevalence and Associated Skin Health Habits: Results from the Austrian Population-Based UVSkinRisk Survey

by Daniela Haluza^1,*

, Stana Simic² and Hanns Moshammer¹

¹ Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria

² Institute of Meteorology, University of Natural Resources and Life Sciences, Vienna, Peter-Jordan-Straße 82, Vienna A-1190, Austria

Int. J. Environ. Res. Public Health 2016, 13(1), 141; https://doi.org/10.3390/ijerph13010141 - 19 Jan 2016

Cited by 22 | Viewed by 5894

Abstract

Recreational sun exposure accounts for a large number of acute and chronic dermatological diseases, including skin cancer. This study aimed at estimating the one-year prevalence of sun exposure and skin health-associated knowledge and attitudes among Austrian citizens. The population-based UVSkinRisk survey investigated a [...] Read more.

Recreational sun exposure accounts for a large number of acute and chronic dermatological diseases, including skin cancer. This study aimed at estimating the one-year prevalence of sun exposure and skin health-associated knowledge and attitudes among Austrian citizens. The population-based UVSkinRisk survey investigated a representative sample of Austrian adults using a structured questionnaire. In total, 1500 study subjects (median age 33.0 years, 50.5% females) participated in this questionnaire survey. Among study participants, prevalence of sun exposure was 47%, with slightly higher rates in males (48%) compared to females (46%). Younger age, lower professional category, darker skin type, motives to tan, sunbed use, sunburn, and outdoor sport activity increased the odds for prevalent sun exposure. This is the first population-based study evaluating the prevailing sun exposure and recreational habits influencing skin health among Austrian citizens. Despite public media campaigns educating on the harmful effects of sunlight exposure, we found a high prevalence of self-reported sunlight exposure. The results suggest that multifaceted socio-cultural characteristics stimulate recreational sun exposure and tanning habits. Communicating individualized Public (Skin) Health messages might be the key to prevent photo-induced skin health hazards in light-skinned populations. The practical and theoretical implications of these findings are discussed. Full article

23 pages, 2730 KiB

Open AccessArticle

The Online Dissemination of Nature–Health Concepts: Lessons from Sentiment Analysis of Social Media Relating to “Nature-Deficit Disorder”

by Marco Palomino^1,*,†, Tim Taylor², Ayse Göker¹, John Isaacs¹ and Sara Warber^2,3

¹ School of Computing and Digital Media, Robert Gordon University, Aberdeen, Scotland AB10 7GE, UK

² European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall TR1 3HD, UK

³ Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI 48104-1213, USA

^† Research started while working for the University of Exeter Medical School.

Int. J. Environ. Res. Public Health 2016, 13(1), 142; https://doi.org/10.3390/ijerph13010142 - 19 Jan 2016

Cited by 39 | Viewed by 16278

Abstract

Evidence continues to grow supporting the idea that restorative environments, green exercise, and nature-based activities positively impact human health. Nature-deficit disorder, a journalistic term proposed to describe the ill effects of people’s alienation from nature, is not yet formally recognized as a [...] Read more.

Evidence continues to grow supporting the idea that restorative environments, green exercise, and nature-based activities positively impact human health. Nature-deficit disorder, a journalistic term proposed to describe the ill effects of people’s alienation from nature, is not yet formally recognized as a medical diagnosis. However, over the past decade, the phrase has been enthusiastically taken up by some segments of the lay public. Social media, such as Twitter, with its opportunities to gather “big data” related to public opinions, offers a medium for exploring the discourse and dissemination around nature-deficit disorder and other nature–health concepts. In this paper, we report our experience of collecting more than 175,000 tweets, applying sentiment analysis to measure positive, neutral or negative feelings, and preliminarily mapping the impact on dissemination. Sentiment analysis is currently used to investigate the repercussions of events in social networks, scrutinize opinions about products and services, and understand various aspects of the communication in Web-based communities. Based on a comparison of nature-deficit-disorder “hashtags” and more generic nature hashtags, we make recommendations for the better dissemination of public health messages through changes to the framing of messages. We show the potential of Twitter to aid in better understanding the impact of the natural environment on human health and wellbeing. Full article

(This article belongs to the Special Issue Green-Blue Space and Health: Advances in Methods, Technologies and Applications)

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26 pages, 1132 KiB

Open AccessArticle

Measuring Indoor Air Quality and Engaging California Indian Stakeholders at the Win-River Resort and Casino: Collaborative Smoke-Free Policy Development

by Neil E. Klepeis^1,2,3,*

, Narinder Dhaliwal¹

, Gary Hayward⁴, Viviana Acevedo-Bolton², Wayne R. Ott², Nathan Read⁵, Steve Layton⁵, Ruoting Jiang², Kai-Chung Cheng², Lynn M. Hildemann², James L. Repace⁶, Stephanie Taylor⁵, Seow-Ling Ong¹, Francisco O. Buchting⁷, Juliet P. Lee⁸ and Roland S. Moore⁸

¹ Education, Training, and Research, Inc., Scotts Valley, CA 95066, USA

² Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA

³ Neil Klepeis and Associates, Environmental Health Research and Consulting, Aromas, CA 95004, USA

⁴ Win-River Resort & Casino, Redding Rancheria, Redding, CA 96001, USA

⁵ Shasta County Public Health Tobacco Education Program, Shasta County Public Health, Redding, CA 96001, USA

⁶ Repace Associates, Inc., Secondhand Smoke Consultants, Bowie, MD 20720, USA

⁷ Buchting Consulting, Oakland, CA 94612, USA

⁸ Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Oakland, CA 94612, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 143; https://doi.org/10.3390/ijerph13010143 - 20 Jan 2016

Cited by 10 | Viewed by 7956

Abstract

Most casinos owned by sovereign American Indian nations allow smoking, even in U.S. states such as California where state laws restrict workplace smoking. Collaborations between casinos and public health workers are needed to promote smoke-free policies that protect workers and patrons from secondhand [...] Read more.

Most casinos owned by sovereign American Indian nations allow smoking, even in U.S. states such as California where state laws restrict workplace smoking. Collaborations between casinos and public health workers are needed to promote smoke-free policies that protect workers and patrons from secondhand tobacco smoke (SHS) exposure and risks. Over seven years, a coalition of public health professionals provided technical assistance to the Redding Rancheria tribe in Redding, California in establishing a smoke-free policy at the Win-River Resort and Casino. The coalition provided information to the casino general manager that included site-specific measurement of employee and visitor PM_2.5 personal exposure, area concentrations of airborne nicotine and PM_2.5, visitor urinary cotinine, and patron and staff opinions (surveys, focus groups, and a Town Hall meeting). The manager communicated results to tribal membership, including evidence of high SHS exposures and support for a smoke-free policy. Subsequently, in concert with hotel expansion, the Redding Rancheria Tribal Council voted to accept a 100% restriction of smoking inside the casino, whereupon PM_2.5 exposure in main smoking areas dropped by 98%. A 70% partial-smoke-free policy was instituted ~1 year later in the face of revenue loss. The success of the collaboration in promoting a smoke-free policy, and the key element of air quality feedback, which appeared to be a central driver, may provide a model for similar efforts. Full article

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20 pages, 2200 KiB

Open AccessArticle

Airborne Particulate Matter in Two Multi-Family Green Buildings: Concentrations and Effect of Ventilation and Occupant Behavior

by Allison P. Patton¹

, Leonardo Calderon², Youyou Xiong², Zuocheng Wang², Jennifer Senick³, MaryAnn Sorensen Allacci³, Deborah Plotnik³, Richard Wener⁴, Clinton J. Andrews³

, Uta Krogmann² and Gediminas Mainelis^1,2,*

¹ Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ 08854, USA

² Department of Environmental Sciences, Rutgers University, 14 College Farm Road, New Brunswick, NJ 08901, USA

³ Edward J. Bloustein School of Planning and Public Policy, Rutgers University, 33 Livingston Ave., New Brunswick, NJ 08901, USA

⁴ Department of Technology, Culture & Society, Polytechnic Institute of New York University, 6 MetroTech Center, Brooklyn, NY 11201, USA

Int. J. Environ. Res. Public Health 2016, 13(1), 144; https://doi.org/10.3390/ijerph13010144 - 20 Jan 2016

Cited by 28 | Viewed by 6998

Abstract

There are limited data on air quality parameters, including airborne particulate matter (PM) in residential green buildings, which are increasing in prevalence. Exposure to PM is associated with cardiovascular and pulmonary diseases, and since Americans spend almost 90% of their time indoors, residential [...] Read more.

There are limited data on air quality parameters, including airborne particulate matter (PM) in residential green buildings, which are increasing in prevalence. Exposure to PM is associated with cardiovascular and pulmonary diseases, and since Americans spend almost 90% of their time indoors, residential exposures may substantially contribute to overall airborne PM exposure. Our objectives were to: (1) measure various PM fractions longitudinally in apartments in multi-family green buildings with natural (Building E) and mechanical (Building L) ventilation; (2) compare indoor and outdoor PM mass concentrations and their ratios (I/O) in these buildings, taking into account the effects of occupant behavior; and (3) evaluate the effect of green building designs and operations on indoor PM. We evaluated effects of ventilation, occupant behaviors, and overall building design on PM mass concentrations and I/O. Median PM_TOTAL was higher in Building E (56 µg/m³) than in Building L (37 µg/m³); I/O was higher in Building E (1.3–2.0) than in Building L (0.5–0.8) for all particle size fractions. Our data show that the building design and occupant behaviors that either produce or dilute indoor PM (e.g., ventilation systems, combustion sources, and window operation) are important factors affecting residents’ exposure to PM in residential green buildings. Full article

(This article belongs to the Special Issue Indoor Environmental Quality: Exposures and Occupant Health)

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14 pages, 3751 KiB

Open AccessArticle

Basic Characteristics and Spatial Patterns of Pseudo-Settlements—Taking Dalian as An Example

by Jiaji Gao^1,2,3,†, Yingjia Zhang^1,3,† and Xueming Li^1,3,*

¹ School of Urban and Environmental Sciences, Liaoning Normal University, Dalian 116029, China

² Applied Technology College of Dalian Ocean University, Dalian 116300, China

³ The Research Center of Human Settlements, Liaoning Normal University, Dalian 116029, China

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2016, 13(1), 145; https://doi.org/10.3390/ijerph13010145 - 20 Jan 2016

Cited by 5 | Viewed by 5880

Abstract

A person’s living behavior patterns are closely related to three types of settlements: real-life settlements, imagined settlements, and pseudo-settlements. The term “pseudo-settlement” (PS) refers to the places that are selectively recorded and represented after the mass media chose and restructure the residence information. [...] Read more.

A person’s living behavior patterns are closely related to three types of settlements: real-life settlements, imagined settlements, and pseudo-settlements. The term “pseudo-settlement” (PS) refers to the places that are selectively recorded and represented after the mass media chose and restructure the residence information. As the mass media rapidly develops and people’s way of obtaining information gradually change, PS has already become one of the main ways for people to recognize and understand real-life settlements, as well as describe their impressions of imagined settlements. PS also has a profound impact on tourism, employment, investment, migration, real estate development, etc. Thus, the study of PSs has important theoretical and practical significance. This paper proposes to put forward residential quarters where the mass media is displayed as the object of study and establishes the pseudo-settlement index system of Dalian in and elaborate analysis of the concept of PSs. From three aspects, including pseudo-buildings, pseudo-districts and pseudo-culture, this paper uses the ArcGIS 10.0 kernel density (spacial analyst) to analyze and interpret the basic characteristics and spatial patterns of 14 elements of the PS in Dalian. Through systemic clustering analysis, it identifies eight major types of PSs in Dalian. Then it systematically elaborates current situations and characteristics of the spatial pattern of PSs in Dalian, namely: regionally concentrated, widely scattered and blank spaces without pseudo-settlements. Finally, this paper discusses the mechanism of formation of PSs in Dalian. Full article

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11 pages, 282 KiB

Open AccessArticle

Maternal and Neonatal Levels of Perfluoroalkyl Substances in Relation to Gestational Weight Gain

by Jillian Ashley-Martin¹, Linda Dodds^2,*, Tye E. Arbuckle³, Anne-Sophie Morisset⁴, Mandy Fisher³, Maryse F. Bouchard⁵, Gabriel D. Shapiro⁶, Adrienne S. Ettinger⁷, Patricia Monnier⁸, Renee Dallaire⁹, Shayne Taback¹⁰ and William Fraser¹¹

¹ Perinatal Epidemiology Research Unit, IWK Health Centre, Halifax, NS B3K 6R8, Canada

² Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS B3K 6R8, Canada

³ Health Canada, Ottawa, ON K1A 0K9, Canada

⁴ Sainte Justine Hospital Research Center, University of Montreal, Montreal, PQ H3T 1C5, Canada

⁵ Department of Environmental and Occupational Health, University of Montreal, Montreal, PQ H3T 1A8, Canada

⁶ Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, PQ H3A 1A2, Canada

⁷ Departmentof Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA

⁸ Department of Obstetrics and Gynecology, McGill University, Montreal, PQ H3A 1A1, Canada

⁹ Faculty of Medicine, Laval University, Quebec City, PQ G1V 0A6, Canada

¹⁰ Departments of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3E 3P4, Canada

¹¹ Departments of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, PQ J1H 5N4, Canada

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Int. J. Environ. Res. Public Health 2016, 13(1), 146; https://doi.org/10.3390/ijerph13010146 - 20 Jan 2016

Cited by 37 | Viewed by 9540

Abstract

Perfluoroalkyl substances (PFASs) are ubiquitous, persistent pollutants widely used in the production of common household and consumer goods. There is a limited body of literature suggesting that these chemicals may alter metabolic pathways and growth trajectories. The relationship between prenatal exposures to these [...] Read more.

Perfluoroalkyl substances (PFASs) are ubiquitous, persistent pollutants widely used in the production of common household and consumer goods. There is a limited body of literature suggesting that these chemicals may alter metabolic pathways and growth trajectories. The relationship between prenatal exposures to these chemicals and gestational weight gain (GWG) has received limited attention. One objective was to analyze the associations among maternal plasma levels of three common perfluoroalkyl substances (perfluorooctanoate (PFOA), perfluorooctanesulfonate (PFOS), perfluorohexanesulfanoate (PFHxS)) and GWG. Additionally, we explored whether GWG was associated with cord blood PFAS levels. This study utilized data collected in the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a trans-Canada cohort study of 2001 pregnant women. Our analysis quantified associations between (1) maternal PFAS concentrations and GWG and (2) GWG and cord blood PFAS concentrations. Maternal PFOS concentrations were positively associated with GWG (β = 0.39 95% CI: 0.02, 0.75). Interquartile increases in GWG were significantly associated with elevated cord blood PFOA (OR = 1.33; 95% CI: 1.13 to 1.56) and PFOS (OR = 1.20; 95% CI: 1.03 to 1.40) concentrations. No statistically significant associations were observed between GWG and either measure of PFHxS. These findings warrant elucidation of the potential underlying mechanisms. Full article

10 pages, 471 KiB

Open AccessArticle

Reliability and Construct Validity of Two Versions of Chalder Fatigue Scale among the General Population in Mainland China

by Meng-Juan Jing¹, Wei-Quan Lin²

, Qiang Wang¹, Jia-Ji Wang², Jie Tang², En-She Jiang¹, Yi-Xiong Lei² and Pei-Xi Wang^1,2,*

¹ Institute of Public Health, School of Nursing, Henan University, Kaifeng 475000, China

² Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou 510182, China

Int. J. Environ. Res. Public Health 2016, 13(1), 147; https://doi.org/10.3390/ijerph13010147 - 21 Jan 2016

Cited by 43 | Viewed by 8439

Abstract

The 14-item Chalder Fatigue Scale (CFS) is widely used, while the 11-item version is seldom to be found in current research in mainland China. The objectives of the present study is to compare the reliability and construct validity between these two versions and [...] Read more.

The 14-item Chalder Fatigue Scale (CFS) is widely used, while the 11-item version is seldom to be found in current research in mainland China. The objectives of the present study is to compare the reliability and construct validity between these two versions and to confirm which may be better for the mainland Chinese setting. Based on a cross-sectional health survey with a constructive questionnaire, 1887 individuals aged 18 years or above were selected. Socio-demographic, health-related, gynecological data were collected, and 11-item and 14-item Chalder Fatigue Scale (CFS) were used to assess fatigue. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were performed to test the fit of models of the two versions. Confirmatory factor analysis of the two versions of CFS did not support the two-factor theorized models. In addition, a three-factor ESEM model of the 11-item version, but not the 14-item version, showed better factor structure and fitness than the other models examined. Both the versions had good internal consistency reliability and a satisfactory internal consistency (Ω = 0.78–0.96, omega coefficient indicates the internal consistency reliability) was obtained from the optimal model. This study provided evidence for satisfactory reliability and structural validity for the three-factor model of the 11-item version, which was proven to be superior to the 14-item version for this data. Full article

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13 pages, 1038 KiB

Open AccessArticle

Occupational Disparities in the Association between Self-Reported Salt-Eating Habit and Hypertension in Older Adults in Xiamen, China

by Manqiong Yuan^1,2

, Wei Chen^1,2, Bogang Teng³ and Ya Fang^1,2,*

¹ State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang’an Nan Road, Xiang’an District, Xiamen 361102, Fujian, China

² Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiang’an Nan Road, Xiang’an District, Xiamen 361102, Fujian, China

³ School of Public Health, Xiamen University, Xiang’an Nan Road, Xiang’an District, Xiamen 361102, Fujian, China

Int. J. Environ. Res. Public Health 2016, 13(1), 148; https://doi.org/10.3390/ijerph13010148 - 21 Jan 2016

Cited by 7 | Viewed by 5443

Abstract

Blood pressure responses to sodium intake are heterogeneous among populations. Few studies have assessed occupational disparities in the association between sodium intake and hypertension in older people. We used cross-sectional data from 14,292 participants aged 60 years or older in Xiamen, China, in [...] Read more.

Blood pressure responses to sodium intake are heterogeneous among populations. Few studies have assessed occupational disparities in the association between sodium intake and hypertension in older people. We used cross-sectional data from 14,292 participants aged 60 years or older in Xiamen, China, in 2013. Self-reported salt-eating habit was examined with three levels: low, medium, and high. The main lifetime occupation was classified into indoor laborer and outdoor laborer. Multivariable logistic regression was used to examine associations of hypertension with self-reported salt-eating habit, main lifetime occupation, and their interactions by adjusting for some covariates, with further stratification by sex. Overall, 13,738 participants had complete data, of whom 30.22% had hypertension. The prevalence of hypertension was 31.57%, 28.63%, and 31.97% in participants who reported to have low, medium, and high salt-eating habit, respectively. Outdoor laborers presented significantly lower prevalence of hypertension than indoor laborers (26.04% vs. 34.26%, p < 0.001). Indoor laborers with high salt-eating habit had the greatest odds of hypertension (OR = 1.32, 95% CI [1.09–1.59]). An increased trend of odds in eating habit as salt-heavier was presented in indoor laborers (p-trend = 0.048), especially for women (p-trend = 0.001). No clear trend presented in men. Conclusively, sex-specific occupational disparities exist in the association between self-reported salt-eating habit and hypertension in older individuals. Overlooking the potential moderating role of sex and occupation might affect the relationship between sodium intake and hypertension. Full article

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13 pages, 2993 KiB

Open AccessArticle

Rainfall–Runoff Simulations to Assess the Potential of SuDS for Mitigating Flooding in Highly Urbanized Catchments

by Daniel Jato-Espino^1,*

, Susanne M. Charlesworth², Joseba R. Bayon³ and Frank Warwick⁴

¹ GITECO Research Group, Universidad de Cantabria, Av. de los Castros S/N, 39005 Santander, Spain

² Centre for Agroecology, Water and Resilience (CAWR), Coventry University, West Midlands CV1 5FB, UK

³ Department of Project and Construction Management, Donostia City Council, Calle Larramendi 16, 20006 Donostia (Gipuzkoa), Spain

⁴ Department of Geography, Environment and Disaster Management, Coventry University, West Midlands CV1 5LW, UK

Int. J. Environ. Res. Public Health 2016, 13(1), 149; https://doi.org/10.3390/ijerph13010149 - 21 Jan 2016

Cited by 43 | Viewed by 9667

Abstract

Sustainable Urban Drainage Systems (SuDS) constitute an alternative to conventional drainage when managing stormwater in cities, reducing the impact of urbanization by decreasing the amount of runoff generated by a rainfall event. This paper shows the potential benefits of installing different types of [...] Read more.

Sustainable Urban Drainage Systems (SuDS) constitute an alternative to conventional drainage when managing stormwater in cities, reducing the impact of urbanization by decreasing the amount of runoff generated by a rainfall event. This paper shows the potential benefits of installing different types of SuDS in preventing flooding in comparison with the common urban drainage strategies consisting of sewer networks of manholes and pipes. The impact of these systems on urban water was studied using Geographic Information Systems (GIS), which are useful tools when both delineating catchments and parameterizing the elements that define a stormwater drainage system. Taking these GIS-based data as inputs, a series of rainfall–runoff simulations were run in a real catchment located in the city of Donostia (Northern Spain) using stormwater computer models, in order to compare the flow rates and depths produced by a design storm before and after installing SuDS. The proposed methodology overcomes the lack of precision found in former GIS-based stormwater approaches when dealing with the modeling of highly urbanized catchments, while the results demonstrated the usefulness of these systems in reducing the volume of water generated after a rainfall event and their ability to prevent localized flooding and surcharges along the sewer network. Full article

(This article belongs to the Special Issue Environmental Systems Engineering)

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Int. J. Environ. Res. Public Health, Volume 13, Issue 1 (January 2016) – 150 articles

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