International Journal of Environmental Research and Public Health

12 pages, 353 KiB

Open AccessEditorial

Environmental Carcinogenesis and Transgenerational Transmission of Carcinogenic Risk: From Genetics to Epigenetics

by Ernesto Burgio^1,2, Prisco Piscitelli^2,*

and Annamaria Colao³

¹ European Cancer and Environment Research Institute (ECERI), 1000 Bruxelles, Belgium

² Euro Mediterranean Scientific Biomedical Institute (ISBEM), 72023 Mesagne, Brindisi, Italy

³ Department of Clinical Medicine and Surgery, University Federico II School of Medicine, 80138 Naples, Italy

Int. J. Environ. Res. Public Health 2018, 15(8), 1791; https://doi.org/10.3390/ijerph15081791 - 20 Aug 2018

Cited by 26 | Viewed by 6702

Abstract

The dominant pathogenic model, somatic mutation theory (SMT), considers carcinogenesis as a ‘genetic accident’ due to the accumulation of ‘stochastic’ DNA mutations. This model was proposed and accepted by the scientific community when cancer mainly affected the elderly, but it does not explain [...] Read more.

The dominant pathogenic model, somatic mutation theory (SMT), considers carcinogenesis as a ‘genetic accident’ due to the accumulation of ‘stochastic’ DNA mutations. This model was proposed and accepted by the scientific community when cancer mainly affected the elderly, but it does not explain the epidemiological observation of the continuous increase in cancer incidence among children and young adults. Somatic mutation theory has been proposed for a revision based on the emerging experimental evidence, as it does not fully address some issues that have proven to be crucial for carcinogenesis, namely: the inflammatory context of cancer; the key role played by the stroma, microenvironment, endothelial cells, activated macrophages, and surrounding tissues; and the distorted developmental course followed by the neoplastic tissue. Furthermore, SMT is often not able to consider either the existence of specific mutations resulting in a well-defined cancer type, or a clear relationship between mutations and tumor progression. Moreover, it does not explain the mechanism of action of the non-mutagenic and environmental carcinogens. In the last decade, cancer research has highlighted the prominent role of an altered regulation of gene expression, suggesting that cancer should be considered as a result of a polyclonal epigenetic disruption of stem/progenitor cells, mediated by tumour-inducing genes. The maternal and fetal exposure to a wide range of chemicals and environmental contaminants is raising the attention of the scientific community. Indeed, the most powerful procarcinogenic mechanisms of endocrine disruptors and other pollutants is linked to their potential to interfere epigenetically with the embryo-fetal programming of tissues and organs, altering the regulation of the genes involved in the cell cycle, cell proliferation, apoptosis, and other key signaling pathways. The embryo-fetal exposure to environmental, stressful, and proinflammatory triggers (first hit), seems to act as a ‘disease primer’, making fetal cells and tissues more susceptible to the subsequent environmental exposures (second hit), triggering the carcinogenic pathways. Furthermore, even at the molecular level, in carcinogenesis, ‘epigenetics precedes genetics’ as global DNA hypomethylation, and the hypermethylation of tumor suppressor genes are common both in cancerous and in precancerous cells, and generally precede mutations. These epigenetic models may better explain the increase of cancer and chronic/degenerative diseases in the last decades and could be useful to adopt appropriate primary prevention measures, essentially based on the reduction of maternal-fetal and child exposure to several procarcinogenic agents and factors dispersed in the environment and in the food-chains, as recently suggested by the World Health Organization. Full article

(This article belongs to the Special Issue Environmental Carcinogens)

18 pages, 2315 KiB

Open AccessReview

Impact of the Refugee Crisis on the Greek Healthcare System: A Long Road to Ithaca

by Ourania S. Kotsiou^1,*

, Panagiotis Kotsios²

, David S. Srivastava³, Vaios Kotsios⁴, Konstantinos I. Gourgoulianis¹ and Aristomenis K. Exadaktylos³

¹ Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Biopolis, 41500 Larissa, Greece

² International Business Department, Perrotis College, 57001 Thessaloniki, Greece

³ Inselspital, University Hospital Bern, 3010 Bern, Switzerland

⁴ Metsovion Interdisciplinary Research Center, National Technical University of Athens, 44200 Athens, Greece

Int. J. Environ. Res. Public Health 2018, 15(8), 1790; https://doi.org/10.3390/ijerph15081790 - 20 Aug 2018

Cited by 40 | Viewed by 13627

Abstract

Greece is the country of “Xenios Zeus”, the Ancient Greek god of foreigners and hospitality; however, it is also the main point of entry to Europe. Since the beginning of 2014, 1,112,332 refugees crossed the borders of Greece. Overall, 33,677 children and adolescent [...] Read more.

Greece is the country of “Xenios Zeus”, the Ancient Greek god of foreigners and hospitality; however, it is also the main point of entry to Europe. Since the beginning of 2014, 1,112,332 refugees crossed the borders of Greece. Overall, 33,677 children and adolescent refugees sought asylum in Greece from 2013 to 2017, while 57,042 refugees are currently being hosted. The rapid entry of refugees into Greece raised the critical issue of health policy. The Greek National Health Service (NHS) faces many challenges. Adequate economic and human support is essential if this situation is to be managed successfully. However, Greece still bears the burden of the economic downturn since 2009. In fact, the crisis led to shortages in crucial equipment, and unmet health needs for both locals and refugees. The NHS deals with traumatic experiences, as well as cultural and linguistic differences. Overcrowded reception centers and hotspots are highly demanding and are associated with severe disease burden. This highlights the importance of guidelines for medical screening, healthcare provision, and a well-managed transition to definitive medical facilities. Furthermore, non-governmental organizations make an essential contribution by ensuring appropriate support to refugee minors, especially when they experience poor access to the NHS. Full article

(This article belongs to the Special Issue Refugee, Migrant and Ethnic Minority Health)

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16 pages, 2647 KiB

Open AccessReview

The Effect of Methylphenidate and Atomoxetine on Heart Rate and Systolic Blood Pressure in Young People and Adults with Attention-Deficit Hyperactivity Disorder (ADHD): Systematic Review, Meta-Analysis, and Meta-Regression

by Edwin F. Liang¹, Samuel Z. Lim¹, Wilson W. Tam², Cyrus S. Ho¹

, Melvyn W. Zhang³, Roger S. McIntyre^4,5,6,7 and Roger C. Ho^1,*

¹ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore

² Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore

³ National Addiction Management Service, Institute of Mental Health, Singapore 539747, Singapore

⁴ Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 1R8, Canada

⁵ Institute of Medical Science, University of Toronto, Toronto, ON M5T 1R8, Canada

⁶ Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada

⁷ Department of Pharmacology, University of Toronto, Toronto, ON M5T 1R8, Canada

Int. J. Environ. Res. Public Health 2018, 15(8), 1789; https://doi.org/10.3390/ijerph15081789 - 20 Aug 2018

Cited by 76 | Viewed by 17831

Abstract

Objectives: This meta-analysis aims to study the effects of atomoxetine and methylphenidate on heart rate (HR), systolic blood pressure (SBP), and a number of adverse cardiac events on patients receiving treatment for attention-deficit hyperactive disorder (ADHD) in comparison to placebo and between [...] Read more.

Objectives: This meta-analysis aims to study the effects of atomoxetine and methylphenidate on heart rate (HR), systolic blood pressure (SBP), and a number of adverse cardiac events on patients receiving treatment for attention-deficit hyperactive disorder (ADHD) in comparison to placebo and between atomoxetine and methylphenidate. Methods: We searched the following databases: PubMed, EMBASE, and ScienceDirect. Meta-analysis was performed on studies that examined the relationships between methylphenidate or atomoxetine and HR, SBP, as well as a number of adverse cardiac events. These studies were either placebo-controlled or comparison studies between methylphenidate and atomoxetine. Meta-regression identified patient- and treatment-related factors that may contribute to heterogeneity. Results: Twenty-two studies were included and the total number of participants was 46,107. Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo. Children and adolescents treated with atomoxetine had more significant increases post- vs. pre-treatment HR (p = 0.025) and SBP (p < 0.001) than those treated with methylphenidate. Meta-regression revealed mean age of participants, mean dose, and duration of atomoxetine and methylphenidate as significant moderators that explained heterogeneity. There were no differences in the number of adverse cardiac events between participants with methylphenidate treatment and placebo or atomoxetine. Conclusions: Children/adolescents and adults treated with methylphenidate resulted in significant increases in post- vs. pre-treatment HR and SBP as compared to placebo. Similarly, children and adolescents treated with atomoxetine had significant increases in post- vs. pre-treatment HR and SBP than those treated with methylphenidate. These findings have potential implications for continuous monitoring of HR and SBP throughout the course of treatment although the risk for adverse cardiac events were insignificant. Full article

(This article belongs to the Special Issue Adult Psychiatry)

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11 pages, 928 KiB

Open AccessArticle

Situational Use of Child Restraint Systems and Carpooling Behaviors in Parents and Caregivers

by Catherine C. McDonald^1,2,3,4,*

, Erin Kennedy^1,3, Linda Fleisher^2,3 and Mark R. Zonfrillo⁵

¹ Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA

² Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA

³ Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA

⁴ Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA 19104, USA

⁵ Department of Emergency Medicine, Alpert Medical School of Brown University and Hasbro Children’s Hospital, Providence, RI 02903, USA

Int. J. Environ. Res. Public Health 2018, 15(8), 1788; https://doi.org/10.3390/ijerph15081788 - 20 Aug 2018

Cited by 7 | Viewed by 4840

Abstract

Suboptimal compliance with child restraint system (CRS) recommendations can increase risk for injury or death in a motor vehicle crash. The purpose of this study was to examine scenarios associated with incomplete CRS use and non-use in children ages 4–10 years. We used [...] Read more.

Suboptimal compliance with child restraint system (CRS) recommendations can increase risk for injury or death in a motor vehicle crash. The purpose of this study was to examine scenarios associated with incomplete CRS use and non-use in children ages 4–10 years. We used a cross-sectional online survey with a convenience sample of parent/caregivers from the United States, age ≥18 years, with a child age 4–10 years in their home, who could read and spoke English, and drove child ≥6 times in previous three months. We used descriptive statistics and Mann-Whitney U to describe and compare the distribution of responses to situational use of CRSs among car seat users and booster seat users. We also used descriptive statistics and the Mann-Whitney U to describe and compare the distribution of responses to carpooling items among booster seat users and non-booster seat users. There were significant differences among those who reported most often using booster seats (n = 282) and car seats (n = 127) in situations involving rental cars, driving just around the corner, car too crowded to fit the CRS, not enough CRSs in the vehicle, the CRS is missing from the car, or the child is in someone else’s car without a CRS (p < 0.05). Among those who reported most often using booster seats and who carpooled other children (n = 159), 71.7% (n = 114) always used a booster seat for their own child. When carpooling other children, booster seat users were significantly more likely to use booster seats for other children ages 4–10 than the non-booster seat users (p < 0.01). Continued education and programs surrounding CRS use is critical, particularly for children who should be in booster seats. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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11 pages, 351 KiB

Open AccessArticle

Psychological Coping with Job Loss. Empirical Study to Contribute to the Development of Unemployed People

by Yolanda Navarro-Abal¹

, José Antonio Climent-Rodríguez¹

, María José López-López² and Juan Gómez-Salgado^3,4,*

¹ Department of Social, Developmental and Education Psychology, Faculty of Education Science, University of Huelva, 21071 Huelva, Spain

² Department of Clinical and Experimental Psychology, Faculty of Education Science, University of Huelva, 21071 Huelva, Spain

³ Department of Nursing, Faculty of Nursing, University of Huelva, 21071 Huelva, Spain

⁴ Espíritu Santo University, Guayaquil 092301, Ecuador

Int. J. Environ. Res. Public Health 2018, 15(8), 1787; https://doi.org/10.3390/ijerph15081787 - 20 Aug 2018

Cited by 26 | Viewed by 8181

Abstract

Having a job is an essential part of people’s development. Unemployment, on the contrary, is one of the most frustrating experiences of life with greater psychological consequences for people’s lives. In this sense, psychology has contributed to an increase in knowledge about the [...] Read more.

Having a job is an essential part of people’s development. Unemployment, on the contrary, is one of the most frustrating experiences of life with greater psychological consequences for people’s lives. In this sense, psychology has contributed to an increase in knowledge about the personal and social experience of unemployment. This article discusses indicators of anxiety and depression in unemployed people, modulating socio-demographic variables, and coping strategies involved in the higher and lower levels of anxiety and depression. For this, a sample of 244 unemployed people who are users of the Career Service Centre of the Andalusian Public Employment Service of the city of Huelva is used for a descriptive and analytical cross-sectional study. The results show that only 5.7% of the participants do not have depressive symptoms. With regards to anxiety levels, 41.3% of participants have no anxiety. Unemployed people with high anxiety and depression scores have developed maladaptive coping strategies such as substance use, self-blaming, or denial. It is necessary to assess the importance of the unemployment process and the incorporation of appropriate coping strategies that facilitate new integration in the labour market, such as planification, emotional or social support and self-distraction between others. Full article

(This article belongs to the Section Health Economics)

22 pages, 663 KiB

Open AccessArticle

The Importance of Using Public Health Impact Criteria to Develop Environmental Health Indicators: The Example of the Indoor Environment in New Zealand

by Kylie Mason^*, Kirstin Lindberg, Deborah Read and Barry Borman

Environmental Health Indicators Programme, Massey University, Wellington Campus, P.O. Box 756, Wellington 6140, New Zealand

Int. J. Environ. Res. Public Health 2018, 15(8), 1786; https://doi.org/10.3390/ijerph15081786 - 20 Aug 2018

Cited by 11 | Viewed by 8172

Abstract

Developing environmental health indicators is challenging and applying a conceptual framework and indicator selection criteria may not be sufficient to prioritise potential indicators to monitor. This study developed a new approach for prioritising potential environmental health indicators, using the example of the indoor [...] Read more.

Developing environmental health indicators is challenging and applying a conceptual framework and indicator selection criteria may not be sufficient to prioritise potential indicators to monitor. This study developed a new approach for prioritising potential environmental health indicators, using the example of the indoor environment for New Zealand. A three-stage process of scoping, selection, and design was implemented. A set of potential indicators (including 4 exposure indicators and 20 health indicators) were initially identified and evaluated against indicator selection criteria. The health indicators were then further prioritised according to their public health impact and assessed by the five following sub-criteria: number of people affected (based on environmental burden of disease statistics); severity of health impact; whether vulnerable populations were affected and/or large inequalities were apparent; whether the indicator related to multiple environmental exposures; and policy relevance. Eight core indicators were ultimately selected, as follows: living in crowded households, second-hand smoke exposure, maternal smoking at two weeks post-natal, asthma prevalence, asthma hospitalisations, lower respiratory tract infection hospitalisations, meningococcal disease notifications, and sudden unexpected death in infancy (SUDI). Additionally, indicators on living in damp and mouldy housing and children’s injuries in the home, were identified as potential indicators, along with attributable burden indicators. Using public health impact criteria and an environmental burden of disease approach was valuable in prioritising and selecting the most important health impacts to monitor, using robust evidence and objective criteria. Full article

(This article belongs to the Special Issue Environmental Health Indicators for Policy Support)

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15 pages, 929 KiB

Open AccessArticle

Concentration and Potential Ecological Risk of PAHs in Different Layers of Soil in the Petroleum-Contaminated Areas of the Loess Plateau, China

by Di Wang¹

, Jing Ma², Hao Li² and Xingchang Zhang^3,*

¹ College of Natural Resources and Environment, Northwest A&F University, Yangling 712100, China

² Inspection and Testing Center for Quality and Safety of Agricultural Products, Ningxia Institute of Agricultural Survey and Design, Yinchuan 750002, China

³ State Key Laboratory of Soil Erosion and Dryland Farming on the Loess Plateau, Institute of Soil and Water Conservation, Northwest A&F University, Yangling 712100, China

Int. J. Environ. Res. Public Health 2018, 15(8), 1785; https://doi.org/10.3390/ijerph15081785 - 20 Aug 2018

Cited by 67 | Viewed by 6129

Abstract

The three most representative areas of petroleum pollution on the Loess Plateau are the research subjects of this study. In this study, 16 priority polycyclic aromatic hydrocarbons (PAHs) were determined by the QuEChERS method combined with gas chromatography-tandem mass spectrometry (GC-MS/MS). The total [...] Read more.

The three most representative areas of petroleum pollution on the Loess Plateau are the research subjects of this study. In this study, 16 priority polycyclic aromatic hydrocarbons (PAHs) were determined by the QuEChERS method combined with gas chromatography-tandem mass spectrometry (GC-MS/MS). The total concentrations of ∑16PAHs in top layer soils (0–10 cm), middle layer soils (10–30 cm), and bottom layer soils (30–50 cm) ranged from 1010.67 to 18,068.80, 495.85 to 9868.56 and 213.16 to 12,552.53 μg/kg, with an average of 5502.44, 2296.94 and 2203.88 μg/kg, respectively. The 3-ring and 4-ring PAHs were the most prominent components in all soil samples. Meanwhile, the average value of ∑16PAHs decreased with the depth, from 5502.44 μg/kg (0–10 cm) to 2203.88 μg/kg (30–50 cm). The PAHs levels in the studied soils were heavily polluted (over 1000 μg/kg) according to the Soils Quality Guidelines and 95% of PAHs come from petroleum sources. Moreover, the total of PAHs in petroleum-contaminated soils was assigned a high ecological risk level. Toxic equivalency quantities (TEQs) indicated that PAHs in petroleum-contaminated soils presented relatively high toxicity. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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13 pages, 2458 KiB

Open AccessArticle

6 Hz Active Anticonvulsant Fluorinated N-Benzamide Enaminones and Their Inhibitory Neuronal Activity

by Isis J. Amaye¹, Thomas Heinbockel²

, Julia Woods², Zejun Wang², Miguel Martin-Caraballo¹ and Patrice Jackson-Ayotunde^1,*

¹ Department of Pharmaceutical Sciences, School of Pharmacy and Health Professions, University of Maryland Eastern Shore, One Backbone Road, Princess Anne, MD 21853, USA

² Department of Anatomy, College of Medicine, Howard University, 520 W Street, NW, Washington, DC 20059, USA

Int. J. Environ. Res. Public Health 2018, 15(8), 1784; https://doi.org/10.3390/ijerph15081784 - 20 Aug 2018

Cited by 15 | Viewed by 4625

Abstract

A small library of novel fluorinated N-benzamide enaminones were synthesized and evaluated in a battery of acute preclinical seizure models. Three compounds (GSA 62, TTA 35, and WWB 67) were found to have good anticonvulsant activity in the 6-Hz ‘psychomotor’ 44-mA rodent model. [...] Read more.

A small library of novel fluorinated N-benzamide enaminones were synthesized and evaluated in a battery of acute preclinical seizure models. Three compounds (GSA 62, TTA 35, and WWB 67) were found to have good anticonvulsant activity in the 6-Hz ‘psychomotor’ 44-mA rodent model. The focus of this study was to elucidate the active analogs’ mode of action on seizure-related molecular targets. Electrophysiology studies were employed to evaluate the compounds’ ability to inhibit neuronal activity in central olfactory neurons, mitral cells, and sensory-like ND7/23 cells, which express an assortment of voltage and ligand-gated ion channels. We did not find any significant effects of the three compounds on action potential generation in mitral cells. The treatment of ND7/23 cells with 50 µM of GSA 62, TTA 35, and WWB 67 generated a significant reduction in the amplitude of whole-cell sodium currents. Similar treatment of ND7/23 cells with these compounds had no effect on T-type calcium currents, indicating that fluorinated N-benzamide enaminone analogs may have a selective effect on voltage-gated sodium channels, but not calcium channels. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

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10 pages, 572 KiB

Open AccessArticle

Postpartum Depression and Subsequent Autoimmune Diseases in Taiwan

by Chien-Yu Lin^1,†

, Cheng-Kai Li^2,†, Jui-Ming Liu^3,4

, Ren-Jun Hsu^4,5,6, Heng-Chang Chuang³ and Fung-Wei Chang^7,8,*

¹ Department of Pediatrics and Infectious Disease, Hsinchu MacKay Memorial Hospital, Hsinchu City 300, Taiwan

² Department of Gynecology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan

³ Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan

⁴ Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan

⁵ Biobank Management Center of the Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan

⁶ Department of Pathology and Graduate Institute of Pathology and Parasitology, the Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan

⁷ Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan

⁸ Superintendent, Tri-Service General Hospital Penghu Branch, National Defence Medical Center, Penghu Branch, Magong City 880, Taiwan

^† These authors contributed equally to this work.

Int. J. Environ. Res. Public Health 2018, 15(8), 1783; https://doi.org/10.3390/ijerph15081783 - 20 Aug 2018

Cited by 14 | Viewed by 4900

Abstract

Postpartum depression (PPD) is one of the most common examples of postnatal morbidity, but the subsequent risks of autoimmune diseases in patients with PPD have yet to be fully investigated. This nationwide population-based study utilized data of the National Health Insurance Research Database [...] Read more.

Postpartum depression (PPD) is one of the most common examples of postnatal morbidity, but the subsequent risks of autoimmune diseases in patients with PPD have yet to be fully investigated. This nationwide population-based study utilized data of the National Health Insurance Research Database of Taiwan for the period from 1996 to 2013. In total, 45,451 women with primiparity were identified. Among them, 542 patients with PPD were enrolled as a study group while 2165 matched patients without PPD were enrolled as a control group. The demographic characteristics and comorbidities of the patients were analyzed, and Cox regression analysis was applied to calculate the hazard ratios for the risk of autoimmune diseases. Of the 2707 women enrolled in this study, 469 (17.3%) patients with newly diagnosed autoimmune diseases were identified, including 123 (22.7%) in the PPD group and 346 (16%) in the non-PPD group. After adjusting for confounding factors, it was determined that the patients with PPD had a significantly higher risk of subsequent autoimmune diseases (adjusted hazard ratio (aHR): 1.61, 95% confidence interval (CI): 1.30–1.99; p < 0.001). Specifically, increased risks of pernicious anemia (aHR: 3.85, 95% CI: 2.06–7.22), rheumatoid arthritis (aHR: 2.62, 95% CI: 1.28–5.39), and Graves’ disease (aHR: 1.57, 95% CI: 1.05–2.33) were observed in the PPD group. This study demonstrated that patients with PPD have higher risks of subsequent autoimmune diseases, especially pernicious anemia, rheumatoid arthritis, and Graves’ disease. This useful information provides physicians with clues regarding the associations between autoimmune diseases and PPD. Full article

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14 pages, 320 KiB

Open AccessArticle

Technology Evolution of China’s Export of Renewable Energy Products

by Xuping Cao^1,2,3,*, Aroskar Rajarshi² and Juxi Tong^1,3

¹ School of Economics and Management, Changshu Institute of Technology, Changshu 215500, China

² School of Business, University of Wisconsin-Eau Claire, Eau Claire, WI 54702, USA

³ Suzhou Agricultural Modernization Research Center, Changshu Institute of Technology, Changshu 215500, China

Int. J. Environ. Res. Public Health 2018, 15(8), 1782; https://doi.org/10.3390/ijerph15081782 - 19 Aug 2018

Cited by 13 | Viewed by 5988

Abstract

With the increasing scarcity of traditional energy sources, global warming and environmental degradation, the increased use of renewable energy (RE) has become an effective path for sustainable development. Therefore, countries are paying more and more attention to the development of the RE industry, [...] Read more.

With the increasing scarcity of traditional energy sources, global warming and environmental degradation, the increased use of renewable energy (RE) has become an effective path for sustainable development. Therefore, countries are paying more and more attention to the development of the RE industry, and the world trade in renewable energy products (REPs) is developing rapidly. First of all, this paper defines REPs, refines the scope of REPs, and proposes the “Equalization Technology Classification” method for the technology classification of REPs. Second, based on the United Nations Comtrade (COMTRADE) data, the export technology structure of China’s REPs from 2007 to 2016 was empirically measured. Finally, a comparative study was conducted on the renewable energy product (REP) export technologies of major REP exporting countries (or regions) in the world. We found that (1) China’s exports of REPs are mainly medium-high and medium technical complexity products, and that there are few high technical complexity products; (2) the export technology structure of China’s REPs is deteriorating, and its overall technical level is in the middle of the global industrial value chain. The export technology of China’s REPs has a gap compared with that of Denmark, Hong Kong China, and Singapore; (3) the technological competition of the world’s REPs is becoming increasingly fierce. The growth rates of REP technologies in South Korea, Japan, and Malaysia’s REPs are significantly higher than that of China. Full article

10 pages, 329 KiB

Open AccessArticle

Eat or Skip Breakfast? The Important Role of Breakfast Quality for Health-Related Quality of Life, Stress and Depression in Spanish Adolescents

by Rosario Ferrer-Cascales¹, Miriam Sánchez-SanSegundo¹

, Nicolás Ruiz-Robledillo^1,*

, Natalia Albaladejo-Blázquez¹

, Ana Laguna-Pérez² and Ana Zaragoza-Martí²

¹ Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain

² Department of Nursing, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain

Int. J. Environ. Res. Public Health 2018, 15(8), 1781; https://doi.org/10.3390/ijerph15081781 - 19 Aug 2018

Cited by 86 | Viewed by 22957

Abstract

This study examined the associations between eating or skipping breakfast and the quality of breakfast eaten on health-related quality of life (HRQOL), perceived stress and depression in 527 Spanish adolescents. Results showed differences in stress and two domains of HRQOL; Moods and Emotions [...] Read more.

This study examined the associations between eating or skipping breakfast and the quality of breakfast eaten on health-related quality of life (HRQOL), perceived stress and depression in 527 Spanish adolescents. Results showed differences in stress and two domains of HRQOL; Moods and Emotions and Parent Relations and Home Life between adolescent breakfast skippers and eaters, those having breakfast showing higher levels of stress and poor HRQOL. When breakfast quality was analyzed in breakfast eaters, adolescents who ate a good quality breakfast showed better HRQOL and lower levels of stress and depression than those who ate a poor or very poor quality breakfast. Further, breakfast skippers showed better HRQOL and lower levels of stress and depression than breakfast eaters who ate a poor or very poor quality breakfast. These findings indicate the importance of eating a good quality breakfast, rather than just having or not having breakfast. The conclusions of the present study are especially relevant for clinicians and nutritional educators, given the significant impact of breakfast quality on health-related quality of life, stress and depression observed in the adolescents studied. Full article

(This article belongs to the Special Issue Stress, Coping, and Resilience in Adolescents)

5 pages, 259 KiB

Open AccessCase Report

Post Vaccinal Temporary Sensorineural Hearing Loss

by Federica De Marco¹, Donato Pompeo De Cesare¹, Francesco Di Folco², Francesco Massoni³, Gianfranco Tomei⁴, Natale Mario Di Luca³, Carmina Sacco³, Francesco Tomei^5,* and Ricci Serafino^1,3

¹ Department of Anatomy, Histology, Medical-Legal and the Orthopedics, Specialty School of Occupational Medicine, Unit of Occupational Medicine, Sapienza University of Rome, 00161 Rome, Italy

² Policlinico Militare Celio, 00184 Rome, Italy

³ Department of Anatomy, Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, 00161 Rome, Italy

⁴ Department of Psychiatric and Psychological Science, University of Rome “Sapienza”, Piazzale Aldo Moro 5, 00185 Rome, Italy

⁵ Spin off Sipro, Via Stimigliano 5, 00199 Rome, Italy

Int. J. Environ. Res. Public Health 2018, 15(8), 1780; https://doi.org/10.3390/ijerph15081780 - 19 Aug 2018

Cited by 8 | Viewed by 4153

Abstract

In our systematic research we identified four studies concerning the onset of neurological adverse events following vaccination and two excluding this association. A 33-year-old Italian man, belonging to the Italian Army was hospitalized because he suffered from vertigo, nausea and sudden right hearing [...] Read more.

In our systematic research we identified four studies concerning the onset of neurological adverse events following vaccination and two excluding this association. A 33-year-old Italian man, belonging to the Italian Army was hospitalized because he suffered from vertigo, nausea and sudden right hearing loss not classified (NDD), that set in 24 h after the administration of tetanus-diphtheria and meningococcal vaccines. Some neurological events arising after vaccination are very difficult to treat. In our case, the functional recovery on low and medium frequencies was possible about 6 months after the morbid event. Full article

(This article belongs to the Special Issue Vaccination and Health Outcomes)

14 pages, 1034 KiB

Open AccessArticle

Compositional Analysis of the Associations between 24-h Movement Behaviours and Health Indicators among Adults and Older Adults from the Canadian Health Measure Survey

by Duncan E. McGregor^1,2,*, Valerie Carson³

, Javier Palarea-Albaladejo²

, Philippa M. Dall¹

, Mark S. Tremblay⁴ and Sebastien F. M. Chastin^1,5

¹ Institute for Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, Scotland, UK

² Biomathematics and Statistics Scotland, JCMB, The King’s Buildings, Peter Guthrie Tait Road, Edinburgh EH9 3FD, Scotland, UK.

³ Faculty of Kinesiology, Sport, and Recreation, 1-151 Van Vliet Complex, University of Alberta, Edmonton, AB T6G 2H9, Canada

⁴ Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada

⁵ Department of Movement and Sport Science, Ghent University, 9000 Ghent, Belgium

Int. J. Environ. Res. Public Health 2018, 15(8), 1779; https://doi.org/10.3390/ijerph15081779 - 18 Aug 2018

Cited by 70 | Viewed by 7688

Abstract

This study investigated the association between the allocation of time-use over the 24-h day between sleep, sedentary behaviour (SB), light-intensity physical activity (LPA) and moderate-to-vigorous-intensity physical activity (MVPA)) and health indicators. A cross-sectional analysis of Canadian Health Measures Survey data was undertaken using [...] Read more.

This study investigated the association between the allocation of time-use over the 24-h day between sleep, sedentary behaviour (SB), light-intensity physical activity (LPA) and moderate-to-vigorous-intensity physical activity (MVPA)) and health indicators. A cross-sectional analysis of Canadian Health Measures Survey data was undertaken using compositional data analysis. SB, LPA and MVPA were derived from Actical accelerometers, whilst sleep was self-reported by respondents. The analysis was stratified by age; adults (aged 18–64 years; n = 6322) and older adults (65–79 years; n = 1454). For adults, beneficial associations were observed between larger proportions of MVPA relative to time in other behaviours and body mass index (BMI), waist circumference, aerobic fitness, resting heart rate, high-density lipoprotein (HDL) cholesterol, triglycerides, blood glucose and insulin levels. More time spent in sleep relative to other movement behaviours was deleteriously associated with aerobic fitness, HDL cholesterol, insulin, C-reactive proteins and grip strength but beneficially with low-density lipoprotein cholesterol. Relative time spent in LPA was deleteriously associated with BMI and beneficially with triglycerides and grip strength. In older adults, these associations were blunted or disappeared but larger proportions of MVPA were associated with better mental health. The importance to health of MVPA when explicitly considered relative to other movement behaviours was confirmed. Full article

(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)

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10 pages, 357 KiB

Open AccessArticle

Lead, Cadmium, and Arsenic Bioaccessibility of 24 h Duplicate Diet Ingested by Preschool Children Attending Day Care Centers in Brazil

by Isabelle Nogueira Leroux^1,†, Ana Paula Sacone da Silva Ferreira^1,†, Fernanda Pollo Paniz², Tatiana Pedron², Fernanda Junqueira Salles¹, Fábio Ferreira Da Silva^2,3, Heloisa França Maltez², Bruno Lemos Batista² and Kelly Polido Kaneshiro Olympio^1,*

¹ Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo 1246-904, Brazil

² Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Avenida dos Estados, 5001, Bairro Santa Terezinha, Santo André—SP—Brasil, Santo André 09210-580, Brazil

³ Agilent Technologies, Alameda Araguaia, 1142 Alphaville Industrial, Barueri 6455000, Brazil

^† The two first authors deserve the same merit because they had the same level of participation in the data collection and manuscript writing.

Int. J. Environ. Res. Public Health 2018, 15(8), 1778; https://doi.org/10.3390/ijerph15081778 - 18 Aug 2018

Cited by 12 | Viewed by 4543

Abstract

Lead, known as a metal with high neurotoxicity to children, cadmium, which is a carcinogenic and bioaccumulative contaminant, and arsenic, a class 1 carcinogenic according to the International Agency for Research on Cancer, are toxic elements (TEs) whose relevant route of exposure may [...] Read more.

Lead, known as a metal with high neurotoxicity to children, cadmium, which is a carcinogenic and bioaccumulative contaminant, and arsenic, a class 1 carcinogenic according to the International Agency for Research on Cancer, are toxic elements (TEs) whose relevant route of exposure may be diet. We determined the bio-accessible fraction of lead, cadmium, and arsenic from the diet of preschool children from two day care centers (DCC). A cross-sectional study was conducted with 64 one–four-year-old children from two DCCs where the 24-h duplicate diet samples were collected. The diet samples were analyzed by ICP-MS for lead, cadmium, and arsenic total concentrations (n = 64) and their bio-accessibility were analyzed for a subsample (n = 10). The dietary intake (DI) mean for lead, cadmium, and arsenic were 0.18 ± 0.11 µg kg⁻¹ bw, 0.08 ± 0.04 µg kg⁻¹ bw, and 0.61 ± 0.41 µg kg⁻¹ bw, respectively. All DI calculated for TEs, considering total intake, were found lower than the tolerable limits (TL) (European Union, or World Health Organization, WHO, when applicable) except for one child’s Pb intake. Bio-accessibilities ranged between 0% to 93%, 0% to 103%, and 0% to 69%, for lead, cadmium, and arsenic, respectively. Although DI for TEs has been found lower than TL, these reference values have been recently decreased or withdrawn since it was for lead and arsenic whose TL were withdrawn by WHO. Full article

(This article belongs to the Section Environmental Health)

8 pages, 2038 KiB

Open AccessArticle

Aluminium in Brain Tissue in Multiple Sclerosis

by Matthew Mold¹

, Agata Chmielecka², Maria Raquel Ramirez Rodriguez¹, Femia Thom², Caroline Linhart³, Andrew King⁴ and Christopher Exley^1,*

¹ The Birchall Centre, Lennard-Jones Laboratories, Keele University, Staffordshire ST5 5BG, UK

² Life Sciences, The Huxley Building, Keele University, Staffordshire ST5 5BG, UK

³ Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, A-6020 Innsbruck, Austria

⁴ Department of Clinical Neuropathology, Kings College Hospital, London SE5 9RS, UK

Int. J. Environ. Res. Public Health 2018, 15(8), 1777; https://doi.org/10.3390/ijerph15081777 - 18 Aug 2018

Cited by 39 | Viewed by 39514

Abstract

Multiple sclerosis (MS) is a devastating and debilitating neurodegenerative disease of unknown cause. A consensus suggests the involvement of both genetic and environmental factors of which the latter may involve human exposure to aluminium. There are no data on the content and distribution [...] Read more.

Multiple sclerosis (MS) is a devastating and debilitating neurodegenerative disease of unknown cause. A consensus suggests the involvement of both genetic and environmental factors of which the latter may involve human exposure to aluminium. There are no data on the content and distribution of aluminium in human brain tissue in MS. The aluminium content of brain tissue from 14 donors with a diagnosis of MS was determined by transversely heated graphite furnace atomic absorption spectrometry. The location of aluminium in the brain tissue of two donors was investigated by aluminium-specific fluorescence microscopy. The aluminium content of brain tissue in MS was universally high with many tissues bearing concentrations in excess of 10 μg/g dry wt. (10 ppm) and some exceeding 50 ppm. There were no statistically significant relationships between brain lobes, donor age or donor gender. Aluminium-specific fluorescence successfully identified aluminium in brain tissue in both intracellular and extracellular locations. The association of aluminium with corpora amylacea suggests a role for aluminium in neurodegeneration in MS. Full article

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25 pages, 2971 KiB

Open AccessArticle

Contaminations of Soil and Two Capsicum annuum Generations Irrigated by Reused Urban Wastewater Treated by Different Reed Beds

by Suhad A. A. A. N. Almuktar^1,2, Suhail N. Abed¹ and Miklas Scholz^1,3,4,*

¹ Civil Engineering Research Group, School of Computing, Science and Engineering, The University of Salford, Salford M5 4WT, UK

² Department of Architectural Engineering, Faculty of Engineering, The University of Basrah, Al Basrah 61001, Iraq

³ Division of Water Resources Engineering, Department of Building and Environmental Technology, Faculty of Engineering, Lund University, P.O. Box 118, 22100 Lund, Sweden

⁴ Department of Civil Engineering Science, School of Civil Engineering and the Built Environment, University of Johannesburg, Kingsway Campus, P.O. Box 524, Aukland Park 2006, Johannesburg, South Africa

Int. J. Environ. Res. Public Health 2018, 15(8), 1776; https://doi.org/10.3390/ijerph15081776 - 18 Aug 2018

Cited by 3 | Viewed by 4625

Abstract

Background: In order to save potable water, this study aims to evaluate the contamination of soil and Capsicum annuum L. (chilli) watered with urban wastewater (sewage) pre-treated by various wetland systems. Methods: The appropriateness of wetland outflow for irrigation when applying [...] Read more.

Background: In order to save potable water, this study aims to evaluate the contamination of soil and Capsicum annuum L. (chilli) watered with urban wastewater (sewage) pre-treated by various wetland systems. Methods: The appropriateness of wetland outflow for irrigation when applying reused wastewater with high contamination of minerals and pathogens was assessed. The impact of wastewaters pre-treated by various wetlands on soil and harvest was tested in terms of mineral and biological contamination risk. Results: The wetlands met the standards for irrigation water for most water quality variables. However, the thresholds for key water quality parameters were significantly (p < 0.05) exceeded. The highest values for total coliforms, ammonium-nitrogen, phosphorus and potassium were 157,072 CFU/100 mL, 8.5 mg/L, 5.0 mg/L, and 7.0 mg/L, respectively. The harvest was moderately polluted only by zinc according to vegetable quality standards (threshold of 50 mg/kg). Zinc concentrations for Filters 2, 4, 6, 7 and 8 were 35.8, 60.6, 65.1, 65.5 and 53.2 mg/kg, respectively. No bacterial contamination was detected. Conclusions: Treatment of domestic wastewater applying constructed wetlands and subsequent recycling of the treated wastewater for irrigation of crops is a good substitute to the traditional application of drinking water for irrigation purposes. Full article

(This article belongs to the Special Issue Frontiers in Environmental Engineering)

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17 pages, 3759 KiB

Open AccessReview

Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and Meta-Analysis of Observational Studies

by Simone M. Costa¹, Carolina C. Martins², Mânia Q. C. Pinto¹, Mara Vasconcelos² and Mauro H. N. G. Abreu^2,*

¹ Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais 39401-089, Brazil

² Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 31270-901, Brazil

Int. J. Environ. Res. Public Health 2018, 15(8), 1775; https://doi.org/10.3390/ijerph15081775 - 18 Aug 2018

Cited by 66 | Viewed by 7521

Abstract

This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. [...] Read more.

This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. With regard to the meta-analysis, statistical heterogeneity was evaluated by I², and the random effect model was used when it was high. A subgroup analysis was conducted for socioeconomic indicators, and a meta-regression was performed. Publication bias was assessed through Egger’s test. Sixty-one studies were included in the systematic review and 25 were included in the meta-analysis. All of the studies were published between 1975 and 2016. The most frequent socioeconomic indicators were schooling, income, and socioeconomic status (SES). In the quantitative analysis, the DMFT (decayed, missing, filled teeth) variation was attributed to the studies’ heterogeneity. The increase of 10.35 units in the proportion of people with lower SES was associated with an increase of one unit in DMFT, p = 0.050. The findings provide evidence that populations with the highest proportions of people with low SES are associated with a greater severity of caries. The results suggest the need for actions to reduce the inequalities in oral health (PROSPERO [CRD42017074434]). Full article

(This article belongs to the Special Issue Socioeconomic Inequality of Health)

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13 pages, 1278 KiB

Open AccessArticle

Live and Let Die? Life Cycle Human Health Impacts from the Use of Tire Studs

by Anna Furberg^*

, Rickard Arvidsson

and Sverker Molander

Environmental Systems Analysis, Chalmers University of Technology, Gothenburg 412 96, Sweden

Int. J. Environ. Res. Public Health 2018, 15(8), 1774; https://doi.org/10.3390/ijerph15081774 - 17 Aug 2018

Cited by 9 | Viewed by 5847

Abstract

Studded tires are used in a number of countries during winter in order to prevent accidents. The use of tire studs is controversial and debated because of human health impacts from increased road particle emissions. The aims of this study are to assess [...] Read more.

Studded tires are used in a number of countries during winter in order to prevent accidents. The use of tire studs is controversial and debated because of human health impacts from increased road particle emissions. The aims of this study are to assess whether the use of tire studs in a Scandinavian studded passenger car actually avoids or causes health impacts from a broader life cycle perspective, and to assess the distribution of these impacts over the life cycle. Life cycle assessment is applied and the disability-adjusted life years indicator is used to quantify the following five types of health impacts: (1) impacts saved in the use phase, (2) particle emissions in the use phase, (3) production system emissions, (4) occupational accidents in the production system, and (5) conflict casualties from revenues of cobalt mining. The results show that the health benefits in the use phase in general are outweighed by the negative impacts during the life cycle. The largest contribution to these negative human health impacts are from use phase particle emissions (67–77%) and occupational accidents during artisanal cobalt mining (8–18%). About 23–33% of the negative impacts occur outside Scandinavia, where the benefits occur. The results inform the current debate and highlight the need for research on alternatives to tire studs with a positive net health balance. Full article

(This article belongs to the Section Environmental Health)

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16 pages, 1304 KiB

Open AccessReview

Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies

by Pedro Henrique Franca Gois^1,2,*, Martin Wolley^1,2, Dwarakanathan Ranganathan^1,2 and Antonio Carlos Seguro³

¹ Kidney Health Service, Royal Brisbane and Women’s Hospital, Herston QLD 4029, Australia

² Medical School, University of Queensland, Herston QLD 4029, Australia

³ Laboratory of Medical Research-LIM12, Nephrology Department, University of São Paulo School of Medicine, São Paulo, CEP 01246-903, Brazil

Int. J. Environ. Res. Public Health 2018, 15(8), 1773; https://doi.org/10.3390/ijerph15081773 - 17 Aug 2018

Cited by 85 | Viewed by 13682

Abstract

Vitamin D (VD) is a pro-hormone essential for life in higher animals. It is present in few types of foods and is produced endogenously in the skin by a photochemical reaction. The final step of VD activation occurs in the kidneys involving a [...] Read more.

Vitamin D (VD) is a pro-hormone essential for life in higher animals. It is present in few types of foods and is produced endogenously in the skin by a photochemical reaction. The final step of VD activation occurs in the kidneys involving a second hydroxylation reaction to generate the biologically active metabolite 1,25(OH)₂-VD. Extrarenal 1α-hydroxylation has also been described to have an important role in autocrine and paracrine signaling. Vitamin D deficiency (VDD) has been in the spotlight as a major public healthcare issue with an estimated prevalence of more than a billion people worldwide. Among individuals with chronic kidney disease (CKD), VDD prevalence has been reported to be as high as 80%. Classically, VD plays a pivotal role in calcium and phosphorus homeostasis. Nevertheless, there is a growing body of evidence supporting the importance of VD in many vital non-skeletal biological processes such as endothelial function, renin-angiotensin-aldosterone system modulation, redox balance and innate and adaptive immunity. In individuals with CKD, VDD has been associated with albuminuria, faster progression of kidney disease and increased all-cause mortality. Recent guidelines support VD supplementation in CKD based on extrapolation from cohorts conducted in the general population. In this review, we discuss new insights on the multifactorial pathophysiology of VDD in CKD as well as how it may negatively modulate different organs and systems. We also critically review the latest evidence and controversies of VD monitoring and supplementation in CKD patients. Full article

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

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15 pages, 306 KiB

Open AccessArticle

Insight into Patients’ Experiences of Cancer Care in Taiwan: An Instrument Translation and Cross-Cultural Adaptation Study

by Tsung-Hsien Yu¹

, Kuo-Piao Chung^2,3,*, Yu-Chi Tung^2,3

and Hsin-Yun Tsai²

¹ Department of Health Care Management, National Taipei University of Nursing and Science, Taipei 108, Taiwan

² Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei 100, Taiwan

³ Population Health Research Center, National Taiwan University, Taipei 100, Taiwan

Int. J. Environ. Res. Public Health 2018, 15(8), 1772; https://doi.org/10.3390/ijerph15081772 - 17 Aug 2018

Cited by 2 | Viewed by 3959

Abstract

Background: Since Taiwan launched the Cancer Prevention Act in 2003, several prevention strategies and early detection programs have been implemented to reduce the incidence, morbidity and mortality rates of cancer. However, most of the programs have concentrated on healthcare providers. Evaluations from [...] Read more.

Background: Since Taiwan launched the Cancer Prevention Act in 2003, several prevention strategies and early detection programs have been implemented to reduce the incidence, morbidity and mortality rates of cancer. However, most of the programs have concentrated on healthcare providers. Evaluations from the patient’s perspective have been lacking. Thus, in this study a cancer patient experience questionnaire was developed in the Taiwanese context and a preliminary nationwide investigation was conducted on the status of cancer care from the patient’s perspective. Methods: An extensive literature review was first conducted to collect information on the existing instruments used to measure the cancer patient’s experience. Thereafter, a multidisciplinary expert panel was convened to select an optimal instrument based on the IOM’s six domains for evaluating patient-centered care. The European Organisation for Research and Treatment of Cancer (EORTC) translation procedure was applied to the questionnaire for cross-cultural adaptation. A nationwide field test was then implemented at certificated cancer care hospitals. Results: Fifteen questionnaires were collected for the literature review. The expert panel selected the National Cancer Patient Experience Survey based on the IOM’s recommendations. After cross-cultural translation of the questionnaire, a total of 4000 questionnaires were administered in 19 certificated cancer care hospitals and two major cancer patient associations, with 1010 being returned (25.25% response rate). Most of the respondents were middle-aged, and 70% were female. The respondents reported they had a good experience with cancer care, except for “Home care and support” and “Finding out what was wrong with you”. Stratified analysis was conducted, with the results showing that the cancer patients’ experiences varied depending on their sociodemographic and cancer-related characteristics. Conclusions: A Taiwanese version of the cancer patient experience survey questionnaire was developed. Its results showed that the cancer patient’s experiences varied, depending on the patient’s age, cancer type, and cancer history. This study can be used as a basis to establish a patient-centered care model for cancer care in Taiwan. Full article

(This article belongs to the Section Health Economics)

12 pages, 1103 KiB

Open AccessFeature PaperArticle

Short-Term Effects of Heat on Mortality and Effect Modification by Air Pollution in 25 Italian Cities

by Matteo Scortichini¹, Manuela De Sario¹

, Francesca K. De’Donato¹, Marina Davoli¹, Paola Michelozzi¹ and Massimo Stafoggia^1,2,*

¹ Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy

² Institute of Environmental medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden

Int. J. Environ. Res. Public Health 2018, 15(8), 1771; https://doi.org/10.3390/ijerph15081771 - 17 Aug 2018

Cited by 63 | Viewed by 7260

Abstract

Evidence on the health effects of extreme temperatures and air pollution is copious. However few studies focused on their interaction. The aim of this study is to evaluate daily PM10 and ozone as potential effect modifiers of the relationship between temperature and natural [...] Read more.

Evidence on the health effects of extreme temperatures and air pollution is copious. However few studies focused on their interaction. The aim of this study is to evaluate daily PM10 and ozone as potential effect modifiers of the relationship between temperature and natural mortality in 25 Italian cities. Time-series analysis was run for each city. To evaluate interaction, a tensor product between mean air temperature (lag 0–3) and either PM10 or ozone (both lag 0–5) was defined and temperature estimates were extrapolated at low, medium, and high levels of pollutants. Heat effects were estimated as percent change in mortality for increases in temperature between 75th and 99th percentiles. Results were pooled by geographical area. Differential temperature-mortality risks by air pollutants were found. For PM10, estimates ranged from 3.9% (low PM10) to 14.1% (high PM10) in the North, from 3.6% to 24.4% in the Center, and from 7.5% to 21.6% in the South. Temperature-related mortality was similarly modified by ozone in northern and central Italy, while no effect modification was observed in the South. This study underlines the synergistic effects of heat and air pollution on mortality. Considering the predicted increase in heat waves and stagnation events in the Mediterranean countries such as Italy, it is time to enclose air pollution within public health heat prevention plans. Full article

(This article belongs to the Special Issue Climate Change, Extreme Temperatures, Air Pollution, and Health)

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10 pages, 616 KiB

Open AccessArticle

Association of Bisphenol A Exposure with LINE-1 Hydroxymethylation in Human Semen

by Youping Tian^1,2,†, Xiaoyu Zhou^1,†, Maohua Miao¹, De-kun Li³, Ziliang Wang¹, Runsheng Li^1,*, Hong Liang^1,* and Wei Yuan¹

¹ Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai 200237, China

² School of Public Health, Fudan University, Shanghai 200032, China

³ Division of Research, Kaiser Foundation Research Institute, Kaiser Permanente Northern California, Oakland, CA 94612, USA

^† These two authors contributed equally.

Int. J. Environ. Res. Public Health 2018, 15(8), 1770; https://doi.org/10.3390/ijerph15081770 - 17 Aug 2018

Cited by 38 | Viewed by 4362

Abstract

Bisphenol A (BPA), an exogenous endocrine-disrupting chemical, has been shown to alter DNA methylation. However, little information is available about the effect of BPA exposure on DNA hydroxymethylation in humans. The objective of the present study was to examine whether BPA exposure was [...] Read more.

Bisphenol A (BPA), an exogenous endocrine-disrupting chemical, has been shown to alter DNA methylation. However, little information is available about the effect of BPA exposure on DNA hydroxymethylation in humans. The objective of the present study was to examine whether BPA exposure was associated with DNA hydroxymethylation in human semen samples. We measured urine BPA levels and LINE-1 hydroxymethylation in 158 male factory workers selected from an occupational cohort study conducted in China between 2004 and 2008. Among them, there were 72 male workers with occupational BPA exposure (BPA-exposed group) and 86 male workers without occupational BPA exposure (unexposed group). Multivariate linear regression models were used to examine the association of exposure to BPA with LINE-1 hydroxymethylation. LINE-1 was more highly hydroxymethylated in the BPA-exposed group than in the unexposed group (median 12.97% vs. 9.68%, respectively; p < 0.05), after adjusting for the potential confounders. The medians of 5-hydroxymethylcytosine (5hmC) generally increased with increasing urine BPA levels: 8.79%, 12.16%, 11.53%, and 13.45%, for undetected BPA and corresponding tertiles for the detected BPA, respectively. After analysis using data at individual level, our findings indicated that BPA exposure was associated with alterations of sperm LINE-1 hydroxymethylation, which might have implications for understanding the mechanisms underlying BPA-induced adverse effects on male reproductive function. Full article

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11 pages, 1219 KiB

Open AccessArticle

Effect of Hypothermia in the Emergency Department on the Outcome of Trauma Patients: A Cross-Sectional Analysis

by Ting-Min Hsieh¹, Pao-Jen Kuo², Shiun-Yuan Hsu², Peng-Chen Chien², Hsiao-Yun Hsieh² and Ching-Hua Hsieh^2,*

¹ Division of Trauma Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Song District, Kaohsiung 833, Taiwan

² Division of Plastic Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Song District, Kaohsiung 833, Taiwan

Int. J. Environ. Res. Public Health 2018, 15(8), 1769; https://doi.org/10.3390/ijerph15081769 - 17 Aug 2018

Cited by 23 | Viewed by 5873

Abstract

This study aimed to assess whether hypothermia is an independent predictor of mortality in trauma patients in the condition of defining hypothermia as body temperatures of <36 °C. Data of all hospitalized adult trauma patients recorded in the Trauma Registry System at a [...] Read more.

This study aimed to assess whether hypothermia is an independent predictor of mortality in trauma patients in the condition of defining hypothermia as body temperatures of <36 °C. Data of all hospitalized adult trauma patients recorded in the Trauma Registry System at a level I trauma center between 1 January 2009 and 12 December 2015 were retrospectively reviewed. A multivariate logistic regression analysis was performed in order to identify factors related to mortality. In addition, hypothermia and normothermia were defined as temperatures <36 °C and from 36 °C to 38 °C, respectively. Propensity score-matched study groups of hypothermia and normothermia patients in a 1:1 ratio were grouped for mortality assessment after adjusting for potential confounders such as age, sex, preexisting comorbidities, and injury severity score (ISS). Of 23,705 enrolled patients, a total of 401 hypothermic patients and 13,368 normothermic patients were included in this study. Only 3.0% of patients had hypothermia upon arrival at the emergency department (ED). Compared to normothermic patients, hypothermic patients had a significantly higher rate of abbreviated injury scale (AIS) scores of ≥3 in the head/neck, thorax, and abdomen and higher ISS. The mortality rate in hypothermic patients was significantly higher than that in normothermic patients (13.5% vs. 2.3%, odds ratio (OR): 6.6, 95% confidence interval (CI): 4.86–9.01, p < 0.001). Of the 399 well-balanced propensity score-matched pairs, there was no significant difference in mortality (13.0% vs. 9.3%, OR: 1.5, 95% CI: 0.94–2.29, p = 0.115). However, multivariate logistic regression analysis revealed that patients with low body temperature were significantly associated with the mortality outcome. This study revealed that low body temperature is associated with the mortality outcome in the multivariate logistic regression analysis but not in the propensity score matching (PSM) model that compared patients with hypothermia defined as body temperatures of <36 °C to those who had normothermia. These contradicting observations indicated the limitation of the traditional definition of body temperature for the diagnosis of hypothermia. Prospective randomized control trials are needed to determine the relationship between hypothermia following trauma and the clinical outcome. Full article

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8 pages, 313 KiB

Open AccessConference Report

Academic Response to Storm-Related Natural Disasters—Lessons Learned

by Jerris R. Hedges^1,*

, Karam F. A. Soliman²

, Gene D’Amour³, Dong Liang⁴, Carlos E. Rodríguez-Díaz⁵

, Kenira Thompson⁶, Josefina Romaguera⁷, Silvia E. Rabionet Sabater^5,8 and Richard Yanagihara¹

¹ John A. Burns School of Medicine, University of Hawaii-Manoa, Honolulu, HI 96813, USA

² College of Pharmacy & Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA

³ Office of the President, Xavier University of Louisiana, New Orleans, LA 70125, USA

⁴ College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA

⁵ Graduate School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA

⁶ Ponce Research Institute, Ponce Health Sciences University, Ponce, PR 00732, USA

⁷ Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico-Medical Sciences Campus, San Juan, PR 00936, USA

⁸ College of Pharmacy, Nova Southeastern University, Fort-Lauderdale-Davie, FL 33314, USA

Int. J. Environ. Res. Public Health 2018, 15(8), 1768; https://doi.org/10.3390/ijerph15081768 - 17 Aug 2018

Cited by 6 | Viewed by 6162

Abstract

On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in [...] Read more.

On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in Puerto Rico, Florida, and Texas. The presenters reviewed emergency response measures taken by their institutions to maintain community health care access and delivery, the storm-related impact on clinical and research infrastructure, and strategies to retain locally grown clinical expertise and translational science research talent in the aftermath of natural disasters. A longer-term perspective was provided through a comparative review of lessons learned by one New Orleans-based institution (now more than a decade post-storm) in the aftermath of Hurricane Katrina. Caring for the internal and external communities associated with each institution and addressing the health disparities exacerbated by storm-related events is one key strategy that will pay long-term dividends in the survival of the academic institutions and the communities they serve. Full article

(This article belongs to the Special Issue Proceedings of Research Centers at Minority Institutions (RCMI) Translational Science 2017 Conference)

20 pages, 340 KiB

Open AccessArticle

Ethiopian Orthodox Fasting and Lactating Mothers: Longitudinal Study on Dietary Pattern and Nutritional Status in Rural Tigray, Ethiopia

by Beruk Berhanu Desalegn^1,2,*, Christine Lambert², Simon Riedel², Tegene Negese¹ and Hans Konrad Biesalski²

¹ College of Agriculture, Hawassa University, Postal code: 05, Hawassa, Ethiopia

² Institute of Biological Chemistry and Nutrition, University of Hohenheim, Garbenstr. 30, 70593 Stuttgart, Germany

Int. J. Environ. Res. Public Health 2018, 15(8), 1767; https://doi.org/10.3390/ijerph15081767 - 17 Aug 2018

Cited by 46 | Viewed by 7620

Abstract

About half of Ethiopians belong to the Orthodox Tewahedo religion. Annually, more than 200 days are dedicated to religious fasting, which includes abstaining from all types of food, animal source foods, and water. However, the association of fasting with undernutrition remains unknown in [...] Read more.

About half of Ethiopians belong to the Orthodox Tewahedo religion. Annually, more than 200 days are dedicated to religious fasting, which includes abstaining from all types of food, animal source foods, and water. However, the association of fasting with undernutrition remains unknown in Ethiopia. Therefore, dietary pattern and nutritional status of lactating women during lent fasting and non-fasting periods were studied, and predictor variables for maternal underweight were identified. To achieve this, lactating mothers in lent fasting (N = 572) and non-fasting (N = 522) periods participated from rural Tigray, Northern Ethiopia. Average minimum diet diversity (MDD-W) was computed from two 24-h recalls, and nutritional status was assessed using body mass index (BMI). Binary logistic regression was used to identify potential predictors of maternal underweight. Wilcoxon signed-rank (WSRT) and McNemar’s tests were used for comparison of the two periods. The prevalence of underweight in fasting mothers was 50.6%. In the multivariate logistic regression model, younger age, sickness in the last four weeks preceding the survey, fasting during pregnancy, lactation periods, grandfathers’ as household decision makers, previous aid experience, non-improved water source, and not owning chicken were positively associated with maternal underweight. In WSRT, there was no significant (p > 0.05) difference on maternal body weight and BMI between periods. The average number of meals, diet diversity, and animal source foods (ASFs), consumption scores were significantly increased in non-fasting compared to fasting periods in both fasting and non-fasting mothers (p < 0.001, p < 0.05, and p < 0.001, respectively). Consumption of dark green leafy vegetables was higher in the fasting period (11%) than non-fasting (3.6%), in the study population. As a conclusion, Ethiopian Orthodox fasting negatively affected maternal nutritional status and dietary pattern in rural Tigray, Northern Ethiopia. To reduce maternal malnutrition in Ethiopia, existing multi-sectoral nutrition intervention strategies, should include religious institutions in a sustainable manner. Full article

14 pages, 306 KiB

Open AccessArticle

Food Insecurity among Older Aboriginal and Torres Strait Islanders

by Jeromey B. Temple^1,*

and Joanna Russell²

¹ Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia

² School of Health and Society, University of Wollongong, Wollongong 2522, Australia

Int. J. Environ. Res. Public Health 2018, 15(8), 1766; https://doi.org/10.3390/ijerph15081766 - 17 Aug 2018

Cited by 24 | Viewed by 9489

Abstract

It is well established that Indigenous populations are at a heightened risk of food insecurity. Yet, although populations (both Indigenous and non-Indigenous) are ageing, little is understood about the levels of food insecurity experienced by older Indigenous peoples. Using Australian data, this study [...] Read more.

It is well established that Indigenous populations are at a heightened risk of food insecurity. Yet, although populations (both Indigenous and non-Indigenous) are ageing, little is understood about the levels of food insecurity experienced by older Indigenous peoples. Using Australian data, this study examined the prevalence and correlates of food insecurity among older Aboriginal and Torres Strait Islanders. Using nationally representative data, we employed ordinal logistic regression models to investigate the association between socio-demographic characteristics and food insecurity. We found that 21% of the older Aboriginal and Torres Strait Islander population were food insecure, with 40% of this group exposed to food insecurity with food depletion and inadequate intake. This places this population at a 5 to 7-fold risk of experiencing food insecurity relative to their older non-Indigenous peers. Measures of geography, language and low socio-economic status were highly associated with exposure to food insecurity. Addressing food insecurity offers one pathway to reduce the disparity in health outcomes between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Policies that consider both remote and non-remote Australia, as well as those that involve Aboriginal people in their design and implementation are needed to reduce food insecurity. Full article

(This article belongs to the Special Issue Addressing Food and Nutrition Security in Developed Countries)

13 pages, 3251 KiB

Open AccessArticle

Methylmercury in Industrial Harbor Sediments in Taiwan: First Observations on Its Occurrence, Distribution, and Measurement

by Chih-Feng Chen, Yun-Ru Ju, Guan-Ting Lin, Chiu-Wen Chen^* and Cheng-Di Dong^*

Department of Marine Environmental Engineering, National Kaohsiung University of Science and Technology, Kaohsiung 81157, Taiwan

Int. J. Environ. Res. Public Health 2018, 15(8), 1765; https://doi.org/10.3390/ijerph15081765 - 16 Aug 2018

Cited by 9 | Viewed by 4261

Abstract

The distribution of methylmercury (MeHg) and total mercury (T-Hg) in sediments of the estuaries and the basin in Kaohsiung Harbor (Taiwan) is studied. MeHg in the sediment samples was determined using gas chromatography-mass spectrometry. The certified reference material of sediments with respect to [...] Read more.

The distribution of methylmercury (MeHg) and total mercury (T-Hg) in sediments of the estuaries and the basin in Kaohsiung Harbor (Taiwan) is studied. MeHg in the sediment samples was determined using gas chromatography-mass spectrometry. The certified reference material of sediments with respect to the method showed the recovery efficiency between 97.4 and 103.6% which confirmed the applicability of analysis method. The T-Hg and MeHg concentrations were between 149 to 9035 μg/kg and <0.31 to 17.7 μg/kg, respectively. The T-Hg and MeHg concentrations in the estuaries of Kaohsiung Harbor were relatively high. Results suggest that Hg in this studied area was likely contributed from the catchments of the rivers. The MeHg level was <0.01 to 2.66% of the T-Hg in the sediments. A positive correlation is obtained between MeHg, T-Hg, and total organic carbon in the sediments, whereas a negative correlation is observed between pH, oxidation-reduction potential, and MeHg concentration. The results further suggest that sediment characteristics contribute mainly to the distribution of MeHg. Full article

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17 pages, 1701 KiB

Open AccessReview

Moderators of School-Based Physical Activity Interventions on Cardiorespiratory Endurance in Primary School-Aged Children: A Meta-Regression

by Ryan D. Burns^1,*

, Timothy A. Brusseau¹

and You Fu²

¹ Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA

² School of Community Health Sciences, University of Nevada Reno, Reno, NV 89557, USA

Int. J. Environ. Res. Public Health 2018, 15(8), 1764; https://doi.org/10.3390/ijerph15081764 - 16 Aug 2018

Cited by 11 | Viewed by 5436

Abstract

The purpose of this study was to examine potential moderators of school-based physical activity interventions on cariorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past [...] Read more.

The purpose of this study was to examine potential moderators of school-based physical activity interventions on cariorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past 30 years. Studies were included if there was a control or comparison group, if the study sample included primary school-aged children, if the targeted outcome of cardiorespiratory endurance was objectively assessed, if the intervention was at least partially school-based, and if the effect estimate’s variability was reported. An inverse-variance random effects meta-regression was employed using the primary predictors of component number (single component or multi-component) and intervention length using 20 extracted studies with 23 total effects. The overall pooled effect on cardiorespiratory endurance was statistically significant (Hedges’ g = 0.30, 95% C.I.: 0.19–0.40; p < 0.001). Using random effects meta-regression, neither component number (b = −0.09, 95% C.I.: −0.40–0.23; p = 0.560) or intervention length (b = 0.001, 95% C.I.: −0.002–0.004; p = 0.427) yielded a significant modifying effect on cardiorespiratory endurance. School-based physical activity interventions have a significant pooled effect on cardiorespiratory endurance in primary school-aged children. Component number and intervention length does not modify this effect, suggesting other sources for between-study heterogeneity. Full article

(This article belongs to the Collection Physical Activity and Public Health)

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23 pages, 3123 KiB

Open AccessArticle

Exploring the Relationship between Ridesharing and Public Transit Use in the United States

by Yuanyuan Zhang^1,2

and Yuming Zhang^1,*

¹ School of Management, Shandong University, Jinan 250100, China

² Stern School of Business, New York University, New York, NY 10012, USA

Int. J. Environ. Res. Public Health 2018, 15(8), 1763; https://doi.org/10.3390/ijerph15081763 - 16 Aug 2018

Cited by 64 | Viewed by 7074

Abstract

Car travel accounts for the largest share of transportation-related greenhouse gas emissions in the United States (U.S.), leading to serious air pollution and negative health effects; approximately 76.3% of car trips are single-occupant. To reduce the negative externalities of cars, ridesharing and public [...] Read more.

Car travel accounts for the largest share of transportation-related greenhouse gas emissions in the United States (U.S.), leading to serious air pollution and negative health effects; approximately 76.3% of car trips are single-occupant. To reduce the negative externalities of cars, ridesharing and public transit are advocated as cost-effective and more environmentally sustainable alternatives. A better understanding of individuals’ uses of these two transport modes and their relationship is important for transport operators and policymakers; however, it is not well understood how ridesharing use is associated with public transit use. The objective of this study is to examine the relationships between the frequency and probability of ridesharing use and the frequency of public transit use in the U.S. Zero-inflated negative binomial regression models were employed to investigate the associations between these two modes, utilizing individual-level travel frequency data from the 2017 National Household Travel Survey. The survey data report the number of times the respondent had used ridesharing and public transit in the past 30 days. The results show that, generally, a one-unit increase in public transit use is significantly positively related to a 1.2% increase in the monthly frequency of ridesharing use and a 5.7% increase in the probability of ridesharing use. Additionally, the positive relationship between ridesharing and public transit use was more pronounced for people who live in areas with a high population density or in households with fewer vehicles. These findings highlight the potential for integrating public transit and ridesharing systems to provide easier multimodal transportation, promote the use of both modes, and enhance sustainable mobility, which are beneficial for the environment and public health. Full article

(This article belongs to the Special Issue Transportation-Related Air Pollution and Human Health)

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24 pages, 2214 KiB

Open AccessArticle

Drivers Analysis of CO₂ Emissions from the Perspective of Carbon Density: The Case of Shandong Province, China

by Feng Dong^1,*, Jingyun Li¹

, Yue-Jun Zhang^2,* and Ying Wang¹

¹ School of Management, China University of Mining and Technology, Xuzhou 221116, China

² Business School, Hunan University, Changsha 410082, China

Int. J. Environ. Res. Public Health 2018, 15(8), 1762; https://doi.org/10.3390/ijerph15081762 - 16 Aug 2018

Cited by 19 | Viewed by 4312

Abstract

Against the backgrounds of emission reduction targets promised by China, it is crucial to explore drivers of CO₂ emissions comprehensively for policy making. In this study, Shandong Province in China is taken as an example to investigate drivers in carbon density by [...] Read more.

Against the backgrounds of emission reduction targets promised by China, it is crucial to explore drivers of CO₂ emissions comprehensively for policy making. In this study, Shandong Province in China is taken as an example to investigate drivers in carbon density by using an extended Kaya identity and a logarithmic mean Divisia index model (LMDI) with two layers. It is concluded that there are eight positive driving factors of carbon density during 2000–2015, including traffic congestion, land urbanization, etc., and seven negative driving factors comprising energy intensity, economic structure, etc. Among these factors, economic growth and energy intensity are the main positive and negative driving factor, respectively. The contribution rate of traffic congestion and land urbanization is gradually increasing. Meanwhile, 15 driving factors are divided into five categories. Economic effect and urbanization effect are the primary positive drivers. Contrarily, energy intensity effect, structural effect, and scale effect contribute negative effects to the changes in carbon density. In the four stages, the contribution of urbanization to carbon density is inverted U. Overall, the results and suggestions can give support to decision maker to draw up relevant government policy. Full article

(This article belongs to the Section Environmental Science and Engineering)

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Int. J. Environ. Res. Public Health, Volume 15, Issue 8 (August 2018) – 231 articles

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