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  Subjects -> HEALTH AND SAFETY (Total: 1322 journals)
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HEALTH AND SAFETY (542 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 12)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 1)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 23)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 38)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 30)
American Journal of Health Promotion     Hybrid Journal   (Followers: 26)
American Journal of Health Sciences     Open Access   (Followers: 7)
American Journal of Health Studies     Full-text available via subscription   (Followers: 11)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 27)
American Journal of Public Health     Full-text available via subscription   (Followers: 210)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4)
Annals of Global Health     Open Access   (Followers: 10)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 12)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access   (Followers: 3)
Archive of Community Health     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 3)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 3)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 7)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 6)
BMC Pregnancy and Childbirth     Open Access   (Followers: 20)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 8)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 16)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 19)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 15)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 3)
Conflict and Health     Open Access   (Followers: 7)
Contraception and Reproductive Medicine     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 3)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 11)
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 17)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 19)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 6)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 4)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 6)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 6)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Food and Public Health     Open Access   (Followers: 12)
Frontiers in Public Health     Open Access   (Followers: 6)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 6)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 12)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 6)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 9)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 54)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 15)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 16)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 42)
Health Policy and Technology     Hybrid Journal   (Followers: 3)
Health Professional Student Journal     Open Access   (Followers: 2)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8)
Health Promotion Practice     Hybrid Journal   (Followers: 16)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 50)
Health Psychology Research     Open Access   (Followers: 19)
Health Psychology Review     Hybrid Journal   (Followers: 40)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 13)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 4)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 12)
Health, Risk & Society     Hybrid Journal   (Followers: 12)
Healthcare     Open Access   (Followers: 3)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Healthcare Technology Letters     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 11)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 6)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 2)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Public Health     Open Access  
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 2)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 6)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 33)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 8)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)

        1 2 3 | Last

Journal Cover International Journal of Environmental Research and Public Health
  [SJR: 0.883]   [H-I: 47]   [19 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1660-4601 - ISSN (Online) 1661-7827
   Published by MDPI Homepage  [198 journals]
  • IJERPH, Vol. 15, Pages 54: Favourable Perceptions of Electronic Cigarettes
           Relative to Cigarettes and the Associations with Susceptibility to
           Electronic Cigarette Use in Hong Kong Chinese Adolescents

    • Authors: Lok Leung, Sai Ho, Jianjiu Chen, Man Wang, Tai Lam
      First page: 54
      Abstract: We investigated favourable perceptions of electronic cigarettes (ECs) relative to cigarettes and their associations with EC use susceptibility in adolescents. Hong Kong Chinese Secondary 1–6 (U.S. grade 7–12) students (n = 40,202) were surveyed in 2014/2015 on EC use, cigarette smoking, favourable perceptions of ECs relative to cigarettes, EC use susceptibility, family smoking, and socio-demographic characteristics. Cox regression yielded adjusted prevalence ratios (APRs) of EC use susceptibility in never users, excluding those unaware of ECs. In all students, 8.9% were ever EC users, 47.2% reported favourable perceptions of ECs relative to cigarettes, such as less likely to cause accidents (25.2%) and less harmful to users (24.5%), and 28.9% did not know ECs. Among never EC users who were aware of ECs (n = 24,663), EC use susceptibility was associated with each of the favourable perceptions, especially greater attractiveness (APR 2.84, 95% CI 2.53–3.19), and better parental (2.75, 2.41–3.15) and school acceptability (2.56, 2.15–3.05). An increased number of favourable perceptions of ECs relative to cigarettes was associated more strongly with the susceptibility (p for trend < 0.001). Our findings inform strategies to reduce unwarranted favourable perceptions and prevent adolescent EC use.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-01
      DOI: 10.3390/ijerph15010054
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 55: Application of SCM with Bayesian B-Spline to
           Spatio-Temporal Analysis of Hypertension in China

    • Authors: Zirong Ye, Li Xu, Zi Zhou, Yafei Wu, Ya Fang
      First page: 55
      Abstract: Most previous research on the disparities of hypertension risk has neither simultaneously explored the spatio-temporal disparities nor considered the spatial information contained in the samples, thus the estimated results may be unreliable. Our study was based on the China Health and Nutrition Survey (CHNS), including residents over 12 years old in seven provinces from 1991 to 2011. Bayesian B-spline was used in the extended shared component model (SCM) for fitting temporal-related variation to explore spatio-temporal distribution in the odds ratio (OR) of hypertension, reveal gender variation, and explore latent risk factors. Our results revealed that the prevalence of hypertension increased from 14.09% in 1991 to 32.37% in 2011, with men experiencing a more obvious change than women. From a spatial perspective, a standardized prevalence ratio (SPR) remaining at a high level was found in Henan and Shandong for both men and women. Meanwhile, before 1997, the temporal distribution of hypertension risk for both men and women remained low. After that, notably since 2004, the OR of hypertension in each province increased to a relatively high level, especially in Northern China. Notably, the OR of hypertension in Shandong and Jiangsu, which was over 1.2, continuously stood out after 2004 for males, while that in Shandong and Guangxi was relatively high for females. The findings suggested that obvious spatial–temporal patterns for hypertension exist in the regions under research and this pattern was quite different between men and women.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-02
      DOI: 10.3390/ijerph15010055
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 56: The Development Evaluation of Economic Zones in

    • Authors: Wei Liu, Hong-Bo Shi, Zhe Zhang, Sang-Bing Tsai, Yuming Zhai, Quan Chen, Jiangtao Wang
      First page: 56
      Abstract: After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China’s economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-02
      DOI: 10.3390/ijerph15010056
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 57: Assessment of Nutritional Status of Infants
           Living in Arsenic-Contaminated Areas in Bangladesh and Its Association
           with Arsenic Exposure

    • Authors: Abul Milton, John Attia, Mohammad Alauddin, Mark McEvoy, Patrick McElduff, Sumaira Hussain, Ayesha Akhter, Shahnaz Akter, M. Islam, AM Ahmed, Vasu Iyengar, Md Islam
      First page: 57
      Abstract: Data is scarce on early life exposure to arsenic and its association with malnutrition during infancy. This study followed the nutritional status of a cohort of 120 infants from birth to 9 months of age in an arsenic contaminated area in Bangladesh. Anthropometric data was collected at 3, 6 and 9 months of the infant’s age for nutritional assessment whereas arsenic exposure level was assessed via tube well drinking water arsenic concentration at the initiation of the study. Weight and height measurements were converted to Z-scores of weight for age (WAZ-underweight), height for age (HAZ-stunting), weight for height (WHZ-wasting) for children by comparing with WHO growth standard. Arsenic exposure levels were categorized as <50 μg/L and ≥50 μg/L. Stunting rates (<−2 SD) were 10% at 3 months and 44% at both 6 and 9 months. Wasting rates (<−2 SD) were 23.3% at 3 months and underweight rates (<−2 SD) were 25% and 10% at 3 and 6 months of age, respectively. There was a significant association of stunting with household drinking water arsenic exposure ≥50 μg/L at age of 9 months (p = 0.009). Except for stunting at 9 months of age, we did not find any significant changes in other nutritional indices over time or with levels of household arsenic exposure in this study. Our study suggests no association between household arsenic exposure and under-nutrition during infancy; with limiting factors being small sample size and short follow-up. Difference in stunting at 9 months by arsenic exposure at ≥50 μg/L might be a statistical incongruity. Further longitudinal studies are warranted to establish any association.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-02
      DOI: 10.3390/ijerph15010057
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 58: Analysis of Gambling in the Media Related to
           Screens: Immersion as a Predictor of Excessive Use'

    • Authors: Jean-Jacques Rémond, Lucia Romo
      First page: 58
      Abstract: This study investigates the intricacies between the player interface proposed by the screens, (in particular on smartphone applications or in video games) and gambling. Recent research indicates connections between “immersion” and excessive screen practice. We want to understand the causal-effects between online gambling and the “immersion” variable and understand their relationship and its contingencies. This article empirically investigates whether and how it is possible to observe immersion with its sub-dimensions in gambling on different screens. The objective of this study was to analyze: (1) the costs and benefits associated with gambling practice on screens (2) the link between gambling practice and screen practice (video game, Internet, mobile screen); (3) to observe the propensity to immersion for individuals practicing gambling on screens; and (4) to examine the comorbidities and cognitive factors associated with the practice of gambling on screen. A total of 432 adults (212 men, 220 women), recruited from Ile-de-France (France), responded to a battery of questionnaires. Our study suggests that immersion variables make it possible to understand the cognitive participation of individuals towards screens in general, the practice of gambling on screens and the excessive practice of screens.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-02
      DOI: 10.3390/ijerph15010058
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 59: Arsenic Uptake, Toxicity, Detoxification, and
           Speciation in Plants: Physiological, Biochemical, and Molecular Aspects

    • Authors: Ghulam Abbas, Behzad Murtaza, Irshad Bibi, Muhammad Shahid, Nabeel Niazi, Muhammad Khan, Muhammad Amjad, Munawar Hussain, Natasha
      First page: 59
      Abstract: Environmental contamination with arsenic (As) is a global environmental, agricultural and health issue due to the highly toxic and carcinogenic nature of As. Exposure of plants to As, even at very low concentration, can cause many morphological, physiological, and biochemical changes. The recent research on As in the soil-plant system indicates that As toxicity to plants varies with its speciation in plants (e.g., arsenite, As(III); arsenate, As(V)), with the type of plant species, and with other soil factors controlling As accumulation in plants. Various plant species have different mechanisms of As(III) or As(V) uptake, toxicity, and detoxification. This review briefly describes the sources and global extent of As contamination and As speciation in soil. We discuss different mechanisms responsible for As(III) and As(V) uptake, toxicity, and detoxification in plants, at physiological, biochemical, and molecular levels. This review highlights the importance of the As-induced generation of reactive oxygen species (ROS), as well as their damaging impacts on plants at biochemical, genetic, and molecular levels. The role of different enzymatic (superoxide dismutase, catalase, glutathione reductase, and ascorbate peroxidase) and non-enzymatic (salicylic acid, proline, phytochelatins, glutathione, nitric oxide, and phosphorous) substances under As(III/V) stress have been delineated via conceptual models showing As translocation and toxicity pathways in plant species. Significantly, this review addresses the current, albeit partially understood, emerging aspects on (i) As-induced physiological, biochemical, and genotoxic mechanisms and responses in plants and (ii) the roles of different molecules in modulation of As-induced toxicities in plants. We also provide insight on some important research gaps that need to be filled to advance our scientific understanding in this area of research on As in soil-plant systems.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-02
      DOI: 10.3390/ijerph15010059
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 60: The Neonatal Intensive Care Unit: Environmental
           Stressors and Supports

    • Authors: Kristen Williams, Kayla Patel, Julie Stausmire, Christy Bridges, Mary Mathis, Jennifer Barkin
      First page: 60
      Abstract: The relationship between maternal mental health and infant development has been established in the literature. The Neonatal Intensive Care Unit (NICU) is a particularly challenging environment for new mothers as several natural processes are disrupted. The objective of this study is to elucidate protective factors and environmental deficits associated with the NICU. The experiences of forty-six (n = 46) mothers of infants admitted to a Level III NICU in the Midwestern United States, who responded to a related open-ended question, were analyzed thematically. Five themes related to the NICU environment emerged as being either stressful or helpful: (1) amount and quality of communication with medical staff, (2) bedside manner of medical staff, (3) feeling alienated from infant’s care, (4) support from other NICU mothers and families, and (5) NICU Physical Environment and Regulations. There is a need for medical staff training on awareness, communication, empathy, and other behaviors that might improve maternal (and parental) experiences in the NICU. The physical environment, including rules and regulations of the NICU, should be reexamined with family comfort in mind in addition to the clinical care of the infant.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-03
      DOI: 10.3390/ijerph15010060
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 61: The Emergence and Unfolding of Telemonitoring
           Practices in Different Healthcare Organizations

    • Authors: Jannie Christensen
      First page: 61
      Abstract: Telemonitoring, a sub-category of telemedicine, is promoted as a solution to meet the challenges in Western healthcare systems in terms of an increasing population of people with chronic conditions and fragmentation issues. Recent findings from large-scale telemonitoring programs reveal that these promises are difficult to meet in complex real-life settings which may be explained by concentrating on the practices that emerge when telemonitoring is used to treat patients with chronic conditions. This paper explores the emergence and unfolding of telemonitoring practices in relation to a large-scale, inter-organizational home telemonitoring program which involved 5 local health centers, 10 district nurse units, four hospitals, and 225 general practice clinics in Denmark. Twenty-eight interviews and 28 h of observations of health professionals and administrative staff were conducted over a 12-month period from 2014 to 2015. This study’s findings reveal how telemonitoring practices emerged and unfolded differently among various healthcare organizations. This study suggests that the emergence and unfolding of novel practices is the result of complex interplay between existing work practices, alterations of core tasks, inscriptions in the technology, and the power to either adopt or ignore such novel practices. The study enhances our understanding of how novel technology like telemonitoring impacts various types of healthcare organizations when implemented in a complex inter-organizational context.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-03
      DOI: 10.3390/ijerph15010061
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 62: An Empirical Study on Low-Carbon: Human
           Resources Performance Evaluation

    • Authors: Quan Chen, Sang-Bing Tsai, Yuming Zhai, Jie Zhou, Jian Yu, Li-Chung Chang, Guodong Li, Yuxiang Zheng, Jiangtao Wang
      First page: 62
      Abstract: Low-carbon logistics meets the requirements of a low-carbon economy and is the most effective operating model for logistic development to achieve sustainability by coping with severe energy consumption and global warming. Low-carbon logistics aims to reduce carbon intensity rather than simply reduce energy consumption and carbon emissions. Human resources are an important part of the great competition in the logistics market and significantly affect the operations of enterprises. Performance evaluations of human resources are particularly important for low-carbon logistics enterprises with scarce talents. Such evaluations in these enterprises are of great significance for their strategic development. This study constructed a human resource performance evaluation system to assess non-managerial employees’ low-carbon job capacity, job performance, and job attitude in the low-carbon logistics sector. The case study results revealed that the investigated company enjoyed initial success after having promoted low-carbon concepts and values to its non-managerial employees, and the success was demonstrated by excellent performance in its employees’ job attitude and knowledge. This study adopts the AHP method to reasonably determine an indicator system of performance evaluation and its weight to avoid certain human-caused bias. This study not only fills the gap in the related literature, but can also be applied to industrial practice.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-03
      DOI: 10.3390/ijerph15010062
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 63: Food Safety Knowledge, Attitudes and Behavior
           among Dairy Plant Workers in Beijing, Northern China

    • Authors: Yan Chen, Hua Ji, Li-Jun Chen, Rong Jiang, Yong-Ning Wu
      First page: 63
      Abstract: The safety of milk and dairy products has always been one of the focuses of consumers, the food industry and regulatory agencies. The purpose of this study was to gain insight into the food safety knowledge, attitudes and behavior of dairy plant workers. A cross-sectional survey was performed between May and August 2015 in three dairy plants in Beijing, northern China. A total of 194 dairy plant workers were interviewed to collect information on food safety knowledge, attitudes and self-reported behavior. The 194 dairy plant workers interviewed showed a sufficient level of knowledge (mean score 34 on a scale from 0–58), perfect attitudes (mean score 17 on a scale from 0–18), and perfect behavior (mean score 38 on a scale from 8–40). Only 39% of workers correctly determined specific pathogens or diseases that could be conveyed through milk and dairy products. 24% of workers knew the correct method of washing hands. A significant positive association was observed between attitudes and knowledge (p < 0.001) as well as behavior (p < 0.01). Education level was positively and significantly associated with food safety knowledge, attitudes, and behavior (p < 0.05). Workers in dairy enterprises in northern China have relatively low levels of knowledge, yet satisfactory attitudes and behavior. The knowledge of microbial food hazards and hand hygiene remains an issue that needs to be emphasized in future training programs. Education level is a determinant of attitudes and behavior with regard to the proper handling of milk and dairy products.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-03
      DOI: 10.3390/ijerph15010063
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 64: Evaluation of Well Designs to Improve Access to
           Safe and Clean Water in Rural Tanzania

    • Authors: Aminata Kilungo, Linda Powers, Nathan Arnold, Kelli Whelan, Kurt Paterson, Dale Young
      First page: 64
      Abstract: The objective of this study was to examine three well designs: drilled wells (20–30 m deep), closed dug wells (>5 m deep), and hand-dug open wells (<5 m deep), to determine the water quality for improving access to safe and clean water in rural communities. Heterotrophic plate count (HPC), total coliforms (TC), Escherichia coli (E. coli) and turbidity, were used to assess the water quality of 97 wells. Additionally, the study looked at the microflora diversity of the water, focusing on potential pathogens using outgrowth, PCR, and genome sequencing for 10 wells. Concentrations of TC for the open dug wells (4 × 104 CFU/100 mL) were higher than the drilled (2 × 103 CFU/100 mL) and closed dug wells (3 × 103 CFU/100 mL). E. coli concentration for drilled and closed dug wells was <22 MPN (most probable number)/100 mL, but higher for open wells (>154 MPN/100 mL). The drilled well turbidity (11 NTU) was within the standard deviation of the closed well (28 NTU) compared to open dug wells (49 NTU). Drilled and closed wells had similar microbial diversity. There were no significant differences between drilled and closed dug wells. The covering and lining of hand-dug wells should be considered as an alternative to improve access to safe and clean water in rural communities.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010064
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 65: Systematic Screening for Occupational Exposures
           in Lung Cancer Patients: A Prospective French Cohort

    • Authors: Olivia Pérol, Barbara Charbotel, Lionel Perrier, Sandrine Bonnand, Elodie Belladame, Virginie Avrillon, Paul Rebattu, Frédéric Gomez, Géraldine Lauridant, Maurice Pérol, Beatrice Fervers
      First page: 65
      Abstract: Occupational lung cancers are under-reported and under-compensated worldwide. We assessed systematic screening for occupational exposure to carcinogens combining a self-administered questionnaire and an occupational consultation to improve the detection of occupational lung cancers and their compensation. Social deprivation and the costs of this investigation were estimated. Patients with lung cancer received a self-administered questionnaire to collect their job history, potential exposure to carcinogens and deprivation. A physician assessed the questionnaire and recommended an occupational consultation if necessary. During the consultation, a physician assessed if the lung cancer was work-related and, if it was, delivered a medical certificate to claim for compensation. Over 18 months, 440 patients received the self-administered questionnaire: 234 returned a completed questionnaire and a consultation was required for 120 patients. Compensation was judged possible for 41 patients. Among the 35 medical certificates delivered, 19 patients received compensation. Nearly half the patients (46%) were assessed as socially deprived and these patients took significantly longer to return the questionnaire compared with those who were not deprived. The mean cost of the process was €62.65 per patient. Our results showed a systematic self-administered questionnaire can be used to identify patients potentially exposed to carcinogens and to improve compensation.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010065
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 66: The Human Exposure Potential from Propylene
           Releases to the Environment

    • Authors: David Morgott
      First page: 66
      Abstract: A detailed literature search was performed to assess the sources, magnitudes and extent of human inhalation exposure to propylene. Exposure evaluations were performed at both the community and occupational levels for those living or working in different environments. The results revealed a multitude of pyrogenic, biogenic and anthropogenic emission sources. Pyrogenic sources, including biomass burning and fossil fuel combustion, appear to be the primary contributors to atmospheric propylene. Despite a very short atmospheric lifetime, measurable levels could be detected in highly remote locations as a result of biogenic release. The indoor/outdoor ratio for propylene has been shown to range from about 2 to 3 in non-smoking homes, which indicates that residential sources may be the largest contributor to the overall exposure for those not occupationally exposed. In homes where smoking takes place, the levels may be up to thirty times higher than non-smoking residences. Atmospheric levels in most rural regions are typically below 2 ppbv, whereas the values in urban levels are much more variable ranging as high as 10 ppbv. Somewhat elevated propylene exposures may also occur in the workplace; especially for firefighters or refinery plant operators who may encounter levels up to about 10 ppmv.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010066
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 67: Risk Assessment for Children Exposed to Arsenic
           on Baseball Fields with Contaminated Fill Material

    • Authors: Alesia Ferguson, Jennifer Black, Isaac Sims, Jennifer Welday, Samir Elmir, Kendra Goff, J. Higginbotham, Helena Solo-Gabriele
      First page: 67
      Abstract: Children can be exposed to arsenic through play areas which may have contaminated fill material from historic land use. The objective of the current study was to evaluate the risk to children who play and/or spend time at baseball fields with soils shown to have arsenic above background levels. Arsenic in soils at the study sites located in Miami, FL, USA showed distinct distributions between infield, outfield, and areas adjacent to the fields. Using best estimates of exposure factors for children baseball scenarios, results show that non-cancer risks depend most heavily upon the age of the person and the arsenic exposure level. For extreme exposure scenarios evaluated in this study, children from 1 to 2 years were at highest risk for non-cancer effects (Hazard Quotient, HQ > 2.4), and risks were higher for children exhibiting pica (HQ > 9.7) which shows the importance of testing fill for land use where children may play. At the study sites, concentration levels of arsenic resulted in a range of computed cancer risks that differed by a factor of 10. In these sites, the child’s play position also affected risk. Outfield players, with a lifetime exposure to these arsenic levels, could have 10 times more increased chance of experiencing cancers associated with arsenic (i.e., lung, bladder, skin) in comparison to infielders. The distinct concentration distributions observed between these portions of the baseball fields emphasize the need to delineate contaminated areas in public property where citizens may spend more free time. This study also showed a need for more tools to improve the risk estimates for child play activities. For instance, more refined measurements of exposure factors for intake (e.g., inhalation rates under rigorous play activities, hand to mouth rates), exposure frequency (i.e., time spent in various activities) and other exposure factors (e.g., soil particulate emission rates at baseball play fields) can help pinpoint risk on baseball fields where arsenic levels may be a concern.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010067
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 68: Self-Medication Practice and Associated Factors
           among Residents in Wuhan, China

    • Authors: Xiaosheng Lei, Heng Jiang, Chaojie Liu, Adamm Ferrier, Janette Mugavin
      First page: 68
      Abstract: Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in the survey to collect information of self-medication behavior. Multivariable logistic regression analyses were used to measure correlates of the prevalence of self-medication. Results: Nearly half of the respondents would select self-medication, and 39.1% would see a doctor if they felt sick. The most common self-medicated illnesses were cold and cough, cardiovascular disease and gastrointestinal disease. The main reasons for self-medication were that the illness was not severe (enough) to see the doctor (45%); the patient did not think that the trouble of seeing a doctor was worth the effort (23%); the patient had no time to see the doctor (12%), and the patient did not want to pay high medical costs (15%). Logistic regression results suggested that respondents tended to select self-medication if the illness was minor or short-term (less than seven days). Conclusions: Our findings suggest that more strict regulation on over-the-counter medicines may be required to reduce health risks related to self-medication. Targeted health education on the risks of self-medication should be considered.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010068
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 69: Dynamic Impact of Online Word-of-Mouth and
           Advertising on Supply Chain Performance

    • Authors: Jian Feng, Bin Liu
      First page: 69
      Abstract: Cooperative (co-op) advertising investments benefit brand goodwill and further improve supply chain performance. Meanwhile, online word-of-mouth (OWOM) can also play an important role in supply chain performance. On the basis of co-op advertising, this paper considers a single supply chain structure led by a manufacturer and examines a fundamental issue concerning the impact of OWOM on supply chain performance. Firstly, by the method of differential game, this paper analyzes the dynamic impact of OWOM and advertising on supply chain performance (i.e., brand goodwill, sales, and profits) under three different supply chain decisions (i.e., only advertising, and manufacturers with and without sharing cost of OWOM with retailers). We compare and analyze the optimal strategies of advertising and OWOM under the above different supply chain decisions. Secondly, the system dynamics model is established to reflect the dynamic impact of OWOM and advertising on supply chain performance. Finally, three supply chain decisions under two scenarios, strong brand and weak brand, are analyzed through the system dynamics simulation. The results show that the input of OWOM can enhance brand goodwill and improve earnings. It further promotes the OWOM reputation and improves the supply chain performance if manufacturers share the cost of OWOM with retailers. Then, in order to eliminate the retailers from word-of-mouth fraud and establish a fair competition mechanism, the third parties (i.e., regulators or e-commerce platforms) should take appropriate punitive measures against retailers. Furthermore, the effect of OWOM on supply chain performance under a strong brand differed from those under a weak brand. Last but not least, if OWOM is improved, there would be more remarkable performance for the weak brand than that for the strong brand in the supply chain.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010069
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 70: Implicit Messages Regarding Unhealthy
           Foodstuffs in Chinese Television Advertisements: Increasing the Risk of

    • Authors: Angela Chang, Peter Schulz, Tony Schirato, Brian Hall
      First page: 70
      Abstract: Previous studies indicated that television (TV) advertising is associated with higher rates of obesity. The rate of obesity and overweight continues to rise in mainland China, bringing into question whether TV advertising to young audiences might be partly to blame. This study investigated messaging delivered through TV advertisements regarding healthy and unhealthy foodstuffs. A total of 42 major food brands and 480 advertisements were analysed for content in this study. The results showed that the majority of TV spots advertised products with poor nutritional content and had a potential to mislead audiences concerning products’ actual nutritional value. The tactics of repetition and appeals of premium offerings on food brands have a potential to influence the purchase intentions. Additional qualitative observation involving the social bond, social context and cultural factors pertaining to mood alterations were highlighted. The discussion addressed product attributes reflected by culture and the implicit messages of marketing claims may increase the risk of obesity. Thus, public health policymakers and researchers were encouraged to act urgently to evaluate the obesity risks of unhealthy food advertised in the media and to support healthy foods.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010070
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 71: The Effect of Protracted Exposure to Radiation
           on Liver Injury: A Cohort Study of Industrial Radiographers in Xinjiang,

    • Authors: Qing Sun, Weiming Mao, Haiyue Jiang, Xiaoyue Zhang, Jing Xiao, Yulong Lian
      First page: 71
      Abstract: Background: At present, a large number of studies indicate that high dose ionizing radiation exposure is an important risk factor for liver damage. Whether protracted exposure to low external doses of ionizing radiation could induce liver injury is unclear. The aim of this study was to assess the risk of liver injury following protracted exposure to occupational radiation compared to a group of unexposed workers. Methods: A three-year cohort study was initiated in Xinjiang, China in 2010 and included 508 industrial radiographers and 2156 unexposed workers. The incidence of liver injury was assessed clinically based on the evaluation of alanine aminotransferase (ALT) and aspartate transaminase (AST) levels. Logistic regression was used to examine whether radiation is a risk factor for liver injury. Results: Compared with the unexposed group, protracted radiation exposure was found to be a risk factor for liver injury. Sex, age at baseline and alcohol consumption were not associated with liver injury. However, hypertension was a risk factor for liver injury. The association between cumulative recorded radiation dose and liver injury was not found in this study. Conclusions: These findings indicate that protracted exposure to radiation is a risk factor for liver injury.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-04
      DOI: 10.3390/ijerph15010071
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 72: Attitudes towards Potential New Tobacco Control
           Regulations among U.S. Adults

    • Authors: Allison Schmidt, Sarah Kowitt, Allison Myers, Adam Goldstein
      First page: 72
      Abstract: Favorable attitudes towards tobacco control policies can facilitate their implementation and success. We examined attitudes toward four potential U.S. Federal tobacco regulations (banning menthol from cigarettes, reducing nicotine levels in cigarettes, banning candy and fruit flavored electronic cigarettes, and banning candy and fruit flavored little cigars and cigarillos) and associations with individual and state variables. A nationally representative phone survey of 4337 adults assessed attitudes toward potential policies. Weighted logistic regression was used to assess relationships between attitudes and demographic factors, smoking behavior, beliefs about the government (knowledge, trust, and credibility), exposure to tobacco control campaigns, and state variables from the US Centers for Disease Control and Prevention (CDC) State Tobacco Activities Tracking and Evaluation (STATE) System. Most respondents supported three out of four policies. Respondents that were female, non-white, Latino, living below the poverty line, had less than high school education, were of older age, did not smoke, had higher trust in government, and were exposed to national tobacco control campaigns had higher odds of expressing favorable attitudes toward potential new tobacco regulations than did their counterparts. No state-level effects were found. While differences in attitudes were observed by individual demographic characteristics, behaviors, and beliefs, a majority of participants supported most of the potential new tobacco regulations surveyed.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-05
      DOI: 10.3390/ijerph15010072
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 73: Workaholism as a Mediator between Work-Related
           Stressors and Health Outcomes

    • Authors: Cecilie Andreassen, Ståle Pallesen, Torbjørn Torsheim
      First page: 73
      Abstract: It is currently unknown if unfavorable working conditions, reflected by the demand–control–support model and the effort–reward imbalance model, directly influence health or if the effects may be mediated by work-related attitudes and behaviors such as workaholism. In the present study, 988 employees (55.6% males, mean age 36.09, SD = 9.23) from a large consultant firm participated in a cross-sectional survey assessing work variables such as job demands, job control, social support, effort, reward, and overcommitment. Workaholism was also assessed together with eight different health-related outcomes. Although direct effects of the work stressors on health were found on most health outcomes, the work-related stressors were overall strongly related to workaholism (R2 = 0.522), which, in turn, was positively related to four (anxiety/insomnia, somatic symptoms, emotional exhaustion, and social dysfunction) of the eight outcome variables. Of a total of 40 relationships between work-related stressors and health outcomes, workaholism fully mediated three of these, and partly mediated 12. Overall, the study suggests that the effects of work-related stressors on health in many cases may be mediated by workaholism.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-05
      DOI: 10.3390/ijerph15010073
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 74: Living with Smoker(s) and Smoking Cessation in
           Chinese Adult Smokers: Cross-Sectional and Prospective Evidence from Hong
           Kong Population Health Survey

    • Authors: Zhi-Ming Mai, Sai-Yin Ho, Man-Ping Wang, Lai-Ming Ho, Tai-Hing Lam
      First page: 74
      Abstract: Background: Results on the environmental influence on unassisted quitting are scarce. We investigated the associations of living with smoker(s) with quitting in Chinese adult smokers. Methods: We examined both cross-sectional and prospective data in the Hong Kong Population Health Survey recruited participants in 2003/04, and followed up to 2006. Unconditional logistic regression yielded adjusted odds ratios (AORs) of (i) planning to quit, (ii) ex-smoking (cross-sectional), and quitting (prospective) for living with smoker(s). 1679 ever smokers aged 18+ years at baseline, and 323 of them who were successfully followed-up were included in the cross-sectional, and prospective analysis. Results: At baseline, living with smoker(s) was significantly associated with lower odds of planning to quit in current smokers (AOR 0.41, 95% CI 0.25–0.68), and lower odds of ex-smoking (AOR 0.45, 95% CI 0.34–0.58), particularly if the smoker(s) smoked inside home (AOR 0.35, 95% CI 0.26–0.47). Prospectively, living with smoker(s) non-significantly predicted lower odds of new quitting (AOR 0.48, 95% CI 0.13–1.78). Conclusions: Our study has provided the first evidence in a Chinese general population that living with smoker(s) is an important barrier against smoking cessation. To boost quit rate in nonusers of smoking cessation services, smoking at home should be banned, especially for populations living in crowed urban environments that are typical of economically developed cities in China.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-05
      DOI: 10.3390/ijerph15010074
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 75: Safety Assessment of Electronic Cigarettes and
           Their Relationship with Cardiovascular Disease

    • Authors: Guangwei Zhang, Zhangli Wang, Kai Zhang, Rui Hou, Chunli Xing, Qi Yu, Enqi Liu
      First page: 75
      Abstract: Smoking leads to the occurrence and development of a variety of diseases. Most importantly, it is an independent risk factor of cardiovascular atherosclerosis. In recent years, electronic cigarettes have become a popular alternative to traditional cigarettes, since modern micro-electronic techniques provide the possibility of simulating the process of traditional smoking. Additionally, it is convenient and fashionable. Nevertheless, comments about the safety of electronic cigarettes remain controversial. Although the research about electronic cigarettes increased exponentially, there has been no systematic study of its safety. The aim of the current study is to review the literature reports about the safety of electronic cigarettes, and to understand their hazards and disadvantages. It was found that most of the current research about electronic cigarettes comprises short-term and in vitro studies. There are few reports of in vivo and long-term studies. Notably, the level of harmful components such as volatile organic compounds, tobacco-specific nitrosamines and heavy metals in electronic cigarettes are even higher than in traditional cigarettes. Therefore, the harm of electronic cigarettes should not be underestimated. In conclusion, the question of whether electronic cigarettes are a safe and sufficient substitute for traditional smoking needs further investigation.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-05
      DOI: 10.3390/ijerph15010075
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 76: Community Engaged Cumulative Risk Assessment of
           Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana

    • Authors: Margaret J. Eggers, John T. Doyle, Myra J. Lefthand, Sara L. Young, Anita L. Moore-Nall, Larry Kindness, Roberta Other Medicine, Timothy E. Ford, Eric Dietrich, Albert E. Parker, Joseph H. Hoover, Anne K. Camper
      First page: 76
      Abstract: An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families’ financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-05
      DOI: 10.3390/ijerph15010076
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 77: Socio-Demographic and Mental Health Profile of
           Admitted Cases of Self-Inflicted Harm in the US Population

    • Authors: Chris Hanuscin, Golara Zahmatkesh, Anaheed Shirazi, Deyu Pan, Senait Teklehaimanot, Shahrzad Bazargan-Hejazi
      First page: 77
      Abstract: Self-inflicted harm (SIH) has a substantial lifetime prevalence, it is associated with tremendous costs, and its rate is increasing on a national scale. To examine the characteristics of those admitted for SIH in the US and to investigate the factors that potentially modify the methods used for SIH. This was a retrospective analysis of admitted cases of SIH including suicide attempts between 2007 and 2012 using the National Trauma Data Bank. We included a total of 204,633 cases admitted for SIH. Our participants were 75.1% males. Those aged 15–24 (21%), 25–34 (22%), 35–44 (19%), 45–54 (19%), and 55–64 (10%) years comprised the largest age groups among our cases—70.8%, 11.5%, 11.1%, and 6.6% were, respectively, Caucasians, Hispanics, Blacks, and Asian/Others. Analyses of the SIH methods revealed that Blacks were less likely to self-poison [Odds Ratio (OR): 0.78] compared to Whites, whereas individuals with psychiatric disorders or substance abuse carried 2.5 and 2.0-fold higher risk, respectively. Blacks were also less likely to use anoxic methods (OR: 0.69), whereas patients with psychiatric disorders or substance abuse carried 1.5-fold higher risk. Being Black, Hispanic, and Asian (OR: 0.58, 0.55, and 0.55, respectively) as well as having psychiatric disorders (OR: 0.80) were associated with lower risks of using firearms, whereas its risk was increased with increasing age. Blacks (OR: 0.77) were less likely to cut or pierce in contrast to Hispanics (OR: 1.4), Asians/Others (OR: 1.29), and those with psychiatric disorders (2.5-fold higher risk) or drug abuse (2-fold higher risk). Blacks (OR: 1.11), Hispanics (OR: 1.13), and Asians/Others (OR: 1.57) were more likely to jump from high places, whereas those with substance abuse were less likely (OR: 0.77). Among patients admitted for SIH, males, those aged 15–64 years, and Whites comprised the largest sex, age, and racial/ethnic groups, respectively. We also found that several factors including race/ethnicity, gender, age, and having concurrent psychiatric or drug abuse disorders can potentially influence the methods used for SIH.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-05
      DOI: 10.3390/ijerph15010077
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 78: Environmental Risk Factors for Developing Type
           2 Diabetes Mellitus: A Systematic Review

    • Authors: Tashi Dendup, Xiaoqi Feng, Stephanie Clingan, Thomas Astell-Burt
      First page: 78
      Abstract: Different elements of the environment have been posited to influence type 2 diabetes mellitus (T2DM). This systematic review summarizes evidence on the environmental determinants of T2DM identified in four databases. It proposes a theoretical framework illustrating the link between environment and T2DM, and briefly discusses some methodological challenges and potential solutions, and opportunities for future research. Walkability, air pollution, food and physical activity environment and roadways proximity were the most common environmental characteristics studied. Of the more than 200 reported and extracted relationships assessed in 60 studies, 82 showed significant association in the expected direction. In general, higher levels of walkability and green space were associated with lower T2DM risk, while increased levels of noise and air pollution were associated with greater risk. Current evidence is limited in terms of volume and study quality prohibiting causal inferences. However, the evidence suggests that environmental characteristics may influence T2DM prevention, and also provides a reasonable basis for further investigation with better quality data and longitudinal studies with policy-relevant environmental measures. This pursuit of better evidence is critical to support health-orientated urban design and city planning.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-05
      DOI: 10.3390/ijerph15010078
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 79: On the Simulation-Based Reliability of Complex
           Emergency Logistics Networks in Post-Accident Rescues

    • Authors: Wei Wang, Li Huang, Xuedong Liang
      First page: 79
      Abstract: This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010079
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 80: Revitalising Silver Nitrate for Caries

    • Authors: Sherry Gao, Irene Zhao, Steve Duffin, Duangporn Duangthip, Edward Lo, Chun Chu
      First page: 80
      Abstract: Silver nitrate has been adopted for medical use as a disinfectant for eye disease and burned wounds. In dentistry, it is an active ingredient of Howe’s solution used to prevent and arrest dental caries. While medical use of silver nitrate as a disinfectant became subsidiary with the discovery of antibiotics, its use in caries treatment also diminished with the use of fluoride in caries prevention. Since then, fluoride agents, particularly sodium fluoride, have gained popularity in caries prevention. However, caries is an infection caused by cariogenic bacteria, which demineralise enamel and dentine. Caries can progress and cause pulpal infection, but its progression can be halted through remineralisation. Sodium fluoride promotes remineralisation and silver nitrate has a profound antimicrobial effect. Hence, silver nitrate solution has been reintroduced for use with sodium fluoride varnish to arrest caries as a medical model strategy of caries management. Although the treatment permanently stains caries lesions black, this treatment protocol is simple, painless, non-invasive, and low-cost. It is well accepted by many clinicians and patients and therefore appears to be a promising strategy for caries control, particularly for young children, the elderly, and patients with severe caries risk or special needs.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010080
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 81: Lipoprotein-Cholesterol Fractions in
           Marginalized Roma versus Majority Population

    • Authors: Beáta Hubková, Gabriel Bódy, Jana Mašlanková, Anna Birková, Eugen Frišman, Vladimír Kraus, Mária Mareková
      First page: 81
      Abstract: The trend of modern clinical biochemistry is to emphasize the composition and the quality of lipoproteins over their quantity. The serum lipoprotein fractions and subfractions were analyzed by the Lipoprint Lipoprotein Subfractions Testing System, the parameters of lipid profile, as total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and triacylglycerides (TAG) were determined by an automated selective biochemical analyzer. Our results showed a significantly lower concentration of cholesterol in the LDL fractions 1 and 2 and in the HDL fractions 8 to 10 in Roma compared to the majority population. The most significant differences between Roma and the majority population when considering body mass index (BMI), waist-to-hip ratio and the index of central obesity were in very low-density lipoproteins (VLDL), intermediate-density lipoproteins, fraction A (IDL-A) and LDL-2. The last two listed were significantly higher in the majority population. VLDL was significantly higher in overweight or obese Roma men and in Roma men with central obesity compared to men from the majority population, as well as in Roma women with normal weight and physiological waist-to-hip ratio compared to the women from majority population. Our study is among the first describing the distribution of lipoprotein subfractions in different ethnic groups.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010081
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 82: Trajectories of Emotional Symptoms and Peer
           Relationship Problems in Children after Nuclear Disaster: Evidence from
           the Fukushima Health Management Survey

    • Authors: Misari Oe, Masaharu Maeda, Tetsuya Ohira, Shuntaro Itagaki, Mayumi Harigane, Yuriko Suzuki, Hirooki Yabe, Seiji Yasumura, Kenji Kamiya, Hitoshi Ohto
      First page: 82
      Abstract: The Fukushima Daiichi Nuclear Power Plant accident, which occurred in March 2011, is having long-term effects on children. We planned this study to describe the trajectories of emotional symptoms and peer relationship problems in children and to examine potential risks and protective factors over the 35 months following the accident. The sample was 11,791 children in the first to sixth elementary grades. We identified four patterns for emotional symptoms and three patterns for peer relationship problems, using group-based trajectory modelling. For emotional symptoms, female gender, experience of tsunami and nuclear plant accident, out-of-prefecture evacuees, and insufficient physical activity were associated with the very severe trajectory. In contrast, for peer relationship problems, male gender, experience of nuclear plant accident, and insufficient physical activity were associated with the very severe trajectory. Different factors might be related to the very severe trajectories of emotional symptoms and peer relationship problems.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010082
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 83: Impact of Smoking Ban on Passive Smoke Exposure
           in Pregnant Non-Smokers in the Southeastern United States

    • Authors: Julia Schechter, Bernard Fuemmeler, Cathrine Hoyo, Susan Murphy, Junfeng Zhang, Scott Kollins
      First page: 83
      Abstract: Prenatal passive smoke exposure raises risk for negative birth outcomes. Legislation regulating public smoking has been shown to impact exposure levels, though fewer studies involving pregnant women have been conducted within the U.S. where bans are inconsistent across regions. This study examined the effect of a ban enacted in the southeastern U.S. on pregnant women’s cotinine levels. Additional analyses compared self-reported exposure to cotinine and identified characteristics associated with passive exposure. Pregnant women (N = 851) were recruited prospectively between 2005 and 2011 in North Carolina. Sociodemographic and health data were collected via surveys; maternal blood samples were assayed for cotinine. Among non-active smokers who provided self-report data regarding passive exposure (N = 503), 20% were inconsistent with corresponding cotinine. Among all non-smokers (N = 668), being unmarried, African American, and less educated were each associated with greater passive exposure. Controlling for covariates, mean cotinine was higher prior to the ban compared to after, F(1, 640) = 24.65, p < 0.001. Results suggest that banning smoking in public spaces may reduce passive smoke exposure for non-smoking pregnant women. These data are some of the first to examine the impact of legislation on passive smoke exposure in pregnant women within the U.S. using a biomarker and can inform policy in regions lacking comprehensive smoke-free legislation.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010083
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 84: Neighborhood Perceptions and Cumulative Impacts
           of Low Level Chronic Exposure to Fine Particular Matter (PM2.5) on
           Cardiopulmonary Health

    • Authors: Kristen Malecki, Amy Schultz, Rachel Bergmans
      First page: 84
      Abstract: Adverse perceptions of neighborhood safety, aesthetics and quality including access to resources can induce stress and may make individuals more sensitive to cardiopulmonary effects of air pollution exposure. Few studies have examined neighborhood perceptions as important and modifiable non-chemical stressors of the built environment that may exacerbate effects of air pollution on cardiopulmonary health outcomes, particularly among general population based cohorts. This study examined associations between low-level chronic exposure to fine particulate matter (PM2.5) and cardiopulmonary health, and the potential mediating or modifying effects of adverse neighborhood perceptions. Using data from the Survey of the Health of Wisconsin (SHOW), 2230 non-asthmatic adults age 21–74 were included in the analyses. The overall goals of this study were to assess if individuals who experience stress from neighborhood environments in which they live were more sensitive to low levels of fine particular matter (PM2.5 μg/m3). Demographic predictors of air pollution exposure included younger age, non-White race, lower education and middle class income. After adjustments, objective lung function measures (FEV1 and FEV1 to FVC ratio) were the only cardiopulmonary health indicators significantly associated with chronic three-year annual averages of PM2.5. Among all non-asthmatics, a ten unit increase in estimated three year annual average PM2.5 exposure was significantly associated with lower forced expiratory volume (L) in one second FEV1 (β = −0.40 μg/L; 95% CI −0.45, −0.06). Among all individuals, adverse perceptions of the neighborhood built environment did not appear to statistically moderate or mediate associations. However, stratified analysis did reveal significant associations between PM2.5 and lung function (FEV1) only among individuals with negative perceptions and increased reports of neighborhood stressors. These findings included individuals who felt their neighborhoods were poorly maintained (β = −0.82; 95% CI −1.35, −0.28), experienced stress from crime (β = −0.45; 95% CI −0.94, 0.04) or reported neighborhood is not well maintained (β = −1.13, CI −2.04, −0.24). These significant associations were similar for FEV1 to FVC ratio. Multi-pronged approaches addressing both neighborhood built environment aesthetics and air pollution regulation may be necessary to protect vulnerable and susceptible individuals and reduce persistent inequalities.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010084
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 85: Risk Assessment of Potentially Toxic Elements
           (PTEs) Pollution at a Rural Industrial Wasteland in an Abandoned
           Metallurgy Factory in North China

    • Authors: Zheng Sun, Jiajun Chen
      First page: 85
      Abstract: The potential toxic elements (PTEs) pollution problems in many rural industrial wastelands have been observed to be conspicuous. Therefore, 40 top soil samples were collected from the wasteland of a typical rural metallurgy factory in Baoding, China. The total concentrations of six key PTEs were measured. The soil properties and speciation of the PTEs were also identified. Extremely high concentrations of As, Cd, Pb, and Zn were observed in the surface soils. Using the PTEs concentration in the top soils of the rural industrial wasteland, the following indices of pollution were calculated: the pollution load index (PLI), the geo-accumulation Index (Igeo), the risk assessment code (RAC), and the health risk assessment (HRA). The analysis of the PLI and Igeo indicated that site #1 was relatively clean, while sites #2 and #3 were heavily polluted. The results of the RAC showed that PTEs in top soils at sites #2 and #3 were significantly increased (p <  0.05) for Cd and Zn. The HRA indicated that both As and Pb presented non-carcinogenic risks to children and adults at sites #2 and #3. Our findings can be a reference for risk prevention of industrially abandoned land in rural China.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010085
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 86: Optimization of Location–Routing Problem for
           Cold Chain Logistics Considering Carbon Footprint

    • Authors: Songyi Wang, Fengming Tao, Yuhe Shi
      First page: 86
      Abstract: In order to solve the optimization problem of logistics distribution system for fresh food, this paper provides a low-carbon and environmental protection point of view, based on the characteristics of perishable products, and combines with the overall optimization idea of cold chain logistics distribution network, where the green and low-carbon location–routing problem (LRP) model in cold chain logistics is developed with the minimum total costs as the objective function, which includes carbon emission costs. A hybrid genetic algorithm with heuristic rules is designed to solve the model, and an example is used to verify the effectiveness of the algorithm. Furthermore, the simulation results obtained by a practical numerical example show the applicability of the model while provide green and environmentally friendly location-distribution schemes for the cold chain logistics enterprise. Finally, carbon tax policies are introduced to analyze the impact of carbon tax on the total costs and carbon emissions, which proves that carbon tax policy can effectively reduce carbon dioxide emissions in cold chain logistics network.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-06
      DOI: 10.3390/ijerph15010086
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 87: Comparing U.S. Injury Death Estimates from GBD
           2015 and CDC WONDER

    • Authors: Yue Wu, Xunjie Cheng, Peishan Ning, Peixia Cheng, David C. Schwebel, Guoqing Hu
      First page: 87
      Abstract: Objective: The purpose of the present study was to examine consistency in injury death statistics from the United States CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) with those from GBD 2015 estimates. Methods: Differences in deaths and the percent difference in deaths between GBD 2015 and CDC WONDER were assessed, as were changes in deaths between 2000 and 2015 for the two datasets. Results: From 2000 to 2015, GBD 2015 estimates for the U.S. injury deaths were somewhat higher than CDC WONDER estimates in most categories, with the exception of deaths from falls and from forces of nature, war, and legal intervention in 2015. Encouragingly, the difference in total injury deaths between the two data sources narrowed from 44,897 (percent difference in deaths = 41%) in 2000 to 34,877 (percent difference in deaths = 25%) in 2015. Differences in deaths and percent difference in deaths between the two data sources varied greatly across injury cause and over the assessment years. The two data sources present consistent changes in direction from 2000 to 2015 for all injury causes except for forces of nature, war, and legal intervention, and adverse effects of medical treatment. Conclusions: We conclude that further studies are warranted to interpret the inconsistencies in data and develop estimation approaches that increase the consistency of the two datasets.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-07
      DOI: 10.3390/ijerph15010087
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 88: The Impact of Load Carriage on Measures of
           Power and Agility in Tactical Occupations: A Critical Review

    • Authors: Aaron Joseph, Amy Wiley, Robin Orr, Benjamin Schram, J. Dawes
      First page: 88
      Abstract: The current literature suggests that load carriage can impact on a tactical officer’s mobility, and that survival in the field may rely on the officer’s mobility. The ability for humans to generate power and agility is critical for performance of the high-intensity movements required in the field of duty. The aims of this review were to critically examine the literature investigating the impacts of load carriage on measures of power and agility and to synthesize the findings. The authors completed a search of the literature using key search terms in four databases. After relevant studies were located using strict inclusion and exclusion criteria, the studies were critically appraised using the Downs and Black Checklist and relevant data were extracted and tabled. Fourteen studies were deemed relevant for this review, ranging in percentage quality scores from 42.85% to 71.43%. Outcome measures used in these studies to indicate levels of power and agility included short-distance sprints, vertical jumps, and agility runs, among others. Performance of both power and agility was shown to decrease when tactical load was added to the participants. This suggests that the increase in weight carried by tactical officers may put this population at risk of injury or fatality in the line of duty.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-07
      DOI: 10.3390/ijerph15010088
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 89: Annual Direct Medical Costs of Diabetic Foot
           Disease in Brazil: A Cost of Illness Study

    • Authors: Cristiana Toscano, Tatiana Sugita, Michelle Rosa, Hermelinda Pedrosa, Roger Rosa, Luciana Bahia
      First page: 89
      Abstract: The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1) peripheral neuropathy without ulcer, (2) non-infected foot ulcer, (3) infected foot ulcer, and (4) clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP) (1 Int$ = 1.748 BRL). We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13%) was for inpatient, and Int$ 333.5 million (87%) for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients. Although we have various reasons to believe that the hospital costs are underestimated, the estimated DFD burden is significant. As such, public health preventive strategies to reduce DFD related morbidity and mortality and costs are of utmost importance.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-08
      DOI: 10.3390/ijerph15010089
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 90: Characteristics of Refractive Errors in a
           Population of Adults in the Central Region of Poland

    • Authors: Michal Nowak, Piotr Jurowski, Andrzej Grzybowski, Janusz Smigielski
      First page: 90
      Abstract: Background: To investigate the distribution of refractive errors and their characteristics in older adults from a Polish population. Methods: The study design was a cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998 subjects underwent refraction. Myopia was defined as spherical equivalent (SER) refraction ≤−0.5 dioptres (D) and hyperopia was defined as SER ≥+0.5 dioptres (D). Results: Among those who were refracted the distribution of myopia and hyperopia was 24.1% (95% CI 21.4–26.7) and 37.5% (95% CI 34.5–40.5), respectively. Myopia decreased from 28.7% in subjects aged 35–59 years to 19.3% in those aged 60 years or older and hyperopia increased from 21.8% at 35–59 years of age to 53.3% in subjects aged ≥60 years. Multiple regression analysis showed decreasing age (OR 0.98, 95% CI 0.96–1.00), female gender (OR 1.87, 95% CI 1.18–2.95) and presence of cataract (OR 2.40, 95% CI 1.24–4.63) were independent risk factors associated with myopia. Conclusions: The distribution of refractive errors found in our study is similar to those reported in other Caucasian populations and differs from Asian populations. Myopia was positively associated with younger age, female gender and presence of cataract.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-08
      DOI: 10.3390/ijerph15010090
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 91: Climate Change Risk Perception in Taiwan:
           Correlation with Individual and Societal Factors

    • Authors: Yingying Sun, Ziqiang Han
      First page: 91
      Abstract: This study differentiates the risk perception and influencing factors of climate change along the dimensions of global severity and personal threat. Using the 2013 Taiwan Social Change Survey (TSGS) data (N = 2001) as a representative sample of adults from Taiwan, we investigated the influencing factors of the risk perceptions of climate change in these two dimensions (global severity and personal threat). Logistic regression models were used to examine the correlations of individual factors (gender, age, education, climate-related disaster experience and risk awareness, marital status, employment status, household income, and perceived social status) and societal factors (religion, organizational embeddedness, and political affiliations) with the above two dimensions. The results demonstrate that climate-related disaster experience has no significant impact on either the perception of global severity or the perception of personal impact. However, climate-related risk awareness (regarding typhoons, in particular) is positively associated with both dimensions of the perceived risks of climate change. With higher education, individuals are more concerned about global severity than personal threat. Regarding societal factors, the supporters of political parties have higher risk perceptions of climate change than people who have no party affiliation. Religious believers have higher risk perceptions of personal threat than non-religious people. This paper ends with a discussion about the effectiveness of efforts to enhance risk perception of climate change with regard to global severity and personal threat.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-08
      DOI: 10.3390/ijerph15010091
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 92: Problematic Smartphone Use, Deep and Surface
           Approaches to Learning, and Social Media Use in Lectures

    • Authors: Dmitri Rozgonjuk, Kristiina Saal, Karin Täht
      First page: 92
      Abstract: Several studies have shown that problematic smartphone use (PSU) is related to detrimental outcomes, such as worse psychological well-being, higher cognitive distraction, and poorer academic outcomes. In addition, many studies have shown that PSU is strongly related to social media use. Despite this, the relationships between PSU, as well as the frequency of social media use in lectures, and different approaches to learning have not been previously studied. In our study, we hypothesized that both PSU and the frequency of social media use in lectures are negatively correlated with a deep approach to learning (defined as learning for understanding) and positively correlated with a surface approach to learning (defined as superficial learning). The study participants were 415 Estonian university students aged 19–46 years (78.8% females; age M = 23.37, SD = 4.19); the effective sample comprised 405 participants aged 19–46 years (79.0% females; age M = 23.33, SD = 4.21). In addition to basic socio-demographics, participants were asked about the frequency of their social media use in lectures, and they filled out the Estonian Smartphone Addiction Proneness Scale and the Estonian Revised Study Process Questionnaire. Bivariate correlation analysis showed that PSU and the frequency of social media use in lectures were negatively correlated with a deep approach to learning and positively correlated with a surface approach to learning. Mediation analysis showed that social media use in lectures completely mediates the relationship between PSU and approaches to learning. These results indicate that the frequency of social media use in lectures might explain the relationships between poorer academic outcomes and PSU.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-08
      DOI: 10.3390/ijerph15010092
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 93: Blood Lead Levels and Risk Factors for Lead
           Exposure in a Pediatric Population in Ho Chi Minh City, Vietnam

    • Authors: Deborah Havens, Minh Pham, Catherine Karr, William Daniell
      First page: 93
      Abstract: Although lead recycling activities are a known risk factor for elevated blood levels in South East Asia, little is known regarding the prevalence of and risk factors for elevated blood lead levels (BLL) among the general pediatric population in Vietnam. This study is a cross-sectional evaluation of 311 children from Children’s Hospital #2 in Ho Chi Minh City, Vietnam. Capillary blood lead testing was performed using the LeadCare II. Mean BLLs were 4.97 μg/dL (Standard Deviation (SD) 5.50), with 7% of the participants having levels greater than 10 μg/dL. Living in Bing Duong province (OR 2.7, 95% CI 1.4–5.6.1) or the Dong Nai province (OR 2.3, 95% CI 1.0–5.1) and having an age greater than 12 months (OR 6.0, 95% CI 3.1–11.8) were associated with higher BLLs. The prevalence of elevated BLLs in Vietnam is consistent with other SE Asian countries. Mean BLLs in Ho Chi Minh City are markedly less than those seen in a separate study of children living near lead recycling activities. Additional evaluation is necessary to better detail potential risk factors if screening is to be implemented within Vietnam.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-08
      DOI: 10.3390/ijerph15010093
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 94: Screaming Body and Silent Healthcare Providers:
           A Case Study with a Childhood Sexual Abuse Survivor

    • Authors: Sigrun Sigurdardottir, Sigridur Halldorsdottir
      First page: 94
      Abstract: Stressful early life experiences cause immune dysregulation across the lifespan. Despite the fact that studies have identified childhood sexual abuse (CSA) survivors as a particularly vulnerable group, only a few attempts have been made to study their lived-experience of the physical health consequences of CSA. The aim of this study was to explore a female CSA survivor’s lived-experience of the physical health consequences of CSA and how she experienced the reactions of healthcare providers. Seven interviews were conducted with this 40-year-old woman, Anne, using a phenomenological research approach. Anne was still a young child (two to three years old) when her father started to rape her. Since her childhood, she has experienced complex and widespread physical health consequences such as repeated vaginal and abdominal infections, widespread and chronic pain, sleeping problems, digestive problems, chronic back problems, fibromyalgia, musculoskeletal problems, repeated urinary tract infections, cervical dysplasia, inflammation of the Fallopian tubes, menorrhagia, endometrial hyperplasia, chlamydia, ovarian cysts, ectopic pregnancies, uterus problems, severe adhesions, and ovarian cancer. Anne disclosed her CSA experience to several healthcare providers but they were silent and failed to provide trauma-informed care. Anne’s situation, albeit unique, might reflect similar problems in other female CSA survivors.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-08
      DOI: 10.3390/ijerph15010094
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 95: Predictors of a Change and Correlation in
           Activities of Daily Living after Hip Fracture in Elderly Patients in a
           Community Hospital in Poland: A Six-Month Prospective Cohort Study

    • Authors: Maria Ganczak, Krzysztof Chrobrowski, Marcin Korzeń
      First page: 95
      Abstract: Objectives: The consequences of hip fractures (HFs) in elderly persons include a deterioration in functional capacity to perform activities that enable independent living. Since prior research into this issue in Central Europe is rather scant, this study sought to assess the change in activities and instrumental activities of daily living (ADL/IADL) after HF surgery among Polish patients, to study predictors of regaining pre-fracture functional status three and six months later, and to evaluate the correlation between ADL and IADL limitations over time. Methods: A prospective study was conducted between 2011 and 2013 in a tertiary hospital in Western Poland. ADL/IADL were evaluated using the Katz index and Lawton scale, respectively. Results: About half (50.8%) of 120 patients (mean age 80.1 ± SD 7.59) had cognitive impairment (CI). Patients with CI were older (p = 0.002) and had lower scores for pre-fracture ADL/IADL (p = 0.001 and p < 0.001, respectively). Six months after HF, 33.3% of patients failed to return to their pre-fracture ADL and 62.5% failed to return to pre-fracture IADL; 20% of those who could walk before HF were unable to walk after six months. The pre-fracture Spearman correlation coefficient between ADL and IADL summary scores was 0.46; it increased to 0.70 at three months after HF surgery and 0.77 at six months (p < 0.0001). Regaining ADL after six months was more likely in patients with pre-fracture intact intellectual function and independence in pre-fracture ADL; regaining IADL, in younger patients and those with higher pre-fracture IADL scores. Conclusions: Impairment in functional performance is common after HF surgery. ADL and IADL were strongly correlated in these patients, with this increasing over time. Functional outcomes after HF were more dependent on patient characteristics than treatment-related factors. Therefore, more emphasis should be directed towards the pre-fracture period and, in particular, maintaining cognitive function and preserving functional capacity in older persons at high risk of HF.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-08
      DOI: 10.3390/ijerph15010095
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 96: The Zika Virus Epidemic in Brazil: From
           Discovery to Future Implications

    • Authors: Rachel Lowe, Christovam Barcellos, Patrícia Brasil, Oswaldo Cruz, Nildimar Honório, Hannah Kuper, Marilia Carvalho
      First page: 96
      Abstract: The first confirmed case of Zika virus infection in the Americas was reported in Northeast Brazil in May 2015, although phylogenetic studies indicate virus introduction as early as 2013. Zika rapidly spread across Brazil and to more than 50 other countries and territories on the American continent. The Aedes aegypti mosquito is thought to be the principal vector responsible for the widespread transmission of the virus. However, sexual transmission has also been reported. The explosively emerging epidemic has had diverse impacts on population health, coinciding with cases of Guillain–Barré Syndrome and an unexpected epidemic of newborns with microcephaly and other neurological impairments. This led to Brazil declaring a national public health emergency in November 2015, followed by a similar decision by the World Health Organization three months later. While dengue virus serotypes took several decades to spread across Brazil, the Zika virus epidemic diffused within months, extending beyond the area of permanent dengue transmission, which is bound by a climatic barrier in the south and low population density areas in the north. This rapid spread was probably due to a combination of factors, including a massive susceptible population, climatic conditions conducive for the mosquito vector, alternative non-vector transmission, and a highly mobile population. The epidemic has since subsided, but many unanswered questions remain. In this article, we provide an overview of the discovery of Zika virus in Brazil, including its emergence and spread, epidemiological surveillance, vector and non-vector transmission routes, clinical complications, and socio-economic impacts. We discuss gaps in the knowledge and the challenges ahead to anticipate, prevent, and control emerging and re-emerging epidemics of arboviruses in Brazil and worldwide.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010096
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 97: Evaluation and Implementation of a Proactive
           Telephone Smoking Cessation Counseling for Parents: A Study Protocol of an
           Effectiveness Implementation Hybrid Design

    • Authors: Tessa Scheffers-van Schayck, Roy Otten, Rutger Engels, Marloes Kleinjan
      First page: 97
      Abstract: Detrimental health consequences of smoking for both parents and children stress the importance for parents to quit. A Dutch efficacy trial supported the efficacy of proactive telephone counseling on parents. Still, how this program would function in “real world” conditions and how parents could be optimally reached is unclear. Therefore, this study will use an innovative method to examine the recruitment success of two implementation approaches (i.e., via a healthcare approach and a mass media approach) to test the (cost)effectiveness of the program. A two-arm randomized controlled trial and an implementation study (i.e., process evaluation) are conducted. Parents (N = 158) will be randomly assigned to the intervention (i.e., telephone counseling) or control conditions (i.e., self-help brochure). Primary outcome measure is 7-day point prevalence abstinence at three months post-intervention. Qualitative and quantitative research methods are used for the process evaluation. We expect that parents in the intervention condition have higher cessation rates than parents in the control condition. We also expect that the recruitment of parents via (youth) health care services is a more promising implementation approach compared to mass media. Results will have implications for the effectiveness of a proactive telephone counseling and provide directions for its successful implementation.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010097
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 98: Impact of Age and Hearing Impairment on Work
           Performance during Long Working Hours

    • Authors: Verena Wagner-Hartl, Nina Grossi, K. Kallus
      First page: 98
      Abstract: Based on demographic prognoses, it must be assumed that a greater number of older workers will be found in the future labor market. How to deal with their possible age-related impairments of sensory functions, like hearing impairment and work performance during extended working time, has not been addressed explicitly until now. The study addresses this interplay. The study was performed on two consecutive days after normal working hours. The 55 participants had to “work” in the study at least three additional hours to simulate a situation of long working hours. The tested measures for (job) performance were: general attention, long-term selective attention, concentration, and reaction time. All of the investigated variables were taken at both days of the study (2 × 2 × 2 repeated measurement design). The results show effects for age, the interaction of hearing impairment and time of measurement, and effects of the measurement time. Older participants reacted slower than younger participants did. Furthermore, younger participants reacted more frequently in a correct way. Hearing impairment seems to have a negative impact especially on measures of false reactions, and therefore especially on measurement time 1. The results can be interpreted in a way that hearing-impaired participants are able to compensate their deficits over time.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010098
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 99: Spatial and Seasonal Dynamics of Water
           Environmental Capacity in Mountainous Rivers of the Southeastern Coast,

    • Authors: Qiankun Liu, Jingang Jiang, Changwei Jing, Jiaguo Qi
      First page: 99
      Abstract: The south-east littoral is one of the most populous and developed regions in China suffering from serious water pollution problems, and the Xian-Jiang Basin in the mid of this region is among the most polluted watersheds. Critical information is needed but lacking for improved pollution control and water quality assessment, among which water environmental capacity (WEC) is the most important variable but is difficult to calculate. In this study, a one-dimensional water quality model combined with a matrix calculation algorithm was first developed and calibrated with in-situ observations in the Xian-Jiang basin. Then, the model was applied to analyze the spatial and temporal patterns of WEC of the entire basin. The results indicated that, in 2015, the total pollutant discharges into the river reached 6719.68 t/yr, 488.12 t/yr, and 128.57 t/yr for COD, NH3-N and TP, respectively. The spatial pattern suggested a strong correlation between these water contaminants and industrial enterprises, residential areas, and land-use types in the basin. Furthermore, it was noticed that there was a significant seasonal pattern in WEC that the dry season pollution is much greater than that in the plum season, while that in the typhoon season appears to be the weakest among all seasons. The WEC differed significantly among the 24 sub-basins during the dry season but varied to a smaller extent in other seasons, suggesting differential complex spatial-temporal dependency of the WEC.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010099
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 100: Identifying Dietary Patterns Associated with
           Mild Cognitive Impairment in Older Korean Adults Using Reduced Rank

    • Authors: Dayeon Shin, Kyung Lee, Mi-Hye Kim, Hung Kim, Yun An, Hae-Kyung Chung
      First page: 100
      Abstract: Diet plays a crucial role in cognitive function. Few studies have examined the relationship between dietary patterns and cognitive functions of older adults in the Korean population. This study aimed to identify the effect of dietary patterns on the risk of mild cognitive impairment. A total of 239 participants, including 88 men and 151 women, aged 65 years and older were selected from health centers in the district of Seoul, Gyeonggi province, and Incheon, in Korea. Dietary patterns were determined using Reduced Rank Regression (RRR) methods with responses regarding vitamin B6, vitamin C, and iron intakes, based on both a one-day 24-h recall and a food frequency questionnaire. Cognitive function was assessed using the Korean-Mini Mental State Examination (K-MMSE). Multivariable logistic regression models were used to estimate the association between dietary pattern score and the risk of mild cognitive impairment. A total of 20 (8%) out of the 239 participants had mild cognitive impairment. Three dietary patterns were identified: seafood and vegetables, high meat, and bread, ham, and alcohol. Among the three dietary patterns, the older adult population who adhered to the seafood and vegetables pattern, characterized by high intake of seafood, vegetables, fruits, bread, snacks, soy products, beans, chicken, pork, ham, egg, and milk had a decreased risk of mild cognitive impairment compared to those who did not (adjusted odds ratios 0.06, 95% confidence interval 0.01–0.72) after controlling for gender, supplementation, education, history of dementia, physical activity, body mass index (BMI), and duration of sleep. The other two dietary patterns were not significantly associated with the risk of mild cognitive impairment. In conclusion, high consumption of fruits, vegetables, seafood, and protein foods was significantly associated with reduced mild cognitive impairment in older Korean adults. These results can contribute to the establishment of dietary guidelines targeting older Korean adults to reduce mild cognitive impairments. Future prospective cohort studies are warranted to examine the effect of the seafood and vegetable dietary pattern on reducing mild cognitive impairment to prove the cause–effect relationship between dietary patterns and cognitive function.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010100
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 101: Adsorption Behavior and Mechanism for the
           Uptake of Fluoride Ions by Reed Residues

    • Authors: Rong Song, Shengke Yang, Haiyang Xu, Zongzhou Wang, Yangyang Chen, Yanhua Wang
      First page: 101
      Abstract: The adsorption behavior and mechanism for the uptake of fluoride ions by untreated and desugared reed residues (roots, stems and leaves) were studied through adsorption experiments, elemental analysis, infrared spectroscopy and surface area analysis. The results showed that the adsorption capacity of untreated and desugared reeds followed the order: desugared roots 2136 mg/kg > desugared leaves 1825 mg/kg > desugared stems 1551 mg/kg > untreated roots 191 mg/kg > untreated stems 175 mg/kg > untreated leaves 150 mg/kg, so adsorption capacity of desugared reeds was larger than that of the untreated reeds. The adsorption kinetic of fluoride ions followed a pseudo-first-order model. A Langmuir model could be used to fit the isothermal adsorption process which was a spontaneous endothermic reaction involving mainly physical adsorption. The ΔG for the uptake of fluoride by the desugared reeds was more negative, so the degree of spontaneity was higher than for the use of the untreated reeds. After samples were desugared, the specific surface area and aromaticity of the reed increased, while the polarity and hydrophilicity decreased, which explained the adsorption amount of desugared reed was higher than that of the untreated. This study enriches techniques and methods of removing fluoride ions from water.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010101
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 102: Preventive Effect of Residential Green Space
           on Infantile Atopic Dermatitis Associated with Prenatal Air Pollution

    • Authors: Ji-Young Lee, Dirga Lamichhane, Myeongjee Lee, Shinhee Ye, Jung-Hyun Kwon, Myung-Sook Park, Hwan-Cheol Kim, Jong-Han Leem, Yun-Chul Hong, Yangho Kim, Mina Ha, Eunhee Ha
      First page: 102
      Abstract: Few birth cohort studies have examined the role of traffic-related air pollution (TRAP) in the development of infantile atopic dermatitis (AD), but none have investigated the role of preventive factors such as green spaces. The aim of this study was to investigate whether exposure to nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter of <10 μm (PM10) during pregnancy is associated with increased risk of development of AD in 6-month-old children and also to examine how this association changes with residential green space. This study used prospective data from 659 participants of the Mothers and Children’s Environmental Health study. Subjects were geocoded to their residential addresses and matched with air pollution data modeled using land-use regression. Information on infantile AD was obtained by using a questionnaire administered to the parents or guardians of the children. The association between infantile AD and exposure to NO2 and PM10 was determined using logistic regression models. We assessed the effects of residential green spaces using stratified analyses and by entering product terms into the logistic regression models. The risk of infantile AD significantly increased with an increase in air pollution exposure during the first trimester of pregnancy. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.219 (1.023–1.452) per 10 μg/m3 increase in PM10 and 1.353 (1.027–1.782) per 10 ppb increase in NO2. An increase in the green space within 200 m of residence was associated with a decreased risk of AD (OR = 0.996, 95% CI: 0.993–0.999). The stratified analysis of residential green space revealed stronger associations between infantile AD and PM10 and NO2 exposure during the first trimester in the areas in the lower tertiles of green space. This study indicated that exposure to TRAP during the first trimester of pregnancy is associated with infantile AD. Less residential green space may intensify the association between TRAP exposure and infantile AD.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010102
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 103: A Qualitative Study of HR/OHS Stress
           Interventions in Australian Universities

    • Authors: Silvia Pignata, Anthony Winefield, Carolyn Boyd, Chris Provis
      First page: 103
      Abstract: To enhance the understanding of psychosocial factors and extend research on work stress interventions, we investigated the key human resource (HR)/occupational health and safety (OHS) stress interventions implemented at five Australian universities over a three-year period. Five senior HR Directors completed an online survey to identify the intervention strategies taken at their university in order to reduce stress and enhance employee well-being and morale. We also explored the types of individual-, organization-, and individual/organization-directed interventions that were implemented, and the strategies that were prioritized at each university. Across universities, the dominant interventions were strategies that aimed to balance the social exchange in the work contract between employee-organization with an emphasis on initiatives to: enhance training, career development and promotional opportunities; improve remuneration and recognition practices; and to enhance the fairness of organizational policies and procedures. Strategies to improve work-life balance were also prominent. The interventions implemented were predominantly proactive (primary) strategies focused at the organizational level and aimed at eliminating or reducing or altering work stressors. The findings contribute to the improved management of people at work by identifying university-specific HR/OHS initiatives, specifically leadership development and management skills programs which were identified as priorities at three universities.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2018-01-09
      DOI: 10.3390/ijerph15010103
      Issue No: Vol. 15, No. 1 (2018)
  • IJERPH, Vol. 15, Pages 1: Bicycle Facilities That Address Safety, Crime,
           and Economic Development: Perceptions from Morelia, Mexico

    • Authors: Inés Alveano-Aguerrebere, Francisco Javier Ayvar-Campos, Maryam Farvid, Anne Lusk
      First page: 1
      Abstract: México is a developing nation and, in the city of Morelia, the concept of the bicyclist as a road user appeared only recently in the Municipal Traffic Regulations. Perhaps the right bicycle infrastructure could address safety, crime, and economic development. To identify the best infrastructure, six groups in Morelia ranked and commented on pictures of bicycle environments that exist in bicycle-friendly nations. Perceptions about bike paths, but only those with impossible-to-be-driven-over solid barriers, were associated with safety from crashes, lowering crime, and contributing to economic development. Shared use paths were associated with lowering the probability of car/bike crashes but lacked the potential to deter crime and foster the local economy. Joint bus and bike lanes were associated with lower safety because of the unwillingness by Mexican bus drivers to be courteous to bicyclists. Gender differences about crash risk biking in the road with the cars (6 best/0 worst scenario) were statistically significant (1.4 for male versus 0.69 for female; p < 0.001). For crashes, crime, and economic development, perceptions about bicycle infrastructure were different in this developing nation perhaps because policy, institutional context, and policing (ticketing for unlawful parking) are not the same as in a developed nation. Countries such as Mexico should consider building cycle tracks with solid barriers to address safety, crime, and economic development.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-22
      DOI: 10.3390/ijerph15010001
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 5: Relationship between Telomere Length, Genetic
           Traits and Environmental/Occupational Exposures in Bladder Cancer Risk by
           Structural Equation Modelling

    • Authors: Sofia Pavanello, Angela Carta, Giuseppe Mastrangelo, Manuela Campisi, Cecilia Arici, Stefano Porru
      First page: 5
      Abstract: Background: Telomere length (TL) maintenance plays an important role in bladder cancer (BC) and prognosis. However the manifold influence of everyday life exposures and genetic traits on leucocyte TL (LTL), is not fully elucidated. Methods: Within the framework of a hospital-based case (n = 96)/control (n = 94) study (all Caucasian males), we investigated the extent to which LTL and BC risk were modulated by genetic polymorphisms and environmental and occupational exposures. Data on lifetime smoking, alcohol and coffee drinking, dietary habits and occupational exposures, pointing to aromatic amines (AAs) and polycyclic aromatic hydrocarbons (PAHs) were collected. Structural equation modelling (SEM) analysis appraised this complex relationships. Results: The SEM analysis indicates negative direct links (p < 0.05) between LTL with age, DNA adducts, alcohol and NAT2, and positive ones with coffee, MPO and XRCC3; and between BC risk (p < 0.01) with cigarettes, cumulative exposure to AAs and coffee, while are negative with LTL and age. There was evidence of indirect effects (p < 0.05) on BC risk, probably via LTL reduction, by age and NAT2 (positive link), MPO and XRCC3 (negative link). Conclusions: Our study supports evidence that LTL attrition is a critical event in BC. The new finding that LTL erosion depends on some preventable everyday life exposures genetically modulated, opens new perspectives in BC prevention.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-21
      DOI: 10.3390/ijerph15010005
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 6: Demand for Long-Term Care Insurance in China

    • Authors: Qun Wang, Yi Zhou, Xinrui Ding, Xiaohua Ying
      First page: 6
      Abstract: The aim of this study was to estimate willingness to pay (WTP) for long-term care insurance (LTCI) and to explore the determinants of demand for LTCI in China. We collected data from a household survey conducted in Qinghai and Zhejiang on a sample of 1842 households. We relied on contingent valuation methods to elicit the demand for LTCI and random effects logistic regression to analyze the factors associated with the demand for LTCI. Complementarily, we used document analysis to compare the LTCI designed in this study and the current LTCI policies in the pilot cities. More than 90% of the respondents expressed their willingness to buy LTCI. The median WTP for LTCI was estimated at 370.14 RMB/year, accounting for 2.29% of average annual per capita disposable income. Price, age, education status, and income were significantly associated with demand for LTCI. Most pilot cities were found to mainly rely on Urban Employees Basic Medical Insurance funds as the financing source for LTCI. Considering that financing is one of the greatest challenges in the development of China’s LTCI, we suggest that policy makers consider individual contribution as an important and possible option as a source of financing for LTCI.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-22
      DOI: 10.3390/ijerph15010006
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 7: Personal, Psychosocial and Environmental Factors
           Related to Sick Building Syndrome in Official Employees of Taiwan

    • Authors: Chung-Yen Lu, Meng-Chuan Tsai, Chih-Hsin Muo, Yu-Hsien Kuo, Fung-Chang Sung, Chin-Ching Wu
      First page: 7
      Abstract: Sick building syndrome (SBS) is a combination of symptoms that can be attributed to exposure to specific building conditions. The present study recruited 389 participants aged 20–65 years from 87 offices of 16 institutions to examine if personal factors, work-related psychosocial stress, and work environments, were associated with five groups of SBS symptoms, including symptoms for eyes, upper respiratory tract, lower respiratory tract, skin, and non-specific systems. Indoor environmental conditions were monitored. Data were analyzed using multivariate logistic regression (MLR) analyses and were reported as adjusted Odds Ratios (aOR). SBS symptoms for eyes were associated with older age, sensitivity to tobacco, and low indoor air flow. Upper respiratory symptoms were related to smoking, low social support, longer work days, and dry air. High indoor air flow was associated with reduced upper respiratory symptoms (aOR = 0.29; 95% confidence interval (CI) = 0.13–0.67). Lower respiratory symptoms were associated with high work pressure, longer work hours, chemical exposure, migraine, and exposure to new interior painting. Recent interior painting exposure was associated with a high estimated relative risk of low respiratory symptoms (aOR = 20.6; 95% CI = 2.96–143). Smoking, longer work days, low indoor air flow, indoor dryness, and volatile organics exposure, were associated with other non-specified symptoms including headache, tiredness, difficulty concentrating, anger, and dizziness. In conclusion, there are various SBS symptoms associated with different personal characteristics, psychosocial, and environmental factors. Psychosocial factors had stronger relationships with lower respiratory symptoms than with other types of SBS symptoms. Good ventilation could reduce risk factors and may relieve SBS symptoms.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-22
      DOI: 10.3390/ijerph15010007
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 8: Adsorption Property and Mechanism of
           Oxytetracycline onto Willow Residues

    • Authors: Di Wang, Haiyang Xu, Shengke Yang, Wenke Wang, Yanhua Wang
      First page: 8
      Abstract: To elucidate the adsorption property and the mechanism of plant residues to reduce oxytetracycline (OTC), the adsorption of OTC onto raw willow roots (WR-R), stems (WS-R), leaves (WL-R), and adsorption onto desugared willow roots (WR-D), stems (WS-D), and leaves (WL-D) were investigated. The structural characterization was analyzed by scanning electron microscopy, Fourier-transform infrared spectra, and an elemental analyzer. OTC adsorption onto the different tissues of willow residues was compared and correlated with their structures. The adsorption kinetics of OTC onto willow residues was found to follow the pseudo-first-order model. The isothermal adsorption process of OTC onto the different tissues of willow residues followed the Langmuir and Freundlich model and the process was also a spontaneous endothermic reaction, which was mainly physical adsorption. After the willow residues were desugared, the polarity decreased and the aromaticity increased, which explained why the adsorption amounts of the desugared willow residues were higher than those of the unmodified residues. These observations suggest that the raw and modified willow residues have great potential as adsorbents to remove organic pollutants.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-22
      DOI: 10.3390/ijerph15010008
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 9: Efficacy of Natural Polymer Derivatives on Soil
           Physical Properties and Erosion on an Experimental Loess Hillslope

    • Authors: Jun’e Liu, Zhanli Wang, Yuanyuan Li
      First page: 9
      Abstract: Raindrops disperse large soil aggregates into smaller particles, which can clog soil pores, cause soil crusting, reduce rainfall infiltration and increase soil loss. It was found that natural polymer derivatives were effective in improving soil physical properties and decreasing soil erosion on an experimental loess hillslope. This study investigated the effect of new natural polymer derivatives (Jag S and Jag C162) on soil properties, rainfall infiltration and sediment yield at four rates of sprayed polymers (0, 1, 3 and 5 g/m2), three rainfall intensities (1, 1.5 and 2 mm/min) and a slope gradient of 15° with a silt loam soil through simulated rain. The results showed that both Jag S and Jag C162 significantly increased the shear strength and improved the aggregates composition of the soil surface. The water-stable soil aggregates >0.25 mm increased from 9% to 50% with increasing rates of Jag S and Jag C162. Jag S and Jag C162 also effectively increased rainfall infiltration and final infiltration rate, and reduced erosion compared to controls without natural polymer derivatives added. However, higher rates of Jag S produced lower infiltration rates. Although both Jag S and Jag C162 effectively influenced soil physical properties and erosion, the effect of Jag C162 was more significant than that of Jag S.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-22
      DOI: 10.3390/ijerph15010009
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 10: Measurement of Scenic Spots Sustainable
           Capacity Based on PCA-Entropy TOPSIS: A Case Study from 30 Provinces,

    • Authors: Xuedong Liang, Canmian Liu, Zhi Li
      First page: 10
      Abstract: In connection with the sustainable development of scenic spots, this paper, with consideration of resource conditions, economic benefits, auxiliary industry scale and ecological environment, establishes a comprehensive measurement model of the sustainable capacity of scenic spots; optimizes the index system by principal components analysis to extract principal components; assigns the weight of principal components by entropy method; analyzes the sustainable capacity of scenic spots in each province of China comprehensively in combination with TOPSIS method and finally puts forward suggestions aid decision-making. According to the study, this method provides an effective reference for the study of the sustainable development of scenic spots and is very significant for considering the sustainable development of scenic spots and auxiliary industries to establish specific and scientific countermeasures for improvement.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-22
      DOI: 10.3390/ijerph15010010
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 11: Evaluation of Behavior Change Communication
           Campaigns to Promote Modern Cookstove Purchase and Use in Lower Middle
           Income Countries

    • Authors: William Evans, Michael Johnson, Kirstie Jagoe, Dana Charron, Bonnie Young, A. Rahman, Daniel Omolloh, Julie Ipe
      First page: 11
      Abstract: Nearly three billion people worldwide burn solid fuels and kerosene in open fires and inefficient stoves to cook, light, and heat their homes. Cleaner-burning stoves reduce emissions and can have positive health, climate, and women’s empowerment benefits. This article reports on the protocol and baseline data from the evaluation of four behavior change communication (BCC) campaigns carried out in lower to middle income countries aimed at promoting the sale and use of cleaner-burning stoves. Interventions implemented in Bangladesh, Kenya, and Nigeria are using a range of BCC methods including mass media, digital media, outdoor advertising, and inter-personal communication. The mixed methods evaluation comprises three large-scale surveys: one pre-BCC and two follow-ups, along with smaller scale assessments of stove uptake and patterns of use. Baseline results revealed varying levels of awareness of previous promotions and positive attitudes and beliefs about modern (i.e., relatively clean-burning) cookstoves. Differences in cookstove preferences and behaviors by gender, socio-demographics, media use, and country/region were observed that may affect outcomes. Across all three countries, cost (lack of funds) a key perceived barrier to buying a cleaner-burning stove. Future multivariate analyses will examine potential dose-response effects of BCC on cookstove uptake and patterns of use. BCC campaigns have the potential to promote modern cookstoves at scale. More research on campaign effectiveness is needed, and on how to optimize messages and channels. This evaluation builds on a limited evidence base in the field.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-22
      DOI: 10.3390/ijerph15010011
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 12: Differences between Dual Users and Switchers
           Center around Vaping Behavior and Its Experiences Rather than Beliefs and

    • Authors: Karolien Adriaens, Dinska Van Gucht, Frank Baeyens
      First page: 12
      Abstract: (1) Background: Many smokers completely switch to vaping (switchers), whereas others use e-cigarettes (e-cigs) alongside tobacco cigarettes (dual users). To the extent that dual users substantially lower the number of cigarettes, they will reduce health risks from smoking. However, from a medical point of view, exclusive vaping is preferable to dual use; (2) Methods: Using an online questionnaire we assessed behavioral, cognitive and attitudinal aspects of e-cig use in smoking and ex-smoking vapers; (3) Results: Our sample consisted of 19% dual users and 81% switchers. Before e-cig initiation, both groups smoked on average 22 cigarettes per day (CPD). After e-cig initiation, dual users decreased tobacco consumption by 82% and were low-to-moderately cigarette dependent. Both groups had been vaping for on average 22 months, were highly e-cig dependent, used state-of-the-art e-cigs, nicotine concentrations of 4–8 mg/mL and often flavors other than tobacco. Dual users used substantially less e-liquid per week than switchers but reported a similar number of puffs/day, experienced less e-cig efficacy, more practical problems, more negative and less positive consequences, and endorsed smoking reduction (rather than quitting) as a more important reason to start vaping. For both groups, e-cig risk perception was low and little stigmatization was experienced. Dual users preferred tobacco cigarettes in stressful situations and when rapid nicotine uptake is required. E-cigs were preferred where cigarettes are prohibited and to reduce second-hand smoke; (4) Conclusions: Differences between dual users and switchers center around variables proximal to the vaping behavior and its experienced effects rather than hinging on more general vaping-related beliefs and attitudes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010012
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 13: On the Impact of Anomalous Noise Events on Road
           Traffic Noise Mapping in Urban and Suburban Environments

    • Authors: Ferran Orga, Francesc Alías, Rosa Alsina-Pagès
      First page: 13
      Abstract: Noise pollution is a critical factor affecting public health, the relationship between road traffic noise (RTN) and several diseases in urban areas being especially disturbing. The Environmental Noise Directive 2002/49/EC and the CNOSSOS-EU framework are the main instruments of the European Union to identify and combat noise pollution, requiring Member States to compose and publish noise maps and noise management action plans every five years. Nowadays, the noise maps are starting to be tailored by means of Wireless Acoustic Sensor Networks (WASN). In order to exclusively monitor the impact of RTN on the well-being of citizens through WASN-based approaches, those noise sources unrelated to RTN denoted as Anomalous Noise Events (ANEs) should be removed from the noise map generation. This paper introduces an analysis methodology considering both Signal-to-Noise Ratio (SNR) and duration of ANEs to evaluate their impact on the A-weighted equivalent RTN level calculation for different integration times. The experiments conducted on 9 h of real-life data from the WASN-based DYNAMAP project show that both individual high-impact events and aggregated medium-impact events bias significantly the equivalent noise levels of the RTN map, making any derived study about public health impact inaccurate.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010013
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 14: Oral Health Status and Behavior among Cancer
           Survivors in Korea Using Nationwide Survey

    • Authors: Mi Han
      First page: 14
      Abstract: Cancer survivors remain at life-long risk of developing oral complications. This study investigated the oral health status and behavior among cancer survivors in comparison to subjects without a history of cancer using a nationwide survey. Cancer survivors and control subjects were selected from the sixth Korean National Health and Nutrition Examination Survey (2013–2015). Survivors reported chewing (34.8%) and speaking difficulties (15.3%) resulting from oral health problems. More than 36% of survivors had periodontal disease and 15.9% needed dentures. In multiple logistic regression analysis, age, household income, education level, smoking status, cancer site, and current cancer status were associated with oral health status. Approximately 43.3% of cancer survivors brushed their teeth more than three times a day. In addition, 44.9% of survivors used secondary oral products, and 30.8% had been screened for oral health problems over the past year. Age, household income and education level were associated with oral health behavior. The oral health status and behavior excepting periodontal disease and the use of secondary oral products were not significantly different between cancer survivors and controls. Although oral health status of cancer survivors was not worse than that of controls, more than half of the survivors maintained unhealthy oral practices.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010014
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 15: Child Nutritional Status in the Changing
           Socioeconomic Region of the Northern Amazon, Brazil

    • Authors: Mônica Cunha, Rejane Marques, José Dórea
      First page: 15
      Abstract: The living conditions (i.e., socioeconomic, healthcare-related, nutritional, and environmental) to which children are exposed may influence their ability to reach their optimal growth potential. This review focuses on the relationship between the nutritional status of children under five years of age and social and environmental factors in Northern Brazil. Children living in this region have limited access to healthcare and face precarious socioeconomic and environmental conditions. This analysis was based on data from national health surveys, the consolidated food, nutrition surveillance system (SISVAN), and indicators of the DPSEEA (driving force, pressure, state, exposures, health effects, and actions) framework. The northern region has the worst living conditions in the country, and children under five years of age have significant height-for-age, weight-for-age, and weight-for-height deficits. Concomitantly, the prevalence of children who are overweight has increased significantly, although it remains lower than that in more developed Brazilian regions. Insufficient and/or inadequate dietary practices and early exposure to unfavorable living conditions are risk factors for nutritional deviations. Further advances in public health policies that consider regional characteristics, particularly in the north, where progress has been slower, are needed.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010015
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 16: Pollution from Fossil-Fuel Combustion is the
           Leading Environmental Threat to Global Pediatric Health and Equity:
           Solutions Exist

    • Authors: Frederica Perera
      First page: 16
      Abstract: Fossil-fuel combustion by-products are the world’s most significant threat to children’s health and future and are major contributors to global inequality and environmental injustice. The emissions include a myriad of toxic air pollutants and carbon dioxide (CO2), which is the most important human-produced climate-altering greenhouse gas. Synergies between air pollution and climate change can magnify the harm to children. Impacts include impairment of cognitive and behavioral development, respiratory illness, and other chronic diseases—all of which may be “seeded“ in utero and affect health and functioning immediately and over the life course. By impairing children’s health, ability to learn, and potential to contribute to society, pollution and climate change cause children to become less resilient and the communities they live in to become less equitable. The developing fetus and young child are disproportionately affected by these exposures because of their immature defense mechanisms and rapid development, especially those in low- and middle-income countries where poverty and lack of resources compound the effects. No country is spared, however: even high-income countries, especially low-income communities and communities of color within them, are experiencing impacts of fossil fuel-related pollution, climate change and resultant widening inequality and environmental injustice. Global pediatric health is at a tipping point, with catastrophic consequences in the absence of bold action. Fortunately, technologies and interventions are at hand to reduce and prevent pollution and climate change, with large economic benefits documented or predicted. All cultures and communities share a concern for the health and well-being of present and future children: this shared value provides a politically powerful lever for action. The purpose of this commentary is to briefly review the data on the health impacts of fossil-fuel pollution, highlighting the neurodevelopmental impacts, and to briefly describe available means to achieve a low-carbon economy, and some examples of interventions that have benefited health and the economy.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010016
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 17: 1950MHz Radio Frequency Electromagnetic
           Radiation Inhibits Testosterone Secretion of Mouse Leydig Cells

    • Authors: Yan-Yun Lin, Tao Wu, Jun-Ye Liu, Peng Gao, Kang-Chu Li, Qi-Yan Guo, Meng Yuan, Hai-Yang Lang, Li-Hua Zeng, Guo-Zhen Guo
      First page: 17
      Abstract: More studies that are focused on the bioeffects of radio-frequency (RF) electromagnetic radiation that is generated from the communication devices, but there were few reports with confirmed results about the bioeffects of RF radiation on reproductive cells. To explore the effects of 1950 MHz RF electromagnetic radiation (EMR) on mouse Leydig (TM3) cells. TM3 cells were irradiated or sham-irradiated continuously for 24 h by the specific absorption rate (SAR) 3 W/kg radiation. At 0, 1, 2, 3, 4, and 5 days after irradiation, cell proliferation was detected by cell counting kit-8 (CCK-8) method, cell cycle distribution, percentage of apoptosis, and cellular reactive oxygen species (ROS) were examined by flow cytometry, Testosterone level was measured using enzyme-linked immunosorbent assay (ELISA) assay, messenger ribonucleic acid (mRNA) expression level of steroidogenic acute regulatory protein (StAR) and P450scc in TM3 cells was detected by real-time polymerase chain reaction (PCR). After being irradiated for 24 h, cell proliferation obviously decreased and cell cycle distribution, secretion capacity of Testosterone, and P450scc mRNA level were reduced. While cell apoptosis, ROS, and StAR mRNA level did not change significantly. The current results indicated that 24 h of exposure at 1950 MHz 3 W/kg radiation could cause some adverse effects on TM3 cells proliferation and Testosterone secretion, further studies about the biological effects in the reproductive system that are induced by RF radiation are also needed.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010017
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 18: Indigenous Infant Mortality by Age and Season
           of Birth, 1800–1899: Did Season of Birth Affect Children’s Chances for

    • Authors: Lena Karlsson
      First page: 18
      Abstract: This paper focuses on the influence of season of birth on infant mortality among the Sami and non-Sami populations in northern Sweden during the nineteenth century. The source material is a set of data files from the Demographic Data Base at Umeå University, making it possible to combine age at death (in days), month of death, and month of birth over the course of the entire century. Cox regression models reveal that for the first week of life, season of birth had no influence on the risk of mortality. For the Sami, the results showed that being born during winter was related to a higher risk of neonatal mortality, and being born during summer was related to a higher risk of mortality after six months of age. Furthermore, for the Sami, the neonatal mortality showed a U-shaped pattern with a minimum in June–August, whereas the corresponding pattern among the non-Sami was flatter. The findings shed light on vulnerability in two populations sharing the same environment, but diverging in terms of social, economic, and cultural factors.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010018
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 19: Is There Any Relationship between Plasma
           25-Hydroxyvitamin D3, Adipokine Profiles and Excessive Body Weight in Type
           2 Diabetic Patients'

    • Authors: Joanna Kocot, Piotr Dziemidok, Małgorzata Kiełczykowska, Jacek Kurzepa, Grzegorz Szcześniak, Irena Musik
      First page: 19
      Abstract: A growing interest in the role of vitamin D in metabolic diseases led us to study the relationships between 25-hydroxyvitamin D3 (25(OH)D3) and the profiles of selected adipokines in type 2 diabetic (T2DM) patients. The study comprised 92 type 2 diabetics divided into quartiles regarding 25(OH)D3 concentration. Each group was divided into male and female subgroups. All the studied patients had their anthropometric and biochemical parameters determined. Plasma 25-hydroxyvitamin D3 concentration was determined by HPLC, while the selected adipokines (leptin, adiponectin, resistin and visfatin) by ELISA methods. The ratio of leptin to adiponectin (L/A) was calculated for all the patients. In 85.3% of diabetics a full (<20 ng/mL) or moderate (20–30 ng/mL) vitamin D deficit was found. Irrespective of sex, plasma leptin concentration decreased across increasing quartiles of 25(OH)D3 level. In women, 25(OH)D3 was negatively correlated with BMI, leptin level as well as L/A ratio, and positively with adiponectin concentration. In men, 25(OH)D3 was positively correlated with HDL and negatively with systolic blood pressure (SBP), leptin level and L/A ratio. Considering all the patients, there ocurred a significant negative correlation between 25(OH)D3 and SBP, BMI, WHR, TG, leptin and L/A ratio and positive ones between 25(OH)D3 and both adiponectin and HDL. The results of the study support the existence of the relationship among vitamin D, obesity and leptin in type 2 diabetic patients.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010019
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 20: Forecasting the Amount of Waste-Sewage Water
           Discharged into the Yangtze River Basin Based on the Optimal Fractional
           Order Grey Model

    • Authors: Shuliang LI, Wei Meng, Yufeng Xie
      First page: 20
      Abstract: With the rapid development of the Yangtze River economic belt, the amount of waste-sewage water discharged into the Yangtze River basin increases sharply year by year, which has impeded the sustainable development of the Yangtze River basin. The water security along the Yangtze River basin is very important for China, It is something aboutwater security of roughly one-third of China’s population and the sustainable development of the 19 provinces, municipalities and autonomous regions among the Yangtze River basin. Therefore, a scientific prediction of the amount of waste-sewage water discharged into Yangtze River basin has a positive significance on sustainable development of industry belt along with Yangtze River basin. This paper builds the fractional DWSGM(1,1)(DWSGM(1,1) model is short for Discharge amount of Waste Sewage Grey Model for one order equation and one variable) model based on the fractional accumulating generation operator and fractional reducing operator, and calculates the optimal order of “r” by using particle swarm optimization(PSO)algorithm for solving the minimum average relative simulation error. Meanwhile, the simulation performance of DWSGM(1,1)model with the optimal fractional order is tested by comparing the simulation results of grey prediction models with different orders. Finally, the optimal fractional order DWSGM(1,1)grey model is applied to predict the amount of waste-sewage water discharged into the Yangtze River basin, and corresponding countermeasures and suggestions are put forward through analyzing and comparing the prediction results. This paper has positive significance on enriching the fractional order modeling method of the grey system.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010020
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 21: Infant Feeding Beliefs, Attitudes, Knowledge
           and Practices of Chinese Immigrant Mothers: An Integrative Review of the

    • Authors: Ana Lindsay, Qun Le, Mary Greaney
      First page: 21
      Abstract: Chinese are a fast-growing immigrant population group in several parts of the world (e.g., Australia, Canada, Europe, Southeast Asia, United States). Research evidence suggests that compared to non-Hispanic whites, individuals of Asian-origin including Chinese are at higher risk of developing cardiovascular disease and type 2 diabetes at a lower body mass index (BMI). These risks may be possibly due to genetic differences in body composition and metabolic responses. Despite the increasing numbers of Chinese children growing up in immigrant families and the increasing prevalence of obesity among Chinese, little research has been focused on children of Chinese immigrant families. This integrative review synthesizes the evidence on infant feeding beliefs, attitudes, knowledge and practices of Chinese immigrant mothers; highlights limitations of available research; and offers suggestions for future research. Using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we searched four electronic academic/research databases (CINAHL, Medline, PsycINFO, and PubMed) to identify peer-reviewed, full-text papers published in English between January 2000 and September 2017. Only studies with mothers 18+ years old of normally developing infants were included. Of the 797 citations identified, 15 full-text papers were retrieved and 11 studies (8 cross-sectional studies, 3 qualitative studies) met the inclusion criteria and were included in this review. Reviewed studies revealed high initiation rates of breastfeeding, but sharp declines in breastfeeding rates by six months of age. In addition, reviewed studies revealed that the concomitantly use of breast milk and formula, and the early introduction of solid foods were common. Finally, reviewed studies identified several familial and socio-cultural influences on infant feeding beliefs and practices that may increase risk of overweight and obesity during infancy and early childhood among Chinese children of immigrant families. Nonetheless, as only 11 studies were identified and because the majority of studies (n = 8) were conducted in Australia, additional research including longitudinal studies, and studies conducted in countries with large Chinese immigrant population are needed to further identify and understand influences on Chinese immigrant mothers’ beliefs, attitudes, and practices related to infant feeding that may increase risk of child overweight and obesity. This information is needed to develop interventions tailored to the beliefs and needs of this fast-growing immigrant group and aimed at promoting healthy infant feeding practices to prevent childhood overweight and obesity.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010021
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 22: Exposure to Ambient Fine Particulate Air
           Pollution in Utero as a Risk Factor for Child Stunting in Bangladesh

    • Authors: Nihit Goyal, David Canning
      First page: 22
      Abstract: Pregnant mothers in Bangladesh are exposed to very high and worsening levels of ambient air pollution. Maternal exposure to fine particulate matter has been associated with low birth weight at much lower levels of exposure, leading us to suspect the potentially large effects of air pollution on stunting in children in Bangladesh. We estimate the relationship between exposure to air pollution in utero and child stunting by pooling outcome data from four waves of the nationally representative Bangladesh Demographic and Health Survey conducted between 2004 and 2014, and calculating children’s exposure to ambient fine particulate matter in utero using high resolution satellite data. We find significant increases in the relative risk of child stunting, wasting, and underweight with higher levels of in utero exposure to air pollution, after controlling for other factors that have been found to contribute to child anthropometric failure. We estimate the relative risk of stunting in the second, third, and fourth quartiles of exposure as 1.074 (95% confidence interval: 1.014–1.138), 1.150 (95% confidence interval: 1.069–1.237, and 1.132 (95% confidence interval: 1.031–1.243), respectively. Over half of all children in Bangladesh in our sample were exposed to an annual ambient fine particulate matter level in excess of 46 µg/m3; these children had a relative risk of stunting over 1.13 times that of children in the lowest quartile of exposure. Reducing air pollution in Bangladesh could significantly contribute to the Sustainable Development Goal of reducing child stunting.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010022
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 23: Preparation and Optimisation of Cross-Linked
           Enzyme Aggregates Using Native Isolate White Rot Fungi Trametes versicolor
           and Fomes fomentarius for the Decolourisation of Synthetic Dyes

    • Authors: Martina Vršanská, Stanislava Voběrková, Ana Jiménez Jiménez, Vladislav Strmiska, Vojtěch Adam
      First page: 23
      Abstract: The key to obtaining an optimum performance of an enzyme is often a question of devising a suitable enzyme and optimisation of conditions for its immobilization. In this study, laccases from the native isolates of white rot fungi Fomes fomentarius and/or Trametes versicolor, obtained from Czech forests, were used. From these, cross-linked enzyme aggregates (CLEA) were prepared and characterised when the experimental conditions were optimized. Based on the optimization steps, saturated ammonium sulphate solution (75 wt.%) was used as the precipitating agent, and different concentrations of glutaraldehyde as a cross-linking agent were investigated. CLEA aggregates formed under the optimal conditions showed higher catalytic efficiency and stabilities (thermal, pH, and storage, against denaturation) as well as high reusability compared to free laccase for both fungal strains. The best concentration of glutaraldehyde seemed to be 50 mM and higher efficiency of cross-linking was observed at a low temperature 4 °C. An insignificant increase in optimum pH for CLEA laccases with respect to free laccases for both fungi was observed. The results show that the optimum temperature for both free laccase and CLEA laccase was 35 °C for T. versicolor and 30 °C for F. fomentarius. The CLEAs retained 80% of their initial activity for Trametes and 74% for Fomes after 70 days of cultivation. Prepared cross-linked enzyme aggregates were also investigated for their decolourisation activity on malachite green, bromothymol blue, and methyl red dyes. Immobilised CLEA laccase from Trametes versicolor showed 95% decolourisation potential and CLEA from Fomes fomentarius demonstrated 90% decolourisation efficiency within 10 h for all dyes used. These results suggest that these CLEAs have promising potential in dye decolourisation.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010023
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 24: Concept of Aided Phytostabilization of
           Contaminated Soils in Postindustrial Areas

    • Authors: Maja Radziemska, Eugeniusz Koda, Ayla Bilgin, Mgdalena Vaverková
      First page: 24
      Abstract: The experiment was carried out in order to evaluate the effects of trace element immobilizing soil amendments, i.e., chalcedonite, dolomite, halloysite, and diatomite on the chemical characteristics of soil contaminated with Cr and the uptake of metals by plants. The study utilized analysis of variance (ANOVA), principal component analysis (PCA) and Factor Analysis (FA). The content of trace elements in plants, pseudo-total and extracted by 0.01 M CaCl2, were determined using the method of spectrophotometry. All of the investigated element contents in the tested parts of Indian mustard (Brassica juncea L.) differed significantly in the case of applying amendments to the soil, as well as Cr contamination. The greatest average above-ground biomass was observed when halloysite and dolomite were amended to the soil. Halloysite caused significant increases of Cr concentrations in the roots. The obtained values of bioconcentration and translocation factors observed for halloysite treatment indicate the effectiveness of using Indian mustard in phytostabilization techniques. The addition of diatomite significantly increased soil pH. Halloysite and chalcedonite were shown to be the most effective and decreased the average Cr, Cu and Zn contents in soil.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010024
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 25: Endocrine Disrupting Chemicals Mediated through
           Binding Androgen Receptor Are Associated with Diabetes Mellitus

    • Authors: Sugunadevi Sakkiah, Tony Wang, Wen Zou, Yuping Wang, Bohu Pan, Weida Tong, Huixiao Hong
      First page: 25
      Abstract: Endocrine disrupting chemicals (EDCs) can mimic natural hormone to interact with receptors in the endocrine system and thus disrupt the functions of the endocrine system, raising concerns on the public health. In addition to disruption of the endocrine system, some EDCs have been found associated with many diseases such as breast cancer, prostate cancer, infertility, asthma, stroke, Alzheimer’s disease, obesity, and diabetes mellitus. EDCs that binding androgen receptor have been reported associated with diabetes mellitus in in vitro, animal, and clinical studies. In this review, we summarize the structural basis and interactions between androgen receptor and EDCs as well as the associations of various types of diabetes mellitus with the EDCs mediated through androgen receptor binding. We also discuss the perspective research for further understanding the impact and mechanisms of EDCs on the risk of diabetes mellitus.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-23
      DOI: 10.3390/ijerph15010025
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 26: Diabetic Ketoacidosis Severity at Diagnosis and
           Glycaemic Control in the First Year of Childhood Onset Type 1 Diabetes—A
           Longitudinal Cohort Study

    • Authors: Amal Khanolkar, Rakesh Amin, David Taylor-Robinson, Russell Viner, Justin Warner, Evelien Gevers, Terence Stephenson
      First page: 26
      Abstract: It is unclear whether diabetic ketoacidosis (DKA) severity at diagnosis affects the natural history of type 1 diabetes (T1D). We analysed associations between DKA severity at diagnosis and glycaemic control during the first year post-diagnosis. We followed 341 children with T1D, <19 years (64% non-white) attending paediatric diabetes clinics in East London. Data were extracted from routine medical registers. Subjects were categorized with normal, mild, moderate, or severe DKA. Linear mixed-effects modelling was used to assess differences in longitudinal HbA1c trajectories (glycaemic control) during 12 months post-diagnosis (1288 HbA1c data-points) based on DKA, adjusting for sex, age, ethnicity, SES (Socioeconomic Status) and treatment type. Females (OR 1.6, 95% CI 1.1–2.4) and younger age, 0–6 vs. 13–18 years (OR 2.9, 95% CI 1.5–5.6) had increased risk for DKA at diagnosis. Moderate or severe DKA was associated with higher HbA1c at diagnosis (adjusted estimates 8 mmol/mol, 2–14, and 10 mmol/mol, 4–15, respectively, compared to normal DKA). Differences in HbA1c trajectories by DKA were no longer apparent at six months post-diagnosis. All subjects experienced a steep decrease in HbA1c during the first three months followed by a gradual increase. While, DKA severity was not associated with glycaemic control at 12 months post-diagnosis, age at diagnosis, ethnicity, gender, and treatment type were significantly associated. For example, Black and mixed ethnicity children had increased risk for poor glycaemic control compared to White children (adjusted RRR 5.4, 95% CI 1.7–17.3 and RRR 2.5, 95% CI 1.2–6.0, respectively). DKA severity at diagnosis is associated with higher initial HbA1c but not glycaemic control from six months post-diagnosis. Age at diagnosis, ethnicity, gender, and insulin pump are associated with glycaemic control at one year post-diagnosis.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-25
      DOI: 10.3390/ijerph15010026
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 27: Association between Exposure to Ambient Air
           Particulates and Metabolic Syndrome Components in a Saudi Arabian

    • Authors: Magdy Shamy, Mansour Alghamdi, Mamdouh Khoder, Abdullah Mohorjy, Alser Alkhatim, Abdulrahman Alkhalaf, Jason Brocato, Lung Chen, George Thurston, Chris Lim, Max Costa
      First page: 27
      Abstract: Recent epidemiological evidence suggests that exposure to particulates may be a factor in the etiology of metabolic syndrome (MetS). In this novel study, we investigated the relationship between particulate levels and prevalence of MetS component abnormalities (hypertension, hyperglycemia, obesity) in a recruited cohort (N = 2025) in Jeddah, Saudi Arabia. We observed significant associations between a 10 μg/m3 increase in PM2.5 and increased risks for MetS (Risk Ratio (RR): 1.12; 95% Confidence Interval (CI): 1.06–1.19), hyperglycemia (RR: 1.08; 95% CI: 1.03–1.14), and hypertension (RR: 1.09; 95% CI: 1.04–1.14). PM2.5 from soil/road dust was found to be associated with hyperglycemia (RR: 1.12; 95% CI: 1.06–1.19) and hypertension (RR: 1.11; 95% CI: 1.05–1.18), while PM2.5 from traffic was associated with hyperglycemia (RR: 1.33; 95% CI: 1.05–1.71). We did not observe any health associations with source-specific mass exposures. Our findings suggest that exposure to specific elemental components of PM2.5, especially Ni, may contribute to the development of cardiometabolic disorders.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-25
      DOI: 10.3390/ijerph15010027
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 28: Mortality Rate Associated with Admission
           Hyperglycemia in Traumatic Femoral Fracture Patients Is Greater Than
           Non-Diabetic Normoglycemic Patients but Not Diabetic Normoglycemic

    • Authors: Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo, Ching-Hua Hsieh
      First page: 28
      Abstract: Background: Admission hyperglycemia is associated with increased morbidity and mortality in trauma patients. However, admission hyperglycemia is not only associated with stress-induced hyperglycemia (SIH) but also with diabetic hyperglycemia (DH); furthermore, patients with normoglycemia may not only have non-diabetic normoglycemia (NDN) but also have a possibility of diabetic normoglycemia (DN), with the diabetes under control. This study aimed to assess the effects of SIH and DH on the mortality outcomes of traumatic femoral fracture patients with NDN and DN. Methods: Admission hyperglycemia was diagnosed as a serum glucose ≥200 mg/dL upon arrival at the emergency department. Diabetes mellitus (DM) was determined by patient history and/or admission HbA1c ≥ 6.5%. DH and SIH were diagnosed by admission hyperglycemia in patients with and without DM. DN and NDN were determined by absence of admission hyperglycemia in patients with and without DM. These patients were allocated into four groups: SIH (n = 75), DH (n = 280), DN (n = 309), and NDN (n = 1326), with detailed information retracted from the Trauma Registry System at a level I trauma center between 1 January 2009, and 31 December 2016. Patients with incomplete registered data were excluded. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for mortality were estimated through a stepwise model selection of a multiple regression model that was adjusted by controlling the cofounding variables such age, sex, co-morbidities, and Injury Severity Score. Results: Compared to NDN, a 9.8-fold (95% CI 1.54–62.05; p = 0.016) and a 5.8-fold (95% CI 1.46–22.67; p = 0.012) increase in the adjusted mortality odds ratio of patients with SIH and DH, respectively, were found in this study. In addition, the adjusted odds of mortality between SIH (AOR = 0.3; 95% CI 0.03–2.99; p = 0.302) as well as DH patients (AOR = 0.6; 95% CI 0.20–1.89; p = 0.394) and DN patients had no significant difference. Conclusions: This study demonstrated that SIH and DH patients with traumatic femoral fractures had higher mortality when compared with NDN patients, but not when compared with DN patients, with or without adjustment of the differences in patient’s age, sex, co-morbidities, and injury severity.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-25
      DOI: 10.3390/ijerph15010028
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 29: Stimulating Parenting Practices in Indigenous
           and Non-Indigenous Mexican Communities

    • Authors: Heather Knauer, Emily Ozer, William Dow, Lia Fernald
      First page: 29
      Abstract: Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range of child-level (age; sex; and cognitive and socio-emotional development); household-level (indigenous ethnicity; poverty; and parental education); and community-level (economic marginalization and majority indigenous population) variables among 1893 children ages 4–18 months in poor; rural communities in Mexico. We also explored modifiers of associations between living in an indigenous community and parenting. Key findings were that stimulating parenting was negatively associated with living in an indigenous community or family self-identification as indigenous (β = −4.25; SE (Standard Error) = 0.98; β = −1.58; SE = 0.83 respectively). However; living in an indigenous community was associated with significantly more stimulating parenting among indigenous families than living in a non-indigenous community (β = 2.96; SE = 1.25). Maternal education was positively associated with stimulating parenting only in indigenous communities; and household crowding was negatively associated with stimulating parenting only in non-indigenous communities. Mothers’ parenting practices were not associated with child sex; father’s residential status; education; or community marginalization. Our findings demonstrate that despite greater community marginalization; living in an indigenous community is protective for stimulating parenting practices of indigenous mothers.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-25
      DOI: 10.3390/ijerph15010029
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 30: Emotional Regulation in Young Adults with
           Internet Gaming Disorder

    • Authors: Ju-Yu Yen, Yi-Chun Yeh, Peng-Wei Wang, Tai-Ling Liu, Yun-Yu Chen, Chih-Hung Ko
      First page: 30
      Abstract: People diagnosed with Internet gaming disorder (IGD) have been frequently reported to experience depression, anxiety, and hostility. Emotional regulation contributes to these mood symptoms. This study evaluated emotional regulation in subjects with IGD and examined relationships between emotional regulation, depression, anxiety, and hostility in young adults with IGD. We recruited 87 people with IGD and a control group of 87 people without a history of IGD. All participants underwent a diagnostic interview based on the IGD criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and they completed a questionnaire on emotional regulation, depression, anxiety, and hostility. We found that subjects with IGD were less likely to practice cognitive reappraisal and were more likely to suppress their emotions. Linear regression revealed the higher cognitive reappraisal and lower expressive suppression associated with depression, anxiety, and hostility among subjects with IGD. The emotional regulation strategies that characterize those with IGD could be contributing factors to the depression and hostility tendencies of these people. When treating patients with IGD, in addition to providing appropriate interventions to relieve depression and hostility, practitioners should effectively assess emotional regulation strategies and provide emotional regulation therapy to prevent a vicious cycle of negative emotions.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-25
      DOI: 10.3390/ijerph15010030
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 31: Contact to Nature Benefits Health: Mixed
           Effectiveness of Different Mechanisms

    • Authors: Mathias Hofmann, Christopher Young, Tina Binz, Markus Baumgartner, Nicole Bauer
      First page: 31
      Abstract: How can urban nature contribute to the reduction of chronic stress' We twice measured the concentration of the “stress hormone” cortisol in the hair of 85 volunteer gardeners (six months apart), relating cortisol level change to (self-reported) characteristics of their recreational activities. Both time spent in nature and physical activity led to decreases in cortisol, while time spent being idle led to an increase. At high levels of present stressors, however, the relationship for time spent in nature and for idleness was reversed. Time spent with social interaction had no effect on cortisol levels. Our results indicate that physical activity is an effective means of mitigating the negative effects of chronic stress. The results regarding the time spent in nature and time spent being idle are less conclusive, suggesting the need for more research. We conclude that if chronic stress cannot be abolished by eradicating its sources, public health may take to measures to reduce it—providing urban nature being one effective possibility.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-25
      DOI: 10.3390/ijerph15010031
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 32: Environment-Aware Production Scheduling for
           Paint Shops in Automobile Manufacturing: A Multi-Objective Optimization

    • Authors: Rui Zhang
      First page: 32
      Abstract: The traditional way of scheduling production processes often focuses on profit-driven goals (such as cycle time or material cost) while tending to overlook the negative impacts of manufacturing activities on the environment in the form of carbon emissions and other undesirable by-products. To bridge the gap, this paper investigates an environment-aware production scheduling problem that arises from a typical paint shop in the automobile manufacturing industry. In the studied problem, an objective function is defined to minimize the emission of chemical pollutants caused by the cleaning of painting devices which must be performed each time before a color change occurs. Meanwhile, minimization of due date violations in the downstream assembly shop is also considered because the two shops are interrelated and connected by a limited-capacity buffer. First, we have developed a mixed-integer programming formulation to describe this bi-objective optimization problem. Then, to solve problems of practical size, we have proposed a novel multi-objective particle swarm optimization (MOPSO) algorithm characterized by problem-specific improvement strategies. A branch-and-bound algorithm is designed for accurately assessing the most promising solutions. Finally, extensive computational experiments have shown that the proposed MOPSO is able to match the solution quality of an exact solver on small instances and outperform two state-of-the-art multi-objective optimizers in literature on large instances with up to 200 cars.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-25
      DOI: 10.3390/ijerph15010032
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 33: Modelling the Transmission Dynamics and Control
           of Mumps in Mainland China

    • Authors: Yong Li, Xianning Liu, Lianwen Wang
      First page: 33
      Abstract: Mumps is a common childhood viral disease and children have been vaccinated throughout the world since 1967. The incidence of mumps has increased with more than 300,000 young people infected with mumps annually in mainland China since 2005. Therefore, we designed and analyzed long-term mumps surveillance data in an SVEILR (susceptible–vaccinated–exposed–severely infectious–mildly infectious–recovered) dynamic transmission model with optimized parameter values to describe the dynamics of mumps infections in China. There were 18.02% of mumps infected young adults seeking medical advice. The vaccine coverage has been insufficient in China. Young adults with frequent contact and mild infection were identified as a major driver of mumps epidemics. The reproduction number of mumps was determined 4.28 in China. Sensitivity analysis of the basic reproduction number and the endemic equilibrium was conducted to evaluate the effectiveness of mumps control measures. We propose to increase the vaccine coverage and make two doses of MMR (Measles, mumps and rubella) vaccines freely available in China.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-26
      DOI: 10.3390/ijerph15010033
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 34: Comparison Study on the Estimation of the
           Spatial Distribution of Regional Soil Metal(loid)s Pollution Based on
           Kriging Interpolation and BP Neural Network

    • Authors: Zhenyi Jia, Shenglu Zhou, Quanlong Su, Haomin Yi, Junxiao Wang
      First page: 34
      Abstract: Soil pollution by metal(loid)s resulting from rapid economic development is a major concern. Accurately estimating the spatial distribution of soil metal(loid) pollution has great significance in preventing and controlling soil pollution. In this study, 126 topsoil samples were collected in Kunshan City and the geo-accumulation index was selected as a pollution index. We used Kriging interpolation and BP neural network methods to estimate the spatial distribution of arsenic (As) and cadmium (Cd) pollution in the study area. Additionally, we introduced a cross-validation method to measure the errors of the estimation results by the two interpolation methods and discussed the accuracy of the information contained in the estimation results. The conclusions are as follows: data distribution characteristics, spatial variability, and mean square errors (MSE) of the different methods showed large differences. Estimation results from BP neural network models have a higher accuracy, the MSE of As and Cd are 0.0661 and 0.1743, respectively. However, the interpolation results show significant skewed distribution, and spatial autocorrelation is strong. Using Kriging interpolation, the MSE of As and Cd are 0.0804 and 0.2983, respectively. The estimation results have poorer accuracy. Combining the two methods can improve the accuracy of the Kriging interpolation and more comprehensively represent the spatial distribution characteristics of metal(loid)s in regional soil. The study may provide a scientific basis and technical support for the regulation of soil metal(loid) pollution.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-26
      DOI: 10.3390/ijerph15010034
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 35: Aerobic Biodegradation Characteristic of
           Different Water-Soluble Azo Dyes

    • Authors: Shixiong Sheng, Bo Liu, Xiangyu Hou, Bing Wu, Fang Yao, Xinchun Ding, Lin Huang
      First page: 35
      Abstract: This study investigated the biodegradation performance and characteristics of Sudan I and Acid Orange 7 (AO7) to improve the biological dye removal efficiency in wastewater and optimize the treatment process. The dyes with different water-solubility and similar molecular structure were biologically treated under aerobic condition in parallel continuous-flow mixed stirred reactors. The biophase analysis using microscopic examination suggested that the removal process of the two azo dyes is different. Removal of Sudan I was through biosorption, since it easily assembled and adsorbed on the surface of zoogloea due to its insolubility, while AO7 was biodegraded incompletely and bioconverted, the AO7 molecule was decomposed to benzene series and inorganic ions, since it could reach the interior area of zoogloea due to the low oxidation-reduction potential conditions and corresponding anaerobic microorganisms. The transformation of NH3-N, SO42− together with the presence of tryptophan-like components confirm that AO7 can be decomposed to non-toxic products in an aerobic bioreactor. This study provides a theoretical basis for the use of biosorption or biodegradation mechanisms for the treatment of different azo dyes in wastewater.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-26
      DOI: 10.3390/ijerph15010035
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 36: Risk Assessment and Implication of Human
           Exposure to Road Dust Heavy Metals in Jeddah, Saudi Arabia

    • Authors: Ibrahim Shabbaj, Mansour Alghamdi, Magdy Shamy, Salwa Hassan, Musaab Alsharif, Mamdouh Khoder
      First page: 36
      Abstract: Data dealing with the assessment of heavy metal pollution in road dusts in Jeddah, Saudi Arabia and its implication to human health risk of human exposure to heavy metals, are scarce. Road dusts were collected from five different functional areas (traffic areas (TA), parking areas (PA), residential areas (RA), mixed residential commercial areas (MCRA) and suburban areas (SA)) in Jeddah and one in a rural area (RUA) in Hada Al Sham. We aimed to measure the pollution levels of heavy metals and estimate their health risk of human exposure applying risk assessment models described by United States Environmental Protection Agency (USEPA). Using geo-accumulation index (Igeo), the pollution level of heavy metals in urban road dusts was in the following order Cd > As > Pb > Zn > Cu > Ni > Cr > V > Mn > Co > Fe. Urban road dust was found to be moderately to heavily contaminated with As, Pb and Zn, and heavily to extremely contaminated with Cd. Calculation of enrichment factor (EF) revealed that heavy metals in TA had the highest values compared to that of the other functional areas. Cd, As, Pb, Zn and Cu were severely enriched, while Mn, V, Co, Ni and Cr were moderately enriched. Fe was considered as a natural element and consequently excluded. The concentrations of heavy metals in road dusts of functional areas were in the following order: TA > PA > MCRA > SA > RA > RUA. The study revealed that both children and adults in all studied areas having health quotient (HQ) < 1 are at negligible non-carcinogenic risk. The only exception was for children exposed to As in TA. They had an ingestion health quotient (HQing) 1.18 and a health index (HI) 1.19. The most prominent exposure route was ingestion. The cancer risk for children and adults from exposure to Pb, Cd, Co, Ni, and Cr was found to be negligible (≤1 × 10−6).
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-26
      DOI: 10.3390/ijerph15010036
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 37: Occupational Exposure to Solar Radiation at
           Different Latitudes and Pterygium: A Systematic Review of the Last 10
           Years of Scientific Literature

    • Authors: Alberto Modenese, Fabriziomaria Gobba
      First page: 37
      Abstract: Pterygium is a chronic eye disease: among its recognized risk factors there is long-term exposure to ultraviolet (UV) radiation. The Sun is the main source of UV exposure: according to the World Health Organization, the Population Attributable Fraction of pterygium due to solar radiation (SR) is 42–74%. Outdoor work can deeply influence the eye exposure to solar UV rays, but, despite this, pterygium is currently not adequately considered as a possible occupational disease in this working category, at least in Europe. For this reason, we performed a systematic review of the scientific literature published in the last ten years (2008–2017) considering the role of outdoor work as a risk factor for pterygium, in order to give new support for the prevention of this UV related disease in workers. We identified 29 relevant papers. Our results show that pterygium prevalence highly increased with latitude and mean annual UV index, and outdoor work is one of the most relevant risk factors, as well as age and male sex, both in high risk and in moderate risk World areas considering the environmental UV levels. Accordingly, pterygium occurring in outdoor workers should be considered an occupational disease. Moreover, our findings clearly support the need of further research on more effective prevention of the occupational risk related to long-term solar radiation exposure of the eye.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-26
      DOI: 10.3390/ijerph15010037
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 38: A Survey of Naturally-Occurring Steroid
           Hormones in Raw Milk and the Associated Health Risks in Tangshan City,
           Hebei Province, China

    • Authors: Xueyin Qu, Chuanyou Su, Nan Zheng, Songli Li, Lu Meng, Jiaqi Wang
      First page: 38
      Abstract: In recent years, high levels of hormone residue in food, capable of damaging the health of consumers, have been recorded frequently. In this study, 195 raw milk samples were obtained from Tangshan City, China, and the concentrations of 22 steroid hormones were measured by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Cortisol was detected in 12.5% of raw milk samples (mean 0.61 µg/kg; range: <limit of quantification (LOQ)–0.94 µg/kg). Progesterone was detected in 85.9% of raw milk samples (mean 5.12 µg/kg; range: <LOQ–9.04 µg/kg). The concentration of cortisol present in milk was lower than the maximum residue limit defined in Japan (10 µg/kg). Children aged between one and five years were expected to be the at-risk population when exposed to detectable steroid hormone concentrations. Based on the mean and maximum concentrations of progesterone detected in milk, the contribution was 0.85% and 0.9%, and 1.48% and 1.6% of the acceptable daily intake for boys and girls, respectively. These results imply that the concentrations of steroid hormones present in raw milk should not present a health risk for young children.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-26
      DOI: 10.3390/ijerph15010038
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 39: Estimating the Causal Impact of Proximity to
           Gold and Copper Mines on Respiratory Diseases in Chilean Children: An
           Application of Targeted Maximum Likelihood Estimation

    • Authors: Ronald Herrera, Ursula Berger, Ondine von Ehrenstein, Iván Díaz, Stella Huber, Daniel Moraga Muñoz, Katja Radon
      First page: 39
      Abstract: In a town located in a desert area of Northern Chile, gold and copper open-pit mining is carried out involving explosive processes. These processes are associated with increased dust exposure, which might affect children’s respiratory health. Therefore, we aimed to quantify the causal attributable risk of living close to the mines on asthma or allergic rhinoconjunctivitis risk burden in children. Data on the prevalence of respiratory diseases and potential confounders were available from a cross-sectional survey carried out in 2009 among 288 (response: 69 % ) children living in the community. The proximity of the children’s home addresses to the local gold and copper mine was calculated using geographical positioning systems. We applied targeted maximum likelihood estimation to obtain the causal attributable risk (CAR) for asthma, rhinoconjunctivitis and both outcomes combined. Children living more than the first quartile away from the mines were used as the unexposed group. Based on the estimated CAR, a hypothetical intervention in which all children lived at least one quartile away from the copper mine would decrease the risk of rhinoconjunctivitis by 4.7 percentage points (CAR: − 4.7 ; 95 % confidence interval ( 95 % CI): − 8.4 ; − 0.11 ); and 4.2 percentage points (CAR: − 4.2 ; 95 % CI: − 7.9 ; − 0.05 ) for both outcomes combined. Overall, our results suggest that a hypothetical intervention intended to increase the distance between the place of residence of the highest exposed children would reduce the prevalence of respiratory disease in the community by around four percentage points. This approach could help local policymakers in the development of efficient public health strategies.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-27
      DOI: 10.3390/ijerph15010039
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 40: Risk Factors for Internet Gaming Disorder:
           Psychological Factors and Internet Gaming Characteristics

    • Authors: Mi Rho, Hyeseon Lee, Taek-Ho Lee, Hyun Cho, Dong Jung, Dai-Jin Kim, In Choi
      First page: 40
      Abstract: Background: Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods: Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results: The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetitive goals (1.105), money spent on gaming (1.005), weekday game time (1.081), offline community meeting attendance (2.060), and game community membership (1.393; p < 0.05 for all eight risk factors); Conclusions: These risk factors allow for the prediction and diagnosis of IGD. In the future, these risk factors could also be used to inform clinical services for IGD diagnosis and treatment.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-27
      DOI: 10.3390/ijerph15010040
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 41: Selection of a Very Active Microbial Community
           for the Coupled Treatment of Tetramethylammonium Hydroxide and Photoresist
           in Aqueous Solutions

    • Authors: Giulio Moretti, Federica Matteucci, Matteo Saraullo, Francesco Vegliò, Maddalena del Gallo
      First page: 41
      Abstract: Aerobic treatment of wastewater containing Tetramethylammonium hydroxide (TMAH) and photoresist was investigated using a lab scale reactor inoculated with activated sludge coming from urban wastewater treatment that never received TMAH before. The consumption of TMAH was monitored by liquid ion chromatography. Biodiversity indices were calculated from Denaturing Gradient Gel Electrophoresis (DGGE) bands distribution and used to estimate changes in community composition related to adaptation to the new feeding compound. The first week of adaptation was crucial, and it was analyzed in detail: many organisms died, and the microbial community suffered a great shock. TMAH levels remained constant through the first four days, and then suddenly dropped to undetectable, and at the same time NH4+ increased. When the community showed complete adaptation, predominant groups of bacteria were obtained by the Illumina sequencing of 16s rDNA amplicons, to provide insights on ecology of the adapted community, focusing on the main actors of TMAH abatement. Richness of species (Rr) peaks suggest that the development of TMAH-consuming bacteria leads to persistent consortia that maintain toxicity resistance over time. This showed adaptation and changes of the population to the different feeding conditions, and it opens new perspectives in the in situ treatment of these important residues of industrial processes without relying on external processing plants.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-27
      DOI: 10.3390/ijerph15010041
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 42: Biomarkers for Pulmonary Inflammation and
           Fibrosis and Lung Ventilation Function in Chinese Occupational Refractory
           Ceramic Fibers-Exposed Workers

    • Authors: Xiaojun Zhu, Yishuo Gu, Wenjun Ma, Panjun Gao, Mengxuan Liu, Pei Xiao, Hongfei Wang, Juan Chen, Tao Li
      First page: 42
      Abstract: Refractory ceramic fibers (RCFs) can cause adverse health effects on workers’ respiratory system, yet no proper biomarkers have been used to detect early pulmonary injury of RCFs-exposed workers. This study assessed the levels of two biomarkers that are related to respiratory injury in RCFs-exposed workers, and explored their relations with lung function. The exposure levels of total dust and respirable fibers were measured simultaneously in RCFs factories. The levels of TGF-β1 and ceruloplasmin (CP) increased with the RCFs exposure level (p < 0.05), and significantly increased in workers with high exposure level (1.21 ± 0.49 ng/mL, 115.25 ± 32.44 U/L) when compared with the control group (0.99 ± 0.29 ng/mL, 97.90 ± 35.01 U/L) (p < 0.05). The levels of FVC and FEV1 were significantly decreased in RCFs exposure group (p < 0.05). Negative relations were found between the concentrations of CP and FVC (B = −0.423, p = 0.025), or FEV1 (B = −0.494, p = 0.014). The concentration of TGF-β1 (B = 0.103, p = 0.001) and CP (B = 8.027, p = 0.007) were associated with respirable fiber exposure level. Occupational exposure to RCFs can impair lung ventilation function and may have the potential to cause pulmonary inflammation and fibrosis. TGF-β1 and CP might be used as sensitive and noninvasive biomarkers to detect lung injury in occupational RCFs-exposed workers. Respirable fiber concentration can better reflect occupational RCFs exposure and related respiratory injuries.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-27
      DOI: 10.3390/ijerph15010042
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 43: Disparities in Non-Fatal Health Outcomes in
           Pediatric General Trauma Studies

    • Authors: Shanthi Ameratunga, Jacqueline Ramke, Nicki Jackson, Sandar Tin Tin, Belinda Gabbe
      First page: 43
      Abstract: When prevention efforts fail, injured children require high-quality health services to support their recovery. Disparities in non-fatal injury outcomes, an indicator of health-care quality, have received minimal attention. We evaluated the extent to which general trauma follow-up studies published in the peer-reviewed scientific literature provide evidence of socially patterned inequities in health, functional or disability outcomes ≥4 weeks after childhood injuries. Using a systematic search, we identified 27 eligible cohort studies from 13 high-income countries. We examined the extent to which the reported health outcomes varied across the PROGRESS criteria: place of residence, race/ethnicity, occupation, gender/sex, religion, socio-economic status, and social capital. The available evidence on differential outcomes is limited as many studies were compromised by selection or retention biases that reduced the participation of children from demographic groups at increased risk of adverse outcomes, or the analyses mainly focused on variations in outcomes by sex. Given the limited research evidence, we recommend greater attention to systematic collection and reporting of non-fatal injury outcomes disaggregated by socio-demographic indicators in order to identify disparities where these exist and inform equity-focused interventions promoting the recovery of injured children.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-27
      DOI: 10.3390/ijerph15010043
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 44: Trauma and Pain in Family-Orientated Societies

    • Authors: Jan Kizilhan
      First page: 44
      Abstract: People from family-oriented societies in particular, in addition to having a post-traumatic stress disorder (PTSD) suffer from chronic pain and physical complaints. Such people have a different understanding of physical illness and pain and, compared to patients from western societies, have different ideas on healing, even when confronted with the therapist. Hitherto, these factors have not been sufficiently taken into account in modern, multi-module therapy approaches. Trauma can be perceived via pain and physical complaints, whereby the pain is not restricted to one part of the body but is seen as covering the body as a whole. Therefore, in the treatment and above all in the patient-therapist relationship, it is necessary to understand what importance is attached to the perceived pain in relation to the trauma. The afflicted body expresses the trauma in the shape of its further-reaching consequences such as the patient’s social, collective, economic and cultural sensitivity. Therefore, for the effective treatment of trauma and chronic pain, it is necessary to use a multi-modal, interdisciplinary, and culture-sensitive approach when treating patients from traditional cultural backgrounds.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-28
      DOI: 10.3390/ijerph15010044
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 45: Contamination of Tea and Tea Infusion with
           Polycyclic Aromatic Hydrocarbons

    • Authors: Alicja Zachara, Dorota Gałkowska, Lesław Juszczak
      First page: 45
      Abstract: The aim of this work was to validate the method of determination of polycyclic aromatic hydrocarbons (PAHs), i.e., benzo(a)pyrene and sum of benzo(a)pyrene, benz(a)anthracene, benzo(b)fluoranthene and chrysene in different types of tea, as well as to assess the transfer of these contaminants from tea to tea infusion. The research materials were popular types of black, green, red and white tea. Quantitative and qualitative determination of PAHs was performed by High Performance Liquid Chromatography with fluorimetric detection (HPLC-FLD). The samples were prepared by QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) technique followed by cleaning-up by dispersion solid-phase extraction (d-SPE). Values of limit of detection and limit of quantification obtained in the validation of the method were lower than the respective maximum values given in Commission Regulation (EU) No. 836/2011. The level of contamination of popular teas commercially available on the Polish market with PAHs is similar to that of teas available in other countries, with a very large variation in the concentration of each of the compounds. The highest benzo(a)pyrene and Σ4PAHs contents (209 ± 42 μg/kg and 756 ± 151 μg/kg, respectively) were found for black tea leaves. The transfer of Σ4PAHs from black tea to tea infusions was 0.48%, while it was 1.55–1.72% for red, white and green teas.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-28
      DOI: 10.3390/ijerph15010045
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 46: Surveillance of Environmental and Procedural
           Measures of Infection Control in the Operating Theatre Setting

    • Authors: Laura Dallolio, Alessandra Raggi, Tiziana Sanna, Magda Mazzetti, Alessandra Orsi, Angela Zanni, Patrizia Farruggia, Erica Leoni
      First page: 46
      Abstract: The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and the staff compliance to the SSI evidence-based control measures. Ten operating rooms were examined for microbiological contamination of air and surfaces, after cleaning procedures, in “at rest” conditions. Furthermore, 10 surgical operations were monitored to assess staff compliance to the recommended practices. None of the air samples exceeded microbiological reference standards and only six of the 200 surface samples (3.0%) were slightly above recommended levels. Potentially pathogenic bacteria and moulds were never detected. Staff compliance to best practices varied depending on the type of behaviour investigated and the role of the operator. The major not compliant behaviours were: pre-operative skin antisepsis, crowding of the operating room and hand hygiene of the anaesthetist. The good environmental microbiological quality observed is indicative of the efficacy of the cleaning-sanitization procedures adopted. The major critical point was staff compliance to recommended practices. Awareness campaigns are therefore necessary, aimed at improving the organisation of work so as to facilitate compliance to operative protocols.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-28
      DOI: 10.3390/ijerph15010046
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 47: Spatiotemporal Risk of Bacillary Dysentery and
           Sensitivity to Meteorological Factors in Hunan Province, China

    • Authors: Chengdong Xu, Gexin Xiao, Jinfeng Wang, Xiangxue Zhang, Jinjun Liang
      First page: 47
      Abstract: Bacillary dysentery remains a public health concern in the world. Hunan Province is one of the provinces having the highest risk of bacillary dysentery in China, however, the spatial-temporal distribution, variation of bacillary dysentery and sensitivity to meteorological factors in there are unclear. In this paper, a Bayesian space-time hierarchical model (BSTHM) was used to detect space-time variation, and effects of meteorological factors between 2010 and 2015. The risk of bacillary dysentery showed apparent spatial-temporal heterogeneity. The highest risk occurred in the summer season. Economically undeveloped mountainous areas in the west and south of the province had the highest incidence rates. Twenty three (18.9%) and 20 (16.4%) counties were identified as hot and cold spots, respectively. Among the hotspots, 11 counties (47.8%) exhibited a rapidly decreasing trend, suggesting they may become low-risk areas in the future. Of the cold spot counties, six (30%) showed a slowly decreasing trend, and may have a higher risk in the future. Among meteorological factors, air temperature, relative humidity, and wind speed all played a significant role in the spatial-temporal distribution of bacillary dysentery risk. These findings can contribute to the implementation of an early warning system for controlling and preventing bacillary dysentery.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-29
      DOI: 10.3390/ijerph15010047
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 48: The Vulnerability of People to Damaging
           Hydrogeological Events in the Calabria Region (Southern Italy)

    • Authors: Olga Petrucci, Paola Salvati, Luigi Aceto, Cinzia Bianchi, Angela Pasqua, Mauro Rossi, Fausto Guzzetti
      First page: 48
      Abstract: Background: Damaging Hydrogeological Events (DHEs) are severe weather periods during which floods, landslides, lightning, windstorms, hail or storm surges can harm people. Climate change is expected to increase the frequency/intensity of DHEs and, consequently, the potential harm to people. Method: We investigated the impacts of DHEs on people in Calabria (Italy) over 37 years (1980–2016). Data on 7288 people physically affected by DHEs were gathered from the systematic analysis of regional newspapers and collected in the database named PEOPLE. The damage was codified in three severity levels as follows: fatalities (people who were killed), injured (people who suffered physical harm) and involved (people who were present at the place where an accident occurred but survived and were not harmed). During the study period, we recorded 68 fatalities, 566 injured and 6654 people involved in the events. Results: Males were more frequently killed, injured and involved than females, and females who suffered fatalities were older than males who suffered fatalities, perhaps indicating that younger females tended to be more cautious than same-aged males, while older females showed an intrinsic greater vulnerability. Involved people were younger than injured people and fatalities, suggesting that younger people show greater promptness in reacting to dangerous situations. Floods caused the majority of the fatalities, injured and involved people, followed by landslides. Lightning was the most dangerous phenomenon, and it affected a relatively low number of people, killing 11.63% of them and causing injuries to 37.2%. Fatalities and injuries mainly occurred outdoors, largely along roads. In contrast, people indoors, essentially in public or private buildings, were more frequently involved without suffering harm. Being “dragged by water/mud” and “surrounded by water/mud”, respectively, represented the two extremes of dynamic dangerousness. The dragging effect of rapid-flowing water totally or partially obstructed the attempts of people to save their lives. In contrast, people surrounded by steady water/mud encountered difficulties but ultimately could survive. Conclusions: The study outcomes can be used in informational campaigns to increase risk awareness among both administrators and citizens and to improve community resilience, particularly in promoting self-protective behaviors and avoiding the underestimation of hazardous situations.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-29
      DOI: 10.3390/ijerph15010048
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 49: Impact of Interprofessional Relationships from
           Nurses’ Perspective on the Decision-Making Capacity of Patients in a
           Clinical Setting

    • Authors: Jesús Molina-Mula, Julia Gallo-Estrada, Catalina Perelló-Campaner
      First page: 49
      Abstract: Interprofessional relationships may impact the decision making of patients in a clinical setting. The objective of this study was to analyse the decision-making capabilities of patients from nurses’ perspectives of interprofessional relationships using Foucauldian ethics. This qualitative study was based on poststructuralist Foucault references with in-depth interviews of nurses working in internal medicine and specialties in a general hospital. The patients constantly appeared in the definition of teamwork, but also as a passive element used by every professional to communicate with others. Nurses continue modelling a type of patient passivity, or what Foucault called passive subjectivity in relation to oneself, because the patient is guided and directed to take charge of a truth provided by professionals. Nurses must break the rigid design of sections or professional skills, and adopt a model of teamwork that meets the needs of the patient and increases their decision-making power. The quality of care will increase to the extent that professionals establish a relationship of equality with the patient, allowing the patient to make real decisions about their care. An egalitarian model of teamwork is beneficial to the patient, abandoning the idea of a team where the patient and family are constantly excluded from decisions about their care.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-29
      DOI: 10.3390/ijerph15010049
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 50: Estimating the Excess Mortality Risk during Two
           Red Alert Periods in Beijing, China

    • Authors: Weilin Zeng, Lingling Lang, Yue Li, Lingchuan Guo, Hualiang Lin, Yonghui Zhang, Tao Liu, Jianpeng Xiao, Xing Li, Yanjun Xu, Xiaojun Xu, Lauren Arnold, Erik Nelson, Zhengmin Qian, Wenjun Ma
      First page: 50
      Abstract: The magnitude of excess mortality risk due to exposures to heavy air pollution during the red alert periods in Beijing remains unknown. A health impact assessment tool combined with the PM2.5-mortality relationship was applied to estimate the number of excess deaths due to high air pollution exposure during two red alert periods in Beijing, China in December 2015. Daily PM2.5 concentration increased from 80.2 µg/m3 to 159.8 µg/m3 during the first red alert period and from 61.9 µg/m3 to 226 µg/m3 during the second period in 2015 when compared to daily PM2.5 concentrations during the same calendar date of 2013 and 2014. It was estimated that 26 to 42 excessive deaths (including 14 to 34 cardiovascular deaths, and four to 16 respiratory deaths) occurred during the first period, and 40 to 65 excessive deaths (22 to 53 cardiovascular deaths, and six to 13 respiratory deaths) occurred during the second period. The results show that heavy smog may have substantially increased the mortality risk in Beijing, suggesting more stringent air pollution controlling measures should be implemented to protect the public health.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-29
      DOI: 10.3390/ijerph15010050
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 51: Influence of Land Use and Point Source
           Pollution on Water Quality in a Developed Region: A Case Study in Shunde,

    • Authors: Wenjing Bo, Xiaoke Wang, Qianqian Zhang, Yi Xiao, Zhiyun Ouyang
      First page: 51
      Abstract: To design and implement policy to manage water quality, it is important to investigate land use and possible sources of pollution. In this study, using Pearson regression analysis, redundancy analysis and multiple regression analysis, we assess the influence of land use and point sources on water quality in the river system in Shunde district in 2000 and 2010. The results show that water quality was related positively with water surface but negatively with impervious and urban greening area. Additionally, water quality was related negatively to point source emissions of chemical oxygen demand (COD) and ammonium-nitrogen (NH4-N). The total explanatory power of spatial variation of water quality was improved from 43.4% to 60.0% in 2000 and from 31.3% to 57.8% in 2010, respectively, when the influence of point sources was added into redundancy analysis between water quality and land use. Thus, both land use management and point source pollution control should be considered for improving river water quality.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-30
      DOI: 10.3390/ijerph15010051
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 52: Antibiotic Resistance of Acinetobacter spp.
           Isolates from the River Danube: Susceptibility Stays High

    • Authors: Clemens Kittinger, Alexander Kirschner, Michaela Lipp, Rita Baumert, Franz Mascher, Andreas Farnleitner, Gernot Zarfel
      First page: 52
      Abstract: Acinetobacter spp. occur naturally in many different habitats, including food, soil, and surface waters. In clinical settings, Acinetobacter poses an increasing health problem, causing infections with limited to no antibiotic therapeutic options left. The presence of human generated multidrug resistant strains is well documented but the extent to how widely they are distributed within the Acinetobacter population is unknown. In this study, Acinetobacter spp. were isolated from water samples at 14 sites of the whole course of the river Danube. Susceptibility testing was carried out for 14 clinically relevant antibiotics from six different antibiotic classes. Isolates showing a carbapenem resistance phenotype were screened with PCR and sequencing for the underlying resistance mechanism of carbapenem resistance. From the Danube river water, 262 Acinetobacter were isolated, the most common species was Acinetobacter baumannii with 135 isolates. Carbapenem and multiresistant isolates were rare but one isolate could be found which was only susceptible to colistin. The genetic background of carbapenem resistance was mostly based on typical Acinetobacter OXA enzymes but also on VIM-2. The population of Acinetobacter (baumannii and non-baumannii) revealed a significant proportion of human-generated antibiotic resistance and multiresistance, but the majority of the isolates stayed susceptible to most of the tested antibiotics.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-30
      DOI: 10.3390/ijerph15010052
      Issue No: Vol. 15, No. 1 (2017)
  • IJERPH, Vol. 15, Pages 53: Factors Associated with Maintaining the Mental
           Health of Employees after the Fukushima Nuclear Disaster: Findings from
           Companies Located in the Evacuation Area

    • Authors: Masatsugu Orui, Yuriko Suzuki, Aya Goto, Seiji Yasumura
      First page: 53
      Abstract: After the nuclear disaster in Fukushima on 11 March 2011, some businesses were permitted to continue operating even though they were located in the evacuation area designated by the Japanese government. The aim of this study was to examine differences in the mental health status, workplace, living environment, and lifestyle of employees in the evacuation and non-evacuation areas. We also investigated factors related to their mental health status. Data for this cross-sectional study were collected from the questionnaire responses of 647 employees at three medium-sized manufacturing companies in the evacuation and non-evacuation areas. Through a cross-tabulation analysis, employees who worked at companies in the evacuation areas showed an increase in the duration of overtime work, work burden, and commute time, and had experienced separation from family members due to the radiation disaster and perceived radiation risks. The results of a multivariate logistic regression analysis showed that, even in a harsh workplace and living environment, being younger, participating regularly in physical activity, having a social network (Lubben Social Network Scale-6 ≤ 12), laughing frequently, and feeling satisfied with one’s workplace and domestic life were significantly associated with maintaining a healthy mental health status after the disaster. These findings are applicable for workers’ health management measures after disasters.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-12-31
      DOI: 10.3390/ijerph15010053
      Issue No: Vol. 15, No. 1 (2017)
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