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HEALTH AND SAFETY (521 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: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
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: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 25)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 179)
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: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 8)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
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: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     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: 9)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
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: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
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: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
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 y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
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: 13)
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: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
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  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
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: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
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: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 7)
Global Journal of Public Health     Open Access   (Followers: 9)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 4)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 14)
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: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 46)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 11)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 10)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 32)
Health Policy and Technology     Hybrid Journal  
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 20)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 47)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
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: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 10)
Health, Risk & Society     Hybrid Journal   (Followers: 9)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
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: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
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: 1)
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: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 1)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
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)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Research     Open Access   (Followers: 4)
International Journal of Health Sciences Education     Open Access   (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
   Published by MDPI Homepage  [149 journals]
  • IJERPH, Vol. 14, Pages 569: Geographical Environment Factors and Risk
           Assessment of Tick-Borne Encephalitis in Hulunbuir, Northeastern China

    • Authors: Yifan Li, Juanle Wang, Mengxu Gao, Liqun Fang, Changhua Liu, Xin Lyu, Yongqing Bai, Qiang Zhao, Hairong Li, Hongjie Yu, Wuchun Cao, Liqiang Feng, Yanjun Wang, Bin Zhang
      First page: 569
      Abstract: Tick-borne encephalitis (TBE) is one of natural foci diseases transmitted by ticks. Its distribution and transmission are closely related to geographic and environmental factors. Identification of environmental determinates of TBE is of great importance to understanding the general distribution of existing and potential TBE natural foci. Hulunbuir, one of the most severe endemic areas of the disease, is selected as the study area. Statistical analysis, global and local spatial autocorrelation analysis, and regression methods were applied to detect the spatiotemporal characteristics, compare the impact degree of associated factors, and model the risk distribution using the heterogeneity. The statistical analysis of gridded geographic and environmental factors and TBE incidence show that the TBE patients mainly occurred during spring and summer and that there is a significant positive spatial autocorrelation between the distribution of TBE cases and environmental characteristics. The impact degree of these factors on TBE risks has the following descending order: temperature, relative humidity, vegetation coverage, precipitation and topography. A high-risk area with a triangle shape was determined in the central part of Hulunbuir; the low-risk area is located in the two belts next to the outside edge of the central triangle. The TBE risk distribution revealed that the impact of the geographic factors changed depending on the heterogeneity.
      PubDate: 2017-05-26
      DOI: 10.3390/ijerph14060569
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 570: The Impact of Prenatal Organophosphate
           Pesticide Exposures on Thai Infant Neurodevelopment

    • Authors: Pornpimol Kongtip, Benyachalee Techasaensiri, Noppanun Nankongnab, Jane Adams, Akkarat Phamonphon, Anu Surach, Supha Sangprasert, Aree Thongsuksai, Prayoon Srikumpol, Susan Woskie
      First page: 570
      Abstract: A birth cohort was begun to investigate the levels and sources of pesticide exposure in pregnant women living in Thailand, and to examine the effects of pesticide exposure on infant neurodevelopment at five months of age. Subjects were interviewed using questionnaires regarding their demographic characteristics, educational background, and work and home activities related to pesticide exposures. Spot urine samples were collected at 28 weeks gestation and analyzed by gas chromatography-mass spectrometry to determine maternal metabolite levels of organophosphate pesticides including dimethyl phosphate (DMP); total DEP (diethyl phosphate (DEP), diethyl thiophosphate (DETP), and diethyl dithiophosphate (DEDTP), and total DAP (the sum of all metabolite levels). At five months of age, infant development was evaluated using the Bayley Scales of Infant and Toddler Development-III (Bayley-III). Higher total DEP and total DAP metabolite levels from the mother at 28 weeks’ gestation were significantly associated with reduced motor composite scores on the Bayley-III at five months of age. The total DEP levels were also significantly associated with reduced cognitive composite scores. Prenatal concentrations of maternal urinary metabolites were associated with infant cognitive and motor development. The results of several studies now suggest the need for public health intervention to reduce prenatal pesticide exposures from both agricultural and domestic use.
      PubDate: 2017-05-27
      DOI: 10.3390/ijerph14060570
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 571: Identification of a Blue Zone in a Typical
           Chinese Longevity Region

    • Authors: Yi Huang, Geoffrey Mark Jacquez
      First page: 571
      Abstract: Influenced by a special local environment, the proportion of centenarians is particularly high in some places, known as “blue zones”. Blue zones are mysterious regions that continue to attract research. This paper explores the spatial distribution of the longevity population in a typical Chinese longevity region. Longevity evaluation indexes are used to analyze the longevity phenomenon in 88 towns between 2011 and 2015. Our research findings show that longevity is more important than birth rate and migration in shaping the degree of deep aging in the research region. Fluctuations in the proportion of centenarians are much higher than for nonagenarians, both in relation to towns and to years. This is because there are so few centenarians that data collected over a short time period cannot accurately represent the overall degree of longevity in a small region; data and statistics must be collected over a longer time period to achieve this. GIS analysis revealed a stable longevity zone located in the center of the research region. This area seems to help people live more easily to 90–99 years old; however, its ability to help nonagenarians live to 100 is a weaker effect.
      PubDate: 2017-05-28
      DOI: 10.3390/ijerph14060571
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 572: FADS Gene Polymorphisms, Fatty Acid Desaturase
           Activities, and HDL-C in Type 2 Diabetes

    • Authors: Meng-Chuan Huang, Wen-Tsan Chang, Hsin-Yu Chang, Hsin-Fang Chung, Fang-Pei Chen, Ya-Fang Huang, Chih-Cheng Hsu, Shang-Jyh Hwang
      First page: 572
      Abstract: Polyunsaturated fatty acids (PUFA) correlate with risk of dyslipidemia and cardiovascular diseases. Fatty acid desaturase (FADS) single nucleotide polymorphisms (SNPs) modulate circulating PUFA concentrations. This study examined influence of FADS1 and FADS2 genetic variants on desaturase activities and blood lipid concentrations in type 2 diabetes patients, and further assessed their interrelationships. Selected SNPs (FADS1: rs174547, rs174548, rs174550; FADS2: rs174575, rs174576, rs174583, rs498793 and rs2727270) were genotyped in 820 type 2 diabetes patients and compared with those reported in the HapMap. Patient subgroups (n = 176) without taking lipid-lowering medicine were studied to assess influence of tag SNPs including rs174547, rs174575, rs498793 and rs2727270 on delta-5 desaturase (D5D: 20:4 (n-6)/20:3 (n-6)) and delta-6 desaturase (D6D:18:3 (n-6)/18:2 (n-6)) activities, and blood lipids. FADS1 rs174547 TT/TC/CC and FADS2 rs2727270 CC/CT/TT were significantly (p for trend < 0.05) associated with reduced HDL-C, D5D and D6D activities. Upon adjustment for confounders, D5D (p = 0.006) correlated significantly and D6D marginally (p = 0.07) correlated with increased HDL-C levels, whereas rs174547 and rs2727270 polymorphisms were not associated. D6D andD5D activities may play a role in modulating HDL-C levels in type 2 diabetes. Future studies with larger sample sizes are needed to investigate how FADS genetic variations interact with desaturase activities or PUFAs in the metabolism of lipoproteins in diabetic patients.
      PubDate: 2017-05-28
      DOI: 10.3390/ijerph14060572
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 573: Socioeconomic, Geospatial, and Geopolitical
           Disparities in Access to Health Care in the US 2011–2015

    • Authors: Samuel D. Towne Jr.
      First page: 573
      Abstract: Individuals forgoing needed medical care due to barriers associated with cost are at risk of missing needed care that may be necessary for the prevention or maintenance of a chronic condition among other things. Thus, continued monitoring of factors associated with forgone medical care, especially among vulnerable populations, is critical. National survey data (2011–2015) for non-institutionalized adults residing in the USA were utilized to assess forgone medical care, defined as not seeking medical care when the individual thought it was necessary because of cost in the past 12 months. Logistic regression was used to predict forgone medical care vs. sought medical care. Racial/ethnic minority working-age adults, those with lower incomes, those with lower educations, those residing in the South, and those residing in states that failed to participate in Medicaid Expansion in 2014 were more likely (p < 0.01) to forgo medical care due to cost in the past year. Policy makers seeking to reduce barriers to forgone medical care can use this information to tailor their efforts (e.g., mechanisms targeted to bridge gaps in access to care) to those most at-risk and to consider state-level policy decisions that may impact access to care.
      PubDate: 2017-05-29
      DOI: 10.3390/ijerph14060573
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 574: A Three-Year Follow-Up Study of Antibiotic and
           Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on
           Kshipra—A River Associated with Holy Religious Mass-Bathing in India:
           Protocol Paper

    • Authors: Vishal Diwan, Manju Purohit, Salesh Chandran, Vivek Parashar, Harshada Shah, Vijay K. Mahadik, Cecilia Stålsby Lundborg, Ashok J. Tamhankar
      First page: 574
      Abstract: Background: Antibiotic resistance (ABR) is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Method/Design: Quantitative and qualitative data will be collected during a 3-year follow-up study of a river associated with religious mass-bathing in Central India. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. Approval has been obtained from the Ethics Committee of R.D. Gardi Medical College, Ujjain, India (No. 2013/07/17-311). Results: The results will address the issue of antibiotic residues and antibiotic resistance with a focus on a river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic residue levels, water-quality, heavy metals and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, and seasonal differences that are associated with religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria in rivers during religious mass-bathing or during periods when there is no mass-bathing.
      PubDate: 2017-05-29
      DOI: 10.3390/ijerph14060574
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 575: Functional Coping Dynamics and Experiential
           Avoidance in a Community Sample with No Self-Injury vs. Non-Suicidal
           Self-Injury Only vs. Those with Both Non-Suicidal Self-Injury and Suicidal

    • Authors: Emma Nielsen, Kapil Sayal, Ellen Townsend
      First page: 575
      Abstract: Although emotional avoidance may be a critical factor in the pathway from psychological distress to self-injury and/or suicidality, little is known about the relative importance of differing functional coping dynamics and experiential avoidance between people with self-injury histories of differing intent (e.g., Non-Suicidal Self-Injury only vs. Non-Suicidal Self-Injury plus Suicidal Behaviour; NSSI vs. NSSI + SB). A community-based survey (N = 313; female, 81%; ages 16–49 years, M = 19.78, SD = 3.48) explored self-reported experiential avoidance and functional coping dynamics in individuals with (i) no self-injury history (controls); (ii) a history of NSSI only; and (iii) a history of NSSI + SB. Jonckheere-Terpstra trend tests indicated that avoidance coping was higher in the NSSI and NSSI + SB groups than in controls. Emotion regulation was higher in controls than those with a history of self-injury (NSSI and NSSI + SB). Approach and reappraisal coping demonstrated significant ordered effects such that control participants were higher in these coping dynamics than those with a history of NSSI only, who, in turn, were higher than those with a history of NSSI + SB (Control > NSSI > NSSI + SB). Endorsement of the reappraisal/denial facet of experiential avoidance was most pronounced in those with a history of NSSI + SB (Control < NSSI < NSSI + SB). No significant ordered effects were observed for other dimensions of experiential avoidance. Understanding how the endorsement of functional coping dynamics and which components of experiential avoidance vary between groups with differing self-injury intent histories has important implications for treatment planning.
      PubDate: 2017-05-29
      DOI: 10.3390/ijerph14060575
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 576: The Occurrence of the Colistin Resistance Gene
           mcr 1 in the Haihe River (China)

    • Authors: Dong Yang, Zhigang Qiu, Zhiqiang Shen, Hong Zhao, Min Jin, Huaying Li, Weili Liu, Jun-Wen Li
      First page: 576
      Abstract: Antibiotic failure is occurring worldwide. In a routine surveillance study on antibioticresistance genes (ARGs) in natural water bodies, we noted the detection of colistin-resistance gene mcr-1, previously identified in Escherichia coli and Klebsiella pneumoniae isolates from human beings and animals in several countries. The mcr-1 gene might be present in water environments, because aquatic ecosystems are recognized as reservoirs for antibiotic resistant bacteria (ARB) and ARGs. In this study, a qPCR assay was developed to monitor and quantify the mcr-1 gene in the Haihe River, China. The results showed that all 18 samples collected from different locations over 6 months along the Haihe River were positive for the mcr-1 gene, and the highest level of mcr-1 reached 3.81 × 105 gene copies (GC) per liter of water. This is the first study to quantify mcr-1 in a natural water system by qPCR. Our findings highlight the potential for this antibiotic resistance determinant to spread extensively, suggesting a significant health and ecological impact.
      PubDate: 2017-05-29
      DOI: 10.3390/ijerph14060576
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 577: Quality of Life in Women with Stage 1 Stress
           Urinary Incontinence after Application of Conservative Treatment—A
           Randomized Trial

    • Authors: Magdalena Ptak, Agnieszka Brodowska, Sylwester Ciećwież, Iwona Rotter
      First page: 577
      Abstract: Stress urinary incontinence (SUI) influences quality of life in female patients. In this study, we used ICIQ LUTS QoL (The International Consultation Incontinence Questionnaire Lower Urinary Tract Symptoms quality of life) to determine the quality of life (QoL) in various domains in patients with stage 1 SUI. The study included 140 perimenopausal women subjected to urodynamic tests at the Department of Gynaecology, Endocrinology and Gynaecologic Oncology, Pomeranian Medical University, Police (Poland) in 2013–2015. The study subjects were divided into two groups, A and B. Each patient completed two questionnaires, an original survey developed by the authors and the validated ICIQ LUTS QoL. Two exercise programs, each lasting for 3 months and consisting of 4 weekly sessions, were recommended to the study subjects. The program for Group A included exercises for pelvic floor muscles (PFM) with simultaneous tension of the transverse abdominal muscle (TrA), and the program for Group B, PFM exercises without TrA tension. After completing the exercise programs, patients with stage 1 SUI, both from Group A and from Group B, showed a significant improvement in most QoL domains measured with ICIQ LUTS QoL. However, more beneficial effects of the training were observed in the group subjected to PFM exercises with TrA tension.
      PubDate: 2017-05-30
      DOI: 10.3390/ijerph14060577
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 578: Cognitive-Motivational Determinants of
           Residents’ Civic Engagement and Health (Inequities) in the Context of
           Noise Action Planning: A Conceptual Model

    • Authors: Natalie Riedel, Irene van Kamp, Heike Köckler, Joachim Scheiner, Adrian Loerbroks, Thomas Claßen, Gabriele Bolte
      First page: 578
      Abstract: The Environmental Noise Directive expects residents to be actively involved in localising and selecting noise abatement interventions during the noise action planning process. Its intervention impact is meant to be homogeneous across population groups. Against the background of social heterogeneity and environmental disparities, however, the impact of noise action planning on exposure to traffic-related noise and its health effects is unlikely to follow homogenous distributions. Until now, there has been no study evaluating the impact of noise action measures on the social distribution of traffic-related noise exposure and health outcomes. We develop a conceptual (logic) model on cognitive-motivational determinants of residents’ civic engagement and health (inequities) by integrating arguments from the Model on household’s Vulnerability to the local Environment, the learned helplessness model in environmental psychology, the Cognitive Activation Theory of Stress, and the reserve capacity model. Specifically, we derive four hypothetical patterns of cognitive-motivational determinants yielding different levels of sustained physiological activation and expectancies of civic engagement. These patterns may help us understand why health inequities arise in the context of noise action planning and learn how to transform noise action planning into an instrument conducive to health equity. While building on existing frameworks, our conceptual model will be tested empirically in the next stage of our research process.
      PubDate: 2017-05-30
      DOI: 10.3390/ijerph14060578
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 579: Ultrafine Particle Distribution and Chemical
           Composition Assessment during Military Operative Trainings

    • Authors: Marcello Campagna, Ilaria Pilia, Gabriele Marcias, Andrea Frattolillo, Sergio Pili, Manuele Bernabei, Ernesto d’Aloja, Pierluigi Cocco, Giorgio Buonanno
      First page: 579
      Abstract: (1) Background: The assessment of airborne particulate matter (PM) and ultrafine particles (UFPs) in battlefield scenarios is a topic of particular concern; (2) Methods: Size distribution, concentration, and chemical composition of UFPs during operative military training activities (target drone launches, ammunition blasting, and inert bomb impact) were investigated using an electric low-pressure impactor (ELPI+) and a scanning electron microscope (SEM), equipped with energy-dispersive spectroscopy (EDS); (3) Results: The median of UFPs, measured for all sampling periods and at variable distance from sources, was between 1.02 × 103 and 3.75 × 103 particles/cm3 for drone launches, between 3.32 × 103 and 15.4 × 103 particles/cm3 for the ammunition blasting and from 7.9 × 103 to 1.3 × 104 particles/cm3 for inert launches. Maximum peak concentrations, during emitting sources starting, were 75.5 × 106 and 17.9 × 106 particles/cm3, respectively. Particles from the drone launches were predominantly composed of silicon (Si), iron (Fe) and calcium (Ca), and those from the blasting campaigns by magnesium (Mg), sulphur (S), aluminum (Al), iron (Fe), barium (Ba) and silicon (Si); (4) Conclusions: The investigated sources produced UFPs with median values lower than other anthropogenic sources, and with a similar chemical composition.
      PubDate: 2017-05-30
      DOI: 10.3390/ijerph14060579
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 580: The Effects of the Global Economic Recession
           and a Reduced Alcohol Tax on Hospitalizations Due to Alcohol-Attributed
           Diseases in Taiwan

    • Authors: Chen-Mao Liao, Chih-Ming Lin
      First page: 580
      Abstract: This study is to assess the effects of the 2008 economic crisis and a 2009 alcohol tax reduction on alcohol-related morbidity for men of different socioeconomic statuses in Taiwan. Admissions data for the period from 2007 to 2012 for men aged 24–59 years in 2007 was retrieved from the National Health Insurance Research Database. With stratification over three income levels, an interrupted time-series analysis examining the effects of the crisis and taxation reduction on incidence rates of hospitalization for alcohol-attributed diseases (AADs) was employed. The low income group showed a significant (p < 0.05) change in the rate of AAD-related hospitalizations in July 2008; specifically, an abrupt 7.11% increase that was then sustained for several months thereafter. In contrast, while the middle income group exhibited a significant 22.9% decline in the rate of AAD-related hospitalizations over the course of the crisis, that downward trend was gradual. The reduction of the alcohol tax resulted in increased rates of AADs among both the low and high income groups. The economic recession and the reduction of the alcohol tax resulted in an increased rate of AAD among low income men.
      PubDate: 2017-05-30
      DOI: 10.3390/ijerph14060580
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 581: Transtheoretical Model of Change during Travel
           Behavior Interventions: An Integrative Review

    • Authors: Margareta Friman, Jana Huck, Lars Olsson
      First page: 581
      Abstract: This study aims to identify the relevant empirical work, to synthesize its findings, and to thus attain a general understanding of the application of the Transtheoretical Model (TTM) in transport behavior research. An integrative literature review was used to determine whether or not the implemented interventions impact the stages and processes of travel behavior change. Data was collected from different databases. English language articles published between 2002 and 2017 were included. After sequentially narrowing the search and removing duplicates, 53 relevant papers remained, 13 of which fulfilled the stated criteria of constituting a transport intervention study using the TTM as a reference frame. The final 13 studies were classified and categorized according to stages and processes in the TTM. Findings showed that none of the interventions met the method requirements for a proper evaluation of design and outcome measurement. Reporting did not follow a standardized structure desirable when enabling comparative analyses. Allowing for these shortcomings, it is inferred that positive travel behavior changes have been obtained during some interventions. Importantly, although it was stated that the empirical studies were based on the TTM, the included interventions were implemented irrespective of the individual’s stage of change. For future research, it will be necessary to conduct evaluations of higher quality.
      PubDate: 2017-05-30
      DOI: 10.3390/ijerph14060581
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 582: Heterogeneous Trajectories of Physical and
           Mental Health in Late Middle Age: Importance of Life-Course Socioeconomic

    • Authors: Eunsun Kwon, Sojung Park
      First page: 582
      Abstract: Drawing on life course and cumulative disadvantage theory, this study examines heterogeneous trajectories of functional limitations and depressive symptoms among late middle-aged individuals. This study used prospective data from 6010 adults, 51 to 64 years old, collected over a 12-year-period from the Health and Retirement Study. Considering the empirical proposition that several physical and mental trajectories may exist, Latent Class Growth Modeling was used. Five heterogeneous patterns of joint trajectories (Relatively healthy, Moderately improving, Steadily deteriorating, Steeply deteriorating, and Persistently high comorbid) were identified. Early life adversity was related to an increasing risk of declines in physical and mental health. The Persistently high comorbid class was characterized by a concentration of disadvantages over the life course. The development of public health interventions could help reduce co-existing physical and mental health problems, especially during late middle-age.
      PubDate: 2017-05-30
      DOI: 10.3390/ijerph14060582
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 583: Water Consumption in European Children:
           Associations with Intake of Fruit Juices, Soft Drinks and Related
           Parenting Practices

    • Authors: Krystallia Mantziki, Carry Renders, Jaap Seidell
      First page: 583
      Abstract: Background: High intake of fruit juices and soft drinks contributes to excessive weight gain and obesity in children. Furthermore, parenting practices play an important role in the development of children’s dietary habits. The way parents play this role in the development of their children’s choices of beverages is still unclear. Objectives: To study the associations: (1) of both fruit juices and soft drinks consumption with water consumption of children and (2) The associations between parenting practices towards fruit juices and soft drinks and water consumption of children. Design: Cross-sectional data from 6 to 8 year old children from seven European communities (n = 1187) were collected. Associations among fruit juices, soft drinks, the respective parenting practices and the child’s water consumption were assessed by parental questionnaires. Results: The consumption of water was inversely associated with that of soft drinks but not with the consumption of fruit juices. The child’s water intake was favorably influenced when stricter parenting practices towards soft drinks were adopted (e.g., less parental allowance, low home availability and high parental self-efficacy in managing intake). There was less influence observed of parenting practices towards fruit juices. Fruit juices were consumed more often than soft drinks. Conclusions: Low consumption of soft drinks—and not of fruit juices—was associated with high water consumption in children in the current study. Moreover, parenting practices towards both fruit juices and soft drinks were associated with the water intake of the children, irrespective of their socio-economic status.
      PubDate: 2017-05-31
      DOI: 10.3390/ijerph14060583
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 584: Health, Well-Being and Energy Poverty in
           Europe: A Comparative Study of 32 European Countries

    • Authors: Harriet Thomson, Carolyn Snell, Stefan Bouzarovski
      First page: 584
      Abstract: Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty—which is characterised by an inability to secure adequate levels of energy services in the home—the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings.
      PubDate: 2017-05-31
      DOI: 10.3390/ijerph14060584
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 585: Evaluation of Low-Cost Mitigation Measures
           Implemented to Improve Air Quality in Nursery and Primary Schools

    • Authors: Juliana Sá, Pedro Branco, Maria Alvim-Ferraz, Fernando Martins, Sofia Sousa
      First page: 585
      Abstract: Indoor air pollution mitigation measures are highly important due to the associated health impacts, especially on children, a risk group that spends significant time indoors. Thus, the main goal of the work here reported was the evaluation of mitigation measures implemented in nursery and primary schools to improve air quality. Continuous measurements of CO2, CO, NO2, O3, CH2O, total volatile organic compounds (VOC), PM1, PM2.5, PM10, Total Suspended Particles (TSP) and radon, as well as temperature and relative humidity were performed in two campaigns, before and after the implementation of low-cost mitigation measures. Evaluation of those mitigation measures was performed through the comparison of the concentrations measured in both campaigns. Exceedances to the values set by the national legislation and World Health Organization (WHO) were found for PM2.5, PM10, CO2 and CH2O during both indoor air quality campaigns. Temperature and relative humidity values were also above the ranges recommended by American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). In general, pollutant concentrations measured after the implementation of low-cost mitigation measures were significantly lower, mainly for CO2. However, mitigation measures were not always sufficient to decrease the pollutants’ concentrations till values considered safe to protect human health.
      PubDate: 2017-05-31
      DOI: 10.3390/ijerph14060585
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 586: Extending Participatory Sensing to Personal
           Exposure Using Microscopic Land Use Regression Models

    • Authors: Luc Dekoninck, Dick Botteldooren, Luc Int Panis
      First page: 586
      Abstract: Personal exposure is sensitive to the personal features and behavior of the individual, and including interpersonal variability will improve the health and quality of life evaluations. Participatory sensing assesses the spatial and temporal variability of environmental indicators and is used to quantify this interpersonal variability. Transferring the participatory sensing information to a specific study population is a basic requirement for epidemiological studies in the near future. We propose a methodology to reduce the void between participatory sensing and health research. Instantaneous microscopic land-use regression modeling (µLUR) is an innovative approach. Data science techniques extract the activity-specific and route-sensitive spatiotemporal variability from the data. A data workflow to prepare and apply µLUR models to any mobile population is presented. The µLUR technique and data workflow are illustrated with models for exposure to traffic related Black Carbon. The example µLURs are available for three micro-environments; bicycle, in-vehicle, and indoor. Instantaneous noise assessments supply instantaneous traffic information to the µLURs. The activity specific models are combined into an instantaneous personal exposure model for Black Carbon. An independent external validation reached a correlation of 0.65. The µLURs can be applied to simulated behavioral patterns of individuals in epidemiological cohorts for advanced health and policy research.
      PubDate: 2017-05-31
      DOI: 10.3390/ijerph14060586
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 587: Short-Term Associations between Air Pollution
           Concentrations and Respiratory Health—Comparing Primary Health Care
           Visits, Hospital Admissions, and Emergency Department Visits in a
           Multi-Municipality Study

    • Authors: Tahir Taj, Ebba Malmqvist, Emilie Stroh, Daniel Oudin Åström, Kristina Jakobsson, Anna Oudin
      First page: 587
      Abstract: Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m3 increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m3 increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.
      PubDate: 2017-05-31
      DOI: 10.3390/ijerph14060587
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 588: Socioeconomic Disparity in Later-Year Group
           Trajectories of Depressive Symptoms: Role of Health and Social Engagement

    • Authors: Hyunjoo Lee, Sojung Park, Eunsun Kwon, Joonyoung Cho
      First page: 588
      Abstract: This study explored heterogeneous change patterns of South Korean older adults’ depressive symptoms by poverty status, focusing on health status and social engagement changes. We used data from four waves (2006–2012) of the Korean Longitudinal Study of Aging (KLoSA). Our sample contained 2461 poor and 1668 non-poor individuals. All were 65 years old or older at baseline. We used latent class growth analysis to identify trajectory groups’ depressive symptoms. Multinomial logistic regression was used to examine how a range of changes in health conditions and social engagement was associated with trajectories among poor and non-poor participants. Among the poor, five heterogeneous trajectories with clear patterns were identified: high-to-moderate, stable-high, slightly-increasing, steeply-increasing, and stable-low. Among non-poor, high-to-moderate, steeply-increasing, and stable-low groups were found. A decrease in health conditions was the most vulnerable subgroup’s (steeply-increasing) primary risk factor. Poor older adults who reduced participation in, or decreased contact with, social networks were likely to belong to the steeply-increasing group. Our study provides impetus for organizational and/or environmental support systems to facilitate social engagement among poor older adults. Future research should examine whether the significance of social engagement among poor elders applies in less-developed and developed countries.
      PubDate: 2017-06-01
      DOI: 10.3390/ijerph14060588
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 589: Interventions Aimed at the Prevention of
           Childhood Injuries in the Indigenous Populations in Canada, Australia and
           New Zealand in the Last 20 Years: A Systematic Review

    • Authors: Alyssa Margeson, Selena Gray
      First page: 589
      Abstract: Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed at preventing injury in Indigenous children in the hope that it guides future strategies. To the best of the authors’ knowledge, no prior systematic reviews exist looking at interventions specifically aimed at preventing injury in Indigenous child populations in the three chosen countries. Electronic databases were systematically searched for relevant childhood interventions aimed at the prevention of injuries in Indigenous populations based in Canada, Australia and New Zealand from 1996 to 2016. A manual search of the reference lists of relevant articles and a manual search of relevant websites were also completed. After 191 records were screened, six interventions were identified meeting the criteria for inclusion. Eligible papers underwent a quality appraisal using adapted assessment checklists and key information was extracted. Findings were then synthesized using a narrative approach. The interventions mainly promoted child safety through activities focusing on education and awareness. Only three of the six studies measured changes in injury hospitalization rates, all but one evaluation reporting a significant decrease. Studies which measured awareness all demonstrated positive changes. Results suggest that interventions delivered in a culturally appropriate manner acted as a main success factor. Barriers identified as hindering intervention success included lack of cohesion within the intervention due to staff turnover and lack of experienced staff with Indigenous knowledge. This review revealed a limited amount of evaluated interventions for the prevention of Indigenous childhood injuries. Conclusive evidence of the effectiveness of existing interventions is lacking due to the predominantly small-scale evaluations of pilot interventions. Future research is needed to provide more rigorous evidence of the mechanisms driving the successful implementation, delivery and uptake of such strategies tailored to Indigenous children.
      PubDate: 2017-06-02
      DOI: 10.3390/ijerph14060589
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 590: Ethnic Groups Differences in Domestic Recovery
           after the Catastrophe: A Case Study of the 2008 Magnitude 7.9 Earthquake
           in China

    • Authors: Ying Wang, Yingqi Zhu, Qi Sui
      First page: 590
      Abstract: This research examined the ethnic differences in domestic recovery after the 2008 Wenchuan Earthquake in China. In 2014, 866 valid questionnaires were collected. Han and Qiang & Zang households were analyzed using logistic regression to determine the factors influencing household recovery. It was found that the householder of the Qiang & Zang group played a more important role in household recovery. Different from the Han, females from Qiang & Zang households had negative attitudes on recovery, and Qiang & Zang households did not believe in the effectiveness of public donations for post-quake recovery. The study also showed that local workers in a household were more helpful for household recovery than were migrant workers in a household, regardless of ethnicity. Therefore, the government should create more local jobs in Han and Qiang & Zang households and pay more attention to women in Qiang households. Assistance should be established specifically for the psychological recovery of Qiang women and family recovery projects.
      PubDate: 2017-06-02
      DOI: 10.3390/ijerph14060590
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 591: Reduced Dietary Selenium Impairs Vascular
           Function by Increasing Oxidative Stress in Sprague-Dawley Rat Aortas

    • Authors: Ana Stupin, Anita Cosic, Sanja Novak, Monika Vesel, Ivana Jukic, Brigita Popovic, Krunoslav Karalic, Zdenko Loncaric, Ines Drenjancevic
      First page: 591
      Abstract: This study aimed to determine whether low dietary Se content affects the function and mechanisms mediating the vascular relaxation of rat aortas, and to test the role of oxidative stress in observed differences. Male Sprague Dawley (SD) rats were maintained for 10 weeks on low Se (low-Se group; N = 20) or normal Se content (norm-Se group; N = 20) rat chow. Dose responses to acetylcholine (ACh; 10−9–10−5M) and the response to reduced pO2 were tested in noradrenaline-precontracted aortic rings in the absence/presence of the nitric oxide synthase (NOS) inhibitor nitro-l-arginine methyl ester (l-NAME), the cyclooxygenase 1 and 2 (COX-1, 2) inhibitor Indomethacin, and the antioxidative agent Tempol in tissue bath. mRNA expression of glutathione peroxidase 1 (GPx1), catalase (CAT), and Cu/Zn superoxide dismutase (SOD) was measured in rat aortas. Oxidative stress (Thiobarbituric Acid Reactive Substances; TBARS), antioxidative plasma capacity (ferric reducing ability of plasma assay; FRAP), and protein levels of GPx1 were measured in plasma and serum samples, respectively. Reduced ACh-induced relaxation (AChIR) (dominantly mediated by NO) in the low-Se group compared to the norm-Se group was restored by Tempol administration. Hypoxia-induced relaxation (HIR) (dominantly mediated by COX-1, 2), TBARS, and FRAP as well as GPx1 serum concentrations were similar between the groups. mRNA GPx1 expression in rat aortas was significantly decreased in the low-Se compared to the norm-Se group. These data suggest that low dietary Se content increases the local oxidative stress level, which subsequently affects the NO-mediated vascular response.
      PubDate: 2017-06-02
      DOI: 10.3390/ijerph14060591
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 592: The Influence of Quercetin on Maternal
           Immunity, Oxidative Stress, and Inflammation in Mice with Exposure of Fine
           Particulate Matter during Gestation

    • Authors: Wei Liu, Minjia Zhang, Jinqiu Feng, Aiqin Fan, Yalin Zhou, Yajun Xu
      First page: 592
      Abstract: The objective is to investigate the influence of PM2.5 exposure on peripheral blood lymphocyte subsets in pregnant mice and the antagonism of quercetin on adverse effects induced by PM2.5 exposure. Pregnant mice were randomly divided into control group, PM2.5 model group and 3 quercetin intervention groups. Dams in all groups except the control group were exposed to PM2.5 suspension by intratracheal instillation on gestational day (GD) 3, 6, 9, 12 and 15. Meanwhile, each dam was given 0.15% carboxymethylcellulose sodium (CMCS) (control group & PM2.5 model group) and different doses of quercetin (quercetin intervention groups) by gavage once a day from GD0 to GD17. The percentage of lymphocyte subsets, Biomarkers of systemic inflammation injuries (IL-2, IL-6, IL-8 & TNF-α) and oxidative stress indicators (CAT, GSH & HO-1) in peripheral blood of the dams were analyzed. The number of T cells increased, accompanied by increased level of IL-2, IL-6, IL-8 and HO-1 due to PM2.5 exposure. Less CD4+ and CD8+ T cells were counted in 100 mg/kg quercetin intervention group, compared with PM2.5 model group. Quercetin may inhibit cytokine production, especially in IL-6 and IL-8 and may upgrade the level of HO-1. Our findings indicate that PM2.5 could significantly influence the distribution of T-lymphocyte subsets, activate inflammatory reaction and elevate oxidative stress level in peripheral blood of pregnant mice. Certain dose of quercetin administration during pregnancy may protect the dams against the adverse effects through various ways.
      PubDate: 2017-06-02
      DOI: 10.3390/ijerph14060592
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 593: Measuring Neighborhood Walkable Environments:
           A Comparison of Three Approaches

    • Authors: Yen-Cheng Chiang, William Sullivan, Linda Larsen
      First page: 593
      Abstract: Multiple studies have revealed the impact of walkable environments on physical activity. Scholars attach considerable importance to leisure and health-related walking. Recent studies have used Google Street View as an instrument to assess city streets and walkable environments; however, no study has compared the validity of Google Street View assessments of walkable environment attributes to assessments made by local residents and compiled from field visits. In this study, we involved nearby residents and compared the extent to which Google Street View assessments of the walkable environment correlated with assessments from local residents and with field visits. We determined the assessment approaches (local resident or field visit assessments) that exhibited the highest agreement with Google Street View. One city with relatively high-quality walkable environments and one city with relatively low-quality walkable environments were examined, and three neighborhoods from each city were surveyed. Participants in each neighborhood used one of three approaches to assess the walkability of the environment: 15 local residents assessed the environment using a map, 15 participants made a field visit to assess the environment, and 15 participants used Google Street View to assess the environment, yielding a total of 90 valid samples for the two cities. Findings revealed that the three approaches to assessing neighborhood walkability were highly correlated for traffic safety, aesthetics, sidewalk quality, and physical barriers. Compared with assessments from participants making field visits, assessments by local residents were more highly correlated with Google Street View assessments. Google Street View provides a more convenient, low-cost, efficient, and safe approach to assess neighborhood walkability. The results of this study may facilitate future large-scale walkable environment surveys, effectively reduce expenses, and improve survey efficiency.
      PubDate: 2017-06-03
      DOI: 10.3390/ijerph14060593
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 594: The Use of Chemoprophylaxis after Floods to
           Reduce the Occurrence and Impact of Leptospirosis Outbreaks

    • Authors: Maria Schneider, Jorge Velasco-Hernandez, Kyung-duk Min, Deise Leonel, David Baca-Carrasco, Matthew Gompper, Rudy Hartskeerl, Claudia Munoz-Zanzi
      First page: 594
      Abstract: Record-breaking and devastating rainfall events have occurred in the past decade. Rain and floods are considered the main risk factors for leptospirosis and several outbreaks have been reported following extreme weather events. In such situations, one possible intervention to prevent leptospirosis cases in high-risk groups is the use of chemoprophylaxis. However, not enough evidence of its effect is available. The objectives of this study were to review the literature on the current practices of chemoprophylaxis for leptospirosis and to explore, using a mathematical model, how various chemoprophylaxis scenarios may affect the progression of a leptospirosis outbreak. Twenty-six peer-reviewed publications were selected (10 quantitative studies, two systematic reviews and 14 articles of other types). Oral doxycycline was the most used antibiotic for chemoprophylaxis of leptospirosis. Post-exposure prophylaxis was assessed in four studies following a natural disaster. Although evidence of the effectiveness of post-exposure prophylaxis is inconsistent, the direction of association supported a protective effect for morbidity and mortality. The theoretical model showed how the assumed benefit of chemoprophylaxis was influenced by the time and rate of administration. Future models should consider the heterogeneity of affected communities, improved estimates of the effect of chemoprophylaxis on leptospirosis infection and disease, as well as potential detrimental impacts. Additional research is critical to provide clear evidence-based recommendations for leptospirosis control during an outbreak. The results of this study suggest that chemoprophylaxis may provide some protection in reducing the number of leptospirosis cases after a high-risk exposure; however, the effective benefit may depend on a variety of factors such as the timing and coverage of prophylaxis. The information summarized can be used to support decision-making during a high-risk event.
      PubDate: 2017-06-03
      DOI: 10.3390/ijerph14060594
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 595: Glyphosate Residues in Groundwater, Drinking
           Water and Urine of Subsistence Farmers from Intensive Agriculture
           Localities: A Survey in Hopelchén, Campeche, Mexico

    • Authors: Jaime Rendon-von Osten, Ricardo Dzul-Caamal
      First page: 595
      Abstract: The use of pesticides in Mexican agriculture creates an interest in learning about the presence of these substances in different environmental matrices. Glyphosate (GLY) is an herbicide widely used in the state of Campeche, located in the Mayan zone in the western Yucatan peninsula. Despite the fact that GLY is considered a non-toxic pesticide to humans, its presence in water bodies through spillage, runoff, and leaching are a risk to human health or biota that inhabit these ecosystems. In the present study, glyphosate residues were determined in groundwater, bottled drinking water, and the urine of subsistence farmers from various localities of the Hopelchén municipality in Campeche. Determination of GLY was carried out using Enzyme-Linked Immunosorbent Assay (ELISA). The highest concentrations of GLY were observed in the groundwater (1.42 μg/L) of Ich-Ek and urine (0.47 μg/L) samples of subsistence farmers from the Francisco J. Mújica communities. The glyphosate concentrations in groundwater and bottled drinking water indicate an exposure and excessive use of glyphosate in these agricultural communities. This is one of the first studies that reports glyphosate concentration levels in human urine and bottled drinking water in México and in the groundwater in the Yucatan Peninsula as part of a prospective pilot study, to which a follow-up will be performed to monitor this trend over time.
      PubDate: 2017-06-03
      DOI: 10.3390/ijerph14060595
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 596: Associations among Screen Time and Unhealthy
           Behaviors, Academic Performance, and Well-Being in Chinese Adolescents

    • Authors: Hanyi Yan, Rui Zhang, Theresa Oniffrey, Guoxun Chen, Yueqiao Wang, Yingru Wu, Xinge Zhang, Quan Wang, Lu Ma, Rui Li, Justin Moore
      First page: 596
      Abstract: Screen time is negatively associated with markers of health in western youth, but very little is known about these relationships in Chinese youth. Middle-school and high-school students (n = 2625) in Wuhan, China, completed questionnaires assessing demographics, health behaviors, and self-perceptions in spring/summer 2016. Linear and logistic regression analyses were conducted to determine whether, after adjustment for covariates, screen time was associated with body mass index (BMI), eating behaviors, average nightly hours of sleep, physical activity (PA), academic performance, and psychological states. Watching television on school days was negatively associated with academic performance, PA, anxiety, and life satisfaction. Television viewing on non-school days was positively associated with sleep duration. Playing electronic games was positively associated with snacking at night and less frequently eating breakfast, and negatively associated with sleep duration and self-esteem. Receiving electronic news and study materials on non-school days was negatively associated with PA, but on school days, was positively associated with anxiety. Using social networking sites was negatively associated with academic performance, but positively associated with BMI z-score, PA and anxiety. Screen time in adolescents is associated with unhealthy behaviors and undesirable psychological states that can contribute to poor quality of life.
      PubDate: 2017-06-04
      DOI: 10.3390/ijerph14060596
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 597: Identifying Factors Associated with Risk
           Assessment Competencies of Public Health Emergency Responders

    • Authors: Jiejing Hao, Jiaojiao Ren, Qunhong Wu, Yanhua Hao, Hong Sun, Ning Ning, Ding Ding
      First page: 597
      Abstract: This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as “relatively low”, contrasting with 21.4% rated as “relatively high”. Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.
      PubDate: 2017-06-04
      DOI: 10.3390/ijerph14060597
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 598: Sex Differences in the Association of Urinary
           Concentrations of Phthalates Metabolites with Self-Reported Diabetes and
           Cardiovascular Diseases in Shanghai Adults

    • Authors: Ruihua Dong, Shanzhen Zhao, Han Zhang, Jingsi Chen, Meiru Zhang, Min Wang, Min Wu, Shuguang Li, Bo Chen
      First page: 598
      Abstract: Phthalate exposure was reported to be associated with diabetes mellitus (DM) and cardiovascular disease (CVD). Yet, reported associations and the potential sex differences are inconsistent. We conducted a cross-sectional study involving 2330 participants in the Fall of 2012. Urinary metabolites of 10 phthalates were measured. The status of having DM and CVD-related outcomes were self-reported. In the overall study population, the logistic regression analyses showed that the urinary levels of mono-2-ethyl-5-oxohexyphthalate (MEOHP), mono-2-ethyl-5-hydroxyhexylphthalate(MEHHP) and mono-2-ethyl-5-carboxypentylphthalate (MECPP) were positively associated with DM. Higher urinary levels of monomethyl phthalate (MMP) and mono-2-carboxymethyl-hexyl phthalate (MCMHP) were associated with increased odds of hyperlipidemia, while mono-2-ethylhexylphthalate (MEHP) was significantly inverse-associated with hyperlipidemia. We did not observe significant associations for other CVD-related outcomes with phthalate metabolites. When stratifying by sex, MEHHP, MEOHP, MECPP, MCMHP and the micromolar sums of the oxidative metabolites of DEHP (ΣDEHPox) were all significantly related to DM in males, but not in females. No significant sex differences were found in CVD-related outcomes, except the sporadic associations between phthalates and hyperlipidemia. These findings highlight the importance of investigating the sex-specific relationship between phthalates exposure and DM.
      PubDate: 2017-06-05
      DOI: 10.3390/ijerph14060598
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 599: Trends in Pediatric and Adolescent Anterior
           Cruciate Ligament Injuries in Victoria, Australia 2005–2015

    • Authors: Louise Shaw, Caroline Finch
      First page: 599
      Abstract: Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams.
      PubDate: 2017-06-05
      DOI: 10.3390/ijerph14060599
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 600: Risk Perceptions on Hurricanes: Evidence from
           the U.S. Stock Market

    • Authors: José Feria-Domínguez, Pilar Paneque, María Gil-Hurtado
      First page: 600
      Abstract: This article examines the market reaction of the main Property and Casualty (P & C) insurance companies listed in the New York Stock Exchange (NYSE) to seven most recent hurricanes that hit the East Coast of the United States from 2005 to 2012. For this purpose, we run a standard short horizon event study in order to test the existence of abnormal returns around the landfalls. P & C companies are one of the most affected sectors by such events because of the huge losses to rebuild, help and compensate the inhabitants of the affected areas. From the financial investors’ perception, this kind of events implies severe losses, which could influence the expected returns. Our research highlights the existence of significant cumulative abnormal returns around the landfall event window in most of the hurricanes analyzed, except for the Katrina and Sandy Hurricanes.
      PubDate: 2017-06-05
      DOI: 10.3390/ijerph14060600
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 601: Quality of Life of Post-Mastectomy Women
           Living in a Semi-Arid Region of Brazil

    • Authors: Emídio Araújo Neto, Beatriz Alves, Flávia Gehrke, Ligia Azzalis, Virginia Junqueira, Luiz Sousa, Fernando Adami, Fernando Fonseca
      First page: 601
      Abstract: Health is the major reference regarding quality of life; when it comes to breast cancer in particular, the loss of a breast traumatically affects a woman’s life, reflecting on her quality of life. Recognizing this problem, our aim was to investigate the quality of life of women who live in a semi-arid region of Brazil after breast cancer mastectomy. In this exploratory, transversal and observational study, a Brazilian variantof the shorter version of the original instrument from the World Health Organization Quality of Life (WHOQOL-BREF), applied in the study population, was analyzed and their socio-demographic profile was obtained. The sample was composed of 50 mastectomized women. The 50 included patients comprised women at a mean age of 54 years. Most of them had finished elementary school, and their average income was one Brazilian minimum monthly wage. Regarding the data related to quality of life, the highest score was found in the social relationships domain (4.29) followed by the psychological (4.09) and environmental (3.88) domains. The lowest score observed was for the physical domain (3.48). With these findings we can say that social and psychological parameters are driving factors of the quality of life in post-mastectomy women. Therefore, these results are useful to establish strategies to improve the quality of life of breast cancer mastectomy patients.
      PubDate: 2017-06-05
      DOI: 10.3390/ijerph14060601
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 602: Understanding the Challenges of Improving
           Sanitation and Hygiene Outcomes in a Community Based Intervention: A
           Cross-Sectional Study in Rural Tanzania

    • Authors: Joseph Kamara, Moses Galukande, Florence Maeda, Sam Luboga, Andre Renzaho
      First page: 602
      Abstract: Good sanitation and clean water are basic human rights yet they remain elusive to many rural communities in Sub-Saharan Africa (SSA). We carried out a cross sectional study to examine the impact of a four-year intervention aimed at improving access to water and sanitation and reducing waterborne disease, especially diarrhea in children under five years old. The study was carried out in April and May 2015 in Busangi, Chela and Ntobo wards of Kahama District of Tanzania. The interventions included education campaigns and improved water supply, and sanitation. The percentage of households (HHs) with access to water within 30 min increased from 19.2 to 48.9 and 17.6 to 27.3 in the wet and dry seasons, respectively. The percentage of HHs with hand washing facilities at the latrine increased from 0% to 13.2%. However, the incidence of diarrhea among children under five years increased over the intervention period, RR 2.91 95% CI 2.71–3.11, p < 0.0001. Availability of water alone may not influence the incidence of waterborne diseases. Factors such as water storage and usage, safe excreta disposal and other hygiene practices are critical for interventions negating the spread of water borne diseases. A model that articulates the extent to which these factors are helpful for such interventions should be explored.
      PubDate: 2017-06-05
      DOI: 10.3390/ijerph14060602
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 603: Development of Activity and Participation
           Norms among General Adult Populations in Taiwan

    • Authors: Chia-Feng Yen, Tzu-Ying Chiu, Tsan-Hon Liou, Wen-Chou Chi, Hua-Fang Liao, Chung-Chao Liang, Reuben Escorpizo
      First page: 603
      Abstract: Based on the International Classification of Functioning, Disability, and Health (ICF) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), The Functioning Disability Evaluation Scale-Adult version (FUNDES-Adult) began development in 2011. The FUNDES-Adult was designed to assess the difficulty level of an individual’s activities and participation in daily life. There is a lack of research regarding the profile of activity and participation for the general adult population. The purposes of this study were to establish activity and participation norms for the general adult population in Taiwan and to describe, discuss, and compare the activity and participation profile with other population. Method: A population-based survey was administered in 2013 using a computer-assisted telephone interviewing system (CATI system). Using probability proportional to size (PPS) sampling and systematic sampling with random digit dialing (RDD), 1500 adults from Taiwan’s general population were selected to participate in the survey. The FUNDES-Adult with six domains and two dimensions (performance and capability) was used to obtain data on activities and participation levels. A higher domain score indicated higher participation restriction. Results: Approximately 50% of the respondents were male, and the average age of the respondents was 45.23 years. There were no significant differences in the demographic features between the sample and the population. Among the six domains, the self-care domain score was the lowest (least restriction) and the participation domain score was the highest (most restriction). Approximately 90% of the sample scored were less than 15, and only 0.1% scored more than 80. This is the first cross-national population-based survey to assess norms of activity and participation relevant to the general population of Taiwan. As such, the results of this survey can be used as a reference for comparing the activity and participation (AP) functioning of other countries and subgroups.
      PubDate: 2017-06-06
      DOI: 10.3390/ijerph14060603
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 604: Work-Related Eye Injuries: A Relevant Health
           Problem. Main Epidemiological Data from a Highly-Industrialized Area of
           Northern Italy

    • Authors: Fabriziomaria Gobba, Enrico Dall’Olio, Alberto Modenese, Michele De Maria, Luca Campi, Gian Cavallini
      First page: 604
      Abstract: The province of Modena is one of the most industrialized areas of Northern Italy. The medical records of the Ophthalmological Emergency Department (OED) of Modena University Hospital were studied: there were 13,470 OED accesses in 2014 and in 754 cases that an occupational eye injury occurred. The frequency of work-related eye injuries (3‰) was lower compared to other published studies, but the absolute number is still relevant, showing the need for more adequate prevention, especially in metal work, construction work, and agriculture, where the worst prognoses were observed. Intervention programs must be implemented as early as possible in the working life, considering that the frequency in younger workers is about double that of the oldest age class (3.5‰ vs. 1.8‰), and special attention should also be given to foreigners, who have a 50% higher injury risk. Furthermore, the planning of specific interventions for eye-injured workers may be useful, considering that a previous injury does not appear to encourage the adoption of preventive interventions, and a subgroup of eye-injured workers have a potential risk for new injuries. Finally, the data presented here indicates how OED records, integrated with specific occupational information, can be applied for studies on work-related eye injuries.
      PubDate: 2017-06-06
      DOI: 10.3390/ijerph14060604
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 605: Seroprevalence of Measles Antibodies and
           Predictors for Seropositivity among Chinese Children

    • Authors: Xiaoqin Wang, Mei Ma, Zhaozhao Hui, Paul Terry, Yue Zhang, Rui Su, Mingxu Wang, Wei Gu, Ling Li
      First page: 605
      Abstract: Background: Supplementary measles immunization has been implemented since 2010 throughout China, yet few studies have reported its effect in the northwest regions. Methods: A cross-sectional study was conducted among children aged 2 to 4 years old (n = 755) from February to September 2014 in 25 towns of Qian County, Shaanxi Province. Blood samples were analyzed for measles antibodies using enzyme-linked immunosorbent immunoglobulin G (IgG) assays. Socio-demographic factors were assessed by questionnaire. Data on vaccine dose were collected from town medical records. Univariate and logistic regression analyses were used to determine factors associated with measles antibody seropositivity. Results: Measles antibody seroprevalence was 91.13% (95% CI: 89.52–92.83) in our sample. Compared with children whose mother’s highest education was primary school, seroprevalence was higher in children whose maternal education was middle school (adjusted OR: 1.4, 95% CI: 0.7–2.8), high school (adjusted OR: 2.4, 95% CI: 1.3–7.7), and college/university (adjusted OR: 2.9, 95% CI: 1.2–9.3). Vaccine dose was positively associated with seropositivity. Conclusions: Measles seroprevalence is high in China and is associated with the mother’s education and vaccine dose.
      PubDate: 2017-06-06
      DOI: 10.3390/ijerph14060605
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 606: Risk Assessment of Face Skin Exposure to UV
           Irradiance from Different Rotation Angle Ranges

    • Authors: Fang Wang, Qian Gao, Yan Deng, Rentong Chen, Yang Liu
      First page: 606
      Abstract: Ultraviolet (UV) is one of the environmental pathogenic factors causing skin damage. Aiming to assess the risk of face skin exposure to UV irradiance from different rotation angles, a rotating model was used to monitor the exposure of the skin on the face to UV irradiance, with skin damage action spectra used to determine the biologically effective UV irradiance (UVBEskin) and UVBEskin radiant exposure (HBEskin) causing skin damage. The results indicate that the UVBEskin is directly influenced by variations in rotation angles. A significant decrease of approximately 52.70% and 52.10% in UVBEskin was found when the cheek and nose measurement sites was rotated from 0° to 90°, while a decrease of approximately 62.70% was shown when the forehead measurement sites was rotated from an angle of 0° to 108°. When HBEskin was compared to the exposure limits (ELs; 30 J·m−2), the maximum relative risk ratios (RR) for cheek, nose, and forehead were found to be approximately 2.01, 2.40, and 2.90, respectively, which were all measured at a rotation angle of 0°. The maximal increase in the percentage of the average HBEskin for rotation angles of 60°, 120°, 180°, and 360° facing the sun to ELs were found to be approximately 62.10%, 52.72%, 43.43%, and 26.27% for the cheek; approximately 130.61%, 109.68%, 86.43%, and 50.06% for the nose; and approximately 178.61%, 159.19%, 134.38%, and 83.41% for the forehead, respectively.
      PubDate: 2017-06-06
      DOI: 10.3390/ijerph14060606
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 607: Getting to Know a Place: Built Environment
           Walkability and Children’s Spatial Representation of Their Home-School
           (h–s) Route

    • Authors: Mika Moran, Efrat Eizenberg, Pnina Plaut
      First page: 607
      Abstract: The literature on environmental walkability to date has mainly focused on walking and related health outcomes. While previous studies suggest associations between walking and spatial knowledge, the associations between environmental walkability and spatial knowledge is yet to be explored. The current study addresses this lacuna in research by exploring children’s mental representations of their home-school (h–s) route, vis-
      PubDate: 2017-06-06
      DOI: 10.3390/ijerph14060607
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 608: Correction: Vialard, L., et al. Toward a
           Socio-Territorial Approach to Health: Health Equity in West Africa. Int.
           J. Environ. Res. Public Health 2017, 14, 106

    • Authors: Lucie Vialard, Clara Squiban, Gilles Riveau, Emmanuel Hermann, Doudou Diop, Florence Fournet, Gérard Salem, Ellen Foley
      First page: 608
      Abstract: n/a
      PubDate: 2017-06-08
      DOI: 10.3390/ijerph14060608
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 609: Volatile Organic Compounds in Anatomical
           Pathology Wards: Comparative and Qualitative Assessment of Indoor Airborne

    • Authors: Massimo Cipolla, Alberto Izzotti, Filippo Ansaldi, Paolo Durando, Maria Piccardo
      First page: 609
      Abstract: The impact of volatile organic compounds (VOCs) on indoor air quality and on human health is widely recognized. However, VOC contamination in hospital indoor air is rarely studied and chemical compounds that singularly do not show high toxicity are not submitted to any regulation. This study aimed to compare VOC contamination in two different anatomical pathology wards in the same hospital. Hydrocarbons, alcohols, and terpenes were sampled by passive diffusive samplers. Analytical tests were performed by thermal desorption coupled with gas chromatography and mass spectrometry detector. Results highlighted a different VOC pollution in the two wards, due to the structural difference of the buildings and different organizational systems. The scarcity of similar data in the literature shows that the presence of VOCs in pathology wards is an underestimated problem. We believe that, because of the adverse effects that VOCs may have on the human health, this topic is worth exploring further.
      PubDate: 2017-06-07
      DOI: 10.3390/ijerph14060609
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 610: Changes in Smoking Behavior over Family
           Transitions: Evidence for Anticipation and Adaptation Effects

    • Authors: Damien Bricard, Stéphane Legleye, Myriam Khlat
      First page: 610
      Abstract: The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a discrete-time logistic model to explore the timing of changes in terms of leads and lags effects up to three years around the event in order to measure both anticipation and adaptation mechanisms. Retrospective biographical data from the Santé et Itinéraires Professionnels (SIP) survey conducted in France in 2006 are used. Partnership formation was followed for both genders by a fall in smoking initiation and an immediate rise in smoking cessation. Childbirth was associated with increased smoking cessation immediately around childbirth, and additionally, females showed an anticipatory increase in smoking cessation up to two years before childbirth. Couple separation was accompanied by an anticipatory increase in smoking initiation for females up to two years prior to the separation, but this effect only occurred in males during separation. Our findings highlight opportunities for more targeted interventions over the life course to reduce smoking, and therefore have relevance for general practitioners and public policy elaboration.
      PubDate: 2017-06-07
      DOI: 10.3390/ijerph14060610
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 611: ‘Hidden Habitus’: A Qualitative Study of
           Socio-Ecological Influences on Drinking Practices and Social Identity in

    • Authors: Stephanie Scott, Janet Shucksmith, Rachel Baker, Eileen Kaner
      First page: 611
      Abstract: This study explored mid-adolescents’ views and experiences of socio-ecological influences on their drinking practices in order to help inform the development of interventions to reduce alcohol-related risk. We conducted 31 in-depth interviews with young people aged 13–17 in North East England. Verbatim interview transcripts and field notes were coded systematically and analysed thematically, following the principles of constant comparison. We adopted Bourdieu’s idea of social game-playing and elements of his conceptual toolkit (particularly habitus, capital and field) during analysis. Analysis yielded three intersecting themes: (1) ‘drinking etiquette’: conveying taste and disgust; (2) ‘playing the drinking game’: demonstrating cultural competency; (3) ‘hidden habitus’—the role of alcohol marketing. Our work demonstrates that there is a nexus of influential factors which come together to help shape and reinforce mid-adolescents’ behaviour, norms and values in relation to alcohol consumption. Drinking practices are not just formed by friendships and family traditions, these are also subject to wider cultural shaping including by the alcohol industry which can encourage brand identification, and gear specific products to add ‘distinction’. However young people are not inactive players and they use aspects of capital and social games to help cement their identity and present themselves in particular ways which in turn are influenced by age, gender and social status. Guided by promising work in the tobacco field, interventions which focus on critical awareness of the framing of alcohol products by key stakeholders, such as policymakers, commercial industry and public health professionals, and by wider society may facilitate behaviour change among young people.
      PubDate: 2017-06-08
      DOI: 10.3390/ijerph14060611
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 612: High Manifestations of Mental Distress in
           Arabic Asylum Seekers Accommodated in Collective Centers for Refugees in

    • Authors: Ekaterini Georgiadou, Eva Morawa, Yesim Erim
      First page: 612
      Abstract: The number of asylum seekers in Germany has significantly increased in the last two years. Coming from regions of political conflict and war, the refugees have often experienced traumatic events which designate them as a high risk group for mental disorders. In a sample of Arabic speaking asylum seekers in collective accommodation centers in Erlangen, Germany, we estimated the extent of posttraumatic stress, depression, and anxiety. A further objective of the study was to test the comprehensibility and cultural appropriateness of the Arabic translations of the questionnaires in this sample. Between August and September 2016, 56 Arabic speaking asylum seekers placed among three collective accommodation centers in Erlangen completed self-report questionnaires assessing posttraumatic stress disorder (Essen Trauma-Inventory, ETI), and symptoms of depression (Patient Health Questionnaire—depression module, PHQ-9) and anxiety (Generalized Anxiety Disorder, GAD-7). The prevalence of participants with personally and/or witnessed traumatic events was 80.4% (n = 45). About one-third of the examinees (35.7%, n = 20) endorsed symptoms of PTSD (posttraumatic stress disorder). The total score for depression in this sample was M = 11.9 (SD = 7.9, range: 0–27). Moderate to severe depression (PHQ-9 score ≥ 15) was found in 35.7% (n = 20) of our sample and severe depression (PHQ-9 score ≥ 20) was found in 23.2% (n = 13). The total score for anxiety was M = 8.8 (SD = 6.9, range: 0–21), with 26.8% (n = 15) of the sample showing symptoms of severe anxiety (GAD-7 score ≥ 15). No significant difference between women and men with respect to frequency and symptom scores of PTSD, depression, and anxiety was found. Amongst asylum seekers of the presented sample, the rates of traumatic events as well as the prevalence of possible PTSD, depression, and anxiety were significantly higher than in the German population. This indicates that the refugee population is in need of culturally sensitive psychological interventions. However, more studies are required to improve the understanding of mental health among this particularly vulnerable population.
      PubDate: 2017-06-07
      DOI: 10.3390/ijerph14060612
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 613: Consumers’ Preferences for Electronic
           Nicotine Delivery System Product Features: A Structured Content Analysis

    • Authors: Christine Kistler, Trisha Crutchfield, Erin Sutfin, Leah Ranney, Micah Berman, Gary Zarkin, Adam Goldstein
      First page: 613
      Abstract: To inform potential governmental regulations, we aimed to develop a list of electronic nicotine delivery system (ENDS) product features important to U.S. consumers by age and gender. We employed qualitative data methods. Participants were eligible if they had used an ENDS at least once. Groups were selected by age and gender (young adult group aged 18–25, n = 11; middle-age group aged 26–64, n = 9; and women’s group aged 26–64, n = 9). We conducted five individual older adult interviews (aged 68–80). Participants discussed important ENDS features. We conducted a structured content analysis of the group and interview responses. Of 34 participants, 68% were white and 56% were female. Participants mentioned 12 important ENDS features, including: (1) user experience; (2) social acceptability; (3) cost; (4) health risks/benefits; (5) ease of use; (6) flavors; (7) smoking cessation aid; (8) nicotine content; (9) modifiability; (10) ENDS regulation; (11) bridge between tobacco cigarettes; (12) collectability. The most frequently mentioned ENDS feature was modifiability for young adults, user experience for middle-age and older adults, and flavor for the women’s group. This study identified multiple features important to ENDS consumers. Groups differed in how they viewed various features by age and gender. These results can inform ongoing regulatory efforts.
      PubDate: 2017-06-07
      DOI: 10.3390/ijerph14060613
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 614: Effects of Perceived Neighbourhood
           Environments on Self-Rated Health among Community-Dwelling Older Chinese

    • Authors: Moses Wong, Ruby Yu, Jean Woo
      First page: 614
      Abstract: In response to the growing number of older people living in cities, the World Health Organization (WHO) introduced the concept of “Age-Friendly Cities” (AFC) to guide the way in designing physical and social environments to encourage active ageing. Limited research has studied the effects of neighbourhood age-friendliness on elderly health outcomes. Using the example of a highly urbanized city in Asia, this study examined the effects of perceived age-friendliness of neighbourhood environments on self-rated health (SRH) among community-dwelling older Chinese. A multi-stage sampling method was used to collect views of community-dwelling older people from two local districts of Hong Kong. A structured questionnaire covering the WHO’s eight AFC domains was developed to collect information on the perceived neighbourhood environments, SRH and individual characteristics. Age-friendliness of neighbourhood was assessed by mean scores of AFC domains, which was used to predict SRH with adjustment for individual and objective neighbourhood characteristics. Furthermore, 719 respondents aged ≥60 years completed the questionnaire, of which 44.5% reported good SRH. Independent of individual and objective neighbourhood characteristics, multiple logistics regressions showed that higher satisfaction on outdoor spaces and buildings, transportation, housing, social participation, and respect and social inclusion was significantly associated with increased odds of reporting good SRH by more than 20% (p < 0.05). Individuals aged 70–79 years, being female, lower education and residents of public or subsidized housing were less likely to report good SRH, after controlling for individual and neighbourhood characteristics. In addition to age, gender, education and housing type, AFC environments have important contributive influence on SRH, after controlling for individual and objective neighbourhood characteristics.
      PubDate: 2017-06-07
      DOI: 10.3390/ijerph14060614
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 615: Environmental Factors Associated with Type 1
           Diabetes Development: A Case Control Study in Egypt

    • Authors: Nabil Awadalla, Amal Hegazy, Manal Abd El-Salam, Marwa Elhady
      First page: 615
      Abstract: Uncertainty still exists regarding the role of some environmental risk in the development of type 1 diabetes mellitus (T1DM) both globally and in Egypt. The objective here was to explore the potential environmental risk factors associated with the development of T1DM among children in Egypt. A case-controlled study of 204 T1DM children and an equal number of age and sex-matched controls was conducted in Assiut, Egypt. Data regarding the parental, gestational, neonatal, and childhood possible risk factors for T1DM were evaluated. The final sex adjusted multivariable logistic regression model revealed that the risk for T1DM was significantly higher among rural residents (aOR = 2.03, 95% CI: 1.30–4.25), those with parental history of T1DM (aOR = 9.03, 95% CI: 1.02–83.32), birth through cesarean section (aOR = 2.13, 95% CI: 1.09–5.03), and having history of early introduction of cow milk in the first year of life (aOR = 19.49, 95% CI: 8.73–45.53). On the other hand, a protective effect was observed between at least six months’ breastfeeding, vitamin D supplementation in the first year of life, high physical activity, and the development of T1DM. Educational programs should be adopted to improve awareness and knowledge of the parents to avoid the increased risk factors and encourage protective practices.
      PubDate: 2017-06-07
      DOI: 10.3390/ijerph14060615
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 616: Enhancement of X-ray Induced Apoptosis by
           Mobile Phone-Like Radio-Frequency Electromagnetic Fields in Mouse
           Spermatocyte-Derived Cells

    • Authors: Ke-Ying Zhang, Hui Xu, Le Du, Jun-Ling Xing, Bin Zhang, Qiang-Shan Bai, Yu-Qiao Xu, Yong-Chun Zhou, Jun-Ping Zhang, Yan Zhou, Gui-Rong Ding
      First page: 616
      Abstract: To explore the combined effects of environmental radio-frequency (RF) field and X-ray, mouse spermatocyte-derived (GC-1) cells were exposed to 1950 MHz RF field at specific absorption rate (SAR) of 3 W/kg for 24 h combined with or without X-ray irradiation at 6 Gy. After treatment, the cell proliferation level was determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) Assay and 5-Bromo-2-deoxy Uridine (BrdU) enzyme linked immunosorbent (ELISA) Assay. The apoptosis level was detected by annexin V flow cytometry assay, transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) Assay and Caspase-3 Activity Assay. It was found that the proliferation and apoptosis level did not change in GC-1 cells after RF exposure alone. However, compared with the X-ray group, the proliferation level significantly decreased and the apoptotic rate significantly increased in the RF+X-ray group. Moreover, a significant decrease in Bcl-2 protein expression and increase in Bax protein expression were observed. The findings suggested that RF exposure at SAR of 3 W/kg did not affect apoptosis and proliferation in GC-1 cells by itself, but that it did enhance the effects of X-ray induced proliferation inhibition and apoptosis, in which B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) might be involved.
      PubDate: 2017-06-07
      DOI: 10.3390/ijerph14060616
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 617: The Technology Acceptance of a TV Platform for
           the Elderly Living Alone or in Public Nursing Homes

    • Authors: Pedro Santana-Mancilla, Luis Anido-Rifón
      First page: 617
      Abstract: In Mexico, many seniors are alone for most of the day or live in public nursing homes. Simple interaction with computer systems is required for older people. This is why we propose the exploration of a medium well known by seniors, such as the television (TV). The primary objective of this study is to improve the quality of life of seniors through an easier reminder system, using the television set. A technological platform was designed based on interactive television, through which seniors and their caregivers can have a better way to track their daily activities. Finally, an evaluation of the technology adoption was performed with 50 seniors living in two public nursing homes. The evaluation found that the elderly perceived the system as useful, easy to use, and they had a positive attitude and good intention to use it. This helped to generate initial evidence that the system supported them in achieving a better quality of life, by reminding them to take their medications and increasing their rate of attendance to their medical appointments.
      PubDate: 2017-06-08
      DOI: 10.3390/ijerph14060617
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 618: Does the Health Impact of Exposure to
           Neighbourhood Green Space Differ between Population Groups? An Explorative
           Study in Four European Cities

    • Authors: Annemarie Ruijsbroek, Mariël Droomers, Hanneke Kruize, Elise van Kempen, Christopher Gidlow, Gemma Hurst, Sandra Andrusaityte, Mark Nieuwenhuijsen, Jolanda Maas, Wim Hardyns, Karien Stronks, Peter Groenewegen
      First page: 618
      Abstract: It has been suggested that certain residents, such as those with a low socioeconomic status, the elderly, and women, may benefit more from the presence of neighbourhood green space than others. We tested this hypothesis for age, gender, educational level, and employment status in four European cities. Data were collected in Barcelona (Spain; n = 1002), Kaunas (Lithuania; n = 989), Doetinchem (The Netherlands; n = 847), and Stoke-on-Trent (UK; n = 933) as part of the EU-funded PHENOTYPE project. Surveys were used to measure mental and general health, individual characteristics, and perceived neighbourhood green space. Additionally, we used audit data about neighbourhood green space. In Barcelona, there were positive associations between neighbourhood green space and general health among low-educated residents. In the other cities and for the other population groups, there was little evidence that the association between health and neighbourhood green space differed between population groups. Overall, our study does not support the assumption that the elderly, women, and residents who are not employed full-time benefit more from neighbourhood green space than others. Only in the highly urbanised city of Barcelona did the low-educated group benefit from neighbourhood green spaces. Perhaps neighbourhood green spaces are more important for the health of low-educated residents in particularly highly urbanised areas.
      PubDate: 2017-06-08
      DOI: 10.3390/ijerph14060618
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 619: Ecological Niche Modeling Identifies
           Fine-Scale Areas at High Risk of Dengue Fever in the Pearl River Delta,

    • Authors: Qiaoxuan Li, Hongyan Ren, Lan Zheng, Wei Cao, An Zhang, Dafang Zhuang, Liang Lu, Huixian Jiang
      First page: 619
      Abstract: Dengue fever (DF) is one of the most common and rapidly spreading mosquito-borne viral diseases in tropical and subtropical regions. In recent years, this imported disease has posed a serious threat to public health in China, especially in the Pearl River Delta (PRD). Although the severity of DF outbreaks in the PRD is generally associated with known risk factors, fine scale assessments of areas at high risk for DF outbreaks are limited. We built five ecological niche models to identify such areas including a variety of climatic, environmental, and socioeconomic variables, as well as, in some models, extracted principal components. All the models we tested accurately identified the risk of DF, the area under the receiver operating characteristic curve (AUC) were greater than 0.8, but the model using all original variables was the most accurate (AUC = 0.906). Socioeconomic variables had a greater impact on this model (total contribution 55.27%) than climatic and environmental variables (total contribution 44.93%). We found the highest risk of DF outbreaks on the border of Guangzhou and Foshan (in the central PRD), and in northern Zhongshan (in the southern PRD). Our fine-scale results may help health agencies to focus epidemic monitoring tightly on the areas at highest risk of DF outbreaks.
      PubDate: 2017-06-09
      DOI: 10.3390/ijerph14060619
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 620: RF EMF Risk Perception Revisited: Is the Focus
           on Concern Sufficient for Risk Perception Studies?

    • Authors: Peter Wiedemann, Frederik Freudenstein, Christoph Böhmert, Joe Wiart, Rodney Croft
      First page: 620
      Abstract: An implicit assumption of risk perception studies is that concerns expressed in questionnaires reflect concerns in everyday life. The aim of the present study is to check this assumption, i.e., the extrapolability of risk perceptions expressed in a survey, to risk perceptions in everyday life. To that end, risk perceptions were measured by a multidimensional approach. In addition to the traditional focus on measuring the magnitude of risk perceptions, the thematic relevance (how often people think about a risk issue) and the discursive relevance (how often people think about or discuss a risk issue) of risk perceptions were also collected. Taking into account this extended view of risk perception, an online survey was conducted in six European countries with 2454 respondents, referring to radio frequency electromagnetic field (RF EMF) risk potentials from base stations, and access points, such as WiFi routers and cell phones. The findings reveal that the present study’s multidimensional approach to measuring risk perception provides a more differentiated understanding of RF EMF risk perception. High levels of concerns expressed in questionnaires do not automatically imply that these concerns are thematically relevant in everyday life. We use thematic relevance to distinguish between enduringly concerned (high concern according to both questionnaire and thematic relevance) and not enduringly concerned participants (high concern according to questionnaire but no thematic relevance). Furthermore, we provide data for the empirical value of this distinction: Compared to other participants, enduringly concerned subjects consider radio frequency electromagnetic field exposure to a greater extent as a moral and affective issue. They also see themselves as highly exposed to radio frequency electromagnetic fields. However, despite these differences, subjects with high levels of thematic relevance are nevertheless sensitive to exposure reduction as a means for improving the acceptance of base stations in their neighborhood. This underlines the value of exposure reduction for the acceptance of radio frequency electromagnetic field communication technologies.
      PubDate: 2017-06-08
      DOI: 10.3390/ijerph14060620
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 621: Occlusal Features and Caries Experience of
           Hong Kong Chinese Preschool Children: A Cross-Sectional Study

    • Authors: Shinan Zhang, Edward Lo, Chun Chu
      First page: 621
      Abstract: Objective: To study occlusal features and their relation to caries experience in Hong Kong Chinese preschool children. Methods: Seven kindergarten classes in Hong Kong were selected using a stratified random sampling method, and the 4- and 5-year-old Chinese kindergarten children were invited to join the survey. Two calibrated dentists performed the clinical examinations in the kindergartens. Occlusion features, including incisal overjet; canine and molar relationship; median diastema; and primate space as well as malocclusion features, including crossbite; anterior open bite; and scissor bite, were recorded. Caries experience was recorded with the dmft index. Results: A total of 538 children were invited to participate in the study, and finally 495 children were examined (92%). Approximately half (52%) had a normal incisor relationship. Most children had a class I canine relationship (left-79%; right-75%). Approximately two-thirds had a flush terminal plane (left-64%; right-65%). Most children (76%) had a maxillary primate space, and 47% had a mandibular primate space. The prevalence of median diastema, anterior crossbite, and unilateral posterior crossbite was 30%, 12% and 1%, respectively. No bilateral posterior crossbite or scissor bite was found. Approximately half (49%) had caries experience. The mean dmft score was 2.1. Gender and age were not associated with either the studied occlusal features or the mean dmft score (p > 0.05). Conclusion: Approximately half of the Hong Kong preschool children studied had a normal occlusion, and two-thirds of them had a flush terminal plane. About three-quarters of them had a maxillary primate space, and half of them had a mandibular primate space. Their occlusal traits were not associated with caries experience and prevalence.
      PubDate: 2017-06-09
      DOI: 10.3390/ijerph14060621
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 622: How Social Reactions to Alcohol-Related Facial
           Flushing Are Affected by Gender, Relationship, and Drinking Purposes:
           Implications for Education to Reduce Aerodigestive Cancer Risks

    • Authors: Ian Newman, Lanyan Ding, Duane Shell, Lida Lin
      First page: 622
      Abstract: Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university students identified gender, friendship, and drinking purpose as important variables related to whether someone would encourage a person who flushes when drinking alcohol to stop or reduce their drinking. A questionnaire was developed that incorporated these variables into 24 drinking scenarios in which someone flushed while drinking. Students responded whether they would (a) encourage the flusher to stop or drink less; (b) do nothing while wishing they could; or (c) do nothing because there was no need. Analysis of survey responses from 2912 university students showed a three-way interaction of the variables and implied that the probability students will intervene when a drinker flushes was highest when the flusher was a female, a close friend, and the drinking purpose was for fun and lowest if the flusher was a male, the friendship was general, and the drinking purpose was risky. The results provide important details about the social factors affecting how other people respond to a person who flushes when drinking alcohol. This information is useful for those considering ways to reduce and prevent aerodigestive cancers through education and information programs.
      PubDate: 2017-06-09
      DOI: 10.3390/ijerph14060622
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 623: Stock Market Fluctuations and Self-Harm among
           Children and Adolescents in Hong Kong

    • Authors: Wilfred Wong, James Lee, Frederick Ho, Tim Li, Patrick Ip, Chun-Bong Chow
      First page: 623
      Abstract: Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and self-harm among children and adolescents in Hong Kong. Daily self-harm attendance records were retrieved from all 18 local Accident and Emergency Departments (AED) from 2001 to 2012. 4931 children and adolescents who committed self-harm were included. The results indicated positive correlation between daily change in stock market index, Hang Seng Index (∇HSI, per 300 points), and daily self-harm incident risk of children and adolescents, without time lag between the two. The incident risk ratio for ∇HSI was 1.09 (p = 0.0339) in children and 1.06 (p = 0.0246) in adolescents. Importantly, non-trading days were found to impose significant protective effect in both groups against self-harm risk. Our results showed that stock market fluctuations were related to self-harm behaviors in children and adolescents. Parents and professionals should be educated about the potential harm of stock market fluctuations and the importance of effective parenting in reducing self-harm among children and adolescents.
      PubDate: 2017-06-09
      DOI: 10.3390/ijerph14060623
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 624: Validation of DESS as a DNA Preservation
           Method for the Detection of Strongyloides spp. in Canine Feces

    • Authors: Meruyert Beknazarova, Shelby Millsteed, Gemma Robertson, Harriet Whiley, Kirstin Ross
      First page: 624
      Abstract: Strongyloides stercoralis is a gastrointestinal parasitic nematode with a life cycle that includes free-living and parasitic forms. For both clinical (diagnostic) and environmental evaluation, it is important that we can detect Strongyloides spp. in both human and non-human fecal samples. Real-time PCR is the most feasible method for detecting the parasite in both clinical and environmental samples that have been preserved. However, one of the biggest challenges with PCR detection is DNA degradation during the postage time from rural and remote areas to the laboratory. This study included a laboratory assessment and field validation of DESS (dimethyl sulfoxide, disodium EDTA, and saturated NaCl) preservation of Strongyloides spp. DNA in fecal samples. The laboratory study investigated the capacity of 1:1 and 1:3 sample to DESS ratios to preserve Strongyloides ratti in spike canine feces. It was found that both ratios of DESS significantly prevented DNA degradation compared to the untreated sample. This method was then validated by applying it to the field-collected canine feces and detecting Strongyloides DNA using PCR. A total of 37 canine feces samples were collected and preserved in the 1:3 ratio (sample: DESS) and of these, 17 were positive for Strongyloides spp. The study shows that both 1:1 and 1:3 sample to DESS ratios were able to preserve the Strongyloides spp. DNA in canine feces samples stored at room temperature for up to 56 days. This DESS preservation method presents the most applicable and feasible method for the Strongyloides DNA preservation in field-collected feces.
      PubDate: 2017-06-09
      DOI: 10.3390/ijerph14060624
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 625: The Magnitude of Occupational Class
           Differences in Sickness Absence: 15-Year Trends among Young and
           Middle-Aged Municipal Employees

    • Authors: Hilla Sumanen, Eero Lahelma, Olli Pietiläinen, Ossi Rahkonen
      First page: 625
      Abstract: Background: Our aim was to examine the magnitude of relative occupational class differences in sickness absence (SA) days over a 15-year period among female and male municipal employees in two age-groups. Methods: 18–34 and 35–59-year-old employees of the City of Helsinki from 2002 to 2016 were included in our data (n = ~37,500 per year). Occupational class was classified into four groups. The magnitude of relative occupational class differences in SA was studied using the relative index of inequality (RII). Results: The relative occupational class differences were larger among older than younger employees; the largest differences were among 35–59-year-old men. Among women in both age-groups the relative class differences remained stable during 2002–2016. Among younger and older men, the differences were larger during the beginning of study period than in the end. Among women in both age-groups the RII values were between 2.19 (95% confidence intervals (CI) 1.98, 2.42) and 3.60 (95% CI 3.28, 3.95). The corresponding differences varied from 3.74 (95% CI 3.13, 4.48) to 1.68 (95% CI 1.44, 1.97) among younger and from 6.43 (95% CI 5.85, 7.06) to 3.31 (95% CI 2.98, 3.68) among older men. Conclusions: Relative occupational class differences were persistent among employees irrespective of age group and gender. Preventive measures should be started at young age.
      PubDate: 2017-06-09
      DOI: 10.3390/ijerph14060625
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 626: Solidification and Biotoxicity Assessment of
           Thermally Treated Municipal Solid Waste Incineration (MSWI) Fly Ash

    • Authors: Bing Gong, Yi Deng, Yuanyi Yang, Swee Tan, Qianni Liu, Weizhong Yang
      First page: 626
      Abstract: In the present work, thermal treatment was used to stabilize municipal solid waste incineration (MSWI) fly ash, which was considered hazardous waste. Toxicity characteristic leaching procedure (TCLP) results indicated that, after the thermal process, the leaching concentrations of Pb, Cu, and Zn decreased from 8.08 to 0.16 mg/L, 0.12 to 0.017 mg/L and 0.39 to 0.1 mg/L, respectively, which well met the limits in GB5085.3-2007 and GB16689-2008. Thermal treatment showed a negative effect on the leachability of Cr with concentrations increasing from 0.1 to 1.28 mg/L; nevertheless, it was still under the limitations. XRD analysis suggested that, after thermal treatments, CaO was newly generated. CaO was a main contribution to higher Cr leaching concentrations owing to the formation of Cr (VI)—compounds such as CaCrO4. SEM/EDS tests revealed that particle adhesion, agglomeration, and grain growth happened during the thermal process and thus diminished the leachability of Pb, Cu, and Zn, but these processes had no significant influence on the leaching of Cr. A microbial assay demonstrated that all thermally treated samples yet possessed strong bactericidal activity according to optical density (OD) test results. Among all samples, the OD value of raw fly ash (RFA) was lowest followed by FA700-10, FA900-10, and FA1100-10 in an increasing order, which indicated that the sequence of the biotoxicity for these samples was RFA > FA700-10 > FA900-10 > FA1100-10. This preliminary study indicated that, apart from TCLP criteria, the biotoxicity assessment was indispensable for evaluating the effect of thermal treatment for MSWI fly ash.
      PubDate: 2017-06-10
      DOI: 10.3390/ijerph14060626
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 627: Lithium in Drinking Water and Incidence of
           Suicide: A Nationwide Individual-Level Cohort Study with 22 Years of

    • Authors: Nikoline Knudsen, Jörg Schullehner, Birgitte Hansen, Lisbeth Jørgensen, Søren Kristiansen, Denitza Voutchkova, Thomas Gerds, Per Andersen, Kristine Bihrmann, Morten Grønbæk, Lars Kessing, Annette Ersbøll
      First page: 627
      Abstract: Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an aggregate level have suggested an association between lithium in drinking water and a reduced risk of suicide; however, a causal relation is uncertain. Individual-level register-based data on the entire Danish adult population (3.7 million individuals) from 1991 to 2012 were linked with a moving five-year time-weighted average (TWA) lithium exposure level from drinking water hypothesizing an inverse relationship. The mean lithium level was 11.6 μg/L ranging from 0.6 to 30.7 μg/L. The suicide rate decreased from 29.7 per 100,000 person-years at risk in 1991 to 18.4 per 100,000 person-years in 2012. We found no significant indication of an association between increasing five-year TWA lithium exposure level and decreasing suicide rate. The comprehensiveness of using individual-level data and spatial analyses with 22 years of follow-up makes a pronounced contribution to previous findings. Our findings demonstrate that there does not seem to be a protective effect of exposure to lithium on the incidence of suicide with levels below 31 μg/L in drinking water.
      PubDate: 2017-06-10
      DOI: 10.3390/ijerph14060627
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 628: Prevalence and Risk Factors of Low Health
           Literacy: A Community-Based Study in Shanghai, China

    • Authors: Ying Wu, Lu Wang, Zhongyuan Cai, Luqi Bao, Pu Ai, Zisheng Ai
      First page: 628
      Abstract: Background: Health literacy is an increasingly important public health concern. However, little is known about the health literacy of general public in China. The aim of this study was to evaluate the prevalence of low health literacy and demographic associations in Shanghai, China. Methods: This study was a community-based cross-sectional health survey utilizing a multi-stage random sampling design. The sample consisted of 1360 individuals aged 15–69 years with the total community-dwelling Chinese as the sample frame. Health literacy was measured by a questionnaire developed on the basis of a national health literacy manual released by the Chinese Ministry of Health. Multiple logistic regression models were used to identify whether common socio-demographic features were associated with health literacy level. Results: The prevalence of low health literacy was 84.49% (95% CI, 82.56% to 86.41%). The prevalence of low health literacy was negatively associated with the level of education, occupation, and annual household income, but was not associated with gender, age, or the presence of non-communicable chronic disease. Conclusions: Simplifying health services, enhancing health education, and promoting interventions to improve health literacy in high-risk populations should be considered as part of the strategies in the making of health policy in China.
      PubDate: 2017-06-12
      DOI: 10.3390/ijerph14060628
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 629: Transportation Matters: A Health Impact
           Assessment in Rural New Mexico

    • Authors: Michelle Del Rio, William Hargrove, Joe Tomaka, Marcelo Korc
      First page: 629
      Abstract: This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060629
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 630: The Effects of the Refugee Crisis on Age
           Estimation Analysis over the Past 10 Years: A 16-Country Survey

    • Authors: Leanne Sykes, Ahmed Bhayat, Herman Bernitz
      First page: 630
      Abstract: Dental age estimation (AE) tests are routinely done on living and deceased persons. There is anecdotal evidence suggesting an increase in age estimations due to the refugee crisis. Our aim is to determine the reasons and methods for performing dental AE tests in both living and deceased individuals. Global trends in AE over the past 10 years were also investigated. A database of all forensic laboratories was obtained and an electronic questionnaire was sent to all of them. The questionnaire was self-developed and included questions on the reasons for performing AE tests, the preferred methods used in living and deceased individuals, and the people/organizations who requested these AE tests. The number of tests performed annually varied between 0 and 500 and the majority were on asylum seekers, refugees, and for adoption cases. Most units used multiple techniques to determine the age among the living, but seldom used more than three techniques for the deceased. The majority of tests were requested by coroners and the legal fraternity. There has been an increase in the number of dental AEs carried out and this has been mostly due to asylum seekers and refugees. The most common techniques for the living were variations of Demirjian’s technique while country specific techniques were used for the deceased.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060630
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 631: Associations of Community Water Fluoridation
           with Caries Prevalence and Oral Health Inequality in Children

    • Authors: Han-Na Kim, Jeong-Hee Kim, Se-Yeon Kim, Jin-Bom Kim
      First page: 631
      Abstract: This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children’s overall oral health.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060631
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 632: Occurrence, Toxicity, and Analysis of Major
           Mycotoxins in Food

    • Authors: Ahmad Alshannaq, Jae-Hyuk Yu
      First page: 632
      Abstract: Mycotoxins are toxic secondary metabolites produced by certain filamentous fungi (molds). These low molecular weight compounds (usually less than 1000 Daltons) are naturally occurring and practically unavoidable. They can enter our food chain either directly from plant-based food components contaminated with mycotoxins or by indirect contamination from the growth of toxigenic fungi on food. Mycotoxins can accumulate in maturing corn, cereals, soybeans, sorghum, peanuts, and other food and feed crops in the field and in grain during transportation. Consumption of mycotoxin-contaminated food or feed can cause acute or chronic toxicity in human and animals. In addition to concerns over adverse effects from direct consumption of mycotoxin-contaminated foods and feeds, there is also public health concern over the potential ingestion of animal-derived food products, such as meat, milk, or eggs, containing residues or metabolites of mycotoxins. Members of three fungal genera, Aspergillus, Fusarium, and Penicillium, are the major mycotoxin producers. While over 300 mycotoxins have been identified, six (aflatoxins, trichothecenes, zearalenone, fumonisins, ochratoxins, and patulin) are regularly found in food, posing unpredictable and ongoing food safety problems worldwide. This review summarizes the toxicity of the six mycotoxins, foods commonly contaminated by one or more of them, and the current methods for detection and analysis of these mycotoxins.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060632
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 633: The Recreovía of Bogotá, a Community-Based
           Physical Activity Program to Promote Physical Activity among Women:
           Baseline Results of the Natural Experiment Al Ritmo de las Comunidades

    • Authors: Olga Sarmiento, Ana Rios, Diana Paez, Karoll Quijano, Rogério Fermino
      First page: 633
      Abstract: Community-based physical activity (PA) programs in Latin America have been recognized because of the use of available environmental resources to offer PA classes. Yet, the evaluation of programs focused on PA classes involving dancing in public spaces is limited. The aim of this study was to assess the physical activity levels, park use, and the contextual characteristics of public parks with and without the Recreovía in Bogotá in Colombia. Al Ritmo de las Comunidades is a natural experiment conducted in nine parks (3 parks implementing new Recreovías, 3 control parks and 3 parks with existing Recreovías) during 2013. We used the System for Observing Play and Recreation in Communities to evaluate park use (gender, age, and physical activity level) and target areas. A total of 4925 people were observed during 702 observation visits to parks. The percentage of women was higher in parks with Recreovía, compared to parks without Recreovía (53% vs. 40% vs. 33%; p < 0.001). Women using parks with Recreovía compared to women in parks without Recreovía were less likely to be sedentary (25% vs. 39%; p < 0.0001) and more likely to engage in moderate-to-vigorous activity (75% vs. 61%; p < 0.0001). Among men, the activity pattern was the opposite. The Recreovía is a promising strategy to promote park use and PA, especially among women who are less likely to meet PA recommendations during their leisure time. The provision of a cost-free community program may be an effective approach and a good investment for health.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060633
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 634: Providing a Clean Environment for Adolescents:
           Evaluation of the Tobacco Hazards Prevention Act in Taiwan

    • Authors: Min-Li Chen, Li-Na Chou, Ya-Cheng Zheng
      First page: 634
      Abstract: Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1) to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2) to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70), grocery stores (n = 83), and betel nut stalls (n = 81). The results indicated that among the 234 retailers, 171 (73.1%) of them routinely failed to confirm the buyers’ ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1%) to 59 (25.2%) and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9%) to 175 (74.8%) after counseling strategies had been provided, thereby revealing statistical significance (χ2 = 11.26, p < 0.001). Study II: A total of 476 (89.1%) participants had received tobacco hazards prevention education and 58 (10.9%) had not. Among the various residential areas, the highest percentage of participants that did not received tobacco hazards prevention education located in the plane regions (8.4%). The government organizations should continue to adopt counseling strategies to reduce the rate of disobedience of the Tobacco Hazards Prevention Act by selling tobacco products to minors. Schools should pay close attention to tobacco hazard prevention education for junior high school students to ensure that such students are adequately educated about tobacco hazard prevention.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060634
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 635: Drivers of Microbial Risk for Direct Potable
           Reuse and de Facto Reuse Treatment Schemes: The Impacts of Source Water
           Quality and Blending

    • Authors: Rabia Chaudhry, Kerry Hamilton, Charles Haas, Kara Nelson
      First page: 635
      Abstract: Although reclaimed water for potable applications has many potential benefits, it poses concerns for chemical and microbial risks to consumers. We present a quantitative microbial risk assessment (QMRA) Monte Carlo framework to compare a de facto water reuse scenario (treated wastewater-impacted surface water) with four hypothetical Direct Potable Reuse (DPR) scenarios for Norovirus, Cryptosporidium, and Salmonella. Consumer microbial risks of surface source water quality (impacted by 0–100% treated wastewater effluent) were assessed. Additionally, we assessed risks for different blending ratios (0–100% surface water blended into advanced-treated DPR water) when source surface water consisted of 50% wastewater effluent. De facto reuse risks exceeded the yearly 10−4 infections risk benchmark while all modeled DPR risks were significantly lower. Contamination with 1% or more wastewater effluent in the source water, and blending 1% or more wastewater-impacted surface water into the advanced-treated DPR water drove the risk closer to the 10−4 benchmark. We demonstrate that de facto reuse by itself, or as an input into DPR, drives microbial risks more so than the advanced-treated DPR water. When applied using location-specific inputs, this framework can contribute to project design and public awareness campaigns to build legitimacy for DPR.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060635
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 636: Fungal Contaminants in Drinking Water
           Regulation? A Tale of Ecology, Exposure, Purification and Clinical

    • Authors: Monika Babič, Nina Gunde-Cimerman, Márta Vargha, Zsófia Tischner, Donát Magyar, Cristina Veríssimo, Raquel Sabino, Carla Viegas, Wieland Meyer, João Brandão
      First page: 636
      Abstract: Microbiological drinking water safety is traditionally monitored mainly by bacterial parameters that indicate faecal contamination. These parameters correlate with gastro-intestinal illness, despite the fact that viral agents, resulting from faecal contamination, are usually the cause. This leaves behind microbes that can cause illness other than gastro-intestinal and several emerging pathogens, disregarding non-endemic microbial contaminants and those with recent pathogenic activity reported. This white paper focuses on one group of contaminants known to cause allergies, opportunistic infections and intoxications: Fungi. It presents a review on their occurrence, ecology and physiology. Additionally, factors contributing to their presence in water distribution systems, as well as their effect on water quality are discussed. Presence of opportunistic and pathogenic fungi in drinking water can pose a health risk to consumers due to daily contact with water, via several exposure points, such as drinking and showering. The clinical relevance and influence on human health of the most common fungal contaminants in drinking water is discussed. Our goal with this paper is to place fungal contaminants on the roadmap of evidence based and emerging threats for drinking water quality safety regulations.
      PubDate: 2017-06-13
      DOI: 10.3390/ijerph14060636
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 637: Dietary Calcium Intake and Adherence to the
           Mediterranean Diet in Spanish Children: The ANIVA Study

    • Authors: Nuria Rubio-López, Agustín Llopis-González, Yolanda Picó, María Morales-Suárez-Varela
      First page: 637
      Abstract: The aim of this study was to evaluate the relationship of dietary calcium intake with anthropometric measures, physical activity and adherence to the Mediterranean diet (MedDiet) in 1176 Spanish children aged 6–9 years. Data were obtained from “Antropometría y Nutrición Infantil de Valencia” (ANIVA), a cross-sectional study of a representative sample. Dietary calcium intake assessed from three-day food records was compared to recommended daily intakes in Spain. Anthropometric measures (weight and height) were measured according to international standards and adherence to the MedDiet was evaluated using the Mediterranean Diet Quality Index (KIDMED) test. For the total sample of children, 25.8% had inadequate calcium intake, a significantly higher prevalence in girls (p = 0.006) and inadequate calcium intake was associated with lower height z-score (p = 0.001) for both sexes. In girls, there was an inverse relationship between calcium intake and body mass index (p = 0.001) and waist/hip ratio (p = 0.018). Boys presented a polarization in physical activity, reporting a greater level of both physical and sedentary activity in comparison with girls (p = 0.001). Children with poor adherence to MedDiet, even if they consume two yogurts or cheese (40 g) daily, adjusted by gender, age, total energy intake, physical activity and father’s level of education, are at risk of inadequate total calcium intake (odds ratio adjusted [ORa]: 3.36, 95% confidence interval [CI]: 1.13–9.94, p = 0.001). The intake of these dairy products was insufficient to cover calcium intake recommendations in this age group (6–9 years). It is important to prioritize health strategies that promote the MedDiet and to increase calcium intake in this age group.
      PubDate: 2017-06-14
      DOI: 10.3390/ijerph14060637
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 638: Dissemination of Chronic Disease
           Self-Management Education (CDSME) Programs in the United States:
           Intervention Delivery by Rurality

    • Authors: Matthew Smith, Samuel Towne, Angelica Herrera-Venson, Kathleen Cameron, Kristie Kulinski, Kate Lorig, Scott Horel, Marcia Ory
      First page: 638
      Abstract: Background: Alongside the dramatic increase of older adults in the United States (U.S.), it is projected that the aging population residing in rural areas will continue to grow. As the prevalence of chronic diseases and multiple chronic conditions among adults continues to rise, there is additional need for evidence-based interventions to assist the aging population to improve lifestyle behaviors, and self-manage their chronic conditions. The purpose of this descriptive study was to identify the geospatial dissemination of Chronic Disease Self-Management Education (CDSME) Programs across the U.S. in terms of participants enrolled, workshops delivered, and counties reached. These dissemination characteristics were compared across rurality designations (i.e., metro areas; non-metro areas adjacent to metro areas, and non-metro areas not adjacent to metro areas). Methods: This descriptive study analyzed data from a national repository including efforts from 83 grantees spanning 47 states from December 2009 to December 2016. Counts were tabulated and averages were calculated. Results: CDSME Program workshops were delivered in 56.4% of all U.S. counties one or more times during the study period. Of the counties where a workshop was conducted, 50.5% were delivered in non-metro areas. Of the 300,640 participants enrolled in CDSME Programs, 12% attended workshops in non-metro adjacent areas, and 7% attended workshops in non-metro non-adjacent areas. The majority of workshops were delivered in healthcare organizations, senior centers/Area Agencies on Aging, and residential facilities. On average, participants residing in non-metro areas had better workshop attendance and retention rates compared to participants in metro areas. Conclusions: Findings highlight the established role of traditional organizations/entities within the aging services network, to reach remote areas and serve diverse participants (e.g., senior centers). To facilitate growth in rural areas, technical assistance will be needed. Additional efforts are needed to bolster partnerships (e.g., sharing resources and knowledge), marketing (e.g., tailored material), and regular communication among stakeholders.
      PubDate: 2017-06-14
      DOI: 10.3390/ijerph14060638
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 639: Association between Food for Life, a Whole
           Setting Healthy and Sustainable Food Programme, and Primary School
           Children’s Consumption of Fruit and Vegetables: A Cross-Sectional Study
           in England

    • Authors: Mat Jones, Hannah Pitt, Liz Oxford, Issy Bray, Richard Kimberlee, Judy Orme
      First page: 639
      Abstract: The promotion of dietary health is a public health priority in England and in other countries. Research shows that the majority of children do not consume the recommended amount of fruit and vegetables (F&V). There has been relatively little research on the impact of programmes, such as Food for Life, that (a) integrate action on nutrition and food sustainability issues, and (b) are delivered as commissions in a local authority area. The study sought to assess pupil F&V in schools engaged with the Food for Life (FFL) programme. The design was a cross-sectional study comparing pupils in FFL engaged (n = 24) and non-engaged (n = 23) schools. A total of 2411 pupils aged 8–10 completed a validated self-report questionnaire. After adjusting for confounders, pupils in schools engaged with FFL consumed significantly more servings of F&V compared to pupils in comparison schools (M = 2.03/1.54, p < 0.001). Pupils in FFL schools were twice as likely to eat five or more portions of F&V per day (Odds Ratio = 2.07, p < 0.001, Confidence Interval = 1.54, 2.77). Total F&V consumption was significantly higher (p < 0.05) amongst pupils in schools with a higher level FFL award. Whilst limitations include possible residual confounding, the study suggests primary school engagement with the FFL programme may be an effective way of improving children’s dietary health.
      PubDate: 2017-06-14
      DOI: 10.3390/ijerph14060639
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 640: An Evaluation of the Proposed Worker
           Protection Standard with Respect to Pesticide Exposure and Parkinson’s

    • Authors: Alica Sparling, David Martin, Lillian Posey
      First page: 640
      Abstract: Citing a lack of information, the U.S. Environmental Protection Agency prudently did not account for the benefits of averting many chronic diseases in analyzing the Worker Protection Standards (WPS) revisions. We demonstrate that sufficient information can exist, using the example of the benefits to agricultural workers of reduced Parkinson’s disease (PD) due to reduced pesticide exposure. We define the benefits as the monetary value gained by improving quality of lives of people who would otherwise develop PD, plus the value of medical care cost averted and income not lost due to being healthy. For estimation, we use readily available parameters and obtain odds ratios of developing PD by conducting a meta-analysis of studies linking pesticide exposure to PD. The sensitivity analysis varies the number of agricultural workers affected by the regulation, the probability of being diagnosed with PD, the measurement and the timing of the benefits. Our initial assessment is that the reduced PD benefits would be a small fraction of the total WPS revision costs. However, if we define benefits as the common environmental economics willingness to pay to avoid PD incidence, then they become a substantial fraction of the costs. Our analysis demonstrates that the benefits of averting PD from the WPS revisions can be estimated using existing information, and that the results are most sensitive to the choice of valuation of benefits to the worker. We encourage other researchers to extend our framework to other chronic ailments.
      PubDate: 2017-06-14
      DOI: 10.3390/ijerph14060640
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 641: Investigation of Acute Pulmonary Deficits
           Associated with Biomass Fuel Cookstove Emissions in Rural Bangladesh

    • Authors: Danielle Medgyesi, Heather Holmes, Jeff Angermann
      First page: 641
      Abstract: The use of solid biomass fuels in cookstoves has been associated with chronic health impacts that disproportionately affect women worldwide. Solid fuel stoves that use wood, plant matter, and cow dung are commonly used for household cooking in rural Bangladesh. This study investigates the immediate effects of acute elevated cookstove emission exposures on pulmonary function. Pulmonary function was measured with spirometry before and during cooking to assess changes in respiratory function during exposure to cookstove emissions for 15 females ages 18–65. Cookstove emissions were characterized using continuous measurements of particulate matter (PM2.5—aerodynamic diameter <2.5 μm) concentrations at a 1 s time resolution for each household. Several case studies were observed where women ≥40 years who had been cooking for ≥25 years suffered from severe pulmonary impairment. Forced expiratory volume in one second over forced vital capacity (FEV1/FVC) was found to moderately decline (p = 0.06) during cooking versus non-cooking in the study cohort. The study found a significant (α < 0.05) negative association between 3- and 10-min maximum PM2.5 emissions during cooking and lung function measurements of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC obtained during cooking intervals. This study found that exposure to biomass burning emissions from solid fuel stoves- associated with acute elevated PM2.5 concentrations- leads to a decrease in pulmonary function, although further research is needed to ascertain the prolonged (e.g., daily, for multiple years) impacts of acute PM2.5 exposure on immediate and sustained respiratory impairment.
      PubDate: 2017-06-15
      DOI: 10.3390/ijerph14060641
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 642: Public Perceptions of Service Dogs, Emotional
           Support Dogs, and Therapy Dogs

    • Authors: Regina Schoenfeld-Tacher, Peter Hellyer, Louana Cheung, Lori Kogan
      First page: 642
      Abstract: As service dogs, emotional support dogs, and therapy dogs have become more prevalent in the USA, so too has the controversy surrounding their legitimacy. Yet, there is a lack of objective data regarding the public’s understanding of the role played by each of these types of animals, as well as their perceptions regarding the legitimacy of their integration. An anonymous, online survey was distributed to examine the perceptions of US adults who do not own any type of assistance animal. A total of 505 individuals responded to the online survey, yielding 284 usable responses. Results suggest widespread misconceptions about definitions, rules, regulations, and rights associated with each type of assistance dog. In general, service dogs are more likely to be perceived as helping with a legitimate need, and their access to public spaces is viewed favorably. While there are some concerns about the legitimacy and necessary access rights for emotional support dogs, members of the public correctly identified the roles and rights of therapy dogs. Despite the media’s focus on abuses and false representation of these dogs, most participants reported feeling the majority of people are not taking advantage of the system.
      PubDate: 2017-06-15
      DOI: 10.3390/ijerph14060642
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 643: Urban Ecological Security Simulation and
           Prediction Using an Improved Cellular Automata (CA) Approach—A Case
           Study for the City of Wuhan in China

    • Authors: Yuan Gao, Chuanrong Zhang, Qingsong He, Yaolin Liu
      First page: 643
      Abstract: Ecological security is an important research topic, especially urban ecological security. As highly populated eco-systems, cities always have more fragile ecological environments. However, most of the research on urban ecological security in literature has focused on evaluating current or past status of the ecological environment. Very little literature has carried out simulation or prediction of future ecological security. In addition, there is even less literature exploring the urban ecological environment at a fine scale. To fill-in the literature gap, in this study we simulated and predicted urban ecological security at a fine scale (district level) using an improved Cellular Automata (CA) approach. First we used the pressure-state-response (PSR) method based on grid-scale data to evaluate urban ecological security. Then, based on the evaluation results, we imported the geographically weighted regression (GWR) concept into the CA model to simulate and predict urban ecological security. We applied the improved CA approach in a case study—simulating and predicting urban ecological security for the city of Wuhan in Central China. By comparing the simulated ecological security values from 2010 using the improved CA model to the actual ecological security values of 2010, we got a relatively high value of the kappa coefficient, which indicates that this CA model can simulate or predict well future development of ecological security in Wuhan. Based on the prediction results for 2020, we made some policy recommendations for each district in Wuhan.
      PubDate: 2017-06-15
      DOI: 10.3390/ijerph14060643
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 644: Examining Associations of Environmental
           Characteristics with Recreational Cycling Behaviour by Street-Level Strava

    • Authors: Yeran Sun, Yunyan Du, Yu Wang, Liyuan Zhuang
      First page: 644
      Abstract: Policymakers pay much attention to effectively increasing frequency of people’s cycling in the context of developing sustainable and green cities. Investigating associations of environmental characteristics and cycling behaviour could offer implications for changing urban infrastructure aiming at encouraging active travel. However, earlier examinations of associations between environmental characteristics and active travel behaviour are limited by low spatial granularity and coverage of traditional data. Crowdsourced geographic information offers an opportunity to determine the fine-grained travel patterns of people. Particularly, Strava Metro data offer a good opportunity for studies of recreational cycling behaviour as they can offer hourly, daily or annual cycling volumes with different purposes (commuting or recreational) in each street across a city. Therefore, in this study, we utilised Strava Metro data for investigating associations between environmental characteristics and recreational cycling behaviour at a large spatial scale (street level). In this study, we took account of population density, employment density, road length, road connectivity, proximity to public transit services, land use mix, proximity to green space, volume of motor vehicles and traffic accidents in an empirical investigation over Glasgow. Empirical results reveal that Strava cyclists are more likely to cycle for recreation on streets with short length, large connectivity or low volume of motor vehicles or on streets surrounded by residential land.
      PubDate: 2017-06-15
      DOI: 10.3390/ijerph14060644
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 645: Environmental, Human Health and Socio-Economic
           Effects of Cement Powders: The Multicriteria Analysis as Decisional

    • Authors: Laura Moretti, Paola Di Mascio, Simona Bellagamba
      First page: 645
      Abstract: The attention to sustainability-related issues has grown fast in recent decades. The experience gained with these themes reveals the importance of considering this topic in the construction industry, which represents an important sector throughout the world. This work consists on conducting a multicriteria analysis of four cement powders, with the objective of calculating and analysing the environmental, human health and socio-economic effects of their production processes. The economic, technical, environmental and safety performances of the examined powders result from official, both internal and public, documents prepared by the producers. The Analytic Hierarchy Process permitted to consider several indicators (i.e., environmental, human health related and socio-economic parameters) and to conduct comprehensive and unbiased analyses which gave the best, most sustainable cement powder. As assumed in this study, the contribution of each considered parameter to the overall sustainability has a different incidence, therefore the procedure could be used to support on-going sustainability efforts under different conditions. The results also prove that it is not appropriate to regard only one parameter to identify the ‘best’ cement powder, but several impact categories should be considered and analysed if there is an interest for pursuing different, often conflicting interests.
      PubDate: 2017-06-16
      DOI: 10.3390/ijerph14060645
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 646: Systematic Review and Meta-Analysis of the
           Association between Ambient Nitrogen Dioxide and Respiratory Disease in

    • Authors: Jiyao Sun, Andrew Barnes, Dongyang He, Meng Wang, Jian Wang
      First page: 646
      Abstract: Objective: This study aimed to assess the quantitative effects of short-term exposure of ambient nitrogen dioxide (NO2) on respiratory disease (RD) mortality and RD hospital admission in China through systematic review and meta-analysis. Methods: A total of 29 publications were finally selected from searches in PubMed, Web of Science, CNKI and Wanfang databases. Generic inverse variance method was used to pool effect estimates. Pooled estimates were used to represent the increased risk of RD mortality and RD hospital admission per 10 μg/m3 increase in NO2 concentration. Results: Positive correlations were found between short-term NO2 exposure and RD in China. RD mortality and RD hospital admission respectively increased by 1.4% (95% CI: 1.1%, 1.7%) and 1.0% (95% CI: 0.5%, 1.5%) per 10 μg/m3 increase in NO2 concentration. Differences were observed across geographic regions of China. The risk of RD mortality due to NO2 was higher in the southern region (1.7%) than in the north (0.7%). Conclusions: Evidence was found that short-term exposure to NO2 was associated with an increased risk of RD mortality and RD hospital admission in China and these risks were more pronounced in the southern regions of the country, due in part to a larger proportion of elderly persons with increased susceptibility to NO2 in the population compared with the north.
      PubDate: 2017-06-16
      DOI: 10.3390/ijerph14060646
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 647: Why Don’t More Smokers Switch to Using
           E-Cigarettes: The Views of Confirmed Smokers

    • Authors: Neil McKeganey, Tiffany Dickson
      First page: 647
      Abstract: Whilst e-cigarettes have been characterised by Public Health England as being around 95% less harmful than combustible tobacco products, only a minority of current smokers (around 16% within the UK) are using these devices. In this paper we report the results of an online survey of 650 smokers in contact with a smokers’ rights group in the UK. A total of 91% of the smokers surveyed were smoking on a daily basis. Fifty nine percent reported having used electronic nicotine delivery systems, the majority of whom reported having used e-cigarettes. Those smokers that had not used these devices principally explained this in terms of the pleasure they derived from smoking. The features smokers’ liked most about e-cigarette had to do with the range of settings in which they could be used, the lack of an offensive smell associated with their use, the available flavours and the reduced level of harm. The elements which smokers liked least about e-cigarettes had to do with the vaping experience, the technology, the chemical nature of e-liquids and the complex technology that was associated with these devices. If a greater number of smokers are to be encouraged to take up e-cigarettes, it will be necessary not only to convey accurate information on the relative harm of these devices (compared to combustible tobacco products), but to ensure that they are able to be used in a wider range of settings than those within which smoking can currently occur and that the vaping experience more closely resembles the smoking experience.
      PubDate: 2017-06-16
      DOI: 10.3390/ijerph14060647
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 648: Geographic Variations in Cardiometabolic Risk
           Factors in Luxembourg

    • Authors: Ala’a Alkerwi, Illiasse El Bahi, Saverio Stranges, Jean Beissel, Charles Delagardelle, Stephanie Noppe, Ngianga-Bakwin Kandala
      First page: 648
      Abstract: Cardiovascular disease (CVD) and associated behavioural and metabolic risk factors constitute a major public health concern at a global level. Many reports worldwide have documented different risk profiles for populations with demographic variations. The objective of this study was to examine geographic variations in the top leading cardio metabolic and behavioural risk factors in Luxembourg, in order to provide an overall picture of CVD burden across the country. The analysis conducted was based on data from the nationwide ORISCAV-LUX survey, including 1432 subjects, aged 18–69 years. A self-reported questionnaire, physical examination and blood sampling were performed. Age and sex-adjusted risk profile maps were generated using multivariate Bayesian geo-additive regression models, based on Markov Chain Monte Carlo techniques and were used to evaluate the significance of the spatial effects on the distribution of a range of cardio metabolic risk factors, namely smoking, high body mass index (BMI), high blood pressure, high fasting plasma glucose, alcohol use, high total cholesterol, low glomerular filtration rate, and physical inactivity. Higher prevalence of smoking was observed in the northern regions, higher overweight/obesity and abdominal obesity clustered in the central belt, whereas hypertension was spotted particularly in the southern part of the country. Maps revealed that subjects residing in Luxembourg canton were significantly less likely to be hypertensive or overweight/obese, whereas they were less likely to practice physical activity of ≥8000 Metabolic Equivalent of Task (MET)-min/week. These patterns were also observed at the municipality level in Luxembourg. Statistically, there were non-significant spatial patterns regarding smoking, diabetes, total serum cholesterol and low glomerular filtration rate risk distribution. This comprehensive risk profile mapping showed remarkable geographic variations in cardio metabolic and behavioural risk factors. Considering the prominent burden of CVD this research provides opportunities for tailored interventions and may help to better fight against this escalating public health problem.
      PubDate: 2017-06-16
      DOI: 10.3390/ijerph14060648
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 649: The Impact of Service Dogs on Engagement in
           Occupation among Females with Mobility Impairments: A Qualitative
           Descriptive Study

    • Authors: Ellen Herlache-Pretzer, Melissa Y. Winkle, Rachel Csatari, Alyssa Kolanowski, Amy Londry, Rachel Dawson
      First page: 649
      Abstract: It is becoming more common for people with disabilities to procure service dogs as a form of assistive technology (AT). However, there is little qualitative research examining the impact of service dogs on engagement in valued daily activities (occupations) among persons with mobility impairments. This study used a qualitative descriptive methodology to learn about the experiences of four female service dog owners with mobility impairments, with a focus on the impact of service dog use on the performance of daily occupations and participation in social activities, and their experiences utilizing a service dog as a form of AT. Data analysis indicated that each participant’s service dog made a significant impact on their everyday lives and their ability to independently perform everyday activities; however, there are also unique challenges associated with service dog ownership that must be considered when evaluating benefits of service dog partnership. Overall, the positive outcomes reported by participants indicate that service dogs can be considered a beneficial, adaptable form of AT for some persons with mobility impairments.
      PubDate: 2017-06-16
      DOI: 10.3390/ijerph14060649
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 650: Media Coverage of Alcohol Issues: A Critical
           Political Economy Framework—A Case Study from Ireland

    • Authors: Julien Mercille
      First page: 650
      Abstract: There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the values and interests of political and economic elites. The media are thus expected to present viewpoints that are more aligned with the alcohol industry than the scientific consensus on public health policy would warrant. The media are also expected, but to a lesser extent, to present a certain amount of support for public health perspectives because these are supported by a few socioeconomic elite groups (the medical professions, progressive politicians). The case of Ireland from 2012 to 2017 illustrates the framework empirically. Four main newspapers’ coverage of the Public Health (Alcohol) Bill and related policies is examined. Results show that, overall, 44.0% of articles support public health measures and 56.0% are opposed or remain neutral. It is argued that the media are not strong proponents of public health for multiple reasons: there are more articles opposed to or neutral toward public health measures than supporting them; the number of supportive articles remains relatively small and there are still many pieces presenting drinks industry views; there are virtually no calls in the media for stronger measures; supportive coverage is partially explained by the pub owners lobby’s support for minimum unit pricing; the media often downplay or ignore the negative consequences of alcohol, such as its role in accidents; many news articles normalise drinking and promote events sponsored by the industry; there is not a single Irish journalist covering alcohol issues systematically; and other policy issues that are prioritised by elites receive multiple times more media coverage than public health measures. In short, the media reflect the views of the political and economic establishment on public health measures: there is some support from the medical professions and progressive politicians, but overall, there is a clear reluctance to support strong public health strategies. One main recommendation for public health advocates to promote their perspectives is to diversify the mass media and make them less commercial in nature, as well as to engage with non-corporate, so-called progressive “alternative media” outlets.
      PubDate: 2017-06-16
      DOI: 10.3390/ijerph14060650
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 651: Lower Physical Performance in Colder Seasons
           and Colder Houses: Evidence from a Field Study on Older People Living in
           the Community

    • Authors: Yukie Hayashi, Steven Schmidt, Agneta Malmgren Fänge, Tanji Hoshi, Toshiharu Ikaga
      First page: 651
      Abstract: The aim of this paper was to explore the effect of seasonal temperature differences and cold indoor environment in winter on the physical performance of older people living in the community based on a field study. We recruited 162 home-dwelling older people from a rehabilitation facility in the Osaka prefecture, Japan; physical performance data were available from 98/162 (60.5%). At the same time, for some participants, a questionnaire survey and a measurement of the indoor temperature of individual houses were conducted. The analysis showed that there were seasonal trends in the physical performance of older people and that physical performance was worse in the winter compared with the autumn. Furthermore, people living in colder houses had worse physical performance. The findings indicate that keeping the house warm in the winter can help to maintain physical performance.
      PubDate: 2017-06-17
      DOI: 10.3390/ijerph14060651
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 652: Structured Additive Quantile Regression for
           Assessing the Determinants of Childhood Anemia in Rwanda

    • Authors: Faustin Habyarimana, Temesgen Zewotir, Shaun Ramroop
      First page: 652
      Abstract: Childhood anemia is among the most significant health problems faced by public health departments in developing countries. This study aims at assessing the determinants and possible spatial effects associated with childhood anemia in Rwanda. The 2014/2015 Rwanda Demographic and Health Survey (RDHS) data was used. The analysis was done using the structured spatial additive quantile regression model. The findings of this study revealed that the child’s age; the duration of breastfeeding; gender of the child; the nutritional status of the child (whether underweight and/or wasting); whether the child had a fever; had a cough in the two weeks prior to the survey or not; whether the child received vitamin A supplementation in the six weeks before the survey or not; the household wealth index; literacy of the mother; mother’s anemia status; mother’s age at the birth are all significant factors associated with childhood anemia in Rwanda. Furthermore, significant structured spatial location effects on childhood anemia was found.
      PubDate: 2017-06-17
      DOI: 10.3390/ijerph14060652
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 653: Association between Six CETP Polymorphisms and
           Metabolic Syndrome in Uyghur Adults from Xinjiang, China

    • Authors: Huixian Hou, Rulin Ma, Heng Guo, Jia He, Yunhua Hu, Lati Mu, Yizhong Yan, Jiaolong Ma, Shugang Li, Jingyu Zhang, Yusong Ding, Mei Zhang, Qiang Niu, Jiaming Liu, Shuxia Guo
      First page: 653
      Abstract: Objective: To explore the association between CETP gene polymorphisms and metabolic syndrome (MS), as well as the relationship between the CETP gene polymorphisms and each component of MS. Methods: A total of 571 individuals which were randomly selected from 5692 Uyghur adults were subdivided into two groups, including 280 patients with MS and 291 control subjects, using the group-matching method after matching for gender. We detected CETP polymorphisms (rs5882, rs1800775, rs3764261, rs12149545, rs711752, and rs708272) by using the Snapshot method. Results: (1) Significant differences were found involving the frequency distribution of genotypes and alleles of rs1800775, rs3764261, rs12149545, rs711752, and rs708272 between the control and MS groups (all p < 0.05). (2) rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms were significantly related to the risk of MS (all p < 0.05). (3) The rs1800775 polymorphism was associated with high fasting blood glucose levels and low high density lipoprotein cholesterol (HDL-C); rs3764261 and rs12149545 polymorphisms were associated with all components of MS except high blood pressure; rs711752 and rs708272 polymorphisms were associated with low HDL-C (all p < 0.05). (4) Complete linkage disequilibrium (LD) was identified for two pairs of single nucleotide polymorphisms (SNPs) (rs3764261 and rs12149545 (D’ = 1.000, r2 = 0.931), rs711752 and rs708272 (D’ = 1.000, r2 = 0.996)). (5) The A-G-G-G-C (p = 0.013, odds ratio [OR] = 0.622, 95% confidence interval [95% CI] = 0.427–0.906) and A-T-A-A-T (p < 0.001, OR = 0.519, 95% CI = 0.386–0.697) haplotypes were more frequent in the control group than in the case group. Conclusions: The rs1800775, rs3764261, rs12149545, rs711752, and rs708272 polymorphisms of CETP were associated with MS and its components among the Uyghur ethnic group. Complete LD was found between two pairs of SNPs (rs3764261 and rs12149545, rs711752, and rs708272). The A-G-G-G-C and A-T-A-A-T haplotypes might be protective factors for MS.
      PubDate: 2017-06-18
      DOI: 10.3390/ijerph14060653
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 654: Assessing Statistically Significant
           Heavy-Metal Concentrations in Abandoned Mine Areas via Hot Spot Analysis
           of Portable XRF Data

    • Authors: Sung-Min Kim, Yosoon Choi
      First page: 654
      Abstract: To develop appropriate measures to prevent soil contamination in abandoned mining areas, an understanding of the spatial variation of the potentially toxic trace elements (PTEs) in the soil is necessary. For the purpose of effective soil sampling, this study uses hot spot analysis, which calculates a z-score based on the Getis-Ord Gi* statistic to identify a statistically significant hot spot sample. To constitute a statistically significant hot spot, a feature with a high value should also be surrounded by other features with high values. Using relatively cost- and time-effective portable X-ray fluorescence (PXRF) analysis, sufficient input data are acquired from the Busan abandoned mine and used for hot spot analysis. To calibrate the PXRF data, which have a relatively low accuracy, the PXRF analysis data are transformed using the inductively coupled plasma atomic emission spectrometry (ICP-AES) data. The transformed PXRF data of the Busan abandoned mine are classified into four groups according to their normalized content and z-scores: high content with a high z-score (HH), high content with a low z-score (HL), low content with a high z-score (LH), and low content with a low z-score (LL). The HL and LH cases may be due to measurement errors. Additional or complementary surveys are required for the areas surrounding these suspect samples or for significant hot spot areas. The soil sampling is conducted according to a four-phase procedure in which the hot spot analysis and proposed group classification method are employed to support the development of a sampling plan for the following phase. Overall, 30, 50, 80, and 100 samples are investigated and analyzed in phases 1–4, respectively. The method implemented in this case study may be utilized in the field for the assessment of statistically significant soil contamination and the identification of areas for which an additional survey is required.
      PubDate: 2017-06-18
      DOI: 10.3390/ijerph14060654
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 655: Association of Education and Smoking Status on
           Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional

    • Authors: Jin-Hyeong Kim, Juhwan Noh, Jae-Woo Choi, Eun-Cheol Park
      First page: 655
      Abstract: Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.
      PubDate: 2017-06-19
      DOI: 10.3390/ijerph14060655
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 656: Towards a Long-Term Strategy for
           Voluntary-Based Internal Radiation Contamination Monitoring:
           Representativeness of the Monitoring Results in Fukushima, Japan

    • Authors: Shuhei Nomura, Masaharu Tsubokura, Michio Murakami, Kyoko Ono, Yoshitaka Nishikawa, Tomoyoshi Oikawa
      First page: 656
      Abstract: Following Japan’s 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10–40 km from the Fukushima nuclear plant. Of approximately 70,000 individuals who were residing in Minamisoma City before the incident, a total of 19,263 residents (aged ≥21 years) participated in the monitoring from 1 October 2011 to 31 March 2015. Based on regression projection techniques with the available data obtained from the voluntary participants, the modeled probabilities of radiocesium (Cs) detection in October 2011 for Cs-137 and Cs-134 were 66.9% and 52.9%, respectively, which declined dramatically within a year following the incident. The rate of decline had stagnated since mid-2012, and the probability was close to zero after mid-2014. Sufficient agreement between the modeled probabilities of Cs detection (for the whole population) versus the measured Cs levels (for voluntary participants) was observed, except for Cs-134 in October 2011, indicating that the voluntary monitoring participant group was a good representative sample. Our findings affirmed the clinical importance of voluntary-based monitoring as a screening and dose-assessment tool in a post-nuclear incident. Our study informs societal decision-making regarding the long-term maintenance of the monitoring program under the current low exposure levels.
      PubDate: 2017-06-20
      DOI: 10.3390/ijerph14060656
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 657: Paternal Risk Factors for Oral Clefts in
           Northern Africans, Southeast Asians, and Central Americans

    • Authors: Stephanie Ly, Madeleine Burg, Ugonna Ihenacho, Frederick Brindopke, Allyn Auslander, Kathleen Magee, Pedro Sanchez-Lara, Thi-Hai-Duc Nguyen, Viet Nguyen, Maria Tangco, Angela Hernandez, Melissa Giron, Fouzia Mahmoudi, Yves DeClerck, William III, Jane Figueiredo
      First page: 657
      Abstract: While several studies have investigated maternal exposures as risk factors for oral clefts, few have examined paternal factors. We conducted an international multi-centered case–control study to better understand paternal risk exposures for oral clefts (cases = 392 and controls = 234). Participants were recruited from local hospitals and oral cleft repair surgical missions in Vietnam, the Philippines, Honduras, and Morocco. Questionnaires were administered to fathers and mothers separately to elicit risk factor and family history data. Associations between paternal exposures and risk of clefts were assessed using logistic regression adjusting for potential confounders. A father’s personal/family history of clefts was associated with significantly increased risk (adjusted OR: 4.77; 95% CI: 2.41–9.45). No other significant associations were identified for other suspected risk factors, including education (none/primary school v. university adjusted OR: 1.29; 95% CI: 0.74–2.24), advanced paternal age (5-year adjusted OR: 0.98; 95% CI: 0.84–1.16), or pre-pregnancy tobacco use (adjusted OR: 0.96; 95% CI: 0.67–1.37). Although sample size was limited, significantly decreased risks were observed for fathers with selected occupations. Further research is needed to investigate paternal environmental exposures as cleft risk factors.
      PubDate: 2017-06-19
      DOI: 10.3390/ijerph14060657
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 658: Attachment Style Is Related to Quality of Life
           for Assistance Dog Owners

    • Authors: Naomi White, Daniel Mills, Sophie Hall
      First page: 658
      Abstract: Attachment styles have been shown to affect quality of life. Growing interest in the value of companion animals highlights that owning a dog can also affect quality of life, yet little research has explored the role of the attachment bond in affecting the relationship between dog ownership and quality of life. Given that the impact of dog ownership on quality of life may be greater for assistance dog owners than pet dog owners, we explored how anxious attachment and avoidance attachment styles to an assistance dog affected owner quality of life (n = 73). Regression analysis revealed that higher anxious attachment to the dog predicted enhanced quality of life. It is suggested that the unique, interdependent relationship between an individual and their assistance dog may mean that an anxious attachment style is not necessarily detrimental. Feelings that indicate attachment insecurity in other relationships may reflect more positive aspects of the assistance dog owner relationship, such as the level of support that the dog provides its owner.
      PubDate: 2017-06-19
      DOI: 10.3390/ijerph14060658
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 659: Level of Sedentary Behavior and Its Associated
           Factors among Saudi Women Working in Office-Based Jobs in Saudi Arabia

    • Authors: Nada M. Albawardi, Hoda Jradi, Abdulla A. Almalki, Hazzaa M. Al-Hazzaa
      First page: 659
      Abstract: Research in Saudi Arabia has revealed a shocking level of insufficiently physically active adults, particularly women. The risk of sedentary behavior will likely increase as the number of women with office-based jobs increases. The aim of this study is to determine the level of sedentary behavior, and its associated factors, among Saudi women working office-based jobs in the city of Riyadh. A cross-sectional study of 420 Saudi female employees at 8 office-based worksites were measured to determine body mass index and were given a self-administered survey to evaluate their level of physical activity and sedentary behavior. Median sitting time on work days was 690 min per day (interquartile range, IQR 541–870), with nearly half accumulated during work hours, and 575 min per day (IQR 360–780) on non-work days. Predictors of work day sitting time were level of education, number of children, and working in the private sector. Number of children, whether they were single, and whether they lived in a small home were found to predict non-work day sitting time. This study identifies Saudi women in office-based jobs as a high-risk group for sedentary behavior. There is a need to promote physical activity at worksites and reduce prolonged sitting.
      PubDate: 2017-06-19
      DOI: 10.3390/ijerph14060659
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 660: Effects of Sulfate, Chloride, and Bicarbonate
           on Iron Stability in a PVC-U Drinking Pipe

    • Authors: Jiaying Wang, Tao Tao, Hexiang Yan
      First page: 660
      Abstract: In order to describe iron stability in plastic pipes and to ensure the drinking water security, the influence factors and rules for iron adsorption and release were studied, dependent on the Unplasticized poly (vinyl chloride) (PVC-U) drinking pipes employed in this research. In this paper, sulfate, chloride, and bicarbonate, as well as synthesized models, were chosen to investigate the iron stability on the inner wall of PVC-U drinking pipes. The existence of the three kinds of anions could significantly affect the process of iron adsorption, and a positive association was found between the level of anion concentration and the adsorption rate. However, the scaling formed on the inner surface of the pipes would be released into the water under certain conditions. The Larson Index (LI), used for a synthetic consideration of anion effects on iron stability, was selected to investigate the iron release under multi-factor conditions. Moreover, a well fitted linear model was established to gain a better understanding of iron release under multi-factor conditions. The simulation results demonstrated that the linear model was better fitted than the LI model for the prediction of iron release.
      PubDate: 2017-06-19
      DOI: 10.3390/ijerph14060660
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 661: Association between Air Pollution and
           Emergency Room Visits for Atrial Fibrillation

    • Authors: Angelo Solimini, Matteo Renzi
      First page: 661
      Abstract: Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years’ time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO2) and the daily count of emergency accesses for AF (ICD-9 code: 427.31). We applied an over-dispersed conditional Poisson model to analyze the associations at different lags after controlling for time, influenza epidemics, holiday periods, temperature, and relative humidity. Additionally, we evaluated bi-pollutant models by including the other pollutant and the influence of several effect modifiers such as personal characteristics and pre-existing medical conditions. In the period of study, 79,892 individuals were admitted to the emergency departments of Rome hospitals because of AF (on average, 15.6 patients per day: min = 1, max = 36). Air pollution levels were associated with increased AF emergency visits within 24 h of exposure. Effect estimates ranged between 1.4% (0.7–2.3) for a 10 µg/m3 increase of PM10 to 3% (1.4–4.7) for a 10 µg/m3 increase of PM2.5 at lag 0–1 day. Those effects were higher in patients ≥75 years for all pollutants, male patients for PM10, and female patients for NO2. The presence of previous cardiovascular conditions, but not other effect modifiers, increase the pollution effects by 5–8% depending on the lag. This study found evidence that air pollution is associated with AF emergency visits in the short term.
      PubDate: 2017-06-20
      DOI: 10.3390/ijerph14060661
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 662: Beyond Food Access: The Impact of Parent-,
           Home-, and Neighborhood-Level Factors on Children’s Diets

    • Authors: Lauren Futrell Dunaway, Thomas Carton, Ping Ma, Adrienne Mundorf, Kelsey Keel, Katherine Theall
      First page: 662
      Abstract: Despite the growth in empirical research on neighborhood environmental characteristics and their influence on children’s diets, physical activity, and obesity, much remains to be learned, as few have examined the relationship between neighborhood food availability on dietary behavior in children, specifically. This analysis utilized data from a community-based, cross-sectional sample of children (n = 199) that was collected in New Orleans, Louisiana, in 2010. This dataset was linked to food environment data to assess the impact of neighborhood food access as well as household and parent factors on children’s diets. We observed a negligible impact of the neighborhood food environment on children’s diets, except with respect to fast food, with children who had access to fast food within 500 m around their home significantly less likely (OR = 0.35, 95% CI: 0.1, 0.8) to consume vegetables. Key parental and household factors did play a role in diet, including receipt of public assistance and cooking meals at home. Children receiving public assistance were 2.5 times (95% CI: 1.1, 5.4) more likely to consume fruit more than twice per day compared with children not receiving public assistance. Children whose family cooked dinner at home more than 5 times per week had significantly more consumption of fruit (64% vs. 58%) and vegetables (55% vs. 39%), but less soda (27% vs. 43%). Findings highlight the need for future research that focuses on the dynamic and complex relationships between built and social factors in the communities and homes of children that impact their diet in order to develop multilevel prevention approaches that address childhood obesity.
      PubDate: 2017-06-20
      DOI: 10.3390/ijerph14060662
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 663: Community Response to Multiple Sound Sources:
           Integrating Acoustic and Contextual Approaches in the Analysis

    • Authors: Peter Lercher, Bert De Coensel, Luc Dekonink, Dick Botteldooren
      First page: 663
      Abstract: Sufficient data refer to the relevant prevalence of sound exposure by mixed traffic sources in many nations. Furthermore, consideration of the potential effects of combined sound exposure is required in legal procedures such as environmental health impact assessments. Nevertheless, current practice still uses single exposure response functions. It is silently assumed that those standard exposure-response curves accommodate also for mixed exposures—although some evidence from experimental and field studies casts doubt on this practice. The ALPNAP-study population (N = 1641) shows sufficient subgroups with combinations of rail-highway, highway-main road and rail-highway-main road sound exposure. In this paper we apply a few suggested approaches of the literature to investigate exposure-response curves and its major determinants in the case of exposure to multiple traffic sources. Highly/moderate annoyance and full scale mean annoyance served as outcome. The results show several limitations of the current approaches. Even facing the inherent methodological limitations (energy equivalent summation of sound, rating of overall annoyance) the consideration of main contextual factors jointly occurring with the sources (such as vibration, air pollution) or coping activities and judgments of the wider area soundscape increases the variance explanation from up to 8% (bivariate), up to 15% (base adjustments) up to 55% (full contextual model). The added predictors vary significantly, depending on the source combination. (e.g., significant vibration effects with main road/railway, not highway). Although no significant interactions were found, the observed additive effects are of public health importance. Especially in the case of a three source exposure situation the overall annoyance is already high at lower levels and the contribution of the acoustic indicators is small compared with the non-acoustic and contextual predictors. Noise mapping needs to go down to levels of 40 dBA,Lden to ensure the protection of quiet areas and prohibit the silent “filling up” of these areas with new sound sources. Eventually, to better predict the annoyance in the exposure range between 40 and 60 dBA and support the protection of quiet areas in city and rural areas in planning sound indicators need to be oriented at the noticeability of sound and consider other traffic related by-products (air quality, vibration, coping strain) in future studies and environmental impact assessments.
      PubDate: 2017-06-20
      DOI: 10.3390/ijerph14060663
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 664: Physical Fitness, Physical Activity, Sedentary
           Behavior, or Diet—What Are the Correlates of Obesity in Polish School

    • Authors: Stanisław Czyż, Abel Toriola, Wojciech Starościak, Marek Lewandowski, Yvonne Paul, Adewale Oyeyemi
      First page: 664
      Abstract: There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence on the relationship of behavioral factors with body weight status of children in Poland. This study examined the association of obesity with physical fitness, physical activity, sedentary behavior and diet among Polish children. A total of 641 children (10–15 years) recruited from the Lower Silesia region of Poland participated in this cross-sectional study. Participants’ anthropometrics, physical fitness, physical activity, sedentary behavior and dietary intake were assessed. Outcome variables were weight categories (according to body mass index [BMI], waist-to-hip ratio [WHR], and percentage body fat [% BF]). The strongest negative correlation was found between VO2max and %BF (r = −0.39, p <0.05). Significant negative correlation was also found between VO2max and weight categories (r = −0.15). Results of the multinomial logit analysis showed that VO2max increased in groups of overweight, normal weight and underweight children by 13%, 26% and 19%, respectively as compared to the group of obese children. VO2max and weight and obesity indices were strongly correlated in both gender and age groups. Education and intervention programs to increase physical fitness (VO2max) through aerobic training are recommended for Physical Education teachers, parents and children in order to reduce the rate of overweight and obesity among children in the Lower Silesia region of Poland.
      PubDate: 2017-06-20
      DOI: 10.3390/ijerph14060664
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 665: Coverage and Influencing Determinants of
           Influenza Vaccination in Elderly Patients in a Country with a Poor
           Vaccination Implementation

    • Authors: Maria Ganczak, Karolina Gil, Marcin Korzeń, Marta Bażydło
      First page: 665
      Abstract: The seasonal influenza vaccination uptake of the elderly in Poland is one of the lowest in Europe. Objective: to assess the vaccination coverage and influencing determinants in patients ≥65 years of age. Methods: A cross-sectional study was conducted (November 2015–April 2016) among consecutive patients admitted to a municipal hospital located in the city of Szczecin, North-west Poland. Patients completed researcher-administered, anonymous questionnaires on socio- demographic data/factors related to the vaccination. Results: The response rate: 92.0%. Among 230 patients (79.6% women, median of age 69 years, range 65–89) who agreed to participate, 34.8% (95% Confidence Interval: 28.6–41.0%) were vaccinated. About 15.7% of respondents had not previously heard about the vaccination; 41.3% of those who stated they were vaccinated or planned on being vaccinated the following year, compared to 19.3% of respondents who stated they were not currently vaccinated (p < 0.001). A multivariable regression analysis revealed that patient factors, such as younger age (Odds Ratio, OR = 7.69), living in the urban area (OR = 7.69), having comorbidities (OR = 2.70), having a vaccinated family member (OR = 3.57), and being informed about vaccination (OR = 5.00) were each associated with greater odds of being immunized. Willingness for vaccination the next year was strongly associated (OR = 8.59) with vaccination status. Conclusions: The influenza vaccination uptake in the elderly population in Poland is disturbingly low. Improved education strategies are needed to increase the uptake. Vaccinated respondents are more likely to plan on being vaccinated the following year. Future interventions related to maximizing vaccination coverage should be more tailored, focusing especially on older patients living in rural areas.
      PubDate: 2017-06-20
      DOI: 10.3390/ijerph14060665
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 666: The Fate of Pollutants in Porous Asphalt
           Pavements, Laboratory Experiments to Investigate Their Potential to Impact
           Environmental Health

    • Authors: Susanne Charlesworth, Jamie Beddow, Ernest Nnadi
      First page: 666
      Abstract: Pervious Paving Systems (PPS) are part of a sustainable approach to drainage in which excess surface water is encouraged to infiltrate through their structure, during which potentially toxic elements, such as metals and hydrocarbons are treated by biodegradation and physical entrapment and storage. However, it is not known where in the PPS structure these contaminants accumulate, which has implications for environmental health, particularly during maintenance, as well as consequences for the recycling of material from the PPS at the end-of-life. A 1 m3 porous asphalt (PA) PPS test rig was monitored for 38 months after monthly additions of road sediment (RS) (367.5 g in total) and unused oil (430 mL in total), characteristic of urban loadings, were applied. Using a rainfall simulator, a typical UK rainfall rate of 15 mm/h was used to investigate its efficiency in dealing with contamination. Water quality of the effluent discharged from the rig was found to be suitable for discharge to most environments. On completion of the monitoring, a core was taken down through its surface, and samples of sediment and aggregate were taken. Analysis showed that most of the sediment remained in the surface course, with metal levels lower than the original RS, but higher than clean, unused aggregate or PA. However, even extrapolating these concentrations to 20 years’ worth of in-service use (the projected life of PPS) did not suggest their accumulation would present an environmental pollution risk when carrying out maintenance of the pavement and also indicates that the material could be recycled at end-of-life.
      PubDate: 2017-06-21
      DOI: 10.3390/ijerph14060666
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 667: Toxicity of Naphthalene and Benzene on
           Tribollium castaneum Herbst

    • Authors: Nerlis Pajaro-Castro, Karina Caballero-Gallardo, Jesus Olivero-Verbel
      First page: 667
      Abstract: Naphthalene and benzene are widely-used volatile organic compounds. The aim of this research was to examine the toxicological effects of naphthalene and benzene against Tribolium castaneum as an animal model. Adult insects were exposed to these aromatic compounds to assess mortality after 4–48 h of exposure. The lethal concentration 50 (LC50) for naphthalene, naphthalin, and benzene were 63.6 µL/L, 20.0 µL/L, and 115.9 µL/L in air, respectively. Real-time polymerase chain reaction (PCR) analysis revealed expression changes in genes related to oxidative stress and metabolism [Glutathione S-Transferase (Gst), and Cytochrome P450 6BQ8 (Cyp6bq8)]; reproduction and metamorphosis [Hormone receptor in 39-like protein (Hr39), Ecdysone receptor: (Ecr), and Chitin synthase 2 (Chs2)]; and neurotransmission [Histamine-gated chloride channel 2 (Hiscl2)] in insects exposed for 4 h to 70.2 µL/L naphthalene. Adults exposed to benzene (80 µL/L; 4 h) overexpressed genes related to neurotransmission [GABA-gated anion channel (Rdl), Hiscl2, and GABA-gated ion channel (Grd)]; reproduction and metamorphosis [Ultraspiracle nuclear receptor (USP), Ecr; and Hr39]; and development (Chs2). The data presented here provides evidence that naphthalene and benzene inhalation are able to induce alterations on reproduction, development, metamorphosis, oxidative stress, metabolism, neurotransmission, and death of the insect.
      PubDate: 2017-06-21
      DOI: 10.3390/ijerph14060667
      Issue No: Vol. 14, No. 6 (2017)
  • IJERPH, Vol. 14, Pages 668: Antibiotic Concentrations Decrease during
           Wastewater Treatment but Persist at Low Levels in Reclaimed Water

    • Authors: Prachi Kulkarni, Nathan Olson, Greg Raspanti, Rachel Rosenberg Goldstein, Shawn Gibbs, Amir Sapkota, Amy Sapkota
      First page: 668
      Abstract: Reclaimed water has emerged as a potential irrigation solution to freshwater shortages. However, limited data exist on the persistence of antibiotics in reclaimed water used for irrigation. Therefore, we examined the fate of nine commonly-used antibiotics (ampicillin, azithromycin, ciprofloxacin, linezolid, oxacillin, oxolinic acid, penicillin G, pipemidic acid, and tetracycline) in differentially treated wastewater and reclaimed water from two U.S. regions. We collected 72 samples from two Mid-Atlantic and two Midwest treatment plants, as well as one Mid-Atlantic spray irrigation site. Antibiotic concentrations were measured using liquid-chromatography- tandem mass spectrometry. Data were analyzed using Mann-Whitney-Wilcoxon tests and Kruskal Wallis tests. Overall, antibiotic concentrations in effluent samples were lower than that of influent samples. Mid-Atlantic plants had similar influent but lower effluent antibiotic concentrations compared to Midwest plants. Azithromycin was detected at the highest concentrations (of all antibiotics) in influent and effluent samples from both regions. For most antibiotics, transport from the treatment plant to the irrigation site resulted in no changes in antibiotic concentrations, and UV treatment at the irrigation site had no effect on antibiotic concentrations in reclaimed water. Our findings show that low-level antibiotic concentrations persist in reclaimed water used for irrigation; however, the public health implications are unclear at this time.
      PubDate: 2017-06-21
      DOI: 10.3390/ijerph14060668
      Issue No: Vol. 14, No. 6 (2017)
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