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  Subjects -> HEALTH AND SAFETY (Total: 1292 journals)
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HEALTH AND SAFETY (524 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: 23)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 12)
American Journal of Health Education     Hybrid Journal   (Followers: 30)
American Journal of Health Promotion     Hybrid Journal   (Followers: 23)
American Journal of Health Sciences     Open Access   (Followers: 6)
American Journal of Health Studies     Full-text available via subscription   (Followers: 10)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 24)
American Journal of Public Health     Full-text available via subscription   (Followers: 199)
American Journal of Public Health Research     Open Access   (Followers: 29)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4)
Annals of Global Health     Open Access   (Followers: 9)
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   (Followers: 1)
Archive of Community Health     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 3)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 6)
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: 5)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 20)
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: 17)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 12)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 20)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 12)
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: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 2)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
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: 4)
Education for Health     Open Access   (Followers: 5)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 4)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 2)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 6)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 6)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 11)
Frontiers in Public Health     Open Access   (Followers: 7)
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: 5)
Global Health Promotion     Hybrid Journal   (Followers: 16)
Global Journal of Health Science     Open Access   (Followers: 9)
Global Journal of Public Health     Open Access   (Followers: 12)
Global Medical & Health Communication     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 49)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 14)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 15)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Policy     Hybrid Journal   (Followers: 36)
Health Policy and Technology     Hybrid Journal   (Followers: 1)
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 48)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 40)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 11)
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: 2)
Health Systems     Hybrid Journal   (Followers: 3)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 12)
Health, Risk & Society     Hybrid Journal   (Followers: 12)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Healthy-Mu Journal     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 11)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 2)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
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: 5)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 33)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 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: 20)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 16)
International Journal of Health & Allied Sciences     Open Access   (Followers: 3)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 9)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 4)

        1 2 3 | Last

Journal Cover International Journal of Environmental Research and Public Health
  [SJR: 0.883]   [H-I: 47]   [20 followers]  Follow
  This is an Open Access Journal Open Access journal
   ISSN (Print) 1660-4601
   Published by MDPI Homepage  [156 journals]
  • IJERPH, Vol. 14, Pages 1287: Fatal Pediatric Motor Vehicle Crashes on U.S.
           Native American Indian Lands Compared to Adjacent Non-Indian Lands:
           Restraint Use and Injury by Driver, Vehicle, Roadway and Crash

    • Authors: Shin Oh, Chang Liu, Joyce Pressley
      First page: 1287
      Abstract: There are large disparities in American Indian pediatric motor vehicle (MV) mortality with reports that several factors may contribute. The Fatality Analysis Reporting System for 2000–2014 was used to examine restraint use for occupants aged 0–19 years involved in fatal MV crashes on Indian lands (n = 1667) and non-Indian lands in adjacent states (n = 126,080). SAS GLIMMIX logistic regression with random effects was used to generate odds ratios (OR) with 95% confidence intervals (CI). Restraint use increased in both areas over the study period with restraint use on Indian lands being just over half that of non-Indian lands for drivers (36.8% vs. 67.8%, p < 0.0001) and for pediatric passengers (33.1% vs. 59.3%, p < 0.0001). Driver restraint was the strongest predictor of passenger restraint on both Indian and non-Indian lands exerting a stronger effect in ages 13–19 than in 0–12 year olds. Valid licensed driver was a significant predictor of restraint use in ages 0–12 years. Passengers in non-cars (SUVs, vans and pickup trucks) were less likely to be restrained. Restraint use improved over the study period in both areas, but disparities failed to narrow as restraint use remains lower and driver, vehicle and crash risk factors higher for MV mortality on Indian lands.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-25
      DOI: 10.3390/ijerph14111287
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1288: Health in All Policies in South
           Australia—Did It Promote and Enact an Equity Perspective'

    • Authors: Helen van Eyk, Elizabeth Harris, Fran Baum, Toni Delany-Crowe, Angela Lawless, Colin MacDougall
      First page: 1288
      Abstract: Mobilising cross-sectoral action is helpful in addressing the range of social determinants that contribute to health inequities. The South Australian Health in All Policies (SA HiAP) approach was implemented from 2007 to stimulate cross-sector policy activity to address the social determinants of health to improve population wellbeing and reduce health inequities. This paper presents selected findings from a five year multi-methods research study of the SA HiAP approach and draws on data collected during interviews, observation, case studies, and document analysis. The analysis shows that SA HiAP had dual goals of facilitating joined-up government for co-benefits (process focus); and addressing social determinants of health and inequities through cross-sectoral policy activity (outcomes focus). Government agencies readily understood HiAP as providing tools for improving the process of intersectoral policy development, while the more distal outcome-focused intent of improving equity was not well understood and gained less traction. While some early rhetorical support existed for progressing an equity agenda through SA HiAP, subsequent economic pressures resulted in the government narrowing its priorities to economic goals. The paper concludes that SA HiAP’s initial intentions to address equity were only partially enacted and little was done to reduce inequities. Emerging opportunities in SA, and internationally, including the UN Sustainable Development Goals, may revive interest in addressing equity.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-25
      DOI: 10.3390/ijerph14111288
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1292: Assessment of SIP Buildings for Sustainable
           Development in Rural China Using AHP-Grey Correlation Analysis

    • Authors: Libiao Bai, Hailing Wang, Chunming Shi, Qiang Du, Yi Li
      First page: 1292
      Abstract: Traditional rural residential construction has the problems of high energy consumption and severe pollution. In general, with sustainable development in the construction industry, rural residential construction should be aimed towards low energy consumption and low carbon emissions. To help achieve this objective, in this paper, we evaluated four different possible building structures using AHP-Grey Correlation Analysis, which consists of the Analytic Hierarchy Process (AHP) and the Grey Correlation Analysis. The four structures included the traditional and currently widely used brick and concrete structure, as well as structure insulated panels (SIPs). Comparing the performances of economic benefit and carbon emission, the conclusion that SIPs have the best overall performance can be obtained, providing a reference to help builders choose the most appropriate building structure in rural China.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-25
      DOI: 10.3390/ijerph14111292
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1294: Frequency of Loud Snoring and Metabolic
           Syndrome among Korean Adults: Results from the Health Examinees (HEXA)

    • Authors: Claire Kim, Sangah Shin, Hwi-Won Lee, Jiyeon Lim, Jong-Koo Lee, Daehee Kang
      First page: 1294
      Abstract: Studies regarding the association between snoring and metabolic abnormalities have been inconsistent. We examine whether snoring frequency and obstructive sleep apnea markers are associated with metabolic syndrome (MetS) among Koreans aged 40–69 years. A total of 72,885 subjects (24,856 men, 48,029 women) from the Health Examinees Gem study between 2009 and 2013 were included. Snoring frequency was grouped into five categories (never, 1–3/month, 1–3/week, 4–5/week, 6+/week). Obstructive sleep apnea markers included breathing interruptions and awakenings. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated through logistic regression. Compared with non-snorers, those who snore 6+/week were associated with increased odds for MetS (OR: 2.07, 95% CI: 1.91–2.25, p-trend < 0.0001 among men; OR: 1.45, CI: 1.33–1.58, p-trend < 0.0001 among women). Snoring frequency is associated with MetS and its components in both men and women. Snoring and obstructive sleep apnea markers are important indicators of sleep quality, which may facilitate early detection of sleep disorders and further complications such as MetS.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111294
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1295: The Combined Influence of Air Pollution and
           Home Learning Environment on Early Cognitive Skills in Children

    • Authors: Lanair Lett, Jeanette Stingone, Luz Claudio
      First page: 1295
      Abstract: Cognitive skills are one component of school readiness that reflect a child’s neurodevelopment and are influenced by environmental and social factors. Most studies assess the impact of these factors individually, without taking into consideration the complex interactions of multiple factors. The objective of this study was to examine the joint association of markers of environmental pollution and of social factors on early cognitive skills in an urban cohort of children. For this, we chose isophorone in ambient air as a marker of industrial air pollution. Low quality home learning environments was chosen as a marker of the social factors contributing to cognitive development. Using a subpopulation from the Early Childhood Longitudinal Study, Birth Cohort (N = 4050), isophorone exposure was assigned using the 2002 National Air Toxics Assessment. Home learning environment was assessed with a modified version of the Home Observation for Measurement of the Environment (HOME) Inventory, and standardized math assessment scores were used as a measure of early cognitive skills. Multiple linear regression was used to estimate the effect of both exposures on math scores. After adjustment for confounders, children living in areas with ambient isophorone in the upper quintile of exposure (>0.49 ng/m3) had math scores that were 1.63 points lower than their less exposed peers [95% CI: −2.91, −0.34], and children with lower HOME scores (at or below 9 out of 12) had math scores that were 1.20 points lower than children with better HOME scores [95% CI: −2.30, −0.10]. In adjusted models accounting for identified confounders and both exposures of interest, both high isophorone exposure and low HOME score remained independently associated with math scores [−1.48, 95% CI: −2.79, −0.18; −1.05, 95% CI: −2.15, 0.05, respectively]. There was no statistical evidence of interaction between the two exposures, although children with both higher isophorone exposure and a low HOME score had a decrement in math scale score beyond the additive effect of each exposure. This was primarily observed among male children. These findings suggest that aspects of both the physical and social environments are independently associated with children’s early cognitive skills. Future research aiming to improve children’s early cognitive skills and subsequent school readiness should address both domains.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111295
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1296: Presence of Legionella spp. in Hot Water
           Networks of Different Italian Residential Buildings: A Three-Year Survey

    • Authors: Michele Totaro, Paola Valentini, Anna Costa, Lorenzo Frendo, Alessia Cappello, Beatrice Casini, Mario Miccoli, Gaetano Privitera, Angelo Baggiani
      First page: 1296
      Abstract: Although the European reports highlight an increase in community-acquired Legionnaires’ disease cases, the risk of Legionella spp. in private houses is underestimated. In Pisa (Italy) we performed a three-year survey on Legionella presence in 121 buildings with an independent hot water production (IB); 64 buildings with a central hot water production (CB); and 35 buildings with a solar thermal system for hot water production (TB). From all the 220 buildings Legionella spp. was researched in two hot water samples collected either at the recirculation point or on the first floor and on the last floor, while the potable water quality was analysed in three cold water samples collected at the inlet from the aqueduct network, at the exit from the autoclave, and at the most remote tap. Legionella pneumophila sg1, Legionella pneumophila sg2–16, and non-pneumophila Legionella species were detected in 26% of the hot water networks, mostly in CB and TB. In these buildings we detected correlations between the presence of Legionella and the total chlorine concentration decrease and/or the increase of the temperature. Cold water resulted free from microbiological hazards, with the exception of Serratia liquefaciens and Enterobacter cloacae isolated at the exit from two different autoclaves. We observed an increase in total microbial counts at 22 °C and 37 °C between the samples collected at the most remote taps compared to the ones collected at the inlet from the aqueduct. The study highlights a condition of potential risk for susceptible categories of population and supports the need for measures of risk assessment and control.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111296
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1297: Environmental Pollution by Benzene and PM10
           and Clinical Manifestations of Systemic Sclerosis: A Correlation Study

    • Authors: Alice Borghini, Andrea Poscia, Silvia Bosello, Adele Teleman, Mario Bocci, Lanfranco Iodice, Gianfranco Ferraccioli, Daniele La Milìa, Umberto Moscato
      First page: 1297
      Abstract: Atmospheric air pollution has been associated with a range of adverse health effects. The environment plays a causative role in the development of Systemic Sclerosis (SSc). The aim of the present study is to explore the association between particulate (PM10) and benzene (B) exposure in Italian patients with systemic sclerosis and their clinical characteristics of the disease. A correlation study was conducted by enrolling 88 patients who suffer from SSc at the Fondazione Policlinico “A. Gemelli” in Rome (Italy) in the period from January 2013 to January 2014. The average mean concentrations of B (in 11 monitoring sites) and PM10 (in 14 sites) were calculated using data from the Regional Environmental Protection Agency’s monitoring stations located throughout the Lazio region (Italy) and then correlated with the clinical characteristics of the SSc patients. Of the study sample, 92.5% were female. The mean age was 55 ± 12.9 years old and the mean disease duration from the onset of Raynaud’s phenomenon was 13.0 ± 9.4 years. The Spearman’s correlation showed that concentrations of B correlate directly with the skin score (R = 0.3; p ≤ 0.05) and inversely with Diffusing Lung Carbon Monoxide (DLCO) results (R = −0.36; p = 0.04). This study suggests a possible role of B in the development of diffuse skin disease and in a worse progression of the lung manifestations of SSc.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111297
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1298: Application of Circular Bubble Plume
           Diffusers to Restore Water Quality in a Sub-Deep Reservoir

    • Authors: Chen Lan, Jingan Chen, Jingfu Wang, Jianyang Guo, Jia Yu, Pingping Yu, Haiquan Yang, Yong Liu
      First page: 1298
      Abstract: Circular bubble plume diffusers have been confirmed as an effective technology for the restoration of the deep water system, but have never been applied in sub-deep water system. In this study, circular bubble plume diffusers were used, for the first time, to restore water quality in the Aha Reservoir, a typical sub-deep reservoir in Southwest China. Axisymmetric intrusive gravity currents were formed with a horizontal radius of 250 m at the equilibrium depth and the intrusion of oxygen-enriched water occurred within the depth of 10–14 m, while thermal stratification remained intact. A total of 95% of the imported oxygen was dissolved, but most was consumed by organic matter and other reduced substances within the hypolimnion. The oxygen consumption of organic matter, NH4+ and remaining reduced materials, accounted for 41.4–52.5%, 25% and 13.3–24.4% of the total imported oxygen, respectively. Compared with the control sites, dissolved oxygen level in the hypolimnion increased 3–4 times, and concentrations of NH4+, total Fe and total Mn were reduced by 15.5%, 45.5% and 48.9%, respectively. A significant decrease in total phosphorus and nitrogen concentrations was observed in the experimental zone (0.04–0.02 mg/L and 1.9–1.7 mg/L, respectively). This indicates that circular bubble plumes have great potential for oxygenation of the hypolimnion and improving water quality in the sub-deep water system. Nevertheless, further efforts are needed to improve the discrete bubble model to elaborate the oxygen transmission dynamics and the plume formation processes in sub-deep water systems, incorporating oxygen consumption processes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111298
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1299: An Integrated Pest Management Intervention
           Improves Knowledge, Pest Control, and Practices in Family Child Care Homes

    • Authors: Michelle Stephens, Kimberly Hazard, Debra Moser, Dana Cox, Roberta Rose, Abbey Alkon
      First page: 1299
      Abstract: To reduce young children’s exposure to pesticides when attending family child care homes (FCCHs), we developed an integrated pest management (IPM) intervention for FCCH directors. First, we developed IPM educational materials and resources to provide the foundation for an IPM educational intervention for FCCHs. Next, we conducted and evaluated a six-month nurse child care health consultant (CCHC)-led education and consultation IPM intervention to increase IPM knowledge, IPM practices, IPM policies, and decrease the presence or evidence of pests. The pilot intervention study was conducted by three CCHCs in 20 FCCHs in three counties in California. Pre- and post-intervention measures were completed by the FCCH directors and observation measures were completed by the CCHCs. Results indicated significant increases in IPM knowledge, (t-statistic (degrees of freedom), (t(df) = 2.55(10), p < 0.05), increases in IPM practices (t(df) = −6.47(17), p < 0.05), and a 90% reduction in the prevalence of pests. There were no significant differences in changes in IPM practices based on director education, FCCH county, or IPM intervention intensity or duration. A nurse-led IPM education and consultation intervention can reduce exposures of young children attending family child care homes to harmful chemicals.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111299
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1300: Nutrient Content and Nutritional Water
           Productivity of Selected Grain Legumes in Response to Production

    • Authors: Tendai Chibarabada, Albert Modi, Tafadzwanashe Mabhaudhi
      First page: 1300
      Abstract: There is a need to incorporate nutrition into aspects of crop and water productivity to tackle food and nutrition insecurity (FNS). The study determined the nutritional water productivity (NWP) of selected major (groundnut, dry bean) and indigenous (bambara groundnut and cowpea) grain legumes in response to water regimes and environments. Field trials were conducted during 2015/16 and 2016/17 at three sites in KwaZulu-Natal, South Africa (Ukulinga, Fountainhill and Umbumbulu). Yield and evapotranspiration (ET) data were collected. Grain was analysed for protein, fat, Ca, Fe and Zn nutrient content (NC). Yield, ET and NC were then used to compute NWP. Overall, the major legumes performed better than the indigenous grain legumes. Groundnut had the highest NWPfat. Groundnut and dry bean had the highest NWPprotein. For NWPFe, Zn and Ca, dry bean and cowpea were more productive. Yield instability caused fluctuations in NWP. Water treatments were not significant (p > 0.05). While there is scope to improve NWP under rainfed conditions, a lack of crop improvement currently limits the potential of indigenous grain legumes. This provides an initial insight on the nutrient content and NWP of a limited number of selected grain legumes in response to the production environment. There is a need for follow-up research to include cowpea data. Future studies should provide more experimental data and explore effects of additional factors such as management practices (fertiliser levels and plant density), climate and edaphic factors on nutrient content and NWP of crops.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111300
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1301: Preparation and Application of Carboxylated
           Graphene Oxide Sponge in Dye Removal

    • Authors: Lianqin Zhao, Sheng-Tao Yang, Shicheng Feng, Qiang Ma, Xiaoling Peng, Deyi Wu
      First page: 1301
      Abstract: Spongy graphene is a newly developed adsorbent of high performance for water treatment. Proper functionalization is an efficient approach to improve the adsorption capacity of graphene adsorbents. In this study, we prepared graphene oxide (GO), functionalized it with carboxyl groups to produce carboxylated GO (GO-COOH) dispersion, and lyophilized the GO-COOH dispersion to obtain the GO-COOH sponge. The adsorption isotherm, kinetics, thermodynamics, influencing factors, and regeneration of the adsorption of dye methylene blue (MB) on GO-COOH sponge were evaluated in batch experiments. The adsorption capacity of GO-COOH sponge was measured as 780 mg/g, which was nearly twice that of GO sponge (446 mg/g). The adsorption isotherm could be well described by the Freundlich model with a KF of 508 (L/mg)1/n. The adsorption kinetic was nicely fitted by pseudo-first-order model with a k1 of 0.00157·min−1. In thermodynamics analysis, the negative ΔG indicated the spontaneous nature of adsorption on GO-COOH sponge. The adsorption process was endothermic and was driven by the increase of entropy. Higher pH benefited the removal of MB by GO-COOH sponge and the ionic strength had no meaningful effect. The regeneration was poor due to the strong electrostatic interaction between MB and the GO-COOH sponge. The results collectively suggested that carboxylation increased the adsorption performance of GO sponge.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111301
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1302: Toward an Asbestos Ban in the United States

    • Authors: Richard Lemen, Philip Landrigan
      First page: 1302
      Abstract: Many developed countries have banned the use of asbestos, but not the United States. There have, however, been multiple efforts in the US to establish strict exposure standards, to limit asbestos use, and to seek compensation through the courts for asbestos-injured workers’ In consequence of these efforts, asbestos use has declined dramatically, despite the absence of a legally mandated ban. This manuscript presents a historical review of these efforts.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111302
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1303: Exploring Perception of Vibrations from Rail:
           An Interview Study

    • Authors: Laura Maclachlan, Kerstin Persson Waye, Eja Pedersen
      First page: 1303
      Abstract: Rail transport is an environmentally responsible approach and traffic is expected to increase in the coming decades. Little is known about the implications for quality of life of populations living close to railways. This study explores the way in which vibrations from rail are perceived and described by these populations. The study took place in the Västra Götaland and Värmland regions of Sweden. A qualitative study approach was undertaken using semi-structured interviews within a framework of predetermined questions in participants’ homes. A 26.3% response rate was achieved and 17 participants were interviewed. The experience of vibrations was described in tangible terms through different senses. Important emerging themes included habituation to and acceptance of vibrations, worry about property damage, worry about family members and general safety. Participants did not reflect on health effects, however, chronic exposure to vibrations through multimodal senses in individual living environments may reduce the possibility for restoration in the home. Lack of empowerment to reduce exposure to vibrations was important. This may alter individual coping strategies, as taking actions to avoid the stressor is not possible. The adoption of other strategies, such as avoidance, may negatively affect an individual’s ability to cope with the stressor and their health.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-26
      DOI: 10.3390/ijerph14111303
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1304: Vaccines as Epidemic Insurance

    • Authors: Mark Pauly
      First page: 1304
      Abstract: This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines) in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs) but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage). It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111304
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1305: Examination of the Relationship between
           In-Store Environmental Factors and Fruit and Vegetable Purchasing among

    • Authors: Jennifer Sanchez-Flack, Julie Pickrel, George Belch, Shih-Fan Lin, Cheryl Anderson, Maria Martinez, Elva Arredondo, Guadalupe Ayala
      First page: 1305
      Abstract: Retail food environments have received attention for their influence on dietary behaviors and for their nutrition intervention potential. To improve diet-related behaviors, such as fruit and vegetable (FV) purchasing, it is important to examine its relationship with in-store environmental characteristics. This study used baseline data from the “El Valor de Nuestra Salud” study to examine how in-store environmental characteristics, such as product availability, placement and promotion, were associated with FV purchasing among Hispanic customers in San Diego County. Mixed linear regression models indicated that greater availability of fresh FVs was associated with a $0.36 increase in FV purchasing (p = 0.01). Placement variables, specifically each additional square foot of display space dedicated to FVs (p = 0.01) and each additional fresh FV display (p = 0.01), were associated with a $0.02 increase and $0.29 decrease, respectively, in FV purchasing. Introducing FV promotions in the final model was not related to FV purchasing. Exploratory analyses indicated that men reported spending $3.69 fewer dollars on FVs compared to women, controlling for covariates (p = 0.02). These results can help inform interventions targeting in-store environmental characteristics to encourage FV purchasing among Hispanics.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111305
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1306: Risk Perception and Anxiety Regarding
           Radiation after the 2011 Fukushima Nuclear Power Plant Accident: A
           Systematic Qualitative Review

    • Authors: Yoshitake Takebayashi, Yuliya Lyamzina, Yuriko Suzuki, Michio Murakami
      First page: 1306
      Abstract: The purpose of this study was to provide a review of the publications of the risk perceptions or anxiety regarding radiation among people living in Japan after the 2011 Fukushima nuclear power plant accident. Two database (MEDLINE and PsycINFO) and hand-searched the references in identified publications were searched. For each identified publication, the measurements and time related-change of risk perception and anxiety regarding radiation were summarized. Twenty-four publications were identified. Quantitative measures of risk perception or anxiety were roughly divided into two types: single-item Likert scales that measure anxiety about radiation; and theoretical, or model-based measures. Rates of Fukushima residents with radiation-related anxiety decreased from 2012 to 2015. Factors governing risk perception or radiation-related anxiety were summarized by demographics, disaster-related stressors, trusted information, and radiation-related variables. The effects of risk perception or anxiety regarding radiation were summarized as severe distress, intention to leave employment or not to return home, or other dimensions. This review provides summary of current findings on risk perception or anxiety regarding radiation in Japan after the accident. Further researches are needed about detailed statistical analysis for time-related change and causality among variables.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111306
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1307: Water Pollution Prediction in the Three
           Gorges Reservoir Area and Countermeasures for Sustainable Development of
           the Water Environment

    • Authors: Yinghui Li, Shuaijin Huang, Xuexin Qu
      First page: 1307
      Abstract: The Three Gorges Project was implemented in 1994 to promote sustainable water resource use and development of the water environment in the Three Gorges Reservoir Area (hereafter “Reservoir Area”). However, massive discharge of wastewater along the river threatens these goals; therefore, this study employs a grey prediction model (GM) to predict the annual emissions of primary pollution sources, including industrial wastewater, domestic wastewater, and oily and domestic wastewater from ships, that influence the Three Gorges Reservoir Area water environment. First, we optimize the initial values of a traditional GM (1,1) model, and build a new GM (1,1) model that minimizes the sum of squares of the relative simulation errors. Second, we use the new GM (1,1) model to simulate historical annual emissions data for the four pollution sources and thereby test the effectiveness of the model. Third, we predict the annual emissions of the four pollution sources in the Three Gorges Reservoir Area for a future period. The prediction results reveal the annual emission trends for the major wastewater types, and indicate the primary sources of water pollution in the Three Gorges Reservoir Area. Based on our predictions, we suggest several countermeasures against water pollution and towards the sustainable development of the water environment in the Three Gorges Reservoir Area.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111307
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1308: Does Parental Migration Have Negative Impact
           on the Growth of Left-Behind Children'—New Evidence from
           Longitudinal Data in Rural China

    • Authors: Xu Tian, Caicui Ding, Chong Shen, Hui Wang
      First page: 1308
      Abstract: The soaring number of left-behind children (LBC) in China has raised concerns about whether or not they can receive adequate care. This study investigated the impact of parents’ migration on LBC’s growth. LBC were divided into father-left children (F-LBC) and at least mother left children (M-LBC), both of which were compared with non-left-behind children (non-LBC) in terms of growth indicators. Data of 466 children with two continuous measurements were obtained from the four recent waves of the China Health and Nutrition Survey (CHNS). Anthropometric measures and 24-h recall of three consecutive days of dietary intake were extracted. The disparity of growth and nutrition status were compared by the difference-in-difference (DID) method. Results showed that LBC had significantly worse height and weight than non-LBC at baseline, respectively (p = 0.006, p = 0.003). This disadvantage was improved after parental migration, especially for M-LBC. However, the impact on growth status caused by parents’ migration was statistically insignificant once the pre-treatment disparity was removed. Further analysis on nutrition status indicated that fathers’ migration had a significant negative impact on F-LBC’s calorie intake (p = 0.014), which was mainly caused by the decline of carbohydrates (p = 0.008). This study indicated that the negative impact detected in previous studies might be caused by the retarded growth of LBC before parents’ migration.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111308
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1309: Using the D-DANP-mV Model to Explore the
           Continuous System Improvement Strategy for Sustainable Development of
           Creative Communities

    • Authors: Lei Xiong, Cheng-Lein Teng, Bo-Wei Zhu, Gwo-Hshiung Tzeng, Shan-Lin Huang
      First page: 1309
      Abstract: With globalization, the notion of “creative city” has become a core concept of many cities in the world development policies, with real properties being upgraded or used to change, renewal is being conducted, and creative industries are emerging. This trend has reached its peak in the past decade, with different forms and scales gathering global development momentum among the creative communities to promote the development of creative economies. In recent years, however, there was still skepticism about the sustainability of the current creative communities. Many scholars have pointed out that signs of unsustainability have begun to appear in many creative communities. To overcome these obstacles, the development of rational and highly effective improvement strategy requires a dynamic thinking process. Therefore, this study employs the DEMATEL-based ANP with modified VIKOR (D-DANP-mV) model in presenting an assessment framework for the sustainability of creative communities. This system is used to assess the sustainability of current creative communities and determine how to solve their problems. Thus, continuous and systemic improvement strategies can be developed to achieve the aim of sustainable development. Two creative communities in Taiwan, Taichung Cultural and Creative Industries Park (TCCIP), and Shen-Ji New Village (SJNV), are used as case studies in this study. Based on the concept of systematic improvement from fundamental issues, the results indicate that the improvement priorities can be determined by applying the D-DANP-mV model. This approach is different from those found by a conventional method with the hypothesis of independent criteria (e.g., diversification of creative talents in TCCIP), and cannot use for performance improvement (e.g., only can be used for ranking and selection among alternatives). Considering these points, unreasonable premises, biased errors, and lack of some real application functions in the process of resource allocation could be more efficient improvement strategies generated in this proposed model.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111309
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1310: Longer Nature-Based Rehabilitation May
           Contribute to a Faster Return to Work in Patients with Reactions to Severe
           Stress and/or Depression

    • Authors: Patrik Grahn, Anna María Pálsdóttir, Johan Ottosson, Ingibjörg H. Jonsdottir
      First page: 1310
      Abstract: The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work' Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111310
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1311: An Improved Graph Model for Conflict
           Resolution Based on Option Prioritization and Its Application

    • Authors: Kedong Yin, Li Yu, Xuemei Li
      First page: 1311
      Abstract: In order to quantitatively depict differences regarding the preferences of decision makers for different states, a score function is proposed. As a foundation, coalition motivation and real-coalition analysis are discussed when external circumstance or opportunity costs are considering. On the basis of a confidence-level function, we establish the score function using a “preference tree”. We not only measure the preference for each state, but we also build a collation improvement function to measure coalition motivation and to construct a coordinate system in which to analyze real-coalition stability. All of these developments enhance the applicability of the graph model for conflict resolution (GMCR). Finally, an improved GMCR is applied in the “Changzhou Conflict” to demonstrate how it can be conveniently utilized in practice.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111311
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1312: Long-Lasting Insecticide Net Ownership,
           Access and Use in Southwest Ethiopia: A Community-Based Cross-Sectional

    • Authors: Dinberu Seyoum, Niko Speybroeck, Luc Duchateau, Patrick Brandt, Angel Rosas-Aguirre
      First page: 1312
      Abstract: Introduction:A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, access and use of LLNs in the malaria endemic southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in southwest Ethiopia during October–November 2015, including 836 households from sixteen villages around Gilgel-Gibe dam area. Indicators of ownership, access and use of LLINs were derived following the Roll Back Malaria (RBM) guidelines. Factors associated with failure for both LLIN access and use were analysed at household level using a multivariate logistic regression model. Results: The proportion of households with at least one LLIN was 82.7% (95% CI: 80.0, 85.1). However, only 68.9% (95% CI: 65.6, 71.9) had enough LLINs to cover all family members (with ≥one LLIN for every two persons). While 75.3% (95% CI: 68.4, 83.0) of the population was estimated to have accessed to LLINs, only 63.8% (95% CI: 62.3, 65.2) reported to have used a LLIN the previous night. The intra-household gap (i.e., households owning at least one LLIN, but unable to cover all family members) and the behavioral gap (i.e., household members who did not sleep under a LLIN despite having access to one) were 16.8% and 10.5%, respectively. Age, marital status and education of household heads, as well as household size and cooking using firewood were associated with the access to enough LLINs within households. Decreased access to LLINs at households was the main determinant for not achieving ≥80% household members sleeping under a LLIN the previous night. Other associated factors were household size and education level of household head. Conclusions: LLIN coverage levels in study villages remain below national targets of 100% for ownership and 80% for use. The access to enough LLINs within the households is the main restriction of LLIN use in the study area.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-27
      DOI: 10.3390/ijerph14111312
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1313: Diet Quality and Satisfaction with Life,
           Family Life, and Food-Related Life across Families: A Cross-Sectional
           Pilot Study with Mother-Father-Adolescent Triads

    • Authors: Berta Schnettler, Germán Lobos, Edgardo Miranda-Zapata, Marianela Denegri, Gastón Ares, Clementina Hueche
      First page: 1313
      Abstract: Family is a major determinant of children’s and adolescents’ eating behavior. The objectives of the present study were to assess diet quality, eating habits, satisfaction with life, family life, and food-related life in mother–father–adolescent triads, and to identify profiles of families according to family members’ diet quality. Questionnaires were administered to a sample of 300 two-parent families with one child over the age of 10 in the city of Temuco (Chile), including the Adapted Healthy Eating Index (AHEI), Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWFoL) scale, Satisfaction with Family Life (SWFaL) scales, and questions relating to their eating habits. Positive relationships were found between the diet quality of the family members, particularly between mothers and adolescents. Three family profiles with different diet qualities were identified: “families with an unhealthy diet” (39.3%), “families in which mothers and adolescents have healthy diets, but the fathers’ diets require changes” (14.3%), and “families that require changes in their diet” (46.4%). These findings stress the key role of mothers in determining family diet quality and suggest a positive relationship between diet quality and satisfaction with life.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-29
      DOI: 10.3390/ijerph14111313
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1314: Executive Function Capacities, Negative
           Driving Behavior and Crashes in Young Drivers

    • Authors: Elizabeth Walshe, Chelsea Ward McIntosh, Daniel Romer, Flaura Winston
      First page: 1314
      Abstract: Motor vehicle crashes remain a leading cause of injury and death in adolescents, with teen drivers three times more likely to be in a fatal crash when compared to adults. One potential contributing risk factor is the ongoing development of executive functioning with maturation of the frontal lobe through adolescence and into early adulthood. Atypical development resulting in poor or impaired executive functioning (as in Attention-Deficit/Hyperactivity Disorder) has been associated with risky driving and crash outcomes. However, executive function broadly encompasses a number of capacities and domains (e.g., working memory, inhibition, set-shifting). In this review, we examine the role of various executive function sub-processes in adolescent driver behavior and crash rates. We summarize the state of methods for measuring executive control and driving outcomes and highlight the great heterogeneity in tools with seemingly contradictory findings. Lastly, we offer some suggestions for improved methods and practical ways to compensate for the effects of poor executive function (such as in-vehicle assisted driving devices). Given the key role that executive function plays in safe driving, this review points to an urgent need for systematic research to inform development of more effective training and interventions for safe driving among adolescents.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-28
      DOI: 10.3390/ijerph14111314
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1315: Who Participates in Running Events'
           Socio-Demographic Characteristics, Psychosocial Factors and Barriers as
           Correlates of Non-Participation—A Pilot Study in Belgium

    • Authors: Delfien van Dyck, Greet Cardon, Ilse de Bourdeaudhuij, Lisa de Ridder, Annick Willem
      First page: 1315
      Abstract: In Western countries, the popularity of running events has increased exponentially during the last three decades. However, little is known about the profile of non-participants. This knowledge is crucial to tailor promotional actions towards people who are currently not participating. Therefore, this study aimed: (1) to examine which socio-ecological factors are related to participation in running events, (2) to give an overview of the barriers towards participation, and (3) to examine differences in barriers depending on gender, age and educational level. Flemish adults (n = 308) completed an online questionnaire about their socio-demographic and psychosocial characteristics, physical activity levels, participation in running events and barriers towards participation. Results showed that motivation, family social support, knowledge about running events and physical activity levels were associated with participation in running events. Among non-participants, the main barriers were bad physical condition, lack of time and lack of interest. In participants, lack of time, distance to the event and financial barriers were most prevalent. With some exceptions, barriers were relatively similar across socio-demographic subgroups. This study confirmed a democratization among participants of running events and provided evidence about which barriers should be tackled to increase participation among population subgroups that are currently underrepresented in such events.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-28
      DOI: 10.3390/ijerph14111315
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1316: Sensitizing Black Adult and Youth Consumers
           to Targeted Food Marketing Tactics in Their Environments

    • Authors: Katherine Isselmann DiSantis, Shiriki Kumanyika, Lori Carter-Edwards, Deborah Rohm Young, Sonya Grier, Vikki Lassiter
      First page: 1316
      Abstract: Food marketing environments of Black American consumers are heavily affected by ethnically-targeted marketing of sugar sweetened beverages, fast foods, and other products that may contribute to caloric overconsumption. This qualitative study assessed Black consumers’ responses to targeted marketing. Black adults (2 mixed gender groups; total n = 30) and youth (2 gender specific groups; total n = 35) from two U.S. communities participated before and after a sensitization procedure—a critical practice used to understand social justice concerns. Pre-sensitization focus groups elicited responses to scenarios about various targeted marketing tactics. Participants were then given an informational booklet about targeted marketing to Black Americans, and all returned for the second (post-sensitization) focus group one week later. Conventional qualitative content analysis of transcripts identified several salient themes: seeing the marketer’s perspective (“it’s about demand”; “consumers choose”), respect for community (“marketers are setting us up for failure”; “making wrong assumptions”), and food environments as a social justice issue (“no one is watching the door”; “I didn’t realize”). Effects of sensitization were reflected in participants’ stated reactions to the information in the booklet, and also in the relative occurrence of marketer-oriented themes and social justice-oriented themes, respectively, less and more after sensitization.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-29
      DOI: 10.3390/ijerph14111316
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1317: Seasonal Patterns of Japanese Encephalitis
           and Associated Meteorological Factors in Taiwan

    • Authors: Che-Liang Lin, Hsiao-Ling Chang, Chuan-Yao Lin, Kow-Tong Chen
      First page: 1317
      Abstract: The persistent transmission of Japanese encephalitis virus (JEV) in Taiwan necessitates exploring the risk factors of occurrence of Japanese encephalitis (JE). The purpose of this study was to assess the relationship between meteorological factors and the incidence of JE in Taiwan. We collected data for cases of JE reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2000 to 2014. Meteorological data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of JE in Taiwan were determined via Poisson regression analysis and a case-crossover methodology. During the 15-year study period, a total of 379 cases of JE were reported. The incidence of JE showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, p < 0.001). The number of JE cases started to increase at temperatures of 22 °C (r2 = 0.88, p < 0.001). Similarly, the number of JE cases began to increase at a relative humidity of 70–74% (r2 = 0.75, p < 0.005). The number of JE cases was positively associated with mean temperature and relative humidity in the period preceding the infection. In conclusion, the occurrence of JE is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-29
      DOI: 10.3390/ijerph14111317
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1318: Molecular Analysis of the SRD5A1 and SRD5A2
           Genes in Patients with Benign Prostatic Hyperplasia with Regard to
           Metabolic Parameters and Selected Hormone Levels

    • Authors: Aleksandra Rył, Iwona Rotter, Anna Grzywacz, Iwona Małecka, Karolina Skonieczna-Żydecka, Katarzyna Grzesiak, Marcin Słojewski, Aleksandra Szylińska, Olimpia Sipak-Szmigiel, Małgorzata Piasecka, Kinga Walczakiewicz, Maria Laszczyńska
      First page: 1318
      Abstract: Introduction: The etiology of benign prostatic hyperplasia (BPH) has not so far been fully explicated. However, it is assumed that changes in the levels of hormones associated with aging can contribute to the development of prostatic hyperplasia. Dihydrotestosterone combines with the androgen receptor (AR) proteins of the prostate gland. Enzyme activity is based on two isoenzymes: type 1 and type 2. 5α-reductase type 1 is encoded by the SRD5A1 gene, and type 2 is encoded by the SRD5A2 gene. The aim of our study was to determine the frequency of the SRD5A1 (rs6884552, rs3797177) and SRD5A2 (rs523349, rs12470143) genes’ polymorphisms, and to assess the relationships between the genotypes of the tested mutations, and the levels of biochemical and hormonal parameters in patients with BPH. Material and Methods: The study involved 299 men with benign prostatic hyperplasia. We determined the serum levels of particular biochemical parameters—fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG)—by the spectrophotometric method, using ready reagent kits. The ELISA method was used to determine the levels of the following hormonal parameters and proteins: total testosterone (TT), free testosterone (FT), insulin (I), luteinizing hormone (LH), and sex hormone binding protein (SHBG). Metabolic syndrome was diagnosed. Genotyping was performed by real-time PCR. Results: We analyzed the relationships between the incidence of particular diseases and the genotypes of the SRD5A1 and SRD5A2 polymorphisms among patients with BPH. The BPH patients with the CC genotype of the SRD5A2 rs523349 and rs12470143 polymorphisms were considerably less frequently diagnosed with metabolic syndrome (MetS) (p = 0.022 and p = 0.023 respectively). Our analysis revealed that homozygotes with the CC of the SDR5A2 rs12470143 polymorphism had visibly higher HDL levels than those with the TT and CT genotypes (p = 0.001). Additionally, we found that the patients with the CC genotype of the SDR5A2 rs12470143 polymorphism had considerably higher FT levels (p = 0.001) than the heterozygotes with the CT and the homozygotes with the TT of the genetic variant analyzed in our study. Furthermore, the patients with at least one G allele of the SRD5A2 rs523349 polymorphism had significantly lower SGBG levels (p = 0.022) compared with the homozygotes with the CC genotype. The presence of at least one A allele (AA + AG genotypes) of the SRD5A1 rs3797177 polymorphism entailed notably lower serum insulin levels than those observed in homozygotes with the GG genotype (p = 0.033). Conclusions: The study described in this article shows that selected SRD5A1 and SRD5A2 polymorphisms can alter the levels of metabolic and hormonal parameters in patients with BPH. Special attention should be paid to the SDR5A2 rs12470143 polymorphism, which is associated with a change in lipid profile, as well as with the inheritance and incidence rate of MetS among these patients. An analysis of the frequency of this polymorphism among BPH patients could be useful in estimating the risk of getting ill, and planning therapies of concomitant diseases for BPH patients.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-30
      DOI: 10.3390/ijerph14111318
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1319: New Instrument to Measure Hospital Patient
           Experiences in Flanders

    • Authors: Luk Bruyneel, Else Tambuyzer, Ellen Coeckelberghs, Dirk De Wachter, Walter Sermeus, Dirk De Ridder, Dirk Ramaekers, Ilse Weeghmans, Kris Vanhaecht
      First page: 1319
      Abstract: Implementing a standardized patient experience survey may initiate a process to apply pressure on hospitals to attend to improving patient experiences. In Flanders, Belgium, the Flemish Patient Survey was developed between 2011 and 2015. A preliminary version was developed from a scoping review and patient and expert focus groups, and included 27 items for eight hypothesized dimensions: ‘preparing for hospital stay’, ‘information and communication’, ‘coordination’, ‘respect’, ‘privacy’, ‘safe care’, pain management’, and ‘participation’. Exploratory factor analysis for 1076 patients in 17 hospitals found that the data did not fit the dimensions. Adaptations in item wording and response categories were based on the US Hospital Consumer Assessment of Healthcare Providers and Systems. The revised version showed excellent model fit in 22,143 patients in 37 hospitals. Multiple group analysis pointed to evidence of measurement invariance over time across mode of administration, type of nursing unit, and various patient characteristics. Fostering a collaborative approach thus proved successful in implementing a standardized patient experience survey. The most recent findings (2016) illustrate substandard performance and a need for patient-mix adjustment. The Flemish government developed a dedicated website to make findings publicly available and the federal government currently considers patient experiences in devising a pay-for-quality scheme.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-30
      DOI: 10.3390/ijerph14111319
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1320: Maternal Mental Health Disorders and Reports
           to Child Protective Services: A Birth Cohort Study

    • Authors: Ivy Hammond, Andrea Eastman, John Leventhal, Emily Putnam-Hornstein
      First page: 1320
      Abstract: Background. Existing literature has documented a strong relationship between parental mental illness and child maltreatment, but little is known about the prevalence of mental illness among childbearing women. In the present study, linked administrative records were used to identify the prevalence of maternal mental health (MH) disorders documented at birth and determine the associated likelihood of maltreatment reports during infancy. Materials and Methods. Vital records for California’s 2006 birth cohort were linked to hospital discharge and Child Protective Services (CPS) records. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) billing codes from the mother’s delivery hospitalization were used to determine diagnosed maternal MH disorders for 551,232 infants born in 2006, and reports of alleged maltreatment were documented from CPS records. Vital birth records were used to control for sociodemographic factors. Finally, the associated risk of reported maltreatment during the first year of life was examined using generalized linear models. Results. Among infants in this statewide birth cohort, 2.8% were born to a mother with a documented MH disorder, of which 41.3% had documented maternal substance abuse issues versus less than 0.5% of infants born to mothers without a diagnosed MH disorder. Further, 34.6% of infants born to mothers with a MH disorder were reported to CPS within one year, and a majority of those reports were made within the first month of life (77.2%). In contrast, among children born to mothers without a MH disorder, 4.4% were reported to CPS during infancy. After controlling for sociodemographic factors, the rate of CPS reports during infancy for infants born to mothers with a MH disorder but no substance use disorder was 2.6 times that of infants born to mothers without a MH disorder (95% CI = 2.47, 2.73). Among infants born to mothers with MH and substance use disorders, the rate of CPS reports during infancy was 5.69 times that of infants born to mothers without a MH disorder (95% CI = 5.51, 5.87). Conclusions. Administrative records provide a method for identifying infants born to mothers with MH disorders, enabling researchers to track rates over time and generate population-level data to inform policy development and improve service delivery.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-30
      DOI: 10.3390/ijerph14111320
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1321: Spatiotemporal Changes in Fine Particulate
           Matter Pollution and the Associated Mortality Burden in China between 2015
           and 2016

    • Authors: Luwei Feng, Bo Ye, Huan Feng, Fu Ren, Shichun Huang, Xiaotong Zhang, Yunquan Zhang, Qingyun Du, Lu Ma
      First page: 1321
      Abstract: In recent years, research on the spatiotemporal distribution and health effects of fine particulate matter (PM2.5) has been conducted in China. However, the limitations of different research scopes and methods have led to low comparability between regions regarding the mortality burden of PM2.5. A kriging model was used to simulate the distribution of PM2.5 in 2015 and 2016. Relative risk (RR) at a specified PM2.5 exposure concentration was estimated with an integrated exposure–response (IER) model for different causes of mortality: lung cancer (LC), ischaemic heart disease (IHD), cerebrovascular disease (stroke) and chronic obstructive pulmonary disease (COPD). The population attributable fraction (PAF) was adopted to estimate deaths attributed to PM2.5. 72.02% of cities experienced decreases in PM2.5 from 2015 to 2016. Due to the overall decrease in the PM2.5 concentration, the total number of deaths decreased by approximately 10,658 per million in 336 cities, including a decrease of 1400, 1836, 6312 and 1110 caused by LC, IHD, stroke and COPD, respectively. Our results suggest that the overall PM2.5 concentration and PM2.5-related deaths exhibited decreasing trends in China, although air quality in local areas has deteriorated. To improve air pollution control strategies, regional PM2.5 concentrations and trends should be fully considered.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-30
      DOI: 10.3390/ijerph14111321
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1322: Association between Eating Out and
           Socio-Demographic Factors of University Students in Chongqing, China

    • Authors: Ping Hu, Tingting Wu, Fan Zhang, Yan Zhang, Lu Lu, Huan Zeng, Zu-min Shi, Manoj Sharma, Lei Xun, Yong Zhao
      First page: 1322
      Abstract: (1) Objective: We aimed to explore the current situation of eating out and the association with socio-demographic factors of university students in Chongqing, China. (2) Methods: We used self-administered questionnaires to collect information. There are 14 universities in Chongqing; four (Chongqing Medical University, Chongqing University, Chongqing Normal University, and Chongqing University of Science & Technology) were randomly selected. In each selected university, two disciplines were randomly selected. (3) Results: 4595 university students participated in the study. The frequency of eating out was relatively high. The frequency of eating out among females was higher than that among males during weekdays. The two main reasons for eating out were having an opportunity to meet friends (56.0%) and improving diet (39.6%). Bistros (61.7%) and hot-pot restaurants (41.1%) were the favorite places for eating out. Only 36.0% of the participants said they considered nutrition and food safety when selecting restaurants. The majority of the participants demonstrated a high demand for nutrition and food safety knowledge when eating out (77.7%). (4) Conclusions: The higher the monthly living expenses were, the higher the frequency of eating out was. An intervention strategy to reduce the frequency or change the behavior of eating out should be formulated by considering the students’ perspectives.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-30
      DOI: 10.3390/ijerph14111322
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1323: Prevalence and Determinants of Current
           Smoking and Intention to Smoke among Secondary School Students: A
           Cross-Sectional Survey among Han and Tujia Nationalities in China

    • Authors: Xianglong Xu, Dengyuan Liu, Manoj Sharma, Yong Zhao
      First page: 1323
      Abstract: Objectives: This study examined the patterns and determinants of current smoking and intention to smoke among secondary school students of Han and Tujia nationalities in China. Methods: A cross-sectional survey was conducted in three regions, namely, Chongqing, Liaocheng, and Tianjin, of China in 2015. A structured self-administered questionnaire was used for data collection. Results: Of the total subjects (n = 1805), 78.9% were ethnic Han and 21.1% were ethnic Tujia. Overall 9.4% (Han: 7.7%; Tujia: 15.5%) secondary school students were smokers and 37.28% smoked more than once per day. Of the non-smoker students (n = 1636), 17.4% have an intention to smoke. A total of 81.1% of students reportedly had never been taught throughout school about smoking or tobacco prevention. When compared to the students who were taught in the school about smoking or tobacco prevention (18.90%) students who were never taught were more likely to smoke (OR = 2.39; 95% CI = 1.14–5.01). As compared to Han nationality students who were from Tujia nationality were more likely to smoke (OR = 2.76; 95% CI = 1.88–4.04) and were more likely to have a higher frequency of smoking (95% CI (0.88, 0.88), p = 0.010). Non-smokers who were high school students (OR = 4.29; 95% CI = 2.12–8.66), whose academic performance were situated in the last 25% (OR = 2.23; 95% CI = 1.48–3.34) and lower than 50% (OR = 1.50; 95% CI = 1.02–2.20) were more likely to have an intention of smoking. Conclusions: About one in ten secondary school students was a smoker, one in three smokers smoked more than one time per day, and a quarter of non-smokers had an intention of smoking in China. Smoking rate was higher among students from Tujia than the Han nationality. This study provided some important information for future tobacco control programs among secondary school students in the ethnic minority autonomous region and minority settlements in a multi-ethnic country.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-30
      DOI: 10.3390/ijerph14111323
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1324: Self-Determination in Health Research: An
           Alaska Native Example of Tribal Ownership and Research Regulation

    • Authors: Vanessa Hiratsuka, Julie Beans, Renee Robinson, Jennifer Shaw, Ileen Sylvester, Denise Dillard
      First page: 1324
      Abstract: Alaska Native (AN) and American Indian (AI) people are underrepresented in health research, yet many decline to participate in studies due to past researcher misconduct. Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and the tribal community by making trust and accountability required features of health research in AN/AI communities. In 1998, SCF assumed ownership from the federal government of health services for AN/AI people in south central Alaska and transformed the health system into a relationship-based model of care. This change reimagines how researchers interact with tribal communities and established community oversight of all health research conducted with AN/AI people in the region. We describe the SCF research review process, which requires tribal approval of the research concept, full proposal, and dissemination products, as well as local institutional review board approval, and a researcher-signed contract. This review evaluates research through the lens of tribal principles, practices, and priorities. The SCF example provides a framework for other tribes and organizations seeking to reshape the future of health research in AN/AI communities.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-31
      DOI: 10.3390/ijerph14111324
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1325: Chronic Stress in Young German Adults: Who Is
           Affected' A Prospective Cohort Study

    • Authors: Ronald Herrera, Ursula Berger, Jon Genuneit, Jessica Gerlich, Dennis Nowak, Wolff Schlotz, Christian Vogelberg, Erika von Mutius, Gudrun Weinmayr, Doris Windstetter, Matthias Weigl, Katja Radon
      First page: 1325
      Abstract: We aimed to prospectively assess changes in chronic stress among young adults transitioning from high school to university or working life. A population-based cohort in Munich and Dresden (Germany) was followed from age 16–18 (2002–2003) to age 20–23 (2007–2009) (n = 1688). Using the Trier Inventory for the Assessment of Chronic Stress, two dimensions of stress at university or work were assessed: work overload and work discontent. In the multiple ordinal generalized estimating equations, socio-demographics, stress outside the workplace, and job history were additionally considered. At follow-up, 52% of the population were university students. Work overload increased statistically significantly from first to second follow-up, while work discontent remained constant at the population level. Students, compared to employees, reported a larger increase in work overload (adjusted odds ratio (OR): 1.33; 95% confidence interval (95% CI): 1.07, 1.67), while work discontent did not differ between the groups. In conclusion, work overload increases when young adults transition from school to university/job life, with university students experiencing the largest increase.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-31
      DOI: 10.3390/ijerph14111325
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1326: Geographical Variations in the Environmental
           Determinants of Physical Inactivity among U.S. Adults

    • Authors: Ruopeng An, Xinye Li, Ning Jiang
      First page: 1326
      Abstract: Physical inactivity is a major modifiable risk factor for morbidity, disability and premature mortality worldwide. This study assessed the geographical variations in the impact of environmental quality on physical inactivity among U.S. adults. Data on county-level prevalence of leisure-time physical inactivity came from the Behavioral Risk Factor Surveillance System. County environment was measured by the Environmental Quality Index (EQI), a comprehensive index of environmental conditions that affect human health. The overall EQI consists of five subdomains—air, water, land, social, and built environment. Geographically weighted regressions (GWRs) were performed to estimate and map county-specific impact of overall EQI and its five subdomains on physical inactivity prevalence. The prevalence of leisure-time physical inactivity among U.S. counties was 25% in 2005. On average, one standard deviation decrease in the overall EQI was associated with an increase in county-level prevalence of leisure-time physical inactivity by nearly 1%. However, substantial geographical variations in the estimated environmental determinants of physical inactivity were present. The estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the overall EQI ranged from an increase of over 3% to a decrease of nearly 2% across U.S. counties. Analogous, the estimated changes of county-level prevalence of leisure-time physical inactivity resulted from one standard deviation decrease of the EQI air, water, land, social, and built environment subdomains ranged from an increase of 2.6%, 1.5%, 2.9%, 3.3%, and 1.7% to a decrease of 2.9%, 1.4%, 2.4%, 2.4%, and 0.8% across U.S. counties, respectively. Given the substantial heterogeneities in the environmental determinants of physical inactivity, locally customized physical activity interventions are warranted to address the most concerning area-specific environmental issue.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-31
      DOI: 10.3390/ijerph14111326
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1327: History of Asbestos Ban in Hong Kong

    • Authors: Chun-Kwan Wong, Sabrina Wan, Ignatius Yu
      First page: 1327
      Abstract: As millions of immigrants moved to Hong Kong (HK) from China in the recent decades, large amount of residential housings were built in the early years and a substantial proportion of those buildings used asbestos-containing materials (ACMs). Since the number of new cases of ARDs diagnosed has increased year by year since 1990’s, the remarkable increase of incidences had drawn the attention of the public and most importantly the HK government. It became one of the trigger points leading to asbestos ban in HK history. Comparatively, non-governmental organizations (NGOs), labor unions and patients’ self-help organizations demonstrated a more aggressive and proactive attitude than the HK government and have played a key role in the development of asbestos banning policy in HK. After numerous petitions and meetings with the government representatives by those parties in the past decade, the HK government eventually changed its attitude and started to consider terminating the endless threat from asbestos by amending the policy, and the new clause of legislation for banning of all forms of asbestos was enacted on 4 April 2014. Other than the restriction of asbestos use, the compensation system about ARDs has also made some great moves by the effort of those parties as well. Based on the experience we learnt through the years, efforts from different stakeholders including patients’ self-help organizations, NGOs, legislative councilors, and media power are absolutely essential to the success of progression and development in today’s asbestos banning in HK.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-31
      DOI: 10.3390/ijerph14111327
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1328: The Gulf Coast Health Alliance: Health Risks
           Related to the Macondo Spill (GC-HARMS) Study: Self-Reported Health

    • Authors: Sharon Croisant, Yu-li Lin, Joseph Shearer, John Prochaska, Amanda Phillips-Savoy, James Gee, Daniel Jackson, Reynold Panettieri, Marilyn Howarth, John Sullivan, Bishop Black, Joi Tate, Dustin Nguyen, Amber Anthony, Asim Khan, Harshica Fernando, G. Ansari, Gilbert Rowe, Bret Howrey, Chantele Singleton, Cornelis Elferink
      First page: 1328
      Abstract: The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S. history. We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill. This is a report of a cross-sectional cohort study (wave 1) to establish ‘baseline’ findings and meant to provide descriptive information to be used for a multi-wave, longitudinal study. Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS) uses a Community-Based Participatory Research approach, thus including multi-disciplinary, multi-institutional academic partners and representatives of three communities impacted by the spill. Three research sites were selected for human sampling along the Gulf of Mexico coast including two from Mississippi and one from Louisiana, with Galveston, Texas, serving as a comparison site, given that it was not directly impacted by the spill. One hundred participants were selected from each community, representing adults, seniors and children, with approximately equal numbers of males and females in each group. Participants completed initial assessments including completion of a ‘baseline’ survey and, rigorous physical assessments. Results from wave 1 data collection reported herein reveal changes in self-reported physical health and mental health status following the oil spill, disparities in access to healthcare, and associations between mental health and emotional conditions related to displacement/unemployment. Few environmental health studies have been conducted in communities impacted by significant oil spills. Results imply potential prolonged effects on mental health and community vulnerability.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-31
      DOI: 10.3390/ijerph14111328
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1329: Cross-Sectional Associations between Home
           Environmental Factors and Domain-Specific Sedentary Behaviors in Adults:
           The Moderating Role of Socio-Demographic Variables and BMI

    • Authors: Sofie Compernolle, Cedric Busschaert, Ilse De Bourdeaudhuij, Greet Cardon, Sebastien Chastin, Jelle Van Cauwenberg, Katrien De Cocker
      First page: 1329
      Abstract: Despite the negative health effects of too much sitting, the majority of adults are too sedentary. To develop effective interventions, insight is needed into home environmental correlates of adults’ sedentary behaviors, and into the susceptibility of population subgroups to these home environmental cues. In total, 559 Flemish adults reported socio-demographics, weight and height, home environmental factors and domain-specific sedentary behaviors. Generalized linear modeling was conducted to examine main associations between home environmental factors and domain-specific sedentary behaviors, and to test the moderating role of socio-demographics and BMI on these associations. In case of significant interactions, stratified analyses were performed. Results showed that, among those who did use a computer/laptop during the last week, a one-unit increase in the number of computers or laptops was associated with 17% (OR = 1.17; 95% CI = 1.02, 1.34) and 24% (OR = 1.24; 95% CI = 1.08, 1.43) more minutes computer time per day, respectively. The proximity of the remote controller (p < 0.001) and the number of televisions (p = 0.03) were positively associated with television time, and the number of motorized vehicles (95% CI = 0.001, 0.12) was positively associated with the odds of participation in transport-related sitting time. The latter two associations were moderated by BMI, with significant positive associations limited to those not overweight. To conclude, home environmental factors were associated with domain-specific sedentary behaviors, especially in healthy weight adults. If confirmed by longitudinal studies, public health professionals should encourage adults to limit the number of indoor entertainment devices and motorized vehicles.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-10-31
      DOI: 10.3390/ijerph14111329
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1330: Research on Storm-Tide Disaster Losses in
           China Using a New Grey Relational Analysis Model with the Dispersion of
           Panel Data

    • Authors: Kedong Yin, Ya Zhang, Xuemei Li
      First page: 1330
      Abstract: Owing to the difference of the sequences’ orders and the surface structure in the current panel grey relational models, research results will not be unique. In addition, individual measurement of indicators and objects and the subjectivity of combined weight would significantly weaken the effective information of panel data and reduce the reliability and accuracy of research results. Therefore, we propose the concept and calculation method of dispersion of panel data, establish the grey relational model based on dispersion of panel data (DPGRA), and prove that DPGRA exhibits the effective properties of uniqueness, symmetry, and normality. To demonstrate its applicability, the proposed DPGRA model is used to research on storm-tide disaster losses in China’s coastal areas. Comparing research results of three models, which are DPGRA, Euclidean distance grey relational model, and grey grid relational model, it was shown that DPGRA is more effective, feasible, and stable. It is indicated that DPGRA can entirely utilize the effective information of panel data; what’s more, it can not only handle the non-uniqueness of the grey relational model’s results but also improve the reliability and accuracy of research results. The research results are of great significance for coastal areas to focus on monitoring storm–tide disasters hazards, strengthen the protection measures of natural disasters, and improve the ability of disaster prevention and reduction.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-01
      DOI: 10.3390/ijerph14111330
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1331: Work–Life Imbalance and Musculoskeletal
           Disorders among South Korean Workers

    • Authors: Young-Mee Kim, Sung-il Cho
      First page: 1331
      Abstract: Employed workers often have family responsibilities such as childcare or homemaking. This dual burden may increase work-related health problems, particularly if there are conflicts between work and family responsibilities. This study assessed whether difficulty in work–life balance is associated with musculoskeletal disorders (MSD) among Korean employees. Data from the population-based Korean Working Conditions Survey of 2011, including 28,640 male and 21,392 female workers, were used. Men and women were analyzed separately to investigate gender differences. MSD were defined as pain in the back, neck, shoulder, or extremities during the past year. Self-assessed difficulty in work–life balance was defined as a work–life conflict (WLC). Adjustments for physical factors, as well as other occupational and socio-demographic variables, were made using multiple logistic regression analysis. Interaction terms including WLCs and key covariates were also incorporated. WLC was significantly associated with increased frequency of MSD in both men (OR: 1.49) and women (OR: 1.50). There were significant interaction effects between WLC and some key covariates (job stress for men and job stress, work hours, physical demand, and frequent overtime work for women). We suggest that having the flexibility to coordinate work and family life is important to prevent MSD among employees.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-01
      DOI: 10.3390/ijerph14111331
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1332: Pricing, Carbon Emission Reduction,
           Low-Carbon Promotion and Returning Decision in a Closed-Loop Supply Chain
           under Vertical and Horizontal Cooperation

    • Authors: Hui Li, Chuanxu Wang, Meng Shang, Wei Ou
      First page: 1332
      Abstract: In this paper, we examine the influences of vertical and horizontal cooperation models on the optimal decisions and performance of a low-carbon closed-loop supply chain (CLSC) with a manufacturer and two retailers, and study optimal operation in the competitive pricing, competitive the low-carbon promotion, the carbon emission reduction, the used-products collection and the profits. We consider the completely decentralized model, M-R vertical cooperation model, R-R horizontal cooperation model, M-R-R vertical and horizontal cooperation model and completely centralized model, and also identify the optimal decision results and profits. It can be observed from a systematic comparison and numerical analysis that the completely centralized model is best in all optimal decision results among all models. In semi-cooperation, the M-R vertical cooperation model is positive, the R-R horizontal cooperation model is passive, and the positivity of the M-R-R vertical and horizontal cooperation model decreases with competitive intensity increasing in the used-products returning, carbon emissions reduction level, low-carbon promotion effort and the profits of the manufacturer and the entire supply chain.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-01
      DOI: 10.3390/ijerph14111332
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1333: Factors Associated with Male Partner
           Involvement in Programs for the Prevention of Mother-to-Child Transmission
           of HIV in Rural South Africa

    • Authors: Motlagabo G. Matseke, Robert A. C. Ruiter, Violeta J. Rodriguez, Karl Peltzer, Geoffrey Setswe, Sibusiso Sifunda
      First page: 1333
      Abstract: Male partner involvement (MPI) can contribute to the success of programs aimed at preventing mother-to-child transmission (PMTCT) of HIV. However, the definition and measures of MPI differ according to context. This study utilized secondary cross-sectional data to investigate the prevalence and determinants of MPI among 463 male partners of HIV-infected pregnant women in rural South Africa. Results indicated that 44.1% of male partners reported involvement in most or all specified male partner involvement activities (i.e., scores of 7 to 9). Descriptive, correlation and multiple linear-regression analyses were conducted. Positive predictors of MPI included relationship status, own HIV status, awareness of female partner’s positive HIV status, female partner’s desire to have more children, having family planning discussions with provider, condom use to prevent HIV and sexually transmitted infections (STIs), and partner reasoning skills. Negative predictors included partner verbal aggression. Overall, although MPI is low, the study underlines important information that could be used to develop interventions aimed at improving maternal and infant health in PMTCT programs in South Africa.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-01
      DOI: 10.3390/ijerph14111333
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1334: Impact of Distance on Mode of Active
           Commuting in Chilean Children and Adolescents

    • Authors: Fernando Rodríguez-Rodríguez, Carlos Cristi-Montero, Carlos Celis-Morales, Danica Escobar-Gómez, Palma Chillón
      First page: 1334
      Abstract: Active commuting could contribute to increasing physical activity. The objective of this study was to characterise patterns of active commuting to and from schools in children and adolescents in Chile. A total of 453 Chilean children and adolescents aged between 10 and 18 years were included in this study. Data regarding modes of commuting and commuting distance was collected using a validated questionnaire. Commuting mode was classified as active commuting (walking and/or cycling) or non-active commuting (car, motorcycle and/or bus). Commuting distance expressed in kilometres was categorised into six subgroups (0 to 0.5, 0.6 to 1, 1.1 to 2, 2.1 to 3, 3.1 to 5 and >5 km). Car commuting was the main mode for children (to school 64.9%; from school 51.2%) and adolescents (to school 50.2%; from school 24.7%). Whereas public bus commuting was the main transport used by adolescents to return from school. Only 11.0% and 24.8% of children and adolescents, respectively, walk to school. The proportion of children and adolescents who engage in active commuting was lower in those covering longer distances compared to a short distance. Adolescents walked to and from school more frequently than children. These findings show that non-active commuting was the most common mode of transport and that journey distances may influence commuting modes in children and adolescents.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-02
      DOI: 10.3390/ijerph14111334
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1335: A Cross-Sectional Investigation of the
           Importance of Park Features for Promoting Regular Physical Activity in

    • Authors: Sarah Costigan, Jenny Veitch, David Crawford, Alison Carver, Anna Timperio
      First page: 1335
      Abstract: Introduction: Parks in the US and Australia are generally underutilised, and park visitors typically engage in low levels of physical activity (PA). Better understanding park features that may encourage visitors to be active is important. This study examined the perceived importance of park features for encouraging park-based PA and examined differences by sex, age, parental-status and participation in PA. Methods: Cross-sectional surveys were completed by local residents (n = 2775) living near two parks (2013/2015). Demographic variables, park visitation and leisure-time PA were self-reported, respondents rated the importance of 20 park features for encouraging park-based PA in the next fortnight. Chi-square tests of independence examined differences in importance of park features for PA among sub-groups of local residents (sex, age, parental-status, PA). Results: Park features ranked most important for park-based PA were: well maintained (96.2%), feel safe (95.4%), relaxing atmosphere (91.2%), easy to get to (91.7%), and shady trees (90.3%). All subgroups ranked ‘well maintained’ as most important. Conclusions: Natural and built environment features of parks are important for promoting adults’ park-based PA, and should be considered in park (re)design.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-02
      DOI: 10.3390/ijerph14111335
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1336: Plant Growth, Antibiotic Uptake, and
           Prevalence of Antibiotic Resistance in an Endophytic System of Pakchoi
           under Antibiotic Exposure

    • Authors: Hao Zhang, Xunan Li, Qingxiang Yang, Linlin Sun, Xinxin Yang, Mingming Zhou, Rongzhen Deng, Linqian Bi
      First page: 1336
      Abstract: Antibiotic contamination in agroecosystems may cause serious problems, such as the proliferation of various antibiotic resistant bacteria and the spreading of antibiotic resistance genes (ARGs) in the environment or even to human beings. However, it is unclear whether environmental antibiotics, antibiotic resistant bacteria, and ARGs can directly enter into, or occur in, the endophytic systems of plants exposed to pollutants. In this study, a hydroponic experiment exposing pakchoi (Brassica chinensis L.) to tetracycline, cephalexin, and sulfamethoxazole at 50% minimum inhibitory concentration (MIC) levels and MIC levels, respectively, was conducted to explore plant growth, antibiotic uptake, and the development of antibiotic resistance in endophytic systems. The three antibiotics promoted pakchoi growth at 50% MIC values. Target antibiotics at concentrations ranging from 6.9 to 48.1 µg·kg−1 were detected in the treated vegetables. Additionally, the rates of antibiotic-resistant endophytic bacteria to total cultivable endophytic bacteria significantly increased as the antibiotics accumulated in the plants. The detection and quantification of ARGs indicated that four types, tetX, blaCTX-M, and sul1 and sul2, which correspond to tetracycline, cephalexin, and sulfamethoxazole resistance, respectively, were present in the pakchoi endophytic system and increased with the antibiotic concentrations. The results highlight a potential risk of the development and spread of antibiotic resistance in vegetable endophytic systems.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-03
      DOI: 10.3390/ijerph14111336
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1337: Reproductive Investment and Health Costs in
           Roma Women

    • Authors: Jelena Čvorović, Kathryn Coe
      First page: 1337
      Abstract: In this paper, we examine whether variation in reproductive investment affects the health of Roma women using a dataset collected through original anthropological fieldwork among Roma women in Serbia. Data were collected in 2014–2016 in several Roma semi-urban settlements in central Serbia. The sample consisted of 468 Roma women, averaging 44 years of age. We collected demographic data (age, school levels, socioeconomic status), risk behaviors (smoking and alcohol consumption), marital status, and reproductive history variables (the timing of reproduction, the intensity of reproduction, reproductive effort and investment after birth), in addition to self-reported health, height, and weight. Data analyses showed that somatic, short-term costs of reproduction were revealed in this population, while evolutionary, long-term costs were unobservable—contrariwise, Roma women in poor health contributed more to the gene pool of the next generation than their healthy counterparts. Our findings appear to be consistent with simple trade-off models that suggest inverse relationships between reproductive effort and health. Thus, personal sacrifice—poor health as an outcome—seems crucial for greater reproductive success.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-03
      DOI: 10.3390/ijerph14111337
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1338: Association between Global Life Satisfaction
           and Self-Rated Oral Health Conditions among Adolescents in Lithuania

    • Authors: Aistė Kavaliauskienė, Antanas Šidlauskas, Apolinaras Zaborskis
      First page: 1338
      Abstract: Background: This study aims to explore the extent to which the perceived oral conditions predict adolescent global life satisfaction (GLS); Methods: The sample in a cross-sectional survey consisted of 1510 Lithuanian adolescents (41.7% boys) aged 11–18. The survey was conducted by means of self-report questionnaires that were administrated in school classrooms ensuring confidentiality and anonymity of the participants. The schoolchildren rated their GLS and answered the questions about perceptions of their oral health. The relationship between GLS and oral health variables was estimated using unadjusted and adjusted binary logistic regression and nonparametric correlation analyses; Results: The research showed that the majority of adolescents rated their GLS highly; however, girls, older adolescents and adolescents from less affluent families were less likely to report high scores. GLS was significantly associated with subjective overall oral health assessment. The odds of reporting low GLS were 50% higher for adolescents with good oral health (OR = 1.51; p < 0.001; 95% CI = 1.18–1.93), and two and half time as higher for adolescents with perceived fair/poor oral health (OR = 2.78; p < 0.001; 95% CI = 1.72–4.50) compared to adolescents with subjectively excellent/very good oral health. Nonparametric correlations indicated lower GLS to be significantly associated with higher scores of Child Perceptions Questionnaire (
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-03
      DOI: 10.3390/ijerph14111338
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1339: Prenatal Heavy Metal Exposure and Adverse
           Birth Outcomes in Myanmar: A Birth-Cohort Study

    • Authors: Kyi Wai, Ohn Mar, Satoko Kosaka, Mitsutoshi Umemura, Chiho Watanabe
      First page: 1339
      Abstract: Arsenic, cadmium and lead are well-known environmental contaminants, and their toxicity at low concentration is the target of scientific concern. In this study, we aimed to identify the potential effects of prenatal heavy metal exposure on the birth outcomes among the Myanmar population. This study is part of a birth-cohort study conducted with 419 pregnant women in the Ayeyarwady Division, Myanmar. Face-to-face interviews were performed using a questionnaire, and maternal spot urine samples were collected at the third trimester. Birth outcomes were evaluated at delivery during the follow up. The median values of adjusted urinary arsenic, cadmium, selenium and lead concentration were 74.2, 0.9, 22.6 and 1.8 μg/g creatinine, respectively. Multivariable logistic regression revealed that prenatal cadmium exposure (adjusted odds ratio (OR) = 1.10; 95% confidence interval (CI): 1.01–1.21; p = 0.043), gestational age (adjusted OR = 0.83; 95% CI: 0.72–0.95; p = 0.009) and primigravida mothers (adjusted OR = 4.23; 95% CI: 1.31–13.65; p = 0.016) were the predictors of low birth weight. The present study identified that Myanmar mothers were highly exposed to cadmium. Prenatal maternal cadmium exposure was associated with an occurrence of low birth weight.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-03
      DOI: 10.3390/ijerph14111339
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1340: Stress-Induced Hyperglycemia, but Not
           Diabetic Hyperglycemia, Is Associated with Higher Mortality in Patients
           with Isolated Moderate and Severe Traumatic Brain Injury: Analysis of a
           Propensity Score-Matched Population

    • Authors: Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo, Ching-Hua Hsieh
      First page: 1340
      Abstract: Background: Admission hyperglycemia is associated with higher morbidity and mortality in patients with traumatic brain injury (TBI). Stress-induced hyperglycemia (SIH), a form of hyperglycemia induced by the stress response, is associated with increased patient mortality following TBI. However, admission hyperglycemia occurs not only in SIH but also in patients with diabetic hyperglycemia (DH). Current information regarding whether trauma patients with SIH represent a distinct group with differential outcomes compared to those with DH remains limited. Methods: Serum glucose concentration ≥200 mg/dL upon arrival at the emergency department was defined as hyperglycemia. Presence of diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6.5%. In the present study, the patient cohort included those with moderate and severe TBI, as defined by an Abbreviated Injury Scale (AIS) score ≥3 points in the head, and excluded those who had additional AIS scores ≥3 points in any other region of the body. A total of 1798 adult patients with isolated moderate to severe TBI were allocated into four groups: SIH (n = 140), DH (n = 187), diabetic normoglycemia (DN, n = 186), and non-diabetic normoglycemia (NDN, n = 1285). Detailed patient information was retrieved from the Trauma Registry System at a level I trauma center between 1 January 2009, and 31 December 2015. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to propensity scores calculated by NCSS software. Logistic regression was used to evaluate the effect of SIH and DH on the adjusted mortality outcome. Results: In patients with isolated moderate to severe TBI, the presence of SIH and DH led to 9.1-fold and 2.3-fold higher odds of mortality, respectively, than patients with NDN. After adjusting for confounding factors, including sex and age, pre-existing co-morbidities, existence of different kinds of intracerebral hemorrhage, and injury severity, patients with SIH still had 6.6-fold higher odds of mortality than those with NDN; however, DH did not present significantly higher adjusted mortality odds. SIH and DH presented different effects on outcomes after TBI. The results also suggested that the pathophysiological effect associated with SIH was different from that of DH. Conclusions: This study demonstrated that patients with SIH and DH had significantly higher mortality than patients with NDN. However, the adjusted mortality was significantly higher only in the selected propensity score-matched patients with SIH and not in those with DH.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-03
      DOI: 10.3390/ijerph14111340
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1341: Genotypic and Epidemiological Trends of Acute
           Gastroenteritis Associated with Noroviruses in China from 2006 to 2016

    • Authors: Shu-Wen Qin, Ta-Chien Chan, Jian Cai, Na Zhao, Zi-Ping Miao, Yi-Juan Chen, She-Lan Liu
      First page: 1341
      Abstract: There are periodical norovirus-associated acute gastroenteritis outbreaks around the world. This study aimed to analyze the molecular and epidemiological features of norovirus infections in China during 2006–2016. We extracted epidemiological data from 132 norovirus outbreaks and the norovirus genotyping for 1291 sequences in China over the past ten years. A total of 132 norovirus outbreaks (8133 cases) were reported in China, where the east and south regions were most affected [47.7% (63/132)]. The highest number of outbreaks occurred in 2015. A seasonal pattern has been observed, with a peak from November to the following March. Most of the outbreaks occurred in middle and primary schools, accounting for 28.8% (38/132), and 28.0% (37/132) of outbreaks, respectively. The dominant age group was 10 to 19 years old, responsible for 75.7% (933/1232) of cases. Generally, the dominant genotypes was GII, for 81.9% (1058/1291) of sequences. G II.4 was the predominant genotype in China from 2004 to 2014. However, the GII.17 became more prevalent starting in 2014. Norovirus-associated acute gastroenteritis increased sharply in recent years caused by the emergence of GII.17, but epidemiological features have not changed during 2006–2016. Vigilant surveillance should be strengthened to promptly detect any variation.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-03
      DOI: 10.3390/ijerph14111341
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1342: Desert Dust and Health: A Central Asian
           Review and Steppe Case Study

    • Authors: Troy Sternberg, Mona Edwards
      First page: 1342
      Abstract: In Asian deserts environmental and anthropomorphic dust is a significant health risk to rural populations. Natural sources in dry landscapes are exacerbated by human activities that increase the vulnerability to dust and dust-borne disease vectors. Today in Central and Inner Asian drylands, agriculture, mining, and rapid development contribute to dust generation and community exposure. Thorough review of limited dust investigation in the region implies but does not quantify health risks. Anthropogenic sources, such as the drying of the Aral Sea, highlight the shifting dust dynamics across the Central EurAsian steppe. In the Gobi Desert, our case study in Khanbogd, Mongolia addressed large-scale mining’s potential dust risk to the health of the local population. Dust traps showed variable exposure to particulates among herder households and town residents; dust density distribution indicated that sources beyond the mine need to be considered when identifying particulate sources. Research suggests that atmospheric dust from multiple causes may enhance human particulate exposure. Greater awareness of dust in greater Central Asia reflects community concern about related health implications. Future human well-being in the region will require more thorough information on dust emissions in the changing environment.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-03
      DOI: 10.3390/ijerph14111342
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1343: In-Class Cycling to Augment College Student
           Academic Performance and Reduce Physical Inactivity: Results from an RCT

    • Authors: Lanae Joubert, Matthew Kilgas, Alexandrea Riley, Yuba Gautam, Lars Donath, Scott Drum
      First page: 1343
      Abstract: Most college students sit 14 hours per week on average, excluding sedentary study time. Researchers observing workplace and elementary school settings with active workstations to combat sedentary behavior have shown enhanced cognition without distraction. Until now, incorporating active workstations in college classroom settings remained relatively unexplored. This study’s purpose was to assess academic performance using in-class stationary cycle desks during a semester-long lecture course. Twenty-one college students (19–24 years) enrolled in a lecture course volunteered and were split into traditional sit (SIT) and stationary cycle (CYC) groups randomly, matched on a calculated factor equal to a physical activity (PA) score (0–680) multiplied by grade point average (GPA; 4.0 scale). CYC pedaled a prescribed rate of perceived exertion (RPE) of less than 2 out of 10 during a 50-min lecture, 3 × week for 12 weeks. CYC averaged 42 min, 7.9 miles, and 1.7 RPE during class throughout the semester. No significant differences (p > 0.05) were observed between CYC and SIT on in-class test scores or overall course grades. Although statistically insignificant, CYC had higher mean test scores and overall course grades vs. SIT (i.e., B+ vs. B, respectively). Low intensity cycling during a college lecture course maintained student academic performance and possibly reduced weekly sedentary behavior time.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-04
      DOI: 10.3390/ijerph14111343
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1344: Effects of 1.8 GHz Radiofrequency Fields on
           the Emotional Behavior and Spatial Memory of Adolescent Mice

    • Authors: Jun-Ping Zhang, Ke-Ying Zhang, Ling Guo, Qi-Liang Chen, Peng Gao, Tian Wang, Jing Li, Guo-Zhen Guo, Gui-Rong Ding
      First page: 1344
      Abstract: The increasing use of mobile phones by teenagers has raised concern about the cognitive effects of radiofrequency (RF) fields. In this study, we investigated the effects of 4-week exposure to a 1.8 GHz RF field on the emotional behavior and spatial memory of adolescent male mice. Anxiety-like behavior was evaluated by open field test (OFT) and elevated plus maze (EPM) test, while depression-like behavior was evaluated by sucrose preference test (SPT), tail suspension test (TST) and forced swim test (FST). The spatial learning and memory ability were evaluated by Morris water maze (MWM) experiments. The levels of amino acid neurotransmitters were determined by liquid chromatography-mass spectrometry (LC-MS). The histology of the brain was examined by hematoxylin-eosin (HE) staining. It was found that the depression-like behavior, spatial memory ability and histology of the brain did not change obviously after RF exposure. However, the anxiety-like behavior increased in mice, while, the levels of γ-aminobutyric acid (GABA) and aspartic acid (Asp) in cortex and hippocampus significantly decreased after RF exposure. These data suggested that RF exposure under these conditions do not affect the depression-like behavior, spatial memory and brain histology in adolescent male mice, but it may however increase the level of anxiety, and GABA and Asp were probably involved in this effect.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-05
      DOI: 10.3390/ijerph14111344
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1345: Electronic Cigarette Use in Students and Its
           Relation with Tobacco-Smoking: A Cross-Sectional Analysis of the i-Share

    • Authors: Shérazade Kinouani, Edwige Pereira, Christophe Tzourio
      First page: 1345
      Abstract: While young adults often try e-cigarettes, little is known about its use and the reasons for experimentation, particularly in relation with tobacco-smoking. In 2016, data were collected from 2720 French-speaking students participating in a web-based study on students’ health: the internet-based Students Health Research Enterprise (i-Share) project. Univariate analyses and multivariable logistic regressions were performed to study the relationship between e-cigarette use and smoking status. Two out of five students declared having tried e-cigarettes and 3.6% were current users. Former smokers were more likely than current smokers to use e-cigarettes currently. Among those who had never smoked, 13.5% had tried e-cigarettes. Very few (0.3%) were current users, alternating e-liquids with and without nicotine. The three main reasons for trying e-cigarettes were curiosity, offer to try by someone, and attractiveness of e-liquid flavors. Among current smokers, previous attempts to quit smoking and a strong desire to stop tobacco were reported more in e-cigarette current users than in former users. In this large sample of French students, findings were consistent with the possibility that e-cigarettes might be used as smoking cessation or reduction aids by some young adults whereas other young never-smokers could be exposed to nicotine.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-05
      DOI: 10.3390/ijerph14111345
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1346: Predicting Physical Activity and Healthy
           Nutrition Behaviors Using Social Cognitive Theory: Cross-Sectional Survey
           among Undergraduate Students in Chongqing, China

    • Authors: Xianglong Xu, Yang Pu, Manoj Sharma, Yunshuang Rao, Yilin Cai, Yong Zhao
      First page: 1346
      Abstract: (1) Background: Generally suggested public health measures to reduce obesity were to limit television (TV) viewing, enhance daily physical activities, enable the consumption of fruit and vegetables, and reduce sugar-sweetened beverage intake. This study analyzed the extent to which selected social cognitive theory constructs can predict these behaviors among Chinese undergraduate students. (2) Methods: This cross-sectional study included 1976 undergraduate students from six universities in Chongqing, China. A self-administered five-point Likert common physical activity and nutrition behavior scale based on social cognitive theory was utilized. (3) Results: This study included 687 (34.77%) males and 1289 (65.23%) females. A total of 60.14% of the students engaged in exercise for less than 30 min per day. Approximately 16.5%of the participants spent at least 4 h watching TV and sitting in front of a computer daily. Approximately 79% of the participants consumed less than five cups of fruit and vegetables daily. Undergraduate students who had high self-efficacy scores had more leisure time physical activities. Those who have high expectation scores had considerable time watching TV and sitting in front of a computer. Undergraduate students who had high expectation and self-efficacy scores had substantially low consumption of sugar-sweetened beverages. Those who had high self-efficacy scores consumed considerable amounts of fruit and vegetables. Furthermore, the type of university, BMI group, gender, age, lack of siblings, and grade level were associated with the aforementioned four behaviors. (4) Conclusion: Physical inactivity and unhealthy nutrition behaviors are common among undergraduate students. This study used social cognitive theory to provide several implications for limiting the TV viewing, enhancing daily physical activities, consuming fruit and vegetables, and reducing sugar-sweetened beverage intake among undergraduate students.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-05
      DOI: 10.3390/ijerph14111346
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1347: Sleep, Health and Wellness at Work: A Scoping

    • Authors: Nicola Magnavita, Sergio Garbarino
      First page: 1347
      Abstract: Many occupational factors may interfere with sleep. Sleep disturbances can, in turn, endanger the health and safety of workers. This rapid review of the literature identifies the main factors that alter the quantity and quality of sleep, indicates the effects these alterations have on the wellbeing of workers and suggests some health promotion measures.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-06
      DOI: 10.3390/ijerph14111347
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1348: A Novel Experimental and Modelling Strategy
           for Nanoparticle Toxicity Testing Enabling the Use of Small Quantities

    • Authors: Marinda van Pomeren, Willie Peijnenburg, Nadja Brun, Martina Vijver
      First page: 1348
      Abstract: Metallic nanoparticles (NPs) differ from other metal forms with respect to their large surface to volume ratio and subsequent inherent reactivity. Each new modification to a nanoparticle alters the surface to volume ratio, fate and subsequently the toxicity of the particle. Newly-engineered NPs are commonly available only in low quantities whereas, in general, rather large amounts are needed for fate characterizations and effect studies. This challenge is especially relevant for those NPs that have low inherent toxicity combined with low bioavailability. Therefore, within our study, we developed new testing strategies that enable working with low quantities of NPs. The experimental testing method was tailor-made for NPs, whereas we also developed translational models based on different dose-metrics allowing to determine dose-response predictions for NPs. Both the experimental method and the predictive models were verified on the basis of experimental effect data collected using zebrafish embryos exposed to metallic NPs in a range of different chemical compositions and shapes. It was found that the variance in the effect data in the dose-response predictions was best explained by the minimal diameter of the NPs, whereas the data confirmed that the predictive model is widely applicable to soluble metallic NPs. The experimental and model approach developed in our study support the development of (eco)toxicity assays tailored to nano-specific features.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-06
      DOI: 10.3390/ijerph14111348
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1349: Benefits of Multidimensional Measures of
           Child Well Being in China

    • Authors: Shirley Gatenio Gabel, Yiwei Zhang
      First page: 1349
      Abstract: In recent decades, measures of child well-being have evolved from single dimension to multidimensional measures. Multi-dimensional measures deepen and broaden our understanding of child well-being and inform us of areas of neglect. Child well-being in China today is measured through proxy measures of household need. This paper discusses the evolution of child well-being measures more generally, explores the benefits of positive indicators and multiple dimensions in formulating policy, and then reviews efforts to date by the Chinese government, researchers, and non-governmental and intergovernmental organizations to develop comprehensive multidimensional measures of child well-being in China. The domains and their potential interactions, as well as data sources and availability, are presented. The authors believe that child well-being in China would benefit from the development of a multidimensional index and that there is sufficient data to develop such an index.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-06
      DOI: 10.3390/ijerph14111349
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1350: Spatiotemporal Association of Real-Time
           Concentrations of Black Carbon (BC) with Fine Particulate Matters (PM2.5)
           in Urban Hotspots of South Korea

    • Authors: Sungroul Kim, Sol Yu, Dongmin Yun
      First page: 1350
      Abstract: We evaluated the spatiotemporal distributions of black carbon (BC) and particulate matters with aerodynamic diameters of less than 2.5 m (PM2.5) concentrations at urban diesel engine emission (DEE) hotspots of South Korea. Concentrations of BC and PM2.5 were measured at the entrance gate of two diesel bus terminals and a train station, in 2014. Measurements were conducted simultaneously at the hotspot (Site 1) and at its adjacent, randomly selected, residential areas, apartment complex near major roadways, located with the same direction of 300 m (Site 2) and 500 m (Site 3) away from Site 1 on 4 different days over the season, thrice per day; morning (n = 120 measurements for each day and site), evening (n = 120), and noon (n = 120). The median (interquartile range) PM2.5 ranged from 12.6 (11.3–14.3) to 60.1 (47.0–76.0) μg/m3 while those of BC concentrations ranged from 2.6 (1.9–3.7) to 6.3 (4.2–10.3) μg/m3. We observed a strong relationship of PM2.5 concentrations between sites (slopes 0.89–0.9, the coefficient of determination 0.89–0.96) while the relationship for BC concentrations between sites was relatively weak (slopes 0.76–0.85, the coefficient of determination 0.54–0.72). PM2.5 concentrations were changed from 4% to 140% by unit increase of BC concentration, depending on site and time while likely supporting the necessity of monitoring of BC as well as PM2.5, especially at urban DEE related hotspot areas.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-06
      DOI: 10.3390/ijerph14111350
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1351: Effects of Airborne Particulate Matter on
           Respiratory Health in a Community near a Cement Factory in Chilanga,
           Zambia: Results from a Panel Study

    • Authors: Emmy Nkhama, Micky Ndhlovu, J. Dvonch, Mary Lynam, Graciela Mentz, Seter Siziya, Kuku Voyi
      First page: 1351
      Abstract: We conducted a panel study to investigate seasonal variations in concentrations of airborne PM2.5 and PM10 and the effects on respiratory health in a community near a cement factory; in Chilanga; Zambia. A panel of 63 and 55 participants aged 21 to 59 years from a community located at the edge of the factory within 1 km and a control community located 18 km from the factory respectively; were followed up for three climatic seasons July 2015 to February 2016. Symptom diary questionnaires were completed and lung function measurements taken daily for 14 days in each of the three climatic seasons. Simultaneously, PM2.5 and PM10 concentrations in ambient air were monitored at a fixed site for each community. Mean seasonal concentrations of PM2.5 and PM10 ranged from 2.39–24.93 μg/m3 and 7.03–68.28 μg/m3 respectively in the exposed compared to the control community 1.69–6.03 μg/m3 and 2.26–8.86 μg/m3. The incident rates of reported respiratory symptoms were higher in the exposed compared to the control community: 46.3 vs. 13.8 for cough; 41.2 vs. 9.6 for phlegm; 49.0 vs.12.5 for nose; and 13.9 vs. 3.9 for wheeze per 100 person-days. There was a lower performance on all lung indices in the exposed community compared to the control; overall the mean FEV1 (forced expiratory volume in one second) and FVC (forced vital capacity) predicted percentage for the exposed was six and four percentage points lower than the control. Restriction of industrial emissions coupled with on-going monitoring and regulatory enforcement are needed to ensure that PM (airborne particulate matter) levels in the ambient air are kept within recommended levels to safeguard the respiratory health of nearby community residents.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-06
      DOI: 10.3390/ijerph14111351
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1352: Measuring the Effect of Housing Quality
           Interventions: The Case of the New Zealand “Rental Warrant of Fitness”

    • Authors: Lucy Telfar-Barnard, Julie Bennett, Philippa Howden-Chapman, David Jacobs, David Ormandy, Matthew Cutler-Welsh, Nicholas Preval, Michael Baker, Michael Keall
      First page: 1352
      Abstract: In New Zealand, as in many other countries, housing in the private-rental sector is in worse condition than in the owner-occupier housing sector. New Zealand residential buildings have no inspection regime after original construction signoff. Laws and regulations mandating standards for existing residential housing are outdated and spread over a range of instruments. Policies to improve standards in existing housing have been notoriously difficult to implement. In this methods paper, we describe the development and implementation of a rental Warrant of Fitness (WoF) intended to address these problems. Dwellings must pass each of 29 criteria for habitability, insulation, heating, ventilation, safety, amenities, and basic structural soundness to reach the WoF minimum standard. The WoF’s development was based on two decades of research on the impact of housing quality on health and wellbeing, and strongly influenced by the UK Housing Health and Safety Rating System and US federal government housing standards. Criteria were field-tested across a range of dwelling types and sizes, cities, and climate zones. The implementation stage of our WoF research consists of a non-random controlled quasi-experimental study in which we work with two city-level local government councils to implement the rental WoF, recruiting adjoining council areas as controls, and measuring changes in health, economic, and social outcomes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-07
      DOI: 10.3390/ijerph14111352
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1353: BUS TRIPS—A Self-Management Program for
           People with Cognitive Impairments after Stroke

    • Authors: Emma Carlstedt, Susanne Iwarsson, Agneta Ståhl, Hélène Pessah-Rasmussen, Eva Månsson Lexell
      First page: 1353
      Abstract: Stroke is a major cause of disability worldwide and different types of impairments can affect the individual’s ability to manage everyday activities such as travel that is essential for participation in society. The purpose of this study was to investigate the feasibility of a new self-management intervention (BUS TRIPS) focusing on travelling by bus, and potential contributions to an improved ability to travel by bus for people with cognitive impairments after stroke. This is a pilot study of five individuals, utilizing a multiple case study design with a mixed methods approach. Assessments (Stroke Impact Scale, General Self-Efficacy Scale and Life Satisfaction Scale-11, Item 1) were performed before, two weeks after, and three months after the program. The data collection also comprised reflection notes from the group leaders (an occupational therapist and a physiotherapist), a semi-structured group interview and an individual phone survey. The feasibility of the intervention was presented in four sub-categories: (1) appreciated group format despite too short sessions; (2) the importance of skilled leaders and motivated participants; (3) session material adequate but needs minor revision to fit the target group; and (4) homework is valuable but reflective group discussions must be supported. The narratives of each case showed that all participants made some progress related to travelling by bus, but the overall positive results could not be verified by all of the quantitative assessments. We conclude that the BUS TRIPS intervention is feasible and can potentially contribute to an improved ability to travel by bus for the target group. Future studies is called for, and should focus on recruitment challenges, to clarify assessments that would be suitable to use in larger scale clinical trials and during subsequent implementation in clinical practice.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-07
      DOI: 10.3390/ijerph14111353
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1354: Pattern of Road Traffic Injuries in Rural
           Bangladesh: Burden Estimates and Risk Factors

    • Authors: Md. Ul Baset, Aminur Rahman, Olakunle Alonge, Priyanka Agrawal, Shirin Wadhwaniya, Fazlur Rahman
      First page: 1354
      Abstract: Globally, road traffic injury (RTI) causes 1.3 million deaths annually. Almost 90% of all RTI deaths occur in low- and middle-income countries. RTI is one of the leading causes of death in Bangladesh; the World Health Organization estimated that it kills over 21,000 people in the country annually. This study describes the current magnitude and risk factors of RTI for different age groups in rural Bangladesh. A household census was carried out in 51 unions of seven sub-districts situated in the north and central part of Bangladesh between June and November 2013, covering 1.2 million individuals. Trained data collectors collected information on fatal and nonfatal RTI events through face-to-face interviews using a set of structured pre-tested questionnaires. The recall periods for fatal and non-fatal RTI were one year and six months, respectively. The mortality and morbidity rates due to RTI were 6.8/100,000 population/year and 889/100,000 populations/six months, respectively. RTI mortality and morbidity rates were significantly higher among males compared to females. Deaths and morbidities due to RTI were highest among those in the 25–64 years age group. A higher proportion of morbidity occurred among vehicle passengers (34%) and pedestrians (18%), and more than one-third of the RTI mortality occurred among pedestrians. Twenty percent of all nonfatal RTIs were classified as severe injuries. RTI is a major public health issue in rural Bangladesh. Immediate attention is needed to reduce preventable deaths and morbidities in rural Bangladesh.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-07
      DOI: 10.3390/ijerph14111354
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1355: Factors That Influence Linkages to HIV
           Continuum of Care Services: Implications for Multi-Level Interventions

    • Authors: Rogério Pinto, Susan Witte, Prema Filippone, Karen Baird, Wendy Whitman
      First page: 1355
      Abstract: Worldwide, the human immunodeficiency virus (HIV) continuum of care involves health promotion providers (e.g., social workers and health educators) linking patients to medical personnel who provide HIV testing, primary care, and antiretroviral treatments. Regrettably, these life-saving linkages are not always made consistently and many patients are not retained in care. To design, test and implement effective interventions, we need to first identify key factors that may improve linkage-making. To help close this gap, we used in-depth interviews with 20 providers selected from a sample of 250 participants in a mixed-method longitudinal study conducted in New York City (2012–2017) in order to examine the implementation of HIV services for at-risk populations. Following a sociomedical framework, we identified provider-, interpersonal- and environmental-level factors that influence how providers engage patients in the care continuum by linking them to HIV testing, HIV care, and other support services. These factors occurred in four domains of reference: Providers’ Professional Knowledge Base; Providers’ Interprofessional Collaboration; Providers’ Work-Related Changes; and Best Practices in a Competitive Environment. Of particular importance, our findings show that a competitive environment and a fear of losing patients to other agencies may inhibit providers from engaging in linkage-making. Our results suggest relationships between factors within and across all four domains; we recommend interventions to modify factors in all domains for maximum effect toward improving care continuum linkage-making. Our findings may be applicable in different areas of the globe with high HIV prevalence.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-07
      DOI: 10.3390/ijerph14111355
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1356: Changes in Sports Participation across
           Transition to Retirement: Modification by Migration Background and
           Acculturation Status

    • Authors: Johanna-Katharina Schönbach, Manuela Pfinder, Claudia Börnhorst, Hajo Zeeb, Tilman Brand
      First page: 1356
      Abstract: While total physical activity decreases over the life course, sports and leisure-time physical activity (LTPA) have shown to increase after transition to retirement. This paper aimed to investigate whether this change in sports participation differs (1) between non-migrant persons (NMP) versus persons with a migrant background (PMB), and (2) by acculturation status. Data was drawn from 16 waves of the German Socio-Economic Panel Study (SOEP) including 2664 NMP and 569 PMB. PMB were grouped according to acculturation status (integrated, assimilated, marginalised, separated), assessed regarding three dimensions (language, social interaction and identification). We applied multilevel logistic regression models, adjusting for sex, retirement age, socioeconomic status, health status and body mass index. Our results show that (1) transition to retirement led to an increase in the sports participation of NMP during the first 5 years and the subsequent 5 years after retirement. Changes in sports participation were modified by migration status: In PMB sports participation increased to a lesser extent than in NMP. (2) While sports participation of integrated PMB was not significantly different from NMP in the preretirement phase, sports participation among integrated PMB increased less after retirement compared with NMP. Marginalized and assimilated PMB did not show consistent sports participation patterns before retirement, but seemingly increased their sports participation less than NMP over the retirement transition. Separated PMB had particularly low levels of sports participation. Considering that LTPA is a key factor for healthy ageing, the increasing gap in levels of sports participation after transition to retirement indicates the need for interventions targeting physical activity of the older migrant population.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-08
      DOI: 10.3390/ijerph14111356
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1357: Coordinating Leader-Follower Supply Chain
           with Sustainable Green Technology Innovation on Their Fairness Concerns

    • Authors: Bisheng Du, Qing Liu, Guiping Li
      First page: 1357
      Abstract: Sustainable green technology innovation is essential in all the stages of the supply chain development. The members of the supply chain in each stage need to invest in sustainable green technology innovation research and development. However, whether the sustainable green technology innovation investments and profits for all the members are fairness concerned is a critical factor to motivate the supply chain members. Motivated by a real business investigation, in this study, a supply chain model with one supplier and one manufacturer is analyzed. We consider fairness concerns for the supplier and the manufacturer with sustainable green technology innovation development. We derive the optimal results in both with and without fairness concern. The results indicate that fairness concerns can promote and coordinate the supply chain members without advantage inequity averseness, to invest more on their sustainable green technology innovation development.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-08
      DOI: 10.3390/ijerph14111357
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1358: Hospital Smoke-Free Policy: Compliance,
           Enforcement, and Practices. A Staff Survey in Two Large Public Hospitals
           in Australia

    • Authors: Sam McCrabb, Amanda Baker, John Attia, Zsolt Balogh, Natalie Lott, Kerrin Palazzi, Justine Naylor, Ian Harris, Christopher Doran, Johnson George, Luke Wolfenden, Eliza Skelton, Billie Bonevski
      First page: 1358
      Abstract: Background: Smoke-free hospital policies are becoming increasingly common to promote good health and quit attempts among patients who smoke. This study aims to assess: staff perceived enforcement and compliance with smoke-free policy; the current provision of smoking cessation care; and the characteristics of staff most likely to report provision of care to patients. Methods: An online cross-sectional survey of medical, nursing, and allied staff from two Australian public hospitals was conducted. Staff report of: patient and staff compliance with smoke-free policy; perceived policy enforcement; the provision of the 5As for smoking cessation (Ask, Assess, Advise, Assist, and Arrange follow-up); and the provision of stop-smoking medication are described. Logistic regressions were used to determine respondent characteristics related to the provision of the 5As and stop-smoking medication use during hospital admission. Results: A total of 805 respondents participated. Self-reported enforcement of smoke-free policy was low (60.9%), together with compliance for both patients (12.9%) and staff (23.6%). The provision of smoking cessation care was variable, with the delivery of the 5As ranging from 74.7% (ask) to 18.1% (arrange follow-up). Medical staff (odds ratio (OR) = 2.09, CI = 1.13, 3.85, p = 0.018) and full time employees (OR = 2.03, CI = 1.06, 3.89, p = 0.033) were more likely to provide smoking cessation care always/most of the time. Stop-smoking medication provision decreased with increasing age of staff (OR = 0.98, CI = 0.96, 0.99, p = 0.008). Conclusions: Smoke-free policy enforcement and compliance and the provision of smoking cessation care remains low in hospitals. Efforts to improve smoking cessation delivery by clinical staff are warranted.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-08
      DOI: 10.3390/ijerph14111358
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1359: Burden of Mortality and Disease Attributable
           to Multiple Air Pollutants in Warsaw, Poland

    • Authors: Piotr Holnicki, Marko Tainio, Andrzej Kałuszko, Zbigniew Nahorski
      First page: 1359
      Abstract: Air pollution is a significant public health issue all over the world, especially in urban areas where a large number of inhabitants are affected. In this study, we quantify the health burden due to local air pollution for Warsaw, Poland. The health impact of the main air pollutants, PM, NOX, SO2, CO, C6H6, BaP and heavy metals is considered. The annual mean concentrations are predicted with the CALPUFF air quality modeling system using the year 2012 emission and meteorological data. The emission field comprises point, mobile and area sources. The exposure to these pollutants was estimated using population data with a spatial resolution of 0.5 × 0.5 km2. Changes in mortality and in disability-adjusted life-years (DALYs) were estimated with relative risk functions obtained from literature. It has been predicted that local emissions cause approximately 1600 attributable deaths and 29,000 DALYs per year. About 80% of the health burden was due to exposure to fine particulate matter (PM2.5). Mobile and area sources contributed 46% and 52% of total DALYs, respectively. When the inflow from outside was included, the burden nearly doubled to 51,000 DALYs. These results indicate that local decisions can potentially reduce associated negative health effects, but a national-level policy is required for reducing the strong environmental impact of PM emissions.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-08
      DOI: 10.3390/ijerph14111359
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1360: Climatic Variables and Malaria Morbidity in
           Mutale Local Municipality, South Africa: A 19-Year Data Analysis

    • Authors: Abiodun Adeola, Joel Botai, Hannes Rautenbach, Omolola Adisa, Katlego Ncongwane, Christina Botai, Temitope Adebayo-Ojo
      First page: 1360
      Abstract: The north-eastern parts of South Africa, comprising the Limpopo Province, have recorded a sudden rise in the rate of malaria morbidity and mortality in the 2017 malaria season. The epidemiological profiles of malaria, as well as other vector-borne diseases, are strongly associated with climate and environmental conditions. A retrospective understanding of the relationship between climate and the occurrence of malaria may provide insight into the dynamics of the disease’s transmission and its persistence in the north-eastern region. In this paper, the association between climatic variables and the occurrence of malaria was studied in the Mutale local municipality in South Africa over a period of 19-year. Time series analysis was conducted on monthly climatic variables and monthly malaria cases in the Mutale municipality for the period of 1998–2017. Spearman correlation analysis was performed and the Seasonal Autoregressive Integrated Moving Average (SARIMA) model was developed. Microsoft Excel was used for data cleaning, and statistical software R was used to analyse the data and develop the model. Results show that both climatic variables’ and malaria cases’ time series exhibited seasonal patterns, showing a number of peaks and fluctuations. Spearman correlation analysis indicated that monthly total rainfall, mean minimum temperature, mean maximum temperature, mean average temperature, and mean relative humidity were significantly and positively correlated with monthly malaria cases in the study area. Regression analysis showed that monthly total rainfall and monthly mean minimum temperature (R2 = 0.65), at a two-month lagged effect, are the most significant climatic predictors of malaria transmission in Mutale local municipality. A SARIMA (2,1,2) (1,1,1) model fitted with only malaria cases has a prediction performance of about 51%, and the SARIMAX (2,1,2) (1,1,1) model with climatic variables as exogenous factors has a prediction performance of about 72% in malaria cases. The model gives a close comparison between the predicted and observed number of malaria cases, hence indicating that the model provides an acceptable fit to predict the number of malaria cases in the municipality. To sum up, the association between the climatic variables and malaria cases provides clues to better understand the dynamics of malaria transmission. The lagged effect detected in this study can help in adequate planning for malaria intervention.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-08
      DOI: 10.3390/ijerph14111360
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1361: Development and Relative Validity of a Food
           Frequency Questionnaire to Assess Intakes of Total and Free Sugars in
           Australian Toddlers

    • Authors: Gemma Devenish, Aqif Mukhtar, Andrea Begley, Loc Do, Jane Scott
      First page: 1361
      Abstract: Background: Dental research into early childhood caries is hindered by a lack of suitable dietary assessment tools that have been developed and validated for the population and outcomes of interest. The aim of this study was to develop and investigate the relative validity and reproducibility of the Study of Mothers’ and Infants’ Life Events Food Frequency Questionnaire (SMILE-FFQ), to assess the total and free sugars intakes of Australian toddlers. Methods: The SMILE-FFQ was designed to capture the leading dietary contributors to dental caries risk in toddlers aged 18–30 months via a proxy report. Ninety-five parents of Australian toddlers completed the questionnaire online before and after providing three 24-h recalls (24HR), collected on non-consecutive days using the multipass method. Total and free sugars were compared between the two SMILE-FFQ administrations and between each SMILE-FFQ and the 24HR using multiple statistical tests and standardised validity criteria. Correlation (Pearson), mean difference (Wilcoxon rank test) and Bland Altman analyses were conducted to compare absolute values, with cross-classification (Chi-Square and Weighted Kappa) used to compare agreement across tertiles. Results: All reproducibility tests showed good agreement except weighted kappa, which showed acceptable agreement. Relative validity tests revealed a mix of good and acceptable agreement, with total sugars performing better at the individual level than free sugars. Compared to the 24HR, the SMILE-FFQ tended to underestimate absolute values at lower levels and overestimate them at higher levels. Conclusions: The combined findings of the various tests indicate that the SMILE-FFQ performs comparably to the 24HR for assessing both total and free sugars among individuals, is most effective for ranking participants rather than determining absolute intakes, and is therefore suitable for use in observational studies of Australian toddlers.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-08
      DOI: 10.3390/ijerph14111361
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1362: Are PCI Service Volumes Associated with
           30-Day Mortality' A Population-Based Study from Taiwan

    • Authors: Tsung-Hsien Yu, Ying-Yi Chou, Chung-Jen Wei, Yu-Chi Tung
      First page: 1362
      Abstract: The volume-outcome relationship has been discussed for over 30 years; however, the findings are inconsistent. This might be due to the heterogeneity of service volume definitions and categorization methods. This study takes percutaneous coronary intervention (PCI) as an example to examine whether the service volume was associated with PCI 30-day mortality, given different service volume definitions and categorization methods. A population-based, cross-sectional multilevel study was conducted. Two definitions of physician and hospital volume were used: (1) the cumulative PCI volume in a previous year before each PCI; (2) the cumulative PCI volume within the study period. The volume was further treated in three ways: (1) a categorical variable based on the American Heart Association’s recommendation; (2) a semi-data-driven categorical variable based on k-means clustering algorithm; and (3) a data-driven categorical variable based on the Generalized Additive Model. The results showed that, after adjusting the patient-, physician-, and hospital-level covariates, physician volume was associated inversely with PCI 30-day mortality, but hospital volume was not, no matter which definitions and categorization methods of service volume were applied. Physician volume is negatively associated with PCI 30-day mortality, but the results might vary because of definition and categorization method.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-09
      DOI: 10.3390/ijerph14111362
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1363: Variation in Point-of-Care Testing of HbA1c
           in Diabetes Care in General Practice

    • Authors: Troels Kristensen, Frans Waldorff, Jørgen Nexøe, Christian Skovsgaard, Kim Olsen
      First page: 1363
      Abstract: Background: Point-of-care testing (POCT) of HbA1c may result in improved diabetic control, better patient outcomes, and enhanced clinical efficiency with fewer patient visits and subsequent reductions in costs. In 2008, the Danish regulators created a framework agreement regarding a new fee-for-service fee for the remuneration of POCT of HbA1c in general practice. According to secondary research, only the Capital Region of Denmark has allowed GPs to use this new incentive for POCT. The aim of this study is to use patient data to characterize patients with diabetes who have received POCT of HbA1c and analyze the variation in the use of POCT of HbA1c among patients with diabetes in Danish general practice. Methods: We use register data from the Danish Drug Register, the Danish Health Service Register and the National Patient Register from the year 2011 to define a population of 44,981 patients with diabetes (type 1 and type 2 but not patients with gestational diabetes) from the Capital Region. The POCT fee is used to measure the amount of POCT of HbA1c among patients with diabetes. Next, we apply descriptive statistics and multilevel logistic regression to analyze variation in the prevalence of POCT at the patient and clinic level. We include patient characteristics such as gender, age, socioeconomic markers, health care utilization, case mix markers, and municipality classifications. Results: The proportion of patients who received POCT was 14.1% and the proportion of clinics which were “POCT clinics” was 26.9%. There were variations in the use of POCT across clinics and patients. A part of the described variation can be explained by patient characteristics. Male gender, age differences (older age), short education, and other ethnicity imply significantly higher odds for POCT. High patient costs in general practice and other parts of primary care also imply higher odds for POCT. In contrast, high patient costs for drugs and/or morbidity in terms of the Charlson Comorbidity index mean lower odds for POCT. The frequency of patients with diabetes per 1000 patients was larger in POCT clinics than Non-POCT clinics. A total of 22.5% of the unexplained variability was related to GP clinics. Conclusions: This study demonstrates variation in the use of POCT which can be explained by patient characteristics such as demographic, socioeconomic, and case mix markers. However, it appears relevant to reassess the system for POCT. Further studies are warranted in order to assess the impacts of POCT of HbA1c on health care outcomes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-09
      DOI: 10.3390/ijerph14111363
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1364: Factors Associated with Activities of Daily
           Life Disability among Centenarians in Rural Chongqing, China: A
           Cross-Sectional Study

    • Authors: Tingting Wu, Lu Lu, Li Luo, Yingqi Guo, Liying Ying, Qingliu Tao, Huan Zeng, Lingli Han, Zumin Shi, Yong Zhao
      First page: 1364
      Abstract: Objective: This study aims to ascertain the health and lifestyle factors associated with the activities of daily living (ADL) disability of centenarians in rural Chongqing, China. Method: 564 centenarians living in rural Chongqing were selected for this cross-sectional study. Demographic characteristics and self-reported lifestyle factors were obtained from face-to-face interviews. ADL disability was measured using the Katz Activities of Daily Living Scale. Result: Among the respondents, 65.7% were considered ADL disability centenarians. Multivariable logistic regression analysis showed that preference for salt, drinking habits, social activities, physical activity, and failure to follow good diet habits were significantly associated with the ADL disability of centenarians. Conclusion: ADL disability of centenarians was associated with certain lifestyle habits. This outcome suggested that target intervention may help maintain ADL independence even among the oldest of the elderly population.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-09
      DOI: 10.3390/ijerph14111364
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1365: Trait Rumination Predicts Elevated Evening
           Cortisol in Sexual and Gender Minority Young Adults

    • Authors: Peggy Zoccola, Andrew Manigault, Wilson Figueroa, Cari Hollenbeck, Anna Mendlein, Alex Woody, Katrina Hamilton, Matt Scanlin, Ryan Johnson
      First page: 1365
      Abstract: Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body’s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol) in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults (Mage = 25.0, SD = 4.1) who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output). The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-09
      DOI: 10.3390/ijerph14111365
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1366: Food Swamps Predict Obesity Rates Better Than
           Food Deserts in the United States

    • Authors: Kristen Cooksey-Stowers, Marlene Schwartz, Kelly Brownell
      First page: 1366
      Abstract: This paper investigates the effect of food environments, characterized as food swamps, on adult obesity rates. Food swamps have been described as areas with a high-density of establishments selling high-calorie fast food and junk food, relative to healthier food options. This study examines multiple ways of categorizing food environments as food swamps and food deserts, including alternate versions of the Retail Food Environment Index. We merged food outlet, sociodemographic and obesity data from the United States Department of Agriculture (USDA) Food Environment Atlas, the American Community Survey, and a commercial street reference dataset. We employed an instrumental variables (IV) strategy to correct for the endogeneity of food environments (i.e., that individuals self-select into neighborhoods and may consider food availability in their decision). Our results suggest that the presence of a food swamp is a stronger predictor of obesity rates than the absence of full-service grocery stores. We found, even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates. All three food swamp measures indicated the same positive association, but reflected different magnitudes of the food swamp effect on rates of adult obesity (p values ranged from 0.00 to 0.16). Our adjustment for reverse causality, using an IV approach, revealed a stronger effect of food swamps than would have been obtained by naïve ordinary least squares (OLS) estimates. The food swamp effect was stronger in counties with greater income inequality (p < 0.05) and where residents are less mobile (p < 0.01). Based on these findings, local government policies such as zoning laws simultaneously restricting access to unhealthy food outlets and incentivizing healthy food retailers to locate in underserved neighborhoods warrant consideration as strategies to increase health equity.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-14
      DOI: 10.3390/ijerph14111366
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1367: Estimation and Evaluation of Future Demand
           and Supply of Healthcare Services Based on a Patient Access Area Model

    • Authors: Shunsuke Doi, Hiroo Ide, Koichi Takeuchi, Shinsuke Fujita, Katsuhiko Takabayashi
      First page: 1367
      Abstract: Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-10
      DOI: 10.3390/ijerph14111367
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1368: Associations of Fasting Blood Glucose with
           Influencing Factors in Northeast China: A Quantile Regression Analysis

    • Authors: Xin Guo, Li Shen, Jing Dou, Yaogai Lv, Anning Zhang, Fanchao Shi, Zhiqiang Xue, Yaqin Yu, Lina Jin, Yan Yao
      First page: 1368
      Abstract: Background: Diabetes mellitus (DM) has become a major public health problem in China. Although a number of researchers have investigated DM risk factors, little is known about the associations between values of fasting blood glucose (FBG) and influencing factors. This study aims to explore these associations by the quantile regression (QR) model. Methods: A cross-sectional survey based on a sample of 23,050 adults aged 18 to 79 years was conducted in Jilin in 2012, and some subjects were excluded due to missing values with respect to necessary variables or having glycemic control, in accordance with the purposes of this study. Finally, in total 14,698 people were included in this study. QR was performed to identify the factors influencing the level of FBG in different quantiles of FBG. Results: The distribution of FBG status was different between males and females (χ2 = 175.30, p < 0.001). The QR model provided more detailed views on the associations of FBG with different factors and revealed apparent quantile-related patterns separately for different factors. Body mass index (BMI) was positively associated with the low and middle quantiles of FBG. Waist circumference (WC) had a positive association with the high quantiles of FBG. Conclusions: FBG had a positive association with BMI in normal FBG, and a positive association with WC in high FBG. Diet and alcohol intake were associated with FBG in normal FBG. FBG was more likely to be elevated in the elderly, female workers, and people with family history of DM.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-10
      DOI: 10.3390/ijerph14111368
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1369: Integration of GIS, Electromagnetic and
           Electrical Methods in the Delimitation of Groundwater Polluted by Effluent
           Discharge (Salamanca, Spain): A Case Study

    • Authors: Rubén Montes, Antonio Martínez-Graña, José Martínez Catalán, Puy Arribas, Francisco Sánchez San Román, Caridad Zazo
      First page: 1369
      Abstract: The present work envisages the possible geometry of a contaminated plume of groundwater near hospital facilities by combining GIS (Geographic Information System) and geophysical methods. The rock underlying the soil and thin sedimentary cover of the study area is moderately fractured quartzite, which makes aquifers vulnerable to pollution. The GIS methodology is used to calculate the area that would be affected by the effluent source of residual water, based on algorithms that consider ground surface mapping (slopes, orientations, accumulated costs and cost per distance). Geophysical methods (electromagnetic induction and electric resistivity tomography) use changes in the electrical conductivity or resistivity of the subsurface to determine the geometry of the discharge and the degree of contamination. The model presented would allow a preliminary investigation regarding potential corrective measures.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-10
      DOI: 10.3390/ijerph14111369
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1370: Are Some of the Cigar Warnings Mandated in
           the U.S. More Believable Than Others'

    • Authors: Kristen Jarman, Sarah Kowitt, Jennifer Cornacchione Ross, Adam Goldstein
      First page: 1370
      Abstract: Background: Text warnings are mandated on cigars sold in the United States (U.S.), however little published research has examined effectiveness of cigar warnings. This is the first study examining the believability of cigar warnings among adults in the U.S. Methods: Adults in the U.S. (n = 5014) were randomized in a phone survey to receive one of three cigar-specific mandated warning messages (“Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”, “Cigar smoking can cause lung cancer and heart disease”, and “Cigars are not a safe alternative to cigarettes”) with one of four warning sources (no source, Surgeon General, CDC (Centers for Disease Control and Prevention), FDA (Food and Drug Administration)). Results: Most adults found the cigar warnings very believable (66.9%). Weighted logistic regression results indicate that the message “Cigar smoking can cause lung cancer and heart disease” was associated with higher odds of being very believable (AOR: 2.05, 95% CI: 1.55, 2.70) and the message “Cigars are not a safe alternative to cigarettes” was associated with lower odds of being very believable (AOR: 0.71, 95% CI: 0.55, 0.92) compared to the message “Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”. Warning source had no impact on believability. Conclusions: We tested three of the currently mandated cigar warnings in the U.S. and found significant differences in believability between them. Further research on cigar warnings may improve communication to the public on cigar health risks, ultimately preventing uptake of cigars and promoting cessation among cigar users.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-10
      DOI: 10.3390/ijerph14111370
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1371: The Impact of a Multi-Level Multi-Component
           Childhood Obesity Prevention Intervention on Healthy Food Availability,
           Sales, and Purchasing in a Low-Income Urban Area

    • Authors: Joel Gittelsohn, Angela Trude, Lisa Poirier, Alexandra Ross, Cara Ruggiero, Teresa Schwendler, Elizabeth Anderson Steeves
      First page: 1371
      Abstract: The multifactorial causes of obesity require multilevel and multicomponent solutions, but such combined strategies have not been tested to improve the community food environment. We evaluated the impact of a multilevel (operating at different levels of the food environment) multicomponent (interventions occurring at the same level) community intervention. The B’more Healthy Communities for Kids (BHCK) intervention worked at the wholesaler (n = 3), corner store (n = 50), carryout (n = 30), recreation center (n = 28), household (n = 365) levels to improve availability, purchasing, and consumption of healthier foods and beverages (low-sugar, low-fat) in low-income food desert predominantly African American zones in the city of Baltimore (MD, USA), ultimately intending to lead to decreased weight gain in children (not reported in this manuscript). For this paper, we focus on more proximal impacts on the food environment, and measure change in stocking, sales and purchase of promoted foods at the different levels of the food system in 14 intervention neighborhoods, as compared to 14 comparison neighborhoods. Sales of promoted products increased in wholesalers. Stocking of these products improved in corner stores, but not in carryouts, and we did not find any change in total sales. Children more exposed to the intervention increased their frequency of purchase of promoted products, although improvement was not seen for adult caregivers. A multilevel food environment intervention in a low-income urban setting improved aspects of the food system, leading to increased healthy food purchasing behavior in children.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-10
      DOI: 10.3390/ijerph14111371
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1372: Occurrences of Organochlorine Pesticides
           along the Course of the Buffalo River in the Eastern Cape of South Africa
           and Its Health Implications

    • Authors: Abdulrazaq Yahaya, Omobola Okoh, Anthony Okoh, Abiodun Adeniji
      First page: 1372
      Abstract: Most organochlorine pesticides (OCPs) which are increasingly used in agriculture and industry are not biodegradable and thereby persist in the environment for a very long period of time. They are capable of negatively impacting the health of humans and biota when present in a higher concentration than recommended. This study evaluated the concentrations of 17 OCPs in surface water samples collected from six sampling sites along the course of the Buffalo River in Eastern Cape, South Africa, between December 2015 and May 2016. The samples were subjected to solvent extraction, followed by florisil clean up, and analyzed using gas chromatography coupled with an electron capture detector. The individual concentrations of OCPs detected ranged from <LOD to 4403 ng/L in summer and <LOD to 313 ng/L in autumn. The levels of OCPs in the study area were generally above the United State Environmental Protection Agency (USEPA) limit of 100 ng/L in all the sampling locations in the two seasons. The cancer risk assessment values were below the permissible limit of the 10−6 level, although the life average daily dose were slightly above the USEPA maximum limits of 10−4. Therefore, there is a need for the adequate regulation of agrochemical storage, use, and disposal in this province and other parts of South Africa.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-10
      DOI: 10.3390/ijerph14111372
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1373: Work Stress and Altered Biomarkers: A
           Synthesis of Findings Based on the Effort–Reward Imbalance Model

    • Authors: Johannes Siegrist, Jian Li
      First page: 1373
      Abstract: While epidemiological studies provide statistical evidence on associations of exposures such as stressful work with elevated risks of stress-related disorders (e.g., coronary heart disease or depression), additional information on biological pathways and biomarkers underlying these associations is required. In this contribution, we summarize the current state of the art on research findings linking stressful work, in terms of an established theoretical model—effort-reward imbalance—with a broad range of biomarkers. Based on structured electronic literature search and recent available systematic reviews, our synthesis of findings indicates that associations of work stress with heart rate variability, altered blood lipids, and risk of metabolic syndrome are rather consistent and robust. Significant relationships with blood pressure, heart rate, altered immune function and inflammation, cortisol release, and haemostatic biomarkers were also observed, but due to conflicting findings additional data will be needed to reach a firm conclusion. This narrative review of empirical evidence supports the argument that the biomarkers under study can act as mediators of epidemiologically established associations of work stress, as measured by effort–reward imbalance, with incident stress-related disorders.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-10
      DOI: 10.3390/ijerph14111373
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1374: Modeling Skin Injury from Hot Spills on

    • Authors: Torgrim Log
      First page: 1374
      Abstract: The present work analyzes scald burns from hot beverages, such as coffee and tea, spilled on the lap, i.e., an incident that may occur in daily life. The Pennes bioheat equation is solved numerically for small spills wetting the clothing, i.e., the fabric prevents the spilled liquid from draining away. Temperatures are analyzed in the wetted fabric and the skin layers and the resulting skin injury is calculated based on the basal layer temperature. Parameters influencing burn severity, such as clothing thickness, liquid temperature, removal of fabric and thermal effects of post scald water cooling are analyzed. The fabric cools the water some but represents a threat since the entrapped water results in a prolonged heat supply. The liquid temperature turned out to be the most important injury parameter, where liquid temperature of about 80–85 °C seems to be a limit for developing superficial partial-thickness burns in the present minimum case, i.e., where the liquid just wets the fabric. Spilling water in excess of just wetting the fabric, more severe burns will develop at lower liquid temperatures due to the prolonged heat supply. Higher liquid temperatures will nearly instantly develop more severe burns. It is demonstrated that removal of the clothing within the first seconds after the spill may significantly reduce the scalding severity. The general advice is therefore to avoid excessive heating of beverages and, if the beverage is spilled, to quickly remove the wetted clothing. Prolonged tempered water cooling is advised to improve the healing processes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-11
      DOI: 10.3390/ijerph14111374
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1375: Physical Activity of German Children and
           Adolescents 2003–2012: The MoMo-Study

    • Authors: Steffen Schmidt, Annette Henn, Claudia Albrecht, Alexander Woll
      First page: 1375
      Abstract: Organized and unorganized physical activity (PA) hold an important role in the daily life of children and adolescents. Regular representative tracking of PA in different settings is important to evaluate social trends and implemented interventions. In this paper, representative PA data of German children and adolescents from the MoMo Baseline-Study (2004, n = 4528) are compared to those of Wave 1 (2010, n = 3994). Participants aged 4–17 were drawn out of 167 sample points in Germany and the data was weighted to ensure representativeness. PA was measured via questionnaire and was differentiated between organized (sports clubs and schools) and unorganized (unorganized sports and playing outside). Organized PA in extracurricular activities and sports clubs increased by eight percent, while unorganized PA decreased by seven percent. In addition to sports clubs, schools became a more prevalent setting for participation in physical activity in Germany.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-11
      DOI: 10.3390/ijerph14111375
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1376: Body Burden of Dichlorodiphenyl
           Dichloroethene (DDE) and Childhood Pulmonary Function

    • Authors: Pallavi Balte, Joachim Kühr, Herrman Kruse, Wilfried Karmaus
      First page: 1376
      Abstract: Longitudinal studies have shown that early life exposure to dichlorodiphenyl dichloroethene (DDE) can lead to growth reduction during childhood and adolescence. In addition, DDE exposure has been linked to respiratory tract infections and an increased risk of asthma in children. Our aim was to understand the relationships between DDE exposure and pulmonary function in children, and, particularly, whether associations are mediated by the height of the children. We used data from an environmental epidemiologic study conducted in central Germany in children aged 8-10 years. The pulmonary function (forced vital capacity, FVC, and forced expiratory volume in one second, FEV1) were measured in three consecutive years. Blood DDE levels were measured at 8 and 10 years. We used linear mixed models for repeated measurements and path analyses to assess the association between blood levels of DDE and pulmonary function measurements. All models were adjusted for confounders. Linear mixed approaches and modelling concurrent effects showed no significant associations. The path analytical models demonstrated that DDE measured at eight years had significant, inverse, indirect, and total effects on FVC at ten years (n = 328; −0.18 L per μg/L of DDE) and FEV1 (n = 328; −0.17 L per μg/L of DDE), mediated through effects of DDE on height and weight. The DDE burden reduces pulmonary function through its diminishing effects on height and weight in children. Further studies are required to test these associations in other samples, preferably from a region with ongoing, high DDT application.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-14
      DOI: 10.3390/ijerph14111376
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1377: Association between Small Fetuses and Puberty
           Timing: A Systematic Review and Meta-Analysis

    • Authors: Xu Deng, Wenyan Li, Yan Luo, Shudan Liu, Yi Wen, Qin Liu
      First page: 1377
      Abstract: Background: Epidemiological studies reporting the effect of small fetuses (SF) on puberty development have shown inconsistent results. Objective: To examine current study evidence and determine the strength and direction of the association between SF and puberty timing. Methods: PubMed, OVID, Web of Science, EBSCO, and four Chinese databases were searched from their date of inception to February 2016. All cohort studies that examined the association between SF and puberty timing in children were identified. Two reviewers independently screened the studies, assessed the quality of included studies, and extracted the data. The quality of the included cohort studies was assessed by the Newcastle–Ottawa Scale. Risk ratio (RR), Weighted Mean Difference (WMD), and 95% confidence intervals (CIs) were calculated and pooled by RevMan5.3 (Cochrane Collaboration, London, UK). Results: A total of 10 cohort studies involving 2366 subjects was included in the final analysis. The pooled estimates showed that SF did not significantly increase the number of pubertal children in boys (RR: 0.97; 95% CI: 0.82 to 1.15), or in girls (RR: 0.91; 95% CI: 0.79 to 1.04). Compared with the control group, the SF group had an earlier onset of puberty in girls (WMD: −0.64; 95% CI: −1.21 to −0.06), and in precocious pubarche (PP) girls (WMD: −0.10; 95% CI: −0.13 to −0.07). There was no difference in the onset of puberty in boys (WMD: −0.48; 95% CI: −1.45 to 0.50) between SF and control groups. The pooled result indicated an earlier age at menarche in girls born small for gestational age (WMD: −0.30; 95% CI: −0.58 to −0.03), but no difference in the age at menarche in the SF group of PP girls. Conclusions: SF may be associated with an earlier age of onset of puberty, especially among girls, as well as earlier age at menarche for girls. Well-designed studies with larger sample sizes and long-term follow-up among different countries and ethnicities are needed.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-13
      DOI: 10.3390/ijerph14111377
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1378: Effect of Age on Glasgow Coma Scale in
           Patients with Moderate and Severe Traumatic Brain Injury: An Approach with
           Propensity Score-Matched Population

    • Authors: Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo, Ching-Hua Hsieh
      First page: 1378
      Abstract: Background: The most widely used methods of describing traumatic brain injury (TBI) are the Glasgow Coma Scale (GCS) and the Abbreviated Injury Scale (AIS). Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an equivalent anatomical severity of TBI. This study aimed to assess these observations with a propensity-score matching approach using the data from Trauma Registry System in a Level I trauma center. Methods: We included all adult patients (aged ≥20 years old) with moderate to severe TBI from 1 January 2009 to 31 December 2016. Patients were categorized into elderly (aged ≥65 years) and young adults (aged 20–64 years). The severity of TBI was defined by an AIS score in the head (AIS 3‒4 and 5 indicate moderate and severe TBI, respectively). We examined the differences in the GCS scores by age at each head AIS score. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using either the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to the propensity scores calculated using NCSS software with the following covariates: sex, pre-existing chronic obstructive pulmonary disease, systolic blood pressure, hemoglobin, sodium, glucose, and alcohol level. Logistic regression was used to evaluate the effects of age on the GCS score in each head AIS stratum. Results: The study population included 2081 adult patients with moderate to severe TBI. These patients were categorized into elderly (n = 847) and young adults (n = 1234): each was exclusively further divided into three groups of patients with head AIS of 3, 4, or 5. In the 162 well-balanced pairs of TBI patients with head AIS of 3, the elderly demonstrated a significantly higher GCS score than the young adults (14.1 ± 2.2 vs. 13.1 ± 3.3, respectively; p = 0.002). In the 362 well-balanced pairs of TBI patients with head AIS of 4, the elderly showed a significantly higher GCS score than the young adults (13.1 ± 3.3 vs. 12.2 ± 3.8, respectively; p = 0.002). In the 89 well-balance pairs of TBI patients with head AIS of 5, no significant differences were observed for the GCS scores. Conclusions: This study demonstrated that elderly patients with moderate TBI present higher GCS score than younger patients. This study underscores the importance of determining of TBI severity in this group of elderly patients based on the GCS score alone. A lower threshold of GCS cutoff should be adopted in the management of the elderly patients with TBI.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-13
      DOI: 10.3390/ijerph14111378
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1379: Asbestos Ban in Italy: A Major Milestone, Not
           the Final Cut

    • Authors: Daniela Marsili, Alessia Angelini, Caterina Bruno, Marisa Corfiati, Alessandro Marinaccio, Stefano Silvestri, Amerigo Zona, Pietro Comba
      First page: 1379
      Abstract: Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-13
      DOI: 10.3390/ijerph14111379
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1380: Epidemiology of Bone Fracture in Female
           Trauma Patients Based on Risks of Osteoporosis Assessed using the
           Osteoporosis Self-Assessment Tool for Asians Score

    • Authors: Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
      First page: 1380
      Abstract: Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < −4, n = 1585), medium-risk (−1 ≥ OSTA ≥ −4, n = 1985), and low-risk (OSTA > −1, n = 3137) patients. Two-sided Pearson’s, chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann–Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed with injury mechanisms as adjusted variables to evaluate the effects of OSTA-related grouping on the fracture patterns. Results: High- and medium-risk patients were significantly older, had higher incidences of comorbidity, and were more frequently injured from a fall and bicycle accident than low-risk patients did. Compared to low-risk patients, high- and medium-risk patients had a higher injury severity and mortality. In the propensity-score matched population, the incidence of fractures was only different in the extremity regions between high- and low-risk patients as well as between medium- and low-risk patients. The incidences of femoral fractures were significantly higher in high-risk (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.73–4.24; p < 0.001) and medium-risk patients (OR, 1.4; 95% CI, 1.24–1.54; p < 0.001) than in low-risk patients. In addition, high-risk patients had significantly lower odds of humeral, radial, patellar, and tibial fractures; however, such lower odds were not found in medium- risk than low-risk patients. Conclusions: The fracture patterns of female trauma patients with high- and medium-risk osteoporosis were different from that of low-risk patients exclusively in the extremity region.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-13
      DOI: 10.3390/ijerph14111380
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1381: The Interaction between Ambient PM10 and NO2
           on Mortality in Guangzhou, China

    • Authors: Yuzhou Gu, Hualiang Lin, Tao Liu, Jianpeng Xiao, Weilin Zeng, Zhihao Li, Xiaojuan Lv, Wenjun Ma
      First page: 1381
      Abstract: Air pollution is now a significant environmental issue in China. To better understand the health impacts of ambient air pollution, this study investigated the potential interaction between PM10 and NO2 on mortality in Guangzhou, China. Time series data of daily non-accidental mortality and concentrations of PM10 and NO2 from 2006 to 2010 were collected. Based on generalized additive model, we developed two models (bivariate model and stratified model) to explore the interaction both qualitatively and quantitatively. At lag of 0–2 days, greater interactive effects between PM10 and NO2 were presented in the graphs. Positive modified effects were also found between the two pollutants on total non-accidental death and cardiovascular death. When the NO2 concentration was at a high level (>76.14 μg/m3), PM10 showed the greatest excess relative risk percentage (ERR%) for total non-accidental mortality (0.46, 95% CI: 0.13–0.79) and cardiovascular disease mortality (0.61, 95% CI: 0.06–1.16) for each 10 μg/m3 increase. During the period of high PM10 concentration (>89.82 μg/m3), NO2 demonstrated its strongest effect for total non-accidental mortality (ERR%: 0.92, 95% CI: 0.42–1.42) and cardiovascular disease mortality (ERR%: 1.20, 95% CI: 0.38–2.03). Our results suggest a positive interaction between PM10 and NO2 on non-accidental mortality in Guangzhou.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-13
      DOI: 10.3390/ijerph14111381
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1382: Establishing Smoke-Free Homes in the
           Indigenous Populations of Australia, New Zealand, Canada and the United
           States: A Systematic Literature Review

    • Authors: Leah Stevenson, Sandy Campbell, India Bohanna, Gillian Gould, Jan Robertson, Alan Clough
      First page: 1382
      Abstract: A smoke-free home can have multiple benefits by reducing exposure to secondhand smoke (SHS), supporting quit attempts among active smokers, and discouraging adolescents from taking up smoking. The aim of this review was to summarize the literature on the establishment of smoke-free homes in Indigenous populations and identify the supporting influences and barriers, using the Social Cognitive Theory lens. A search of the Medline, CINAHL, Cochrane Collaboration and PyscINFO databases and manual searches of relevant peer-reviewed literature was completed, focusing on Indigenous populations in developed economies of North America and Oceania. Of 2567 articles identified, 15 studies were included. Ten studies included Indigenous participants only, and of these just three focused entirely on SHS in the home. Knowledge of the harms associated with SHS was the most common theme represented in all the studies. This knowledge fueled parents’ motivation to protect their children from SHS by establishing smoke-free homes. Individuals who approached implementation with confidence, coupled with clear communication about smoke-free home rules were more successful. Barriers included challenges for families with multiple smokers living in the same dwelling. There is limited research regarding managing smoking behaviors in the home among Indigenous populations, even though this approach is a successful catalyst for smoking prevention and cessation. Research to understand the influences that support the establishment of smoke-free homes is required for better-informed intervention studies.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-14
      DOI: 10.3390/ijerph14111382
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1383: Humidity May Modify the Relationship between
           Temperature and Cardiovascular Mortality in Zhejiang Province, China

    • Authors: Jie Zeng, Xuehai Zhang, Jun Yang, Junzhe Bao, Hao Xiang, Keith Dear, Qiyong Liu, Shao Lin, Wayne Lawrence, Aihua Lin, Cunrui Huang
      First page: 1383
      Abstract: Background: The evidence of increased mortality attributable to extreme temperatures is widely characterized in climate-health studies. However, few of these studies have examined the role of humidity on temperature-mortality association. We investigated the joint effect between temperature and humidity on cardiovascular disease (CVD) mortality in Zhejiang Province, China. Methods: We collected data on daily meteorological and CVD mortality from 11 cities in Zhejiang Province during 2010–2013. We first applied time-series Poisson regression analysis within the framework of distributed lag non-linear models to estimate the city-specific effect of temperature and humidity on CVD mortality, after controlling for temporal trends and potential confounding variables. We then applied a multivariate meta-analytical model to pool the effect estimates in the 11 cities to generate an overall provincial estimate. The joint effects between them were calculated by the attributable fraction (AF). The analyses were further stratified by gender, age group, education level, and location of cities. Results: In total, 120,544 CVD deaths were recorded in this study. The mean values of temperature and humidity were 17.6 °C and 72.3%. The joint effect between low temperature and high humidity had the greatest impact on the CVD death burden over a lag of 0–21 days with a significant AF of 31.36% (95% eCI: 14.79–38.41%), while in a condition of low temperature and low humidity with a significant AF of 16.74% (95% eCI: 0.89, 24.44). The AFs were higher at low temperature and high humidity in different subgroups. When considering the levels of humidity, the AFs were significant at low temperature and high humidity for males, youth, those with a low level of education, and coastal area people. Conclusions: The combination of low temperature and high humidity had the greatest impact on the CVD death burden in Zhejiang Province. This evidence has important implications for developing CVD interventions.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-14
      DOI: 10.3390/ijerph14111383
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1385: Prevalence of Mental Health Problems and
           Associated Risk Factors among Rural-to-Urban Migrant Children in
           Guangzhou, China

    • Authors: Jun Wang, Ke Liu, Jing Zheng, Jiali Liu, Liming You
      First page: 1385
      Abstract: Rural-to-urban migration, which has achieved a huge scale during China’s economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen’s behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-14
      DOI: 10.3390/ijerph14111385
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1386: Forecasting the Water Demand in Chongqing,
           China Using a Grey Prediction Model and Recommendations for the
           Sustainable Development of Urban Water Consumption

    • Authors: Hua’an Wu, Bo Zeng, Meng Zhou
      First page: 1386
      Abstract: High accuracy in water demand predictions is an important basis for the rational allocation of city water resources and forms the basis for sustainable urban development. The shortage of water resources in Chongqing, the youngest central municipality in Southwest China, has significantly increased with the population growth and rapid economic development. In this paper, a new grey water-forecasting model (GWFM) was built based on the data characteristics of water consumption. The parameter estimation and error checking methods of the GWFM model were investigated. Then, the GWFM model was employed to simulate the water demands of Chongqing from 2009 to 2015 and forecast it in 2016. The simulation and prediction errors of the GWFM model was checked, and the results show the GWFM model exhibits better simulation and prediction precisions than those of the classical Grey Model with one variable and single order equation GM(1,1) for short and the frequently-used Discrete Grey Model with one variable and single order equation, DGM(1,1) for short. Finally, the water demand in Chongqing from 2017 to 2022 was forecasted, and some corresponding control measures and recommendations were provided based on the prediction results to ensure a viable water supply and promote the sustainable development of the Chongqing economy.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-15
      DOI: 10.3390/ijerph14111386
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1387: Cross-Cultural Adaptation of the Social
           Vulnerability Index for Use in the Dutch Context

    • Authors: Steven Bunt, Nardi Steverink, Melissa K. Andrew, Cees P. van der Schans, Hans Hobbelen
      First page: 1387
      Abstract: Being able to identify socially frail older adults is essential for designing interventions and policy and for the prediction of health outcomes, both on the level of individual older adults and of the population. The aim of the present study was to adapt the Social Vulnerability Index (SVI) to the Dutch language and culture for those purposes. A systematic cross-cultural adaptation of the initial Social Vulnerability Index was performed following five steps: initial translation, synthesis of translations, back translation, a Delphi procedure, and a test for face validity and feasibility. The main result of this study is a face-valid 32 item Dutch version of the Social Vulnerability Index (SVI-D) that is feasible in health care and social care settings. The SVI-D is a useful index to measure social frailty in Dutch-language countries and offers a broad, holistic quantification of older people’s social circumstances related to the risk of adverse health outcomes.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-14
      DOI: 10.3390/ijerph14111387
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1388: Comprehensive Survey on Improved Focality and
           Penetration Depth of Transcranial Magnetic Stimulation Employing
           Multi-Coil Arrays

    • Authors: Xile Wei, Yao Li, Meili Lu, Jiang Wang, Guosheng Yi
      First page: 1388
      Abstract: Multi-coil arrays applied in transcranial magnetic stimulation (TMS) are proposed to accurately stimulate brain tissues and modulate neural activities by an induced electric field (EF). Composed of numerous independently driven coils, a multi-coil array has alternative energizing strategies to evoke EFs targeting at different cerebral regions. To improve the locating resolution and the stimulating focality, we need to fully understand the variation properties of induced EFs and the quantitative control method of the spatial arrangement of activating coils, both of which unfortunately are still unclear. In this paper, a comprehensive analysis of EF properties was performed based on multi-coil arrays. Four types of planar multi-coil arrays were used to study the relationship between the spatial distribution of EFs and the structure of stimuli coils. By changing coil-driven strategies in a basic 16-coil array, we find that an EF induced by compactly distributed coils decays faster than that induced by dispersedly distributed coils, but the former has an advantage over the latter in terms of the activated brain volume. Simulation results also indicate that the attenuation rate of an EF induced by the 36-coil dense array is 3 times and 1.5 times greater than those induced by the 9-coil array and the 16-coil array, respectively. The EF evoked by the 36-coil dispense array has the slowest decay rate. This result demonstrates that larger multi-coil arrays, compared to smaller ones, activate deeper brain tissues at the expense of decreased focality. A further study on activating a specific field of a prescribed shape and size was conducted based on EF variation. Accurate target location was achieved with a 64-coil array 18 mm in diameter. A comparison between the figure-8 coil, the planar array, and the cap-formed array was made and demonstrates an improvement of multi-coil configurations in the penetration depth and the focality. These findings suggest that there is a tradeoff between attenuation rate and focality in the application of multi-coil arrays. Coil-energizing strategies and array dimensions should be based on an adequate evaluation of these two important demands and the topological structure of target tissues.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-14
      DOI: 10.3390/ijerph14111388
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1389: What If Healthy Aging Is the ‘New

    • Authors: Marcia Ory, Matthew Smith
      First page: 1389
      Abstract: We dedicate this special issue to our colleague, Dr. Lucinda Bryant (1941–2016).[...]
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-15
      DOI: 10.3390/ijerph14111389
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1390: Does Effort and Reward at Work Predict
           Changes in Cognitive Function' First Longitudinal Results from the
           Representative German Socio-Economic Panel

    • Authors: Natalie Riedel, Johannes Siegrist, Natalia Wege, Adrian Loerbroks, Peter Angerer, Jian Li
      First page: 1390
      Abstract: It has been suggested that work characteristics, such as mental demands, job control, and occupational complexity, are prospectively related to cognitive function. However, current evidence on links between psychosocial working conditions and cognitive change over time is inconsistent. In this study, we applied the effort–reward imbalance model that allows to build on previous research on mental demands and to introduce reward-based learning as a principle with beneficial effect on cognitive function. We aimed to investigate whether high effort, high reward, and low over-commitment in 2006 were associated with positive changes in cognitive function in terms of perceptual speed and word fluency (2006–2012), and whether the co-manifestation of high effort and high reward would yield the strongest association. To this end, we used data on 1031 employees who participated in a large and representative study. Multivariate linear regression analyses supported our main hypotheses (separate and combined effects of effort and reward), particularly on changes in perceptual speed, whereas the effects of over-commitment did not reach the level of statistical significance. Our findings extend available knowledge by examining the course of cognitive function over time. If corroborated by further evidence, organization-based measures in the workplace can enrich efforts towards preventing cognitive decline in ageing workforces.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-15
      DOI: 10.3390/ijerph14111390
      Issue No: Vol. 14, No. 11 (2017)
  • IJERPH, Vol. 14, Pages 1391: The Trends in Cardiovascular Diseases and
           Respiratory Diseases Mortality in Urban and Rural China, 1990–2015

    • Authors: Weiwei Sun, Yun Zhou, Zhuang Zhang, Limin Cao, Weihong Chen
      First page: 1391
      Abstract: With the rapid development of the economy over the past 20 years, the mortality rates from cardiovascular diseases (CVDs) and respiratory diseases (RDs) have changed in China. This study aimed to analyze the trends of mortality rates and years of life lost (YLLs) from CVDs and RDs in the rural and urban population from 1990 to 2015. Using data from Chinese yearbooks, joinpoint regression analysis was employed to estimate the annual percent change (APC) of mortality rates from CVDs and RDs. YLLs due to CVDs and RDs were calculated by a standard method, adopting recommended standard life expectancy at birth values of 80 years for men and 82.5 years for women. Age-standardized mortality rates and YLL rates were calculated by using the direct method based on the Chinese population from the sixth population census of 2010. Age-standardized mortality rates from CVDs for urban residents and from RDs for both urban and rural residents showed decreasing trends in China from 1990 to 2015. Age-standardized mortality rates from CVDs among rural residents remained constant during above period and outstripped those among urban residents gradually. The age-standardized YLL rates of CVDs for urban and rural residents decreased 35.2% and 8.3% respectively. Additionally, the age-standardized YLL rates of RDs for urban and rural residents decreased 64.2% and 79.0% respectively. The age-standardized mortality and YLL rates from CVDs and RDs gradually decreased in China from 1990 to 2015. We observed more substantial declines of the mortality rates from CVDs in urban areas and from RDs in rural areas.
      Citation: International Journal of Environmental Research and Public Health
      PubDate: 2017-11-15
      DOI: 10.3390/ijerph14111391
      Issue No: Vol. 14, No. 11 (2017)
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