IJERPH, Vol. 15, Pages 1898: The Effectiveness and Cost-Effectiveness of Screening for and Vaccination Against Hepatitis B Virus among Migrants in the EU/EEA: A Systematic Review

IJERPH, Vol. 15, Pages 1898: The Effectiveness and Cost-Effectiveness of Screening for and Vaccination Against Hepatitis B Virus among Migrants in the EU/EEA: A Systematic Review

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091898

Authors: Daniel T Myran Rachael Morton Beverly-Ann Biggs Irene Veldhuijzen Francesco Castelli Anh Tran Lukas P Staub Eric Agbata Prinon Rahman Manish Pareek Teymur Noori Kevin Pottie

Migrants from hepatitis B virus (HBV) endemic countries to the European Union/European Economic Area (EU/EEA) comprise 5.1% of the total EU/EEA population but account for 25% of total chronic Hepatitis B (CHB) infection. Migrants from high HBV prevalence regions are at the highest risk for CHB morbidity. These migrants are at risk of late detection of CHB complications; mortality and onwards transmission. The aim of this systematic review is to evaluate the effectiveness and cost-effectiveness of CHB screening and vaccination programs among migrants to the EU/EEA. We found no RCTs or direct evidence evaluating the effectiveness of CHB screening on morbidity and mortality of migrants. We therefore used a systematic evidence chain approach to identify studies relevant to screening and prevention programs; testing, treatment, and vaccination. We identified four systematic reviews and five additional studies and guidelines that reported on screening and vaccination effectiveness. Studies reported that vaccination programs were highly effective at reducing the prevalence of CHB in children (RR 0.07 95% CI 0.04 to 0.13) following vaccination. Two meta-analyses of therapy for chronic HBV infection found improvement in clinical outcomes and intermediate markers of disease. We identified nine studies examining the cost-effectiveness of screening for CHB: a strategy of screening and treating CHB compared to no screening. The median acceptance of HB screening was 87.4% (range 32.3–100%). Multiple studies highlighted barriers to and the absence of effective strategies to ensure linkage of treatment and care for migrants with CHB. In conclusion, screening of high-risk children and adults and vaccination of susceptible children, combined with treatment of CHB infection in migrants, are promising and cost-effective interventions, but linkage to treatment requires more attention.

https://ift.tt/2CdGg8i

IJERPH, Vol. 15, Pages 1896: Physical Activity and Fundamental Motor Skill Performance of 5–10 Year Old Children in Three Different Playgrounds

IJERPH, Vol. 15, Pages 1896: Physical Activity and Fundamental Motor Skill Performance of 5–10 Year Old Children in Three Different Playgrounds

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091896

Authors: Jessie Adams Jenny Veitch Lisa Barnett

Playgrounds provide opportunities for children to engage in physical activity and develop their fundamental motor skills. The aim of this descriptive pilot study was to examine whether playground design facilitated different levels of physical activity and fundamental motor skills. Children aged 5 to 10 (n = 57) were recruited from three independent playgrounds located in Melbourne (Australia). Whilst playing, children wore accelerometers which measured time spent in physical activity and direct observations recorded fundamental motor skills and play equipment use. A general linear model with playground type as the predictor and adjusting for monitor wear-time identified whether mean time in physical activity was different for the three playgrounds. Frequencies and a one-way ANOVA assessed whether the observed mean number of fundamental motor skills varied between playgrounds. On average, 38.1% of time (12.0 min) was spent in moderate- vigorous-intensity physical activity. Children in the traditional playground (n = 16) engaged in more moderate-intensity physical activity (9.4 min) than children in the adventure playground (n = 21), (5.6 min) (p = 0.027). There were no significant associations with vigorous-intensity physical activity or fundamental motor skills between playgrounds. Children performed few fundamental motor skills but used a wider variety of equipment in the contemporary and adventure playgrounds. Playgrounds need to maximise opportunities for children to engage in physical activity and develop fundamental motor skills.

https://ift.tt/2MHhxOQ

IJERPH, Vol. 15, Pages 1897: Spatial Distribution and Contamination Assessment of Surface Heavy Metals off the Western Guangdong Province and Northeastern Hainan Island

IJERPH, Vol. 15, Pages 1897: Spatial Distribution and Contamination Assessment of Surface Heavy Metals off the Western Guangdong Province and Northeastern Hainan Island

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091897

Authors: Qian Ge Zuo George Xue Fengyou Chu

Surface sediments collected from the continental shelf off the western Guangdong Province and northeastern Hainan Island are analyzed for selected heavy metals contents including Cd, Cr, Cu, Pb, Zn, and As to determine spatial distribution, potential ecological risks, and sources. In addition, some of the controlling factors of heavy metals distribution are also discussed. The average heavy metals contents decrease in the order of Zn > Cr > Pb > Cu > As > Cd. The averaged pollution degree, as shown by the index of geo-accumulation (Igeo), decreases in the order of Zn > Cu > Pb > Cr > Cd > As. Due to the barrier of islands, the Igeo values of Zn, Pb, Cr, Cu, and Cd near the Hailing and Xiachuan Islands are larger than those in other areas. Meanwhile, the Igeo value of As near the coastal area off the estuary of Wanquan River is clearly larger than that in other areas. Based on the results of potential ecological risk index, Cd, Cu, and As should be paid more attention for the contamination risk in future. The results of Pearson correlation analysis and principal component analysis indicate that Zn, Cr, Pb, Cu, and Cd are mainly from the Pearl River and surrounding small rivers, whereas As originates from the Hainan Island. The grain size is one of the main controlling factors for heavy metals distribution, and the anthropogenic activity also plays an important role.

https://ift.tt/2NHAdtW

IJERPH, Vol. 15, Pages 1894: The Combined Process of Paper Filtration and Ultrafiltration for the Pretreatment of the Biogas Slurry from Swine Manure

IJERPH, Vol. 15, Pages 1894: The Combined Process of Paper Filtration and Ultrafiltration for the Pretreatment of the Biogas Slurry from Swine Manure

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091894

Authors: Yuanhang Zhan Hongmin Dong Fubin Yin Caide Yue

The membrane process had been applied for the advanced treatment of pig farm biogas slurry. As studied, this physical pretreatment, with low cost and high efficiency of the suspended solids removal and nutrient retention, is required to control membrane fouling. The combined process of paper filtration and ultrafiltration in a pilot scale was applied in the present study. The main objective was to explore and identify the feasibility of the new process for the pretreatment of the separation liquid of pig farm biogas slurry. A precision identification experiment of paper filtration and the multi-batch repetitive experiments of the combined process were designed. The results showed, at the identified paper filtration precision of 50μm and an operating pressure of 0.3 bar of the ultrafiltration process, that the flux rate at the stable stage of the multi-batch operation was around 295.00 L/h. The combined process achieved an overall processing rate of 345.41 ± 18.81 L/h and a volume permeation proportion of 82.45% ± 0.85%. The TSS was removed by 95.71%, but total nitrogen (TN) and ammonia nitrogen (NH3-N) were retained by 76.29% ± 2.04% and 73.74% ± 2.10%, respectively. Comprehensively, the requirement for the pretreatment was obtained.

https://ift.tt/2C4g7c8

IJERPH, Vol. 15, Pages 1892: Spatial Patterns of Urban Wastewater Discharge and Treatment Plants Efficiency in China

IJERPH, Vol. 15, Pages 1892: Spatial Patterns of Urban Wastewater Discharge and Treatment Plants Efficiency in China

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091892

Authors: Min An Weijun He Dagmawi Mulugeta Degefu Zaiyi Liao Zhaofang Zhang Liang Yuan

With the rapid economic development, water pollution has become a major concern in China. Understanding the spatial variation of urban wastewater discharge and measuring the efficiency of wastewater treatment plants are prerequisites for rationally designing schemes and infrastructures to control water pollution. Based on the input and output urban wastewater treatment data of the 31 provinces of mainland China for the period 2011–2015, the spatial variation of urban water pollution and the efficiency of wastewater treatment plants were measured and mapped. The exploratory spatial data analysis (ESDA) model and super-efficiency data envelopment analysis (DEA) combined Malmquist index were used to achieve this goal. The following insight was obtained from the results. (1) The intensity of urban wastewater discharge increased, and the urban wastewater discharge showed a spatial agglomeration trend for the period 2011 to 2015. (2) The average inefficiency of wastewater treatment plants (WWTPs) for the study period was 39.2%. The plants’ efficiencies worsened from the eastern to western parts of the country. (3) The main reasons for the low efficiency were the lack of technological upgrade and scale-up. The technological upgrade rate was −4.8%, while the scale efficiency increases as a result of scaling up was −0.2%. Therefore, to improve the wastewater treatment efficiency of the country, the provinces should work together to increase capital investment and technological advancement.

https://ift.tt/2PRyP9H

IJERPH, Vol. 15, Pages 1895: Using a Clustering Approach to Investigate Socio-Environmental Inequality in Preterm Birth—A Study Conducted at Fine Spatial Scale in Paris (France)

IJERPH, Vol. 15, Pages 1895: Using a Clustering Approach to Investigate Socio-Environmental Inequality in Preterm Birth—A Study Conducted at Fine Spatial Scale in Paris (France)

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091895

Authors: Severine Deguen Nina Ahlers Morgane Gilles Arlette Danzon Marion Carayol Denis Zmirou-Navier Wahida Kihal-Talantikite

Background & Objectives: Today, to support public policies aiming to tackle environmental and health inequality, identification and monitoring of the spatial pattern of adverse birth outcomes are crucial. Spatial identification of the more vulnerable population to air pollution may orient health interventions. In this context, the objective of this study is to investigate the geographical distribution of the risk of preterm birth (PTB, gestational age ≤36 weeks) at the census block level in in city of Paris, France. We also aimed to assess the implication of neighborhood characteristics including air pollution and socio-economic deprivation. Material & Methods: Newborn health data are available from the first birth certificate registered by the Maternal and Child Care department of Paris. All PTB from January 2008 to December 2011 were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level and annual average ambient concentrations of NO2. A spatial clustering approach was used to investigate the spatial distribution of PTB. Results: Our results highlight that PTB is non-randomly spatially distributed, with a cluster of high risk in the northeastern area of Paris (RR = 1.15; p = 0.06). After adjustment for socio-economic deprivation and NO2 concentrations, this cluster becomes not statistically significant or shifts suggesting that these characteristics explain the spatial distribution of PTB; further, their combination shows an interaction in comparison with SES or NO2 levels alone. Conclusions: Our results may inform the decision makers about the areas where public health efforts should be strengthened to tackle the risk of PTB and to choose the most appropriate and specific community-oriented health interventions.

https://ift.tt/2NAQ2CS

IJERPH, Vol. 15, Pages 1893: Rapid Population Growth throughout Asia’s Earthquake-Prone Areas: A Multiscale Analysis

IJERPH, Vol. 15, Pages 1893: Rapid Population Growth throughout Asia’s Earthquake-Prone Areas: A Multiscale Analysis

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091893

Authors: Yinyin Dou Qingxu Huang Chunyang He Shiting Meng Qiang Zhang

Assessing the changes of the population living throughout the most seismically hazardous area (MSHA) constitutes an important foundation for seismic risk assessment. However, the changes of the population living in the MSHA of Asia, which exhibits the highest number of earthquake related fatalities, were poorly understood. Therefore, this study analyzed the changes of the population in the MSHA between 2000 and 2015 at the continental, subcontinental, and national scales. We found that the population, especially the vulnerable population (i.e., children under or equal to the age of 14 and elderly people over or equal to the age of 65), in Asia’s MSHA increased rapidly between 2000 and 2015. The population in the MSHA increased by 185.88 million with a growth rate of 20.93%, which was 3.38% greater than that in the non-MSHA region. Meanwhile, the vulnerable population in the MSHA increased by 63.65 million with a growth rate of 19.73%. The increase of the vulnerable population in the MSHA was 19.93% greater than that in the non-MSHA region. We also found that urban population growth was a major factor impacting the increase in both the population and the vulnerable population throughout Asia’s MSHA. Therefore, attention should be paid to the changes of the population in Asia’s MSHA, whilst it is imperative to execute strict building codes and select the development location more carefully in the MSHA.

https://ift.tt/2MDNU0G

IJERPH, Vol. 15, Pages 1890: Heavy Metal Contamination Near Industrial Estate Areas in Phra Nakhon Si Ayutthaya Province, Thailand and Human Health Risk Assessment

IJERPH, Vol. 15, Pages 1890: Heavy Metal Contamination Near Industrial Estate Areas in Phra Nakhon Si Ayutthaya Province, Thailand and Human Health Risk Assessment

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091890

Authors: Rachaneekorn Mingkhwan Suwalee Worakhunpiset

Industrial activity is one of the significant sources of environmental contamination with heavy metals, especially in developing countries. Flood can also lead to the distribution of toxic substances into the environment, regarding the Thailand flood in 2011 as some industrial estates are affected, leading to concern about heavy metals from industrial wastewater contamination. We aimed to measure the levels of Cd, Cr, Cu, Ni, Mn, Pb, and Zn in river and stream water, sediment, and fish collected from the area around the industrial estates in Uthai District and Bangpa-in District of Phra Nakhon Si Ayutthaya Province, following the floods of 2011. The results revealed that heavy metal levels in water did not exceed Thailand surface water quality standards, except for Mn levels at one sampling site. Metal levels in sediment and fish samples also did not exceed published standards. The hazard quotient for fish consumption was highest for Ni (0.2178) in Trichopodus trichopterus collected from the area near the industrial estate in Bangpa-in District, while the hazard index from Cd, Cr, and Cu exposure were 0.86966, which was lower than 1, indicating that the health risks for these seven metals were within acceptable ranges.

https://ift.tt/2wwbKRV

IJERPH, Vol. 15, Pages 1891: Evaluation of Hand–Dug Wells in Rural Haiti

IJERPH, Vol. 15, Pages 1891: Evaluation of Hand–Dug Wells in Rural Haiti

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091891

Authors: Hayley E. Schram Peter J. Wampler

Water resources, especially safe, potable water, are limited for many Haitians. In areas where shallow groundwater is available, many household water needs such as laundry, bathing, and cooking are supplied by hand–dug wells. In order to better understand the water quality and prevalence of these household wells, 35 hand–dug wells were surveyed and sampled near the Hôpital Albert Schweitzer in Deschapelles, Haiti. Water samples were collected and tested for fecal coliform and Escherichia coli using the IDEXX Colilert–18 method. Of the samples collected, 89 percent were determined unsafe to use as a drinking water source based on the World Health Organization standard of 1.0 colony–forming unit (cfu) E. coli per 100 mL. Sixty–six percent of the wells exceeded recreational/body contact standards for the state of Michigan (130 cfu/100 mL). Some of these wells were deemed suitable for conversion to a new well type called in situ filtration (ISF) wells. In situ filtration wells are installed with an internal sand filter pack, PVC casing, pump, and cap which seals the well from surface contamination and provides additional water treatment as water is pumped. Previous ISF installations have reduced E. coli to safe drinking water levels within 90 days.

https://ift.tt/2NzpNfX

IJERPH, Vol. 15, Pages 1888: Analysis of Green Public Procurement of Works by Spanish Public Universities

IJERPH, Vol. 15, Pages 1888: Analysis of Green Public Procurement of Works by Spanish Public Universities

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091888

Authors: Jose Luis Fuentes-Bargues Pablo Sebastian Ferrer-Gisbert Mª. Carmen González-Cruz

Universities play an important role among public institutions because they initiate huge purchasing and contracting activities and contribute to sustainable development through education, research, and day-to-day operations. Existing studies on green public procurement (GPP) practices at Spanish universities focus on products and services. For this study, a total of 316 procedures were collected and analysed from the calls for tenders made by Spanish public universities between 2016 and 2017. The environmental criteria involved in the tenders and their weights were classified by subsector, geographical scope, and project budget. The results of this study show the use of environmental criteria in the works tendered by Spanish public universities is low (19.2%) in comparison with the results of other studies. It is therefore necessary to encourage GPP practices in the contracting process to comply with the environmental policies that universities have defined as part of their institutional policies.

https://ift.tt/2ND9A9x

IJERPH, Vol. 15, Pages 1889: Atrazine Contamination of Drinking Water and Adverse Birth Outcomes in Community Water Systems with Elevated Atrazine in Ohio, 2006–2008

IJERPH, Vol. 15, Pages 1889: Atrazine Contamination of Drinking Water and Adverse Birth Outcomes in Community Water Systems with Elevated Atrazine in Ohio, 2006–2008

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091889

Authors: Kirsten S. Almberg Mary E. Turyk Rachael M. Jones Kristin Rankin Sally Freels Leslie T. Stayner

Atrazine, a common water contaminant in the U.S., has been associated with adverse birth outcomes in previous studies. This study aimed to determine if atrazine concentrations in drinking water are associated with adverse birth outcomes including small for gestational age (SGA), term low birth weight (term LBW), very low birth weight (VLBW), preterm birth (PTB), and very preterm birth (VPTB). This study included 14,445 live singleton births from Ohio communities served by 22 water systems enrolled in the U.S. Environmental Protection Agency’s Atrazine Monitoring Program between 2006 and 2008. Mean gestational and trimester-specific atrazine concentrations were calculated. Significantly increased odds of term LBW birth was associated with atrazine exposure over the entire gestational period (OR 1.27, 95% CI 1.10, 1.45), as well as the first (OR 1.20, 95% CI 1.08, 1.34) and second trimesters (OR 1.13, 95% CI 1.07, 1.20) of pregnancy. We observed no evidence of an association between atrazine exposure via drinking water and SGA, VLBW, PTB, or VPTB. Our results suggest that atrazine exposure is associated with reduced birth weight among term infants and that exposure to atrazine in drinking water in early and mid-pregnancy may be most critical for its toxic effects on the fetus.

https://ift.tt/2PSOyVW

IJERPH, Vol. 15, Pages 1887: Annoyance in Response to Vibrations from Railways

IJERPH, Vol. 15, Pages 1887: Annoyance in Response to Vibrations from Railways

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091887

Authors: Laura Maclachlan Mikael Ögren Elise van Kempen Laith Hussain-Alkhateeb Kerstin Persson Waye

Rail transport is a key stepping stone in the EU’s transport policy and is pinpointed for investment and growth over the coming decades. This expanding infrastructure implies increased exposure to environmental stressors, such as noise and ground-borne vibrations. Little is known about the health impacts of exposure to these vibrations. The aim of this paper is to examine the association between annoyance from rail vibrations and the distance of residential dwelling from the railway. It reports the first results of a large epidemiological study, EpiVib, which was designed to investigate the long-term health effects of exposure to rail vibrations. The first part of this study examines a self-reported questionnaire. In total, 6894 individuals aged between 18 and 80 living within 1 km of a railway in west Sweden participated. Results presented here examine the association between distance to the railway and annoyance from vibrations and are stratified by train type. A positive association between closer distance and increased annoyance is seen. After adjustment for important modifiers, results showed that vibrations from freight trains and maintenance operations are reported to be moderately and highly annoying at distances of up to 400 m from the railway and diesel up to 300 m. Vibration from passenger and fast trains are significantly annoying up to 200 m from the track. Vibration from freight trains and maintenance operations were considered highly annoying up to 300 m from the track, diesel up to 400 m. Vibration from passenger and fast trains are not reported to be highly annoying after adjustment. Heavier, slower moving locomotives, in the form of diesel and freight trains, appear to be the source of annoyance at distances further from the railway compared to passenger and fast trains. This has implications in terms of property, transport, and infrastructure planning.

https://ift.tt/2NvTTky

Changes in working life expectancy with disability in the Netherlands, 1992–2016

Objectives Like other western countries, the Netherlands has abolished early retirement schemes and is currently increasing the statutory retirement age. It is likely that also older workers with disabilities will be required to work longer. We examine the change in working life expectancy (WLE) with disability of older workers by comparing data from three periods: 1992–1996, 2002–2006 and 2012–2016. Methods Data are from the Longitudinal Aging Study Amsterdam (LASA). Respondents aged 55–65 with a paid job at baseline were included (N=1074). Disability was measured using the Global Activity Limitations Indicator (GALI). First, a continuous-time three-state survival model was created. Second, WLE with and without disability were estimated using MSM and ELECT in R. The modifying effects of gender and educational level were examined. Results Among those initially in paid employment, total WLE increased over 20 years. For example at age 58, total WLE increased from 3.7 to 5.5 years. WLE with disability at age 58 increased from 0.8 to 1.5 years. There was no difference in WLE with disability between male and female workers or low- and highly educated workers. Conclusions Between the 1990s and the 2010s, subsequent generations of older workers with disabilities have extended their working lives. The findings emphasize the importance of workplace interventions that facilitate older workers with disabilities to maintain well-being and work ability. In addition, the question arises whether current exit routes out of the workforce are still adequate. by van der Noordt M, van der Pas S, van Tilburg TG, van den Hout A, Deeg DJH. doi:10.5271/sjweh.3757

https://ift.tt/2C5BWrY

IJERPH, Vol. 15, Pages 1886: About One in Five Novice Vapers Buying Their First E-Cigarette in a Vape Shop Are Smoking Abstinent after Six Months

IJERPH, Vol. 15, Pages 1886: About One in Five Novice Vapers Buying Their First E-Cigarette in a Vape Shop Are Smoking Abstinent after Six Months

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091886

Authors: Karolien Adriaens Dinska Van Gucht Frank Baeyens

Background: E-cigarette use is rising with the majority of vapers purchasing their e-cigarettes in vape shops. We investigated the smoking/vaping trajectories and quit-smoking success rates of smokers deciding to start vaping for the first time and buying their e-cigarette in brick-and-mortar vape shops in Flanders. Methods: Participants filled out questionnaires assessing smoking/vaping behaviour at three moments (intake, after three and six months) and smoking status was biochemically verified using eCO measurements. Results: Participants (n = 71) were regular smokers (MeCO-intake = 22 ppm), half of whom reported a motivation to quit smoking in the near future. Participants bought 3rd/4th generation e-cigarettes and e-liquid with a nicotine concentration averaging 7 mg/mL. A smoking reduction of 53% (17 cigarettes per day (CPD) at intake to 8 CPD after six months) was observed, whereas eCO decreased to 15 ppm. Eighteen percent of participants had quit smoking completely (eCO = 2 ppm), another 25% had at least halved CPD, whereas 57% had failed to reduce CPD by at least 50% (including 13% lost to follow-up). Quitters consumed more e-liquid than reducers and those who continued to smoke. Conclusions: Around one in five smoking customers buying their first e-cigarette in a brick-and-mortar vape shop had quit smoking completely after six months.

https://ift.tt/2PjOcqv

The prevalence of exposure to high molecular weight asthmagens derived from plants among workers in Australia

American Journal of Industrial Medicine, EarlyView.


https://ift.tt/2wsD9Eo

IJERPH, Vol. 15, Pages 1885: Factors Associated with Substance Use and Sexual Behavior among Drug Users in Three Mountainous Provinces of Vietnam

IJERPH, Vol. 15, Pages 1885: Factors Associated with Substance Use and Sexual Behavior among Drug Users in Three Mountainous Provinces of Vietnam

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091885

Authors: Bach Xuan Tran Hue Thi Mai Mercedes Fleming Ha Ngoc Do Tam Minh Thi Nguyen Quan Hoang Vuong Manh Tung Ho Nhue Van Dam Thu Trang Vuong Giang Hai Ha Nu Thi Truong Carl A. Latkin Cyrus S. H. Ho Roger C. M. Ho

Due to their geographical characteristics, the mountainous areas of Vietnam are particularly vulnerable to illicit drug use. Drug users in remote areas are also more likely to engage in risky sexual behaviors. This study aimed to describe the prevalence and characteristics of substance use and sexual behaviors and explored their related factors among newly admitted drug users in three mountainous provinces of Vietnam. A cross-sectional study was conducted on 300 newly-admitted drug users registering for Methadone Maintenance Treatment (MMT) at 6 clinics in three provinces: Dien Bien, Lai Chau and Yen Bai from October 2014 to December 2015. Information about the socio-demographic characteristics, history of substance use, and sexual behaviors were collected. The multivariate logistic regression model was used to identify potential predictors of four outcomes, which included: drug injection, re-use of needles, using condoms during the last time of having sex, and having sexual intercourse with female sex workers. The proportion of injecting drug users was 68.3%; of those 9% never re-used needles. Of note, 69% of those who reported having sex with female sex workers in the last month did not use condoms. Regression models showed that those who injected drugs and had health problems in last 30 days had greater odds of having sex with female sex workers. Drug users in mountainous settings acknowledged the high prevalence of human immunodeficiency virus (HIV)-related risk behaviors and a demand for physical and psychological care. Scaling up MMT services is key to approaching this high-risk group; however, at the same time, comprehensive harm-reduction interventions, counseling, and health care services should also be made accessible and effective in this setting.

https://ift.tt/2or03aA

IJERPH, Vol. 15, Pages 1884: Impacts of Climate Change on Health and Wellbeing in South Africa

IJERPH, Vol. 15, Pages 1884: Impacts of Climate Change on Health and Wellbeing in South Africa

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091884

Authors: Matthew F. Chersich Caradee Y. Wright Francois Venter Helen Rees Fiona Scorgie Barend Erasmus

Given its associated burden of disease, climate change in South Africa could be reframed as predominately a health issue, one necessitating an urgent health-sector response. The growing impact of climate change has major implications for South Africa, especially for the numerous vulnerable groups in the country. We systematically reviewed the literature by searching PubMed and Web of Science. Of the 820 papers screened, 34 were identified that assessed the impacts of climate change on health in the country. Most papers covered effects of heat on health or on infectious diseases (20/34; 59%). We found that extreme weather events are the most noticeable effects to date, especially droughts in the Western Cape, but rises in vector-borne diseases are gaining prominence. Climate aberration is also linked in myriad ways with outbreaks of food and waterborne diseases, and possibly with the recent Listeria epidemic. The potential impacts of climate change on mental health may compound the multiple social stressors that already beset the populace. Climate change heightens the pre-existing vulnerabilities of women, fishing communities, rural subsistence farmers and those living in informal settlements. Further gender disparities, eco-migration and social disruptions may undermine the prevention—but also treatment—of HIV. Our findings suggest that focused research and effective use of surveillance data are required to monitor climate change’s impacts; traditional strengths of the country’s health sector. The health sector, hitherto a fringe player, should assume a greater leadership role in promoting policies that protect the public’s health, address inequities and advance the country’s commitments to climate change accords.

https://ift.tt/2NCoBZd

IJERPH, Vol. 15, Pages 1879: A Systematic Review of Access to General Healthcare Services for People with Disabilities in Low and Middle Income Countries

IJERPH, Vol. 15, Pages 1879: A Systematic Review of Access to General Healthcare Services for People with Disabilities in Low and Middle Income Countries

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091879

Authors: Tess Bright Hannah Kuper

Background: A systematic review was undertaken to explore access to general healthcare services for people with disabilities in low and middle-income countries (LMICs). Methods: Six electronic databases were searched in February 2017. Studies comparing access to general healthcare services by people with disabilities to those without disabilities from LMICs were included. Eligible measures of healthcare access included: utilisation, coverage, adherence, expenditure, and quality. Studies measuring disability using self-reported or clinical assessments were eligible. Title, abstract and full-text screening and data extraction was undertaken by the two authors. Results: Searches returned 13,048 studies, of which 50 studies were eligible. Studies were predominantly conducted in sub-Saharan Africa (30%), Latin America (24%), and East Asia/Pacific (12%). 74% of studies used cross-sectional designs and the remaining used case-control designs. There was evidence that utilisation of healthcare services was higher for people with disabilities, and healthcare expenditure was higher. There was less consistent differences between people with and without disabilities in other access measures. However, the wide variation in type and measurement of disability, and access outcomes, made comparisons across studies difficult. Conclusions: Developing common metrics for measuring disability and healthcare access will improve the availability of high quality, comparable data, so that healthcare access for people with disabilities can be monitored and improved.

https://ift.tt/2Nz00EM

IJERPH, Vol. 15, Pages 1882: Water Quality of Inflows to the Everglades National Park over Three Decades (1985–2014) Analyzed by Multivariate Statistical Methods

IJERPH, Vol. 15, Pages 1882: Water Quality of Inflows to the Everglades National Park over Three Decades (1985–2014) Analyzed by Multivariate Statistical Methods

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091882

Authors: Lei Wan Xiaohui Fan

The Everglades, a vast subtropical wetland, dominates the landscape of south Florida and is widely recognized as an ecosystem of great ecological importance. Data from seven inflow sites to the Everglades National Park (ENP) were analyzed over three decades (1985–2014) for temporal trends by the STL (integrated seasonal-trend decomposition using LOESS) method. A cluster analysis (CA) and principal component analysis (PCA) were applied for the evaluation of spatial variation. The results indicate that the water quality change trend is closely associated with rainfall. Increasing rainfall results in increasing flow and thus, decreasing concentrations of nitrogen and phosphorus. Based on 10 variables, the seven sampling stations were classified by CA into four distinct clusters: A, B, C, and D. The PCA analysis indicated that total nitrogen (TN) and total phosphorus (TP) are the main pollution factors, especially TN. The results suggest that non-point sources are the main pollution sources and best management practices (BMPs) effectively reduce organic nitrogen. However, TN and TP control is still the focus of future work in this area. Increasing the transfer water quantity can improve the water quality temporarily and planting submersed macrophytes can absorb nitrogen and phosphorus and increase the dissolved oxygen (DO) concentration in water, continuously improving the water quality.

https://ift.tt/2N5waus

IJERPH, Vol. 15, Pages 1881: Hyperspectral Data and Machine Learning for Estimating CDOM, Chlorophyll a, Diatoms, Green Algae and Turbidity

IJERPH, Vol. 15, Pages 1881: Hyperspectral Data and Machine Learning for Estimating CDOM, Chlorophyll a, Diatoms, Green Algae and Turbidity

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091881

Authors: Sina Keller Philipp M. Maier Felix M. Riese Stefan Norra Andreas Holbach Nicolas Börsig Andre Wilhelms Christian Moldaenke André Zaake Stefan Hinz

Inland waters are of great importance for scientists as well as authorities since they are essential ecosystems and well known for their biodiversity. When monitoring their respective water quality, in situ measurements of water quality parameters are spatially limited, costly and time-consuming. In this paper, we propose a combination of hyperspectral data and machine learning methods to estimate and therefore to monitor different parameters for water quality. In contrast to commonly-applied techniques such as band ratios, this approach is data-driven and does not rely on any domain knowledge. We focus on CDOM, chlorophyll a and turbidity as well as the concentrations of the two algae types, diatoms and green algae. In order to investigate the potential of our proposal, we rely on measured data, which we sampled with three different sensors on the river Elbe in Germany from 24 June–12 July 2017. The measurement setup with two probe sensors and a hyperspectral sensor is described in detail. To estimate the five mentioned variables, we present an appropriate regression framework involving ten machine learning models and two preprocessing methods. This allows the regression performance of each model and variable to be evaluated. The best performing model for each variable results in a coefficient of determination R 2 in the range of 89.9% to 94.6%. That clearly reveals the potential of the machine learning approaches with hyperspectral data. In further investigations, we focus on the generalization of the regression framework to prepare its application to different types of inland waters.

https://ift.tt/2LGk7Pr

IJERPH, Vol. 15, Pages 1880: Reproductive Function in a Population of Young Faroese Men with Elevated Exposure to Polychlorinated Biphenyls (PCBs) and Perfluorinated Alkylate Substances (PFAS)

IJERPH, Vol. 15, Pages 1880: Reproductive Function in a Population of Young Faroese Men with Elevated Exposure to Polychlorinated Biphenyls (PCBs) and Perfluorinated Alkylate Substances (PFAS)

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091880

Authors: Maria Skaalum Petersen Jónrit Halling Niels Jørgensen Flemming Nielsen Philippe Grandjean Tina Kold Jensen Pál Weihe

Semen quality may be adversely affected by exposure to environmental chemicals such as polychlorinated biphenyls (PCBs) and perfluorinated alkylate substances (PFASs) that are persistent and may act as endocrine disrupting compounds. The aim of this study was to explore whether PCBs or PFASs exposure were associated with abnormalities in semen quality or reproductive hormones in Faroese men. This population based cross-sectional study includes 263 Faroese men (24–26 years) who delivered a semen sample for assessment of sperm concentration, total sperm count, semen volume, morphology and motility. A blood sample was drawn and analyzed for reproductive hormones, PCBs and PFASs. Exposure to ∑PCBs and perfluorooctane sulfonate (PFOS) was positively associated with sex hormone-binding globulin (SHBG) and luteinizing hormone (LH). In addition, total testosterone (T) was positively associated with ∑PCB. Both PCBs and PFOS appear to lead to increased SHBG, perhaps mediated via the liver. The higher total T associated with PCB may represent a compensatory adaption to elevated SHBG levels to maintain an unchanged free testosterone concentration. The positive association to LH for both PCBs and PFOS may indicate a direct adverse effect on the testosterone producing Leydig cells.

https://ift.tt/2N415aB

IJERPH, Vol. 15, Pages 1883: Mitigation Policy Acceptance Model: An Analysis of Individual Decision Making Process toward Residential Seismic Strengthening

IJERPH, Vol. 15, Pages 1883: Mitigation Policy Acceptance Model: An Analysis of Individual Decision Making Process toward Residential Seismic Strengthening

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091883

Authors: Cheng Tsou

Mitigation policy is regarded as an effective strategy to achieve the purpose of building health resilience and reducing disaster risk with the current high frequency of environmental event occurrences. To enhance public acceptance of mitigation policy, the issue of decision-making behavior has been a concern of researchers and planners. In the past literature, qualitative measures employed to reveal the behavioral intention of hazard risk mitigation cause restricted outcomes due to the problem of sample representativeness and the fact that quantitative research is restricted to discuss the linear relationship between the two selected variables. The purpose of this article is to attempt to construct a Mitigation Policy Acceptance Model (MPAM) to analyze the behavioral intention of seismic risk mitigation strategies. Based on Dual Processing Theory, affective is conducted as the core variable for constructing two types of thinking processes, and the variables of risk perception, trust and responsibility are selected in MPAM from theories and past research. In this study, the mitigation policy of residential seismic strengthening, adapted in Yongkang District of Tainan, has been conducted as the case study. According to the results, the result of model fit test has confirmed the MPAM framework, and two thinking modes could be associated together when people face a risky decision-making process. The variable of affective is the most effective factor to influence each variable, and a direct effect on intention is also shown in this model. The results could provide suggestions in communication risk strategies for the government.

https://ift.tt/2LA2RLX

Nonsubsampled contourlet domain visible and infrared image fusion framework for fire detection using pulse coupled neural network and spatial fuzzy clustering

Publication date: Available online 29 August 2018

Source: Fire Safety Journal

Author(s): Siva Mouni Nemalidinne, Deep Gupta

Abstract

The rapidly spreading forest fire is always uncontrollable and unpredictable and also has a disastrous effect on the environment as well as human individuals. This is also able to wipe out large acres of forest as well as the agricultural lands. Therefore, in this paper, a fire detection approach is presented in the nonsubsampled contourlet (NSCT) domain by extracting the fused fire regions of visible and infrared (IR) images using spatial fuzzy C-means clustering (SpFCM). Firstly, the NSCT is applied to decompose the source visible and IR images into one low and several high-frequency components. Low-frequency NSCT component is fused using a pulse coupled neural network (PCNN) motivated by the sum-modified Laplacian to retain the maximum information available in both the source images. Local log Gabor energy based fusion rule is employed to fuse the high-frequency NSCT components that are able to preserve the maximum detail information. Later, the fused image is reconstructed by applying the inverse NSCT. Finally, all the fire pixels are identified in the fused images and segmented using the fuzzy clustering approach having spatial information also. Furthermore, several experiments are conducted to evaluate the fire detection ability of the proposed framework in terms of visual appearance as well as several performance evaluation parameters. Experimental results show the superiority of the proposed approach over the other existing fusion approaches by improving all the performance parameters.

https://ift.tt/2PiOFZM

IJERPH, Vol. 15, Pages 1878: Evaluating the Impact of the Dementia Care in Hospitals Program (DCHP) on Hospital-Acquired Complications: Study Protocol

IJERPH, Vol. 15, Pages 1878: Evaluating the Impact of the Dementia Care in Hospitals Program (DCHP) on Hospital-Acquired Complications: Study Protocol

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091878

Authors: Mark Yates Jennifer J. Watts Kasia Bail Mohammadreza Mohebbi Sean MacDermott Jessica C. Jebramek Henry Brodaty

Despite the increasing number of older people, many with cognitive impairment (CI), in hospitals, there is yet to be an evaluation of hospital-wide interventions improving the management of those with CI. In hospitalized patients with CI, there are likely to be associations between increased complications that impact on outcomes, length of stay, and costs. This prospective study will evaluate the effectiveness of an established hospital CI support program on patient outcomes, patient quality of life, staff awareness of CI, and carer satisfaction. Using a stepped-wedge, continuous-recruitment method, the pre-intervention patient data will provide the control data for usual hospital care. The intervention, the Dementia Care in Hospitals Program, provides hospital-wide CI awareness and support education, and screening for all patients aged 65+, along with a bedside alert, the Cognitive Impairment Identifier. The primary outcome is a reduction in hospital-acquired complications: urinary tract infections, pressure injuries, pneumonia and delirium. Secondary outcome measures include cost effectiveness, patient quality of life, carer satisfaction, staff awareness of CI, and staff perceived impact of care. This large-sample study across four sites offers an opportunity for research evaluation of health service functioning at a whole-of-hospital level, which is important for sustainable change in hospital practice.

https://ift.tt/2PNT3Bg

IJERPH, Vol. 15, Pages 1876: The Potential Implications of Autonomous Vehicles in and around the Workplace

IJERPH, Vol. 15, Pages 1876: The Potential Implications of Autonomous Vehicles in and around the Workplace

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091876

Authors: Simone Pettigrew Lin Fritschi Richard Norman

The advent of autonomous vehicles is forecast to bring enormous changes to the workplace as positions primarily involving driving become progressively redundant. Little is known about public awareness of these impending changes and the potential impacts on society and individuals. This study involved a national survey of Australians and interviews with key stakeholders across multiple countries to identify major potential issues associated with vehicle automation, including in and around the workplace. Most survey respondents had concerns relating to job losses in driving occupations, while almost half anticipated increased employment in technology-related areas. Three primary themes were evident in the data from the stakeholder interviews: (1) the inevitability of the universal use of AVs and hence the immediate need for labour market planning, (2) associated potential effects on occupations that are not primarily structured around driving, and (3) the possibility of increased worker safety and enhanced commuting opportunities.

https://ift.tt/2Nww9Nh

IJERPH, Vol. 15, Pages 1875: Which School Community Agents Influence Adolescents’ Motivational Outcomes and Physical Activity? Are More Autonomy-Supportive Relationships Necessarily Better?

IJERPH, Vol. 15, Pages 1875: Which School Community Agents Influence Adolescents’ Motivational Outcomes and Physical Activity? Are More Autonomy-Supportive Relationships Necessarily Better?

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091875

Authors: Javier Sevil Luis García-González Ángel Abós Eduardo Generelo Lanaspa Alberto Aibar Solana

The first aim of this work was to examine the independent influence of students’ perceived autonomy support for leisure-time physical activity (LTPA), from different school community agents, on motivational outcomes in a LTPA context and objective PA levels. Using both a variable- and person-centered approach, the second aim was to examine how different combinations of autonomy-support were associated with students’ motivational outcomes in a LTPA context and PA levels. A sample of 178 secondary students (M = 13.26 ± 0.64) participated in the study. Autonomy support for LTPA from the PE teacher, mother, father, and peers were the only agents that significantly and positively predicted motivational outcomes in a LTPA context and PA levels. While the two- and three-way interactions of some of these four significant sources significantly increased the explained variance of some motivational outcomes, the plots revealed that the lowest values of motivational outcomes were associated with low values of perceived autonomy support. A cluster analysis revealed five profiles. The “high autonomy support” group reported the most optimal outcomes, whereas the “low autonomy support” group showed the opposite pattern. However, mixed autonomy support profiles did not differ in any of the outcomes. The adoption of a whole-of-school approach seems decisive to empower adolescents to be active in and out of school.

https://ift.tt/2wrhXyr

IJERPH, Vol. 15, Pages 1877: Mining Facebook Data of People with Rare Diseases: A Content-Based and Temporal Analysis

IJERPH, Vol. 15, Pages 1877: Mining Facebook Data of People with Rare Diseases: A Content-Based and Temporal Analysis

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091877

Authors: Laia Subirats Natalia Reguera Antonio Miguel Bañón Beni Gómez-Zúñiga Julià Minguillón Manuel Armayones

This research characterized how Facebook deals with rare diseases. This characterization included a content-based and temporal analysis, and its purpose was to help users interested in rare diseases to maximize the engagement of their posts and to help rare diseases organizations to align their priorities with the interests expressed in social networks. This research used Netvizz to download Facebook data, word clouds in R for text mining, a log-likelihood measure in R to compare texts and TextBlob Python library for sentiment analysis. The Facebook analysis shows that posts with photos and positive comments have the highest engagement. We also observed that words related to diseases, attention, disability and services have a lot of presence in the decalogue of priorities (which serves for all associations to work on the same objectives and provides the lines of action to be followed by political decision makers) and little on Facebook, and words of gratitude are more present on Facebook than in the decalogue. Finally, the temporal analysis shows that there is a high variation between the polarity average and the hour of the day.

https://ift.tt/2NAx3Zj

IJERPH, Vol. 15, Pages 1874: Healthy Indoor Environments: The Need for a Holistic Approach

IJERPH, Vol. 15, Pages 1874: Healthy Indoor Environments: The Need for a Holistic Approach

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091874

Authors: Aneta Wierzbicka Eja Pedersen Roger Persson Birgitta Nordquist Kristian Stålne Chuansi Gao Lars-Erik Harderup Jonas Borell Héctor Caltenco Barry Ness Emilie Stroh Yujing Li Mats Dahlblom Karin Lundgren-Kownacki Christina Isaxon Anders Gudmundsson Pawel Wargocki

Indoor environments have a large impact on health and well-being, so it is important to understand what makes them healthy and sustainable. There is substantial knowledge on individual factors and their effects, though understanding how factors interact and what role occupants play in these interactions (both causative and receptive) is lacking. We aimed to: (i) explore interactions between factors and potential risks if these are not considered from holistic perspective; and (ii) identify components needed to advance research on indoor environments. The paper is based on collaboration between researchers from disciplines covering technical, behavioural, and medical perspectives. Outcomes were identified through literature reviews, discussions and workshops with invited experts and representatives from various stakeholder groups. Four themes emerged and were discussed with an emphasis on occupant health: (a) the bio-psycho-social aspects of health; (b) interaction between occupants, buildings and indoor environment; (c) climate change and its impact on indoor environment quality, thermal comfort and health; and (d) energy efficiency measures and indoor environment. To advance the relevant research, the indoor environment must be considered a dynamic and complex system with multiple interactions. This calls for a transdisciplinary and holistic approach and effective collaboration with various stakeholders.

https://ift.tt/2POZwvK

IJERPH, Vol. 15, Pages 1873: Developments in the Research Base on Reducing Exposure to Second-Hand Smoke

IJERPH, Vol. 15, Pages 1873: Developments in the Research Base on Reducing Exposure to Second-Hand Smoke

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091873

Authors: Olivia Wynne Billie Bonevski

n/a

https://ift.tt/2Pk3j3b

Self‐reported physician‐diagnosed chronic obstructive pulmonary disease and spirometry patterns in Vietnam Era US Army Chemical Corps veterans: A retrospective cohort study

American Journal of Industrial Medicine, EarlyView.


https://ift.tt/2MG4FZe

IJERPH, Vol. 15, Pages 1872: The Impacts of Land Use Patterns on Water Quality in a Trans-Boundary River Basin in Northeast China Based on Eco-Functional Regionalization

IJERPH, Vol. 15, Pages 1872: The Impacts of Land Use Patterns on Water Quality in a Trans-Boundary River Basin in Northeast China Based on Eco-Functional Regionalization

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091872

Authors: Peixuan Cheng Fansheng Meng Yeyao Wang Lingsong Zhang Qi Yang Mingcen Jiang

The relationships between land use patterns and water quality in trans-boundary watersheds remain elusive due to the heterogeneous natural environment. We assess the impact of land use patterns on water quality at different eco-functional regions in the Songhua River basin during two hydrological seasons in 2016. The partial least square regression indicated that agricultural activities associated with most water quality pollutants in the region with a relative higher runoff depth and lower altitude. Intensive grazing had negative impacts on water quality in plain areas with low runoff depth. Forest was related negatively with degraded water quality in mountainous high flow region. Patch density and edge density had major impacts on water quality contaminants especially in mountainous high flow region; Contagion was related with non-point source pollutants in mountainous normal flow region; landscape shape index was an effective indicator for anions in some eco-regions in high flow season; Shannon’s diversity index contributed to degraded water quality in each eco-region, indicating the variation of landscape heterogeneity influenced water quality regardless of natural environment. The results provide a regional based approach of identifying the impact of land use patterns on water quality in order to improve water pollution control and land use management.

https://ift.tt/2PiUoiq

Gender differences in injuries attributed to workplace violence in Ontario 2002-2015

Objectives

The aim of the study is to compare trends in the incidence of injury resulting from workplace violence for men and women at the population level over the period 2002–2015 among working-age adults in Ontario, Canada.

Methods

Administrative records of injury resulting from workplace violence were obtained from two population-based data sources in Ontario: 21 228 lost-time workers’ compensation claims (2002–2015) and 13 245 records of non-scheduled emergency department visits (2004–2014), where the main problem was attributed to a workplace violence event. Denominator counts were estimated from labour force surveys conducted by Statistics Canada, stratified by age and sex. Age-standardised rates were calculated using the direct method.

Results

Over the observation period, workplace violence incidence rates were in the range of 0.2–0.5 per 1000 full-time equivalent workers. Incidence rates of injury due to workplace violence among women increased over the observation period, with an average annual per cent change (APC) of 2.8% (95% CI 1.7% to 3.9%) in compensation claims and 2.7% (95% CI 1.0% to 4.4%) in emergency department visits. In contrast, there was no change in workplace violence injury rates among men in compensation claims (APC: –0.2% (95% CI –1.2% to 0.9%)) or in emergency department visits (APC: –0.5% (95% CI –1.6% to 0.6%)). A pronounced increase in workplace violence injury rates was observed in the education sector with an APC=7.0% (95% CI 5.6% to 8.5%) for women and an APC=4.1% (95% CI 0.9% to 7.4%) for men.

Conclusions

Differences in the risk of injury resulting from workplace violence for women relative to men in Ontario between 2002 and 2015 were verified by two data sources. The relative risk of violence for men and women also differed across industries.

https://ift.tt/2NvaHIu

Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom

Objectives

The presence of asbestos in public buildings is a legacy of past asbestos use in many developed countries. Of particular concern is the amount and current condition in schools and the vulnerability of children to mesothelioma. Our aim was to compare the risk of mesothelioma between those exposed to blue asbestos as children and as adults at Wittenoom.

Methods

Public sources were used to establish the Wittenoom residents’ cohort. Mesothelioma incidence rates per 100 000 person-years at risk were derived for those first exposed to asbestos at Wittenoom as children (<15 years) or adults separately. Proportional hazards survival models examined the slope of the exposure-response relationship between asbestos exposure and incidence of mesothelioma in different sex and age groups.

Results

The mesothelioma rate was lower among those first exposed as children (76.8 per 100 000) than those first exposed as adults (121.3 per 100 000). Adjusting for cumulative exposure to asbestos and sex, those exposed as adults had a greater risk of mesothelioma (adjusted HR 2.5, 95% CI 1.7 to 3.7). The slope of the exposure-response relationship did not differ between those exposed as children and those exposed as adults.

Conclusion

We found no greater susceptibility to mesothelioma among those first exposed to asbestos as children than those first exposed as adults. However, given the long latency of mesothelioma, and the greater years of life yet to be lived by the Wittenoom children, it is likely that there will be more cases of mesothelioma in the future among those first exposed as children.

https://ift.tt/2MWZMu8

IJERPH, Vol. 15, Pages 1871: Changes in Urinary Hydrogen Peroxide and 8-Hydroxy-2′-Deoxyguanosine Levels after a Forest Walk: A Pilot Study

IJERPH, Vol. 15, Pages 1871: Changes in Urinary Hydrogen Peroxide and 8-Hydroxy-2′-Deoxyguanosine Levels after a Forest Walk: A Pilot Study

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091871

Authors: Da-Hong Wang Ai Yamada Masamitsu Miyanaga

Some studies have shown that exposure to forests has positive effects on human health, although the mechanisms underlying the health benefits of a forest environment have not been elucidated yet. The current study was aimed at examining how the levels of urinary hydrogen peroxide (H2O2) and 8-hydroxy-2&rsquo;deoxyguanosine (8-OHdG) change after a forest or urban walk in healthy subjects. Twenty-eight volunteers (19 men and 9 women) participated in the study. The forest walks were carried out in a forest in Okayama Prefecture, Japan, and the urban walks (15 men and 7 women) were carried out in the downtown area of Okayama city, each for two hours. Spot urine samples were collected before the walk, the next day and one week after the forest or urban walk. Compared with pre-forest walk levels, urinary H2O2 (p &lt; 0.1) and 8-OHdG (p &lt; 0.1) concentrations significantly decreased in the participants the day after the forest walk; furthermore, urinary 8-OHdG remained at a low level even at one week after the forest walk (p &lt; 0.05). However, there were no significant changes in the concentrations of these oxidative biomarkers after the urban walk. These findings suggest the possibility that exposure to forests may alleviate oxidative stress in the body.

https://ift.tt/2PMBEsE

IJERPH, Vol. 15, Pages 1870: Relationship between Problematic Internet Use, Sleep Problems, and Oral Health in Korean Adolescents: A National Survey

IJERPH, Vol. 15, Pages 1870: Relationship between Problematic Internet Use, Sleep Problems, and Oral Health in Korean Adolescents: A National Survey

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091870

Authors: Kyung-Yi Do Kang-Sook Lee

We examined the relationship between Problematic Internet Use (PIU), sleep (sleep satisfaction, sleep duration), and experience of oral disease symptoms in Korean adolescents by gender. This cross-sectional study utilized the 6th (2010) Korean Youth Risk Behavior Web-based Survey. Participants comprised 74,980 students from 400 middle schools and 400 high schools nationwide. Among these, 73,238 students from 799 schools (38,391 boys, 34,847 girls, aged 13&ndash;18 years) were included in the analysis (inclusion rate = 97.7%). Multiple logistic regression and analysis of moment structures (AMOS) analyses were performed to identify meaningful relationships between the three factors. The &ldquo;high risk group&rdquo; of problematic internet usage had increased experience of oral disease symptoms (boys: adjusted odds ratio (AOR) = 1.92, 95% confidence interval (CI) = 1.63&ndash;2.28, girls: AOR = 1.98, 95% CI = 1.50&ndash;2.63) compared to the general group. Boys who used the Internet for &ldquo;5&ndash;6 h&rdquo; had a higher risk of oral disease symptoms compared to those who used it for &ldquo;less than 1 h&rdquo; (OR = 1.24, 95% CI = 1.01&ndash;1.53); however, this difference was not significant in Models II and III. For girls, the risk of 5&ndash;6 h of use (Model I: OR = 1.69, 95% CI = 1.40&ndash;2.04) was higher than that of the boys. In addition, the difference was significant in Models II and III for girl students who used the Internet for 5&ndash;6 h. In subgroup analysis, the high-risk group had a higher odds ratio for mild symptoms of bad breath to severe symptoms such as sore and bleeding gums. In addition, in the path analysis, PIU affected sleep and indirectly affected oral health. Direct and indirect causal relationships between the three factors were confirmed. Therefore, it is important to recognize that PIU can have a detrimental effect on mental, physical, and oral health.

https://ift.tt/2PLEX3f

IJERPH, Vol. 15, Pages 1868: Exploring the Influence of Built Environment on Car Ownership and Use with a Spatial Multilevel Model: A Case Study of Changchun, China

IJERPH, Vol. 15, Pages 1868: Exploring the Influence of Built Environment on Car Ownership and Use with a Spatial Multilevel Model: A Case Study of Changchun, China

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091868

Authors: Xiaoquan Wang Chunfu Shao Chaoying Yin Chengxiang Zhuge

Although the impacts of built environment on car ownership and use have been extensively studied, limited evidence has been offered for the role of spatial effects in influencing the interaction between built environment and travel behavior. Ignoring the spatial effects may lead to misunderstanding the role of the built environment and providing inconsistent transportation policies. In response to this, we try to employ a two-step modeling approach to investigate the impacts of built environment on car ownership and use by combining multilevel Bayesian model and conditional autocorrelation (CAR) model to control for spatial autocorrelation. In the two-step model, the predicting car ownership status in the first-step model is used as a mediating variable in the second-step car use model. Taking Changchun as a case study, this paper identifies the presence of spatial effects in influencing the effects of built environment on car ownership and use. Meanwhile, the direct and cascading effects of built environment on car ownership and use are revealed. The results show that the spatial autocorrelation exists in influencing the interaction between built environment and car dependency. The results suggest that it is necessary for urban planners to pay attention to the spatial effects and make targeted policy according to local land use characteristics.

https://ift.tt/2PMGUfK

IJERPH, Vol. 15, Pages 1869: Spatial Clustering of Dengue Fever Incidence and Its Association with Surrounding Greenness

IJERPH, Vol. 15, Pages 1869: Spatial Clustering of Dengue Fever Incidence and Its Association with Surrounding Greenness

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091869

Authors: Chi-Chieh Huang Tuen Yee Tiffany Tam Yinq-Rong Chern Shih-Chun Candice Lung Nai-Tzu Chen Chih-Da Wu

With more than 58,000 cases reported by the country&rsquo;s Centers for Disease Control, the dengue outbreaks from 2014 to 2015 seriously impacted the southern part of Taiwan. This study aims to assess the spatial autocorrelation of the dengue fever (DF) outbreak in southern Taiwan in 2014 and 2015, and to further understand the effects of green space (such as forests, farms, grass, and parks) allocation on DF. In this study, two different greenness indexes were used. The first green metric, the normalized difference vegetation index (NDVI), was provided by the long-term NASA MODIS satellite NDVI database, which quantifies and represents the overall vegetation greenness. The latest 2013 land use survey GIS database completed by the National Land Surveying and Mapping Center was obtained to access another green metric, green land use in Taiwan. We first used Spearman&rsquo;s rho to find out the relationship between DF and green space, and then three spatial autocorrelation methods, including Global Moran&rsquo;s I, high/low clustering, and Hot Spot were employed to assess the spatial autocorrelation of DF outbreak. In considering the impact of social and environmental factors in DF, we used generalized linear mixed models (GLMM) to further clarify the relationship between different types of green land use and dengue cases. Results of spatial autocorrelation analysis showed a high aggregation of dengue epidemic in southern Taiwan, and the metropolitan areas were the main hotspots. Results of correlation analysis and GLMM showed a positive correlation between parks and dengue fever, and the other five green space metrics and land types revealed a negative association with DF. Our findings may be an important asset for improving surveillance and control interventions for dengue.

https://ift.tt/2Nu3NTX

IJERPH, Vol. 15, Pages 1865: Loneliness at Universities: Determinants of Emotional and Social Loneliness among Students

IJERPH, Vol. 15, Pages 1865: Loneliness at Universities: Determinants of Emotional and Social Loneliness among Students

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091865

Authors: Katharina Diehl Charlotte Jansen Kamila Ishchanova Jennifer Hilger-Kolb

The transition from school to university is associated with social, structural, and behavioral changes. These changes may be related to feelings of loneliness, which are in turn related to morbidity. The authors&rsquo; aim was to quantify loneliness among students and to identify its determinants and its relation to transition-related variables (e.g., changes in weight, diet, or physical activity since the transition from high school to university). Coming from across Germany, 689 students participated in the Nutrition and Physical Activity in Adolescence (NuPhA) survey (16&ndash;29 years; 69.5% female). Associations of loneliness with the above-mentioned aspects were analyzed using descriptive statistics and linear regressions. Altogether, 32.4% felt moderately lonely and 3.2%, severely lonely. Emotional loneliness was more common than social loneliness (severe loneliness: 7.7% vs. 3.2%). Both were positively associated with feelings of depression and anxiety. Being married or in a committed relationship seemed to be protective factors for emotional loneliness. Physical inactivity, an immigrant background, and studying social sciences were related to higher social loneliness. Transition-related variables produced mixed results. In conclusion, this study&rsquo;s findings indicated that loneliness seemed to be prevalent in university students. The authors identified important starting points for interventions to prevent loneliness. Such interventions may help reduce the disease burden in the students&rsquo; future professional life.

https://ift.tt/2LErkj4

IJERPH, Vol. 15, Pages 1866: An Explanatory Model for the Relationship between Motivation in Sport, Victimization, and Video Game Use in Schoolchildren

IJERPH, Vol. 15, Pages 1866: An Explanatory Model for the Relationship between Motivation in Sport, Victimization, and Video Game Use in Schoolchildren

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091866

Authors: Manuel Castro-Sánchez Ramón Chacón-Cuberos José Luis Ubago-Jiménez Edson Zafra-Santos Félix Zurita-Ortega

(1) Background: Society is changing amazingly fast, and this is bringing about changes in the way that people spend their free time. In the 21st century, free time is increasingly spent using technological devices such as video games, thus increasing levels of sedentariness. The aim of the present study was to define an explanatory model for the problematic use of video games, physical activity, motivational climate in sports, and victimization in schoolchildren, and to analyze the relationships between these variables according to gender; (2) Methods: A total of 734 schoolchildren, of both sexes, participated in this research study. They were aged from 10 to 12 and lived in the province of Granada (Spain). The main instruments used were the questionnaires PMCSQ-2, PAQ-C, QERV, and SVS. A multigroup structural equation model was used, which had an excellent fit (&chi;2 = 319.472; df = 72; p &lt; 0.001; CFI = 0.962; NFI = 0.952; IFI = 0.962; RMSEA = 0.048); (3) Results: The practice of physical activity was related negatively and indirectly to the problematic use of video games ((r = &minus;0.085, boys); (r = &minus;0.081, girls)), and this in turn was related positively and directly to victimization ((r = 0.094, boys); (r = 0.174, girls)). Additionally, task climate was inversely related to the problematic use of video games for girls (r = &minus;0.133), and ego climate was directly related to the use of these devices only with regard to boys (r = 0.250). (4) Conclusions: It must be noted that schoolchildren&rsquo;s pathological use of video games is closely related to lower levels of physical activity. In addition, those motivational climates in sports that are oriented towards performance exacerbate this pathological behavior, which accentuates the importance of promoting motivational climates that are oriented towards tasks in schoolchildren.

https://ift.tt/2PM98Y8

IJERPH, Vol. 15, Pages 1867: The Role of Psychosocial Stress on a Family-Based Treatment for Adolescents with Problematic Behaviors

IJERPH, Vol. 15, Pages 1867: The Role of Psychosocial Stress on a Family-Based Treatment for Adolescents with Problematic Behaviors

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091867

Authors: Jesús Maya Bárbara Lorence Victoria Hidalgo Lucía Jiménez

The stressful life events experienced by adolescents with problematic behaviors, should be considered for implementing effective interventions. This study aimed to examine the adjustment of adolescents with problematic behaviors, and to assess the effectiveness of a family-based treatment, namely Scene-Based Psychodramatic Family Therapy (SB-PFT), according to different stress profiles. Ten SB-PFT sessions, over 17 trials were implemented. Stressful life events and adolescent adjustment were evaluated at pretest and posttest, for the SB-PFT participants (n = 104 adolescents) and a control group (n = 106). The adolescents were categorized into three profiles depending on the nature of the stressors: family stress profile, individual and family stress profile, and low stress profile. The individual and family stress group showed worse adjustment. Effectiveness analyses revealed improvements in SB-PFT participants&rsquo; emotional intelligence, but not in anger and hostility. Furthermore, adolescents with low and family-related stress profiles showed enhancements in parent attachment. In conclusion, interventions involving adolescents with problematic behaviors must be tailored to the stressful life events experienced. Specific treatments should be used alongside SB-PFT, when adolescents are met with individual-related stress. Nevertheless, SB-PFT seemed to promote emotional intelligence and parent attachment, particularly in adolescents with problematic behaviors that experienced only family stressors.

https://ift.tt/2LzGZQM

IJERPH, Vol. 15, Pages 1864: Selenium, Mercury, and Their Molar Ratio in Sportfish from Drinking Water Reservoirs

IJERPH, Vol. 15, Pages 1864: Selenium, Mercury, and Their Molar Ratio in Sportfish from Drinking Water Reservoirs

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091864

Authors: Tara K. B. Johnson Catherine E. LePrevost Thomas J. Kwak W. Gregory Cope

Mercury (Hg) bioaccumulates in aquatic ecosystems and may pose a risk to humans who consume fish. Selenium (Se) has the ability to reduce Hg toxicity, but the current guidance for human consumption of fish is based on Hg concentration alone. The purpose of the present study was to examine the relationship between Se and Hg in freshwater sportfish, for which there is a paucity of existing data. We collected three species of fish from different trophic positions from two drinking water reservoirs in central North Carolina, USA, to assess Hg and Se concentrations in relation to fish total length and to compare two measures of the protective ability of Se, the Se:Hg molar ratio and Se health benefit value (HBVSe), to current guidance for Hg. According to the Se:Hg molar ratio, all of the low trophic position fish sampled and the middle trophic position fish sampled from one of the reservoirs were safe for consumption. The same number of fish were considered safe using the HBVSe. More fish were deemed unsafe when using the Se:Hg molar ratio and HBVSe than were considered unsafe when using the U.S. Environmental Protection Agency (USEPA) Hg threshold. These findings suggest that the measures of Se protection may be unnecessarily conservative or that the USEPA Hg threshold may not be sufficiently protective of human health, especially the health of sensitive populations like pregnant or nursing mothers and young children. Future examination of the Se:Hg molar ratio and HBVSe from a variety of fish tissue samples would help refine the accuracy of these measures so that they may be appropriately utilized in ecological and human health risk assessment.

https://ift.tt/2wxKl14

Knee pain in nursing home workers after implementation of a safe resident handling program

American Journal of Industrial Medicine, EarlyView.


https://ift.tt/2LyRnbu

Secular trends in work disability and its relationship to musculoskeletal pain and mental health: a time-trend analysis using five cross-sectional surveys (2002-2010) in the general population

Objectives

International evidence suggests that rates of inability to work because of illness can change over time. We hypothesised that one reason for this is that the link between inability to work and common illnesses, such as musculoskeletal pain and mental illness, may also change over time. We have investigated this in a study based in one UK district.

Methods

Five population surveys (spanning 2002–2010) of working-age people aged >50 years and ≤65 years were used. Work disability was defined as a single self-reported item ‘not working due to ill-health’. Presence of moderate–severe depressive symptoms was identified from the Mental Component Score of the Short Form-12, and pain from a full-body manikin. Data were analysed with multivariable logistic regression.

Results

The proportion of people reporting work disability across the surveys declined, from 17.0% in 2002 to 12.1% in 2010. Those reporting work disability, one-third reported regional pain, one-half widespread pain (53%) and two-thirds moderate–severe depressive symptoms (68%). Both factors were independently associated with work disability; their co-occurrence was associated with an almost 20-fold increase in the odds of reporting work disability compared with those with neither condition.

Conclusions

The association of work disability with musculoskeletal pain was stable over time; depressive symptoms became more prominent in persons reporting work disability, but overall prevalence of work disability declined. The frequency and impact of both musculoskeletal pain and depression highlight the need to move beyond symptom-directed approaches towards a more comprehensive model of health and vocational advice for people unable to work because of illness.

https://ift.tt/2of05CC

Sinonasal cancer and exposure to styrene

We read with interest the recent article by Nissen et al,1 which described a possible association of sinonasal adenocarcinoma with occupational exposure to styrene in the production of glass-reinforced plastics. Noting the limited statistical significance of their finding, and the potential for uncontrolled residual confounding by occupational exposure to wood dust, the authors called for further studies to confirm or refute the hazard.

During the 1980s we assembled a cohort of 7970 workers exposed to styrene in the British glass-reinforced plastics industry.2 Our cohort included 3488 laminators with exposures to styrene in the order of 40–100 parts per million (ppm), in many cases for a year or longer. We extended our follow-up of this cohort at the end of 2012.3 In response to the call from Nissen and colleagues1 for more studies, we have revisited our analysis of the most recent follow-up, examining mortality...

https://ift.tt/2wtxHAd

IJERPH, Vol. 15, Pages 1863: Hydrothermal Treatment of Arsenic Sulfide Residues from Arsenic-Bearing Acid Wastewater

IJERPH, Vol. 15, Pages 1863: Hydrothermal Treatment of Arsenic Sulfide Residues from Arsenic-Bearing Acid Wastewater

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091863

Authors: Liwei Yao Xiaobo Min Hui Xu Yong Ke Yanjie Liang Kang Yang

Arsenic sulfide residue (ASR), a by-product from the treatment of arsenic-bearing acidic wastewater, is abundantly generated but not properly disposed of in China. The utilization of such high-content arsenic waste residue is limited by the market. The traditional methods of stabilization/solidification (S/S) by lime cement or iron salt have a large mass/volume addition, high dumping cost and secondary pollution risk. In this paper, hydrothermal technology was used to treat three kinds of ASRs obtained from different smelters to minimize waste. The leaching toxicity and chemical speciation of the generated products was also evaluated by TCLP and BCR analyses. It was found that the hydrothermal treatment could greatly reduce the volume and moisture content of the ASRs. TCLP tests showed that the leachability of arsenic and heavy metals significantly decreased after the treatment. According to the BCR analysis, most of the unstable As, Cd and Cr transformed into a residual fraction. Finally, XRD, SEM, Raman and XPS techniques were carried out to reveal the mechanism. As a result, hydrothermal treatment can efficiently achieve the dehydration, volume reduction and stabilization/solidification of ASRs.

https://ift.tt/2Mze44F

IJERPH, Vol. 15, Pages 1860: Affordable Care Act and Disparities in Health Services Utilization among Ethnic Minority Breast Cancer Survivors: Evidence from Longitudinal Medical Expenditure Panel Surveys 2008–2015

IJERPH, Vol. 15, Pages 1860: Affordable Care Act and Disparities in Health Services Utilization among Ethnic Minority Breast Cancer Survivors: Evidence from Longitudinal Medical Expenditure Panel Surveys 2008–2015

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091860

Authors: Shelley I. White-Means Ahmad Reshad Osmani

Breast cancer is the most prevalent female cancer in the US. Incidence rates are similar for white and black women but mortality rates are higher for black women. This study draws on rich, nationally representative data, the 2008&ndash;2015 Medical Expenditure Panel Surveys, to estimate effects of the Affordable Care Act (ACA) on reducing disparities in and access to use of diagnostic and medical services for black and Hispanic breast cancer survivors. Random effects multinomial logit, flexible hurdle and Box-Cox estimation techniques are used. The robust estimates indicate that the ACA narrowed the racial/ethnic disparity in health insurance coverage, health care utilization and out-of-pocket prescription drug expenditures among breast cancer survivors. Gaps in uninsurance significantly declined for black and Hispanic survivors. Hispanic women generally and black breast cancer survivors specifically increased use of mammography services post-ACA. The ACA did not significantly impact disparities in physician utilization or out-of-pocket prescription drug expenditures for Hispanic survivors, while there were substantive improvements for black breast cancer survivors. The paper concludes with a discussion of the strengths and limitations of the ACA for reducing disparities and improving health outcomes for a growing population of breast cancer survivors in the US.

https://ift.tt/2PenEHa

IJERPH, Vol. 15, Pages 1861: Truck and Multivehicle Truck Accidents with Injuries Near Colorado Oil and Gas Operations

IJERPH, Vol. 15, Pages 1861: Truck and Multivehicle Truck Accidents with Injuries Near Colorado Oil and Gas Operations

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091861

Authors: Benjamin D. Blair John Hughes William B. Allshouse Lisa M. McKenzie John L. Adgate

Unconventional and conventional oil and gas (O&amp;G) operations raise public health concerns, such as the potential impacts from trucking activity in communities that host these operations. In this work, we used two approaches to evaluate accidents in relation to O&amp;G activities in the State of Colorado. First, we calculated the rate of truck accidents by computing the ratio of accident count and county population. When comparing counties with increased O&amp;G operations to counties with less activity, we found that counties with more activity have greater rates of truck traffic accidents per capita (Rate Ratio = 1.07, p &lt; 0.05, 95% CI: 1.01&ndash;1.13). Second, we laid a grid over the eleven counties of interest and counted, for each cell, the number of truck accidents, the number of multivehicle accidents with injuries, the number of homes, and the number of O&amp;G wells. We then applied hurdle count models, using the accident counts as the outcomes and the number of homes and number of wells as independent variables. We found that both independent variables are significant predictors of truck accidents and multivehicle truck accidents. These accidents are of concern since they can have an impact on the people who live near O&amp;G operations.

https://ift.tt/2PKJ3sE

IJERPH, Vol. 15, Pages 1862: Learning and Action in Community Health: Using the Health Belief Model to Assess and Educate African American Community Residents about Participation in Clinical Research

IJERPH, Vol. 15, Pages 1862: Learning and Action in Community Health: Using the Health Belief Model to Assess and Educate African American Community Residents about Participation in Clinical Research

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091862

Authors: Latrice Rollins Angela Sy Nicole Crowell Desiree Rivers Assia Miller Pamela Cooper Debra Teague Cassandra Jackson Tabia Henry Akintobi Elizabeth Ofili

The Learning and Action in Community Health project was implemented to gather preliminary data needed to inform community-engaged educational approaches to increase clinical research participation among racial minorities. The Health Belief Model was the theoretical framework utilized to develop the intervention and assessment tools. An educational session about clinical research and biorepository participation was designed using clinicaltrials.gov information and administered to adult, African American community residents (n = 60) in Atlanta, Georgia. Pre- and post-tests were collected and analyzed to assess changes in participants&rsquo; knowledge, perceptions, and willingness to participate in clinical studies and biorepositories. There were statistically significant changes in knowledge about joining a clinical study (p &lt; 0.001) and registry or biorepository (p &lt; 0.001). There was no statistically significant change in willingness to participate in clinical research or biorepositories after the educational session. Focus groups were conducted to gather feedback on the educational session and perceived barriers and benefits to participating in clinical research. Perceived benefits were improving health, receiving incentives, early detection of health issues, and access to care. Perceived barriers included fear, lack of knowledge, historical mistrust of research, and time constraints. Results have implications for subsequent community-engaged approaches to increasing minority participation in clinical research.

https://ift.tt/2PcAiGA

IJERPH, Vol. 15, Pages 1859: A Portfolio Analysis of Culturally Tailored Trials to Address Health and Healthcare Disparities

IJERPH, Vol. 15, Pages 1859: A Portfolio Analysis of Culturally Tailored Trials to Address Health and Healthcare Disparities

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091859

Authors: Marisa Torres-Ruiz Kaitlynn Robinson-Ector Dionna Attinson Jamie Trotter Ayodola Anise Steven Clauser

In 2010, Patient-Centered Outcomes Research Institute (PCORI) was authorized by Congress to improve the quality and relevance of evidence available to help patients, caregivers, employers, insurers, and policy makers make better-informed health decisions. We conducted a qualitative analysis of behavioral health trials in the PCORI Addressing Disparities portfolio to examine cultural tailoring strategies across the following priority populations: racial and ethnic minorities, rural populations, people with low-income or low socioeconomic status, individuals with disabilities, people with low health literacy, and lesbian, gay, bisexual, and transgender (LGBT) communities. The Common Strategies for Enhancing Cultural Appropriateness model was used to examine cultural tailoring strategies within trials. We hypothesized increased intersectionality within a patient population at risk for disparities would correlate with the dosage and type of cultural tailoring strategies applied. Thirty-three behavioral health trials applied cultural tailoring strategies and a majority of trials (n = 30) used three or more strategies. Trends in cultural tailoring were associated with certain racial and ethnic groups; however, increased use of tailoring was not associated with the number of priority populations included in a trial. The PCORI Addressing Disparities portfolio demonstrates how a range of cultural tailoring strategies are used, within comparative clinical effectiveness research trials, to address the needs and intersectionality of patients to reduce health and healthcare disparities.

https://ift.tt/2BVF9u6

IJERPH, Vol. 15, Pages 1858: The Human Right to Water and Unconventional Energy

IJERPH, Vol. 15, Pages 1858: The Human Right to Water and Unconventional Energy

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091858

Authors: Robert C Palmer Damien Short Walter E. Ted Auch

Access to water, in sufficient quantities and of sufficient quality is vital for human health. The United Nations Committee on Economic, Social and Cultural Rights (in General Comment 15, drafted 2002) argued that access to water was a condition for the enjoyment of the right to an adequate standard of living, inextricably related to the right to the highest attainable standard of health, and thus a human right. On 28 July 2010 the United Nations General Assembly declared safe and clean drinking water and sanitation a human right essential to the full enjoyment of life and all other human rights. This paper charts the international legal development of the right to water and its relevance to discussions surrounding the growth of unconventional energy and its heavy reliance on water. We consider key data from the country with arguably the most mature and extensive industry, the USA, and highlight the implications for water usage and water rights. We conclude that, given the weight of testimony of local people from our research, along with data from scientific literature, non-governmental organization (NGO) and other policy reports, that the right to water for residents living near fracking sites is likely to be severely curtailed. Even so, from the data presented here, we argue that the major issue regarding water use is the shifting of the resource from society to industry and the demonstrable lack of supply-side price signal that would demand that the industry reduce or stabilize its water demand per unit of energy produced. Thus, in the US context alone, there is considerable evidence that the human right to water will be seriously undermined by the growth of the unconventional oil and gas industry, and given its spread around the globe this could soon become a global human rights issue.

https://ift.tt/2LxLzPx

IJERPH, Vol. 15, Pages 1857: Increased Urgent Care Center Visits by Southeast European Migrants: A Retrospective, Controlled Trial from Switzerland

IJERPH, Vol. 15, Pages 1857: Increased Urgent Care Center Visits by Southeast European Migrants: A Retrospective, Controlled Trial from Switzerland

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091857

Authors: Jolanta Klukowska-Röetzler Maria Eracleous Martin Müller David S. Srivastava Gert Krummrey Osnat Keidar Aristomenis K. Exadaktylos

We investigated whether immigrants from Southeast Europe (SE) and Swiss patients have different reasons for visiting the emergency department (ED). Our retrospective data analysis for the years 2013&ndash;2017 describes the pattern of ED consultations for immigrants from SE living in Switzerland (Canton Bern), in comparison with Swiss nationals, with a focus on type of referral and reason for admission. A total of 153,320 Swiss citizens and 12,852 immigrants from SE were included in the study. The mean age was 51.30 (SD = 21.13) years for the Swiss patients and 39.70 (SD = 15.87) years for the SE patients. For some countries of origin (Albania, Bosnia and Herzegovina, and Turkey), there were highly statistically significant differences in sex distribution, with a predominance of males. SE immigrants had a greater proportion of patients in the lower triage level (level 3: SE: 67.3% vs. Swiss: 56.0%) and a greater proportion of patients in the high triage level than the Swiss population (level 1: SE: 3.4% vs. Swiss: 8.8%). SE patients of working age (16&ndash;65 years) were six times more often admitted by ambulance than older (&ge;65 years) SE patients, whereas this ratio was similar in the Swiss population. In both groups, the fast track service was primarily used for patients of working age (&lt;65) and more than three times more often in the SE than the Swiss group (SE: 39.1%, Swiss: 12.6%). We identified some indications for access to primary care in emergency departments for immigrants and highlighted the need for attention to the role of organizational characteristics of primary health care in Switzerland. We highlighted the need for professional support to improve the quality of healthcare for immigrants. In the future, we will need more primary care services and general practitioners with a migrant background.

https://ift.tt/2whHZEa

IJERPH, Vol. 15, Pages 1856: Synergistic Effects of Ambient Temperature and Air Pollution on Health in Europe: Results from the PHASE Project

IJERPH, Vol. 15, Pages 1856: Synergistic Effects of Ambient Temperature and Air Pollution on Health in Europe: Results from the PHASE Project

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091856

Authors: Antonis Analitis Francesca de’ Donato Matteo Scortichini Timo Lanki Xavier Basagana Ferran Ballester Christopher Astrom Anna Paldy Mathilde Pascal Antonio Gasparrini Paola Michelozzi Klea Katsouyanni

We studied the potential synergy between air pollution and meteorology and their impact on mortality in nine European cities with data from 2004 to 2010. We used daily series of Apparent Temperature (AT), measurements of particulate matter (PM10), ozone (O3), and nitrogen dioxide (NO2) and total non-accidental, cardiovascular, and respiratory deaths. We applied Poisson regression for city-specific analysis and random effects meta-analysis to combine city-specific results, separately for the warm and cold seasons. In the warm season, the percentage increase in all deaths from natural causes per &deg;C increase in AT tended to be greater during high ozone days, although this was only significant for all ages when all causes were considered. On low ozone days, the increase in the total daily number of deaths was 1.84% (95% CI 0.87, 2.82), whilst it was 2.20% (95% CI 1.28, 3.13) in the high ozone days per 1 &deg;C increase in AT. Interaction with PM10 was significant for cardiovascular (CVD) causes of death for all ages (2.24% on low PM10 days (95% CI 1.01, 3.47) whilst it is 2.63% (95% CI 1.57, 3.71) on high PM10 days) and for ages 75+. In days with heat waves, no consistent pattern of interaction was observed. For the cold period, no evidence for synergy was found. In conclusion, some evidence of interactive effects between hot temperature and the levels of ozone and PM10 was found, but no consistent synergy could be identified during the cold season.

https://ift.tt/2BV7OiZ

IJERPH, Vol. 15, Pages 1855: Mature or Emerging? The Impact of Treatment-Related Internet Health Information Seeking on Patients’ Trust in Physicians

IJERPH, Vol. 15, Pages 1855: Mature or Emerging? The Impact of Treatment-Related Internet Health Information Seeking on Patients’ Trust in Physicians

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091855

Authors: Runtong Zhang Xinyi Lu Wen Wu Xiaopu Shang Manlu Liu

Years of clinical trials have proven the maturity and safety of certain treatments, however, some of these mature treatments may not be highly effective. Several treatments have emerged through technological innovations, but their long-term safety, efficacy, and adverse effects remain unknown. At present, many patients seek information related to their treatments on the Internet, which may impact their attitudes towards different treatments and their trust in physicians. In this study, a research model was developed to examine how patients&rsquo; trust in their physicians is influenced by related online information on mature or emerging treatments. The hypotheses were tested using confirmatory factor analysis (CFA) and structural equation modelling (SEM). A total of 336 valid responses were collected through an online survey. Mature treatments related health information was found to significantly improve patients&rsquo; trust. Thus, physicians should pay more attention to mature treatments, and encourage their patients to seek related information online. Moreover, the quality of online information should be developed further to increase patients&rsquo; satisfaction. Physicians should also consider their patients&rsquo; psychological safety in communication with patients to strengthen their trust.

https://ift.tt/2oe8dDl

IJERPH, Vol. 15, Pages 1854: Perceived Neighbourhood Problems over Time and Associations with Adiposity

IJERPH, Vol. 15, Pages 1854: Perceived Neighbourhood Problems over Time and Associations with Adiposity

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091854

Authors: Anne Ellaway Ruth Dundas Jonathan R. Olsen Paul G. Shiels

There is growing interest in understanding which aspects of the local environment influence obesity. Using data from the longitudinal West of Scotland Twenty-07 study (n = 2040) we examined associations between residents&rsquo; self-reported neighbourhood problems, measured over a 13-year period, and nurse-measured body weight and size (body mass index, waist circumference, waist&ndash;hip ratio) and percentage body fat. We also explored whether particular measures such as abdominal obesity, postulated as a marker for stress, were more strongly related to neighbourhood conditions. Using life course models adjusted for sex, cohort, household social class, and health behaviours, we found that the accumulation of perceived neighbourhood problems was associated with percentage body fat. In cross-sectional analyses, the strongest relationships were found for contemporaneous measures of neighbourhood conditions and adiposity. When analyses were conducted separately by gender, perceived neighbourhood stressors were strongly associated with central obesity measures (waist circumference, waist&ndash;hip ratio) among both men and women. Our findings indicate that chronic neighbourhood stressors are associated with obesity. Neighbourhood environments are modifiable, and efforts should be directed towards improving deleterious local environments to reduce the prevalence of obesity.

https://ift.tt/2BUdz0e

IJERPH, Vol. 15, Pages 1853: Influence of Coil Power Ranges on the E-Liquid Consumption in Vaping Devices

IJERPH, Vol. 15, Pages 1853: Influence of Coil Power Ranges on the E-Liquid Consumption in Vaping Devices

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091853

Authors: S´ebastien Soulet Marie Duquesne Jean Toutain Charly Pairaud H´elène Lalo

As electronic cigarettes (e-cigarettes) represent a new constantly evolving product category, the systematic analysis of the developed devices and the e-liquid vaporization is challenging. Indeed, understanding how e-cigarettes work and the role of key parameters in the process are major issues. This work focuses on an experimental study of how the power supplied by the battery to the atomizer coil influences e-liquid consumption. The reproducibility and the repeatability of e-liquid consumption were investigated over 20 series of 20 puffs for one of the tested atomizers. Then, the reproducibility and the repeatability of the e-liquid consumption was investigated over five series of 20 puffs for each tested atomizer. The wire behavior according to the supplied power could be separated into three regimes: under-heating (insufficient power to generate an aerosol), optimal vaporization characterized by a linear trend (vaporization of the e-liquid proportional to the supplied energy) and over-heating (dry-burn occurs). Using a controllable and repeatable energy supply, the reproducibility of the quantity of vaporized e-liquid was verified for each of the five series of 20 puffs programed for all the atomizers except one. Finally, the influence of the supplied power on the vaporization and the consumption of the e-liquid as well as the optimal power ranges were investigated and discussed. The results showed that atomizers with resistance ranging from 1 &Omega; to 1.8 &Omega; are efficient using all the energy supplied by the battery to vaporize the e-liquid and reducing the energy lost in the cotton or in the metal part of atomizer coil.

https://ift.tt/2LyeCT0

IJERPH, Vol. 15, Pages 1852: Sleep and Mental Health in Truck Drivers: Descriptive Review of the Current Evidence and Proposal of Strategies for Primary Prevention

IJERPH, Vol. 15, Pages 1852: Sleep and Mental Health in Truck Drivers: Descriptive Review of the Current Evidence and Proposal of Strategies for Primary Prevention

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15091852

Authors: Sergio Garbarino Ottavia Guglielmi Walter G Sannita Nicola Magnavita Paola Lanteri

Background: Professional truck drivers (TDs) are exposed to stressful working (and living) conditions and are vulnerable. They report physical and mental health problems and psychological distress more frequently than the general population and their problems can affect safety on the roads. Actions to improve TDs&rsquo; health and reduce the risks of (co-)morbidity or unsafe driving are imperative. Methods: The published studies dealing with the TDs&rsquo; sleep habits and mental health were reviewed to define the scenario and organize the preventive strategies proposed thus far. Results: Awareness among TDs of the high risk for health and safety due to (often co-existing) untreated sleep and mental health problems is critical. Alcohol and prescribed or illicit drugs are often misused to compensate for depression, anxiety, job strain, fatigue, and social isolation. Polypharmacy and dependence increase the chance of unsafe behaviors on the road. The TDs&rsquo; access to healthcare services is scant, and participation in industry-sponsored wellness programs is limited. Conclusions: Primary prevention is a first unavoidable step to deal with sleep and mental health problems. Educational programs, online support and tele-health assessment/monitoring would help improve the well-being, safety and health of professional TDs and increase safety on the road.

https://ift.tt/2whnh7q