International Journal of Environmental Research and Public Health

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Open AccessArticle

Impact of Oral Health Behaviors on Dental Caries in Children with Intellectual Disabilities in Guangzhou, China

by Zifeng Liu, Dongsheng Yu, Wei Luo, Jing Yang, Jiaxuan Lu, Shuo Gao, Wenqing Li and Wei Zhao

Int. J. Environ. Res. Public Health 2014, 11(10), 11015-11027; https://doi.org/10.3390/ijerph111011015 - 22 Oct 2014

Cited by 33 | Viewed by 8506

Abstract

Dental care is consistently reported as one of the primary medical needs of children with disabilities (IDC). The aim of the present study was to explore the influence of oral health behaviors on the caries experience in children with intellectual disabilities in Guangzhou, [...] Read more.

Dental care is consistently reported as one of the primary medical needs of children with disabilities (IDC). The aim of the present study was to explore the influence of oral health behaviors on the caries experience in children with intellectual disabilities in Guangzhou, China. A cross-sectional study was carried out in 477 intellectually disabled children, 12 to 17 years old, who were randomly selected from special educational schools in Guangzhou. A self-administered parental questionnaire was used to collect data on socio-demographic characteristics and oral health behavior variables, and 450 valid questionnaires were returned. Multiple regression analysis was used to examine the factors associated with dental caries. The average age of those in the sample was 14.6 years (SD = 1.3), 68.4% of whom were male, and the caries prevalence rate was 53.5% (DMFT = 1.5 ± 2.0). The factors significantly affecting the development of dental caries in IDC included gender, the presence or absence of cerebral palsy, and the frequency of dental visits and toothbrushing. In conclusion, the presence of cerebral palsy contributed to an increase risk of caries experience in intellectually disabled children, while toothbrushing more than twice a day and routine dental visits were caries-protective factors. Oral health promotion action may lead to a reduction in dental caries levels in IDC. Full article

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Open AccessArticle

Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening

by Tommi Kärki, Christian Napoli, Flavia Riccardo, Massimo Fabiani, Maria Grazia Dente, Manuel Carballo, Teymur Noori and Silvia Declich

Int. J. Environ. Res. Public Health 2014, 11(10), 11004-11014; https://doi.org/10.3390/ijerph111011004 - 21 Oct 2014

Cited by 64 | Viewed by 8975

Abstract

Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a [...] Read more.

Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries. Full article

(This article belongs to the Special Issue Migrant Health)

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Open AccessArticle

The Study of External Dose Rate and Retained Body Activity of Patients Receiving ¹³¹I Therapy for Differentiated Thyroid Carcinoma

by Haiying Zhang, Ling Jiao, Songye Cui, Liang Wang, Jian Tan, Guizhi Zhang, Yajing He, Shuzhou Ruan, Saijun Fan and Wenyi Zhang

Int. J. Environ. Res. Public Health 2014, 11(10), 10991-11003; https://doi.org/10.3390/ijerph111010991 - 21 Oct 2014

Cited by 11 | Viewed by 6391

Abstract

Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving ¹³¹I therapy. Seventy patients were stratified [...] Read more.

Radiation safety is an integral part of targeted radionuclide therapy. The aim of this work was to study the external dose rate and retained body activity as functions of time in differentiated thyroid carcinoma patients receiving ¹³¹I therapy. Seventy patients were stratified into two groups: the ablation group (A) and the follow-up group (FU). The patients’ external dose rate was measured, and simultaneously, their retained body radiation activity was monitored at various time points. The equations of the external dose rate and the retained body activity, described as a function of hours post administration, were fitted. Additionally, the release time for patients was calculated. The reduction in activity in the group receiving a second or subsequent treatment was more rapid than the group receiving only the initial treatment. Most important, an expeditious method was established to indirectly evaluate the retained body activity of patients by measuring the external dose rate with a portable radiation survey meter. By this method, the calculated external dose rate limits are 19.2, 8.85, 5.08 and 2.32 μSv·h⁻¹at 1, 1.5, 2 and 3 m, respectively, according to a patient’s released threshold level of retained body activity <400 MBq. This study is beneficial for radiation safety decision-making. Full article

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Open AccessReview

New Roles for Pharmacists in Community Mental Health Care: A Narrative Review

by Maria Rubio-Valera, Timothy F. Chen and Claire L. O'Reilly

Int. J. Environ. Res. Public Health 2014, 11(10), 10967-10990; https://doi.org/10.3390/ijerph111010967 - 21 Oct 2014

Cited by 139 | Viewed by 18032

Abstract

Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence [...] Read more.

Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists’ role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists’ attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma. Full article

(This article belongs to the Special Issue Mental Health Care)

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Open AccessConcept Paper

Effects of Non-Differential Exposure Misclassification on False Conclusions in Hypothesis-Generating Studies

by Igor Burstyn, Yunwen Yang and A. Robert Schnatter

Int. J. Environ. Res. Public Health 2014, 11(10), 10951-10966; https://doi.org/10.3390/ijerph111010951 - 21 Oct 2014

Cited by 21 | Viewed by 6589

Abstract

Despite the theoretical success of obviating the need for hypothesis-generating studies, they live on in epidemiological practice. Cole asserted that “… there is boundless number of hypotheses that could be generated, nearly all of them wrong” and urged us to focus on evaluating [...] Read more.

Despite the theoretical success of obviating the need for hypothesis-generating studies, they live on in epidemiological practice. Cole asserted that “… there is boundless number of hypotheses that could be generated, nearly all of them wrong” and urged us to focus on evaluating “credibility of hypothesis”. Adopting a Bayesian approach, we put this elegant logic into quantitative terms at the study planning stage for studies where the prior belief in the null hypothesis is high (i.e., “hypothesis-generating” studies). We consider not only type I and II errors (as is customary) but also the probabilities of false positive and negative results, taking into account typical imperfections in the data. We concentrate on a common source of imperfection in the data: non-differential misclassification of binary exposure classifier. In context of an unmatched case-control study, we demonstrate—both theoretically and via simulations—that although non-differential exposure misclassification is expected to attenuate real effect estimates, leading to the loss of ability to detect true effects, there is also a concurrent increase in false positives. Unfortunately, most investigators interpret their findings from such work as being biased towards the null rather than considering that they are no less likely to be false signals. The likelihood of false positives dwarfed the false negative rate under a wide range of studied settings. We suggest that instead of investing energy into understanding credibility of dubious hypotheses, applied disciplines such as epidemiology, should instead focus attention on understanding consequences of pursuing specific hypotheses, while accounting for the probability that the observed “statistically significant” association may be qualitatively spurious. Full article

(This article belongs to the Special Issue Methodological Innovations and Reflections-1)

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Open AccessArticle

Secular Trends in Habitual Physical Activities of Mozambican Children and Adolescents from Maputo City

by Fernanda Karina Dos Santos, José A. R. Maia, Thayse Natacha Q. F. Gomes, Timóteo Daca, Aspacia Madeira, Albertino Damasceno, Peter T. Katzmarzyk and António Prista

Int. J. Environ. Res. Public Health 2014, 11(10), 10940-10950; https://doi.org/10.3390/ijerph111010940 - 21 Oct 2014

Cited by 19 | Viewed by 5976

Abstract

Social and economic changes occurring in the last two decades in Mozambique may have induced lifestyle changes among youth. This study aimed to document secular changes in habitual physical activities of Mozambican youth between 1992, 1999 and 2012. A total of 3393 youth [...] Read more.

Social and economic changes occurring in the last two decades in Mozambique may have induced lifestyle changes among youth. This study aimed to document secular changes in habitual physical activities of Mozambican youth between 1992, 1999 and 2012. A total of 3393 youth (eight–15 years), were measured in three different time periods (1992, 1999, 2012). Habitual physical activity (PA) was estimated with a questionnaire, including items related to household chores, sport participation, traditional games and walking activities. Biological maturation was assessed. Analysis of Covariance (ANCOVA) was used to compare mean differences in PA across the years. Significant decreases between 1992–1999 and 1992–2012 were observed for boys in household chores, games and walking, and a significant decline between 1999 and 2012 was found in sport participation. Among girls, a significant and consistent decline (1992 > 1999 > 2012) was observed for household chores, a decline between 1992–1999 and 1992–2012 for games and walking, and a significant increase between 1992 and 1999 in sport participation. In general, a negative secular trend was found in habitual PA among Mozambican youth. Interventions aimed at increasing PA represent important educational and public health opportunities. Full article

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Open AccessArticle

Horizon 2020 Priorities in Clinical Mental Health Research: Results of a Consensus-Based ROAMER Expert Survey

by Iman Elfeddali, Christina M. Van der Feltz-Cornelis, Jim Van Os, Susanne Knappe, Eduard Vieta, Hans-Ulrich Wittchen, Carla Obradors-Tarragó and Josep Maria Haro

Int. J. Environ. Res. Public Health 2014, 11(10), 10915-10939; https://doi.org/10.3390/ijerph111010915 - 21 Oct 2014

Cited by 22 | Viewed by 7704

Abstract

Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to [...] Read more.

Within the ROAMER project, which aims to provide a Roadmap for Mental Health Research in Europe, a two-stage Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental health research. Expert consensus existed with regard to the importance of three challenges in the field of clinical mental health research: (1) the development of new, safe and effective interventions for mental disorders; (2) understanding the mechanisms of disease in order to be able to develop such new interventions; and (3) defining outcomes (an improved set of outcomes, including alternative outcomes) to use for clinical mental health research evaluation. Proposed actions involved increasing the utilization of tailored approaches (personalized medicine), developing blended eHealth/mHealth decision aids/guidance tools that help the clinician to choose between various treatment modalities, developing specific treatments in order to better target comorbidity and (further) development of biological, psychological and psychopharmacological interventions. The experts indicated that addressing these priorities will result in increased efficacy and impact across Europe; with a high probability of success, given that Europe has important strengths, such as skilled academics and a long research history. Finally, the experts stressed the importance of creating funding and coordinated networking as essential action needed in order to target the variety of challenges in clinical mental health research. Full article

(This article belongs to the Special Issue Mental Health Care)

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Open AccessArticle

Ultrasensitive UPLC-MS-MS Method for the Quantitation of Etheno-DNA Adducts in Human Urine

by Shiwei Cui, Haibin Li, Shaojia Wang, Xiao Jiang, Shusheng Zhang, Rongjie Zhang and Xin Sun

Int. J. Environ. Res. Public Health 2014, 11(10), 10902-10914; https://doi.org/10.3390/ijerph111010902 - 21 Oct 2014

Cited by 10 | Viewed by 6214

Abstract

Etheno-DNA adducts are generated from the metabolism of exogenous carcinogens and endogenous lipid peroxidation. We and others have previously reported that 1,N⁶-ethenodeoxyadenosine (εdA) and 3,N⁴-ethenodeoxycytidine (εdC) are present in human urine and can be utilized as biomarkers [...] Read more.

Etheno-DNA adducts are generated from the metabolism of exogenous carcinogens and endogenous lipid peroxidation. We and others have previously reported that 1,N⁶-ethenodeoxyadenosine (εdA) and 3,N⁴-ethenodeoxycytidine (εdC) are present in human urine and can be utilized as biomarkers of oxidative stress. In this study, we report a new ultrasensitive UPLC-ESI-MS/MS method for the analysis of εdA and edC in human urine, capable of detecting 0.5 fmol εdA and 0.3 fmol εdC in 1.0 mL of human urine, respectively. For validation of the method, 20 human urine samples were analyzed, and the results revealed that the mean levels of εdA and εdC (SD) fmol/µmol creatinine are 5.82 ± 2.11 (range 3.0–9.5) for εdA and 791.4 ± 328.8 (range 116.7–1264.9) for εdC in occupational benzene-exposed workers and 2.10 ± 1.32 (range 0.6–4.7) for εdA and 161.8 ± 200.9 (range 1.8–557.5) for εdC in non-benzene-exposed workers, respectively. The ultrasensitive detection method is thus suitable for applications in human biomonitoring and molecular epidemiology studies. Full article

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Open AccessArticle

Impact of Viewing vs. Not Viewing a Real Forest on Physiological and Psychological Responses in the Same Setting

by Masahiro Horiuchi, Junko Endo, Norimasa Takayama, Kazutaka Murase, Norio Nishiyama, Haruo Saito and Akio Fujiwara

Int. J. Environ. Res. Public Health 2014, 11(10), 10883-10901; https://doi.org/10.3390/ijerph111010883 - 20 Oct 2014

Cited by 63 | Viewed by 8487

Abstract

We investigated the impact of viewing versus not viewing a real forest on human subjects’ physiological and psychological responses in the same setting. Fifteen healthy volunteers (11 males, four females, mean age 36 years) participated. Each participant was asked to view a forest [...] Read more.

We investigated the impact of viewing versus not viewing a real forest on human subjects’ physiological and psychological responses in the same setting. Fifteen healthy volunteers (11 males, four females, mean age 36 years) participated. Each participant was asked to view a forest while seated in a comfortable chair for 15 min (Forest condition) vs. sitting the same length of time with a curtain obscuring the forest view (Enclosed condition). Both conditions significantly decreased blood pressure (BP) variables, i.e., systolic BP, diastolic BP, and mean arterial pressure between pre and post experimental stimuli, but these reductions showed no difference between conditions. Interestingly, the Forest viewing reduced cerebral oxygenated hemoglobin (HbO₂) assessed by near-infrared spectroscopy (NIRS) and improved the subjects’ Profile of Mood States (POMS) scores, whereas the Enclosed condition increased the HbO₂ and did not affect the POMS scores. There were no significant differences in saliva amylase or heart rate variability (HRV) between the two conditions. Collectively, these results suggest that viewing a real forest may have a positive effect on cerebral activity and psychological responses. However, both viewing and not viewing the forest had similar effects on cardiovascular responses such as BP variables and HRV. Full article

(This article belongs to the Special Issue Health Benefits of Nature)

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Open AccessArticle

Functional Validity of a Judgment Skills Measure within the Concept of Health Literacy for Sleeping Disorder Patients

by Arthur Dubowicz and Peter J. Schulz

Int. J. Environ. Res. Public Health 2014, 11(10), 10868-10882; https://doi.org/10.3390/ijerph111010868 - 17 Oct 2014

Cited by 2 | Viewed by 5906

Abstract

The concept of health literacy has been widened to include higher order aspects such as patient decision-making skills while its measurement continued to rely narrowly on reading and numeracy skills, known as functional health literacy. We developed a Judgment Skills measure, designed to [...] Read more.

The concept of health literacy has been widened to include higher order aspects such as patient decision-making skills while its measurement continued to rely narrowly on reading and numeracy skills, known as functional health literacy. We developed a Judgment Skills measure, designed to assess patients’ ability to make appropriate decisions with regard to their condition. The measure offers scenarios with answer options ranked for biomedical adequacy. This study aims to examine the psychometric properties and the functional validity of the Judgment Skills measure. A self-administered survey among 87 primary insomnia patients in the Italian-speaking part of Switzerland was conducted. The extensive path model included variables such as functional health literacy, coping with the medical condition, experience of the scenario, sleep quality, duration suffering, education, and age. Correlation analyses were conducted to link the variables. The Judgment Skills measure showed the expected significant correlations. In general, higher Judgment Skills were related to coping strategies leading to better health outcomes. Functional health literacy correlated highly with education, while Judgment Skills did not, which confirmed the conceptual difference of these skills. The findings propose a model for conducting research that does embrace the broader conceptualization of health literacy. Full article

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Open AccessArticle

Are Delta-Aminolevulinate Dehydratase Inhibition and Metal Concentrations Additional Factors for the Age-Related Cognitive Decline?

by Marília Baierle, Mariele F. Charão, Gabriela Göethel, Anelise Barth, Rafael Fracasso, Guilherme Bubols, Elisa Sauer, Sarah C. Campanharo, Rafael C. C. Rocha, Tatiana D. Saint'Pierre, Suelen Bordignon, Murilo Zibetti, Clarissa M. Trentini, Daiana S. Ávila, Adriana Gioda and Solange C. Garcia

Int. J. Environ. Res. Public Health 2014, 11(10), 10851-10867; https://doi.org/10.3390/ijerph111010851 - 17 Oct 2014

Cited by 15 | Viewed by 6061

Abstract

Aging is often accompanied by cognitive impairments and influenced by oxidative status and chemical imbalances. Thus, this study was conducted to examine whether age-related cognitive deficit is associated with oxidative damage, especially with inhibition of the enzyme delta-aminolevulinate dehydratase (ALA-D), as well as [...] Read more.

Aging is often accompanied by cognitive impairments and influenced by oxidative status and chemical imbalances. Thus, this study was conducted to examine whether age-related cognitive deficit is associated with oxidative damage, especially with inhibition of the enzyme delta-aminolevulinate dehydratase (ALA-D), as well as to verify the influence of some metals in the enzyme activity and cognitive performance. Blood ALA-D activity, essential (Fe, Zn, Cu, Se) and non-essential metals (Pb, Cd, Hg, As, Cr, Ni, V) were measured in 50 elderly and 20 healthy young subjects. Cognitive function was assessed by tests from Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) battery and other. The elderly group presented decreased ALA-D activity compared to the young group. The index of ALA-D reactivation was similar to both study groups, but negatively associated with metals. The mean levels of essential metals were within the reference values, while the most toxic metals were above them in both groups. Cognitive function impairments were observed in elderly group and were associated with decreased ALA-D activity, with lower levels of Se and higher levels of toxic metals (Hg and V). Results suggest that the reduced ALA-D activity in elderly can be an additional factor involved in cognitive decline, since its inhibition throughout life could lead to accumulation of the neurotoxic compound ALA. Toxic metals were found to contribute to cognitive decline and also to influence ALA-D reactivation. Full article

(This article belongs to the Special Issue Proceedings of 1st Latin American Congress of Clinical and Laboratorial Toxicology (Toxi-Latin 2014))

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Open AccessArticle

Sociobehavioral Factors Associated with Caries Increment: A Longitudinal Study from 24 to 36 Months Old Children in Thailand

by Karl Peltzer, Aroonsri Mongkolchati, Gamon Satchaiyan, Sunsanee Rajchagool and Taksin Pimpak

Int. J. Environ. Res. Public Health 2014, 11(10), 10838-10850; https://doi.org/10.3390/ijerph111010838 - 17 Oct 2014

Cited by 27 | Viewed by 6659

Abstract

The aim of this study is to investigate sociobehavioral risk factors from the prenatal period until 36 months of age, and the caries increment from 24 to 36 months of the child in Thailand. The data utilized in this study come from the [...] Read more.

The aim of this study is to investigate sociobehavioral risk factors from the prenatal period until 36 months of age, and the caries increment from 24 to 36 months of the child in Thailand. The data utilized in this study come from the prospective cohort study of Thai children (PCTC) from prenatal to 36 months of the child in Mueang Nan district, Northern Thailand. The total sample size recruited was 783 infants. The sample size with dental caries data was 603 and 597, at 24 months and at 36 months, respectively. The sample size of having two assessment points with a dental examination (at 24 months and at 36 months) was 597. Results indicate that the caries increment was 52.9%, meaning from 365 caries free children at 24 months 193 had developed dental caries at 36 months. The prevalence of dental caries was 34.2% at 24 months (n = 206) and 68.5% at 36 months of age (n = 409). In bivariate analysis, higher education of the mother, lower household income, bottle feeding of the infant, frequent sweet candy consumptions, and using rain or well water as drinking water were associated with dental caries increment, while in multivariate conditional logistic regression analysis lower household income, higher education of the mother, and using rain or well water as drinking water remained associated with dental caries increment. In conclusion, a very significant increase in caries development was observed, and oral health may be influenced by sociobehavioural risk factors. Full article

(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)

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Open AccessArticle

Bioluminescence ATP Monitoring for the Routine Assessment of Food Contact Surface Cleanliness in a University Canteen

by Andrea Osimani, Cristiana Garofalo, Francesca Clementi, Stefano Tavoletti and Lucia Aquilanti

Int. J. Environ. Res. Public Health 2014, 11(10), 10824-10837; https://doi.org/10.3390/ijerph111010824 - 17 Oct 2014

Cited by 59 | Viewed by 9387

Abstract

ATP bioluminescence monitoring and traditional microbiological analyses (viable counting of total mesophilic aerobes, coliforms and Escherichia coli) were used to evaluate the effectiveness of Sanitation Standard Operating Procedures (SSOP) at a university canteen which uses a HACCP-based approach. To that end, 10 [...] Read more.

ATP bioluminescence monitoring and traditional microbiological analyses (viable counting of total mesophilic aerobes, coliforms and Escherichia coli) were used to evaluate the effectiveness of Sanitation Standard Operating Procedures (SSOP) at a university canteen which uses a HACCP-based approach. To that end, 10 cleaning control points (CPs), including food contact surfaces at risk of contamination from product residues or microbial growth, were analysed during an 8-month monitoring period. Arbitrary acceptability limits were set for both microbial loads and ATP bioluminescence readings. A highly significant correlation (r = 0.99) between the means of ATP bioluminescence readings and the viable counts of total mesophilic aerobes was seen, thus revealing a strong association of these parameters with the level of surface contamination. Among CPs, the raw meat and multi-purpose chopping boards showed the highest criticalities. Although ATP bioluminescence technology cannot substitute traditional microbiological analyses for the determination of microbial load on food contact surfaces, it has proved to be a powerful tool for the real time monitoring of surface cleanliness at mass catering plants, for verify the correct application of SSOP, and hence for their implementation/revision in the case of poor hygiene. Full article

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Open AccessArticle

Evaluation of Toxic Metals and Essential Elements in Children with Learning Disabilities from a Rural Area of Southern Brazil

by Sabrina Nunes do Nascimento, Mariele Feiffer Charão, Angela Maria Moro, Miguel Roehrs, Clovis Paniz, Marília Baierle, Natália Brucker, Adriana Gioda, Fernando Barbosa, Jr., Denise Bohrer, Daiana Silva Ávila and Solange Cristina Garcia

Int. J. Environ. Res. Public Health 2014, 11(10), 10806-10823; https://doi.org/10.3390/ijerph111010806 - 17 Oct 2014

Cited by 21 | Viewed by 8351

Abstract

Children’s exposure to metals can result in adverse effects such as cognitive function impairments. This study aimed to evaluate some toxic metals and levels of essential trace elements in blood, hair, and drinking water in children from a rural area of Southern Brazil. [...] Read more.

Children’s exposure to metals can result in adverse effects such as cognitive function impairments. This study aimed to evaluate some toxic metals and levels of essential trace elements in blood, hair, and drinking water in children from a rural area of Southern Brazil. Cognitive ability and δ-aminolevulinate dehydratase (ALA-D) activity were evaluated. Oxidative stress was evaluated as a main mechanism of metal toxicity, through the quantification of malondialdehyde (MDA) levels. This study included 20 children from a rural area and 20 children from an urban area. Our findings demonstrated increase in blood lead (Pb) levels (BLLs). Also, increased levels of nickel (Ni) in blood and increase of aluminum (Al) levels in hair and drinking water in rural children were found. Deficiency in selenium (Se) levels was observed in rural children as well. Rural children with visual-motor immaturity presented Pb levels in hair significantly increased in relation to rural children without visual-motor immaturity (p < 0.05). Negative correlations between BLLs and ALA-D activity and positive correlations between BLLs and ALA-RE activity were observed. MDA was significantly higher in rural compared to urban children (p < 0.05). Our findings suggest that rural children were co-exposed to toxic metals, especially Al, Pb and Ni. Moreover, a slight deficiency of Se was observed. Low performance on cognitive ability tests and ALA-D inhibition can be related to metal exposure in rural children. Oxidative stress was suggested as a main toxicological mechanism involved in metal exposure. Full article

(This article belongs to the Special Issue Proceedings of 1st Latin American Congress of Clinical and Laboratorial Toxicology (Toxi-Latin 2014))

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Open AccessArticle

Decreased Survival of Glioma Patients with Astrocytoma Grade IV (Glioblastoma Multiforme) Associated with Long-Term Use of Mobile and Cordless Phones

by Michael Carlberg and Lennart Hardell

Int. J. Environ. Res. Public Health 2014, 11(10), 10790-10805; https://doi.org/10.3390/ijerph111010790 - 16 Oct 2014

Cited by 43 | Viewed by 39520

Abstract

On 31 May 2011 the WHO International Agency for Research on Cancer (IARC) categorised radiofrequency electromagnetic fields (RF-EMFs) from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields, as a Group 2B, i.e., a “possible”, human carcinogen. A causal [...] Read more.

On 31 May 2011 the WHO International Agency for Research on Cancer (IARC) categorised radiofrequency electromagnetic fields (RF-EMFs) from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields, as a Group 2B, i.e., a “possible”, human carcinogen. A causal association would be strengthened if it could be shown that the use of wireless phones has an impact on the survival of glioma patients. We analysed survival of 1678 glioma patients in our 1997–2003 and 2007–2009 case-control studies. Use of wireless phones in the >20 years latency group (time since first use) yielded an increased hazard ratio (HR) = 1.7, 95% confidence interval (CI) = 1.2–2.3 for glioma. For astrocytoma grade IV (glioblastoma multiforme; n = 926) mobile phone use yielded HR = 2.0, 95% CI = 1.4–2.9 and cordless phone use HR = 3.4, 95% CI = 1.04–11 in the same latency category. The hazard ratio for astrocytoma grade IV increased statistically significant per year of latency for wireless phones, HR = 1.020, 95% CI = 1.007–1.033, but not per 100 h cumulative use, HR = 1.002, 95% CI = 0.999–1.005. HR was not statistically significant increased for other types of glioma. Due to the relationship with survival the classification of IARC is strengthened and RF-EMF should be regarded as human carcinogen requiring urgent revision of current exposure guidelines. Full article

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Open AccessReview

Animal Leptospirosis in Latin America and the Caribbean Countries: Reported Outbreaks and Literature Review (2002–2014)

by Jessica Petrakovsky, Alejandra Bianchi, Helen Fisun, Patricia Nájera-Aguilar and Martha Maria Pereira

Int. J. Environ. Res. Public Health 2014, 11(10), 10770-10789; https://doi.org/10.3390/ijerph111010770 - 16 Oct 2014

Cited by 57 | Viewed by 12708

Abstract

Leptospirosis is a worldwide zoonotic disease whose transmission is linked through multiple factors in the animal-human-ecosystem interface. The data on leptospirosis reported to the World Organization for Animal Health (OIE) for Latin America and Caribbean (LAC) countries/sovereign territories from 2005–2011 were mapped, showing [...] Read more.

Leptospirosis is a worldwide zoonotic disease whose transmission is linked through multiple factors in the animal-human-ecosystem interface. The data on leptospirosis reported to the World Organization for Animal Health (OIE) for Latin America and Caribbean (LAC) countries/sovereign territories from 2005–2011 were mapped, showing a wide distribution of outbreaks in the region. Tropical terrestrial biomes are the predominate ecosystems showing reports of outbreaks. Climatic and ecological factors were relevant to the occurrence of epidemic outbreaks. The available scientific information from 2002–2014 was summarized to obtain a general overview and identify key issues related to the One Health approach. The primary serological test used for diagnosis and for conducting surveys was the microscopic agglutination test (MAT). Reports regarding the isolation and typing of leptospires were scattered and limited to data from a few countries, but their results revealed considerable biodiversity at the species and serovar levels. A total of six out of 11 currently named pathogenic species were found in the region. There was also high diversity of animal species showing evidence of infection by leptospires, including rodents, pets, livestock and wild animals. Prevention and control measures for leptospirosis should consider issues of animal and human health in the context of ecosystems, the territorial land borders of countries and trade. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessArticle

Staying the Course? Challenges in Implementing Evidence-Based Programs in Community Mental Health Services

by Urban Markström

Int. J. Environ. Res. Public Health 2014, 11(10), 10752-10769; https://doi.org/10.3390/ijerph111010752 - 16 Oct 2014

Cited by 13 | Viewed by 5999

Abstract

This paper focuses on the second phase of the deinstitutionalisation of mental health care in which the development of community-based interventions are supposed to be implemented in local community mental health care systems. The challenge to sustainable implementation is illustrated by the Swedish [...] Read more.

This paper focuses on the second phase of the deinstitutionalisation of mental health care in which the development of community-based interventions are supposed to be implemented in local community mental health care systems. The challenge to sustainable implementation is illustrated by the Swedish case where the government put forward a national training program that sought to introduce Assertive Community Treatment (ACT) for people with severe mental illness. This study is based on document analysis and qualitative interviews with actors at the national, regional, and local levels covering a total of five regions and 15 municipalities that participated in the program. The analysis of the national experiences is put in relation to both research on public administration and policy analysis as well as to current research on implementation of evidence-based programs. The results showed a “drift” of the original model, which had already begun at the policy formulation stage and ended up in a large number of different local arrangements where only a few of the original components of ACT remained. We conclude that issues with implementation can only be fully understood by considering factors at different analytical levels. Full article

(This article belongs to the Special Issue Mental Health Care)

1228 KiB

Open AccessArticle

Managing the Health Impacts of Drought in Brazil

by Aderita Sena, Christovam Barcellos, Carlos Freitas and Carlos Corvalan

Int. J. Environ. Res. Public Health 2014, 11(10), 10737-10751; https://doi.org/10.3390/ijerph111010737 - 16 Oct 2014

Cited by 46 | Viewed by 11327

Abstract

Drought is often a hidden risk with the potential to become a silent public health disaster. It is difficult to define precisely when it starts or when it is over, and although it is a climatological event, its impacts depend on other human [...] Read more.

Drought is often a hidden risk with the potential to become a silent public health disaster. It is difficult to define precisely when it starts or when it is over, and although it is a climatological event, its impacts depend on other human activities, and are intensified by social vulnerability. In Brazil, half of all natural disaster events are drought related, and they cause half of the impacts in number of affected persons. One large affected area is the semiarid region of Brazil’s Northeast, which has historically been affected by drought. Many health and well-being indicators in this region are worse than the rest of the country, based on an analysis of 5565 municipalities using available census data for 1991, 2000 and 2010, which allowed separating the 1133 municipalities affected by drought in order to compare them with the rest of the country. Although great progress has been made in reducing social and economic vulnerability, climate change and the expected changes in the semiarid region in the next few decades call for a review of current programs, particularly in public health, and the planning of new interventions with local communities. This study reviews the literature, analyzes available data and identifies possible actions and actors. The aim is to ensure there will be sufficient and sustainable local adaptive capacity and resilience, for a population already living within the limits of environmental vulnerability. Full article

(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)

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9114 KiB

Open AccessArticle

Effect of Humic Acid on As Redox Transformation and Kinetic Adsorption onto Iron Oxide Based Adsorbent (IBA)

by Hoda Fakour and Tsair-Fuh Lin

Int. J. Environ. Res. Public Health 2014, 11(10), 10710-10736; https://doi.org/10.3390/ijerph111010710 - 16 Oct 2014

Cited by 16 | Viewed by 6337

Abstract

Due to the importance of adsorption kinetics and redox transformation of arsenic (As) during the adsorption process, the present study elucidated natural organic matter (NOM) effects on As adsorption-desorption kinetics and speciation transformation. The experimental procedures were conducted by examining interactions of arsenate [...] Read more.

Due to the importance of adsorption kinetics and redox transformation of arsenic (As) during the adsorption process, the present study elucidated natural organic matter (NOM) effects on As adsorption-desorption kinetics and speciation transformation. The experimental procedures were conducted by examining interactions of arsenate and arsenite with different concentrations of humic acid (HA) as a model representative of NOM, in the presence of iron oxide based adsorbent (IBA), as a model solid surface in three environmentally relevant conditions, including the simultaneous adsorption of both As and HA onto IBA, HA adsorption onto As-presorbed IBA, and As adsorption onto HA-presorbed IBA. Experimental adsorption-desorption data were all fitted by original and modified Lagergren pseudo-first and -second order adsorption kinetic models, respectively. Weber’s intraparticle diffusion was also used to gain insight into the mechanisms and rate controlling steps, which the results suggested that intraparticle diffusion of As species onto IBA is the main rate-controlling step. Different concentrations of HA mediated the redox transformation of As species, with a higher oxidation ability than reduction. The overall results indicated the significant effect of organic matter on the adsorption kinetics and redox transformation of As species, and consequently, the fate, transport and mobility of As in different environmentally relevant conditions. Full article

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1299 KiB

Open AccessArticle

Predictiveness of Disease Risk in a Global Outreach Tourist Setting in Thailand Using Meteorological Data and Vector-Borne Disease Incidences

by Suwannapa Ninphanomchai, Chitti Chansang, Yien Ling Hii, Joacim Rocklöv and Pattamaporn Kittayapong

Int. J. Environ. Res. Public Health 2014, 11(10), 10694-10709; https://doi.org/10.3390/ijerph111010694 - 16 Oct 2014

Cited by 16 | Viewed by 7414

Abstract

Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease [...] Read more.

Dengue and malaria are vector-borne diseases and major public health problems worldwide. Changes in climatic factors influence incidences of these diseases. The objective of this study was to investigate the relationship between vector-borne disease incidences and meteorological data, and hence to predict disease risk in a global outreach tourist setting. The retrospective data of dengue and malaria incidences together with local meteorological factors (temperature, rainfall, humidity) registered from 2001 to 2011 on Koh Chang, Thailand were used in this study. Seasonal distribution of disease incidences and its correlation with local climatic factors were analyzed. Seasonal patterns in disease transmission differed between dengue and malaria. Monthly meteorological data and reported disease incidences showed good predictive ability of disease transmission patterns. These findings provide a rational basis for identifying the predictive ability of local meteorological factors on disease incidence that may be useful for the implementation of disease prevention and vector control programs on the tourism island, where climatic factors fluctuate. Full article

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Open AccessArticle

Longitudinal Trajectories of Cholesterol from Midlife through Late Life according to Apolipoprotein E Allele Status

by Brian Downer, Steven Estus, Yuriko Katsumata and David W. Fardo

Int. J. Environ. Res. Public Health 2014, 11(10), 10663-10693; https://doi.org/10.3390/ijerph111010663 - 16 Oct 2014

Cited by 27 | Viewed by 7560

Abstract

Background: Previous research indicates that total cholesterol levels increase with age during young adulthood and middle age and decline with age later in life. This is attributed to changes in diet, body composition, medication use, physical activity, and hormone levels. In the current [...] Read more.

Background: Previous research indicates that total cholesterol levels increase with age during young adulthood and middle age and decline with age later in life. This is attributed to changes in diet, body composition, medication use, physical activity, and hormone levels. In the current study we utilized data from the Framingham Heart Study Original Cohort to determine if variations in apolipoprotein E (APOE), a gene involved in regulating cholesterol homeostasis, influence trajectories of total cholesterol, HDL cholesterol, and total: HDL cholesterol ratio from midlife through late life. Methods: Cholesterol trajectories from midlife through late life were modeled using generalized additive mixed models and mixed-effects regression models. Results: APOE e2+ subjects had lower total cholesterol levels, higher HDL cholesterol levels, and lower total: HDL cholesterol ratios from midlife to late life compared to APOE e3 and APOE e4+ subjects. Statistically significant differences in life span cholesterol trajectories according to gender and use of cholesterol-lowering medications were also detected. Conclusion: The findings from this research provide evidence that variations in APOE modify trajectories of serum cholesterol from midlife to late life. In order to efficiently modify cholesterol through the life span, it is important to take into account APOE allele status. Full article

(This article belongs to the Special Issue Genetic Epidemiology)

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889 KiB

Open AccessArticle

Modeling Population Exposure to Ultrafine Particles in a Major Italian Urban Area

by Andrea Spinazzè, Andrea Cattaneo, Carlo Peruzzo and Domenico M. Cavallo

Int. J. Environ. Res. Public Health 2014, 11(10), 10641-10662; https://doi.org/10.3390/ijerph111010641 - 15 Oct 2014

Cited by 11 | Viewed by 5288

Abstract

Average daily ultrafine particles (UFP) exposure of adult Milan subpopulations (defined on the basis of gender, and then for age, employment or educational status), in different exposure scenarios (typical working day in summer and winter) were simulated using a microenvironmental stochastic simulation model. [...] Read more.

Average daily ultrafine particles (UFP) exposure of adult Milan subpopulations (defined on the basis of gender, and then for age, employment or educational status), in different exposure scenarios (typical working day in summer and winter) were simulated using a microenvironmental stochastic simulation model. The basic concept of this kind of model is that time-weighted average exposure is defined as the sum of partial microenvironmental exposures, which are determined by the product of UFP concentration and time spent in each microenvironment. In this work, environmental concentrations were derived from previous experimental studies that were based on microenvironmental measurements in the city of Milan by means of personal or individual monitoring, while time-activity patterns were derived from the EXPOLIS study. A significant difference was observed between the exposures experienced in winter (W: 28,415 pt/cm³) and summer (S: 19,558 pt/cm³). Furthermore, simulations showed a moderate difference between the total exposures experienced by women (S: 19,363 pt/cm³; W: 27,623 pt/cm³) and men (S: 18,806 pt/cm³; W: 27,897 pt/cm³). In addition, differences were found as a function of (I) age, (II) employment status and (III) educational level; accordingly, the highest total exposures resulted for (I) 55–59 years old people, (II) housewives and students and (III) people with higher educational level (more than 10 years of scholarity). Finally, significant differences were found between microenvironment-specific exposures. Full article

(This article belongs to the Special Issue Ultrafine Particles and Potential Health Effects)

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704 KiB

Open AccessArticle

Lifestyle Course as an Investment in Perceived Improved Health among Newly Arrived Women from Countries outside Europe

by Solvig Ekblad and Ulla-Britt Persson-Valenzuela

Int. J. Environ. Res. Public Health 2014, 11(10), 10622-10640; https://doi.org/10.3390/ijerph111010622 - 15 Oct 2014

Cited by 11 | Viewed by 5593

Abstract

Family reunification was the most common reason (34%) for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a [...] Read more.

Family reunification was the most common reason (34%) for resettlement in Sweden in 2013. About one-fifth of the population is foreign-born. This study used mixed methods to evaluate a culturally tailored clinical health-promotion intervention. The intervention was conducted by licensed clinicians and a local coordinator. Sessions were five-weeks long, two hours a week. The quantitative data cover results from 54 participants, mainly Arabic and Somali-speaking, who participated in 10 groups. The participants’ perceived health improved significantly over the three measures. They also shared that their health significantly improved according to moderate effect size. The qualitative data, analyzed using revised content analysis, reflected one general theme: “the intervention is an investment in perceived improved health”, and four categories: “perceived increased health literacy”, “strength, empowerment and security”, “finding a new lifestyle”, and “the key to entry into Swedish society is language”. An intervention focusing on the prevention of ill-health, on health as a human right, and on empowerment, and aimed at female newcomers, has practical implications. Full article

(This article belongs to the Special Issue Migrant Health)

689 KiB

Open AccessReview

Potential Transferability of Economic Evaluations of Programs Encouraging Physical Activity in Children and Adolescents across Different Countries—A Systematic Review of the Literature

by Katharina Korber

Int. J. Environ. Res. Public Health 2014, 11(10), 10606-10621; https://doi.org/10.3390/ijerph111010606 - 15 Oct 2014

Cited by 10 | Viewed by 5830

Abstract

Physical inactivity is an increasing problem. Owing to limited financial resources, one method of getting information on the cost-effectiveness of different types of prevention programs is to examine existing programs and their results. The aim of this paper is to give an overview [...] Read more.

Physical inactivity is an increasing problem. Owing to limited financial resources, one method of getting information on the cost-effectiveness of different types of prevention programs is to examine existing programs and their results. The aim of this paper is to give an overview of the transferability of cost-effectiveness results of physical activity programs for children and adolescents to other contexts. Based on a systematic review of the literature, the transferability of the studies found was assessed using a sub-checklist of the European Network of Health Economic Evaluation Databases (EURONHEED). Thirteen studies of different physical activity interventions were found and analyzed. The results for transferability ranged from “low” to “very high”. A number of different factors influence a program’s cost-effectiveness (i.e., discount rate, time horizon, etc.). Therefore, transparency with regard to these factors is one fundamental element in the transferability of the results. A major point of criticism is that transferability is often limited because of lack of transparency. This paper is the first to provide both an overview and an assessment of transferability of economic evaluations of existing programs encouraging physical activity in children and adolescents. This allows decision makers to gain an impression on whether the findings are transferable to their decision contexts, which may lead to time and cost savings. Full article

(This article belongs to the Special Issue Health Economics)

922 KiB

Open AccessArticle

Future Climate Data from RCP 4.5 and Occurrence of Malaria in Korea

by Jaewon Kwak, Huiseong Noh, Soojun Kim, Vijay P. Singh, Seung Jin Hong, Duckgil Kim, Keonhaeng Lee, Narae Kang and Hung Soo Kim

Int. J. Environ. Res. Public Health 2014, 11(10), 10587-10605; https://doi.org/10.3390/ijerph111010587 - 15 Oct 2014

Cited by 6 | Viewed by 6671

Abstract

Since its reappearance at the Military Demarcation Line in 1993, malaria has been occurring annually in Korea. Malaria is regarded as a third grade nationally notifiable disease susceptible to climate change. The objective of this study is to quantify the effect of climatic [...] Read more.

Since its reappearance at the Military Demarcation Line in 1993, malaria has been occurring annually in Korea. Malaria is regarded as a third grade nationally notifiable disease susceptible to climate change. The objective of this study is to quantify the effect of climatic factors on the occurrence of malaria in Korea and construct a malaria occurrence model for predicting the future trend of malaria under the influence of climate change. Using data from 2001–2011, the effect of time lag between malaria occurrence and mean temperature, relative humidity and total precipitation was investigated using spectral analysis. Also, a principal component regression model was constructed, considering multicollinearity. Future climate data, generated from RCP 4.5 climate change scenario and CNCM3 climate model, was applied to the constructed regression model to simulate future malaria occurrence and analyze the trend of occurrence. Results show an increase in the occurrence of malaria and the shortening of annual time of occurrence in the future. Full article

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756 KiB

Open AccessArticle

Predictors of Healthcare Service Utilization for Mental Health Reasons

by Marie-Josée Fleury, André Ngamini Ngui, Jean-Marie Bamvita, Guy Grenier and Jean Caron

Int. J. Environ. Res. Public Health 2014, 11(10), 10559-10586; https://doi.org/10.3390/ijerph111010559 - 15 Oct 2014

Cited by 78 | Viewed by 10570

Abstract

This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons [...] Read more.

This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior) and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care. Full article

(This article belongs to the Special Issue Mental Health Care)

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Open AccessArticle

Land Ecological Security Evaluation of Guangzhou, China

by Linyu Xu, Hao Yin, Zhaoxue Li and Shun Li

Int. J. Environ. Res. Public Health 2014, 11(10), 10537-10558; https://doi.org/10.3390/ijerph111010537 - 15 Oct 2014

Cited by 38 | Viewed by 6508

Abstract

As the land ecosystem provides the necessary basic material resources for human development, land ecological security (LES) plays an increasingly important role in sustainable development. Given the degradation of land ecological security under rapid urbanization and the urgent LES requirements of urban populations, [...] Read more.

As the land ecosystem provides the necessary basic material resources for human development, land ecological security (LES) plays an increasingly important role in sustainable development. Given the degradation of land ecological security under rapid urbanization and the urgent LES requirements of urban populations, a comprehensive evaluation method, named Double Land Ecological Security (DLES), has been introduced with the city of Guangzhou, China, as a case study, which evaluates the LES in regional and unit scales for reasonable and specific urban planning. In the evaluation process with this method, we have combined the material security with the spiritual security that is inevitably associated with LES. Some new coefficients of land-security supply/demand distribution and technology contribution for LES evaluation have also been introduced for different spatial scales, including the regional and the unit scales. The results for Guangzhou indicated that, temporally, the LES supply indices were 0.77, 0.84 and 0.77 in 2000, 2006 and 2009 respectively, while LES demand indices for the city increased in 2000, 2006 and 2009 from 0.57 to 0.95, which made the LES level decreased slowly in this period. Spatially, at the regional scale, the urban land ecological security (ULES) level decreased from 0.2 (marginal security) to −0.18 (marginal insecurity) as a whole; in unit scale, areas in the north and in parts of the east were relatively secure and the security area was shrinking with time, but the central and southern areas turned to be marginal insecurity, especially in 2006 and 2009. This study proposes that DLES evaluation should be conducted for targeted and efficient urban planning and management, which can reflect the LES level of study area in general and in detail. Full article

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Open AccessArticle

A Method for Estimating Urban Background Concentrations in Support of Hybrid Air Pollution Modeling for Environmental Health Studies

by Saravanan Arunachalam, Alejandro Valencia, Yasuyuki Akita, Marc L. Serre, Mohammad Omary, Valerie Garcia and Vlad Isakov

Int. J. Environ. Res. Public Health 2014, 11(10), 10518-10536; https://doi.org/10.3390/ijerph111010518 - 15 Oct 2014

Cited by 25 | Viewed by 7568

Abstract

Exposure studies rely on detailed characterization of air quality, either from sparsely located routine ambient monitors or from central monitoring sites that may lack spatial representativeness. Alternatively, some studies use models of various complexities to characterize local-scale air quality, but often with poor [...] Read more.

Exposure studies rely on detailed characterization of air quality, either from sparsely located routine ambient monitors or from central monitoring sites that may lack spatial representativeness. Alternatively, some studies use models of various complexities to characterize local-scale air quality, but often with poor representation of background concentrations. A hybrid approach that addresses this drawback combines a regional-scale model to provide background concentrations and a local-scale model to assess impacts of local sources. However, this approach may double-count sources in the study regions. To address these limitations, we carefully define the background concentration as the concentration that would be measured if local sources were not present, and to estimate these background concentrations we developed a novel technique that combines space-time ordinary kriging (STOK) of observations with outputs from a detailed chemistry-transport model with local sources zeroed out. We applied this technique to support an exposure study in Detroit, Michigan, for several pollutants (including NO_x and PM_2.5), and evaluated the estimated hybrid concentrations (calculated by combining the background estimates that addresses this issue of double counting with local-scale dispersion model estimates) using observations. Our results demonstrate the strength of this approach specifically by eliminating the problem of double-counting reported in previous hybrid modeling approaches leading to improved estimates of background concentrations, and further highlight the relative importance of NO_x vs. PM_2.5in their relative contributions to total concentrations. While a key limitation of this approach is the requirement for another detailed model simulation to avoid double-counting, STOK improves the overall characterization of background concentrations at very fine spatial scales. Full article

(This article belongs to the Special Issue Air Pollution Modeling)

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669 KiB

Open AccessArticle

Creating an eLearning Resource to Improve Knowledge and Understanding of Pregnancy in the Context of HIV Infection

by Carmel Kelly, Esther Reid, Maria Lohan, Fiona Alderdice and Dale Spence

Int. J. Environ. Res. Public Health 2014, 11(10), 10504-10517; https://doi.org/10.3390/ijerph111010504 - 14 Oct 2014

Cited by 3 | Viewed by 5515

Abstract

Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. [...] Read more.

Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. This paper presents how we sought to translate the evidence from a qualitative study of the perspectives of HIV affected pregnant women and expectant fathers on the care they received, from the pre conception to post natal period, into educational material for maternity care practice. Narrative scripts were written based on the original research interviews, with care taken to reflect the key themes from the research. We explore the way in which the qualitative findings bring to life patient and partner experiences and what it means for nurses, midwives and doctors to be prepared to care for couples affected by HIV. In so doing, we challenge the inequity between the dominance of biomedical knowledge over understanding the patient experience in the preparation of health professionals to care for HIV affected women and men who are having a baby or seeking to have a baby. Full article

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Open AccessArticle

Cryptosporidium and Giardia in Surface Water: A Case Study from Michigan, USA to Inform Management of Rural Water Systems

by Erin A. Dreelin, Rebecca L. Ives, Stephanie Molloy and Joan B. Rose

Int. J. Environ. Res. Public Health 2014, 11(10), 10480-10503; https://doi.org/10.3390/ijerph111010480 - 14 Oct 2014

Cited by 24 | Viewed by 10305

Abstract

Cryptosporidium and Giardia pose a threat to human health in rural environments where water supplies are commonly untreated and susceptible to contamination from agricultural animal waste/manure, animal wastewater, septic tank effluents and septage. Our goals for this paper are to: (1) explore the [...] Read more.

Cryptosporidium and Giardia pose a threat to human health in rural environments where water supplies are commonly untreated and susceptible to contamination from agricultural animal waste/manure, animal wastewater, septic tank effluents and septage. Our goals for this paper are to: (1) explore the prevalence of these protozoan parasites, where they are found, in what quantities, and which genotypes are present; (2) examine relationships between disease and land use comparing human health risks between rural and urban environments; and (3) synthesize available information to gain a better understanding of risk and risk management for rural water supplies. Our results indicate that Cryptosporidium and Giardia were more prevalent in rural versus urban environments based on the number of positive samples. Genotyping showed that both the human and animal types of the parasites are found in rural and urban environments. Rural areas had a higher incidence of disease compared to urban areas based on the total number of disease cases. Cryptosporidiosis and giardiasis were both positively correlated (p < 0.001) with urban area, population size, and population density. Finally, a comprehensive strategy that creates knowledge pathways for data sharing among multiple levels of management may improve decision-making for protecting rural water supplies. Full article

(This article belongs to the Special Issue Evaluation of Rural Water Systems and Public Health)

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Int. J. Environ. Res. Public Health, Volume 11, Issue 10 (October 2014) – 62 articles , Pages 9938-11027

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